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Costas-Carrera A, Verdolini N, Garcia-Rizo C, Mezquida G, Janssen J, Valli I, Corripio I, Sanchez-Torres AM, Bioque M, Lobo A, Gonzalez-Pinto A, Rapado-Castro M, Vieta E, De la Serna H, Mane A, Roldan A, Crossley N, Penades R, Cuesta MJ, Parellada M, Bernardo M. Difficulties during delivery, brain ventricle enlargement and cognitive impairment in first episode psychosis. Psychol Med 2024; 54:1339-1349. [PMID: 38014924 DOI: 10.1017/s0033291723003185] [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: 11/29/2023]
Abstract
BACKGROUND Patients with a first episode of psychosis (FEP) display clinical, cognitive, and structural brain abnormalities at illness onset. Ventricular enlargement has been identified in schizophrenia since the initial development of neuroimaging techniques. Obstetric abnormalities have been associated with an increased risk of developing psychosis but also with cognitive impairment and brain structure abnormalities. Difficulties during delivery are associated with a higher risk of birth asphyxia leading to brain structural abnormalities, such as ventriculomegaly, which has been related to cognitive disturbances. METHODS We examined differences in ventricular size between 142 FEP patients and 123 healthy control participants using magnetic resonance imaging. Obstetric complications were evaluated using the Lewis-Murray scale. We examined the impact of obstetric difficulties during delivery on ventricle size as well as the possible relationship between ventricle size and cognitive impairment in both groups. RESULTS FEP patients displayed significantly larger third ventricle size compared with healthy controls. Third ventricle enlargement was associated with diagnosis (higher volume in patients), with difficulties during delivery (higher volume in subjects with difficulties), and was highest in patients with difficulties during delivery. Verbal memory was significantly associated with third ventricle to brain ratio. CONCLUSIONS Our results suggest that difficulties during delivery might be significant contributors to the ventricular enlargement historically described in schizophrenia. Thus, obstetric complications may contribute to the development of psychosis through changes in brain architecture.
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Affiliation(s)
| | - Norma Verdolini
- Department of Mental Health, Umbria 1 Mental Health Center, Perugia, Italy
| | - Clemente Garcia-Rizo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Joost Janssen
- 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, Spain
| | - Isabel Valli
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Psychiatry Psychology and Neuroscience, King's College London, UK
| | - Iluminada Corripio
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ana M Sanchez-Torres
- Department of Psychiatry, Navarra University Hospital, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Miquel Bioque
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Department of Medicine and Psychiatry, University of Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana Gonzalez-Pinto
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Department of Psychiatry, Hospital Universitario de Alava, UPV/EHU, BIOARABA, Spain
| | - Marta Rapado-Castro
- 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, Spain
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, Victoria 3053, Australia
| | - Eduard Vieta
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Institute of Neurosciences, Barcelona, Spain
| | - Helena De la Serna
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Anna Mane
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Hospital del Mar Medical Research Institute (IMIM), Pompeu Fabra University, Barcelona, Spain
| | - Alexandra Roldan
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Nicolas Crossley
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
- Department of Psychiatry, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Rafael Penades
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Navarra University Hospital, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Mara Parellada
- 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, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Peralta D, Janda L, García de Jalón E, Moreno-Izco L, Sánchez-Torres AM, Cuesta MJ, Peralta V. Long-term diagnostic stability, predictors of diagnostic change, and time until diagnostic change of first-episode psychosis: a 21-year follow-up study. Psychol Med 2024; 54:1329-1338. [PMID: 37987188 DOI: 10.1017/s0033291723003173] [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: 11/22/2023]
Abstract
BACKGROUND Although diagnostic instability in first-episode psychosis (FEP) is of major concern, little is known about its determinants. This very long-term follow-up study aimed to examine the diagnostic stability of FEP diagnoses, the baseline predictors of diagnostic change and the timing of diagnostic change. METHODS This was a longitudinal and naturalistic study of 243 subjects with FEP who were assessed at baseline and reassessed after a mean follow-up of 21 years. The diagnostic stability of DSM-5 psychotic disorders was examined using prospective and retrospective consistencies, logistic regression was used to establish the predictors of diagnostic change, and survival analysis was used to compare time to diagnostic change across diagnostic categories. RESULTS The overall diagnostic stability was 47.7%. Schizophrenia and bipolar disorder were the most stable diagnoses, with other categories having low stability. Predictors of diagnostic change to schizophrenia included a family history of schizophrenia, obstetric complications, developmental delay, poor premorbid functioning in several domains, long duration of untreated continuous psychosis, spontaneous dyskinesia, lack of psychosocial stressors, longer duration of index admission, and poor early treatment response. Most of these variables also predicted diagnostic change to bipolar disorder but in the opposite direction and with lesser effect sizes. There were no significant differences between specific diagnoses regarding time to diagnostic change. At 10-year follow-up, around 80% of the diagnoses had changed. CONCLUSIONS FEP diagnoses other than schizophrenia or bipolar disorder should be considered as provisional. Considering baseline predictors of diagnostic change may help to enhance diagnostic accuracy and guide therapeutic interventions.
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Affiliation(s)
- David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
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3
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Cuesta MJ, García de Jalón E, Sánchez-Torres AM, Gil-Berrozpe GJ, Aranguren L, Gutierrez G, Corrales A, Zarzuela A, Ibañez B, Peralta V. Additive effects of a family history of schizophrenia spectrum disorders and an environmental risk score for the outcome of patients with non-affective first-episode psychosis. Psychol Med 2024:1-9. [PMID: 38505954 DOI: 10.1017/s0033291724000576] [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] [Indexed: 03/21/2024]
Abstract
BACKGROUND First-episode psychotic disorders comprise a heterogeneous phenotype with a complex etiology involving numerous common small-effect genetic variations and a wide range of environmental exposures. We examined whether a family of schizophrenia spectrum disorder (FH-Sz) interacts with an environmental risk score (ERS-Sz) regarding the outcome of patients with non-affective first episode psychosis (NAFEP). METHODS We included 288 patients with NAFEP who were evaluated after discharge from an intensive 2-year program. We evaluated three outcome measures: symptomatic remission, psychosocial functioning, and personal recovery. We analyzed the main and joint associations of a FH-Sz and the ERS-Sz on the outcomes by using the relative excess risk due to interaction (RERI) approach. RESULTS A FH-Sz showed a significant association with poor symptomatic remission and psychosocial functioning outcomes, although there was no significant interaction between a FH-Sz and the ERS-Sz on these outcomes. The ERS-Sz did not show a significant association with poor symptomatic remission and psychosocial functioning outcomes, even though the magnitude of the interaction between ERS-Sz and FH-Sz with the later outcome was moderate (RERI = 6.89, 95% confidence interval -16.03 to 29.81). There was no association between a FH-Sz and the ERS-Sz and personal recovery. CONCLUSIONS Our results provide further empirical support regarding the contribution of FH-Sz to poor symptomatic remission and poor psychosocial functioning outcomes in patients with NAFEP.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Elena García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Departament of Health Sciences, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Gustavo J Gil-Berrozpe
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Lidia Aranguren
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Gerardo Gutierrez
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Asier Corrales
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Amalia Zarzuela
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Berta Ibañez
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Methodology Unit, Navarrabiomed - HUN - UPNA, RICAPPS, Pamplona, Spain
| | - Víctor Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
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4
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Llorca-Bofí V, Madero S, Amoretti S, Cuesta MJ, Moreno C, González-Pinto A, Bergé D, Rodriguez-Jimenez R, Roldán A, García-León MÁ, Ibáñez A, Usall J, Contreras F, Mezquida G, García-Rizo C, Berrocoso E, Bernardo M, Bioque M. Inflammatory blood cells and ratios at remission for psychosis relapse prediction: A three-year follow-up of a cohort of first episodes of schizophrenia. Schizophr Res 2024; 267:24-31. [PMID: 38513331 DOI: 10.1016/j.schres.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 02/19/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND The clinical course following a first episode of schizophrenia (FES) is often characterized by recurrent relapses, resulting in unfavorable clinical and functional outcomes. Inflammatory dysregulation has been implicated in relapse risk; however, the predictive value of inflammatory blood cells in clinically remitted patients after a FES has not been previously explored. METHODS In this study, we closely monitored 111 patients in remission after a FES until relapse or a three-year follow-up endpoint. The participants were recruited from the multicenter 2EPS Project. Data on inflammatory blood cells and ratios were collected at baseline and at the time of relapse or after three years of follow-up. RESULTS Monocyte counts (OR = 1.91; 95 % CI = 1.07-3.18; p = 0.009) and basophil counts (OR = 1.09; 95 % CI = 1.01-1.12; p = 0.005) at baseline were associated with an increased risk of relapse, while the platelet-lymphocyte ratio (OR = 0.98; 95 % CI = 0.97-0.99; p = 0.019) was identified as a protective factor. However, after adjusting for cannabis and tobacco use during the follow-up, only monocyte counts (OR = 1.73; 95 % CI = 1.03-2.29; p = 0.027) and basophil counts (OR = 1.08; 95 % CI = 1.01-1.14; p = 0.008) remained statistically significant. ROC curve analysis indicated that the optimal cut-off values for discriminating relapsers were 0.52 × 10^9/L (AUC: 0.66) for monocytes and 0.025 × 10^9/L (AUC: 0.75) for basophils. When considering baseline inflammatory levels, no significant differences were observed in the inflammatory biomarkers at the endpoint between relapsers and non-relapsers. CONCLUSION This study provides evidence that higher monocyte and basophil counts measured at remission after a FES are associated with an increased risk of relapse during a three-year follow-up period.
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Affiliation(s)
- Vicent Llorca-Bofí
- Department of Medicine, University of Barcelona, Barcelona, Spain; Department of Psychiatry, Santa Maria University Hospital Lleida, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Lleida, Spain
| | - Santiago Madero
- Department of Medicine, University of Barcelona, Barcelona, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Silvia Amoretti
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, Spain; Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Instituto de Salud Carlos III, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Spain; University of Barcelona, Spain.
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain.
| | - Ana González-Pinto
- Bioaraba, Alava University Hospital, UPV/EHU, Vitoria, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Dani Bergé
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Roberto Rodriguez-Jimenez
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain; Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Alexandra Roldán
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, IIB-SANT PAU, Barcelona, Spain; CIBERSAM, ISCIII, Spain.
| | - María Ángeles García-León
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
| | - Angela Ibáñez
- Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), ISCIII, Madrid, Spain
| | - Judith Usall
- Research Institute Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
| | - Fernando Contreras
- Psychiatric Service, Bellvitge Universitari Hospital, IDIBELL, CIBERSAM, Spain.
| | - Gisela Mezquida
- University of Barcelona, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clínic of Barcelona, Neuroscience Institute, Spain; Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Spain.
| | - Clemente García-Rizo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Madrid, Spain.
| | - Esther Berrocoso
- Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, ISCIII, Barcelona, Spain.
| | - Miquel Bioque
- Department of Medicine, University of Barcelona, Barcelona, 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; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Spain.
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5
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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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Cuesta MJ, Sánchez-Torres AM, Moreno-Izco L, García de Jalón E, Gil-Berrozpe GJ, Peralta V, Ballesteros A, Fañanás L, Janda L, Papiol S, Peralta D, Ribeiro M, Rosero Á, Zarzuela A, Giné E, Rosado E. Long-term trajectories of clinical staging in first-episode psychosis and their associated cognitive outcome: A 21-year follow-up study. Span J Psychiatry Ment Health 2024:S2950-2853(24)00014-0. [PMID: 38423184 DOI: 10.1016/j.sjpmh.2024.02.001] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/25/2024] [Accepted: 02/13/2024] [Indexed: 03/02/2024]
Abstract
Cognitive deficits are already present before psychosis onset but are a key feature of first-episode psychosis (FEP). The objective of this study was to investigate the cognitive outcomes of a cohort of FEP patients who were diagnosed using the clinical staging approach and were followed for up to 21 years. We analyzed data from 173 participants with first-admission psychosis who were followed-up for a mean of 20.9 years. The clinical staging assessment was adapted from the clinical staging framework developed by McGorry et al.1 Cognitive assessment was performed using the MATRICS Consensus Cognitive Battery (MMCB) at the end of follow-up. FEP patients who were longitudinally diagnosed in the lowest clinical stages (stages 2A and 2B) showed better performance in attention, processing speed, and MCCB overall composite score than those in the highest clinical stages (stages 4A and 4B). There was a significant linear trend association between worsening of all MCCB cognitive functions and MCCB overall composite score and progression in clinical staging. Furthermore, the interval between two and five years of follow-up appears to be associated with deficits in processing speed as a cognitive marker. Our results support the validation of the clinical staging model over a long-term course of FEP based on neuropsychological performance. A decline in some cognitive functions, such as processing speed, may facilitate the transition of patients to an advanced stage during the critical period of first-episode psychosis.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - Ana M Sánchez-Torres
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Department of Health Sciences, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Lucia Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Elena García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Gustavo J Gil-Berrozpe
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Victor Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | | | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Spain
| | - Lucia Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Sergi Papiol
- Network Centre for Biomedical Research in Mental Health (CIBER of Mental Health, CIBERSAM), Spain; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich 80336, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - María Ribeiro
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Ángela Rosero
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - Amalia Zarzuela
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Eloi Giné
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Esther Rosado
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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Giné-Servén E, Boix-Quintana E, Daví-Loscos E, Cepedello S, Moreno-Sancho L, Niubó M, Hernández-Antón R, Cuesta MJ, Labad J. Psychosocial stress moderates the relationship between cerebrospinal fluid lactate dehydrogenase and the duration of untreated psychosis in first-episode psychosis. Front Psychiatry 2024; 15:1327928. [PMID: 38426005 PMCID: PMC10902114 DOI: 10.3389/fpsyt.2024.1327928] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Introduction Previous research has shown that lower lactate dehydrogenase (LDH) concentrations in cerebrospinal fluid (CSF) are associated with longer prodromal symptoms in first-episode psychosis (FEP). We aimed to study whether there is a relationship between the duration of untreated psychosis (DUP) and LDH and other CSF biomarkers in FEP and whether stressful life events moderate this association. Methods Ninety-five inpatients with FEP and with less than 6 weeks of antipsychotic treatment were included in the study. All participants were informed about the nature of the study, which was approved by the local ethics committee, and signed an informed consent form. A lumbar puncture was performed at index admission (baseline) to measure CSF parameters (glucose, total protein, LDH). The DUP was assessed with the Quick Psychosis Onset and Prodromal Symptoms Inventory (Q-POPSI). Stressful life events (SLEs) in the previous 6 months were assessed with the List of Threatening Experiences. We dichotomized the SLE variable into having experienced at least one SLE or no experience of SLEs. Statistical analyses were performed with SPSS v. 25.0. Total protein and LDH concentrations were natural log transformed (ln) to reduce skewness. Multiple linear regression analyses were conducted to explore the association between the DUP and CSF parameters (considered the dependent variable). Age, sex, DUP and SLEs were considered independent variables. We tested the DUP by SLE interaction. Significant interactions were included in the final model. The threshold for significance was set at p<0.05. Results Fifty-four FEP patients (56.8%) reported an SLE in the previous 6 months. There were no significant differences in the DUP between patients with or without SLEs. There were no significant differences in CSF biomarkers between the SLE groups. In the multiple linear regression analyses, we found a significant DUP by SLE interaction effect on CSF LDH concentrations (standardized beta= -0.320, t= -2.084, p= 0.040). In patients with SLEs, a shorter DUP was associated with higher CSF LDH concentrations and vice versa. No significant associations were found between the DUP or SLEs and other CSF biomarkers (glucose, total proteins). Conclusions Our study suggests that psychosocial stress moderates the relationship between the onset of psychosis and CSF biomarkers related to bioenergetic systems.
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Affiliation(s)
- Eloi Giné-Servén
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Ester Boix-Quintana
- Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Mataró, Spain
| | - Eva Daví-Loscos
- Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Mataró, Spain
| | - Sandra Cepedello
- Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Mataró, Spain
| | - Lara Moreno-Sancho
- Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Mataró, Spain
| | - Marta Niubó
- Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Mataró, Spain
| | - Rebeca Hernández-Antón
- Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Mataró, Spain
| | - Manuel J. Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Javier Labad
- Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Mataró, Spain
- Translational Neuroscience Research Unit I3PT-INc-UAB, Institut de Innovació i Investigació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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8
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Prohens L, Rodríguez N, Segura ÀG, Martínez-Pinteño A, Olivares-Berjaga D, Martínez I, González A, Mezquida G, Parellada M, Cuesta MJ, Bernardo M, Gassó P, Mas S. Gene expression imputation provides clinical and biological insights into treatment-resistant schizophrenia polygenic risk. Psychiatry Res 2024; 332:115722. [PMID: 38198858 DOI: 10.1016/j.psychres.2024.115722] [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: 10/23/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
Genome-wide association studies (GWAS) have revealed the polygenic nature of treatment-resistant schizophrenia TRS. Gene expression imputation allowed the translation of GWAS results into regulatory mechanisms and the construction of gene expression (GReX) risk scores (GReX-RS). In the present study we computed GReX-RS from the largest GWAS of TRS to assess its association with clinical features. We perform transcriptome imputation in the largest GWAS of TRS to find GReX associated with TRS using brain tissues. Then, for each tissue, we constructed a GReX-RS of the identified genes in a sample of 254 genotyped first episode of psychosis (FEP) patients to test its association with clinical phenotypes, including clinical symptomatology, global functioning and cognitive performance. Our analysis provides evidence that the polygenic basis of TRS includes genetic variants that modulate the expression of certain genes in certain brain areas (substantia nigra, hippocampus, amygdala and frontal cortex), which at the same time are related to clinical features in FEP patients, mainly persistence of negative symptoms and cognitive alterations in sustained attention, which have also been suggested as clinical predictors of TRS. Our results provide a clinical explanation of the polygenic architecture of TRS and give more insight into the biological mechanisms underlying TRS.
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Affiliation(s)
- Llucia Prohens
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Natalia Rodríguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Àlex-Gonzàlez Segura
- 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; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - David Olivares-Berjaga
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Irene Martínez
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Aitor González
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gisela Mezquida
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), ISCIII, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), ISCIII, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Manuel J Cuesta
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), ISCIII, Spain; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Miquel Bernardo
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), ISCIII, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), ISCIII, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), ISCIII, Spain.
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9
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Peralta V, de Jalón EG, Moreno-Izco L, Peralta D, Janda L, Sánchez-Torres AM, Cuesta MJ. The effect of anticholinergic burden of psychiatric medications on major outcome domains of psychotic disorders: A 21-year prospective cohort study. Schizophr Res 2024; 264:386-393. [PMID: 38237360 DOI: 10.1016/j.schres.2024.01.020] [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: 03/27/2023] [Revised: 09/20/2023] [Accepted: 01/07/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Most medications used to treat psychotic disorders possess anticholinergic properties. This may result in a considerable anticholinergic burden (ACB), which may have deleterious effects on long-term outcomes. The extent to which cumulative ACB over years of treatment with psychotropic medications impacts different outcome domains remains unknown. METHODS This was a naturalistic study of 243 subjects with first-episode psychosis aimed at examining the cumulative effect of ACB of psychotropic medications administered over the illness course (ACB-years exposure) on several outcome domains assessed after a mean 21-year follow-up. Associations between ACB and the outcomes were modelled accounting for relevant confounding factors by using hierarchical linear regression analysis. RESULTS Over the study period, 81.9 % of the participants were dispensed at least one drug with strong anticholinergic effects for at least 1 year; at the follow-up visit, 60.5 % of the participants continued to take medications with strong ACB. ACB-years exposure was uniquely related to severity of negative symptoms (β = 0.144, p = 0.004), poor psychosocial functioning (β = 0.186, p < 0.001) and poor cognitive performance (β = -0.273, p < 0.001). This association pattern was independent of a schizophrenia diagnosis. Most of the associations between ACB at the follow-up visit and the outcomes were accounted for ACB-years exposure. CONCLUSION Lifetime ACB of psychotropic medications has deleterious effects on the outcome of psychotic disorders. Clinicians should avoid prescribing medications with strong ACB, since there are numerous alternatives within each psychotropic drug group for prescribing medications with low ACB.
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Affiliation(s)
- Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
| | - Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Manuel J Cuesta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
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10
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Clougher D, G Segura À, Forte MF, Mezquida G, J Cuesta M, Vieta E, Amoretti S, Lobo A, González-Pinto A, M Díaz-Caneja C, Roldán A, Fico G, de la Serna E, Bergé D, Gassó P, Rodriguez N, Verdolini N, Tortorella A, Menculini G, Ribasés M, Bernardo M, Mas S. The role of cognitive reserve and clinical symptoms in the association between genetic liability for educational attainment and functioning in first-episode psychosis: a mediation analysis. Eur Psychiatry 2024:1-31. [PMID: 38178712 DOI: 10.1192/j.eurpsy.2023.2480] [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] [Indexed: 01/06/2024] Open
Affiliation(s)
- Derek Clougher
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Àlex G Segura
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Maria Florencia Forte
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Gisela Mezquida
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Medicine and Psychiatry. Zaragoza University. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Araba University Hospital, Bioaraba Research Institute, Spain
- University of the Basque Country (UPV-EHU), Spain
| | - Covadonga M Díaz-Caneja
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Alexandra Roldán
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Giovanna Fico
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institut Clinic de Neurociències, Hospital Clínic Universitari, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Daniel Bergé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Hospital del Mar Medical Research Institute; Universitat Pompeu Fabra, MELIS Department, Barcelona, Spain
| | - Patricia Gassó
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Natalia Rodriguez
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Norma Verdolini
- Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Italy
| | - Alfonso Tortorella
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giulia Menculini
- Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Marta Ribasés
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Sergi Mas
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
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11
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Cuesta MJ, Sánchez-Torres AM, García de Jalón E, Moreno-Izco L, Gil-Berrozpe GJ, Zarzuela A, Papiol S, Fañanás L, Peralta V. Empirical validity of Leonhard's psychoses: A long-term follow-up study of first-episode psychosis patients. Schizophr Res 2024; 263:237-245. [PMID: 36682995 DOI: 10.1016/j.schres.2022.12.022] [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: 10/13/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/21/2023]
Abstract
The validation of nosological diagnoses in psychiatry remains a conundrum. Leonhard's (1979) nosology seems to be one of the few acceptable alternative categorical models to current DSM/ICD systems. We aimed to empirically validate Leonhard's four classes of psychoses: systematic schizophrenia (SSch), unsystematic (USch), cycloid psychosis (Cyclo), and manic-depressive illness (MDI) using a comprehensive set of explanatory validators. 243 patients with first-episode psychosis were followed between 10 and 31 years. A wide-ranging assessment was carried out by collecting data on antecedent, illness-related, concurrent, response to treatment, neuromotor abnormalities, and cognitive impairment variables. Compared with USch, Cyclo, and MDI, SSch displayed a pattern of impairments significantly larger across the seven blocks of explanatory variables. There were no significant differences between Cyclo and MDI in explanatory variables. Except for the majority of illness-onset features, USch displayed more substantial abnormalities in the explanatory variables than Cyclo and MDI. SSch and MDI showed higher percentages of correctly classified patients than USch and Cyclo in linear discriminant analyses. Partial validation of Leonhard's classification was found. SSch showed differences in explanatory variables with respect to Cyclo and MDI. USch showed also significant differences in explanatory variables regarding Cyclo and MDI, although with a lower strength than SSch. There was strong empirical evidence of the separation between both Leonhard's schizophrenia subtypes; however, the distinction between the Cyclo and MDI groups was not empirically supported. A mild to moderate discriminative ability between Leonhard's subtypes on the basis of explanatory blocks of variables was observed.
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Affiliation(s)
- M J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - A M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - E García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - L Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - G J Gil-Berrozpe
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - A Zarzuela
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - S Papiol
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Spain; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, 80336, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
| | - L Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Spain
| | - V Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
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12
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Peralta V, de Jalón EG, Moreno-Izco L, Peralta D, Janda L, Sánchez-Torres AM, Cuesta MJ. Neuromotor dysfunction as a major outcome domain of psychotic disorders: A 21-year follow-up study. Schizophr Res 2024; 263:229-236. [PMID: 35667948 DOI: 10.1016/j.schres.2022.05.026] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The long-term stability of neuromotor domains assessed at the first episode of psychosis (FEP) and their ability for predicting a number of outcomes remains largely unknown, and this study addressed these issues. METHODS This was a longitudinal study of 243 participants with FEP who were assessed at baseline for background variables and parkinsonism, dyskinesia, neurological soft signs (NSS) and catatonia, and reassessed 21 years later for the same neuromotor variables, psychopathology, functioning, personal recovery, cognitive performance and medical comorbidity. Stability of neuromotor ratings was assessed using the intraclass correlations coefficient and associations between the predictors and outcomes were examined using univariate and multivariate statistics. RESULTS Baseline dyskinesia and NSS ratings showed excellent stability over time whereas that for parkinsonism and catatonia was relatively low. Neuromotor dysfunction at follow-up was independently predicted by a family history of schizophrenia, obstetric complications, neurodevelopmental delay, low premorbid IQ and baseline ratings of dyskinesia and NSS. Moreover, baseline dyskinesia and NSS ratings independently predicted more positive and negative symptoms, poor functioning and less personal recovery; catatonia predicted less personal recovery and more medical comorbidity. Baseline neuromotor ratings explained between 4% (for medical comorbidity) and 34% (for neuromotor dysfunction) of the variance in the outcomes. Lastly, neuromotor dysfunction at baseline highly predicted clinical staging at follow-up. CONCLUSION Baseline neuromotor domains show variable stability over time and relate distinctively to very long-term outcomes. Both baseline dyskinesia and NSS are trait markers of the disease process and robust predictors of the outcomes.
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Affiliation(s)
- Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
| | - Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Manuel J Cuesta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
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13
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Cuesta MJ, Gil-Berrozpe GJ, Sánchez-Torres AM, Moreno-Izco L, García de Jalón E, Peralta V. 20-Year trajectories of six psychopathological dimensions in patients with first-episode psychosis: Could they be predicted? Psychiatry Res 2024; 331:115614. [PMID: 38039651 DOI: 10.1016/j.psychres.2023.115614] [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: 08/01/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023]
Abstract
Patients with first-episode psychoses (FEP) exhibit heterogeneity in clinical manifestations and outcomes. This study investigated the long-term trajectories of six key psychopathological dimensions (reality-distortion, negative, disorganization, catatonia, mania and depression) in patients diagnosed with FEP. A total of 243 patients were followed up for 20 years and the trajectories of the dimensions were analysed using growth mixture modelling. These dimensions showed varied course patterns, ranging from two to five trajectories. Additionally, the study examined the predictive value of different factors in differentiating between the long-term trajectories. The exposome risk score showed that familial load, distal and intermediate risk factors, acute psychosocial stressors and acute onset were significant predictors for differentiating between long-term psychopathological trajectories. In contrast, polygenic risk score, duration of untreated psychosis and duration of untreated illness demonstrated little or no predictive value. The findings highlight the importance of conducting a multidimensional assessment not only at FEP but also during follow-up to customize the effectiveness of interventions. Furthermore, the results emphasize the relevance of assessing premorbid predictors from the onset of illness. This may enable the identification of FEP patients at high-risk of poor long-term outcomes who would benefit from targeted prevention programs on specific psychopathological dimensions.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain).
| | - Gustavo J Gil-Berrozpe
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain)
| | - Ana M Sánchez-Torres
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Departament of Health Sciences, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra (Pamplona, Spain); Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain)
| | - Elena García de Jalón
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Mental Health Department, Servicio Navarro de Salud - Osasunbidea (Pamplona, Spain)
| | - Victor Peralta
- Navarra Institute for Health Research (IdiSNA) (Pamplona, Spain); Mental Health Department, Servicio Navarro de Salud - Osasunbidea (Pamplona, Spain)
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14
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Garcia-Marti G, Escarti MJ, Nacher J, Perez-Rando M, Mane A, Usall J, Berrocoso E, Pomarol-Clotet E, Lopez-Ilundain JM, Cuesta MJ, Rodriguez-Jimenez R, Gonzalez-Pinto A, Mar L, Ibañez A, Roldan A, Janssen J, Parellada M, Amoretti S, Bernardo M, Sanjuan J, Aguilar EJ. Progressive loss of cortical gray matter in first episode psychosis patients with auditory hallucinations. Schizophr Res 2023:S0920-9964(23)00423-1. [PMID: 38044223 DOI: 10.1016/j.schres.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/18/2023] [Accepted: 11/26/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Previous longitudinal magnetic resonance imaging studies have shown progressive gray matter (GM) reduction during the earliest phases of schizophrenia. It is unknown whether these progressive processes are homogeneous in all groups of patients. One way to obtain more valid findings is to focus on the symptoms. Auditory hallucinations (AHs) are frequent and reliable symptoms of psychosis. The present study aims to analyze whether longitudinal changes in structural abnormalities in cortical regions are related to the presence of AHs and the intensity of psychotic symptoms in a large sample. METHODS A Magnetic Resonance (MR) voxel-based morphometry analysis was applied to a group of 128 first episodes psychosis (FEP) patients (63 patients with AHs and 65 patients without AHs) and 78 matched healthy controls at baseline and at a 2-year follow-up. RESULTS At baseline, FEP patients exhibited significant GM volume reductions in the temporal, frontal and precentral regions. At follow-up, FEP patients exhibited GM volume changes in the temporal, Rolandic, frontal, precentral and insula regions. At baseline, no significant differences were found between FEP patients with and without AHs. At follow-up, while FEP patients with AHs showed less GM volume in temporal and frontal lobes, non-AH FEP patients showed reductions in the frontal, precentral and fusiform areas. PANSS scores showed statistically significant correlations with GM volume reductions at baseline and follow-up. CONCLUSIONS Brain cortical loss in the early phases of psychosis is not associated with potentially transitory AHs; however, brain structural changes may emerge as AHs appear in chronic patients.
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Affiliation(s)
- Gracian Garcia-Marti
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Biomedical Engineering Unit / Radiology Department, Quirónsalud Hospital, Valencia, Spain; Institute of research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain.
| | - Maria J Escarti
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain; Unit of Psychiatry, Clinic Hospital Valencia, University of Valencia, Valencia, Spain
| | - Juan Nacher
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain; Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain
| | - Marta Perez-Rando
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain; Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Burjassot, Spain
| | - Anna Mane
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Department of Medicine and Life Sciences (MELIS). Universitat Pompeu Fabra, Barcelona, 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
| | - Esther Berrocoso
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Neuropsychopharmacology and Psychobiology Research Group, Department of Neuroscience, Faculty of Medicine, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Edith Pomarol-Clotet
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Jose M Lopez-Ilundain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Roberto Rodriguez-Jimenez
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre, Madrid, Spain; Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Ana Gonzalez-Pinto
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Bioaraba, Department of Psychiatry, Hospital Universitario de Alava, UPV/EHU, Vitoria, Spain
| | - Lorea Mar
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Bioaraba, Department of Psychiatry, Hospital Universitario de Alava, UPV/EHU, Vitoria, Spain
| | - Angela Ibañez
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Alexandra Roldan
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatry Department, Hospital de la Santa Creu i Sant Pau, IIB SANT PAU, Barcelona, Spain
| | - Joost Janssen
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Silvia Amoretti
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona; University of Barcelona, Spain; Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Miquel Bernardo
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Julio Sanjuan
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain; Unit of Psychiatry, Clinic Hospital Valencia, University of Valencia, Valencia, Spain
| | - Eduardo J Aguilar
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of research of the Clinic Hospital from Valencia (INCLIVA), Valencia, Spain; Unit of Psychiatry, Clinic Hospital Valencia, University of Valencia, Valencia, Spain
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15
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Sánchez-Torres AM, García de Jalón E, Gil-Berrozpe GJ, Peralta V, Cuesta MJ. Cognitive intraindividual variability, cognitive impairment and psychosocial functioning in first-episode psychosis patients. Psychiatry Res 2023; 328:115473. [PMID: 37716321 DOI: 10.1016/j.psychres.2023.115473] [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: 05/10/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 09/18/2023]
Abstract
Cognitive intraindividual variability (IIV) refers to fluctuations in performance across tasks (i.e. dispersion) or in a single task on multiple occasions (i.e. inconsistency). Little is known about IIV in patients with first-episode psychosis (FEP). We aimed to explore the association between IIV and both global cognitive performance and psychosocial functioning in a sample of 103 FEP patients. Patients were recruited at discharge from the PEPsNa program, a FEP follow-up intervention program lasting 24 months. The Social and Occupational Functioning Scale (SOFAS) and the Cognitive Assessment Interview (CAI-Sp) were employed for assessing psychosocial functioning. Cognitive assessments were performed using the MATRICS Cognitive Assessment Battery (MCCB), and the variability in the cognitive functions assessed with the MCCB was used to calculate the IIV. Significant correlations were obtained between IIV and global MCCB scores, the CAI-Sp and the SOFAS. We found significant differences in psychosocial functioning and cognitive performance between patients with high and low IIV. A higher IIV in FEP patients was related both to worse psychosocial functioning and worse global cognitive performance. Unlike global cognitive performance, IIV was not related to clinical characteristics, suggesting that it could be an indicator of cognitive impairment even in the absence of global impairment.
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Affiliation(s)
- A M Sánchez-Torres
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - E García de Jalón
- Mental Health Department, Navarra Health Service - Osasunbidea, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - G J Gil-Berrozpe
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - V Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - M J Cuesta
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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16
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Segura ÀG, Prohens L, Gassó P, Rodríguez N, Garcia-Rizo C, Moreno-Izco L, Andreu-Bernabeu Á, Zorrilla I, Mane A, Rodriguez-Jimenez R, Roldán A, Sarró S, Ibáñez Á, Usall J, Sáiz PA, Cuesta MJ, Parellada M, González-Pinto A, Berrocoso E, Bernardo M, Mas S, Mezquida G, Arbelo N, De Matteis M, Galvañ J, Duque Guerra A, Arias I Queralt L, Perez-Bacigalupe M, Gonzalez-Ortega I, Toll A, Casanovas F, Sanchez-Pastor L, Valtueña M, Pomarol-Clotet E, García-León MÁ, Butjosa A, Rubio-Abadal E, Ribeiro M, López-Ilundain JM, Saiz-Ruiz J, León-Quismondo L, Rivero O, Ruiz P, Echevarría RS, García-Portilla MP. The polygenic basis of relapse after a first episode of schizophrenia. Eur Neuropsychopharmacol 2023; 75:80-92. [PMID: 37603902 DOI: 10.1016/j.euroneuro.2023.06.003] [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: 02/15/2023] [Revised: 05/31/2023] [Accepted: 06/07/2023] [Indexed: 08/23/2023]
Abstract
Little is known about genetic predisposition to relapse. Previous studies have linked cognitive and psychopathological (mainly schizophrenia and bipolar disorder) polygenic risk scores (PRS) with clinical manifestations of the disease. This study aims to explore the potential role of PRS from major mental disorders and cognition on schizophrenia relapse. 114 patients recruited in the 2EPs Project were included (56 patients who had not experienced relapse after 3 years of enrollment and 58 patients who relapsed during the 3-year follow-up). PRS for schizophrenia (PRS-SZ), bipolar disorder (PRS-BD), education attainment (PRS-EA) and cognitive performance (PRS-CP) were used to assess the genetic risk of schizophrenia relapse.Patients with higher PRS-EA, showed both a lower risk (OR=0.29, 95% CI [0.11-0.73]) and a later onset of relapse (30.96± 1.74 vs. 23.12± 1.14 months, p=0.007. Our study provides evidence that the genetic burden of neurocognitive function is a potentially predictors of relapse that could be incorporated into future risk prediction models. Moreover, appropriate treatments for cognitive symptoms appear to be important for improving the long-term clinical outcome of relapse.
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Affiliation(s)
- Àlex-González Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Llucia Prohens
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain
| | - Natalia Rodríguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain
| | - Clemente Garcia-Rizo
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Lucía Moreno-Izco
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Álvaro Andreu-Bernabeu
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iñaki Zorrilla
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, BIOARABA Health Research Institute Vitoria, Hospital Universitario de Alava, Spain; University of the Basque Country, Vitoria, Spain
| | - Anna Mane
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Hospital del Mar, Medical Research Institute (IMIM), Barcelona, Spain
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Universidad Complutense de Madrid (UCM), Madrid, Spain; Department of Psychiatry. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Alexandra Roldán
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Salvador Sarró
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Ángela Ibáñez
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Alcalá de Henares, Universidad de Alcalá, Spain
| | - Judith Usall
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Pilar A Sáiz
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA). Instituto de Neurociencias del Principado de Asturias (INEUROPA). Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
| | - Manuel J Cuesta
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, BIOARABA Health Research Institute Vitoria, Hospital Universitario de Alava, Spain; University of the Basque Country, Vitoria, Spain
| | - Ester Berrocoso
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Miquel Bernardo
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain.
| | - Gisela Mezquida
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Néstor Arbelo
- Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, Neuroscience Institute, Barcelona, Spain
| | - Mario De Matteis
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Joaquín Galvañ
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Alejandra Duque Guerra
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Laia Arias I Queralt
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Perez-Bacigalupe
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, BIOARABA Health Research Institute Vitoria, Hospital Universitario de Alava, Spain; University of the Basque Country, Vitoria, Spain
| | - Itxaso Gonzalez-Ortega
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, BIOARABA Health Research Institute Vitoria, Hospital Universitario de Alava, Spain; University of the Basque Country, Vitoria, Spain
| | - Alba Toll
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Hospital del Mar, Medical Research Institute (IMIM), Barcelona, Spain
| | | | - Luis Sanchez-Pastor
- Department of Psychiatry. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Mercedes Valtueña
- Department of Psychiatry. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Maria Ángeles García-León
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Ana Butjosa
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Elena Rubio-Abadal
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - María Ribeiro
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Jose M López-Ilundain
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Jeronimo Saiz-Ruiz
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Alcalá de Henares, Universidad de Alcalá, Spain
| | - Luis León-Quismondo
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Alcalá de Henares, Universidad de Alcalá, Spain
| | - Olga Rivero
- Biomedical Research Institute INCLIVA, Fundación Investigación Hospital Clínico de Valencia, Valencia, Spain; Departament of Genetics, Universitat de València, Valencia, Spain
| | - Pedro Ruiz
- Hospital Clínico Universitario and Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, Spain; Department of Medicine and Psychiatry.Universidad de Zaragoza, Zaragoza, Spain
| | - Rafael Segarra Echevarría
- Cruces University Hospital, BioCruces Health Research Institute, Vizcaya, Spain; University of the Basque Country (UPV/EHU) Vizcaya, Spain
| | - M Paz García-Portilla
- Centro de Investigación Biomédica en red en salud Mental (CIBERSAM), Spain; Department of Psychiatry, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA). Instituto de Neurociencias del Principado de Asturias (INEUROPA). Mental Health Services of the Principality of Asturias (SESPA), Oviedo, Spain
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Amoretti S, Mezquida G, Verdolini N, Bioque M, Sánchez-Torres AM, Pina-Camacho L, Zorrilla I, Trabsa A, Rodriguez-Jimenez R, Corripio I, Sarró S, Ibañez A, Usall J, Segarra R, Vieta E, Roberto N, Ramos-Quiroga JA, Tortorella A, Menculini G, Cuesta MJ, Parellada M, González-Pinto A, Berrocoso E, Bernardo M. Negative symptoms and sex differences in first episode schizophrenia: What's their role in the functional outcome? A longitudinal study. Span J Psychiatry Ment Health 2023:S2950-2853(23)00010-8. [PMID: 38591832 DOI: 10.1016/j.sjpmh.2023.04.001] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/17/2023] [Accepted: 04/12/2023] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Negative symptoms (NS) include asociality, avolition, anhedonia, alogia, and blunted affect and are linked to poor prognosis. It has been suggested that they reflect two different factors: diminished expression (EXP) (blunted affect and alogia) and amotivation/pleasure (MAP) (anhedonia, avolition, asociality). The aim of this article was to examine potential sex differences among first-episode schizophrenia (FES) patients and analyze sex-related predictors of two NS symptoms factors (EXP and MAP) and functional outcome. MATERIAL AND METHODS Two hundred and twenty-three FES (71 females and 152 males) were included and evaluated at baseline, six-months and one-year. Repeated measures ANOVA was used to examine the effects of time and sex on NS and a multiple linear regression backward elimination was performed to predict NS factors (MAP-EXP) and functioning. RESULTS Females showed fewer NS (p=0.031; Cohen's d=-0.312), especially those related to EXP (p=0.024; Cohen's d=-0.326) rather than MAP (p=0.086), than males. In both male and female group, worse premorbid adjustment and higher depressive symptoms made a significant contribution to the presence of higher deficits in EXP at one-year follow-up, while positive and depressive symptoms predicted alterations in MAP. Finally, in females, lower deficits in MAP and better premorbid adjustment predicted better functioning at one-year follow-up (R2=0.494; p<0.001), while only higher deficits in MAP predicted worse functioning in males (R2=0.088; p=0.012). CONCLUSIONS Slightly sex differences have been found in this study. Our results lead us to consider that early interventions of NS, especially those focusing on motivation and pleasure symptoms, could improve functional outcomes.
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Affiliation(s)
- Silvia Amoretti
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institute of Neurosciences (UBNeuro), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, University of Perugia, Perugia, Italy
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Serra Húnter Fellow, Department of Basic Clinical Practice, University of Barcelona
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institute of Neurosciences (UBNeuro), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Laura Pina-Camacho
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Iñaki Zorrilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain
| | - Amira Trabsa
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CogPsy Group, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Salvador Sarró
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Angela Ibañez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Rafael Segarra
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Cruces University Hospital, BioCruces Health Research Institute, University of the Basque Country (UPV/EHU), Vizcaya, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institute of Neurosciences (UBNeuro), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Natalia Roberto
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Institute of Neurosciences (UBNeuro), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Alfonso Tortorella
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Giulia Menculini
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain
| | - Esther Berrocoso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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18
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Cuesta MJ. Response to Kleebayoon and Wiwanitkit's (2023): Towards a ChatGPT psychopathology: Comment. Eur Neuropsychopharmacol 2023; 74:76. [PMID: 37301002 DOI: 10.1016/j.euroneuro.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Manuel J Cuesta
- Jefe del Servicio de Psiquiatría, Hospital Universitario de Navarra, Pamplona (España), Spain
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19
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Arrarás JI, Cuesta MJ, Peralta V, Gil-Berrozpe GJ, Barrado L, Correa O, Elorza R, González L, Garmendia I, Janda L, Macaya P, Núñez C, Sabater P, Torrejon A. Psychometric analysis of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) and determinants of psychopathology in two outpatient clinics in Navarre (Spain). An Sist Sanit Navar 2023; 46:e1043. [PMID: 37647203 PMCID: PMC10520750 DOI: 10.23938/assn.1043] [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: 12/13/2022] [Revised: 03/28/2023] [Accepted: 06/28/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND The self-report Psychiatric Diagnostic Screening Questionnaire PDSQ is designed to screen Axis I psychiatric disorders. We aim to determine its psychometric properties in Spanish outpatients and assess its relationship with two interviews (for psychopathology and for personality disorders) and clinical/demographic variables. METHODOLOGY We administered the study questionnaire, the Mini International Neuropsychiatric Interview Plus (MINI-Plus), the Standardised Assessment of Personality Abbreviated Scale (SAPAS), and the List of Threatening Experiences Questionnaire (LTE-Q) to 375 patients at two public outpatient centres. Reliability of the study questionnaire was evaluated (Cronbach's alpha, ?) and known-group validity measured by comparing groups based on demographic and clinical variables (binary logistic regression analysis) and MINI-Plus diagnoses (Mann-Whitney U). The diagnostic accuracy of the study questionnaire score was analysed taking the MINI-Plus diagnoses as the gold standard (ROC analysis). RESULTS Internal consistency was adequate across all PDSQ scales (? >0.7; mean ?=0.85). Known-group comparisons were satisfactory. Female and male patients showed higher prevalence of internalizing and externalizing diagnoses, respectively. Younger age, more life events and limitations, higher SAPAS scores, and lower economic levels were linked to a greater number of PDSQ diagnoses. Inter-group differences were found for all PDSQ scales based on the corresponding MINI-Plus diagnoses. Mean values of sensitivity, AUC, and negative predictive value were 88.7, 0.82, and 96.7, respectively. CONCLUSIONS When applied to a sample of Spanish outpatients, the PDSQ exhibits satisfactory psychometric properties and adequate relationships with the psychopathology and personality interviews, and clinical and demographic variables. The study questionnaire is suitable for assessing comorbidity and psychopathology dimensions.
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Affiliation(s)
| | | | | | | | - Laura Barrado
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Olga Correa
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Rebeca Elorza
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Lorea González
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Irma Garmendia
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Lucía Janda
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Patricia Macaya
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Camino Núñez
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Pablo Sabater
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
| | - Aileen Torrejon
- Mental Health Department. Servicio Navarro de Salud - Osasunbidea. Pamplona. Spain.
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20
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Gutiérrez G, Goicoa T, Ugarte MD, Aranguren L, Corrales A, Gil-Berrozpe G, Librero J, Sánchez-Torres AM, Peralta V, García de Jalon E, Cuesta MJ, Martínez M, Otero M, Azcarate L, Pereda N, Monclús F, Moreno L, Fernández A, Ariz MC, Sabaté A, Aquerreta A, Aguirre I, Lizarbe T, Begué MJ. Small area variations in non-affective first-episode psychosis: the role of socioeconomic and environmental factors. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01665-z. [PMID: 37612449 DOI: 10.1007/s00406-023-01665-z] [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: 11/21/2022] [Accepted: 07/31/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND There is strong evidence supporting the association between environmental factors and increased risk of non-affective psychotic disorders. However, the use of sound statistical methods to account for spatial variations associated with environmental risk factors, such as urbanicity, migration, or deprivation, is scarce in the literature. METHODS We studied the geographical distribution of non-affective first-episode psychosis (NA-FEP) in a northern region of Spain (Navarra) during a 54-month period considering area-level socioeconomic indicators as putative explanatory variables. We used several Bayesian hierarchical Poisson models to smooth the standardized incidence ratios (SIR). We included neighborhood-level variables in the spatial models as covariates. RESULTS We identified 430 NA-FEP cases over a 54-month period for a population at risk of 365,213 inhabitants per year. NA-FEP incidence risks showed spatial patterning and a significant ecological association with the migrant population, unemployment, and consumption of anxiolytics and antidepressants. The high-risk areas corresponded mostly to peripheral urban regions; very few basic health sectors of rural areas emerged as high-risk areas in the spatial models with covariates. DISCUSSION Increased rates of unemployment, the migrant population, and consumption of anxiolytics and antidepressants showed significant associations linked to the spatial-geographic incidence of NA-FEP. These results may allow targeting geographical areas to provide preventive interventions that potentially address modifiable environmental risk factors for NA-FEP. Further investigation is needed to understand the mechanisms underlying the associations between environmental risk factors and the incidence of NA-FEP.
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Affiliation(s)
- Gerardo Gutiérrez
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain
- Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain
| | - Tomas Goicoa
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Statistics, Computer Science and Mathematics, Public University of Navarra, Pamplona, Spain
- Institute for Advanced Material and Mathematics, INAMAT2, Public University of Navarra, Pamplona, Spain
| | - María Dolores Ugarte
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Statistics, Computer Science and Mathematics, Public University of Navarra, Pamplona, Spain
- Institute for Advanced Material and Mathematics, INAMAT2, Public University of Navarra, Pamplona, Spain
| | - Lidia Aranguren
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain
- Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain
| | - Asier Corrales
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain
- Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain
| | - Gustavo Gil-Berrozpe
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Julián Librero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Navarrabiomed, Navarra University Hospital, Public University of Navarra, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Victor Peralta
- Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Elena García de Jalon
- Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain.
- Mental Health Department, Navarra Health Service-Osasunbidea, Pamplona, Spain.
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21
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Cuesta MJ. Psychopathology for the twenty-first century: Towards a ChatGPT psychopathology? Eur Neuropsychopharmacol 2023; 73:21-23. [PMID: 37119559 DOI: 10.1016/j.euroneuro.2023.04.016] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 05/01/2023]
Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain.
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22
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Valli I, Gonzalez Segura A, Verdolini N, Garcia-Rizo C, Berge D, Baeza I, Cuesta MJ, Gonzalez-Pinto A, Lobo A, Martinez-Aran A, Mezquida G, Pina-Camacho L, Roldan Bejarano A, Mas S, McGuire P, Bernardo M, Vieta E. Obstetric complications and genetic risk for schizophrenia: Differential role of antenatal and perinatal events in first episode psychosis. Acta Psychiatr Scand 2023; 148:81-90. [PMID: 36912272 DOI: 10.1111/acps.13546] [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: 12/09/2022] [Revised: 02/09/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Obstetric complications (OCs) are key contributors to psychosis risk. However, it is unclear whether they increase psychosis vulnerability independently of genetic risk, in interaction with it, or are a manifestation of psychosis proneness. We examined the role of distinct types of OCs in terms of psychosis risk and tested whether they interact differently with genetic vulnerability, whilst accounting for other known environmental risk factors. STUDY DESIGN 405 participants (219 first episode psychosis patients and 186 healthy volunteers) underwent a comprehensive assessment of OCs, measured using the Lewis-Murray scale and divided into complications of pregnancy, abnormalities of foetal growth and development, and complications of delivery. Participants were compared in terms of history of OCs, polygenic risk score for schizophrenia (PRS-SZ) and interactions between these. RESULTS Both complications of pregnancy and abnormalities of foetal growth were significantly associated with case-control status (p = 0.02 and 0.03, respectively), whereas complications of delivery were not. PRS-SZ showed a significant association with psychosis (p = 0.04), but there were no significant interactions between genetic risk for schizophrenia and OCs, either when these were considered globally or separated based on their timeframe. CONCLUSIONS We observed no significant interaction between genetic and obstetric vulnerability, yet distinct types of OCs may have a different impact on psychosis risk, based on their nature and timeframe. Examining their differential role might clarify their relative contributions to this risk.
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Affiliation(s)
- Isabel Valli
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Alex Gonzalez Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Norma Verdolini
- Department of Mental Health, Umbria 1 Mental Health Center, Perugia, Italy
| | - Clemente Garcia-Rizo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
| | - Daniel Berge
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
- Universitat Pompeu Fabra, MELIS Department, Barcelona, Spain
| | - Inmaculada Baeza
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Navarra University Hospital, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Ana Gonzalez-Pinto
- Department of Psychiatry, Hospital Universitario de Alava, UPV/EHU, BIOARABA, Vitoria, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Department of Medicine and Psychiatry, University of Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Anabel Martinez-Aran
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institute of Neurosciences, University of Barcelona, Spain
- Bipolar and Depressive Unit, Hospital Clinic de Barcelona, Institute of Neurosciences, Barcelona, Spain
| | - Gisela Mezquida
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institute of Neurosciences, University of Barcelona, Spain
| | - Laura Pina-Camacho
- 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, Madrid, Spain
- School of Medicine, Complutense University, Madrid, Spain
| | - Alexandra Roldan Bejarano
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry, Autonoma University of Barcelona, Barcelona, Spain
| | - Sergi Mas
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Miquel Bernardo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institute of Neurosciences, University of Barcelona, Spain
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en red de salud Mental (CIBERSAM), Spain
- Institute of Neurosciences, University of Barcelona, Spain
- Bipolar and Depressive Unit, Hospital Clinic de Barcelona, Institute of Neurosciences, Barcelona, Spain
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23
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García de Jalón E, Ariz MC, Aquerreta A, Aranguren L, Gutierrez G, Corrales A, Sánchez-Torres AM, Gil-Berrozpe GJ, Peralta V, Cuesta MJ. Effectiveness of the early intervention service for first-episode psychosis in Navarra (PEPsNa): Broadening the scope of outcome measures. Span J Psychiatry Ment Health 2023; 16:192-203. [PMID: 38520115 DOI: 10.1016/j.rpsm.2022.07.002] [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: 04/22/2022] [Revised: 07/07/2022] [Accepted: 07/10/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND This study compares the effectiveness of a new early intervention service for firstepisode psychosis (FEP) in patients under conventional treatment. Six primary and 10 secondary outcome measures are used to better characterize the comparative effectiveness between two FEP groups. METHODS This study plans to enroll 250 patients aged 15-55 years with FEP from all inpatient and outpatient mental health services and primary health care from January 2020 until December 2022. The control group will be composed of 130 FEP patients treated in mental health centers in the 2 years prior to the start of PEPsNa (Programa de Primeros Episodios de Psicosis de Navarra). The primary outcome measures are symptomatic remission, functional recovery, personal recovery, cognitive performance, functional capacity in real-world settings, and costs. The secondary outcome measures are duration of untreated psychosis, substance abuse rate, antipsychotic monotherapy, minimal effective dose of antipsychotic drugs, therapeutic alliance, drop-out rate, number of relapses, global mortality and suicidality, resource use, and general satisfaction in the program. DISCUSSION This study arises from the growing need to broaden the scope of outcome measures in FEP patients and to account for unmet needs of recovery for FEPs. It aims to contribute in the dissemination of the NAVIGATE model in Europe and to provide new evidence of the effectiveness of early intervention services for stakeholders of the National Health Service.
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Affiliation(s)
- Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Mari Cruz Ariz
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Ainhoa Aquerreta
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Lidia Aranguren
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Gerardo Gutierrez
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Asier Corrales
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - Gustavo J Gil-Berrozpe
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - Víctor Peralta
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Manuel J Cuesta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain.
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24
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Cuesta MJ. First-episode psychosis: Current research and future developments. Span J Psychiatry Ment Health 2023; 16:133-134. [PMID: 38008553 DOI: 10.1016/j.sjpmh.2023.11.002] [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: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
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25
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Mezquida G, Amoretti S, Bioque M, García-Rizo C, Sánchez-Torres AM, Pina-Camacho L, Lopez-Pena P, Mané A, Rodriguez-Jimenez R, Corripio I, Sarró S, Ibañez A, Usall J, García-Portilla MP, Vieta E, Mas S, Cuesta MJ, Parellada M, González-Pinto A, Berrocoso E, Bernardo M. Identifying risk factors for predominant negative symptoms from early stages in schizophrenia: A longitudinal and sex-specific study in first-episode schizophrenia patients. Span J Psychiatry Ment Health 2023; 16:159-168. [PMID: 37716849 DOI: 10.1016/j.rpsm.2023.01.004] [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: 09/01/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND People with schizophrenia and predominant negative symptoms (PNS) present a different clinical and functional profile from those without such symptomatology. Few studies have examined the risk factors and the incidence of PNS in first-episode schizophrenia patients (FES) and differentiating by sex. This study aims to assess prevalence, demographic and clinical characteristics related to PNS from early stages and to study if there are sex-specific features in terms of developing PNS. METHODS In a sample of 121 FES patients derived from a multicentre and naturalistic study, those who developed PNS at 12-months were identified. Environmental, clinical, functional, and cognitive ratings were examined longitudinally. Binary logistic regressions were applied to detect baseline risk factors for developing PNS at one-year follow-up. RESULTS In the present FES cohort, 24.8% of the patients (n=30) developed PNS (20% of the women, 27.6% of the men). Compared to non-PNS (75.2%, n=91), at baseline, PNS group had more negative (t=-6.347; p<0.001) and depressive symptoms (t=-5.026; p<0.001), poorer premorbid adjustment (t=-2.791; p=0.006) and functional outcome (t=-2.649; p<0.001), more amotivation (t=-7.333; p<0.001), more expressivity alterations (t=-4.417; p<0.001), worse cognitive reserve (t=2.581; p<0.011), a lower estimated intelligent quotient (t=2.417; p=0.017), worse verbal memory (t=2.608; p=0.011), and worse fluency (t=2.614; p=0.010). Regressions showed that the premorbid adjustment was the main predictor of PNS in females (p=0.007; Exp(B)=1.106) while in males were a worse verbal memory performance (p=0.031; Exp(B)=0.989) and more alterations in the motivation domain (p=0.001; Exp(B)=1.607). CONCLUSIONS A different baseline clinical profile and notable risk factors differences in the development of PNS between males and females were found. Results suggest that sex may be an important confounder in studies comparing schizophrenia patients with predominant and non-predominant negative symptomatology.
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Affiliation(s)
- Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain.
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Laura Pina-Camacho
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Purificación Lopez-Pena
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain
| | - Anna Mané
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain; Fundació Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Roberto Rodriguez-Jimenez
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; CogPsy Group, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Salvador Sarró
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Angela Ibañez
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Judith Usall
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - María Paz García-Portilla
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, University of Oviedo; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA; Instituto de Neurociencias del Principado de Asturias (INEUROPA; Servicio de Psiquiatría, Oviedo, SESPA, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Sergi Mas
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Mara Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Universidad del País Vasco/Euskal Herriko Unibertsitatea, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain
| | - Esther Berrocoso
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz, INiBICA, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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26
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Segura AG, Mezquida G, Martínez-Pinteño A, Gassó P, Rodriguez N, Moreno-Izco L, Amoretti S, Bioque M, Lobo A, González-Pinto A, García-Alcon A, Roldán-Bejarano A, Vieta E, de la Serna E, Toll A, Cuesta MJ, Mas S, Bernardo M. Link between cognitive polygenic risk scores and clinical progression after a first-psychotic episode. Psychol Med 2023; 53:4634-4647. [PMID: 35678455 PMCID: PMC10388335 DOI: 10.1017/s0033291722001544] [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: 12/22/2021] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Clinical intervention in early stages of psychotic disorders is crucial for the prevention of severe symptomatology trajectories and poor outcomes. Genetic variability is studied as a promising modulator of prognosis, thus novel approaches considering the polygenic nature of these complex phenotypes are required to unravel the mechanisms underlying the early progression of the disorder. METHODS The sample comprised of 233 first-episode psychosis (FEP) subjects with clinical and cognitive data assessed periodically for a 2-year period and 150 matched controls. Polygenic risk scores (PRSs) for schizophrenia, bipolar disorder, depression, education attainment and cognitive performance were used to assess the genetic risk of FEP and to characterize their association with premorbid, baseline and progression of clinical and cognitive status. RESULTS Schizophrenia, bipolar disorder and cognitive performance PRSs were associated with an increased risk of FEP [false discovery rate (FDR) ⩽ 0.027]. In FEP patients, increased cognitive PRSs were found for FEP patients with more cognitive reserve (FDR ⩽ 0.037). PRSs reflecting a genetic liability for improved cognition were associated with a better course of symptoms, functionality and working memory (FDR ⩽ 0.039). Moreover, the PRS of depression was associated with a worse trajectory of the executive function and the general cognitive status (FDR ⩽ 0.001). CONCLUSIONS Our study provides novel evidence of the polygenic bases of psychosis and its clinical manifestation in its first stage. The consistent effect of cognitive PRSs on the early clinical progression suggests that the mechanisms underlying the psychotic episode and its severity could be partially independent.
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Affiliation(s)
- Alex G. Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Gisela Mezquida
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de 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
| | - Albert Martínez-Pinteño
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, 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
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Silvia Amoretti
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Miquel Bioque
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de 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
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (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
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitario de Alava, Vitoria-Gasteiz, Spain
- Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Spain
- University of the Basque Country, Vizcaya, Spain
| | - Alicia García-Alcon
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Alexandra Roldán-Bejarano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Psychiatry Department, Institut d'Investigació Biomèdica-SantPau (IIB-SANTPAU), 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), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Alba Toll
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, 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
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de 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
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - PEPs Group
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
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27
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Serra-Navarro M, Amoretti S, Verdolini N, Forte MF, Sánchez-Torres AM, Vieta E, Clougher D, Lobo A, González-Pinto A, Panadero R, Roldán A, Carvalho AF, de la Serna E, Toll A, Ramos-Quiroga JA, Torrent C, Cuesta MJ, Bernardo M. Corrigendum: Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: differences between males and females. Front Psychiatry 2023; 14:1200313. [PMID: 37383614 PMCID: PMC10299165 DOI: 10.3389/fpsyt.2023.1200313] [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: 04/04/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2022.982583.].
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Affiliation(s)
- Maria Serra-Navarro
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, Italy
| | - María Florencia Forte
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ana M. Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Derek Clougher
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Medicine and Psychiatry, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza University, Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain
- Department of Psychiatry, University of the Basque Country (UPV-EHU), Vitoria-Gasteiz, Spain
| | - Rocío Panadero
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Institute of Psychiatry and Mental Health, Universidad Complutense, IiSGM, Madrid, Spain
| | - Alexandra Roldán
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - André F. Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT), School of Medicine, Barwon Health, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institut Clínic de Neurociències, Hospital Clínic Universitari, CIBERSAM, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Alba Toll
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J. A. Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
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28
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Segura AG, Mané A, Prohens L, Rodriguez N, Mezquida G, Cuesta MJ, Vieta E, Amoretti S, Lobo A, González-Pinto A, Diaz-Caneja CM, Roldán-Bejarano A, Jimenez E, Baeza I, Legido T, Saiz-Ruiz J, Bernardo M, Mas S. Exploration of cannabis use and polygenic risk scores on the psychotic symptom progression of a FEP cohort. Psychiatry Res 2023; 325:115249. [PMID: 37178502 DOI: 10.1016/j.psychres.2023.115249] [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: 02/06/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 05/15/2023]
Abstract
Cannabis use is highly prevalent in first-episode psychosis (FEP) and plays a critical role in its onset and prognosis, but the genetic underpinnings promoting both conditions are poorly understood. Current treatment strategies for cannabis cessation in FEP are clearly inefficacious. Here, we aimed to characterize the association between cannabis-related polygenic risk scores (PRS) on cannabis use and clinical course after a FEP. A cohort of 249 FEP individuals were evaluated during 12 months. Symptom severity was measured with the Positive and Negative Severity Scale and cannabis use with the EuropASI scale. Individual PRS for lifetime cannabis initiation (PRSCI) and cannabis use disorder (PRSCUD) were constructed. Current cannabis use was associated with increased positive symptoms. Cannabis initiation at younger ages conditioned the 12-month symptom progression. FEP patients with higher cannabis PRSCUD reported increased baseline cannabis use. PRSCI was associated with the course of negative and general symptomatology over follow-up. Cannabis use and symptom progression after a FEP were modulated by cannabis PRS, suggesting that lifetime initiation and use disorders may have partially independent genetic factors. These exploratory results may be the first step to identify those FEP patients more vulnerable to cannabis use and worse outcomes to ultimately develop tailored treatments.
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Affiliation(s)
- Alex G Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Anna Mané
- Hospital del Mar Medical Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Llucia Prohens
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Natalia Rodriguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Gisela Mezquida
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (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
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital Universitario de Alava, Vitoria-Gasteiz, Spain; Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Spain; University of the Basque Country, Vizcaya, Spain
| | - Covadonga M Diaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Alexandra Roldán-Bejarano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANTPAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Esther Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Immaculada Baeza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Teresa Legido
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Jeronimo Saiz-Ruiz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Universidad de Alcala, Alcalá de Henares, Spain; Hospital Ramon y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Madrid, Spain
| | - Miguel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, 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.
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29
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Peralta V, de Jalón EG, Moreno-Izco L, Peralta D, Janda L, Sánchez-Torres AM, Cuesta MJ. A clinical staging model of psychotic disorders based on a long-term follow-up of first-admission psychosis: A validation study. Psychiatry Res 2023; 322:115109. [PMID: 36841052 DOI: 10.1016/j.psychres.2023.115109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
We examined the empirical validity of a staging model of psychotic disorders primarily based on their long-term course. The model distinguished 6 consecutive stages (2A, 2B, 3A, 3B, 4A, 4B) based on symptom recurrence, persistence and progression, such as functional decline. We analyzed data from 243 participants with first-admission psychosis who were followed-up for a mean of 20.9 years and assessed for 22 baseline variables, 23 construct-related variables and 31 outcome variables. Later stages scored significantly poorer than early stages on most validators by showing generally medium to large effect sizes and a dose-response pattern, thus confirming the validity of the model. For each set of validators, differences between consecutive stages were especially evident for stages 2 and 3A, although many variables from each validation realm also differentiated between the consecutive stages 3A and above. Baseline predictors including familial load of schizophrenia, neurodevelopmental impairment, childhood adversity, treatment delay, negative symptoms, neurological impairment and poor early response to treatment, independently accounted for 49.9% of the variance of staging. A staging model of psychosis based primarily on its long-term course has sound construct, outcome and predictive validity, which may inform about stage indicators and predictors of clinical stages from psychosis onset.
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Affiliation(s)
- Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
| | - Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Manuel J Cuesta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
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30
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Peralta V, Cuesta MJ. Schneider's first-rank symptoms have neither diagnostic value for schizophrenia nor higher clinical validity than other delusions and hallucinations in psychotic disorders. Psychol Med 2023; 53:2708-2711. [PMID: 32943125 DOI: 10.1017/s0033291720003293] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The validity of studies on the diagnostic significance of first-rank symptoms (FRS) for schizophrenia has been put in doubt because of a poor compliance with Schneider's criterion for their definition and the lack of use of the phenomenological method for their assessment. In this study, using a rigorously phenomenological approach to elicit FRS, we examined (a) the degree to which unequivocally present FRS differentiated schizophrenia (n=513) from other psychotic disorders (n=633), and (b) the comparative validity between FRS and other reality-distortion symptoms against 16 external validators in the whole sample of psychotic disorders (n=1146). Diagnostic performance indices (with 95% CIs) of FRS for diagnosing schizophrenia were as follows: sensitivity=0.58 (0.54-0.61), specificity=0.65 (0.62-0.67), positive predictive value=0.57 (0.54-0.60) and negative predictive value=0.65 (0.63-0.68). While the overall association pattern of FRS and non-FRS scores with the validators was rather similar, three validators (premorbid social adjustment, number of hospitalizations and global assessment of functioning) were significantly related to non-FRS scores (p < 0.006) but not to FRS scores (p > 0.05). Furthermore, no validator was significantly related to FRS scores and unrelated to non-FRS scores, all of which indicates an overall better predictive validity for non-FRS delusions and hallucinations. These findings suggest that FRS do not have diagnostic value for diagnosing schizophrenia and that they do not meaningfully add to the external validity showed by other delusions and hallucinations. We believe that much of the misunderstanding about the diagnostic and clinical validity of FRS for schizophrenia is rooted in Schneider's confusing concept of the disorder.
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Affiliation(s)
- Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Instituto de Investigación Sanitaria de Navarra (IdISNa), Pamplona, Spain
| | - Manuel J Cuesta
- Psychiatry Service, Complejo Hospitalario de Navarra, Instituto de Investigación Sanitaria de Navarra (IdISNa), Pamplona, Spain
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31
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Cuesta MJ, Papiol S, Ibañez B, García de Jalón E, Sánchez-Torres AM, Gil-Berrozpe GJ, Moreno-Izco L, Zarzuela A, Fañanás L, Peralta V. Effect of polygenic risk score, family load of schizophrenia and exposome risk score, and their interactions, on the long-term outcome of first-episode psychosis. Psychol Med 2023; 53:1-10. [PMID: 36876482 DOI: 10.1017/s0033291723000351] [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] [Indexed: 03/07/2023]
Abstract
BACKGROUND Consistent evidence supports the involvement of genetic and environmental factors, and their interactions, in the etiology of psychosis. First-episode psychosis (FEP) comprises a group of disorders that show great clinical and long-term outcome heterogeneity, and the extent to which genetic, familial and environmental factors account for predicting the long-term outcome in FEP patients remains scarcely known. METHODS The SEGPEPs is an inception cohort study of 243 first-admission patients with FEP who were followed-up for a mean of 20.9 years. FEP patients were thoroughly evaluated by standardized instruments, with 164 patients providing DNA. Aggregate scores estimated in large populations for polygenic risk score (PRS-Sz), exposome risk score (ERS-Sz) and familial load score for schizophrenia (FLS-Sz) were ascertained. Long-term functioning was assessed by means of the Social and Occupational Functioning Assessment Scale (SOFAS). The relative excess risk due to interaction (RERI) was used as a standard method to estimate the effect of interaction of risk factors. RESULTS Our results showed that a high FLS-Sz gave greater explanatory capacity for long-term outcome, followed by the ERS-Sz and then the PRS-Sz. The PRS-Sz did not discriminate significantly between recovered and non-recovered FEP patients in the long term. No significant interaction between the PRS-Sz, ERS-Sz or FLS-Sz regarding the long-term functioning of FEP patients was found. CONCLUSIONS Our results support an additive model of familial antecedents of schizophrenia, environmental risk factors and polygenic risk factors as contributors to a poor long-term functional outcome for FEP patients.
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Affiliation(s)
- M J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - S Papiol
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, 80336, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - B Ibañez
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Navarrabiomed - Hospital Universitario de Navarra - UPNA, Pamplona, Spain
- Red de Investigación en Atención Primaria, Servicios Sanitarios y Cronicidad (RICAPPS), Barcelona, Spain
| | - E García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - A M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - G J Gil-Berrozpe
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - L Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - A Zarzuela
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - L Fañanás
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain
| | - V Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
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32
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Sánchez-Torres AM, Amoretti S, Enguita-Germán M, Mezquida G, Moreno-Izco L, Panadero-Gómez R, Rementería L, Toll A, Rodriguez-Jimenez R, Roldán A, Pomarol-Clotet E, Ibáñez Á, Usall J, Contreras F, Vieta E, López-Ilundain JM, Merchán-Naranjo J, González-Pinto A, Berrocoso E, Bernardo M, Cuesta MJ. Relapse, cognitive reserve, and their relationship with cognition in first episode schizophrenia: a 3-year follow-up study. Eur Neuropsychopharmacol 2023; 67:53-65. [PMID: 36495858 DOI: 10.1016/j.euroneuro.2022.11.011] [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: 07/06/2022] [Revised: 10/18/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Abstract
Schizophrenia is frequently characterized by the presence of multiple relapses. Cognitive impairments are core features of schizophrenia. Cognitive reserve (CR) is the ability of the brain to compensate for damage caused by pathologies such as psychotic illness. As cognition is related to CR, the study of the relationship between relapse, cognition and CR may broaden our understanding of the course of the disease. We aimed to determine whether relapse was associated with cognitive impairment, controlling for the effects of CR. Ninety-nine patients with a remitted first episode of schizophrenia or schizophreniform disorder were administered a set of neuropsychological tests to assess premorbid IQ, attention, processing speed, working memory, verbal and visual memory, executive functions and social cognition. They were followed up for 3 years (n=53) or until they relapsed (n=46). Personal and familial CR was estimated from a principal component analysis of the premorbid information gathered. Linear mixed-effects models were applied to analyse the effect of time and relapse on cognitive function, with CR as covariate. Patients who relapsed and had higher personal CR showed less deterioration in attention, whereas those with higher CR (personal and familial CR) who did not relapse showed better performance in processing speed and visual memory. Taken together, CR seems to ameliorate the negative effects of relapse on attention performance and shows a positive effect on processing speed and visual memory in those patients who did not relapse. Our results add evidence for the protective effect of CR over the course of the illness.
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Affiliation(s)
- Ana M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR); Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Mónica Enguita-Germán
- Navarra Institute of Health Research (IdiSNA), Pamplona, Spain; Unidad de Metodología. Navarrabiomed-CHN -UPNA. Pamplona
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Rocío Panadero-Gómez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Lide Rementería
- BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Alba Toll
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital del Mar Medical Research Institute (IMIM)
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12); Universidad Complutense de Madrid (UCM), Plaza Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - Alexandra Roldán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Ángela Ibáñez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat
| | - Fernando Contreras
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatric Department. Bellvitge Universitary Hospital. IDIBELL
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jose M López-Ilundain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Jessica Merchán-Naranjo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Esther Berrocoso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychology, University of Cadiz, Spain, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain.
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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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Gil-Berrozpe GJ, Peralta V, Sánchez-Torres AM, Moreno-Izco L, García de Jalón E, Peralta D, Janda L, Cuesta MJ. Psychopathological networks in psychosis: Changes over time and clinical relevance. A long-term cohort study of first-episode psychosis. Schizophr Res 2023; 252:23-32. [PMID: 36621323 DOI: 10.1016/j.schres.2022.12.046] [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: 01/24/2022] [Revised: 03/22/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND First-episode psychosis is a critical period for early interventions to reduce the risk of poor outcomes and relapse as much as possible. However, uncertainties about the long-term outcomes of symptomatology remain to be ascertained. METHODS The aim of the present study was to use network analysis to investigate first-episode and long-term stages of psychosis at three levels of analysis: micro, meso and macro. The sample was a cohort of 510 patients with first-episode psychoses from the SEGPEP study, who were reassessed at the long-term follow-up (n = 243). We used the Comprehensive Assessment of Symptoms and History for their assessments and lifetime outcome variables of clinical relevance. RESULTS Our results showed a similar pattern of clustering between first episodes and long-term follow-up in seven psychopathological dimensions at the micro level, 3 and 4 dimensions at the meso level, and one at the macro level. They also revealed significant differences between first-episode and long-term network structure and centrality measures at the three levels, showing that disorganization symptoms have more influence in long-term stabilized patients. CONCLUSIONS Our findings suggest a relative clustering invariance at all levels, with the presence of two domains of disorganization as the most notorious difference over time at micro level. The severity of disorganization at the follow-up was associated with a more severe course of the psychosis. Moreover, a relative stability in global strength of the interconnections was found, even though the network structure varied significantly in the long-term follow-up. The macro level was helpful in the integration of all dimensions into a common psychopathology factor, and in unveiling the strong relationships of psychopathological dimensions with lifetime outcomes, such as negative with poor functioning, disorganization with high antipsychotic dose-years, and delusions with poor adherence to treatment. These results add evidence to the hierarchical, dimensional and longitudinal structure of psychopathological symptoms and their clinical relevance in first-episode psychoses.
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Affiliation(s)
- Gustavo J Gil-Berrozpe
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Victor Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Elena García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
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Segura ÀG, Prohens L, Mezquida G, Amoretti S, Bioque M, Ribeiro M, Gurriarán-Bas X, Rementería L, Berge D, Rodriguez-Jimenez R, Roldán A, Pomarol-Clotet E, Ibáñez A, Usall J, García-Portilla MP, Cuesta MJ, Parellada M, González-Pinto A, Berrocoso E, Bernardo M, Mas S, González-Díaz JM, Arbelo N, González-Peñas J, Pina-Camacho L, Diestre A, Selma J, Zorrilla I, López P, Trabsa A, Monserrat C, Sanchez-Pastor L, Nuñez-Doyle A, Fatjó-Vilas M, Sarró S, Butjosa A, Pardo M, López-Ilundain JM, Sánchez Torres AM, Saiz-Ruiz J, Ochoa-Mangado E, RIevero O, De-la-Cámara C, Echevarría RS, González-Blanco L. Epigenetic clocks in relapse after a first episode of schizophrenia. Schizophr 2022; 8:61. [PMID: 35869075 PMCID: PMC9307769 DOI: 10.1038/s41537-022-00268-2] [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: 05/05/2022] [Accepted: 07/04/2022] [Indexed: 11/17/2022]
Abstract
The main objective of the present study was to investigate the association between several epigenetic clocks, covering different aspects of aging, with schizophrenia relapse evaluated over a 3-year follow-up period in a cohort of ninety-one first-episode schizophrenia patients. Genome-wide DNA methylation was profiled and four epigenetic clocks, including epigenetic clocks of chronological age, mortality and telomere length were calculated. Patients that relapsed during the follow-up showed epigenetic acceleration of the telomere length clock (p = 0.030). Shorter telomere length was associated with cognitive performance (working memory, r = 0.31 p = 0.015; verbal fluency, r = 0.28 p = 0.028), but no direct effect of cognitive function or symptom severity on relapse was detected. The results of the present study suggest that epigenetic age acceleration could be involved in the clinical course of schizophrenia and could be a useful marker of relapse when measured in remission stages.
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36
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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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37
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Cuesta MJ, Sánchez-Torres AM, Moreno-Izco L, García de Jalón E, Gil-Berrozpe GJ, Zarzuela A, Peralta V, Ballesteros A, Fañanás L, Hernández R, Janda L, Lorente R, Papiol S, Peralta D, Ribeiro M, Rosero A, Zandio M. Neurocognitive correlates of the varied domains of outcomes at 20 year follow-up of first-episode psychosis. Psychiatry Res 2022; 318:114933. [PMID: 36334328 DOI: 10.1016/j.psychres.2022.114933] [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: 08/08/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Little is known about long-term outcomes of the first episode of psychosis (FEP) other than in the symptomatic domain. We hypothesised that cognitive impairment is associated with poorer multi-domain outcomes at a long-term follow-up of FEP patients. We followed-up 172 FEP patients for a mean of 20.3 years. Ten outcome dimensions were assessed (symptomatic, functional and personal recovery, social disadvantage, physical health, suicide attempts, number of episodes, current drug use, chlorpromazine equivalent doses (CPZ), and schizophrenia/schizoaffective disorder final diagnosis). Cognition was assessed at follow-up. Processing speed and verbal memory deficits showed significant associations with poor outcomes on symptomatic, social functioning, social disadvantage, higher number of episodes, and higher CPZ. Significant associations were found between visual memory impairments were significantly associated with low symptomatic and functional recovery, between attentional deficits and a final diagnosis of schizophrenia/schizoaffective disorder, and between social cognition deficits and poor personal recovery.Lower cognitive global scores were significantly associated with all outcome dimensions except for drug abuse and physical status. Using multiple outcome dimensions allowed for the inclusion of the patients' perspective and other commonly neglected outcome measures. Taken together, cognitive impairment in FEP patients is strongly related to poor performance on several outcome dimensions beyond symptomatic remission.
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Affiliation(s)
- M J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.
| | - A M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - L Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - E García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - G J Gil-Berrozpe
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - A Zarzuela
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - V Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - A Ballesteros
- Red de Salud Mental de Álava, Vitoria-Gasteiz, Spain
| | - L Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Biomedicine Institute of the University of Barcelona (IBUB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Spain
| | - R Hernández
- CSMIJ Ciutat Vella. Consorci Parc de Salut Mar, Barcelona, Spain
| | - L Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - R Lorente
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - S Papiol
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Spain; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, 80336, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, 80336, Germany
| | - D Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - M Ribeiro
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - A Rosero
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - M Zandio
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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38
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Cuesta MJ, Arrarás JI, Gil-Berrozpe GJ, Peralta V, Barrado L, Correa O, Elorza R, Fernández L, Garmendia I, Janda L, Macaya P, Núñez C, Sabater P, Torrejon A. The network structure of self-reported psychopathological dimensions in common mental disorders (CMDs). The European Journal of Psychiatry 2022. [DOI: 10.1016/j.ejpsy.2022.11.003] [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: 12/15/2022]
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Sánchez-Torres AM, Moreno-Izco L, Gil-Berrozpe GJ, Lorente-Omeñaca R, Zandio M, Zarzuela A, Peralta V, Cuesta MJ. Assessment of cognitive impairment in psychosis spectrum disorders through self-reported and interview-based measures. Eur Arch Psychiatry Clin Neurosci 2022; 272:1183-1192. [PMID: 35362774 DOI: 10.1007/s00406-022-01399-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 03/14/2022] [Indexed: 11/25/2022]
Abstract
Self-reported and interview-based measures can be considered coprimary measures of cognitive performance. We aimed to ascertain to what extent cognitive impairment in psychotic disorders, as assessed with a neuropsychological battery, is associated with subjective cognitive complaints compared to difficulties in daily activities caused by cognitive impairment. We assessed 114 patients who had a psychotic disorder with a set of neuropsychological tests and two additional measures: the Cognitive Assessment Interview-Spanish version (CAI-Sp) and the Frankfurt Complaint Questionnaire (FCQ). Patients also underwent a clinical assessment. The CAI-Sp correlated significantly with all the clinical dimensions, while the FCQ correlated only with positive and depressive symptoms. The CAI-Sp correlated significantly with all cognitive domains, except for verbal memory and social cognition. The FCQ was associated with attention, processing speed and working memory. The combination of manic and depressive symptoms and attention, processing speed, working memory and explained 38-46% of the variance in the patients' CAI-Sp. Education and negative symptoms, in combination with attention, processing speed, and executive functions, explained 54-59% of the CAI-Sp rater's variance. Only negative symptoms explained the variance in the CAI-Sp informant scores (37-42%). Depressive symptoms with attention and working memory explained 15% of the FCQ variance. The ability to detect cognitive impairment with the CAI-Sp and the FCQ opens the possibility to consider these instruments to approximate cognitive impairment in clinical settings due to their ease of application and because they are less time-consuming for clinicians.
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Affiliation(s)
| | - Lucía Moreno-Izco
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | | | | | - María Zandio
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
| | - Amalia Zarzuela
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Victor Peralta
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Manuel J Cuesta
- Navarra Institute of Health Research, IdiSNA, Pamplona, Spain.
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain.
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40
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Bioque M, Catarina Matias-Martins A, Llorca-Bofí V, Mezquida G, Cuesta MJ, Vieta E, Amoretti S, Lobo A, González-Pinto A, Moreno C, Roldán A, Martinez-Aran A, Baeza I, Bergé D, García-Rizo C, Mas Herrero S, Bernardo M. Neutrophil to Lymphocyte Ratio in Patients With a First Episode of Psychosis: A Two-Year Longitudinal Follow-up Study. Schizophr Bull 2022; 48:1327-1335. [PMID: 35876785 PMCID: PMC9673249 DOI: 10.1093/schbul/sbac089] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS A pro-inflammatory phenotype has been related to psychotic disorders. The neutrophil-lymphocyte ratio (NLR) is an accessible biomarker that could be helpful to characterize this systemic inflammation state. STUDY DESIGN This study evaluated the NLR in a cohort of 310 subjects with a first episode of psychosis (FEP) and a matched group of 215 healthy controls, recruited in 16 Spanish centers participating in the PEPs Project. We investigated the NLR measures over 2 years in a prospective, naturalistic study. STUDY RESULTS At baseline, the FEP group showed a significant higher mean NLR compared to the control group (1.96 ± 1.11 vs 1.72 ± 0.74, P = 0.03). These ratio differences between groups grew at the 24 months follow-up visit (2.04 ± 0.86 vs 1.65 ± 0.65, P < 0.001). Within the FEP group, there were no significant differences in NLR across the follow-up visits, between genders or diagnosis groups (affective vs nonaffective). NLR values did not correlate with the Positive and Negative Symptoms Scale scores. The group of patients who did not reach remission criteria at the end of the study showed a significant higher NLR than those who remitted (2.1896 ± 0.85 vs 1.95 ± 0.87, P = 0.042). A significant correlation between antipsychotic doses and NLR was found at the two-years follow-up visit (r=0.461, P < 0.001). CONCLUSIONS Our results highlight the existence of an underlying predisposition of FEP patients to present an increased mean NLR. The use of NLR in clinical practice could be helpful to identify this inflammatory imbalance.
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Affiliation(s)
- Miquel Bioque
- To whom correspondence should be addressed; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; tel: 34932275400 (X 4568), fax: 34932275548, e-mail:
| | | | - Vicent Llorca-Bofí
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona (Navarra), Spain,Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Eduard Vieta
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain,Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain
| | - Sílvia Amoretti
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain,Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d’Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Hospital Universitario Araba, Servicio de Psiquiatria, UPV/EHU, Bioaraba, Spain
| | - Carmen Moreno
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain,School of Medicine, Universidad Complutense, Madrid, Spain
| | - Alexandra Roldán
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Psychiatry Department, Institut d’Investigació Biomèdica-Sant Pau, (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain,Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Anabel Martinez-Aran
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain,Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Barcelona, Spain
| | - Immaculada Baeza
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain,Child and Adolescent Psychiatry and Psychology Department, SGR-881, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Daniel Bergé
- Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain,Pompeu Fabra University (UPF), Barcelona, Spain
| | - Clemente García-Rizo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sergi Mas Herrero
- Department of Basic Clinical Practice, Pharmacology Unit, University of Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain,Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en red en salud Mental, Instituto de Salud Carlos III, Barcelona, Spain,Department of Medicine, University of Barcelona, Barcelona, Spain
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Almodóvar-Payá C, Guardiola-Ripoll M, Giralt-López M, Gallego C, Salgado-Pineda P, Miret S, Salvador R, Muñoz MJ, Lázaro L, Guerrero-Pedraza A, Parellada M, Carrión MI, Cuesta MJ, Maristany T, Sarró S, Fañanás L, Callado LF, Arias B, Pomarol-Clotet E, Fatjó-Vilas M. NRN1 Gene as a Potential Marker of Early-Onset Schizophrenia: Evidence from Genetic and Neuroimaging Approaches. Int J Mol Sci 2022; 23:ijms23137456. [PMID: 35806464 PMCID: PMC9267632 DOI: 10.3390/ijms23137456] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 12/10/2022] Open
Abstract
Included in the neurotrophins family, the Neuritin 1 gene (NRN1) has emerged as an attractive candidate gene for schizophrenia (SZ) since it has been associated with the risk for the disorder and general cognitive performance. In this work, we aimed to further investigate the association of NRN1 with SZ by exploring its role on age at onset and its brain activity correlates. First, we developed two genetic association analyses using a family-based sample (80 early-onset (EO) trios (offspring onset ≤ 18 years) and 71 adult-onset (AO) trios) and an independent case–control sample (120 healthy subjects (HS), 87 EO and 138 AO patients). Second, we explored the effect of NRN1 on brain activity during a working memory task (N-back task; 39 HS, 39 EO and 39 AO; matched by age, sex and estimated IQ). Different haplotypes encompassing the same three Single Nucleotide Polymorphisms(SNPs, rs3763180–rs10484320–rs4960155) were associated with EO in the two samples (GCT, TCC and GTT). Besides, the GTT haplotype was associated with worse N-back task performance in EO and was linked to an inefficient dorsolateral prefrontal cortex activity in subjects with EO compared to HS. Our results show convergent evidence on the NRN1 association with EO both from genetic and neuroimaging approaches, highlighting the role of neurotrophins in the pathophysiology of SZ.
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Affiliation(s)
- Carmen Almodóvar-Payá
- FIDMAG Germanes Hospitalàries Research Foundation, 08830 Sant Boi de Llobregat, Barcelona, Spain; (C.A.-P.); (M.G.-R.); (P.S.-P.); (R.S.); (A.G.-P.); (S.S.)
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
| | - Maria Guardiola-Ripoll
- FIDMAG Germanes Hospitalàries Research Foundation, 08830 Sant Boi de Llobregat, Barcelona, Spain; (C.A.-P.); (M.G.-R.); (P.S.-P.); (R.S.); (A.G.-P.); (S.S.)
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
| | - Maria Giralt-López
- Departament de Psiquiatria, Hospital Universitari Germans Trias i Pujol (HUGTP), 08916 Badalona, Barcelona, Spain;
- Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain
| | - Carme Gallego
- Department of Cell Biology, Molecular Biology Institute of Barcelona (IBMB-CSIC), 08028 Barcelona, Barcelona, Spain;
| | - Pilar Salgado-Pineda
- FIDMAG Germanes Hospitalàries Research Foundation, 08830 Sant Boi de Llobregat, Barcelona, Spain; (C.A.-P.); (M.G.-R.); (P.S.-P.); (R.S.); (A.G.-P.); (S.S.)
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
| | - Salvador Miret
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
- Centre de Salut Mental d’Adults de Lleida, Servei de Psiquiatria, Salut Mental i Addiccions, Hospital Universitari Santa Maria de Lleida, 25198 Lleida, Lleida, Spain
- Institut de Recerca Biomèdica (IRB), 25198 Lleida, Lleida, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, 08830 Sant Boi de Llobregat, Barcelona, Spain; (C.A.-P.); (M.G.-R.); (P.S.-P.); (R.S.); (A.G.-P.); (S.S.)
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
| | - María J. Muñoz
- Complex Assistencial en Salut Mental Benito Menni, 08830 Sant Boi de Llobregat, Barcelona, Spain;
| | - Luisa Lázaro
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic de Barcelona, 08036 Barcelona, Barcelona, Spain
- Departament de Medicina, Universitat de Barcelona (UB), 08036 Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Barcelona, Spain
| | - Amalia Guerrero-Pedraza
- FIDMAG Germanes Hospitalàries Research Foundation, 08830 Sant Boi de Llobregat, Barcelona, Spain; (C.A.-P.); (M.G.-R.); (P.S.-P.); (R.S.); (A.G.-P.); (S.S.)
- Complex Assistencial en Salut Mental Benito Menni, 08830 Sant Boi de Llobregat, Barcelona, Spain;
| | - Mara Parellada
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
- Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Gregorio Marañón (IiSGM), 28007 Madrid, Madrid, Spain
- Departamento de Psiquiatría, Facultad de Medicina, Universidad Complutense, 28040 Madrid, Madrid, Spain
| | | | - Manuel J. Cuesta
- Servicio de Psiquiatría, Hospital Universitario de Navarra, 31008 Pamplona, Navarra, Spain;
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Navarra, Spain
| | - Teresa Maristany
- Departament de Diagnòstic per la Imatge, Hospital Sant Joan de Déu Fundació de Recerca, 08950 Esplugues de Llobregat, Barcelona, Spain;
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, 08830 Sant Boi de Llobregat, Barcelona, Spain; (C.A.-P.); (M.G.-R.); (P.S.-P.); (R.S.); (A.G.-P.); (S.S.)
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
| | - Lourdes Fañanás
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
- Departament de Biologia Evolutiva, Ecología i Ciències Ambientals, Universitat de Barcelona (UB), 08028 Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), 08028 Barcelona, Barcelona, Spain
| | - Luis F. Callado
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
- Department of Pharmacology, University of the Basque Country, UPV/EHU, 48940 Leioa, Bizkaia, Spain
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Bizkaia, Spain
| | - Bárbara Arias
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
- Departament de Biologia Evolutiva, Ecología i Ciències Ambientals, Universitat de Barcelona (UB), 08028 Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), 08028 Barcelona, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, 08830 Sant Boi de Llobregat, Barcelona, Spain; (C.A.-P.); (M.G.-R.); (P.S.-P.); (R.S.); (A.G.-P.); (S.S.)
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
- Correspondence: (E.P.-C.); (M.F.-V.)
| | - Mar Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, 08830 Sant Boi de Llobregat, Barcelona, Spain; (C.A.-P.); (M.G.-R.); (P.S.-P.); (R.S.); (A.G.-P.); (S.S.)
- Instituto de Salud Carlos III, Biomedical Research Network in Mental Health (CIBERSAM), 28029 Madrid, Madrid, Spain; (S.M.); (L.L.); (M.P.); (L.F.); (L.F.C.); (B.A.)
- Departament de Biologia Evolutiva, Ecología i Ciències Ambientals, Universitat de Barcelona (UB), 08028 Barcelona, Barcelona, Spain
- Correspondence: (E.P.-C.); (M.F.-V.)
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Peralta V, García de Jalón E, Moreno-Izco L, Peralta D, Janda L, Sánchez-Torres AM, Cuesta MJ. Long-Term Outcomes of First-Admission Psychosis: A Naturalistic 21-Year Follow-Up Study of Symptomatic, Functional and Personal Recovery and Their Baseline Predictors. Schizophr Bull 2022; 48:631-642. [PMID: 34999894 PMCID: PMC9077430 DOI: 10.1093/schbul/sbab145] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study was aimed at characterizing long-term outcomes of first-admission psychosis and examining their baseline predictors. Participants were assessed at baseline for 38 candidate predictors and re-assessed after a median follow-up of 21 years for symptomatic, functional, and personal recovery. Associations between the predictors and the outcomes were examined using univariate and multivariate Cox regression models. At baseline, 623 subjects were assessed for eligibility, 510 met the inclusion/exclusion criteria and 243 were successfully followed-up (57.3% of the survivors). At follow-up, the percentages of subjects achieving symptomatic, functional, and personal recovery were 51.9%, 52.7%, and 51.9%, respectively; 74.2% met at least one recovery criterion and 32.5% met all three recovery criteria. Univariate analysis showed that outcomes were predicted by a broad range of variables, including sociodemographics, familial risk, early risk factors, premorbid functioning, triggering factors, illness-onset features, neurological abnormalities, deficit symptoms and early response to treatment. Many of the univariate predictors became nonsignificant when entered into a hierarchical multivariate model, indicating a substantial degree of interdependence. Each single outcome component was independently predicted by parental socioeconomic status, family history of schizophrenia spectrum disorders, early developmental delay, childhood adversity, and mild drug use. Spontaneous dyskinesia/parkinsonism, neurological soft signs and completion of high school remained specific predictors of symptomatic, functional, and personal outcomes, respectively. Predictors explained between 27.5% and 34.3% of the variance in the outcomes. In conclusion, our results indicate a strong potential for background and first-episode characteristics in predicting long-term outcomes of psychotic disorders, which may inform future intervention research.
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Affiliation(s)
- Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Manuel J Cuesta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
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Safont G, Garriga M, Amoretti S, Cuesta MJ, Parellada M, González-Pinto A, Bergé D, Rodriguez-Jimenez R, Bejarano AR, Sarró S, Ibáñez Á, Usall J, Gutiérrez M, Vieta E, Arranz B, Berrocoso E, Verdolini N, Bernardo M. Sex and substance use in first episode psychosis: impact on clinical symptoms, psychosocial functioning and cognitive performance. Revista de Psiquiatría y Salud Mental 2022. [DOI: 10.1016/j.rpsm.2022.03.002] [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: 01/10/2023]
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Soldevila-Matías P, Schoretsanitis G, Tordesillas-Gutierrez D, Cuesta MJ, de Filippis R, Ayesa-Arriola R, González-Vivas C, Setién-Suero E, Verdolini N, Sanjuán J, Radua J, Crespo-Facorro B. Neuroimaging correlates of insight in non-affective psychosis: A systematic review and meta-analysis. Rev Psiquiatr Salud Ment (Engl Ed) 2022; 15:117-133. [PMID: 35840278 DOI: 10.1016/j.rpsmen.2022.06.007] [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: 03/29/2021] [Accepted: 07/01/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Neurological correlates of impaired insight in non-affective psychosis remain unclear. This study aimed to review and meta-analyze the studies assessing the grey matter volumetric correlates of impaired insight in non-affective psychosis. METHODS This study consisted of a systematic review of 23 studies, and a meta-analysis with SDM-PSI of the 11 studies that were whole-brain and reported maps or peaks of correlation of studies investigating the grey matter volumetric correlates of insight assessments of non-affective psychosis, PubMed and OVID datasets were independently reviewed for articles reporting neuroimaging correlates of insight in non-affective psychosis. Quality assessment was realized following previous methodological approaches for the ABC quality assessment test of imaging studies, based on two main criteria: the statistical power and the multidimensional assessment of insight. Study peaks of correlation between grey matter volume and insight were used to recreate brain correlation maps. RESULTS A total of 418 records were identified through database searching. Of these records, twenty-three magnetic resonance imaging (MRI) studies that used different insight scales were included. The quality of the evidence was high in 11 studies, moderate in nine, and low in three. Patients with reduced insight showed decreases in the frontal, temporal (specifically in superior temporal gyrus), precuneus, cingulate, insula, and occipital lobes cortical grey matter volume. The meta-analysis indicated a positive correlation between grey matter volume and insight in the right insula (i.e., the smaller the grey matter, the lower the insight). CONCLUSION Several brain areas might be involved in impaired insight in patients with non-affective psychoses. The methodologies employed, such as the applied insight scales, may have contributed to the considerable discrepancies in the findings.
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Affiliation(s)
- Pau Soldevila-Matías
- Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain; Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain; National Reference Center for Psychosocial Care for People with Serious Mental Disorder (CREAP), Valencia, Spain
| | - Georgios Schoretsanitis
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA
| | - Diana Tordesillas-Gutierrez
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain.
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Renato de Filippis
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA; Psychiatry Unit Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Rosa Ayesa-Arriola
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Carlos González-Vivas
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain
| | - Esther Setién-Suero
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel Street, 12-0, 08036 Barcelona, Spain
| | - Julio Sanjuán
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
| | - Joaquim Radua
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Benedicto Crespo-Facorro
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
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Amoretti S, Verdolini N, Varo C, Mezquida G, Sánchez-Torres AM, Vieta E, Garcia-Rizo C, Lobo A, González-Pinto A, Abregú-Crespo R, Corripio I, Serra M, de la Serna E, Mané A, Ramos-Quiroga JA, Ribases M, Cuesta MJ, Bernardo M. Is the effect of cognitive reserve in longitudinal outcomes in first-episode psychoses dependent on the use of cannabis? J Affect Disord 2022; 302:83-93. [PMID: 35066012 DOI: 10.1016/j.jad.2022.01.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cognitive reserve (CR) is a protective factor against cognitive and functional impairment in first-episode psychosis (FEP). The aim of this study was to evaluate the differences in clinical presentation according to the use of cannabis (cannabis users vs non-users) among patients presenting a FEP (non-affective vs affective psychosis), to investigate the impact of CR and cannabis use on several outcomes and to explore the potentially mediatory role played by CR in the relationship between cognitive domains or clinical status and functionality, depending on the use of cannabis. METHODS Linear regression analysis models were carried out to assess the predictive value of CR on clinical, functional and cognitive variables at baseline and at two-year follow-up. The mediation analyzes were performed according to the principles of Baron and Kenny. RESULTS CR was associated with better cognitive performance, regardless of cannabis consumption or diagnosis. In both diagnoses, CR was associated with better clinical and functional outcomes in those patients who did not use cannabis. In terms of mediation procedure, CR mediates the relationship between some cognitive domains and functioning at follow-up only in patients without cannabis use. LIMITATIONS The small sample size of the affective group. CONCLUSIONS CR plays a differential role in the outcome of psychoses according to whether patients are cannabis users or not. Both in affective and non-affective groups CR exerted a greater effect in patients without cannabis use. Our results suggest that the deleterious effect of cannabis use on functioning in FEP surpasses the protective effect of CR.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain
| | - Norma Verdolini
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Cristina Varo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain.
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Medicine and Psychiatry, Zaragoza University. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Araba University Hospital, Bioaraba Research Institute, Spain; University of the Basque Country (UPV-EHU), Spain
| | - Renzo Abregú-Crespo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Serra
- Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, SGR2017881, Institut Clinic de Neurociències, Hospital Clínic Universitari, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Anna Mané
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Hospital del Mar Medical research Institute (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J Antoni Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Catalonia, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Barcelona, Spain
| | - Marta Ribases
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, SGR2017881, Institut Clinic de Neurociències, Hospital Clínic Universitari, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
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Martínez A, Cuesta MJ, Peralta V. Dependence Graphs Based on Association Rules to Explore Delusional Experiences. Multivariate Behav Res 2022; 57:458-477. [PMID: 33538621 DOI: 10.1080/00273171.2020.1870912] [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] [Indexed: 06/12/2023]
Abstract
Methods to estimate dependence graphs among variables, have quickly gained popularity in psychopathology research. To date, multiple methods have been proposed but recent studies report several drawbacks impacting on the validity of the conclusions as it is argued that assumptions and conditions underlying the methods commonly used and the nature of the data is lacking alignment. A particularly important issue is that underlying dynamics potentially present in heterogeneous datasets are disregarded, as the methods focus on the variables but not on individuals. This work also argues that the networks may lack relevant components as current methods ignore connections beyond pairwise interactions between individual symptoms. This study addresses these issues with a novel method for constructing dependence graphs based on applying Association Rules to binary records, which is often the type of records in the psychopathology domain. To demonstrate the benefits, we examine 12 delusional experiences in a sample of 1423 subjects with psychotic disorders. We show that by extracting Association Rules using an algorithm called apriori, in addition to facilitating an intuitive interpretation, previously unseen relevant dependencies are revealed from higher order interactions among psychotic experiences in subgroups of patients.
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Affiliation(s)
| | - Manuel J Cuesta
- Psychiatry Service, Complejo Hospitalario de Navarra
- Navarrabiomed and Instituto de Investigación Sanitaria de Navarra (IdISNa)
| | - Victor Peralta
- Mental Health Department, Servicio Navarro de Salud
- Navarrabiomed and Instituto de Investigación Sanitaria de Navarra (IdISNa)
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47
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Prokopez CR, Farinola R, Vallejos M, Lopredo LS, Sfriso LE, Chiapella LC, Arce C, Corral RM, Cuesta MJ, Alomo M. Olanzapine, risperidone and quetiapine: Do these atypical antipsychotics have a protective effect for SARS-CoV-2? Schizophr Res 2022; 241:140-141. [PMID: 35123336 PMCID: PMC8784573 DOI: 10.1016/j.schres.2022.01.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/16/2022] [Accepted: 01/16/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Cintia R. Prokopez
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina,Institute of Pharmacology, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina,Corresponding author at: Paraguay 2155, Buenos Aires City, Argentina
| | | | | | - Lorena S. Lopredo
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina
| | - Luciano E. Sfriso
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina
| | - Luciana C. Chiapella
- National Scientific and Technical Research Council (Gordon, Jang et al.), Buenos Aires, Argentina,Pharmacology Area, Faculty of Biochemical and Pharmaceutical Sciences, National University of Rosario, Santa Fe, Argentina
| | - Claudio Arce
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina
| | | | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Martín Alomo
- Braulio Aurelio Moyano Neuropsychiatric Hospital, Buenos Aires, Argentina,Faculty of Psychology, University of Buenos Aires, Buenos Aires, Argentina
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48
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Amoretti S, Rosa AR, Mezquida G, Cabrera B, Ribeiro M, Molina M, Bioque M, Lobo A, González-Pinto A, Fraguas D, Corripio I, Vieta E, de la Serna E, Morro L, Garriga M, Torrent C, Cuesta MJ, Bernardo M. The impact of cognitive reserve, cognition and clinical symptoms on psychosocial functioning in first-episode psychoses. Psychol Med 2022; 52:526-537. [PMID: 32900395 DOI: 10.1017/s0033291720002226] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Functional impairment is a defining feature of psychotic disorders. A range of factors has been shown to influence functioning, including negative symptoms, cognitive performance and cognitive reserve (CR). However, it is not clear how these variables may affect functioning in first-episode psychosis (FEP) patients. This 2-year follow-up study aimed to explore the possible mediating effects of CR on the relationship between cognitive performance or specific clinical symptoms and functional outcome. METHODS A prospective study of non-affective FEP patients was performed (211 at baseline and 139 at follow-up). CR was entered in a path analysis model as potential mediators between cognitive domains or clinical symptoms and functioning. RESULTS At baseline, the relationship between clinical variables or cognitive performance and functioning was not mediated by CR. At follow-up, the effect of attention (p = 0.003) and negative symptoms (p = 0.012) assessed at baseline on functioning was partially mediated by CR (p = 0.032 and 0.016), whereas the relationship between verbal memory (p = 0.057) and functioning was mediated by CR (p = 0.014). Verbal memory and positive and total subscales of PANSS assessed at follow-up were partially mediated by CR and the effect of working memory on functioning was totally mediated by CR. CONCLUSIONS Our results showed the influence of CR in mediating the relationship between cognitive domains or clinical symptoms and functioning in FEP. In particular, CR partially mediated the relationship between some cognitive domains or clinical symptoms and functioning at follow-up. Therefore, CR could improve our understanding of the long-term functioning of patients with a non-affective FEP.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Adriane R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Postgraduate Program: Psychiatry and Behavioral Science, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Pharmacology and Postgraduate Program: Pharmacology and Therapeutics, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - María Ribeiro
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Mariola Molina
- Instituto de Investigación Sanitaria Gregorio Marañón. School of Psychology, Complutense University, Madrid, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Medicine and Psychiatry. Zaragoza University. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Psychiatry, Hospital Universitario de Álava (Sede Santiago), University of the Basque Country (UPV-EHU), Bioaraba Research Institute, Spain
| | - David Fraguas
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Institute of Psychiatry and Mental Health, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, 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
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute of Neurosciences, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Laura Morro
- Hospital del Mar, Department of Psychiatry, Barcelona, Spain
| | - Marina Garriga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neurosciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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49
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Serra-Navarro M, Amoretti S, Verdolini N, Forte MF, Sánchez-Torres AM, Vieta E, Clougher D, Lobo A, González-Pinto A, Panadero R, Roldán A, Carvalho AF, de la Serna E, Toll A, Ramos-Quiroga JA, Torrent C, Cuesta MJ, Bernardo M. Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: Differences between males and females. Front Psychiatry 2022; 13:982583. [PMID: 36339856 PMCID: PMC9632657 DOI: 10.3389/fpsyt.2022.982583] [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: 06/30/2022] [Accepted: 09/28/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Deficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset. MATERIALS AND METHODS The initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up. RESULTS FEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = -0.307, p = 0.012) were significantly associated with functioning. CONCLUSION Our data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended.
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Affiliation(s)
- Maria Serra-Navarro
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, Italy
| | - María Florencia Forte
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Derek Clougher
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Medicine and Psychiatry, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza University, Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain.,Department of Psychiatry, University of the Basque Country (UPV-EHU), Vitoria-Gasteiz, Spain
| | - Rocío Panadero
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Institute of Psychiatry and Mental Health, Universidad Complutense, IiSGM, Madrid, Spain
| | - Alexandra Roldán
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - André F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT), School of Medicine, Barwon Health, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institut Clínic de Neurociències, Hospital Clínic Universitari, CIBERSAM, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Alba Toll
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J A Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
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50
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Fernández‐Arana A, Olórtegui‐Yzú A, Vega‐Dienstmaier JM, Cuesta MJ. Depression and anxiety symptoms and perceived stress in health professionals in the context of COVID-19: Do adverse childhood experiences have a modulating effect? Brain Behav 2022; 12:e2452. [PMID: 34910383 PMCID: PMC8785635 DOI: 10.1002/brb3.2452] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACE) have a great impact on mental health outcomes of adults. However, little is known whether ACE may act as modulators of the mental health of health professionals caring for patients with COVID-19. METHODS Data were collected through an online cross-sectional survey administered to health professionals in Lima (Peru) between May and July 2020. The survey included standardized self-assessment instruments for anxiety, depression, acute stress (AS) and history of ACE. RESULTS A total of 542 health professionals completed the survey. Caring for patients with COVID-19 was significantly associated with depression and anxiety and when caring for patients with COVID-19 was combined with a history of early sexual abuse, its effect on the risk of anxiety increased (OR = 7.71, p = .010). Mental health problems were associated with female gender in almost all the analyses and with the majority of ACEs. CONCLUSIONS Health workers in the context of the COVID-19 pandemic presented a high risk of mental health disorders. Antecedents of sexual abuse acted as a potentiating factor of anxiety in professionals providing COVID-19 care. These findings suggest that the burden of ACE modulates mental health problems in health professionals during the pandemic.
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Affiliation(s)
| | - Adriel Olórtegui‐Yzú
- Universidad Nacional Mayor de San MarcosFacultad de Medina de San FernandoLimaPeru
- Instituto Nacional Cardiovascular ‐ INCOR ‐ EsSaludLimaPeru
| | | | - Manuel J. Cuesta
- Department of PsychiatryComplejo Hospitalario de NavarraPamplonaSpain
- Navarra Institute for Health Research (IdiSNA)Mental health areaPamplonaSpain
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