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van Houtum LAEM, Baaré WFC, Beckmann CF, Castro-Fornieles J, Cecil CAM, Dittrich J, Ebdrup BH, Fegert JM, Havdahl A, Hillegers MHJ, Kalisch R, Kushner SA, Mansuy IM, Mežinska S, Moreno C, Muetzel RL, Neumann A, Nordentoft M, Pingault JB, Preisig M, Raballo A, Saunders J, Sprooten E, Sugranyes G, Tiemeier H, van Woerden GM, Vandeleur CL, van Haren NEM. Running in the FAMILY: understanding and predicting the intergenerational transmission of mental illness. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02423-9. [PMID: 38613677 DOI: 10.1007/s00787-024-02423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/15/2024] [Indexed: 04/15/2024]
Abstract
Over 50% of children with a parent with severe mental illness will develop mental illness by early adulthood. However, intergenerational transmission of risk for mental illness in one's children is insufficiently considered in clinical practice, nor is it sufficiently utilised into diagnostics and care for children of ill parents. This leads to delays in diagnosing young offspring and missed opportunities for protective actions and resilience strengthening. Prior twin, family, and adoption studies suggest that the aetiology of mental illness is governed by a complex interplay of genetic and environmental factors, potentially mediated by changes in epigenetic programming and brain development. However, how these factors ultimately materialise into mental disorders remains unclear. Here, we present the FAMILY consortium, an interdisciplinary, multimodal (e.g., (epi)genetics, neuroimaging, environment, behaviour), multilevel (e.g., individual-level, family-level), and multisite study funded by a European Union Horizon-Staying-Healthy-2021 grant. FAMILY focuses on understanding and prediction of intergenerational transmission of mental illness, using genetically informed causal inference, multimodal normative prediction, and animal modelling. Moreover, FAMILY applies methods from social sciences to map social and ethical consequences of risk prediction to prepare clinical practice for future implementation. FAMILY aims to deliver: (i) new discoveries clarifying the aetiology of mental illness and the process of resilience, thereby providing new targets for prevention and intervention studies; (ii) a risk prediction model within a normative modelling framework to predict who is at risk for developing mental illness; and (iii) insight into social and ethical issues related to risk prediction to inform clinical guidelines.
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Affiliation(s)
- Lisanne A E M van Houtum
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
| | - William F C Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark
| | - Christian F Beckmann
- Centre for Functional MRI of the Brain, Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, FCRB-IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | | | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jörg M Fegert
- President European Society for Child and Adolescent Psychiatry (ESCAP), Brussels, Belgium
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Alexandra Havdahl
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
| | - Raffael Kalisch
- Leibniz Institute for Resilience Research, Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Steven A Kushner
- Department of Psychiatry, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Isabelle M Mansuy
- Laboratory of Neuroepigenetics, Medical Faculty, Brain Research Institute, Department of Health Science and Technology of ETH, University of Zurich and Institute for Neuroscience, Zurich, Switzerland
- Zurich Neuroscience Centre, ETH and University of Zurich, Zurich, Switzerland
| | - Signe Mežinska
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ryan L Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Alexander Neumann
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jean-Baptiste Pingault
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Centre, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Andrea Raballo
- Public Health Division, Department of Health and Social Care, Cantonal Socio-Psychiatric Organization, Repubblica e Cantone Ticino, Mendrisio, Switzerland
- Chair of Psychiatry, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - John Saunders
- Executive Director European Federation of Associations of Families of People with Mental Illness (EUFAMI), Louvain, Belgium
| | - Emma Sprooten
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, the Netherlands
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, FCRB-IDIBAPS, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands
- Department of Social and Behavioural Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Geeske M van Woerden
- Department of Neuroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands
- ENCORE Expertise Center for Neurodevelopmental Disorders, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Clinical Genetics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Caroline L Vandeleur
- Psychiatric Epidemiology and Psychopathology Research Centre, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Neeltje E M van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre-Sophia, Rotterdam, The Netherlands.
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2
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Segura AG, Serna EDL, Sugranyes G, Baeza I, Valli I, Martínez-Serrano I, Díaz-Caneja CM, Andreu-Bernabeu Á, Moreno DM, Gassó P, Rodríguez N, Martínez-Pinteño A, Prohens L, Torrent C, García-Rizo C, Mas S, Castro-Fornieles J. Polygenic risk scores mediating functioning outcomes through cognitive and clinical features in youth at family risk and controls. Eur Neuropsychopharmacol 2024; 81:28-37. [PMID: 38310718 DOI: 10.1016/j.euroneuro.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
Schizophrenia and bipolar disorder exhibit substantial clinical overlap, particularly in individuals at familial high risk, who frequently present sub-threshold symptoms before the onset of illness. Severe mental disorders are highly polygenic traits, but their impact on the stages preceding the manifestation of mental disorders remains relatively unexplored. Our study aimed to examine the influence of polygenic risk scores (PRS) on sub-clinical outcomes over a 2-year period in youth at familial high risk for schizophrenia and bipolar disorder and controls. The sample included 222 children and adolescents, comprising offspring of parents with schizophrenia (n = 38), bipolar disorder (n = 80), and community controls (n = 104). We calculated PRS for psychiatric disorders, neuroticism and cognition using the PRS-CS method. Linear mixed-effects models were employed to investigate the association between PRS and cognition, symptom severity and functioning. Mediation analyses were conducted to explore whether clinical features acted as intermediaries in the impact of PRS on functioning outcomes. SZoff exhibited elevated PRS for schizophrenia. In the entire sample, PRS for depression, neuroticism, and cognitive traits showed associations with sub-clinical features. The effect of PRS for neuroticism and general intelligence on functioning outcomes were mediated by cognition and symptoms severity, respectively. This study delves into the interplay among genetics, the emergence of sub-clinical symptoms and functioning outcomes, providing novel evidence on mechanisms underpinning the continuum from sub-threshold features to the onset of mental disorders. The findings underscore the interplay of genetics, cognition, and clinical features, providing insights for personalized early interventions.
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Affiliation(s)
- Alex G Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gisela Sugranyes
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Isabel Valli
- Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Irene Martínez-Serrano
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Covadonga M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Álvaro Andreu-Bernabeu
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Dolores M Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Adolescent Inpatient Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Psychiatry Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Natalia Rodríguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Albert Martínez-Pinteño
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Llucia Prohens
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Carla Torrent
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, Fundació Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Clemente García-Rizo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Clinic Schizophrenia Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Masias Bruns M, Ramirez-Mahaluf JP, Valli I, Ortuño M, Ilzarbe D, de la Serna E, Navarro OP, Crossley NA, González Ballester MÁ, Baeza I, Piella G, Castro-Fornieles J, Sugranyes G. Altered Temporal Dynamics of Resting-State Functional Magnetic Resonance Imaging in Adolescent-Onset First-Episode Psychosis. Schizophr Bull 2024; 50:418-426. [PMID: 37607335 PMCID: PMC10919773 DOI: 10.1093/schbul/sbad107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
BACKGROUND Dynamic functional connectivity (dFC) alterations have been reported in patients with adult-onset and chronic psychosis. We sought to examine whether such abnormalities were also observed in patients with first episode, adolescent-onset psychosis (AOP), in order to rule out potential effects of chronicity and protracted antipsychotic treatment exposure. AOP has been suggested to have less diagnostic specificity compared to psychosis with onset in adulthood and occurs during a period of neurodevelopmental changes in brain functional connections. STUDY DESIGN Seventy-nine patients with first episode, AOP (36 patients with schizophrenia-spectrum disorder, SSD; and 43 with affective psychotic disorder, AF) and 54 healthy controls (HC), aged 10 to 17 years were included. Participants underwent clinical and cognitive assessments and resting-state functional magnetic resonance imaging. Graph-based measures were used to analyze temporal trajectories of dFC, which were compared between patients with SSD, AF, and HC. Within patients, we also tested associations between dFC parameters and clinical variables. STUDY RESULTS Patients with SSD temporally visited the different connectivity states in a less efficient way (reduced global efficiency), visiting fewer nodes (larger temporal modularity, and increased immobility), with a reduction in the metabolic expenditure (cost and leap size), relative to AF and HC (effect sizes: Cohen's D, ranging 0.54 to.91). In youth with AF, these parameters did not differ compared to HC. Connectivity measures were not associated with clinical severity, intelligence, cannabis use, or dose of antipsychotic medication. CONCLUSIONS dFC measures hold potential towards the development of brain-based biomarkers characterizing adolescent-onset SSD.
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Affiliation(s)
- Mireia Masias Bruns
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Juan Pablo Ramirez-Mahaluf
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Isabel Valli
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - María Ortuño
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel Ilzarbe
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Olga Puig Navarro
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Nicolas A Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Miguel Ángel González Ballester
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Inmaculada Baeza
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Gemma Piella
- BCN-MedTech, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Gisela Sugranyes
- Clinical and Experimental Neuroscience, Fundació de Recerca Clínic Barcelona, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, 2017SGR881, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Group G04, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
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Muñoz-Lopetegi A, Guasp M, Prades L, Martínez-Hernández E, Rosa-Justícia M, Patricio V, Armangué T, Rami L, Borràs R, Castro-Fornieles J, Compte A, Gaig C, Santamaria J, Dalmau J. Neurological, psychiatric, and sleep investigations after treatment of anti-leucine-rich glioma-inactivated protein 1 (LGI1) encephalitis in Spain: a prospective cohort study. Lancet Neurol 2024; 23:256-266. [PMID: 38365378 DOI: 10.1016/s1474-4422(23)00463-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/25/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND Anti-leucine-rich glioma-inactivated protein 1 (LGI1) encephalitis is an autoimmune disorder that can be treated with immunotherapy, but the symptoms that remain after treatment have not been well described. We aimed to characterise the clinical features of patients with anti-LGI1 encephalitis for 1 year starting within the first year after initial immunotherapy. METHODS For this prospective cohort study, we recruited patients with anti-LGI1 encephalitis as soon as possible after they had received conventional immunotherapy for initial symptoms; patients were recruited from 21 hospitals in Spain. Patients were excluded if they had an interval of more than 1 year since initial immunotherapy, had pre-existing neurodegenerative or psychiatric disorders, or were unable to travel to Hospital Clínic de Barcelona (Barcelona, Spain). Patients visited Hospital Clínic de Barcelona on three occasions-the first at study entry (visit 1), the second 6 months later (visit 2), and the third 12 months after the initial visit (visit 3). They underwent neuropsychiatric and videopolysomnography assessments at each visit. Healthy participants who were matched for age and sex and recruited from Hospital Clínic de Barcelona underwent the same investigations at study entry and at 12 months. Cross-sectional comparisons of clinical features between groups were done with conditional logistic regression, and binary logistic regression was used to assess associations between cognitive outcomes at 12 months and clinical features before initial immunotherapy and at study entry. FINDINGS Between May 1, 2019, and Sept 30, 2022, 42 participants agreed to be included in this study. 24 (57%) participants had anti-LGI1 encephalitis (mean age 63 years [SD 12]; 13 [54%] were female and 11 [46%] were male) and 18 (43%) were healthy individuals (mean age 62 years [10]; 11 [61%] were female and seven [39%] were male). At visit 1 (median 88 days [IQR 67-155] from initiation of immunotherapy), all 24 patients had one or more symptoms; 20 (83%) patients had cognitive deficits, 20 (83%) had psychiatric symptoms, 14 (58%) had insomnia, 12 (50%) had rapid eye movement (REM)-sleep behaviour disorder, nine (38%) had faciobrachial dystonic seizures, and seven (29%) had focal onset seizures. Faciobrachial dystonic seizures were unnoticed in four (17%) of 24 patients and focal onset seizures were unnoticed in five (21%) patients. At visit 1, videopolysomnography showed that 19 (79%) patients, but no healthy participants, had disrupted sleep structure (p=0·013); 15 (63%) patients and four (22%) healthy participants had excessive fragmentary myoclonus (p=0·039), and nine (38%) patients, but no healthy participants, had myokymic discharges (p=0·0051). These clinical and videopolysomnographic features led to additional immunotherapy in 15 (63%) of 24 patients, which resulted in improvement of these features in all 15 individuals. However, at visit 3, 13 (65%) of 20 patients continued to have cognitive deficits. Persistent cognitive deficits at visit 3 were associated with no use of rituximab before visit 1 (odds ratio [OR] 4·0, 95% CI 1·5-10·7; p=0·0015), REM sleep without atonia at visit 1 (2·2, 1·2-4·2; p=0·043), and presence of LGI1 antibodies in serum at visit 1 (11·0, 1·1-106·4; p=0·038). INTERPRETATION Unsuspected but ongoing clinical and videopolysomnography alterations are common in patients with anti-LGI1 encephalitis during the first year or more after initial immunotherapy. Recognising these alterations is important as they are treatable, can be used as outcome measures in clinical trials, and might influence cognitive outcome. FUNDING Fundació La Caixa.
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Affiliation(s)
| | - Mar Guasp
- Neurology Department, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red, Enfermedades Raras, Madrid, Spain
| | - Laia Prades
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Eugenia Martínez-Hernández
- Neurology Department, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Víctor Patricio
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Thaís Armangué
- Institute of Neuroscience, Hospital Clínic de Barcelona and Pediatric Neuroimmunology Unit, Department of Neurology, Sant Joan de Déu Children Hospital, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Lorena Rami
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Roger Borràs
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red, Salud Mental, Madrid, Spain
| | - Albert Compte
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Carles Gaig
- Neurology Department, University of Barcelona, Barcelona, Spain
| | - Joan Santamaria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Josep Dalmau
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red, Enfermedades Raras, Madrid, Spain; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Catalan Institution for Research and Advanced Studies, Barcelona, Spain.
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Baeza I, de la Serna E, Mezquida G, Cuesta MJ, Vieta E, Amoretti S, Lobo A, González-Pinto A, Díaz-Caneja CM, Corripio I, Valli I, Puig O, Mané A, Bioque M, Ayora M, Bernardo M, Castro-Fornieles J. Prodromal symptoms and the duration of untreated psychosis in first episode of psychosis patients: what differences are there between early vs. adult onset and between schizophrenia vs. bipolar disorder? Eur Child Adolesc Psychiatry 2024; 33:799-810. [PMID: 37027026 PMCID: PMC10894175 DOI: 10.1007/s00787-023-02196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/10/2023] [Indexed: 04/08/2023]
Abstract
To assess the role of age (early onset psychosis-EOP < 18 years vs. adult onset psychosis-AOP) and diagnosis (schizophrenia spectrum disorders-SSD vs. bipolar disorders-BD) on the duration of untreated psychosis (DUP) and prodromal symptoms in a sample of patients with a first episode of psychosis. 331 patients with a first episode of psychosis (7-35 years old) were recruited and 174 (52.6%) diagnosed with SSD or BD at one-year follow-up through a multicenter longitudinal study. The Symptom Onset in Schizophrenia (SOS) inventory, the Positive and Negative Syndrome Scale and the structured clinical interviews for DSM-IV diagnoses were administered. Generalized linear models compared the main effects and group interaction. 273 AOP (25.2 ± 5.1 years; 66.5% male) and 58 EOP patients (15.5 ± 1.8 years; 70.7% male) were included. EOP patients had significantly more prodromal symptoms with a higher frequency of trouble with thinking, avolition and hallucinations than AOP patients, and significantly different median DUP (91 [33-177] vs. 58 [21-140] days; Z = - 2.006, p = 0.045). This was also significantly longer in SSD vs. BD patients (90 [31-155] vs. 30 [7-66] days; Z = - 2.916, p = 0.004) who, moreover had different profiles of prodromal symptoms. When assessing the interaction between age at onset (EOP/AOP) and type of diagnosis (SSD/BD), avolition was significantly higher (Wald statistic = 3.945; p = 0.047), in AOP patients with SSD compared to AOP BD patients (p = 0.004). Awareness of differences in length of DUP and prodromal symptoms in EOP vs. AOP and SSD vs. BD patients could help improve the early detection of psychosis among minors.
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Affiliation(s)
- Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, 2021SGR01319, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain.
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain.
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain.
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, 2021SGR01319, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
| | - Gisela Mezquida
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona. IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
- Group of Psychiatry, Psychiatric Genetics Unit, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Medicine and Psychiatry, Hospital Clínico Universitario and Instituto de Investigación Sanitaria (IIS) Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, EHU, Vitoria, Spain
| | - Covadonga M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IiSGM, Madrid, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Isabel Valli
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Olga Puig
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, 2021SGR01319, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Anna Mané
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University, Barcelona, Spain
| | - Miquel Bioque
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Miriam Ayora
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IiSGM, Madrid, Spain
| | - Miquel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clínic de Barcelona, 2021SGR01319, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
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6
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Cortese S, Purper-Ouakil D, Apter A, Arango C, Baeza I, Banaschewski T, Buitelaar J, Castro-Fornieles J, Coghill D, Cohen D, Correll CU, Grünblatt E, Hoekstra PJ, James A, Jeppesen P, Nagy P, Pagsberg AK, Parellada M, Persico AM, Roessner V, Santosh P, Simonoff E, Stevanovic D, Stringaris A, Vitiello B, Walitza S, Weizman A, Wong ICK, Zalsman G, Zuddas A, Carucci S, Butlen-Ducuing F, Tome M, Bea M, Getin C, Hovén N, Konradsson-Geuken A, Lamirell D, Olisa N, Nafria Escalera B, Moreno C. Psychopharmacology in children and adolescents: unmet needs and opportunities. Lancet Psychiatry 2024; 11:143-154. [PMID: 38071998 DOI: 10.1016/s2215-0366(23)00345-0] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 01/22/2024]
Abstract
Psychopharmacological treatment is an important component of the multimodal intervention approach to treating mental health conditions in children and adolescents. Currently, there are many unmet needs but also opportunities, alongside possible risks to consider, regarding the pharmacological treatment of mental health conditions in children and adolescents. In this Position Paper, we highlight and address these unmet needs and opportunities, including the perspectives of clinicians and researchers from the European College of Neuropsychopharmacology-Child and Adolescent Network, alongside those of experts by lived experience from national and international associations, via a survey involving 644 participants from 13 countries, and of regulators, through representation from the European Medicines Agency. We present and discuss the evidence base for medications currently used for mental disorders in children and adolescents, medications in the pipeline, opportunities in the development of novel medications, crucial priorities for the conduct of future clinical studies, challenges and opportunities in terms of the regulatory and legislative framework, and innovations in the way research is conducted, reported, and promoted.
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Affiliation(s)
- Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, and Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; DiMePRe-J-Department of Precision and Regenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy.
| | - Diane Purper-Ouakil
- Centre Hospitalo-Universitaire de Montpellier, Service Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, France; INSERM U 1018, CESP, Psychiatrie du développement - Evaluer et traiter les troubles émotionnels et du neurodéveloppement (ETE-ND), Villejuif, France
| | - Alan Apter
- Schneider Children's Medical Center of Israel, Petach Tikva, Israel; Ivcher School of Psychology, Reichman University, Herzliya, Israel
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, SGR01319, Hospital Clínic de Barcelona, Neurosciences Institute, University of Barcelona, IDIBAPS, CIBERSAM-ISCIII, Barcelona, Spain
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands; Karakter Child and Adolescent Psychiatry University Center, Nijmegen, Netherlands
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, SGR01319, Hospital Clínic de Barcelona, Neurosciences Institute, University of Barcelona, IDIBAPS, CIBERSAM-ISCIII, Barcelona, Spain
| | - David Coghill
- Departments of Paediatrics and Psychiatry, University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's research Institute, Melbourne, VIC, Australia
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France; CNRS UMR 7222, Institute for Intelligent Systems and Robotics, Sorbonne Université, UPMC, Paris, France
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany; Psychiatry Research, Northwell Health, Zucker Hillside Hospital, New York, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine, Hempstead, NY, USA; Center for Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Swiss Federal Institute of Technology and University of Zurich, Zurich, Switzerland
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry & Accare Child Study Center, Groningen, Netherlands
| | - Anthony James
- Department of Psychiatry, Oxford University, and Oxford Health Biomedical Research Centre, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Pia Jeppesen
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Péter Nagy
- Bethesda Children's Hospital, Budapest, Hungary
| | - Anne Katrine Pagsberg
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Antonio M Persico
- Child & Adolescent Neuropsychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust (SLaM), London, UK; Maudsley Biomedical Research Centre for Mental Health, London, UK
| | - Dejan Stevanovic
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Argyris Stringaris
- Department of Clinical, Educational and Health Psychology, Division of Psychiatry, University College London, London, UK; Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Benedetto Vitiello
- Division of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Swiss Federal Institute of Technology and University of Zurich, Zurich, Switzerland
| | - Abraham Weizman
- Geha Mental Health Center, Petah Tikva, and Department of Psychiatry, Faculty of Medicine, and Laboratory of Biological and Molecular Psychiatry, Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel
| | - Ian C K Wong
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, China; Aston Pharmacy School, Aston University, Birmingham, UK
| | - Gil Zalsman
- Geha Mental Health Center, Petah Tikva, and Department of Psychiatry, Faculty of Medicine, and Laboratory of Biological and Molecular Psychiatry, Felsenstein Medical Research Center, Tel Aviv University, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA
| | - Alessandro Zuddas
- Department Biomedical Science, Sect Neuroscience & Clinical Pharmacology, University of Cagliari, A. Cao Paediatric Hospital, Cagliari, Italy
| | - Sara Carucci
- Department Biomedical Science, Sect Neuroscience & Clinical Pharmacology, University of Cagliari, A. Cao Paediatric Hospital, Cagliari, Italy
| | | | - Maria Tome
- European Medicines Agency, Human Medicines Division, Amsterdam, Netherlands
| | | | - Christine Getin
- Hypersupers TDAH France, National Association, Paris, France
| | | | - Asa Konradsson-Geuken
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden; European Federation of Associations of Families of People with Mental Illness (EUFAMI), Leuven, Belgium
| | - Daphne Lamirell
- Global Alliance of Mental Illness Advocacy Networks- Europe (GAMIAN Europe), Ixelles, Belgium
| | - Nigel Olisa
- Global Alliance of Mental Illness Advocacy Networks- Europe (GAMIAN Europe), Ixelles, Belgium
| | - Begonya Nafria Escalera
- Patient Engagement in Research Department, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Innovation Department Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
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7
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Si S, Bi A, Yu Z, See C, Kelly S, Ambrogi S, Arango C, Baeza I, Banaj N, Berk M, Castro-Fornieles J, Crespo-Facorro B, Crouse JJ, Díaz-Caneja CM, Fett AK, Fortea A, Frangou S, Goldstein BI, Hickie IB, Janssen J, Kennedy KG, Krabbendam L, Kyriakopoulos M, MacIntosh BJ, Morgado P, Nerland S, Pascual-Diaz S, Picó-Pérez M, Piras F, Rund BR, de la Serna E, Spalletta G, Sugranyes G, Suo C, Tordesillas-Gutiérrez D, Vecchio D, Radua J, McGuire P, Thomopoulos SI, Jahanshad N, Thompson PM, Barth C, Agartz I, James A, Kempton MJ. Mapping gray and white matter volume abnormalities in early-onset psychosis: an ENIGMA multicenter voxel-based morphometry study. Mol Psychiatry 2024:10.1038/s41380-023-02343-1. [PMID: 38195979 DOI: 10.1038/s41380-023-02343-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/07/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Regional gray matter (GM) alterations have been reported in early-onset psychosis (EOP, onset before age 18), but previous studies have yielded conflicting results, likely due to small sample sizes and the different brain regions examined. In this study, we conducted a whole brain voxel-based morphometry (VBM) analysis in a large sample of individuals with EOP, using the newly developed ENIGMA-VBM tool. METHODS 15 independent cohorts from the ENIGMA-EOP working group participated in the study. The overall sample comprised T1-weighted MRI data from 482 individuals with EOP and 469 healthy controls. Each site performed the VBM analysis locally using the standardized ENIGMA-VBM tool. Statistical parametric T-maps were generated from each cohort and meta-analyzed to reveal voxel-wise differences between EOP and healthy controls as well as the individual-based association between GM volume and age of onset, chlorpromazine (CPZ) equivalent dose, and other clinical variables. RESULTS Compared with healthy controls, individuals with EOP showed widespread lower GM volume encompassing most of the cortex, with the most marked effect in the left median cingulate (Hedges' g = 0.55, p = 0.001 corrected), as well as small clusters of lower white matter (WM), whereas no regional GM or WM volumes were higher in EOP. Lower GM volume in the cerebellum, thalamus and left inferior parietal gyrus was associated with older age of onset. Deficits in GM in the left inferior frontal gyrus, right insula, right precentral gyrus and right superior frontal gyrus were also associated with higher CPZ equivalent doses. CONCLUSION EOP is associated with widespread reductions in cortical GM volume, while WM is affected to a smaller extent. GM volume alterations are associated with age of onset and CPZ equivalent dose but these effects are small compared to case-control differences. Mapping anatomical abnormalities in EOP may lead to a better understanding of the role of psychosis in brain development during childhood and adolescence.
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Affiliation(s)
- Shuqing Si
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
| | - Anbreen Bi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Zhaoying Yu
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Cheryl See
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sinead Kelly
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Hospital Clinic Barcelona. CIBERSAM-ISCIII. Fundació de Recerca Clínic Barcelona - August Pi i Sunyer Biomedical Research Institute (FCRB-IDIBAPS). Institute of Neuroscience, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Hospital Clinic Barcelona. CIBERSAM-ISCIII. Fundació de Recerca Clínic Barcelona - August Pi i Sunyer Biomedical Research Institute (FCRB-IDIBAPS). Institute of Neuroscience, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Benedicto Crespo-Facorro
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Department of Psychiatry, CIBERSAM, IBiS-CSIC, Sevilla, Spain
| | - Jacob J Crouse
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Anne-Kathrin Fett
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- Department of Psychology, City, University of London, London, UK
| | - Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Hospital Clinic Barcelona. CIBERSAM-ISCIII. Fundació de Recerca Clínic Barcelona - August Pi i Sunyer Biomedical Research Institute (FCRB-IDIBAPS). Institute of Neuroscience, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sophia Frangou
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Kody G Kennedy
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Institute for Brain and Behaviour (IBBA) Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marinos Kyriakopoulos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 2CA-Braga Cinical Academic Center, Hospital de Braga, 4710-243, Braga, Portugal
| | - Stener Nerland
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Saül Pascual-Diaz
- Laboratory of Surgical Neuroanatomy, Universitat de Barcelona, Barcelona, Spain
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Bjørn Rishovd Rund
- Research Department, Vestre Viken Hospital Trust, 3004, Drammen, Norway
- Department of Psychology, University of Oslo, P. O. box 1094, Blindern, 0317, Oslo, Norway
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Hospital Clinic Barcelona. CIBERSAM-ISCIII. Fundació de Recerca Clínic Barcelona - August Pi i Sunyer Biomedical Research Institute (FCRB-IDIBAPS). Institute of Neuroscience, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Hospital Clinic Barcelona. CIBERSAM-ISCIII. Fundació de Recerca Clínic Barcelona - August Pi i Sunyer Biomedical Research Institute (FCRB-IDIBAPS). Institute of Neuroscience, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Chao Suo
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Diana Tordesillas-Gutiérrez
- Department of Radiology, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Santander (Cantabria), Spain
- Advanced Computing and e-Science, Instituto de Física de Cantabria (UC-CSIC), Santander (Cantabria), Spain
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Anthony James
- Department of Psychiatry, University of Oxford, Oxford, UK
- Highfield Unit, Warneford Hospital, Oxford, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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Plana MT, Flamarique I, Julià L, Tasa-Vinyals E, Citoler B, Díaz C, Moreno E, Andrés-Perpiñá S, Martínez E, Lázaro L, Castro-Fornieles J. Accuracy of estimating self and other body size among adolescent girls with anorexia nervosa. Eat Disord 2024; 32:29-42. [PMID: 37599453 DOI: 10.1080/10640266.2023.2243425] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
This study aimed to analyze body size estimates of others by patients with anorexia nervosa (AN) and to identify any differences with the perception of their own body size. Adolescent females (age, 13-17 years) were enrolled into AN (n = 30) and control(n = 23) groups. The Subjective Body Dimensions Apparatus (SBDA) was used to evaluate body size estimates for oneself (self-estimation) and others (other-estimation). Participants also completed questionnaires assessing eating disorders and depressive symptoms. The AN and control groups scored significantly higher in self-estimation than in other-estimation. However, the AN group showed higher self-estimation scores than the control group for all the body parts and for the global silhouette (p < .001). Patients with more severe eating disorder symptomatology showed more distorted self-estimation (p < .05). No statistically significant differences were found in the other-estimation scores between the groups (p = .714), indicating that AN and control patients estimate the body sizes of others similarly. Eating disorder symptomatology correlates with self-estimation scores but not with other-estimation scores in adolescents with AN. No correlations existed between clinical symptomatology and other-estimation.
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Affiliation(s)
- Maria Teresa Plana
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Itziar Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red - Salud Mental (CIBERSAM), Spain
| | - Laia Julià
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Elisabet Tasa-Vinyals
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Bárbara Citoler
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Cristina Díaz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Elena Moreno
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Susana Andrés-Perpiñá
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red - Salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Psychology, University of Barcelona, Barcelona, Spain
| | - Esteban Martínez
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red - Salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red - Salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
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9
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Santosh P, Sala R, Lievesley K, Singh J, Arango C, Buitelaar JK, Castro-Fornieles J, Coghill D, Dittmann RW, Flamarique I, Hoekstra PJ, Llorente C, Purper-Ouakil D, Schulze U, Zuddas A, Parnell N, Mohan M, Fiori F. Suicidality Treatment Occurring in Paediatrics (STOP) Medication Suicidality Side Effects Scale in young people in two cohorts across Europe. BMJ Open 2023; 13:e068140. [PMID: 38097236 PMCID: PMC10728977 DOI: 10.1136/bmjopen-2022-068140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 09/29/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES As part of the 'Suicidality: Treatment Occurring in Paediatrics (STOP)' study, we developed and performed psychometric validation of an electronic-clinical-outcome-assessment (eCOA), which included a patient-reported-outcome (ePRO), an observer-rated-outcome (eObsRO) for parents/carers and a clinician-reported-outcome (eClinRO) that allows identification and monitoring of medication-related suicidality (MRS) in adolescents. DESIGN STOP: Prospective study: A two phase validation study to assess the impact of medication on suicidal ideations. SETTING Six participating countries: Netherlands, UK, Germany, France, Spain and Italy that were part of the Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 261411. PARTICIPANTS Cohort 1 consisted of 41 adolescent-completions, 50 parent-completions and 56 clinician-completions. Cohort 2 consisted of 244 adolescent-completions, 198 parent-completions and 240 clinician-completions from across the six countries. The scale was administered only to participants who have screened positive for the STOP-Suicidality Assessment Scale (STOP-SAS). RESULTS A total of 24 items for the development of the STOP-Medication Suicidality Side Effects Scale (STOP-MS3) were identified and three versions (for patients, parents and clinicians) of the STOP-MS3 were developed and validated in two separate study cohorts comprising of adolescents, their parents and clinicians. Cronbach's α coefficients were above 0.85 for all domains. The inter-rater reliability of the STOP-MS3 was good and significant for the adolescent (ePRO), clinician (eClinRO) (r=0.613), parent (eObsRO) versions of the scale (r=0.394) and parent and clinician (r=0.347). Exploratory factor analysis identified a 3-factor model across 24 items for the adolescent and parent version of the scale: (1) Emotional Dysregulation, (2) Somatic Dysregulation and (3) Behavioural Dysregulation. For the clinician version, a 4-factor model defined the scale structure: (1) Somatic Dysregulation, (2) Emotional Dysregulation, (3) Behavioural Dysregulation and (4) Mood Dysregulation. CONCLUSION These findings suggest that the STOP-MS3 scale, a web-based eCOA, allows identification and monitoring of MRS in the adolescent population and shows good reliability and validity.
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Affiliation(s)
- Paramala Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Limited, Gillingham, UK
| | - Regina Sala
- Centre for Psychiatry, Wolfson Institute, Barts & The London School of Medicine & Dentistry Queen Mary University of London, London, UK
| | - Kate Lievesley
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jatinder Singh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - David Coghill
- Departments of Paediatrics and Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Royal Children's Hospital, Melbourne, Victoria, Australia
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
| | - Ralf W Dittmann
- Dept. of Child & Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Itziar Flamarique
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry & Accare Child Study Center, University of Groningen, Groningen, The Netherlands
| | - Cloe Llorente
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Diane Purper-Ouakil
- Hôpital Saint Eloi, Médecine Psychologique de l'Enfant et de l'Adolescent, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, Languedoc-Roussillon, France
- Psychiatry Development and Trajectories, National Institute of Health and Medical Research (Inserm) U1018 CESP, Villejuif, France
| | - Ulrike Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, Universitatsklinikum Ulm, Ulm, Baden-Württemberg, Germany
| | - Alessandro Zuddas
- Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Science, University of Cagliari, Cagliari, Italy
- Child & Adolescent Neuropsychiatry Unit, "A.Cao" Paediatric Hospital, Cagliari, Italy
| | - Nathan Parnell
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mohapradeep Mohan
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federico Fiori
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Limited, Gillingham, UK
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10
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Kleine Deters R, Naaijen J, Holz NE, Banaschewski T, Schulze UME, Sethi A, Craig MC, Sagar-Ouriaghli I, Santosh P, Rosa M, Castro-Fornieles J, Penzol MJ, Arango C, Brandeis D, Franke B, Glennon JC, Buitelaar JK, Hoekstra PJ, Dietrich A. Emotion recognition profiles in clusters of youth based on levels of callous-unemotional traits and reactive and proactive aggression. Eur Child Adolesc Psychiatry 2023; 32:2415-2425. [PMID: 36127566 PMCID: PMC10682164 DOI: 10.1007/s00787-022-02079-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/04/2022] [Indexed: 11/28/2022]
Abstract
Youth with disruptive behavior showing high callous-unemotional (CU) traits and proactive aggression are often assumed to exhibit distinct impairments in emotion recognition from those showing mainly reactive aggression. Yet, reactive and proactive aggression and CU traits may co-occur to varying degrees across individuals. We aimed to investigate emotion recognition in more homogeneous clusters based on these three dimensions. In a sample of 243 youth (149 with disruptive behavior problems and 94 controls) aged 8-18 years, we used model-based clustering on self-report measures of CU traits and reactive and proactive aggression and compared the resulting clusters on emotion recognition (accuracy and response bias) and working memory. In addition to a Low and Low-Moderate symptom cluster, we identified two high CU clusters. The CU-Reactive cluster showed high reactive and low-to-medium proactive aggression; the CU-Mixed cluster showed high reactive and proactive aggression. Both CU clusters showed impaired fear recognition and working memory, whereas the CU-Reactive cluster also showed impaired recognition of disgust and sadness, partly explained by poor working memory, as well as a response bias for anger and happiness. Our results confirm the importance of CU traits as a core dimension along which youth with disruptive behavior may be characterized, yet challenge the view that high CU traits are closely linked to high proactive aggression per se. Notably, distinct neurocognitive processes may play a role in youth with high CU traits and reactive aggression with lower versus higher proactive aggression.
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Affiliation(s)
- Renee Kleine Deters
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- Accare Child Study Center, Groningen, The Netherlands.
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Arjun Sethi
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
| | - Michael C Craig
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
| | - Ilyas Sagar-Ouriaghli
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
| | - Paramala Santosh
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley Hospital, London, UK
| | - Mireia Rosa
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, CIBERSAM, IDIBAPS, University of Barcelona, 2017SGR881, Barcelona, Spain
| | - María José Penzol
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Universidad Complutense, Madrid, Spain
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Conway Institute for Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
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11
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Werhahn JE, Smigielski L, Sacu S, Mohl S, Willinger D, Naaijen J, Mulder LM, Glennon JC, Hoekstra PJ, Dietrich A, Deters RK, Aggensteiner PM, Holz NE, Baumeister S, Banaschewski T, Saam MC, Schulze UME, Lythgoe DJ, Sethi A, Craig M, Mastroianni M, Sagar-Ouriaghli I, Santosh PJ, Rosa M, Bargallo N, Castro-Fornieles J, Arango C, Penzol MJ, Zwiers MP, Franke B, Buitelaar JK, Walitza S, Brandeis D. Different whole-brain functional connectivity correlates of reactive-proactive aggression and callous-unemotional traits in children and adolescents with disruptive behaviors. Neuroimage Clin 2023; 40:103542. [PMID: 37988996 PMCID: PMC10701077 DOI: 10.1016/j.nicl.2023.103542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/20/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Disruptive behavior in children and adolescents can manifest as reactive aggression and proactive aggression and is modulated by callous-unemotional traits and other comorbidities. Neural correlates of these aggression dimensions or subtypes and comorbid symptoms remain largely unknown. This multi-center study investigated the relationship between resting state functional connectivity (rsFC) and aggression subtypes considering comorbidities. METHODS The large sample of children and adolescents aged 8-18 years (n = 207; mean age = 13.30±2.60 years, 150 males) included 118 cases with disruptive behavior (80 with Oppositional Defiant Disorder and/or Conduct Disorder) and 89 controls. Attention-deficit/hyperactivity disorder (ADHD) and anxiety symptom scores were analyzed as covariates when assessing group differences and dimensional aggression effects on hypothesis-free global and local voxel-to-voxel whole-brain rsFC based on functional magnetic resonance imaging at 3 Tesla. RESULTS Compared to controls, the cases demonstrated altered rsFC in frontal areas, when anxiety but not ADHD symptoms were controlled for. For cases, reactive and proactive aggression scores were related to global and local rsFC in the central gyrus and precuneus, regions linked to aggression-related impairments. Callous-unemotional trait severity was correlated with ICC in the inferior and middle temporal regions implicated in empathy, emotion, and reward processing. Most observed aggression subtype-specific patterns could only be identified when ADHD and anxiety were controlled for. CONCLUSIONS This study clarifies that hypothesis-free brain connectivity measures can disentangle distinct though overlapping dimensions of aggression in youths. Moreover, our results highlight the importance of considering comorbid symptoms to detect aggression-related rsFC alterations in youths.
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Affiliation(s)
- Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Lukasz Smigielski
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Seda Sacu
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Susanna Mohl
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - David Willinger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Leandra M Mulder
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands; Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands; Conway Institute of Biomedical and Biomolecular Research, School of Medicine, University College Dublin, Dublin, Ireland
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Renee Kleine Deters
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Pascal M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Arjun Sethi
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Michael Craig
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mathilde Mastroianni
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ilyas Sagar-Ouriaghli
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Paramala J Santosh
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Mireia Rosa
- Child and Adolescent Psychiatry Department, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nuria Bargallo
- Clinic Image Diagnostic Center (CDIC), Hospital Clinic of Barcelona, Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Maria J Penzol
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Marcel P Zwiers
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center. Radboud University, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Center, Radboud University Medical Center, Radboud University, Nijmegen, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.
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12
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Camprodon-Boadas P, De la Serna E, Plana MT, Flamarique I, Lázaro L, Borràs R, Baeza I, Tasa-Vinyals E, Sugranyes G, Ortiz AE, Castro-Fornieles J. Delusional beliefs in adolescents with anorexia nervosa, obsessive-compulsive disorder, or first-episode psychosis: A comparative study. Psychiatry Res 2023; 328:115490. [PMID: 37748237 DOI: 10.1016/j.psychres.2023.115490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 09/27/2023]
Abstract
Delusional thinking is a key symptom of first-episode psychosis (FEP), but it has also been studied in obsessive-compulsive disorder (OCD) and anorexia nervosa (AN). This study aimed to analyze the psychometric properties of the Brown Assessment of Beliefs Scale (BABS) in a sample of adolescents diagnosed with a FEP, AN, or OCD, and to compare delusional thinking among the three samples. The sample comprised 60 patients in three groups of 20 diagnosed with OCD, AN, or FEP. Participants underwent assessment by diagnostic interview, the BABS scale, and a measure of depressive symptomatology. Specific instruments were also used to assess the main symptomatology of each disorder. The BABS had good internal consistency, and high validity and reliability. The OCD group scored significantly lower than the other two groups in all scale items except for items 4 (fixation of ideas), 6 (insight), and 7 (delusions of reference). A significant difference only existed between the AN and FEP groups for item 7 (delusions of reference). The BABS scale is a valid and reliable tool for assessing delusionality in adolescents diagnosed with OCD, AN, or FEP, with evidence of marked differences between the disorders. Assessing these symptoms could influence management, helping to improve treatment adherence and prognosis.
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Affiliation(s)
- Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM - ISCIII, Spain
| | - Elena De la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM - ISCIII, Spain.
| | - Maria Teresa Plana
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Itziar Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM - ISCIII, Spain
| | - Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM - ISCIII, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
| | - Roger Borràs
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM - ISCIII, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM - ISCIII, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
| | - Elisabet Tasa-Vinyals
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM - ISCIII, Spain
| | - Ana Encarnación Ortiz
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM - ISCIII, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
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Fortea A, van Eijndhoven P, Calvet-Mirabent A, Ilzarbe D, Batalla A, de la Serna E, Puig O, Castro-Fornieles J, Dolz M, Tor J, Parrilla S, Via E, Stephan-Otto C, Baeza I, Sugranyes G. Age-related change in cortical thickness in adolescents at clinical high risk for psychosis: a longitudinal study. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02278-6. [PMID: 37644217 DOI: 10.1007/s00787-023-02278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
Progression to psychosis has been associated with increased cortical thinning in the frontal, temporal and parietal lobes in individuals at clinical high risk for the disorder (CHR-P). The timing and spatial extent of these changes are thought to be influenced by age. However, most evidence so far stems from adult samples. Longitudinal studies are essential to understanding the neuroanatomical changes associated to transition to psychosis during adolescence, and their relationship with age. We conducted a longitudinal, multisite study including adolescents at CHR-P and healthy controls (HC), aged 10-17 years. Structural images were acquired at baseline and at 18-month follow-up. Images were processed with the longitudinal pipeline in FreeSurfer. We used a longitudinal two-stage model to compute the regional cortical thickness (CT) change, and analyze between-group differences controlling for age, sex and scan, and corrected for multiple comparisons. Linear regression was used to study the effect of age at baseline. A total of 103 individuals (49 CHR-P and 54 HC) were included in the analysis. During follow-up, the 13 CHR-P participants who transitioned to psychosis exhibited greater CT decrease over time in the right parietal cortex compared to those who did not transition to psychosis and to HC. Age at baseline correlated with longitudinal changes in CT, with younger individuals showing greater cortical thinning in this region. The emergence of psychosis during early adolescence may have an impact on typical neuromaturational processes. This study provides new insights on the cortical changes taking place prior to illness onset.
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Affiliation(s)
- Adriana Fortea
- Psychiatry and Psychology Department, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
| | - Philip van Eijndhoven
- Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain Cognition and Behavior, Nijmegen, The Netherlands
| | - Angels Calvet-Mirabent
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain
| | - Daniel Ilzarbe
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Albert Batalla
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Olga Puig
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Montserrat Dolz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Sara Parrilla
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Christian Stephan-Otto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Pediatric Computational Imaging Group (PeCIC), Hospital Sant Joan de Déu, Barcelona, Spain
| | - Inmaculada Baeza
- Department of Medicine, University of Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain.
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain.
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain.
| | - Gisela Sugranyes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain.
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain.
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain.
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de la Serna E, Montejo L, Solé B, Castro-Fornieles J, Camprodon-Boadas P, Sugranyes G, Rosa-Justicia M, Martinez-Aran A, Vieta E, Vicent-Gil M, Serra-Blasco M, Cardoner N, Torrent C. Effectiveness of enhancing cognitive reserve in children, adolescents and young adults at genetic risk for psychosis: Study protocol for a randomized controlled trial. Span J Psychiatry Ment Health 2023; 16:184-191. [PMID: 33631372 DOI: 10.1016/j.rpsm.2021.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/01/2021] [Accepted: 02/13/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Offspring of patients diagnosed with bipolar disorder and schizophrenia (Off-BDSZ) have a high genetic risk of developing a mental illness. The aim of this project is to develop and investigate the efficacy of an intervention aimed at this population, based on the concept of cognitive reserve. METHODS This is a multicenter randomized trial with an experimental test-retest design study with control group. Two groups will be included: a community comparison group (CC) and a Off-BDSZ group. A total of 108 Off-BDSZ and 65 CC aged between 6 and 25 years will be recruited. Off-BDSZ participants will be randomized to receive either Cognitive Reserve EnhAncement ThErapy (CREATE) (n=54), or a supportive approach (n=54). The CC group will be assessed at baseline. The duration of the intervention will be 3 months, with 12 weekly group sessions. The primary outcome will be the improvement in CR measured according to change in the Cognitive Reserve Assessment Scale in Health (CRASH) and Cognitive Reserve scale for Adolescents (CORE-A). All participants will be blindly evaluated using clinical, cognitive and neuroimaging measures at baseline, at three months (after the psychological intervention), and at twelve-month follow-up after treatment completion. DISCUSSION The results will provide insight into whether the CREATE-Offspring version may enhance cognitive reserve (CR) in child, adolescent and young adult Off-BDSZ as well as advance knowledge about changes in clinical manifestations, neuropsychological performance and brain structure and function associated with improving CR. This novel and cost-effective intervention represents an advance in the framework of preventive interventions in mental health. TRIAL REGISTRATION Clinicaltrials.gov, NCT03722082. Registered on 26 October 2018.
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Affiliation(s)
- Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Laura Montejo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Brisa Solé
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain.
| | - Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Mireia Rosa-Justicia
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona 2017SGR881, Institut Clinic de Neurociències, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Anabel Martinez-Aran
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain.
| | - Muriel Vicent-Gil
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Depression and Anxiety Program, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Maria Serra-Blasco
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Depression and Anxiety Program, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Narcís Cardoner
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Depression and Anxiety Program, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona (UAB), CIBERSAM, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Carla Torrent
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Barcelona Bipolar and Depressive Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, IDIBAPS, Barcelona, Spain
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Holz NE, Floris DL, Llera A, Aggensteiner PM, Kia SM, Wolfers T, Baumeister S, Böttinger B, Glennon JC, Hoekstra PJ, Dietrich A, Saam MC, Schulze UME, Lythgoe DJ, Williams SCR, Santosh P, Rosa-Justicia M, Bargallo N, Castro-Fornieles J, Arango C, Penzol MJ, Walitza S, Meyer-Lindenberg A, Zwiers M, Franke B, Buitelaar J, Naaijen J, Brandeis D, Beckmann C, Banaschewski T, Marquand AF. Age-related brain deviations and aggression. Psychol Med 2023; 53:4012-4021. [PMID: 35450543 PMCID: PMC10325848 DOI: 10.1017/s003329172200068x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Disruptive behavior disorders (DBD) are heterogeneous at the clinical and the biological level. Therefore, the aims were to dissect the heterogeneous neurodevelopmental deviations of the affective brain circuitry and provide an integration of these differences across modalities. METHODS We combined two novel approaches. First, normative modeling to map deviations from the typical age-related pattern at the level of the individual of (i) activity during emotion matching and (ii) of anatomical images derived from DBD cases (n = 77) and controls (n = 52) aged 8-18 years from the EU-funded Aggressotype and MATRICS consortia. Second, linked independent component analysis to integrate subject-specific deviations from both modalities. RESULTS While cases exhibited on average a higher activity than would be expected for their age during face processing in regions such as the amygdala when compared to controls these positive deviations were widespread at the individual level. A multimodal integration of all functional and anatomical deviations explained 23% of the variance in the clinical DBD phenotype. Most notably, the top marker, encompassing the default mode network (DMN) and subcortical regions such as the amygdala and the striatum, was related to aggression across the whole sample. CONCLUSIONS Overall increased age-related deviations in the amygdala in DBD suggest a maturational delay, which has to be further validated in future studies. Further, the integration of individual deviation patterns from multiple imaging modalities allowed to dissect some of the heterogeneity of DBD and identified the DMN, the striatum and the amygdala as neural signatures that were associated with aggression.
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Affiliation(s)
- Nathalie E. Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Dorothea L. Floris
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
- Methods of Plasticity Research, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Alberto Llera
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Pascal M. Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Seyed Mostafa Kia
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Thomas Wolfers
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Boris Böttinger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jeffrey C. Glennon
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Pieter J. Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Melanie C. Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Ulrike M. E. Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - David J. Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Steve C. R. Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paramala Santosh
- Department of Child Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), South London and Maudsley NHS Trust, London, UK
| | - Mireia Rosa-Justicia
- Clinic Image Diagnostic Center (CDIC), Hospital Clinic of Barcelona; Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Nuria Bargallo
- Clinic Image Diagnostic Center (CDIC), Hospital Clinic of Barcelona; Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, Department of Medicine, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Maria J. Penzol
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Marcel Zwiers
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Buitelaar
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Jilly Naaijen
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Child and Adolescent Psychiatry and Psychology Department, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
- Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Christian Beckmann
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
- Centre for Functional MRI of the Brain, University of Oxford, Oxford, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Andre F. Marquand
- Donders Center for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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McNicholas F, Castro-Fornieles J, Nicholls DE, Schulze UME. Editorial: How to better understand and treat children and adolescents suffering from eating disorders. Front Psychiatry 2023; 14:1209371. [PMID: 37383619 PMCID: PMC10295721 DOI: 10.3389/fpsyt.2023.1209371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 05/26/2023] [Indexed: 06/30/2023] Open
Affiliation(s)
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | | | - Ulrike M. E. Schulze
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
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Segura AG, de la Serna E, Sugranyes G, Baeza I, Valli I, Díaz-Caneja C, Martín N, Moreno DM, Gassó P, Rodriguez N, Mas S, Castro-Fornieles J. Epigenetic age deacceleration in youth at familial risk for schizophrenia and bipolar disorder. Transl Psychiatry 2023; 13:155. [PMID: 37156786 PMCID: PMC10167217 DOI: 10.1038/s41398-023-02463-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/10/2023] Open
Abstract
Epigenetic modifications occur sequentially during the lifespan, but their pace can be altered by external stimuli. The onset of schizophrenia and bipolar disorder is critically modulated by stressors that may alter the epigenetic pattern, a putative signature marker of exposure to environmental risk factors. In this study, we estimated the age-related epigenetic modifications to assess the differences between young individuals at familial high risk (FHR) and controls and their association with environmental stressors. The sample included 117 individuals (6-17 years) at FHR (45%) and a control group (55%). Blood and saliva samples were used estimate the epigenetic age with six epigenetic clocks through methylation data. Environmental risk was measured with obstetric complications, socioeconomic statuses and recent stressful life events data. Epigenetic age was correlated with chronological age. FHR individuals showed epigenetic age deacceleration of Horvath and Hannum epigenetic clocks compared to controls. No effect of the environmental risk factors on the epigenetic age acceleration could be detected. Epigenetic age acceleration adjusted by cell counts showed that the FHR group was deaccelerated also with the PedBE epigenetic clock. Epigenetic age asynchronicities were found in the young at high risk, suggesting that offspring of affected parents follow a slower pace of biological aging than the control group. It still remains unclear which environmental stressors orchestrate the changes in the methylation pattern. Further studies are needed to better characterize the molecular impact of environmental stressors before illness onset, which could be critical in the development of tools for personalized psychiatry.
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Affiliation(s)
- Alex G Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gisela Sugranyes
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Isabel Valli
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Covadonga Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Nuria Martín
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Dolores M Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Adolescent Inpatient Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Psychiatry Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Natalia Rodriguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Zwicker A, Fullerton JM, Mullins N, Rice F, Hafeman DM, van Haren NEM, Setiaman N, Merranko JA, Goldstein BI, Ferrera AG, Stapp EK, de la Serna E, Moreno D, Sugranyes G, Herrero SM, Roberts G, Toma C, Schofield PR, Edenberg HJ, Wilcox HC, McInnis MG, Powell V, Propper L, Denovan-Wright E, Rouleau G, Castro-Fornieles J, Hillegers MHJ, Birmaher B, Thapar A, Mitchell PB, Lewis CM, Alda M, Nurnberger JI, Uher R. Polygenic Scores and Onset of Major Mood or Psychotic Disorders Among Offspring of Affected Parents. Am J Psychiatry 2023; 180:285-293. [PMID: 36856707 DOI: 10.1176/appi.ajp.20220476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Family history is an established risk factor for mental illness. The authors sought to investigate whether polygenic scores (PGSs) can complement family history to improve identification of risk for major mood and psychotic disorders. METHODS Eight cohorts were combined to create a sample of 1,884 participants ages 2-36 years, including 1,339 offspring of parents with mood or psychotic disorders, who were prospectively assessed with diagnostic interviews over an average of 5.1 years. PGSs were constructed for depression, bipolar disorder, anxiety, attention deficit hyperactivity disorder (ADHD), schizophrenia, neuroticism, subjective well-being, p factor, and height (as a negative control). Cox regression was used to test associations between PGSs, family history of major mental illness, and onsets of major mood and psychotic disorders. RESULTS There were 435 onsets of major mood and psychotic disorders across follow-up. PGSs for neuroticism (hazard ratio=1.23, 95% CI=1.12-1.36), schizophrenia (hazard ratio=1.15, 95% CI=1.04-1.26), depression (hazard ratio=1.11, 95% CI=1.01-1.22), ADHD (hazard ratio=1.10, 95% CI=1.00-1.21), subjective well-being (hazard ratio=0.90, 95% CI=0.82-0.99), and p factor (hazard ratio=1.14, 95% CI=1.04-1.26) were associated with onsets. After controlling for family history, neuroticism PGS remained significantly positively associated (hazard ratio=1.19, 95% CI=1.08-1.31) and subjective well-being PGS remained significantly negatively associated (hazard ratio=0.89, 95% CI=0.81-0.98) with onsets. CONCLUSIONS Neuroticism and subjective well-being PGSs capture risk of major mood and psychotic disorders that is independent of family history, whereas PGSs for psychiatric illness provide limited predictive power when family history is known. Neuroticism and subjective well-being PGSs may complement family history in the early identification of persons at elevated risk.
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Affiliation(s)
- Alyson Zwicker
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Janice M Fullerton
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Niamh Mullins
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Frances Rice
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Danella M Hafeman
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Neeltje E M van Haren
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Nikita Setiaman
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - John A Merranko
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Benjamin I Goldstein
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Alessandra G Ferrera
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Emma K Stapp
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Elena de la Serna
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Dolores Moreno
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Gisela Sugranyes
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Sergio Mas Herrero
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Gloria Roberts
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Claudio Toma
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Peter R Schofield
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Howard J Edenberg
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Holly C Wilcox
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Melvin G McInnis
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Victoria Powell
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Lukas Propper
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Eileen Denovan-Wright
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Guy Rouleau
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Josefina Castro-Fornieles
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Manon H J Hillegers
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Boris Birmaher
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Anita Thapar
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Philip B Mitchell
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Cathryn M Lewis
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Martin Alda
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - John I Nurnberger
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Rudolf Uher
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
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19
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Castro-Fornieles J, Toro J. History of child psychiatry in Spain. Span J Psychiatry Ment Health 2023; 16:65-67. [PMID: 38591719 DOI: 10.1016/j.sjpmh.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 04/10/2024]
Affiliation(s)
- Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic of Barcelona, University of Barcelona, Spain; IDIBAPS, CIBERSAM, Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain.
| | - Josep Toro
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic of Barcelona, University of Barcelona, Spain
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20
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Barth C, Kelly S, Nerland S, Jahanshad N, Alloza C, Ambrogi S, Andreassen OA, Andreou D, Arango C, Baeza I, Banaj N, Bearden CE, Berk M, Bohman H, Castro-Fornieles J, Chye Y, Crespo-Facorro B, de la Serna E, Díaz-Caneja CM, Gurholt TP, Hegarty CE, James A, Janssen J, Johannessen C, Jönsson EG, Karlsgodt KH, Kochunov P, Lois NG, Lundberg M, Myhre AM, Pascual-Diaz S, Piras F, Smelror RE, Spalletta G, Stokkan TS, Sugranyes G, Suo C, Thomopoulos SI, Tordesillas-Gutiérrez D, Vecchio D, Wedervang-Resell K, Wortinger LA, Thompson PM, Agartz I. In vivo white matter microstructure in adolescents with early-onset psychosis: a multi-site mega-analysis. Mol Psychiatry 2023; 28:1159-1169. [PMID: 36510004 PMCID: PMC10005938 DOI: 10.1038/s41380-022-01901-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022]
Abstract
Emerging evidence suggests brain white matter alterations in adolescents with early-onset psychosis (EOP; age of onset <18 years). However, as neuroimaging methods vary and sample sizes are modest, results remain inconclusive. Using harmonized data processing protocols and a mega-analytic approach, we compared white matter microstructure in EOP and healthy controls using diffusion tensor imaging (DTI). Our sample included 321 adolescents with EOP (median age = 16.6 years, interquartile range (IQR) = 2.14, 46.4% females) and 265 adolescent healthy controls (median age = 16.2 years, IQR = 2.43, 57.7% females) pooled from nine sites. All sites extracted mean fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) for 25 white matter regions of interest per participant. ComBat harmonization was performed for all DTI measures to adjust for scanner differences. Multiple linear regression models were fitted to investigate case-control differences and associations with clinical variables in regional DTI measures. We found widespread lower FA in EOP compared to healthy controls, with the largest effect sizes in the superior longitudinal fasciculus (Cohen's d = 0.37), posterior corona radiata (d = 0.32), and superior fronto-occipital fasciculus (d = 0.31). We also found widespread higher RD and more localized higher MD and AD. We detected significant effects of diagnostic subgroup, sex, and duration of illness, but not medication status. Using the largest EOP DTI sample to date, our findings suggest a profile of widespread white matter microstructure alterations in adolescents with EOP, most prominently in male individuals with early-onset schizophrenia and individuals with a shorter duration of illness.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Sinead Kelly
- Department of Psychosis Studies, King's College London, London, UK
| | - Stener Nerland
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Sonia Ambrogi
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Dimitrios Andreou
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Inmaculada Baeza
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Hannes Bohman
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Josefina Castro-Fornieles
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Yann Chye
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Benedicto Crespo-Facorro
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Department of Psychiatry, CIBERSAM, IBiS-CSIC, Sevilla, Spain
| | - Elena de la Serna
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | - Tiril P Gurholt
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Anthony James
- Highfield Unit, Warneford Hospital, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Madrid, Spain
| | - Cecilie Johannessen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik G Jönsson
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Katherine H Karlsgodt
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MA, USA
| | - Noemi G Lois
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | - Mathias Lundberg
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Anne M Myhre
- Section of Child and Adolescent Mental Health Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Saül Pascual-Diaz
- Magnetic Resonance Imaging Core Facility, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Runar E Smelror
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Therese S Stokkan
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gisela Sugranyes
- Department Child and Adolescent Psychiatry and Psychology, 2017SGR881 Institute of Neuroscience, Hospital Clinic Barcelona. CIBERSAM. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Chao Suo
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Diana Tordesillas-Gutiérrez
- Department of Radiology, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Santander (Cantabria), Spain
- Advanced Computing and e-Science, Instituto de Física de Cantabria (UC-CSIC), Santander (Cantabria), Spain
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Kirsten Wedervang-Resell
- Norwegian Center for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Laura A Wortinger
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
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21
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Via E, Calvo A, de la Serna E, Blázquez A, Lázaro L, Andrés-Perpiñá S, Plana MT, Flamarique I, Martínez E, Pariente J, Moreno E, Bargallo N, Castro-Fornieles J. Longitudinal study in adolescent anorexia nervosa: evaluation of cortico-striatal and default mode network resting-state brain circuits. Eur Child Adolesc Psychiatry 2023; 32:513-526. [PMID: 34604924 DOI: 10.1007/s00787-021-01880-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
Anorexia nervosa (AN) typically emerges in adolescence. The cortico-striatal system (CSTS) and the default mode network (DMN) are brain circuits with a crucial development during this period. These circuits underlie cognitive functions that are impaired in AN, such as cognitive flexibility and inhibition, among others. Little is known about their involvement in adolescent AN and how weight and symptom improvement might modulate potential alterations in these circuits. Forty-seven adolescent females (30 AN, 17 healthy control) were clinically/neuropsychologically evaluated and scanned during a 3T-MRI resting-state session on two occasions, before and after a 6-month multidisciplinary treatment of the AN patients. Baseline and baseline-to-follow-up between-group differences in CSTS and DMN resting-state connectivity were evaluated, as well as their association with clinical/neuropsychological variables. Increased connectivity between the left dorsal putamen and the left precuneus was found in AN at baseline. At follow-up, body mass index and clinical symptoms had improved in the AN group. An interaction effect was found in the connectivity between the right dorsal caudate to right mid-anterior insular cortex, with lower baseline AN connectivity that improved at follow-up; this improvement was weakly associated with changes in neuropsychological (Stroop test) performance. These results support the presence of CSTS connectivity alterations in adolescents with AN, which improve with weight and symptom improvement. In addition, at the level of caudate-insula connectivity, they might be associated with inhibitory processing performance. Alterations in CSTS pathways might be involved in AN from the early stages of the disorder.
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Affiliation(s)
- Esther Via
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain.
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Anna Calvo
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Anna Blázquez
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Luisa Lázaro
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Susana Andrés-Perpiñá
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - María Teresa Plana
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Itziar Flamarique
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Esteve Martínez
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Jose Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena Moreno
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Nuria Bargallo
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Image Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
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22
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Cortese S, McGinn K, Højlund M, Apter A, Arango C, Baeza I, Banaschewski T, Buitelaar J, Castro-Fornieles J, Coghill D, Cohen D, Grünblatt E, Hoekstra PJ, James A, Jeppesen P, Nagy P, Pagsberg AK, Parellada M, Persico AM, Purper-Ouakil D, Roessner V, Santosh P, Simonoff E, Stevanovic D, Stringaris A, Vitiello B, Walitza S, Weizman A, Wohlfarth T, Wong ICK, Zalsman G, Zuddas A, Moreno C, Solmi M, Correll CU. The Future of Child and Adolescent Clinical Psychopharmacology: A Systematic Review of Phase 2, 3, or 4 Randomized Controlled Trials of Pharmacologic Agents Without Regulatory Approval or for Unapproved Indications. Neurosci Biobehav Rev 2023; 149:105149. [PMID: 37001575 DOI: 10.1016/j.neubiorev.2023.105149] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
We aimed to identify promising novel medications for child and adolescent mental health problems. We systematically searched https://clinicaltrials.gov/ and https://www.clinicaltrialsregister.eu/ (from 01/01/2010-08/23/2022) for phase 2 or 3 randomized controlled trials (RCTs) of medications without regulatory approval in the US, Europe or Asia, including also RCTs of dietary interventions/probiotics. Additionally, we searched phase 4 RCTs of agents targeting unlicensed indications for children/adolescents with mental health disorders. We retrieved 234 ongoing or completed RCTs, including 26 (11%) with positive findings on ≥ 1 primary outcome, 43 (18%) with negative/unavailable results on every primary outcome, and 165 (70%) without publicly available statistical results. The only two compounds with evidence of significant effects that were replicated in ≥ 1 additional RCT without any negative RCTs were dasotraline for attention-deficit/hyperactivity disorder, and carbetocin for hyperphagia in Prader-Willi syndrome. Among other strategies, targeting specific symptom dimensions in samples stratified based on clinical characteristics or established biomarkers may increase chances of success in future development programmes.
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23
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Butjosa A, Usall J, Vila-Badia R, Mezquida G, Cuesta MJ, Rodríguez-Toscano E, Amoretti S, Lobo A, González-Pinto A, Espliego A, Corripio I, Vieta E, Baeza I, Bergé D, Bernardo M, García-Rizo C, Mayoral M, Merchan J, Alonso-Solís A, Rabella M, López P, Zorrilla I, De-la-Cámara C, Barcones F, Sanjuan J, Dolores Moltó M, Morro L, Monserrat C, Verdolini N, Salagre E, la Serna ED, Castro-Fornieles J, Contreras Fernández F, Saiz Masvidal C, Paz Garcia-Portilla M, Bousoño M, Gutiérrez Fraile M, Zabala Rabadán A, Dompablo M, Rodriguez-Jimenez R, Rubio-Abadal E, Pardo M, Sarró S, Pomarol-Clotet E, Ibanez A, Sánchez-Torres AM, Selva-Vera G. Impact of traumatic life events on clinical variables of individuals with first-episode psychosis and healthy controls. Int J Soc Psychiatry 2023; 69:134-145. [PMID: 35068217 DOI: 10.1177/00207640211070398] [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: 11/17/2022]
Abstract
BACKGROUND Traumatic life events (TLEs) are one of the most robust environmental risk factors for the onset of first-episode psychosis (FEP). AIMS To explore TLEs in FEP patients and healthy controls (HC), to analyze gender differences and to examine whether TLEs were associated with sociodemographic, clinical and psychofunctional variables in all FEP sample and split by age. METHODS Descriptive and cross-sectional study. Three hundred and thirty-five FEP and 253 HC were recruited at 16 Spanish mental health research centers. The Traumatic Experiences in Psychiatric Outpatients Questionnaire was administered. RESULTS We found a higher number of TLEs in FEP than in HC, and the proportion of individuals with three or more TLEs was significantly higher in the FEP group. No differences were found in terms of gender and age. There was no relationship between total number of TLEs and psychotic symptomatology and functional outcomes. CONCLUSIONS The number and cumulative TLEs should be taken into account in the detection, epidemiology and process of recovery in FEP.
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Affiliation(s)
- Anna Butjosa
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain
| | - Judith Usall
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Regina Vila-Badia
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Gisela Mezquida
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Elisa Rodríguez-Toscano
- Instituto de Psiquiatría y Salud Mental del Hospital Gregorio Marañón, Servicio de Psiquiatría del Niño y del Adolescente, Madrid, Spain.,Departamento de Psicología experimental, Procesos psicológicos y logopedia, Universidad Complutense de Madrid, Spain
| | - Silvia Amoretti
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Medicine and Psychiatry, University of Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, UPV/EHU, Vitoria, Spain
| | - Ana Espliego
- Departamento de Psicología experimental, Procesos psicológicos y logopedia, Universidad Complutense de Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Psychiatry, Hospital de Sant Pau, Barcelona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Catalonia, Spain
| | - Inmaculada Baeza
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Child and Adolescent Psychiatry and Psychology Department, SGR489, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, Spain
| | - Dani Bergé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
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24
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Saiz-Masvidal C, Contreras F, Soriano-Mas C, Mezquida G, Díaz-Caneja CM, Vieta E, Amoretti S, Lobo A, González-Pinto A, Janssen J, Sagué-Vilavella M, Castro-Fornieles J, Bergé D, Bioque M, Lois NG, Parellada M, Bernardo M. Structural covariance predictors of clinical improvement at 2-year follow-up in first-episode psychosis. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110645. [PMID: 36181960 DOI: 10.1016/j.pnpbp.2022.110645] [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: 04/27/2022] [Revised: 09/07/2022] [Accepted: 09/22/2022] [Indexed: 11/30/2022]
Abstract
The relationship between structural brain alterations and prediction of clinical improvement in first-episode psychosis (FEP) has been scarcely studied. We investigated whether structural covariance, a well-established approach to identify abnormal patterns of volumetric correlation across distant brain regions, which allows incorporating network-level information to structural assessments, is associated with longitudinal clinical course. We assessed a sample of 74 individuals from a multicenter study. Magnetic resonance imaging scans were acquired at baseline, and clinical assessments at baseline and at a 2-year follow-up. Participants were split in two groups as a function of their clinical improvement after 2 years (i.e., ≥ < 40% reduction in psychotic symptom severity, (n = 29, n = 45)). We performed a seed-based approach and focused our analyses on 3 cortical and 4 subcortical regions of interest to identify alterations in cortical and cortico-subcortical networks. Improvers presented an increased correlation between the volumes of the right posterior cingulate cortex (PCC) and the left precentral gyrus, and between the left PCC and the left middle occipital gyrus. They also showed an increased correlation between right posterior hippocampus and left angular gyrus volumes. Our study provides a novel mean to identify structural correlates of clinical improvement in FEP, describing clinically-relevant anatomical differences in terms of large-scale brain networks, which is better aligned with prevailing neurobiological models of psychosis. The results involve brain regions considered to participate in the multisensory processing of bodily signals and the construction of bodily self-consciousness, which resonates with recent theoretical accounts in psychosis research.
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Affiliation(s)
- Cristina Saiz-Masvidal
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Fernando Contreras
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Department of Social Psychology and Quantitative Psychology, University of Barcelona, Spain.
| | - Gisela Mezquida
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Covadonga M Díaz-Caneja
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón and School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Bipolar and Depressive Disorders Unit, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Instituto de Investigación Sanitaria Bioaraba (BIOARABA), Vitoria, Spain; Department of Psychiatry, Hospital Universitario de Alava, Vitoria, Spain; Universidad del País Vasco/ Euskal Harriko Unibertsitatea (UPV/EHU), País Vasco, Spain
| | - Joost Janssen
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón and School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Maria Sagué-Vilavella
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Clinical Institute of Neurosciences, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institut Clínic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Daniel Bergé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Institute of Neuropsychiatry and Addiction of the Barcelona MAR Health Park, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Department of Medicine and Life Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Miquel Bioque
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Noemi G Lois
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón and School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Mara Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón and School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
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25
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Valli I, De la Serna E, Segura AG, Pariente JC, Calvet-Mirabent A, Borras R, Ilzarbe D, Moreno D, Martín-Martínez N, Baeza I, Rosa-Justicia M, Garcia-Rizo C, Díaz-Caneja CM, Crossley NA, Young AH, Vieta E, Mas S, Castro-Fornieles J, Sugranyes G. Genetic and Structural Brain Correlates of Cognitive Subtypes Across Youth at Family Risk for Schizophrenia and Bipolar Disorder. J Am Acad Child Adolesc Psychiatry 2023; 62:74-83. [PMID: 35710081 DOI: 10.1016/j.jaac.2022.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/21/2022] [Accepted: 06/06/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Cognitive impairment is an important feature of schizophrenia (SZ) and bipolar disorder (BP) with severity across the two disorders characterized by significant heterogeneity. Youth at family risk for SZ and BP were clustered based on cognitive function and examined in terms of the clinical, genetic, and brain imaging correlates of cluster membership. METHOD One hundred sixty participants, 32 offspring of patients with SZ, 59 offspring of patients with BP and 69 offspring of healthy control parents underwent clinical and cognitive assessments, genotyping and structural MRI. K-means clustering was used to group family risk participants based on cognitive measures. Clusters were compared in terms of cortical and subcortical brain measures as well as polygenic risk scores. RESULTS Participants were grouped in 3 clusters with intact, intermediate, and impaired cognitive performance. The intermediate and impaired clusters had lower total brain surface area compared with the intact cluster, with prominent localization in frontal and temporal cortices. No between-cluster differences were identified in cortical thickness and subcortical brain volumes. The impaired cluster also had poorer psychosocial functioning and worse PRS-COG compared with the other 2 clusters and with offspring of healthy control parents, while there was no significant between-cluster difference in terms of PRS-SZ and PRS-BP. PRS-COG predicted psychosocial functioning, yet this effect did not appear to be mediated by an effect of PRS-COG on brain area. CONCLUSION Stratification based on cognition may help to elucidate the biological underpinnings of cognitive heterogeneity across SZ and BP risk.
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Affiliation(s)
- Isabel Valli
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London.
| | - Elena De la Serna
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain
| | | | - Jose C Pariente
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Roger Borras
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel Ilzarbe
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain
| | - Dolores Moreno
- Institute of Neuroscience, Hospital Clínic Barcelona, Spain; Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nuria Martín-Martínez
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Inmaculada Baeza
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain; University of Barcelona, Spain
| | - Mireia Rosa-Justicia
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Clemente Garcia-Rizo
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain
| | - Covadonga M Díaz-Caneja
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nicolas A Crossley
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London; Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Allan H Young
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, United Kingdom
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain; University of Barcelona, Spain
| | - Sergi Mas
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Spain
| | - Josefina Castro-Fornieles
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain; University of Barcelona, Spain
| | - Gisela Sugranyes
- Institut d'Investigacions Biomèdiques Agustí Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clínic Barcelona, Spain; University of Barcelona, Spain
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26
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Aggensteiner PM, Holz NE, Böttinger BW, Baumeister S, Hohmann S, Werhahn JE, Naaijen J, Ilbegi S, Glennon JC, Hoekstra PJ, Dietrich A, Deters RK, Saam MC, Schulze UME, Lythgoe DJ, Sethi A, Craig MC, Mastroianni M, Sagar-Ouriaghli I, Santosh PJ, Rosa M, Bargallo N, Castro-Fornieles J, Arango C, Penzol MJ, Vidal J, Franke B, Zwiers MP, Buitelaar JK, Walitza S, Banaschewski T, Brandeis D. The effects of callous-unemotional traits and aggression subtypes on amygdala activity in response to negative faces - ERRATUM. Psychol Med 2023; 53:304. [PMID: 32854789 DOI: 10.1017/s0033291720003049] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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27
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Fortea A, Pinzón-Espinosa J, Ilzarbe D, Espinosa L, Lázaro L, Calvo RM, Castro-Fornieles J, de la Serna E, Bargalló N, Baeza I, Sugranyes G. Radiological findings in brain MRI scans in youth with early-onset psychosis: A controlled study. J Psychiatr Res 2022; 156:151-158. [PMID: 36252344 DOI: 10.1016/j.jpsychires.2022.10.016] [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: 05/20/2022] [Revised: 08/08/2022] [Accepted: 10/03/2022] [Indexed: 12/12/2022]
Abstract
There is a lack of consensus on whether routine brain magnetic resonance imaging (MRI) should be recommended as part of the initial assessment in patients with psychosis. No study so far has qualitatively assessed brain MRI in patients with early-onset psychosis (EOP), in whom neurodevelopmental factors may play a stronger role. We aimed to determine the prevalence of brain MRI findings in patients with EOP compared to healthy controls, and assess whether these findings were clinically relevant. Retrospective clinical chart review of all patients with EOP in whom a brain MRI scan was acquired during admission to an inpatient child and adolescent psychiatry unit during January 2013-December 2017, compared to age and biologically assigned gender matched healthy controls. Between group analyses tested differences in rates of qualitatively abnormal MRI scans and changes in clinical management as a result of radiological findings. A total of 256 individuals were included (128 patients with EOP and 128 healthy controls). Patients with EOP presented with a significantly higher rate of abnormal MRI scans relative to healthy controls (21.9% vs 11.7%, p = .030; OR = 2.11, [95% CI:1.06-4.17]). Radiological findings in the EOP group triggered clinical referral for further evaluation or management more often than in the healthy control group (7.0% vs 1.6%, p = .030; OR = 4.76, [95% CI:1.01-22.50]). MRI scans in youth with EOP may be characterized by an increased number of radiological abnormalities than in controls. The rates of MRI findings requiring clinical referral suggests that routine MRI acquisition may need to be considered in patients with EOP.
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Affiliation(s)
- Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; Fundació Clínic per a La Recerca Biomèdica (FCRB), 153 Rosselló St., Barcelona, 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Justo Pinzón-Espinosa
- Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Mental Health, Parc Tauli University Hospital, Sabadell, 1 Parc Taulí, Sabadell, 08208, Barcelona, Spain; Department of Clinical Psychiatry, School of Medicine, University of Panama, Ave. Octavio Méndez Pereira, Panamá, XFJ8+V2Q, Panama
| | - Daniel Ilzarbe
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Laura Espinosa
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Child and Adolescent Psychiatry, Hospital Sant Joan de Deu, Fundació Althaia, 1-3 Dr. Joan Soler St., Manresa, 08243, Barcelona, Spain
| | - Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Rosa M Calvo
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Nuria Bargalló
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Department of Radiology, Imaging Diagnosis Center, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Department of Medicine, School of Medicine, University of Barcelona, 143 Casanova St Barcelona 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR-881 Institute of Neuroscience, Hospital Clínic of Barcelona, 170 Villarroel St., Barcelona, 08036, Spain; Fundació Clínic per a La Recerca Biomèdica (FCRB), 153 Rosselló St., Barcelona, 08036, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 153 Rosselló St., Barcelona, 08036, Spain; Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 3-5, Monforte de Lemos St., Madrid, 28029, Spain.
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Pina-Camacho L, Martinez K, Diaz-Caneja CM, Mezquida G, Cuesta MJ, Moreno C, Amoretti S, González-Pinto A, Arango C, Vieta E, Castro-Fornieles J, Lobo A, Fraguas D, Bernardo M, Janssen J, Parellada M, Madero S, Gómez-Ramiro M, Rodriguez-Toscano E, Santonja J, Zorrilla I, González-Ortega I, Fayed N, Santabárbara J, Berge D, Toll A, Nacher J, Martí GG, Sague-Vilavella M, Sanchez-Moreno J, de la Serna E, Baeza I, Saiz-Masvidal C, Contreras F, González-Blanco L, Bobes-Bascarán T, Dompablo M, Rodriguez-Jimenez R, Usall J, Butjosa A, Pomarol-Clotet E, Sarró S. Cortical thinning over two years after first-episode psychosis depends on age of onset. Schizophr 2022; 8:20. [PMID: 35277520 PMCID: PMC8917180 DOI: 10.1038/s41537-021-00196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/10/2021] [Indexed: 11/09/2022]
Abstract
AbstractFirst-episode psychosis (FEP) patients show structural brain abnormalities at the first episode. Whether the cortical changes that follow a FEP are progressive and whether age at onset modulates these changes remains unclear. This is a multicenter MRI study in a deeply phenotyped sample of 74 FEP patients with a wide age range at onset (15–35 years) and 64 neurotypical healthy controls (HC). All participants underwent two MRI scans with a 2-year follow-up interval. We computed the longitudinal percentage of change (PC) for cortical thickness (CT), surface area (CSA) and volume (CV) for frontal, temporal, parietal and occipital lobes. We used general linear models to assess group differences in PC as a function of age at FEP. We conducted post-hoc analyses for metrics where PC differed as a function of age at onset. We found a significant age-by-diagnosis interaction effect for PC of temporal lobe CT (d = 0.54; p = 002). In a post-hoc-analysis, adolescent-onset (≤19 y) FEP showed more severe longitudinal cortical thinning in the temporal lobe than adolescent HC. We did not find this difference in adult-onset FEP compared to adult HC. Our study suggests that, in individuals with psychosis, CT changes that follow the FEP are dependent on the age at first episode, with those with an earlier onset showing more pronounced cortical thinning in the temporal lobe.
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Solanes A, Mezquida G, Janssen J, Amoretti S, Lobo A, González-Pinto A, Arango C, Vieta E, Castro-Fornieles J, Bergé D, Albacete A, Giné E, Parellada M, Bernardo M, Bioque M, Morén C, Pina-Camacho L, Díaz-Caneja CM, Zorrilla I, Corres EG, De-la-Camara C, Barcones F, Escarti MJ, Aguilar EJ, Legido T, Martin M, Verdolini N, Martinez-Aran A, Baeza I, de la Serna E, Contreras F, Bobes J, García-Portilla MP, Sanchez-Pastor L, Rodriguez-Jimenez R, Usall J, Butjosa A, Salgado-Pineda P, Salvador R, Pomarol-Clotet E, Radua J. Combining MRI and clinical data to detect high relapse risk after the first episode of psychosis. Schizophr 2022; 8:100. [PMID: 36396933 PMCID: PMC9672064 DOI: 10.1038/s41537-022-00309-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022]
Abstract
AbstractDetecting patients at high relapse risk after the first episode of psychosis (HRR-FEP) could help the clinician adjust the preventive treatment. To develop a tool to detect patients at HRR using their baseline clinical and structural MRI, we followed 227 patients with FEP for 18–24 months and applied MRIPredict. We previously optimized the MRI-based machine-learning parameters (combining unmodulated and modulated gray and white matter and using voxel-based ensemble) in two independent datasets. Patients estimated to be at HRR-FEP showed a substantially increased risk of relapse (hazard ratio = 4.58, P < 0.05). Accuracy was poorer when we only used clinical or MRI data. We thus show the potential of combining clinical and MRI data to detect which individuals are more likely to relapse, who may benefit from increased frequency of visits, and which are unlikely, who may be currently receiving unnecessary prophylactic treatments. We also provide an updated version of the MRIPredict software.
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Walton E, Bernardoni F, Batury VL, Bahnsen K, Larivière S, Abbate-Daga G, Andres-Perpiña S, Bang L, Bischoff-Grethe A, Brooks SJ, Campbell IC, Cascino G, Castro-Fornieles J, Collantoni E, D'Agata F, Dahmen B, Danner UN, Favaro A, Feusner JD, Frank GKW, Friederich HC, Graner JL, Herpertz-Dahlmann B, Hess A, Horndasch S, Kaplan AS, Kaufmann LK, Kaye WH, Khalsa SS, LaBar KS, Lavagnino L, Lazaro L, Manara R, Miles AE, Milos GF, Monteleone AM, Monteleone P, Mwangi B, O'Daly O, Pariente J, Roesch J, Schmidt UH, Seitz J, Shott ME, Simon JJ, Smeets PAM, Tamnes CK, Tenconi E, Thomopoulos SI, van Elburg AA, Voineskos AN, von Polier GG, Wierenga CE, Zucker NL, Jahanshad N, King JA, Thompson PM, Berner LA, Ehrlich S. Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis by the ENIGMA Eating Disorders Working Group. Biol Psychiatry 2022; 92:730-738. [PMID: 36031441 DOI: 10.1016/j.biopsych.2022.04.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/01/2022] [Accepted: 04/28/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in gray matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy control subjects. Recent weight regain before scanning may explain some of this heterogeneity. To clarify the extent, magnitude, and dependencies of gray matter changes in AN, we conducted a prospective, coordinated meta-analysis of multicenter neuroimaging data. METHODS We analyzed T1-weighted structural magnetic resonance imaging scans assessed with standardized methods from 685 female patients with AN and 963 female healthy control subjects across 22 sites worldwide. In addition to a case-control comparison, we conducted a 3-group analysis comparing healthy control subjects with acutely underweight AN patients (n = 466) and partially weight-restored patients in treatment (n = 251). RESULTS In AN, reductions in cortical thickness, subcortical volumes, and, to a lesser extent, cortical surface area were sizable (Cohen's d up to 0.95), widespread, and colocalized with hub regions. Highlighting the effects of undernutrition, these deficits were associated with lower body mass index in the AN sample and were less pronounced in partially weight-restored patients. CONCLUSIONS The effect sizes observed for cortical thickness deficits in acute AN are the largest of any psychiatric disorder investigated in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Consortium to date. These results confirm the importance of considering weight loss and renutrition in biomedical research on AN and underscore the importance of treatment engagement to prevent potentially long-lasting structural brain changes in this population.
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Affiliation(s)
- Esther Walton
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Fabio Bernardoni
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Victoria-Luise Batury
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Klaas Bahnsen
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec
| | - Giovanni Abbate-Daga
- Eating Disorders Center for Treatment and Research, University of Turin, Turin, Italy
| | - Susana Andres-Perpiña
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Centro de Investigación Biomédica en Red de Salud Mental, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Lasse Bang
- Norwegian Institute of Public Health, Oslo; Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Amanda Bischoff-Grethe
- Department of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California
| | - Samantha J Brooks
- School of Psychology, Faculty of Health Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Department of Neuroscience, Uppsala University, Sweden
| | - Iain C Campbell
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Eating Disorders Unit, Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Giammarco Cascino
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Centro de Investigación Biomédica en Red de Salud Mental, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | | | | | - Brigitte Dahmen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Unna N Danner
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, the Netherlands; Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Jamie D Feusner
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, California
| | - Guido K W Frank
- Department of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California
| | - Hans-Christoph Friederich
- Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - John L Graner
- Center for Cognitive Neuroscience, Duke University, Durham, North Carolina
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Andreas Hess
- Institute for Pharmacology and Toxicology, University Erlangen-Nuremberg, Erlangen, Germany
| | - Stefanie Horndasch
- Department of Child and Adolescent Psychiatry, University Clinic Erlangen, Erlangen, Germany
| | - Allan S Kaplan
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Lisa-Katrin Kaufmann
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich; Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Walter H Kaye
- Department of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Kevin S LaBar
- Center for Cognitive Neuroscience, Duke University, Durham, North Carolina
| | - Luca Lavagnino
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston Texas
| | - Luisa Lazaro
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Centro de Investigación Biomédica en Red de Salud Mental, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Renzo Manara
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Amy E Miles
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Gabriella F Milos
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich
| | | | - Palmiero Monteleone
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Benson Mwangi
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston Texas
| | - Owen O'Daly
- Centre for Neuroimaging Studies, King's College London, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jose Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Julie Roesch
- Department of Neuroradiology, University Clinic Erlangen, Erlangen, Germany
| | - Ulrike H Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Eating Disorders Unit, Department of Psychological Medicine, King's College London, London, United Kingdom
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Megan E Shott
- Department of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California
| | - Joe J Simon
- Centre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Paul A M Smeets
- UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands; Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Christian K Tamnes
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - Annemarie A van Elburg
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, the Netherlands; Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Georg G von Polier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany; Institute for Neuroscience and Medicine: Brain and Behaviour, Forschungszentrum Jülich, Jülich, Germany; Department of Child and Adolescent Psychiatry, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Christina E Wierenga
- Department of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California
| | - Nancy L Zucker
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - Joseph A King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - Laura A Berner
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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Guasp M, Rosa-Justicia M, Muñoz-Lopetegi A, Martínez-Hernández E, Armangué T, Sugranyes G, Stein H, Borràs R, Prades L, Ariño H, Planagumà J, De-La-Serna E, Escudero D, Llufriu S, Sánchez-Valle R, Santamaria J, Compte A, Castro-Fornieles J, Dalmau J, Páramo D, Medrano V, Casado V, Guanyabens N, Giné-Servén E, Ángeles del Real M, Pardo J, Martin-Gil L, Barrero-Hernández FJ, García-Barragán N, Falip M, Simó M, Rodríguez E, Ruiz Ezquerro JJ, Bataller L, Safont G, Vicente-Hervàs J, Brieva L, Casado I, Portilla JC, Escalante S, Arenillas JF, Erro E, Jericó-Pascual I, Fuerte-Hortigón A, Morató A, Saiz A, Blanco Y, Sepúlveda M, Ruiz R, Naranjo L, Rodés M, Aguilar E, Alba M, Caballero E. Clinical characterisation of patients in the post-acute stage of anti-NMDA receptor encephalitis: a prospective cohort study and comparison with patients with schizophrenia spectrum disorders. Lancet Neurol 2022; 21:899-910. [DOI: 10.1016/s1474-4422(22)00299-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 10/14/2022]
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Gilsbach S, Plana MT, Castro-Fornieles J, Gatta M, Karlsson GP, Flamarique I, Raynaud JP, Riva A, Solberg AL, van Elburg AA, Wentz E, Nacinovich R, Herpertz-Dahlmann B. Increase in admission rates and symptom severity of childhood and adolescent anorexia nervosa in Europe during the COVID-19 pandemic: data from specialized eating disorder units in different European countries. Child Adolesc Psychiatry Ment Health 2022; 16:46. [PMID: 35725621 PMCID: PMC9208345 DOI: 10.1186/s13034-022-00482-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [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: 01/23/2022] [Accepted: 05/31/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic, associated with confinement and social isolation, seems to have impacted the course of many mental disorders in children and adolescents. An increase in hospital admission rates for juvenile anorexia nervosa (AN) has been documented in many regions of the world. However, data from Europe are scarce. METHODS We asked clinicians in specialized eating disorder units in hospitals of maximum care in France, Germany, Italy, Spain, Sweden, and the Netherlands to report on (i) overall (inpatient and outpatient) and (ii) inpatient admission rates for adolescents with AN during 2019 and 2020. Additionally, a modified version of the COVID Isolation Eating Scale (CIES) was used to assess the child and adolescent psychiatrists' estimations of a possible increase in symptom severity in children and adolescents with AN during the COVID-19 pandemic and to (iii) inquire about the contributing factors perceived by the caring professionals. RESULTS Four out of six representatives of European hospitals described a higher rate of overall admissions during the pandemic. Three hospitals out of six reported an increase in inpatient admissions, and two centres had constant high numbers of admissions of both outpatients and inpatients. The clinicians perceived a higher symptom severity in 2020 than in 2019, especially involving more frequent use of social media, longer duration of exercising, and more restrictive eating. They supposed an increase in social media consumption, a perceived "loss of control", and a lack of in-person assessments and weight controls as the main contributing factors for the deterioration in AN numbers and symptomatology. CONCLUSIONS The COVID-19 pandemic seems to have had a deep impact on symptom severity in AN, which is mirrored by a large increase in admission rates across Europe. An increase in exercise, social media consumption, a perceived "loss of control", and a lack of face-to-face health care seem to have contributed to this development. Further investigation is required to identify which factors may lead to the increase in incidence and deterioration of childhood and adolescent AN. Possible preventive means for the future could include educating paediatricians and health care workers about AN, regular weight assessment, and home-based treatments.
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Affiliation(s)
- Susanne Gilsbach
- grid.1957.a0000 0001 0728 696XDepartment of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 21, 52064 Aachen, Germany
| | - Maria Teresa Plana
- Child and Adolescent Psychiatry and Psychology Department, IDIBAPS, CIBERSAM, Institute Clínic of Neurosciences, Hospital Clínic of Barcelona, University of Barcelona, C. de Villarroel, 170, I2017SGR88108036 Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, IDIBAPS, CIBERSAM, Institute Clínic of Neurosciences, Hospital Clínic of Barcelona, University of Barcelona, C. de Villarroel, 170, I2017SGR88108036 Barcelona, Spain
| | - Michela Gatta
- Children and Adolescents Neuropsychiatry Unit, Woman and Child Health Department, University Hospital of Padova, University of Padova, Via VIII Febbraio, 2, 35122 Padua, PD Italy
| | - Gunilla Paulson Karlsson
- grid.1649.a000000009445082XEating Disorder Center Children & Young Adults, The Sahlgrenska University Hospital, University of Gothenburg, Vitaminvägen 17, 416 50 Göteborg, Sweden
| | - Itziar Flamarique
- Child and Adolescent Psychiatry and Psychology Department, IDIBAPS, CIBERSAM, Institute Clínic of Neurosciences, Hospital Clínic of Barcelona, University of Barcelona, C. de Villarroel, 170, I2017SGR88108036 Barcelona, Spain
| | - Jean-Philippe Raynaud
- Service Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, CHU de Toulouse, Hôpital Purpan, Université de Toulouse, Place du Docteur Baylac, 31059 Toulouse cedex 9, France
| | - Anna Riva
- grid.415025.70000 0004 1756 8604Child and Adolescent Mental Health, San Gerardo Hospital, University of Milano Bicocca, Via G. B. Pergolesi, 33, 20900 Monza, MB Italy
| | - Anne-Line Solberg
- grid.1649.a000000009445082XEating Disorder Center Children & Young Adults, The Sahlgrenska University Hospital, University of Gothenburg, Vitaminvägen 17, 416 50 Göteborg, Sweden
| | - Annemarie A. van Elburg
- grid.5477.10000000120346234Faculty of Social Sciences, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands ,Centre for Eating Disorders, Altrecht Mental Health Institute, Rintveld, 3705WE Zeist, The Netherlands
| | - Elisabet Wentz
- grid.1649.a000000009445082XDepartment of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Ätstörningsmottagning Högsbo, Sahlgrenska University Hospital, Lilla Kapplandsgatan 26B, 421 37 Västra Frölunda, Sweden
| | - Renata Nacinovich
- grid.415025.70000 0004 1756 8604Child and Adolescent Mental Health, San Gerardo Hospital, University of Milano Bicocca, Via G. B. Pergolesi, 33, 20900 Monza, MB Italy
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 21, 52064, Aachen, Germany.
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Janssen J, Alloza C, Díaz-Caneja CM, Santonja J, Pina-Camacho L, Gordaliza PM, Fernández-Pena A, Lois NG, Buimer EEL, van Haren NEM, Cahn W, Vieta E, Castro-Fornieles J, Bernardo M, Arango C, Kahn RS, Hulshoff Pol HE, Schnack HG. Longitudinal Allometry of Sulcal Morphology in Health and Schizophrenia. J Neurosci 2022; 42:3704-3715. [PMID: 35318286 PMCID: PMC9087719 DOI: 10.1523/jneurosci.0606-21.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 11/21/2022] Open
Abstract
Scaling between subcomponents of folding and total brain volume (TBV) in healthy individuals (HIs) is allometric. It is unclear whether this is true in schizophrenia (SZ) or first-episode psychosis (FEP). This study confirmed normative allometric scaling norms in HIs using discovery and replication samples. Cross-sectional and longitudinal diagnostic differences in folding subcomponents were then assessed using an allometric framework. Structural imaging from a longitudinal (Sample 1: HI and SZ, nHI Baseline = 298, nSZ Baseline = 169, nHI Follow-up = 293, nSZ Follow-up = 168, totaling 1087 images, all individuals ≥ 2 images, age 16-69 years) and a cross-sectional sample (Sample 2: nHI = 61 and nFEP = 89, age 10-30 years), all human males and females, is leveraged to calculate global folding and its nested subcomponents: sulcation index (SI, total sulcal/cortical hull area) and determinants of sulcal area: sulcal length and sulcal depth. Scaling of SI, sulcal area, and sulcal length with TBV in SZ and FEP was allometric and did not differ from HIs. Longitudinal age trajectories demonstrated steeper loss of SI and sulcal area through adulthood in SZ. Longitudinal allometric analysis revealed that both annual change in SI and sulcal area was significantly stronger related to change in TBV in SZ compared with HIs. Our results detail the first evidence of the disproportionate contribution of changes in SI and sulcal area to TBV changes in SZ. Longitudinal allometric analysis of sulcal morphology provides deeper insight into lifespan trajectories of cortical folding in SZ.SIGNIFICANCE STATEMENT Psychotic disorders are associated with deficits in cortical folding and brain size, but we lack knowledge of how these two morphometric features are related. We leverage cross-sectional and longitudinal samples in which we decompose folding into a set of nested subcomponents: sulcal and hull area, and sulcal depth and length. We reveal that, in both schizophrenia and first-episode psychosis, (1) scaling of subcomponents with brain size is different from expected scaling laws and (2) caution is warranted when interpreting results from traditional methods for brain size correction. Longitudinal allometric scaling points to loss of sulcal area as a principal contributor to loss of brain size in schizophrenia. These findings advance the understanding of cortical folding atypicalities in psychotic disorders.
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Affiliation(s)
- Joost Janssen
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Ciber del Área de Salud Mental, 28007 Madrid, Spain
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Ciber del Área de Salud Mental, 28007 Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Ciber del Área de Salud Mental, 28007 Madrid, Spain
- School of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Javier Santonja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
| | - Laura Pina-Camacho
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Ciber del Área de Salud Mental, 28007 Madrid, Spain
- School of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Pedro M Gordaliza
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Madrid, Spain
| | - Alberto Fernández-Pena
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Madrid, Spain
| | - Noemi González Lois
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
| | - Elizabeth E L Buimer
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Sophia Children's Hospital, 3015 GD Rotterdam, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Eduard Vieta
- Ciber del Área de Salud Mental, 28007 Madrid, Spain
- Bipolar Disorders Unit, Clinical Institute of Neurosciences, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, 08036 Barcelona, Spain
| | - Josefina Castro-Fornieles
- Ciber del Área de Salud Mental, 28007 Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Clinical Institute of Neurosciences, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, 08036 Barcelona, Spain
| | - Miquel Bernardo
- Ciber del Área de Salud Mental, 28007 Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, 08036 Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Ciber del Área de Salud Mental, 28007 Madrid, Spain
- School of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - René S Kahn
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 10029 New York
| | - Hilleke E Hulshoff Pol
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Hugo G Schnack
- Department of Psychiatry, UMCU Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
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Rodríguez-Toscano E, Martínez K, Fraguas D, Janssen J, Pina-Camacho L, Arias B, Vieta E, Mezquida G, Amoretti S, Bernardo M, Castro-Fornieles J, Cuesta-Zorita MJ, Lobo A, González-Pinto A, Collado IC, Mané A, Arango C, Parellada M. Prefrontal abnormalities, executive dysfunction and symptoms severity are modulated by COMT Val 158Met polymorphism in first episode psychosis. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:74-87. [PMID: 35840287 DOI: 10.1016/j.rpsmen.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/06/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Core dysfunctions proposed for psychotic disorders include prefrontal cortex (PFC) dopaminergic hypoactivity, executive function (EF) deficits and reduced gray matter in the PFC. The Val variant of COMT Val158Met polymorphism is associated with reduced dopaminergic signaling in the PFC. However, it is unclear how COMT Val158Met modulates PFC gray matter reduction, EF deficits and symptom severity at the time of the first psychotic episode. METHODS The effect of COMT on both EF performance and prefrontal volume (PFC-VOL) was tested in 158 first episode psychosis (FEP) patients and 141 healthy controls (HC) matched for age (range 9-35 years), sex, ethnicity, handedness and COMT Val158Met distribution. EF and PFC-VOL were compared between FEP and HC groups within each polymorphism status (Met/Met versus Val carriers) to assess whether COMT influenced diagnostic differences. Next, correlations between PFC-VOL and EF performance were computed, as well as between both variables and other clinical characteristics of interest (PANSS scores, PAS infancy and premorbid IQ) in the FEP sample. RESULTS COMT influenced the diagnostic differences mainly in PFC-VOL, but also in EF performance. FEP-Val carriers showed lower EF scores and reduced PFC-VOL compared to the HC group but also poorer EF performance than FEP Met/Met. Poorer EF performance was associated with smaller PFC-VOL, and both were related to increased severity of negative symptoms, poorer premorbid adjustment, and lower estimated premorbid IQ in FEP patients. CONCLUSIONS Our findings suggest that COMT Val158Met polymorphism might contribute to PFC-VOL reductions, executive dysfunctions and symptom severity in FEP patients.
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Affiliation(s)
- Elisa Rodríguez-Toscano
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Experimental Psychology, Cognitive Psychology and Speech & Language Therapy Immunology, Faculty of Psychology, Universidad Complutense Madrid, Spain.
| | - Kenia Martínez
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain
| | - David Fraguas
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Joost Janssen
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain
| | - Laura Pina-Camacho
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Bárbara Arias
- Departament Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Institut de Biomedicina de la Universitat de Barcelona (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, Spain
| | - Eduard Vieta
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Gisela Mezquida
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Spain
| | - Silvia Amoretti
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Spain
| | - Miguel Bernardo
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain
| | - Manuel Jesús Cuesta-Zorita
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Zaragoza University, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, CIBERSAM, Madrid, Spain
| | - Ana González-Pinto
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Department of Neurociences, University of the Basque Country, Vitoria, Spain
| | - Iluminada Corripio Collado
- Department of Psychiatry, Sant Pau Hospital, Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Anna Mané
- Ciber del Area de Salud Mental (CIBERSAM), Spain; Hospital del Mar Medical Research Institute (IMIM), Spain; Autonomous University of Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; Ciber del Area de Salud Mental (CIBERSAM), Spain; School of Medicine, Universidad Complutense, Madrid, Spain
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35
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Guasp M, Martín-Aguilar L, Sabater L, Bioque M, Armangué T, Martínez-Hernández E, Landa J, Maudes E, Borràs R, Muñoz-Lopetegi A, Saiz A, Castro-Fornieles J, Graus F, Parellada E, Querol L, Dalmau J. Neurofilament Light Chain Levels in Anti-NMDAR Encephalitis and Primary Psychiatric Psychosis. Neurology 2022; 98:e1489-e1498. [PMID: 35145006 DOI: 10.1212/wnl.0000000000200021] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION An important challenge in diagnosing anti-NMDAR encephalitis (NMDARe) is differentiating it from a first episode of psychosis (FEP) caused by a psychiatric disease (pFEP). CSF antibody testing distinguishes these diseases, but spinal taps are difficult to obtain in psychiatric facilities. A separate problem is the lack of biomarkers of NMDARe severity and outcome. Here we assessed the performance of neurofilament light chain (NfL) testing in these settings. METHODS In this observational study, NfL were determined with Single molecule array (SiMoA) in patients with NMDARe, pFEP, herpes simplex encephalitis (HSE), and healthy subjects (HC), the latter two groups used as controls. Receiver operating characteristic (ROC) analyses were performed to assess the prediction accuracy of serum NfL (sNfL) levels for NMDARe and pFEP, and to obtain clinically useful cutoffs. RESULTS 118 patients with NMDARe (33 with isolated psychosis at presentation), 45 pFEP, 36 HSE, and 36 HC were studied. NMDARe patients with seizures/status epilepticus, ICU admission, CSF pleocytosis (>20 WBC/µL), and without early immunotherapy were more likely to have higher sNfL than NMDARe without these features. NfL levels at diagnosis of NMDARe did not correlate with outcome at 1 year follow-up assessed with the modified Ranking Scale (mRS). NMDARe patients had significantly higher NfL than pFEP and HC, and lower than HSE patients. ROC analysis of sNfL between NMDARe with isolated psychosis and pFEP provided an AUC of 0.93 (95% CI 0.87-0.99) and a sNfL cutoff ≥15 pg/mL to distinguish these disorders (sensitivity 85%, specificity 96%, positive likelihood ratio 19.3). Forty-three/45 (96%) pFEP had sNfL<15pg/mL whereas only 5/33 (15%) NMDARe with isolated psychosis were below this cutoff (risk estimation NMDARe vs pFEP: odds ratio 120.4 [95% CI 21.8-664], p<0.001). None of the HSE and 35/36 (97%) HC had sNfL<15pg/mL. DISCUSSION NfL measured at diagnosis of NMDARe associated with features of disease severity but not with long-term outcome. Young patients with FEP and sNfL≥15pg/mL had 120 times higher chance of having NMDARe than pFEP. This cutoff correctly classified 96% of pFEP and 85% of NMDARe with isolated psychosis. Patients with FEP of unclear etiology and sNfL≥15pg/mL should undergo CSF NMDAR-antibody testing.
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Affiliation(s)
- Mar Guasp
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Neurology Department, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - Lorena Martín-Aguilar
- Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | - Lidia Sabater
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - Miquel Bioque
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit (BCSU), Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.,Department of Medicine, University of Barcelona, Spain.,Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Spain
| | - Thaís Armangué
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Pediatric Neuroimmunology Unit, Department of Neurology, Sant Joan de Déu (SJD) Children's Hospital, University of Barcelona, Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Eugenia Martínez-Hernández
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Neurology Department, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - Jon Landa
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Estíbaliz Maudes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Roger Borràs
- Medical Statistics Core Facility, Hospital Clínic, Barcelona, Spain
| | - Amaia Muñoz-Lopetegi
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Neurology Department, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Albert Saiz
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Neurology Department, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.,Department of Medicine, University of Barcelona, Spain
| | - Josefina Castro-Fornieles
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Department of Medicine, University of Barcelona, Spain.,Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Spain.,Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Francesc Graus
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Eduard Parellada
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Barcelona Clínic Schizophrenia Unit (BCSU), Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.,Department of Medicine, University of Barcelona, Spain.,Centro de Investigación Biomédica en Red, Salud Mental (CIBERSAM), Spain
| | - Luis Querol
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain.,Neuromuscular Diseases Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | - Josep Dalmau
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Neurology Department, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain.,Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Catalan Institute for Research and Advanced Studies (ICREA), Barcelona, Spain
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Camprodon-Boadas P, la Serna ED, Baeza I, Ilzarbe D, Puig O, Andrés-Perpiñá S, Sugranyes G, Castro-Fornieles J. Psychometric Properties of the Cognitive Reserve Questionnaire for Adolescents (CoRe-A). Revista de Psiquiatría y Salud Mental 2022. [DOI: 10.1016/j.rpsm.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Aggensteiner PM, Holz NE, Böttinger BW, Baumeister S, Hohmann S, Werhahn JE, Naaijen J, Ilbegi S, Glennon JC, Hoekstra PJ, Dietrich A, Deters RK, Saam MC, Schulze UME, Lythgoe DJ, Sethi A, Craig MC, Mastroianni M, Sagar-Ouriaghli I, Santosh PJ, Rosa M, Bargallo N, Castro-Fornieles J, Arango C, Penzol MJ, Vidal J, Franke B, Zwiers MP, Buitelaar JK, Walitza S, Banaschewski T, Brandeis D. The effects of callous-unemotional traits and aggression subtypes on amygdala activity in response to negative faces. Psychol Med 2022; 52:476-484. [PMID: 32624021 DOI: 10.1017/s0033291720002111] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Brain imaging studies have shown altered amygdala activity during emotion processing in children and adolescents with oppositional defiant disorder (ODD) and conduct disorder (CD) compared to typically developing children and adolescents (TD). Here we aimed to assess whether aggression-related subtypes (reactive and proactive aggression) and callous-unemotional (CU) traits predicted variation in amygdala activity and skin conductance (SC) response during emotion processing. METHODS We included 177 participants (n = 108 cases with disruptive behaviour and/or ODD/CD and n = 69 TD), aged 8-18 years, across nine sites in Europe, as part of the EU Aggressotype and MATRICS projects. All participants performed an emotional face-matching functional magnetic resonance imaging task. RESULTS Differences between cases and TD in affective processing, as well as specificity of activation patterns for aggression subtypes and CU traits, were assessed. Simultaneous SC recordings were acquired in a subsample (n = 63). Cases compared to TDs showed higher amygdala activity in response to negative faces (fearful and angry) v. shapes. Subtyping cases according to aggression-related subtypes did not significantly influence on amygdala activity; while stratification based on CU traits was more sensitive and revealed decreased amygdala activity in the high CU group. SC responses were significantly lower in cases and negatively correlated with CU traits, reactive and proactive aggression. CONCLUSIONS Our results showed differences in amygdala activity and SC responses to emotional faces between cases with ODD/CD and TD, while CU traits moderate both central (amygdala) and peripheral (SC) responses. Our insights regarding subtypes and trait-specific aggression could be used for improved diagnostics and personalized treatment.
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Affiliation(s)
- Pascal-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Boris W Böttinger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Shahrzad Ilbegi
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Renee Kleine Deters
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Germany
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Germany
| | - David J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Arjun Sethi
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael C Craig
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mathilde Mastroianni
- Department of Child Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ilyas Sagar-Ouriaghli
- Department of Child Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paramala J Santosh
- Department of Child Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mireia Rosa
- Clinic Image Diagnostic Center (CDIC), Hospital Clinic of Barcelona; Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Nuria Bargallo
- Clinic Image Diagnostic Center (CDIC), Hospital Clinic of Barcelona; Magnetic Resonance Image Core Facility, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Maria J Penzol
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Jorge Vidal
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Marcel P Zwiers
- Radboud University, Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
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Flamarique I, Vidal B, Plana MT, Andrés-Perpiñá S, Gárriz M, Sánchez P, Pajuelo C, Mont L, Castro-Fornieles J. Long-term cardiac assessment in a sample of adolescent-onset anorexia nervosa. J Eat Disord 2022; 10:12. [PMID: 35101147 PMCID: PMC8802465 DOI: 10.1186/s40337-022-00533-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/19/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND High mortality rates have been reported in patients with anorexia nervosa, mainly due to cardiovascular alterations. The purpose of the present study was to assess cardiac structural and functional abnormalities some 20 years after initial treatment in a sample of adolescent-onset anorexia nervosa (A-AN) and to compare them with matched healthy controls (HC). METHODS A sample of 29 women diagnosed and treated for AN during adolescence (A-AN) were assessed more than 20 years later. A complete cardiac evaluation was carried out including an electrocardiogram (ECG) and a standard 2D echocardiography. Thirty matched HC were also assessed. RESULTS In the A-AN group, four subjects had a body mass index lower than 18.5 and met full DSM 5 criteria for AN at follow-up (Low-Weight group). They were compared with the rest of the sample (n = 25) who had normalized their weight (Normal-Weight group), though some still showed some eating disorder symptoms. Both groups were compared with the HC group. Subjects in the Low-Weight group presented statistically significant decreases in the left ventricular end-diastolic and left atrium dimensions and left ventricular mass in comparison with the Normal-Weight group and the HC. No other differences in cardiac parameters were found between groups. CONCLUSIONS Echocardiographic and ECG parameters of adults who had presented A-AN twenty years earlier and currently maintained normal weight were similar to those of HC who had never been treated or diagnosed with AN. Adult subjects with A-AN who still had low weight in the long term present certain cardiac abnormalities similar to those seen in short-lasting disease. More studies are needed to confirm these results in a larger sample.
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Affiliation(s)
- I Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Clinic Institute of Neurosciences, Hospital Clínic Universitari de Barcelona, IDIBAPS, CIBERSAM, C/Villarroel, 170, 08036, Barcelona, Spain.
| | - B Vidal
- Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Instituto de Salud Carlos III (CB16/11/00354), CIBERCV, Madrid, Spain
| | - M T Plana
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Clinic Institute of Neurosciences, Hospital Clínic Universitari de Barcelona, IDIBAPS, CIBERSAM, C/Villarroel, 170, 08036, Barcelona, Spain
| | - S Andrés-Perpiñá
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Clinic Institute of Neurosciences, Hospital Clínic Universitari de Barcelona, IDIBAPS, CIBERSAM, C/Villarroel, 170, 08036, Barcelona, Spain
| | - M Gárriz
- Institute of Neuropsychiatry and Addictions, Parc de Salut Mar de Barcelona, Llull, 410, 08019, Barcelona, Spain
| | - P Sánchez
- Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Instituto de Salud Carlos III (CB16/11/00354), CIBERCV, Madrid, Spain
| | - C Pajuelo
- Department of Cardiology, Hospital Plató, Barcelona, Spain
| | - L Mont
- Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Instituto de Salud Carlos III (CB16/11/00354), CIBERCV, Madrid, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - J Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Clinic Institute of Neurosciences, Hospital Clínic Universitari de Barcelona, IDIBAPS, CIBERSAM, C/Villarroel, 170, 08036, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
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Rosa-Justicia M, Saam MC, Flamarique I, Borràs R, Naaijen J, Dietrich A, Hoekstra PJ, Banaschewski T, Aggensteiner P, Craig MC, Sethi A, Santosh P, Sagar-Ouriaghli I, Arango C, Penzol MJ, Brandeis D, Werhahn JE, Glennon JC, Franke B, Zwiers MP, Buitelaar JK, Schulze UME, Castro-Fornieles J. Subgrouping children and adolescents with disruptive behaviors: symptom profiles and the role of callous-unemotional traits. Eur Child Adolesc Psychiatry 2022; 31:51-66. [PMID: 33147348 DOI: 10.1007/s00787-020-01662-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
Disruptive behavior during childhood and adolescence is heterogeneous and associated with several psychiatric disorders. The identification of more homogeneous subgroups might help identify different underlying pathways and tailor treatment strategies. Children and adolescents (aged 8-18) with disruptive behaviors (N = 121) and healthy controls (N = 100) were included in a European multi-center cognition and brain imaging study. They were assessed via a battery of standardized semi-structured interviews and questionnaires. K-means cluster-model analysis was carried out to identify subgroups within the group with disruptive behaviors, based on clinical symptom profiles, callous-unemotional (CU) traits, and proactive and reactive aggression. The resulting subgroups were then compared to healthy controls with regard to these clinical variables. Three distinct subgroups were found within the group with disruptive behaviors. The High CU Traits subgroup presented elevated scores for CU traits, proactive aggression and conduct disorder (CD) symptoms, as well as a higher proportion of comorbidities (CD + oppositional defiant disorder + attention deficit hyperactivity disorder (ADHD). The ADHD and Affective Dysregulation subgroup showed elevated scores for internalizing and ADHD symptoms, as well as a higher proportion of females. The Low Severity subgroup had relatively low levels of psychopathology and aggressive behavior compared to the other two subgroups. The High CU Traits subgroup displayed more antisocial behaviors than the Low Severity subgroup, but did not differ when compared to the ADHD and Affective Dysregulation subgroup. All three subgroups differed significantly from the healthy controls in all the variables analyzed. The present study extends previous findings on subgrouping children and adolescents with disruptive behaviors using a multidimensional approach and describes levels of anxiety, affective problems, ADHD, proactive aggression and CU traits as key factors that differentiate conclusively between subgroups.
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Affiliation(s)
- Mireia Rosa-Justicia
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Itziar Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, CIBERSAM, Barcelona, Spain
| | - Roger Borràs
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Pascal Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Michael C Craig
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Arjun Sethi
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Paramala Santosh
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Ilyas Sagar-Ouriaghli
- Department of Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - María José Penzol
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry, University of Groningen Medical Center, Groningen, The Netherlands.,Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel P Zwiers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University Hospital, University of Ulm, Ulm, Germany
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain.
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Romero S, de la Serna E, Baeza I, Valli I, Pariente JC, Picado M, Bargalló N, Sugranyes G, Castro-Fornieles J. Altered White Matter Integrity at Illness Onset in Adolescents With a First Episode of Psychosis. Front Psychiatry 2022; 13:876793. [PMID: 35619614 PMCID: PMC9127302 DOI: 10.3389/fpsyt.2022.876793] [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: 02/15/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Disruption in white matter integrity has been consistently observed in individuals with psychosis. However, whether such abnormalities are already present at illness onset or are related to downstream processes remains elusive. The study of adolescents with a recent onset of psychosis provides the opportunity to evaluate white matter integrity proximally to disease onset. METHODS Twenty-six adolescents (aged 15.9 ± 1.3 years) with a first episode of psychosis (FEP) (less than 6 months duration) were compared with 26 age and sex-matched healthy controls (HC) (16.8 ± 2 years). In participants with a FEP, clinical diagnoses were confirmed after a minimum of 1 year follow-up (main categories: schizophrenia, bipolar disorder, or schizoaffective disorder). Anatomical images and diffusion tensor sequences were acquired using a 1.5T scanner. Whole brain, voxel-wise group differences in fractional anisotropy (FA) were investigated between participants with a FEP and controls. RESULTS Relative to HC, FEP participants displayed decreased FA in the right posterior cingulate gyrus, encompassing the right superior and posterior corona radiata, and the right parahippocampal gyrus, including the cingulum and fornix. FEP patients showed no areas of increased FA relative to HC. The results remained significant after controlling for medication, cannabis use and intelligence. CONCLUSION Our findings indicate that adolescents with recent onset of psychotic disorders show decreased white matter integrity in circuits implicated in cognitive functions and emotion regulation.
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Affiliation(s)
- Soledad Romero
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Isabel Valli
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - José Carlos Pariente
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marisol Picado
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain
| | - Nuria Bargalló
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Image Diagnostic Center, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
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41
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Camprodon-Boadas P, de la Serna E, Baeza I, Puig O, Ilzarbe D, Sugranyes G, Borras R, Castro-Fornieles J. Cognitive reserve in patients with first-episode psychosis as outcome predictor at 5-year follow-up. Eur Child Adolesc Psychiatry 2021; 30:1959-1967. [PMID: 33113026 DOI: 10.1007/s00787-020-01668-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 10/18/2020] [Indexed: 12/13/2022]
Abstract
Cognitive reserve (CR) is the premorbid brain capacity to cope with neural damage. People with good CR can tolerate higher levels of pathological brain injuries before displaying clinical symptoms than others. This study aimed to analyze CR in a sample of patients diagnosed with first-episode psychosis (FEP) during childhood or adolescence, comparing them to a community control group (CC) and assessing the predictive value of CR regarding psychosocial functioning, clinical symptoms and neuropsychological variables at the 5-year follow-up. 57 patients diagnosed with FEP during childhood or adolescence and 37 controls completed clinical, neuropsychological, and psychosocial functioning assessments at baseline and 5-year follow-up. CR was assessed in both groups at baseline. The FEP group showed lower CR scores than the CC group. Higher CR in the FEP group was associated with fewer psychotic negative symptoms, total psychotic symptoms and depressive symptoms, higher psychosocial functioning, and less impaired memory and attention at the 5-year follow-up. CR is associated with long-term clinical, neuropsychological and psychosocial functioning outcomes in patients diagnosed with FEP during childhood or adolescence.
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Affiliation(s)
- Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Fundació Clínic Per a La Recerca Biomèdica, Barcelona, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Olga Puig
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Daniel Ilzarbe
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain
| | - Roger Borras
- Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Villarroel, 170, 08036, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. .,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain. .,Department of Medicine, University of Barcelona, Barcelona, Spain.
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Rodríguez-Toscano E, Martínez K, Fraguas D, Janssen J, Pina-Camacho L, Arias B, Vieta E, Mezquida G, Amoretti S, Bernardo M, Castro-Fornieles J, Cuesta-Zorita MJ, Lobo A, González-Pinto A, Collado IC, Mané A, Arango C, Parellada M. Prefrontal abnormalities, executive dysfunction and symptoms severity are modulated by COMT Val158Met polymorphism in first episode psychosis. Revista de Psiquiatría y Salud Mental 2021. [DOI: 10.1016/j.rpsm.2021.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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43
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Baeza I, de la Serna E, Amoretti S, Cuesta MJ, Díaz-Caneja CM, Mezquida G, Lobo A, González-Pinto A, Corripio I, Vieta E, Puig O, Legido T, Bioque M, García-Rizo C, Bernardo M, Castro-Fornieles J. Premorbid Characteristics as Predictors of Early Onset Versus Adult Onset in Patients With a First Episode of Psychosis. J Clin Psychiatry 2021; 82. [PMID: 34529899 DOI: 10.4088/jcp.21m13907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 10/20/2022]
Abstract
Objective: To study the differences in early-life characteristics between patients with an early onset of psychotic disorders (EOP, aged < 18 years) versus adult onset of psychotic disorders (AOP, aged ≥ 18 years) and to identify predictors of earlier onset. Methods: 278 patients with a first episode of psychosis between the ages of 7 and 35 years were recruited as part of a multicenter prospective longitudinal study conducted in Spain between January 1, 2009, and December 31, 2011, with diagnoses made for AOP using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and for EOP using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS). Early-stage factors such as prenatal, perinatal, and other premorbid factors were registered and compared between EOP and AOP patients. To analyze the association between baseline variables and outcome, univariate and multivariate logistic regression models were used, and the association or odds ratios (ORs) for significant risk factors were calculated. Results: 224 patients with AOP (mean ± SD age = 25.6 ± 5.0 years; 65.6% male) and 54 patients with EOP (16.1 ± 1.7 years; 68.5% male) were included. Univariate analysis revealed significant differences between the groups. Specifically, compared to AOP subjects, EOP patients had more frequent obstetric complications (OCs) (P < .001), birth weight < 2.500 g (P < .028), a background of any personal psychiatric disorder (P < .001), a previous diagnosis of attention-deficit/hyperactivity disorder (P = .001), and premorbid IQ < 85 (P < .001). In the multivariate model, only OCs (OR = 5.44), personal psychiatric background (OR = 4.05), and IQ < 85 (OR = 3.96) predicted an onset of the first episode of psychosis before age 18 years. Conclusions: Premorbid factors such as OCs, personal psychiatric background, and IQ < 85 could help predict which patients are more likely to have an early onset of psychosis. Awareness of these factors could help clinicians work to prevent the early transition to psychosis in children and adolescents.
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Affiliation(s)
- Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, SGR-881, Hospital Clínic de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Corresponding author: Inmaculada Baeza, MD, PhD, Department of Child and Adolescent Psychiatry and Psychology, Institut Clínic of Neurosciences, Hospital Clínic Universitari, Barcelona, Villarroel, 170, Barcelona 08036, Spain
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, SGR-881, Hospital Clínic de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
| | - Silvia Amoretti
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Covadonga M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid
| | - Gisela Mezquida
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Antonio Lobo
- Hospital Clínico Universitario and Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Department of Psychiatry, BIOARABA, UPV/EHU, Vitoria, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic, Barcelona, Spain
| | - Olga Puig
- Child and Adolescent Psychiatry and Psychology Department, SGR-881, Hospital Clínic de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
| | | | - Miquel Bioque
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Clemente García-Rizo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Miquel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain.,Universitat de Barcelona, Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, SGR-881, Hospital Clínic de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
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- Members of the PEPs Group are listed at the end of the article
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Sugranyes G, de la Serna E, Ilzarbe D, Pariente JC, Borras R, Romero S, Rosa M, Baeza I, Moreno MD, Bernardo M, Vieta E, Castro-Fornieles J. Brain structural trajectories in youth at familial risk for schizophrenia or bipolar disorder according to development of psychosis spectrum symptoms. J Child Psychol Psychiatry 2021; 62:780-789. [PMID: 32951255 DOI: 10.1111/jcpp.13321] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/30/2020] [Accepted: 07/24/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND The evaluation of child and adolescent offspring of patients with schizophrenia (SzO) or bipolar disorder (BpO) may help understand changes taking place in the brain in individuals at heightened risk for disease during a key developmental period. METHODS One hundred twenty-eight individuals (33 SzO and 46 BpO, considered jointly as 'Familial High Risk' (FHR), and 49 controls) aged 6-17 years underwent clinical, cognitive and neuroimaging assessment at baseline, 2- and 4-year follow-up. Twenty FHR participants (11 SzO and 9 BpO) developed psychotic spectrum symptoms during follow-up, while 59 FHR participants did not. Magnetic resonance imaging was performed on a 3Tesla scanner; cortical surface reconstruction was applied to measure cortical thickness, surface area and grey matter volume. RESULTS FHR participants who developed psychotic spectrum symptoms over time showed greater time-related mean cortical thinning than those who did not and than controls. By subgroups, this effect was present in both BpO and SzO in the occipital cortex. At baseline, FHR participants who developed psychotic spectrum symptoms over time had smaller total surface area and grey matter volume than those who did not and than controls. Over time, all FHR participants showed less longitudinal decrease in surface area than controls. In those who developed psychotic spectrum symptoms over time, this effect was driven by BpO, while in those who did not, this was due to SzO, who also showed less grey matter volume reduction. CONCLUSION The emergence of psychotic spectrum symptoms in FHR was indexed by smaller cross-sectional surface area and progressive cortical thinning. Relative preservation of surface area over time may signal different processes according to familial risk. These findings lay the foundation for future studies aimed at stratification of FHR youth.
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Affiliation(s)
- Gisela Sugranyes
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center Consortium (CIBERSAM), Madrid, Spain
| | - Elena de la Serna
- Biomedical Research Networking Center Consortium (CIBERSAM), Madrid, Spain
| | - Daniel Ilzarbe
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain
| | | | - Roger Borras
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Soledad Romero
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center Consortium (CIBERSAM), Madrid, Spain
| | - Mireia Rosa
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Inmaculada Baeza
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center Consortium (CIBERSAM), Madrid, Spain.,Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain
| | - Maria Dolores Moreno
- Biomedical Research Networking Center Consortium (CIBERSAM), Madrid, Spain.,Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Miguel Bernardo
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Biomedical Research Networking Center Consortium (CIBERSAM), Madrid, Spain.,Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain.,Department of Psychiatry and Clinical Psychology Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Eduard Vieta
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Biomedical Research Networking Center Consortium (CIBERSAM), Madrid, Spain.,Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain.,Department of Psychiatry and Clinical Psychology Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center Consortium (CIBERSAM), Madrid, Spain.,Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain
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45
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Fortea A, Batalla A, Radua J, van Eijndhoven P, Baeza I, Albajes-Eizagirre A, Fusar-Poli P, Castro-Fornieles J, De la Serna E, Luna LP, Carvalho AF, Vieta E, Sugranyes G. Cortical gray matter reduction precedes transition to psychosis in individuals at clinical high-risk for psychosis: A voxel-based meta-analysis. Schizophr Res 2021; 232:98-106. [PMID: 34029948 DOI: 10.1016/j.schres.2021.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 01/20/2021] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 01/10/2023]
Abstract
Gray matter and cortical thickness reductions have been documented in individuals at clinical high-risk for psychosis and may be more pronounced in those who transition to psychosis. However, these findings rely on small samples and are inconsistent across studies. In this review and meta-analysis we aimed to investigate neuroanatomical correlates of clinical high-risk for psychosis and potential predictors of transition, using a novel meta-analytic method (Seed-based d Mapping with Permutation of Subject Images) and cortical mask, combining data from surface-based and voxel-based morphometry studies. Individuals at clinical high-risk for psychosis who later transitioned to psychosis were compared to those who did not and to controls, and included three statistical maps. Overall, individuals at clinical high-risk for psychosis did not differ from controls, however, within the clinical high-risk for psychosis group, transition to psychosis was associated with less cortical gray matter in the right temporal lobe (Hedges' g = -0.377), anterior cingulate and paracingulate (Hedges' g = -0.391). These findings have the potential to help refine prognostic and etiopathological research in early psychosis.
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Affiliation(s)
- Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Fundació Clínic per a la Recerca Biomèdica (FCRB), Esther Koplowitz Centre, Rosselló 153, 08036 Barcelona, Spain; Medicina i Recerca Traslacional, University of Barcelona, Casanova 143, 08036 Barcelona, Spain.
| | - Albert Batalla
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Center for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Philip van Eijndhoven
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behavior, Center for Cognitive Neuroimaging, Nijmegen, the Netherlands.
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Medicina i Recerca Traslacional, University of Barcelona, Casanova 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Anton Albajes-Eizagirre
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Medicina i Recerca Traslacional, University of Barcelona, Casanova 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Elena De la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
| | - Licia P Luna
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Division of Neuroradiology, 600 N Wolfe Street Phipps B100F, 21287 Baltimore, MD, USA
| | - André F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Center of Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Barcelona Bipolar Disorders and Depressive Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain.
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Fundació Clínic per a la Recerca Biomèdica (FCRB), Esther Koplowitz Centre, Rosselló 153, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló 149, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.
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46
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Guasp M, Giné-Servén E, Maudes E, Rosa-Justicia M, Martínez-Hernández E, Boix-Quintana E, Bioque M, Casado V, Módena-Ouarzi Y, Guanyabens N, Muriana D, Sugranyes G, Pacchiarotti I, Davi-Loscos E, Torres-Rivas C, Ríos J, Sabater L, Saiz A, Graus F, Castro-Fornieles J, Parellada E, Dalmau J. Clinical, Neuroimmunologic, and CSF Investigations in First Episode Psychosis. Neurology 2021; 97:e61-e75. [PMID: 33980703 DOI: 10.1212/wnl.0000000000012191] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/26/2021] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To report the neuropsychiatric features and frequency of NMDA receptor (NMDAR) and other neuronal immunoglobulin G antibodies in patients with first episode psychosis (FEP) and to assess the performance of reported warning signs and criteria for autoimmune psychosis (AP). METHODS This was a prospective observational study of patients with FEP assessed for neuropsychiatric symptoms, serum and CSF neuronal antibodies (brain immunohistochemistry, cell-based assays, live neurons), and warning signs and criteria of AP. Previous autoimmune FEP series were reviewed. RESULTS One hundred five patients were included; their median age was 30 (range 14-75) years, and 44 (42%) were female. None had neuronal antibodies. Two of 105 (2%) had CSF pleocytosis, 4 of 100 (4%) had brain MRI abnormalities, and 3 of 73 (4%) EEG alterations. Thirty-four (32%) and 39 (37%) patients fulfilled 2 sets of warning signs of AP, and 21 (20%) fulfilled criteria of possible or probable AP, yet none developed AP. The cause of FEP was psychiatric in 101 (96%) and nonpsychiatric in 4 (4%). During this study, 3 patients with psychosis caused by anti-NMDAR encephalitis were transferred to our center; 2 did not meet criteria for possible AP. Of 1,159 reported patients with FEP, only 7 (1%) had CSF studies; 36 (3%) had serum NMDAR antibodies (without definite diagnosis of AP), and 4 had CSF NMDAR antibodies (3 classic anti-NMDAR encephalitis and 1 with isolated psychiatric features). CONCLUSIONS NMDAR antibodies were not found in patients with FEP unless they had anti-NMDAR encephalitis. Warning signs and criteria for AP have limited utility when neurologic symptoms are absent or paraclinical tests are normal. A diagnostic algorithm for autoimmune FEP is provided.
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Affiliation(s)
- Mar Guasp
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Eloi Giné-Servén
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Estibaliz Maudes
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Mireia Rosa-Justicia
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Eugenia Martínez-Hernández
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Ester Boix-Quintana
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Miquel Bioque
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Virginia Casado
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Yasmina Módena-Ouarzi
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Nicolau Guanyabens
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Desiree Muriana
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Gisela Sugranyes
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Isabella Pacchiarotti
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Eva Davi-Loscos
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Cristina Torres-Rivas
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - José Ríos
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Lidia Sabater
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Albert Saiz
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Francesc Graus
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Josefina Castro-Fornieles
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Eduard Parellada
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain
| | - Josep Dalmau
- From the Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (M.G., E.M., E.M.-H., M.B., Y.M.-O., G.S., I.P, L.S., A.S., F.G., J.C.-F., E.P., J.D.), Hospital Clínic, and Department of Medicine (M.B., A.S., J.C.-F., E.P.), Universitat de Barcelona; Neurology Department (M.G., E.M.-H., A.S., J.D.), Department of Child and Adolescent Psychiatry and Psychology (M.R.-J., G.S., J.C.-F.), Barcelona Clínic Schizophrenia Unit (BCSU) (M.B., E.P.), and Bipolar and Depressive Disorders Unit (I.P.), Institute of Neuroscience, Hospital Clínic; Centro de Investigación Biomédica en Red (M.G., E.M.-H., L.S., J.D.), Enfermedades Raras (CIBERER); Psychiatry Department (E.G.-S., E.B.-Q., E.D.-L.), Hospital de Mataró Consorci Sanitari del Maresme, Mataró; Centro de Investigación Biomédica en Red (M.B., G.S., I.P., J.C.-F., E.P.), Salud Mental (CIBERSAM); Neurology Department (V.C., N.G., D.M., C.T.-R.), Hospital de Mataró Consorci Sanitari del Maresme; Medical Statistics Core Facility (J.R.), IDIBAPS and Hospital Clínic, Barcelona, Spain; Department of Neurology (J.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Catalan Institute for Research and Advanced Studies (ICREA) (J.D.), Barcelona, Spain.
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47
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Salagre E, Grande I, Jiménez E, Mezquida G, Cuesta MJ, Llorente C, Amoretti S, Lobo A, González-Pinto A, Carballo JJ, Corripio I, Verdolini N, Castro-Fornieles J, Legido T, Carvalho AF, Vieta E, Bernardo M. Trajectories of suicidal ideation after first-episode psychosis: a growth mixture modeling approach. Acta Psychiatr Scand 2021; 143:418-433. [PMID: 33501646 DOI: 10.1111/acps.13279] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/08/2021] [Accepted: 01/20/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The period immediately after the onset of first-episode psychosis (FEP) may present with high risk for suicidal ideation (SI) and attempts, although this risk may differ among patients. Thus, we aimed to identify trajectories of SI in a 2-years follow-up FEP cohort and to assess baseline predictors and clinical/functional evolution for each trajectory of SI. METHODS We included 334 FEP participants with data on SI. Growth mixture modeling was used to identify trajectories of SI. Putative sociodemographic, clinical, and cognitive predictors of the distinct trajectories were examined using multinomial logistic regression. RESULTS We identified three distinct trajectories: Non-SI trajectory (85.53% sample), Improving SI trajectory (9.58%), and Worsening SI trajectory (6.89%). Multinomial logistic regression model revealed that greater baseline pessimistic thoughts, anhedonia, and worse perceived family environment were associated with higher baseline SI followed by an Improving trajectory. Older age, longer duration of untreated psychosis, and reduced sleep predicted Worsening SI trajectory. Regarding clinical/functional evolution, individuals within the Improving SI trajectory displayed moderate depression at baseline which ameliorated during the study period, while the Worsening SI subgroup exhibited persistent mild depressive symptoms and greater functional impairment at follow-up assessments. CONCLUSION Our findings delineated three distinct trajectories of SI among participants with FEP, one experiencing no SI, another in which SI might depend on acute depressive symptomatology, and a last subset where SI might be associated with mild but persistent clinical and functional impairments. These data provide insights for the early identification and tailored treatment of suicide in this at-risk population.
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Affiliation(s)
- Estela Salagre
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Iria Grande
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Esther Jiménez
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.,Department of Psychiatry, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IdiSNa), Pamplona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IdiSNa), Pamplona, Spain
| | - Cloe Llorente
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Sílvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Department of Psychiatry, Hospital Universitario de Alava, BIOARABA Health Research Institute, University of the Basque Country, Vitoria, Spain
| | - Juan José Carballo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Biomedical Research Institute Sant Pau (IIB-SANT PAU), Hospital Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clinic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, CIBERSAM, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Teresa Legido
- Neuroscience Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto, the Centre for Addiction and Mental Health, Toronto, ON, Canada.,The IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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48
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Portengen CM, Sprooten E, Zwiers MP, Hoekstra PJ, Dietrich A, Holz NE, Aggensteiner PM, Banaschewski T, Schulze UME, Saam MC, Craig MC, Sethi A, Santosh P, Ouriaghli IS, Castro-Fornieles J, Rosa M, Arango C, Penzol MJ, Werhahn JE, Brandeis D, Walitza S, Oldehinkel M, Franke B, Buitelaar JK, Naaijen J. Reward and Punishment Sensitivity are Associated with Cross-disorder Traits. Psychiatry Res 2021; 298:113795. [PMID: 33582524 DOI: 10.1016/j.psychres.2021.113795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/03/2021] [Indexed: 10/22/2022]
Abstract
Reversal learning deficits following reward and punishment processing are observed across disruptive behaviors (DB) and attention-deficit/hyperactivity disorder (ADHD), and have been associated with callous-unemotional (CU) traits. However, it remains unknown to what extent these altered reinforcement sensitivities are linked to the co-occurrence of oppositional traits, ADHD symptoms, and CU traits. Reward and punishment sensitivity and perseverative behavior were therefore derived from a probabilistic reversal learning task to investigate reinforcement sensitivity in participants with DB (n=183, ODD=62, CD=10, combined=57, age-range 8-18), ADHD (n=144, age-range 11-28), and controls (n=191, age-range 8-26). The SNAP-IV and Conners rating scales were used to assess oppositional and ADHD traits. The Inventory of CU traits was used to assess CU traits. Decreased reward sensitivity was associated with ADHD symptom severity (p=0.018) if corrected for oppositional symptoms. ADHD symptomatology interacted with oppositional behavior on perseveration (p=0.019), with the former aggravating the effect of oppositional behavior on perseveration and vice versa. Within a pooled sample, reversal learning alterations were associated with the severity of ADHD symptoms, underpinned by hyposensitivity to reward and increased perseveration. These results show ADHD traits, as opposed to oppositional behavior and CU traits, is associated with decreased reward-based learning in adolescents and adults.
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Affiliation(s)
- Christel M Portengen
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands; Department of Child and Adolescent Studies, Clinical Child and Family Studies, Utrecht University, Utrecht, The Netherlands.
| | - Emma Sprooten
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Marcel P Zwiers
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Hanzeplein 1 XA10, 9713 GZ Groningen, The Netherlands
| | - Andrea Dietrich
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Hanzeplein 1 XA10, 9713 GZ Groningen, The Netherlands
| | - Nathalie E Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Mannheim, Germany
| | - Pascal M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Mannheim, Germany
| | - Ulrike M E Schulze
- Department of Child and Adolescent Psychiatry / Psychotherapy, University of Ulm, Germany; Department of Child and Adolescent Psychiatry, Centre for Psychiatry Calw, Böblingen, Germany
| | - Melanie C Saam
- Department of Child and Adolescent Psychiatry / Psychotherapy, University of Ulm, Germany
| | - Michael C Craig
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Arjun Sethi
- Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Paramala Santosh
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley Hospital, London, United Kingdom
| | - Ilyas Sagar Ouriaghli
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, IDIBAPS, CIBERSAM, University of Barcelona, Spain
| | - Mireia Rosa
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, IDIBAPS, CIBERSAM, University of Barcelona, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - María José Penzol
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Julia E Werhahn
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich (ZNZ), Switzerland; Zurich Center for Integrative Human Physiology (ZHIP), University of Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland; Zurich Center for Integrative Human Physiology (ZHIP), University of Zurich, Switzerland
| | - Marianne Oldehinkel
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands; Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Barbara Franke
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Human Genetics, Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands; Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
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49
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Ilzarbe D, Baeza I, de la Serna E, Fortea A, Valli I, Puig O, Masias M, Borras R, Pariente JC, Dolz M, Castro-Fornieles J, Sugranyes G. Theory of mind performance and prefrontal connectivity in adolescents at clinical high risk for psychosis. Dev Cogn Neurosci 2021; 48:100940. [PMID: 33721828 PMCID: PMC7970321 DOI: 10.1016/j.dcn.2021.100940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 11/28/2022] Open
Abstract
Onset of psychosis was linked to a lack of age-related improvement in theory of mind. Reduced prefrontal connectivity preceded onset of psychosis in high risk youth. High risk youth with lower prefrontal connectivity were at greatest risk of psychosis.
Theory of mind(ToM) impairment is a key feature of psychotic disorders and has been documented in individuals at clinical high-risk for psychosis (CHR), suggesting that it may predate illness onset. However, no study to date has examined brain functional correlates of ToM in individuals at CHR during adolescence. The “Reading-the-Mind-in-the-Eyes” test was used to measure ToM performance in 50 CHR youth, 15 of whom transitioned to psychosis (CHR-t) at follow-up (12 ± 6 months) and 36 healthy volunteers. Resting-state functional MRI was acquired to evaluate functional connectivity within the default mode network. Group by age interaction revealed an age-positive association in ToM performance in healthy volunteers, which was not present in adolescents at CHR-t. Intrinsic functional connectivity in the medial prefrontal cortex was reduced in adolescents at CHR-t relative to those who did not transition and to healthy volunteers. Survival analyses revealed that participants at CHR with lower medial prefrontal cortex connectivity were at greatest risk of developing psychosis at follow-up. We demonstrate that lack of age-related maturation of ToM and reduced medial prefrontal cortex connectivity both precede the onset of psychosis during adolescence. Medial prefrontal cortex connectivity holds potential as a brain-based marker for the early identification of transition to psychosis.
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Affiliation(s)
- Daniel Ilzarbe
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Elena de la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Isabel Valli
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Olga Puig
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Mireia Masias
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Roger Borras
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Jose C Pariente
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Montserrat Dolz
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry and Psychology, Hospital Sant Joan de Deu, Esplugues de Llobregat, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Department of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain.
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50
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De la Serna E, Ilzarbe D, Sugranyes G, Baeza I, Moreno D, Rodríguez-Toscano E, Espliego A, Ayora M, Romero S, Sánchez-Gistau V, Castro-Fornieles J. Lifetime psychopathology in child and adolescent offspring of parents diagnosed with schizophrenia or bipolar disorder: a 2-year follow-up study. Eur Child Adolesc Psychiatry 2021; 30:117-129. [PMID: 32146538 DOI: 10.1007/s00787-020-01500-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
Having one parent diagnosed with a severe mental disorder is considered one of the main risk factors for developing that disorder in adulthood, and it also increases the risk of a wide range of mental disorders in the offspring. The aim of this study is to compare the prevalence of several psychopathological diagnoses, the presence of prodromal symptoms, and global functioning in offspring of parents with schizophrenia or bipolar disorder and in offspring of controls at baseline and 2-year follow-up. This study included 41 offspring of parents with schizophrenia, 90 offspring of parents with bipolar disorder, and 107 offspring of controls (mean age 11.7 ± 3.2 at baseline and 13.9 ± 3.2 at follow-up). The prevalence of psychopathology and comorbidity was higher in offspring of parents with schizophrenia and offspring of parents with bipolar disorder than in offspring of controls at baseline and at 2-year follow-up. Interestingly, mood disorders were more prevalent in offspring of parents with bipolar disorder and disruptive disorders were more prevalent in offspring of parents with schizophrenia. Prodromal symptoms were more frequent in offspring of parents with schizophrenia than in offspring of controls, while the offspring of parents with bipolar disorder showed an intermediate pattern. Finally, global functioning was lower in the offspring of parents with schizophrenia than the offspring of parents with bipolar disorder and the offspring of controls. Screening patients' children is clinically relevant, since, as a group, they have an elevated risk of developing a psychiatric disorder and of experiencing their first symptoms during childhood and adolescence.
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Affiliation(s)
- E De la Serna
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
| | - D Ilzarbe
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, C/ Villarroel, 170, 08036, Barcelona, Spain
| | - G Sugranyes
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, C/ Villarroel, 170, 08036, Barcelona, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain
| | - I Baeza
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, C/ Villarroel, 170, 08036, Barcelona, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain.,Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain
| | - D Moreno
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - E Rodríguez-Toscano
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - A Espliego
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - M Ayora
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - S Romero
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, C/ Villarroel, 170, 08036, Barcelona, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain
| | - V Sánchez-Gistau
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Early Intervention Psychosis Service, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira I Virgili, Reus, Spain
| | - J Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, C/ Villarroel, 170, 08036, Barcelona, Spain.,Institut D´Investigació Biomèdica August Pi I Sunyer, IDIBAPS, Barcelona, Spain.,Department of Psychiatry and Clinical Psychology, University of Barcelona, Barcelona, Spain
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