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Formica MJC, Fuller-Tyszkiewicz M, Reininghaus U, Kempton M, Delespaul P, de Haan L, Nelson B, Mikocka-Walus A, Olive L, Ruhrmann S, Rutten B, Riecher-Rössler A, Sachs G, Valmaggia L, van der Gaag M, McGuire P, van Os J, Hartmann JA. Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis. Psychol Med 2024:1-10. [PMID: 38450445 DOI: 10.1017/s0033291724000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND Pre-diagnostic stages of psychotic illnesses, including 'clinical high risk' (CHR), are marked by sleep disturbances. These sleep disturbances appear to represent a key aspect in the etiology and maintenance of psychotic disorders. We aimed to examine the relationship between self-reported sleep dysfunction and attenuated psychotic symptoms (APS) on a day-to-day basis. METHODS Seventy-six CHR young people completed the Experience Sampling Methodology (ESM) component of the European Union Gene-Environment Interaction Study, collected through PsyMate® devices, prompting sleep and symptom questionnaires 10 times daily for 6 days. Bayesian multilevel mixed linear regression analyses were performed on time-variant ESM data using the brms package in R. We investigated the day-to-day associations between sleep and psychotic experiences bidirectionally on an item level. Sleep items included sleep onset latency, fragmentation, and quality. Psychosis items assessed a range of perceptual, cognitive, and bizarre thought content common in the CHR population. RESULTS Two of the seven psychosis variables were unidirectionally predicted by previous night's number of awakenings: every unit increase in number of nightly awakenings predicted a 0.27 and 0.28 unit increase in feeling unreal or paranoid the next day, respectively. No other sleep variables credibly predicted next-day psychotic symptoms or vice-versa. CONCLUSION In this study, the relationship between sleep disturbance and APS appears specific to the item in question. However, some APS, including perceptual disturbances, had low levels of endorsement amongst this sample. Nonetheless, these results provide evidence for a unidirectional relationship between sleep and some APS in this population.
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Affiliation(s)
- M J C Formica
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - M Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - U Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - M Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, King's College London, London, UK
| | - P Delespaul
- Facalty of Health, Medicine and Life Sciences, Psychiatrie & Neuropsychologie, Maastricht University, Maastricht, The Netherlands
- Mondriaan Mental Health Centre, Maastricht/Heerlen, The Netherlands
| | - L de Haan
- Department of Psychiatry, Early Psychosis, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - B Nelson
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - A Mikocka-Walus
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - L Olive
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - S Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - B Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), European Graduate School of Neuroscience (EURON), Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - G Sachs
- Medical University of Vienna, Vienna, Austria
| | - L Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M van der Gaag
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - P McGuire
- Department of Psychiatry, University of Oxford, Warneford Hospital OX3 7JX, UK
| | - J van Os
- Department of Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - J A Hartmann
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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2
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Casetta C, Santosh P, Bayley R, Bisson J, Byford S, Dixon C, Drake RJ, Elvins R, Emsley R, Fung N, Hayes D, Howes O, James A, James K, Jones R, Killaspy H, Lennox B, Marchant L, McGuire P, Oloyede E, Rogdaki M, Upthegrove R, Walters J, Egerton A, MacCabe JH. CLEAR - clozapine in early psychosis: study protocol for a multi-centre, randomised controlled trial of clozapine vs other antipsychotics for young people with treatment resistant schizophrenia in real world settings. BMC Psychiatry 2024; 24:122. [PMID: 38355533 PMCID: PMC10865566 DOI: 10.1186/s12888-023-05397-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/22/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Clozapine is an antipsychotic drug with unique efficacy, and it is the only recommended treatment for treatment-resistant schizophrenia (TRS: failure to respond to at least two different antipsychotics). However, clozapine is also associated with a range of adverse effects which restrict its use, including blood dyscrasias, for which haematological monitoring is required. As treatment resistance is recognised earlier in the illness, the question of whether clozapine should be prescribed in children and young people is increasingly important. However, most research to date has been in older, chronic patients, and evidence regarding the efficacy and safety of clozapine in people under age 25 is lacking. The CLEAR (CLozapine in EARly psychosis) trial will assess whether clozapine is more effective than treatment as usual (TAU), at the level of clinical symptoms, patient rated outcomes, quality of life and cost-effectiveness in people below 25 years of age. Additionally, a nested biomarker study will investigate the mechanisms of action of clozapine compared to TAU. METHODS AND DESIGN This is the protocol of a multi-centre, open label, blind-rated, randomised controlled effectiveness trial of clozapine vs TAU (any other oral antipsychotic monotherapy licenced in the British National Formulary) for 12 weeks in 260 children and young people with TRS (12-24 years old). AIM AND OBJECTIVES The primary outcome is the change in blind-rated Positive and Negative Syndrome Scale scores at 12 weeks from baseline. Secondary outcomes include blind-rated Clinical Global Impression, patient-rated outcomes, quality of life, adverse effects, and treatment adherence. Patients will be followed up for 12 months and will be invited to give consent for longer term follow-up using clinical records and potential re-contact for further research. For mechanism of action, change in brain magnetic resonance imaging (MRI) biomarkers and peripheral inflammatory markers will be measured over 12 weeks. DISCUSSION The CLEAR trial will contribute knowledge on clozapine effectiveness, safety and cost-effectiveness compared to standard antipsychotics in young people with TRS, and the results may guide future clinical treatment recommendation for early psychosis. TRIAL REGISTRATION ISRCTN Number: 37176025, IRAS Number: 1004947. TRIAL STATUS In set-up. Protocol version 4.0 01/08/23. Current up to date protocol available here: https://fundingawards.nihr.ac.uk/award/NIHR131175# /.
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Affiliation(s)
- C Casetta
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
| | - P Santosh
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - R Bayley
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - J Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - S Byford
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - C Dixon
- Wonford House Hospital, Devon Partnership NHS Trust, Exeter, UK
| | - R J Drake
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - R Elvins
- Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - R Emsley
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - N Fung
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - D Hayes
- South London and Maudsley NHS Foundation Trust, London, UK
| | - O Howes
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - A James
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - K James
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - R Jones
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - H Killaspy
- Division of Psychiatry, University College London, London, UK
| | - B Lennox
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - L Marchant
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - P McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - E Oloyede
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - M Rogdaki
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - R Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Birmingham Early Intervention Service, Birmingham Womens and Childrens NHS Foundation Trust, Birmingham, UK
| | - J Walters
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - A Egerton
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - J H MacCabe
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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3
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Bethlehem RAI, Seidlitz J, White SR, Vogel JW, Anderson KM, Adamson C, Adler S, Alexopoulos GS, Anagnostou E, Areces-Gonzalez A, Astle DE, Auyeung B, Ayub M, Bae J, Ball G, Baron-Cohen S, Beare R, Bedford SA, Benegal V, Beyer F, Blangero J, Blesa Cábez M, Boardman JP, Borzage M, Bosch-Bayard JF, Bourke N, Calhoun VD, Chakravarty MM, Chen C, Chertavian C, Chetelat G, Chong YS, Cole JH, Corvin A, Costantino M, Courchesne E, Crivello F, Cropley VL, Crosbie J, Crossley N, Delarue M, Delorme R, Desrivieres S, Devenyi GA, Di Biase MA, Dolan R, Donald KA, Donohoe G, Dunlop K, Edwards AD, Elison JT, Ellis CT, Elman JA, Eyler L, Fair DA, Feczko E, Fletcher PC, Fonagy P, Franz CE, Galan-Garcia L, Gholipour A, Giedd J, Gilmore JH, Glahn DC, Goodyer IM, Grant PE, Groenewold NA, Gunning FM, Gur RE, Gur RC, Hammill CF, Hansson O, Hedden T, Heinz A, Henson RN, Heuer K, Hoare J, Holla B, Holmes AJ, Holt R, Huang H, Im K, Ipser J, Jack CR, Jackowski AP, Jia T, Johnson KA, Jones PB, Jones DT, Kahn RS, Karlsson H, Karlsson L, Kawashima R, Kelley EA, Kern S, Kim KW, Kitzbichler MG, Kremen WS, Lalonde F, Landeau B, Lee S, Lerch J, Lewis JD, Li J, Liao W, Liston C, Lombardo MV, Lv J, Lynch C, Mallard TT, Marcelis M, Markello RD, Mathias SR, Mazoyer B, McGuire P, Meaney MJ, Mechelli A, Medic N, Misic B, Morgan SE, Mothersill D, Nigg J, Ong MQW, Ortinau C, Ossenkoppele R, Ouyang M, Palaniyappan L, Paly L, Pan PM, Pantelis C, Park MM, Paus T, Pausova Z, Paz-Linares D, Pichet Binette A, Pierce K, Qian X, Qiu J, Qiu A, Raznahan A, Rittman T, Rodrigue A, Rollins CK, Romero-Garcia R, Ronan L, Rosenberg MD, Rowitch DH, Salum GA, Satterthwaite TD, Schaare HL, Schachar RJ, Schultz AP, Schumann G, Schöll M, Sharp D, Shinohara RT, Skoog I, Smyser CD, Sperling RA, Stein DJ, Stolicyn A, Suckling J, Sullivan G, Taki Y, Thyreau B, Toro R, Traut N, Tsvetanov KA, Turk-Browne NB, Tuulari JJ, Tzourio C, Vachon-Presseau É, Valdes-Sosa MJ, Valdes-Sosa PA, Valk SL, van Amelsvoort T, Vandekar SN, Vasung L, Victoria LW, Villeneuve S, Villringer A, Vértes PE, Wagstyl K, Wang YS, Warfield SK, Warrier V, Westman E, Westwater ML, Whalley HC, Witte AV, Yang N, Yeo B, Yun H, Zalesky A, Zar HJ, Zettergren A, Zhou JH, Ziauddeen H, Zugman A, Zuo XN, Bullmore ET, Alexander-Bloch AF. Brain charts for the human lifespan. Nature 2022; 604:525-533. [PMID: 35388223 PMCID: PMC9021021 DOI: 10.1038/s41586-022-04554-y] [Citation(s) in RCA: 400] [Impact Index Per Article: 200.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 02/16/2022] [Indexed: 02/02/2023]
Abstract
Over the past few decades, neuroimaging has become a ubiquitous tool in basic research and clinical studies of the human brain. However, no reference standards currently exist to quantify individual differences in neuroimaging metrics over time, in contrast to growth charts for anthropometric traits such as height and weight1. Here we assemble an interactive open resource to benchmark brain morphology derived from any current or future sample of MRI data ( http://www.brainchart.io/ ). With the goal of basing these reference charts on the largest and most inclusive dataset available, acknowledging limitations due to known biases of MRI studies relative to the diversity of the global population, we aggregated 123,984 MRI scans, across more than 100 primary studies, from 101,457 human participants between 115 days post-conception to 100 years of age. MRI metrics were quantified by centile scores, relative to non-linear trajectories2 of brain structural changes, and rates of change, over the lifespan. Brain charts identified previously unreported neurodevelopmental milestones3, showed high stability of individuals across longitudinal assessments, and demonstrated robustness to technical and methodological differences between primary studies. Centile scores showed increased heritability compared with non-centiled MRI phenotypes, and provided a standardized measure of atypical brain structure that revealed patterns of neuroanatomical variation across neurological and psychiatric disorders. In summary, brain charts are an essential step towards robust quantification of individual variation benchmarked to normative trajectories in multiple, commonly used neuroimaging phenotypes.
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Affiliation(s)
- R A I Bethlehem
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | - J Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA.
| | - S R White
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - J W Vogel
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Informatics & Neuroimaging Center, University of Pennsylvania, Philadelphia, PA, USA
| | - K M Anderson
- Department of Psychology, Yale University, New Haven, CT, USA
| | - C Adamson
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - S Adler
- UCL Great Ormond Street Institute for Child Health, London, UK
| | - G S Alexopoulos
- Weill Cornell Institute of Geriatric Psychiatry, Department of Psychiatry, Weill Cornell Medicine, New York, USA
| | - E Anagnostou
- Department of Pediatrics University of Toronto, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - A Areces-Gonzalez
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
- University of Pinar del Río "Hermanos Saiz Montes de Oca", Pinar del Río, Cuba
| | - D E Astle
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - B Auyeung
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - M Ayub
- Queen's University, Department of Psychiatry, Centre for Neuroscience Studies, Kingston, Ontario, Canada
- University College London, Mental Health Neuroscience Research Department, Division of Psychiatry, London, UK
| | - J Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - G Ball
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - S Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridge Lifetime Asperger Syndrome Service (CLASS), Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - R Beare
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - S A Bedford
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - V Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - F Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - J Blangero
- Department of Human Genetics, South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - M Blesa Cábez
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - J P Boardman
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - M Borzage
- Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - J F Bosch-Bayard
- McGill Centre for Integrative Neuroscience, Ludmer Centre for Neuroinformatics and Mental Health, Montreal Neurological Institute, Montreal, Quebec, Canada
- McGill University, Montreal, Quebec, Canada
| | - N Bourke
- Department of Brain Sciences, Imperial College London, London, UK
- Care Research and Technology Centre, Dementia Research Institute, London, UK
| | - V D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - M M Chakravarty
- McGill University, Montreal, Quebec, Canada
- Computational Brain Anatomy (CoBrA) Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - C Chen
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C Chertavian
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - G Chetelat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Y S Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - J H Cole
- Centre for Medical Image Computing (CMIC), University College London, London, UK
- Dementia Research Centre (DRC), University College London, London, UK
| | - A Corvin
- Department of Psychiatry, Trinity College, Dublin, Ireland
| | - M Costantino
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada
- Undergraduate program in Neuroscience, McGill University, Montreal, Quebec, Canada
| | - E Courchesne
- Department of Neuroscience, University of California, San Diego, San Diego, CA, USA
- Autism Center of Excellence, University of California, San Diego, San Diego, CA, USA
| | - F Crivello
- Institute of Neurodegenerative Disorders, CNRS UMR5293, CEA, University of Bordeaux, Bordeaux, France
| | - V L Cropley
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - J Crosbie
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - N Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Instituto Milenio Intelligent Healthcare Engineering, Santiago, Chile
| | - M Delarue
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - R Delorme
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, AP-HP, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - S Desrivieres
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G A Devenyi
- Cerebral Imaging Centre, McGill Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - M A Di Biase
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - R Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, London, UK
| | - K A Donald
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - G Donohoe
- Center for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - K Dunlop
- Weil Family Brain and Mind Research Institute, Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - A D Edwards
- Centre for the Developing Brain, King's College London, London, UK
- Evelina London Children's Hospital, London, UK
- MRC Centre for Neurodevelopmental Disorders, London, UK
| | - J T Elison
- Institute of Child Development, Department of Pediatrics, Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
| | - C T Ellis
- Department of Psychology, Yale University, New Haven, CT, USA
- Haskins Laboratories, New Haven, CT, USA
| | - J A Elman
- Department of Psychiatry, Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - L Eyler
- Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, Los Angeles, CA, USA
| | - D A Fair
- Institute of Child Development, Department of Pediatrics, Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
| | - E Feczko
- Institute of Child Development, Department of Pediatrics, Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
| | - P C Fletcher
- Department of Psychiatry, University of Cambridge, and Wellcome Trust MRC Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - P Fonagy
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - C E Franz
- Department of Psychiatry, Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | | | - A Gholipour
- Computational Radiology Laboratory, Boston Children's Hospital, Boston, MA, USA
| | - J Giedd
- Department of Child and Adolescent Psychiatry, University of California, San Diego, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - J H Gilmore
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - D C Glahn
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - I M Goodyer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - P E Grant
- Division of Newborn Medicine and Neuroradiology, Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - N A Groenewold
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - F M Gunning
- Weill Cornell Institute of Geriatric Psychiatry, Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - C F Hammill
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Mouse Imaging Centre, Toronto, Ontario, Canada
| | - O Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - T Hedden
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - A Heinz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Berlin, Germany
| | - R N Henson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - K Heuer
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Université de Paris, Paris, France
| | - J Hoare
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - B Holla
- Department of Integrative Medicine, NIMHANS, Bengaluru, India
- Accelerator Program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, NIMHANS, Bengaluru, India
| | - A J Holmes
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, USA
| | - R Holt
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - H Huang
- Radiology Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K Im
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Newborn Medicine and Neuroradiology, Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - J Ipser
- Department of Psychiatry and Mental Health, Clinical Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - C R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - A P Jackowski
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- National Institute of Developmental Psychiatry, Beijing, China
| | - T Jia
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and BrainInspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology and Neuroscience, SGDP Centre, King's College London, London, UK
| | - K A Johnson
- Harvard Medical School, Boston, MA, USA
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - P B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - D T Jones
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - R S Kahn
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - H Karlsson
- Department of Clinical Medicine, Department of Psychiatry and Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - L Karlsson
- Department of Clinical Medicine, Department of Psychiatry and Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - R Kawashima
- Institute of Development, Aging and Cancer, Tohoku University, Seiryocho, Aobaku, Sendai, Japan
| | - E A Kelley
- Queen's University, Departments of Psychology and Psychiatry, Centre for Neuroscience Studies, Kingston, Ontario, Canada
| | - S Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - K W Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, South Korea
| | - M G Kitzbichler
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - W S Kremen
- Department of Psychiatry, Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - F Lalonde
- Section on Developmental Neurogenomics, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - B Landeau
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - S Lee
- Department of Brain & Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - J Lerch
- Mouse Imaging Centre, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - J D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - J Li
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - W Liao
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - C Liston
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
| | - M V Lombardo
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems @UniTn, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - J Lv
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
- School of Biomedical Engineering and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - C Lynch
- Weil Family Brain and Mind Research Institute, Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - T T Mallard
- Department of Psychology, University of Texas, Austin, TX, USA
| | - M Marcelis
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
| | - R D Markello
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - S R Mathias
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - B Mazoyer
- Institute of Neurodegenerative Disorders, CNRS UMR5293, CEA, University of Bordeaux, Bordeaux, France
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - P McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M J Meaney
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - A Mechelli
- Bordeaux University Hospital, Bordeaux, France
| | - N Medic
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - B Misic
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - S E Morgan
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - D Mothersill
- Department of Psychology, School of Business, National College of Ireland, Dublin, Ireland
- School of Psychology and Center for Neuroimaging and Cognitive Genomics, National University of Ireland Galway, Galway, Ireland
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - J Nigg
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - M Q W Ong
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - C Ortinau
- Department of Pediatrics, Washington University in St Louis, St Louis, MO, USA
| | - R Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Lund University, Clinical Memory Research Unit, Lund, Sweden
| | - M Ouyang
- Radiology Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - L Palaniyappan
- Robarts Research Institute and The Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada
| | - L Paly
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - P M Pan
- Department of Psychiatry, Federal University of Sao Poalo (UNIFESP), Sao Poalo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Sao Poalo, Brazil
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Melbourne School of Engineering, The University of Melbourne, Parkville, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - M M Park
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - T Paus
- Department of Psychiatry, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
- Departments of Psychiatry and Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Z Pausova
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - D Paz-Linares
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
- Cuban Neuroscience Center, Havana, Cuba
| | - A Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - K Pierce
- Department of Neuroscience, University of California, San Diego, San Diego, CA, USA
| | - X Qian
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - J Qiu
- School of Psychology, Southwest University, Chongqing, China
| | - A Qiu
- Department of Biomedical Engineering, The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - A Raznahan
- Section on Developmental Neurogenomics, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - T Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - A Rodrigue
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - C K Rollins
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - R Romero-Garcia
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Instituto de Biomedicina de Sevilla (IBiS) HUVR/CSIC/Universidad de Sevilla, Dpto. de Fisiología Médica y Biofísica, Seville, Spain
| | - L Ronan
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - M D Rosenberg
- Department of Psychology and Neuroscience Institute, University of Chicago, Chicago, IL, USA
| | - D H Rowitch
- Department of Paediatrics and Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - G A Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Informatics & Neuroimaging Center, University of Pennsylvania, Philadelphia, PA, USA
| | - H L Schaare
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Juelich, Juelich, Germany
| | - R J Schachar
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - A P Schultz
- Harvard Medical School, Boston, MA, USA
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - G Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Institute for Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
- PONS-Centre, Charite Mental Health, Dept of Psychiatry and Psychotherapy, Charite Campus Mitte, Berlin, Germany
| | - M Schöll
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
- Dementia Research Centre, Queen's Square Institute of Neurology, University College London, London, UK
| | - D Sharp
- Department of Brain Sciences, Imperial College London, London, UK
- Care Research and Technology Centre, UK Dementia Research Institute, London, UK
| | - R T Shinohara
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Biomedical Image Computing and Analytics, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - I Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - C D Smyser
- Departments of Neurology, Pediatrics, and Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - R A Sperling
- Harvard Medical School, Boston, MA, USA
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - D J Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Dept of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - A Stolicyn
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - G Sullivan
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Y Taki
- Institute of Development, Aging and Cancer, Tohoku University, Seiryocho, Aobaku, Sendai, Japan
| | - B Thyreau
- Institute of Development, Aging and Cancer, Tohoku University, Seiryocho, Aobaku, Sendai, Japan
| | - R Toro
- Université de Paris, Paris, France
- Department of Neuroscience, Institut Pasteur, Paris, France
| | - N Traut
- Department of Neuroscience, Institut Pasteur, Paris, France
- Center for Research and Interdisciplinarity (CRI), Université Paris Descartes, Paris, France
| | - K A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - N B Turk-Browne
- Department of Psychology, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - J J Tuulari
- Department of Clinical Medicine, Department of Psychiatry and Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
| | - C Tzourio
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, Bordeaux, France
| | - É Vachon-Presseau
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
| | | | - P A Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
- Alan Edwards Centre for Research on Pain (AECRP), McGill University, Montreal, Quebec, Canada
| | - S L Valk
- Institute for Neuroscience and Medicine 7, Forschungszentrum Jülich, Jülich, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - T van Amelsvoort
- Department of Psychiatry and Neurosychology, Maastricht University, Maastricht, The Netherlands
| | - S N Vandekar
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Vasung
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - L W Victoria
- Weill Cornell Institute of Geriatric Psychiatry, Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - S Villeneuve
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - A Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - P E Vértes
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - K Wagstyl
- Wellcome Centre for Human Neuroimaging, London, UK
| | - Y S Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Developmental Population Neuroscience Research Center, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- National Basic Science Data Center, Beijing, China
- Research Center for Lifespan Development of Brain and Mind, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - S K Warfield
- Computational Radiology Laboratory, Boston Children's Hospital, Boston, MA, USA
| | - V Warrier
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - E Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - M L Westwater
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - H C Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - A V Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
- Faculty of Medicine, CRC 1052 'Obesity Mechanisms', University of Leipzig, Leipzig, Germany
| | - N Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Developmental Population Neuroscience Research Center, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- National Basic Science Data Center, Beijing, China
- Research Center for Lifespan Development of Brain and Mind, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - B Yeo
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
- Centre for Sleep and Cognition and Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore, Singapore
| | - H Yun
- Division of Newborn Medicine and Neuroradiology, Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Zalesky
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - A Zettergren
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - J H Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - H Ziauddeen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - A Zugman
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Sao Poalo, Brazil
- National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA
- Department of Psychiatry, Escola Paulista de Medicina, São Paulo, Brazil
| | - X N Zuo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Developmental Population Neuroscience Research Center, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- National Basic Science Data Center, Beijing, China
- Research Center for Lifespan Development of Brain and Mind, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Brain and Education, School of Education Science, Nanning Normal University, Nanning, China
| | - E T Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - A F Alexander-Bloch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
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4
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Rutherford S, Fraza C, Dinga R, Kia SM, Wolfers T, Zabihi M, Berthet P, Worker A, Verdi S, Andrews D, Han LK, Bayer JM, Dazzan P, McGuire P, Mocking RT, Schene A, Sripada C, Tso IF, Duval ER, Chang SE, Penninx BW, Heitzeg MM, Burt SA, Hyde LW, Amaral D, Wu Nordahl C, Andreasssen OA, Westlye LT, Zahn R, Ruhe HG, Beckmann C, Marquand AF. Charting brain growth and aging at high spatial precision. eLife 2022; 11:72904. [PMID: 35101172 PMCID: PMC8828052 DOI: 10.7554/elife.72904] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/26/2022] [Indexed: 11/28/2022] Open
Abstract
Defining reference models for population variation, and the ability to study individual deviations is essential for understanding inter-individual variability and its relation to the onset and progression of medical conditions. In this work, we assembled a reference cohort of neuroimaging data from 82 sites (N=58,836; ages 2-100) and used normative modeling to characterize lifespan trajectories of cortical thickness and subcortical volume. Models are validated against a manually quality checked subset (N=24,354) and we provide an interface for transferring to new data sources. We showcase the clinical value by applying the models to a transdiagnostic psychiatric sample (N=1985), showing they can be used to quantify variability underlying multiple disorders whilst also refining case-control inferences. These models will be augmented with additional samples and imaging modalities as they become available. This provides a common reference platform to bind results from different studies and ultimately paves the way for personalized clinical decision-making.
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Affiliation(s)
- Saige Rutherford
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Charlotte Fraza
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Richard Dinga
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Seyed Mostafa Kia
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Department of Psychiatry, Utrecht University Medical Center, Utrecht, Netherlands
| | - Thomas Wolfers
- Department of Psychology, University of Oslo, Oslo, Norway.,Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Mariam Zabihi
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Pierre Berthet
- Department of Psychology, University of Oslo, Oslo, Norway.,Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway
| | - Amanda Worker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Serena Verdi
- Centre for Medical Image Computing, Medical Physics and Biomedical Engineering, University College London, London, United Kingdom.,Dementia Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Derek Andrews
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Davis, Sacramento, United States
| | - Laura Km Han
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,GGZ inGeest, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Johanna Mm Bayer
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,Orygen Youth Health, Melbourne, Australia
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust and King's College London, London, United Kingdom
| | - Phillip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Roel T Mocking
- Department of Psychiatry, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Aart Schene
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Chandra Sripada
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Ivy F Tso
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - Brenda Wjh Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.,GGZ inGeest, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, United States
| | - Luke W Hyde
- Department of Psychology, University of Michigan, Ann Arbor, United States
| | - David Amaral
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Davis, Sacramento, United States
| | - Christine Wu Nordahl
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, Davis, Sacramento, United States
| | - Ole A Andreasssen
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for Neurodevelopmental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway.,Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for Neurodevelopmental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Roland Zahn
- Centre for Affective Disorders at the Institute of Psychiatry, King's College London, London, United Kingdom
| | - Henricus G Ruhe
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
| | - Christian Beckmann
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom
| | - Andre F Marquand
- Donders Institute for Brain, Cognition, and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
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5
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Bento MHL, Lewis EA, Ramírez de Arellano I, Millán C, King E, Scott-Baird E, McGuire P, Richardson K. Establishing the tolerability to broiler chickens and laying hens of nonanoic acid at practical levels of use as a feed flavouring. Br Poult Sci 2021; 63:218-225. [PMID: 34404304 DOI: 10.1080/00071668.2021.1966752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
1. The following experiments were conducted to evaluate the effects of nonanoic acid (NA) in broilers and laying hens, at practical levels as a flavouring in complete feed.2. In the first experiment, 1100, one-day-old Ross 308 chicks, half male and female, were randomly assigned to 50 floor pens containing 22 chicks each. Chicks were fed one of five treatment diets containing either 0 (control), 100, 300, 500 or 1,000 mg NA/kg complete feed for 42 days.3. The NA treatment had no effect on ADFI, but there was a linear relationship with ADG and FCR. No differences were observed in blood parameters or tissue pathology among treatment groups.4. In a second study, 150 Hyline hens aged 24 weeks old were randomly assigned to 50 pens containing three birds each. Laying hens were fed one of five treatment diets containing 0 (control), 100, 300, 500 or 1,000 mg NA/kg complete feed for 56 days.5. Treatment with NA has no effect on live weight, ADFI or egg production in laying hens, and there were no observed changes in tissue pathology.6. The results supported the toleration of NA in broilers or layers at dietary levels of up to 1,000 mg/kg.
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Affiliation(s)
- M H L Bento
- NutraSteward, Bridge Innovation Center, Pembroke Dock, UK
| | - E A Lewis
- NutraSteward, Bridge Innovation Center, Pembroke Dock, UK
| | | | - C Millán
- IMASDE Agroalimentaria, Madrid, Spain
| | - E King
- Drayton Animal Health, Stratford-upon-Avon, UK
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6
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Jauhar S, Lai S, Bonoldi I, Salazar de Pablo G, di Forti M, Alameda L, Donocik J, Iacoponi E, Spencer T, Haege B, McLaughlan D, Taylor D, Young AH, Thornicroft G, Gaughran F, MacCabe JH, Murray RM, McGuire P, Fusar-Poli P. Early intervention in psychosis during the COVID-19 pandemic: Maudsley recommendations. Eur Neuropsychopharmacol 2021; 47:130-135. [PMID: 33642195 PMCID: PMC8640608 DOI: 10.1016/j.euroneuro.2021.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 02/02/2021] [Accepted: 02/09/2021] [Indexed: 12/12/2022]
Affiliation(s)
- S Jauhar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; COAST service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - S Lai
- COAST service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - I Bonoldi
- TREAT service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom
| | - G Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - M di Forti
- LEO service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - L Alameda
- LEO service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - J Donocik
- LEIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - E Iacoponi
- LEO service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - T Spencer
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - B Haege
- STEP service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - D McLaughlan
- LEO Ward, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - D Taylor
- Pharmacy and Pathology, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - A H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - G Thornicroft
- LEO service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - F Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; National Psychosis Unit, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - J H MacCabe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; National Psychosis Unit, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - R M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom
| | - P McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom
| | - P Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
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7
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Rogers JP, Chesney E, Oliver D, Begum N, Saini A, Wang S, McGuire P, Fusar-Poli P, Lewis G, David AS. Suicide, self-harm and thoughts of suicide or self-harm in infectious disease epidemics: a systematic review and meta-analysis. Epidemiol Psychiatr Sci 2021; 30:e32. [PMID: 33902775 PMCID: PMC7610720 DOI: 10.1017/s2045796021000214] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 12/22/2022] Open
Abstract
AIMS Suicide accounts for 2.2% of all years of life lost worldwide. We aimed to establish whether infectious epidemics are associated with any changes in the incidence of suicide or the period prevalence of self-harm, or thoughts of suicide or self-harm, with a secondary objective of establishing the frequency of these outcomes. METHODS In this systematic review and meta-analysis, MEDLINE, Embase, PsycINFO and AMED were searched from inception to 9 September 2020. Studies of infectious epidemics reporting outcomes of (a) death by suicide, (b) self-harm or (c) thoughts of suicide or self-harm were identified. A random-effects model meta-analysis for the period prevalence of thoughts of suicide or self-harm was conducted. RESULTS In total, 1354 studies were screened with 57 meeting eligibility criteria, of which 7 described death by suicide, 9 by self-harm, and 45 thoughts of suicide or self-harm. The observation period ranged from 1910 to 2020 and included epidemics of Spanish Flu, severe acute respiratory syndrome, human monkeypox, Ebola virus disease and coronavirus disease 2019 (COVID-19). Regarding death by suicide, data with a clear longitudinal comparison group were available for only two epidemics: SARS in Hong Kong, finding an increase in suicides among the elderly, and COVID-19 in Japan, finding no change in suicides among children and adolescents. In terms of self-harm, five studies examined emergency department attendances in epidemic and non-epidemic periods, of which four found no difference and one showed a reduction during the epidemic. In studies of thoughts of suicide or self-harm, one large survey showed a substantial increase in period prevalence compared to non-epidemic periods, but smaller studies showed no difference. As a secondary objective, a meta-analysis of thoughts of suicide and self-harm found that the pooled prevalence was 8.0% overall (95% confidence interval (CI) 5.2-12.0%; 14 820 of 99 238 cases in 24 studies) over a time period of between seven days and six months. The quality assessment found 42 studies were of high quality, nine of moderate quality and six of high quality. CONCLUSIONS There is little robust evidence on the association of infectious epidemics with suicide, self-harm and thoughts of suicide or self-harm. There was an increase in suicides among the elderly in Hong Kong during SARS and no change in suicides among young people in Japan during COVID-19, but it is unclear how far these findings may be generalised. The development of up-to-date self-harm and suicide statistics to monitor the effect of the current pandemic is an urgent priority.
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Affiliation(s)
- J. P. Rogers
- Division of Psychiatry, University College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - E. Chesney
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychosis Studies, King's College London, London, UK
| | - D. Oliver
- Department of Psychosis Studies, King's College London, London, UK
| | - N. Begum
- GKT School of Medical Education, King's College London, London, UK
| | - A. Saini
- Medical School, University College London, London, UK
| | - S. Wang
- Department of Psychology, King's College London, London, UK
| | - P. McGuire
- Department of Psychosis Studies, King's College London, London, UK
| | - P. Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - G. Lewis
- Division of Psychiatry, University College London, London, UK
| | - A. S. David
- UCL Institute of Mental Health, University College London, London, UK
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8
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Lukow PB, Kiemes A, Kempton MJ, Turkheimer FE, McGuire P, Modinos G. Neural correlates of emotional processing in psychosis risk and onset - A systematic review and meta-analysis of fMRI studies. Neurosci Biobehav Rev 2021; 128:780-788. [PMID: 33722617 PMCID: PMC8345001 DOI: 10.1016/j.neubiorev.2021.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/17/2020] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
The neural bases of altered emotion processing in psychosis are still unclear. Systematic review indicated widespread activation decreases to emotion in first-episode psychosis. Evidence in people at clinical high-risk for psychosis lacked convergence. These findings were corroborated by image-based meta-analyses.
Aberrant emotion processing is a well-established component of psychotic disorders and is already present at the first episode of psychosis (FEP). However, the role of emotion processing abnormalities in the emergence of psychosis and the underlying neurobiology remain unclear. Here, we systematically reviewed functional magnetic resonance studies that used emotion processing task paradigms in FEP patients, and in people at clinical high-risk for psychosis (CHRp). Image-based meta-analyses with Seed-based d Mapping on available studies (n = 6) were also performed. Compared to controls, FEP patients showed decreased neural responses to emotion, particularly in the amygdala and anterior cingulate cortex. There were no significant differences between CHRp subjects and controls, but a high degree of heterogeneity was identified across studies. The role of altered emotion processing in the early phase of psychosis may be clarified through more homogenous experimental designs, particularly in the CHRp population.
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Affiliation(s)
- P B Lukow
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - A Kiemes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - M J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - F E Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - P McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - G Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK; MRC Centre for Neurodevelopmental Disorders, King's College London, new hunt's House, Guy's Campus, SE1 1UL, London, UK.
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9
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Appiah-Kusi E, Wilson R, Colizzi M, Foglia E, Klamerus E, Caldwell A, Bossong MG, McGuire P, Bhattacharyya S. Childhood trauma and being at-risk for psychosis are associated with higher peripheral endocannabinoids. Psychol Med 2020; 50:1862-1871. [PMID: 31422779 DOI: 10.1017/s0033291719001946] [Citation(s) in RCA: 10] [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: 12/20/2022]
Abstract
BACKGROUND Evidence has been accumulating regarding alterations in components of the endocannabinoid system in patients with psychosis. Of all the putative risk factors associated with psychosis, being at clinical high-risk for psychosis (CHR) has the strongest association with the onset of psychosis, and exposure to childhood trauma has been linked to an increased risk of development of psychotic disorder. We aimed to investigate whether being at-risk for psychosis and exposure to childhood trauma were associated with altered endocannabinoid levels. METHOD We compared 33 CHR participants with 58 healthy controls (HC) and collected information about previous exposure to childhood trauma as well as plasma samples to analyse endocannabinoid levels. RESULTS Individuals with both CHR and experience of childhood trauma had higher N-palmitoylethanolamine (p < 0.001) and anandamide (p < 0.001) levels in peripheral blood compared to HC and those with no childhood trauma. There was also a significant correlation between N-palmitoylethanolamine levels and symptoms as well as childhood trauma. CONCLUSIONS Our results suggest an association between CHR and/or childhood maltreatment and elevated endocannabinoid levels in peripheral blood, with a greater alteration in those with both CHR status and history of childhood maltreatment compared to those with either of those risks alone. Furthermore, endocannabinoid levels increased linearly with the number of risk factors and elevated endocannabinoid levels correlated with the severity of CHR symptoms and extent of childhood maltreatment. Further studies in larger cohorts, employing longitudinal designs are needed to confirm these findings and delineate the precise role of endocannabinoid alterations in the pathophysiology of psychosis.
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Affiliation(s)
- E Appiah-Kusi
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - R Wilson
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - M Colizzi
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Policlinico 'G. B. Rossi', P.le L.A. Scuro 10, 37134, Verona, Italy
| | - E Foglia
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - E Klamerus
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - A Caldwell
- King's College London, Mass Spectometry Facility, Franklin Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
| | - M G Bossong
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - P McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - S Bhattacharyya
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Box PO 63, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
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10
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Valmaggia L, Stahl D, Yung A, Nelson B, McGorry P, McGuire P. The structure of the ultra high risk mental state for psychosis. A latent class cluster analysis study. Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)73790-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionIndividuals at Ultra High Risk (UHR) for psychosis typically present with attenuated psychotic symptoms. However it is difficult to predict which individuals will later develop frank psychosis when their mental state is rated in terms of individual symptoms.The objective of the study was to examine the phenomenological structure of the UHR mental state and identify symptom profiles that predict later transition to psychosis.MethodPsychopathological data from a large sample of UHR subjects were analysed using latent class cluster analysis.A total of 318 individuals with a UHR for psychosis. Data were collected from two specialised community mental health services for people at UHR for psychosis: OASIS in London and PACE, in Melbourne.ResultsLatent class cluster analysis produced 4 classes: Class 1 - Mild was characterized by lower scores on all the CAARMS items. Subjects in Class 2 - Moderate scored moderately on all CAARMS items and was more likely to be in employment. Those in Class 3 - Moderate-Severe scored moderately-severe on negative symptoms, social isolation and impaired role functioning. Class 4 - Severe was the smallest group and was associated with the most impairment: subjects in this class scored highest on all items of the CAARMS, had the lowest GAF score and were more likely to be unemployed. This group was also characterized by the highest transition rate (41%).ConclusionsDifferent constellations of symptomatology are associates with varying levels of risk to of transition to psychosis.
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Abstract
BackgroundStress is a key feature of many aetiological models of psychosis and there is considerable empirical evidence implicating stress in the development of psychosis. This paper investigates the role of psychosocial stress in the onset of psychosis by examining the relationship between current and lifetime exposure to traumatic experiences and psychosocial stressors, HPA axis function, and psychopathology in people at high risk of developing psychosis.MethodsSixty ‘high risk’ (HR) participants were compared with 50 healthy control (HC) participants on measures of exposure to psychosocial stressors. Subgroups of HR and HC participants which provided saliva samples were compared regarding measures of HPA axis function.ResultsHR participants were exposed to greater levels of psychosocial stress than HC participants. Specifically, HR participants were more likely to have been separated from their parents (p = .003), report severe parental antipathy (p = .011), and have been bullied while growing up (p = .024). HR participants experienced greater levels of perceived stress than HC participants (p = .001) and were more likely to have had a negative life event in the previous 6 months (p < .001). Positive correlations were found between current stress and number of life events and attenuated psychotic symptoms (r = .585, p < .001, and r = .384, p = < .001, respectively) in the HR participants.DiscussionThis study shows that people at high risk of developing psychosis experience greater levels of psychosocial stress than matched healthy control participants throughout the lifetime, from early childhood to the present day, and that current stress is strongly associated with psychotic symptomatology.
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12
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Theleritis C, Bonaccorso S, Habib N, Stahl D, Gaughran F, Vitoratou S, Atakan Z, Kolliakou A, Gardner Sood P, Dazzan P, Marques T, McGuire P, Greenwood K, Eberhard J, Breedvelt J, Ferracuti S, Di Forti M, Murray R, Smith S. Sexual dysfunction and central obesity in patients with first episode psychosis. Eur Psychiatry 2020; 42:1-7. [DOI: 10.1016/j.eurpsy.2016.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 10/14/2016] [Accepted: 11/13/2016] [Indexed: 12/18/2022] Open
Abstract
AbstractBackgroundIn recent years the association between sexual dysfunction (SD) and obesity in the general population has drawn major attention. Although sexual dysfunction is common in psychosis, its relationship with weight gain and obesity remains unclear.AimsTo investigate the association between sexual dysfunction and obesity in a cohort of patients with first episode psychosis.MethodSexual function was assessed in a cohort of patients with first episode psychosis using the Sexual Function Questionnaire (SFQ). Anthropometric measures, including weight, BMI, waist, waist–hip ratio were investigated. Additionally, leptin and testosterone were investigated in male patients.ResultsA total of 116 patients (61 males and 55 females) were included. Of these 59% of males and 67.3% of females showed sexual dysfunction (SD) according to the SFQ. In males, higher SFQ scores were significantly correlated with higher BMI (Std. β = 0.36, P = 0.01), higher leptin levels (Std. β = 0.34, P = 0.02), higher waist–hip ratio (Std. β = 0.32, P = 0.04) and lower testosterone levels (Std. β = −0.44, P = 0.002). In contrast, in females, SFQ scores were not associated with any of these factors.ConclusionsWhile sexual dysfunction is present in both female and male patients with their first episode of psychosis, only in males is sexual dysfunction associated with increased BMI and waist–hip ratio. The association between SD, BMI, low levels of testosterone and high levels of leptin suggest that policies that lead to healthier diets and more active lifestyles can be beneficial at least, to male patients.
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13
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Tognin S, van Hell HH, Merritt K, Winter-van Rossum I, Bossong MG, Kempton MJ, Modinos G, Fusar-Poli P, Mechelli A, Dazzan P, Maat A, de Haan L, Crespo-Facorro B, Glenthøj B, Lawrie SM, McDonald C, Gruber O, van Amelsvoort T, Arango C, Kircher T, Nelson B, Galderisi S, Bressan R, Kwon JS, Weiser M, Mizrahi R, Sachs G, Maatz A, Kahn R, McGuire P. Towards Precision Medicine in Psychosis: Benefits and Challenges of Multimodal Multicenter Studies-PSYSCAN: Translating Neuroimaging Findings From Research into Clinical Practice. Schizophr Bull 2020; 46:432-441. [PMID: 31424555 PMCID: PMC7043057 DOI: 10.1093/schbul/sbz067] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In the last 2 decades, several neuroimaging studies investigated brain abnormalities associated with the early stages of psychosis in the hope that these could aid the prediction of onset and clinical outcome. Despite advancements in the field, neuroimaging has yet to deliver. This is in part explained by the use of univariate analytical techniques, small samples and lack of statistical power, lack of external validation of potential biomarkers, and lack of integration of nonimaging measures (eg, genetic, clinical, cognitive data). PSYSCAN is an international, longitudinal, multicenter study on the early stages of psychosis which uses machine learning techniques to analyze imaging, clinical, cognitive, and biological data with the aim of facilitating the prediction of psychosis onset and outcome. In this article, we provide an overview of the PSYSCAN protocol and we discuss benefits and methodological challenges of large multicenter studies that employ neuroimaging measures.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Outreach and Support in South London (OASIS), South London and Maudsley NHS Foundation Trust, London, UK
| | - Hendrika H van Hell
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands,To whom correspondence should be addressed; Clinical Trial Center, Department of Psychiatry, University Medical Center Utrecht Brain Center, PO Box 85500, 3508 GA Utrecht, The Netherlands; tel: +31 88 755 7247, e-mail:
| | - Kate Merritt
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Inge Winter-van Rossum
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands
| | - Matthijs G Bossong
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Arija Maat
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands
| | - Lieuwe de Haan
- Department Early Psychosis, Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Benedicto Crespo-Facorro
- CIBERSAM, Department of Psychiatry, University Hospital Virgen del Rocío, Sevilla, Spain,IDIVAL, Marqués de Valdecilla University Hospital, Santander, Spain,School of Medicine, University of Cantabria, Santander, Spain
| | - Birte Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark,Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), NCBES Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañon, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Tilo Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Rodrigo Bressan
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Jun S Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Romina Mizrahi
- Institute of Medical Science, University of Toronto, Toronto, Canada,Centre for Addiction and Mental Health, Toronto, Canada,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Anke Maatz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - René Kahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Phillip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Outreach and Support in South London (OASIS), South London and Maudsley NHS Foundation Trust, London, UK,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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Appiah-Kusi E, Petros N, Wilson R, Colizzi M, Bossong MG, Valmaggia L, Mondelli V, McGuire P, Bhattacharyya S. Effects of short-term cannabidiol treatment on response to social stress in subjects at clinical high risk of developing psychosis. Psychopharmacology (Berl) 2020; 237:1121-1130. [PMID: 31915861 PMCID: PMC7113209 DOI: 10.1007/s00213-019-05442-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 12/27/2019] [Indexed: 11/29/2022]
Abstract
RATIONALE Stress is a risk factor for psychosis and treatments which mitigate its harmful effects are needed. Cannabidiol (CBD) has antipsychotic and anxiolytic effects. OBJECTIVES We investigated whether CBD would normalise the neuroendocrine and anxiety responses to stress in clinical high risk for psychosis (CHR) patients. METHODS Thirty-two CHR patients and 26 healthy controls (HC) took part in the Trier Social Stress Test (TSST) and their serum cortisol, anxiety and stress associated with public speaking were estimated. Half of the CHR participants were on 600 mg/day of CBD (CHR-CBD) and half were on placebo (CHR-P) for 1 week. RESULTS One-way analysis of variance (ANOVA) revealed a significant effect of group (HC, CHR-P, CHR-CBD (p = .005) on cortisol reactivity as well as a significant (p = .003) linear decrease. The change in cortisol associated with experimental stress exposure was greatest in HC controls and least in CHR-P patients, with CHR-CBD patients exhibiting an intermediate response. Planned contrasts revealed that the cortisol reactivity was significantly different in HC compared with CHR-P (p = .003), and in HC compared with CHR-CBD (p = .014), but was not different between CHR-P and CHR-CBD (p = .70). Across the participant groups (CHR-P, CHR-CBD and HC), changes in anxiety and experience of public speaking stress (all p's < .02) were greatest in the CHR-P and least in the HC, with CHR-CBD participants demonstrating an intermediate level of change. CONCLUSIONS Our findings show that it is worthwhile to design further well powered studies which investigate whether CBD may be used to affect cortisol response in clinical high risk for psychosis patients and any effect this may have on symptoms.
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Affiliation(s)
- E. Appiah-Kusi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, PO Box 63, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - N. Petros
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, PO Box 63, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - R. Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, PO Box 63, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - M. Colizzi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, PO Box 63, De Crespigny Park, Denmark Hill, London, SE5 8AF UK ,Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, Policlinico “G. B. Rossi”, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - M. G. Bossong
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, PO Box 63, De Crespigny Park, Denmark Hill, London, SE5 8AF UK ,Department of Psychiatry, University Medical Centre Utrecht Brain Centre, Utrecht University Utrecht, The Netherlands
| | - L. Valmaggia
- Department of Psychology, IoPPN, King’s College London, London, PO Box 77 UK ,National Institute for Health Research, Biomedical Research Centre, London, UK
| | - V. Mondelli
- National Institute for Health Research, Biomedical Research Centre, London, UK ,Department of Psychological Medicine, IoPPN, King’s College London, London, UK
| | - P. McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, PO Box 63, De Crespigny Park, Denmark Hill, London, SE5 8AF UK ,National Institute for Health Research, Biomedical Research Centre, London, UK
| | - S. Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, PO Box 63, De Crespigny Park, Denmark Hill, London, SE5 8AF UK ,National Institute for Health Research, Biomedical Research Centre, London, UK
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15
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Jauhar S, Ratheesh A, Davey C, Yatham LN, McGorry PD, McGuire P, Berk M, Young AH. The case for improved care and provision of treatment for people with first-episode mania. Lancet Psychiatry 2019; 6:869-876. [PMID: 31248840 DOI: 10.1016/s2215-0366(19)30082-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 11/19/2022]
Abstract
The care of people with first-episode mania has been overlooked in comparison with the care of patients with other non-affective psychoses, despite evidence suggesting targeted treatments might be of benefit for this patient group. In this Personal View, we outline the general epidemiology of first-episode mania in the context of bipolar disorder, the natural history of mania (with an emphasis on its recurrent nature), current evidence for pharmacological, psychological, and service-level interventions, current guidelines for the treatment of first-episode mania, and provide a patient's point of view of the care pathway (appendix). We note the paucity of high-quality evidence for interventions in first-episode mania and the lack of agreement among treatment guidelines in relation to treatment, especially maintenance treatment. We suggest that, based on high morbidity and clinical need, research evidence to inform guideline development is necessary, and in the interim, clearer guidance on treatment and diagnosis should be given; specifically, we have suggested that patients should be cared for within a first-episode psychosis service, when such a service exists.
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Affiliation(s)
- Sameer Jauhar
- Department of Psychological Medicine, Psychology and Neuroscience, King's College London, London; Early intervention Pathway, Psychosis Clinical Academic Group, South London and Maudsley National Health Service Foundation Trust, London.
| | - Aswin Ratheesh
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Christopher Davey
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Phillip McGuire
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London; Early intervention Pathway, Psychosis Clinical Academic Group, South London and Maudsley National Health Service Foundation Trust, London
| | - Michael Berk
- The Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia; IMPACT Strategic Research Centre, School of Medicine and Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Allan H Young
- Department of Psychological Medicine, Psychology and Neuroscience, King's College London, London
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16
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Jauhar S, Ratheesh A, Davey C, Yatham LN, McGorry PD, McGuire P, Berk M, Young AH. First episode mania: we should have intervened earlier. Lancet Psychiatry 2019; 6:807-808. [PMID: 31544759 DOI: 10.1016/s2215-0366(19)30340-2] [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: 07/22/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Sameer Jauhar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Aswin Ratheesh
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Christopher Davey
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Lakshmi N Yatham
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Patrick D McGorry
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Phillip McGuire
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Michael Berk
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
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Leung CJ, Fosuaah A, Frerichs J, Heslin M, Kabir T, Lee TMC, McGuire P, Meek C, Mouchlianitis E, Nath AS, Peters E, Shergill S, Stahl D, Trotta A, Yiend J. A qualitative study of the acceptability of cognitive bias modification for paranoia (CBM-pa) in patients with psychosis. BMC Psychiatry 2019; 19:225. [PMID: 31337373 PMCID: PMC6651961 DOI: 10.1186/s12888-019-2215-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 03/02/2019] [Accepted: 07/17/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cognitive Bias Modification (CBM) has been used successfully as a computer-based intervention in disorders such as anxiety. However, CBM to modify interpretations of ambiguous information relevant to paranoia has not yet been tested. We conducted a qualitative investigation of a novel intervention called CBM for paranoia (CBM-pa) to examine its acceptability in patients with psychosis. METHODS Eight participants with psychosis who completed CBM-pa were identified by purposive sampling and invited for a semi-structured interview to explore the facilitators and barriers to participation, optimum form of delivery, perceived usefulness of CBM-pa and their opinions on applying CBM-pa as a computerised intervention. The interviews were transcribed and analysed using thematic analysis by researchers working in collaboration with service users. RESULTS Themes emerged relating to participants' perception about delivery, engagement, programme understanding, factors influencing experience, perceived impact and application of CBM-pa. CBM-pa was regarded as easy, straightforward and enjoyable. It was well-accepted among those we interviewed, who understood the procedure as a psychological intervention. Patients reported that it increased their capacity for adopting alternative interpretations of emotionally ambiguous scenarios. Although participants all agreed on the test-like nature of the current CBM-pa format, they considered that taking part in sessions had improved their overall wellbeing. Most of them valued the computer-based interface of CBM-pa but favoured the idea of combining CBM-pa with some form of human interaction. CONCLUSIONS CBM-pa is an acceptable intervention that was well-received by our sample of patients with paranoia. The current findings reflect positively on the acceptability and experience of CBM-pa in the target population. Patient opinion supports further development and testing of CBM-pa as a possible adjunct treatment for paranoia. TRIAL REGISTRATION Current Controlled Trials ISRCTN: 90749868 . Retrospectively registered on 12 May 2016.
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Affiliation(s)
- C. J. Leung
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK ,0000000121742757grid.194645.bLaboratory of Neuropsychology, The University of Hong Kong, Hongkong, Hong Kong
| | - A. Fosuaah
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J. Frerichs
- grid.490917.2The McPin Foundation, London, UK
| | - M. Heslin
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - T. Kabir
- grid.490917.2The McPin Foundation, London, UK
| | - T. M. C. Lee
- 0000000121742757grid.194645.bLaboratory of Neuropsychology, The University of Hong Kong, Hongkong, Hong Kong ,0000000121742757grid.194645.bThe State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hongkong, Hong Kong
| | - P. McGuire
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK ,0000 0001 2324 5535grid.415717.1South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX UK
| | - C. Meek
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - E. Mouchlianitis
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - A. S. Nath
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - E. Peters
- 0000 0001 2324 5535grid.415717.1South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX UK ,0000 0001 2322 6764grid.13097.3cDepartment of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - S. Shergill
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK ,0000 0001 2324 5535grid.415717.1South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX UK
| | - D. Stahl
- 0000 0001 2322 6764grid.13097.3cDepartment of Biostatistics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - A. Trotta
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J. Yiend
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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McGuire P. 366 The liver is a metabolic and immunologic organ: a reconsideration of metabolic decompensation in mitochondrial hepatopathy. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P McGuire
- National Human Genome Research Institute,Bethesda, MD, United States
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Kravariti E, Reeve-Mates C, Da Gama Pires R, Tsakanikos E, Hayes D, Renshaw S, McAllister S, Bhavsar V, Patterson P, Daley E, Stewart J, Pritchard M, Shetty H, Ramsay R, Perez-Iglesias R, McGuire P. Effectiveness of automated appointment reminders in Psychosis Community Services: A randomised controlled trial - CORRIGENDUM. BJPsych Open 2018; 4:419. [PMID: 30295223 PMCID: PMC6235977 DOI: 10.1192/bjo.2018.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Winton-Brown T, Schmidt A, Roiser JP, Howes OD, Egerton A, Fusar-Poli P, Bunzeck N, Grace AA, Duzel E, Kapur S, McGuire P. Correction: Altered activation and connectivity in a hippocampal-basal ganglia-midbrain circuit during salience processing in subjects at ultra high risk for psychosis. Transl Psychiatry 2018; 8:170. [PMID: 30171182 PMCID: PMC6119195 DOI: 10.1038/s41398-018-0189-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This Article was originally published under Nature Research's License to Publish, but has now been made available under a CC BY 4.0 license. The PDF and HTML versions of the Article have been modified accordingly.
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Affiliation(s)
- T. Winton-Brown
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK ,0000 0004 1936 7857grid.1002.3Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, VIC Australia
| | - A. Schmidt
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
| | - J. P. Roiser
- 0000000121901201grid.83440.3bInstitute of Cognitive Neuroscience, University College London, London, UK
| | - O. D. Howes
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK ,0000 0001 0705 4923grid.413629.bPsychiatric Imaging, MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK
| | - A. Egerton
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
| | - P. Fusar-Poli
- 0000 0001 2322 6764grid.13097.3cEarly Psychosis: Intervention and Clinical-prediction (EPIC) Lab, Department of Psychosis Studies, Institute of Psychology, Psychiatry and Neuroscience, King’s College London, London, UK ,OASIS Service, South London and Maudsley (SLaM) NHS Foundation Trusts, Beckenham, UK
| | - N. Bunzeck
- 0000 0001 0057 2672grid.4562.5Institute of Psychology, University of Luebeck, Luebeck, Germany ,0000 0001 2180 3484grid.13648.38Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A. A. Grace
- 0000 0004 1936 9000grid.21925.3dDepartment of Neuroscience, University of Pittsburgh, Pittsburgh, PA USA
| | - E. Duzel
- 0000000121901201grid.83440.3bInstitute of Cognitive Neuroscience, University College London, London, UK
| | - S. Kapur
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK ,0000 0001 2179 088Xgrid.1008.9Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC Australia
| | - P. McGuire
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
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Patel R, Chesney E, Taylor M, Taylor D, McGuire P. Is paliperidone palmitate more effective than other long-acting injectable antipsychotics? Psychol Med 2018; 48:1616-1623. [PMID: 29039277 PMCID: PMC6088783 DOI: 10.1017/s0033291717003051] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Paliperidone palmitate is one of the most widely prescribed long-acting injectable (LAI) antipsychotics in the UK. However, it is relatively expensive and there are few data comparing its effectiveness to that of other LAI antipsychotics. We sought to address this issue by analyzing a large anonymized electronic health record (EHR) dataset from patients treated with LAI antipsychotics. METHODS EHR data were obtained from 1281 patients in the South London and Maudsley NHS Foundation Trust (SLaM) who started treatment with a LAI antipsychotic between 1 April 2011 and 31 January 2015. The number of days spent as a psychiatric inpatient and the number of admissions to a psychiatric hospital were analyzed in each of the 3 years before and after LAI prescription. RESULTS Patients treated with paliperidone palmitate (n = 430; 33.6%) had a greater number of inpatient days and a greater number of admissions in the year prior to treatment than those treated with other LAI antipsychotics. Nevertheless, in the 3 years after initiation there were no significant differences between paliperidone and the other LAI antipsychotics in the number of days as an inpatient (B coefficient 5.4 days, 95% confidence interval (CI) -57.3 to 68.2, p = 0.86) or number of hospital admissions (Incidence rate ratio 1.07, 95% CI 0.62 to 1.83, p = 0.82). CONCLUSION Paliperidone palmitate was more likely to be prescribed in patients with more frequent and lengthy hospital admissions prior to initiation. However, the absence of differences in outcomes after initiation indicates that paliperidone palmitate was not more effective than other cheaper LAI antipsychotics.
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Affiliation(s)
- R. Patel
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Box PO 63, De Crespigny Park, Denmark Hill, London, UK
| | - E. Chesney
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Box PO 63, De Crespigny Park, Denmark Hill, London, UK
| | - M. Taylor
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Box PO 63, De Crespigny Park, Denmark Hill, London, UK
| | - D. Taylor
- Pharmacy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
- King's College London, Institute of Pharmaceutical Science, 5th Floor, Franklin-Wilkins Building, 150 Stamford Street, London, UK
| | - P. McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, Box PO 63, De Crespigny Park, Denmark Hill, London, UK
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22
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Bargiota SI, Bozikas VP, Garyfallos G, McGuire P. Early intervention services in Greece: Time to focus on people at high risk. Psychiatriki 2018; 29:58-63. [PMID: 29754121 DOI: 10.22365/jpsych.2018.291.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Over the last twenty years, a lot of early intervention services operate worldwide with the aim of offering assistance and promoting the early diagnosis and management, not only of people who experience a first episode of psychosis but also of individuals that are at high risk of developing psychosis. The early intervention services that operate in other countries have been reviewed in correlation with the current status of early intervention services for psychosis in Greece. Early intervention services were first established in Australia, and now hundreds of similar programs exist in Europe, North America and Asia. Furthermore, early intervention services incorporate teams that engage people who have an at risk mental state (ARMS), and are at high risk of developing psychosis. The first clinical service for individuals at high risk for psychosis was established in Melbourne in 1995, and an increasing number of similar services have since emerged worldwide. One of the largest of these is OASIS (Outreach and Support in South London). The first early intervention service was developed during the December 2007, in a rural catchment region of north-western Greece, in Ioannina. After the establishment of Ioannina Early Intervention Service, there was a growing interest of the Greek psychiatric community in the issues of early detection and prevention of psychotic disorders which led to the development of early psychosis units in other regions of Greece, like Athens, Thessaloniki and Patras. However, this field remains neglected in Greece, since in the absence of funding for such early detection services, there are only a few programs that operate mainly on a voluntary basis. Moreover, specialized mental health services for people at high risk for psychosis that have significant clinical benefits and are also cost effective, do not exist in the majority of Greek services. Greece and other countries in a similar condition need to understand the significance of untreated or poorly treated psychotic disorders that affect a lot of young people in late adolescence and early adult life. Focusing on people at high risk of developing psychosis will promote public health and will help not only to prevent the onset of psychotic disorders but to enhance their prognosis as well.
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Affiliation(s)
- S I Bargiota
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - V P Bozikas
- 1st Department of Psychiatry, Aristotle University of Thessaloniki, General Hospital "Papageorgiou", Thessaloniki
| | - G Garyfallos
- 2nd Department of Psychiatry, Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
| | - P McGuire
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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23
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Kraan TC, Velthorst E, Themmen M, Valmaggia L, Kempton MJ, McGuire P, van Os J, Rutten BPF, Smit F, de Haan L, van der Gaag M. Child Maltreatment and Clinical Outcome in Individuals at Ultra-High Risk for Psychosis in the EU-GEI High Risk Study. Schizophr Bull 2018; 44:584-592. [PMID: 28666366 PMCID: PMC5890491 DOI: 10.1093/schbul/sbw162] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Child maltreatment has been associated with a wide range of mental disorders in adulthood. Whether child maltreatment is specifically associated with psychosis risk in individuals at ultra-high risk (UHR) for psychosis, or leads to a general vulnerability for overall psychopathology in the UHR stage remains unclear. The present study examines the association between child maltreatment and transition to psychosis and other mental disorders. METHODS The sample consisted of 259 UHR individuals from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Participants were followed-up for 2 years to assess clinical outcome. Clinical outcome was assessed at 6 months, 12 months, and 24 months after baseline. Child maltreatment before the age of 17 years was assessed at baseline. RESULTS Our findings show that a history of emotional abuse was associated with an increased risk for transition to psychosis (OR = 3.78, 95% CI = 1.17 to 12.39, P = .027). Apart from psychosis, a history of physical abuse was associated with depressive disorder (OR = 4.92, 95% CI = 2.12 to 11.39, P = .001), post-traumatic stress disorder (OR = 2.06, 95% CI = 1.10 to 3.86, P = .023), panic disorder (OR = 2.00, 95% CI = 1.00 to 3.99, P = .048) and social phobia (OR = 2.47, 95% CI = 1.18 to 5.16, P = .016) at follow-up. CONCLUSION Our findings suggest that in the UHR stage child maltreatment is a pluripotent risk factor for developing psychosis, depressive disorder, post-traumatic stress disorder (PTSD), panic disorder, and social phobia in adulthood.
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Affiliation(s)
- Tamar C Kraan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine, Mount Sinai, NY
| | - Manouk Themmen
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Phillip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, The Netherlands,King’s College London, King’s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Filip Smit
- Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands,Department of Public Mental Health, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands,Department of Clinical Psychology, VU University and Amsterdam Public Health research institute, Amsterdam, The Netherlands,To whom correspondence should be addressed; Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; tel: +31-6-45780463, fax: +31-20-5988758, e-mail:
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Oliver D, Kotlicka-Antczak M, Minichino A, Spada G, McGuire P, Fusar-Poli P. Meta-analytical prognostic accuracy of the Comprehensive Assessment of at Risk Mental States (CAARMS): The need for refined prediction. Eur Psychiatry 2018; 49:62-68. [PMID: 29413807 DOI: 10.1016/j.eurpsy.2017.10.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/04/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022] Open
Abstract
Primary indicated prevention is reliant on accurate tools to predict the onset of psychosis. The gold standard assessment for detecting individuals at clinical high risk (CHR-P) for psychosis in the UK and many other countries is the Comprehensive Assessment for At Risk Mental States (CAARMS). While the prognostic accuracy of CHR-P instruments has been assessed in general, this is the first study to specifically analyse that of the CAARMS. As such, the CAARMS was used as the index test, with the reference index being psychosis onset within 2 years. Six independent studies were analysed using MIDAS (STATA 14), with a total of 1876 help-seeking subjects referred to high risk services (CHR-P+: n=892; CHR-P-: n=984). Area under the curve (AUC), summary receiver operating characteristic curves (SROC), quality assessment, likelihood ratios, and probability modified plots were computed, along with sensitivity analyses and meta-regressions. The current meta-analysis confirmed that the 2-year prognostic accuracy of the CAARMS is only acceptable (AUC=0.79 95% CI: 0.75-0.83) and not outstanding as previously reported. In particular, specificity was poor. Sensitivity of the CAARMS is inferior compared to the SIPS, while specificity is comparably low. However, due to the difficulties in performing these types of studies, power in this meta-analysis was low. These results indicate that refining and improving the prognostic accuracy of the CAARMS should be the mainstream area of research for the next era. Avenues of prediction improvement are critically discussed and presented to better benefit patients and improve outcomes of first episode psychosis.
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Affiliation(s)
- D Oliver
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom.
| | - M Kotlicka-Antczak
- Medical University of Lodz, Department of Affective and Psychotic Disorders, Lodz, Poland
| | - A Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - G Spada
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - P McGuire
- Department of Psychosis Studies, IoPPN, King's College London, London SE5 8AF, United Kingdom; OASIS Service, South London and the Maudsley NHS National Health Service Foundation Trust, London, United Kingdom; National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, IoPPN, King's College London, SE5 8AF, United Kingdom
| | - P Fusar-Poli
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom; OASIS Service, South London and the Maudsley NHS National Health Service Foundation Trust, London, United Kingdom; National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health, IoPPN, King's College London, SE5 8AF, United Kingdom
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25
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Bhavsar V, Fusar-Poli P, McGuire P. Neighbourhood deprivation is positively associated with detection of the ultra-high risk (UHR) state for psychosis in South East London. Schizophr Res 2018; 192:371-376. [PMID: 28601502 PMCID: PMC5821699 DOI: 10.1016/j.schres.2017.06.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/27/2017] [Accepted: 06/03/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND Individuals are defined as being at ultra-high risk (UHR) for psychosis based on a combination of attenuated psychotic symptoms, help-seeking behaviour, genetic risk, and social/occupational deterioration. Limited evidence is available on whether UHR detection differs by neighbourhood, and potential explanations. AIMS To examine neighbourhood distribution of detected UHR using cases from the OASIS service in South East London, investigating neighbourhood deprivation as an explanatory variable. METHODS Geographic data were collected on patients who met UHR criteria over a fourteen-year period, at the neighbourhood (lower super output area, LSOA) level. Rates were calculated based on cases and age-specific population estimates. Poisson regression assessed associations between UHR rate and neighbourhood deprivation, and with particular deprivation domains, adjusting for referrals for UHR assessment, population density, and proportions of non-White people, and young single people. RESULTS Rate of UHR detection was statistically related to neighbourhood deprivation, but referral rate was not: compared to the least deprived neighbourhoods, the most deprived neighbourhoods had a greater than two-fold increase in incidence rate of detected UHR (adjusted incidence rate ratio (IRR): 2.11, 95% confidence interval (CI): 1.21,3.67). In contrast, a small, imprecise association was observed for referral for assessment for UHR (adjusted IRR: 1.26 (95%CI: 0.84,1.89)). Evidence was also found for associations of UHR detection rate with domains of deprivation pertaining to health and barriers to services. CONCLUSIONS The distribution of UHR detection rates by neighbourhood is not random and may be explained in part by differences in the social environment between neighbourhoods.
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Affiliation(s)
| | - P. Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, United Kingdom
| | - P. McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, United Kingdom
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26
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Fusar-Poli P, Palombini E, Davies C, Oliver D, Bonoldi I, Ramella-Cravaro V, McGuire P. Why transition risk to psychosis is not declining at the OASIS ultra high risk service: The hidden role of stable pretest risk enrichment. Schizophr Res 2018; 192:385-390. [PMID: 28734908 DOI: 10.1016/j.schres.2017.06.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 06/07/2017] [Accepted: 06/10/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The reason for declining risk to psychosis across individuals assessed and meeting Ultra High Risk (UHR) criteria is still unclear. No studies have investigated the potential substantial role of the underlying risk enrichment across all the individuals undergoing an UHR assessment. METHODS Cohort study including all non-psychotic subjects who were assessed on suspicion of psychosis risk by the OASIS UHR service in the period 2001 to 2015. Posttest (after UHR assessment) and pretest risk (before UHR assessment) of psychosis were stratified and compared across three time periods (2001-2005, 2006-2010, 2011-2015) with Cox analysis and modulating factors were investigated. RESULTS The posttest risk of psychosis at the OASIS service has increased from the initial pilot years of the service (2001-2005) and then stabilised and not declined over the following decade (2006-2010 and 2011-2015). This was paralleled by a similar course of pretest risk for psychosis. Stability of pretest risk for psychosis over the past decade was associated with a lack of change in ethnicity and to counterweighting changes in the type of referral sources over different time periods. CONCLUSIONS The time course of transition risk to psychosis in UHR services is strictly associated with the time course of pretest risk enrichment. If the latter remains stable over time, as for the OASIS service, no declining transition risk is observed over the most recent years. Pretest risk enrichment is determined by recruitment and sampling strategies. This study confirms the need to control these factors in the UHR field.
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Affiliation(s)
- P Fusar-Poli
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, United Kingdom.
| | - E Palombini
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
| | - C Davies
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
| | - D Oliver
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
| | - I Bonoldi
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom; OASIS Service, South London and the Maudsley NHS Foundation Trust, London, United Kingdom
| | - V Ramella-Cravaro
- Early Psychosis: Interventions & Clinical-detection (EPIC) lab, Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
| | - P McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry Psychology and Neuroscience, London, United Kingdom
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27
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Murray RM, Englund A, Abi-Dargham A, Lewis DA, Di Forti M, Davies C, Sherif M, McGuire P, D'Souza DC. Cannabis-associated psychosis: Neural substrate and clinical impact. Neuropharmacology 2017. [PMID: 28634109 DOI: 10.1016/j.neuropharm.2017.06.018] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Prospective epidemiological studies have consistently demonstrated that cannabis use is associated with an increased subsequent risk of both psychotic symptoms and schizophrenia-like psychoses. Early onset of use, daily use of high-potency cannabis, and synthetic cannabinoids carry the greatest risk. The risk-increasing effects are not explained by shared genetic predisposition between schizophrenia and cannabis use. Experimental studies in healthy humans show that cannabis and its active ingredient, delta-9-tetrahydrocannabinol (THC), can produce transient, dose-dependent, psychotic symptoms, as well as an array of psychosis-relevant behavioral, cognitive and psychophysiological effects; the psychotogenic effects can be ameliorated by cannabidiol (CBD). Findings from structural imaging studies in cannabis users have been inconsistent but functional MRI studies have linked the psychotomimetic and cognitive effects of THC to activation in brain regions implicated in psychosis. Human PET studies have shown that acute administration of THC weakly releases dopamine in the striatum but that chronic users are characterised by low striatal dopamine. We are beginning to understand how cannabis use impacts on the endocannabinoid system but there is much still to learn about the biological mechanisms underlying how cannabis increases risk of psychosis. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology".
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Affiliation(s)
- R M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.
| | - A Englund
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - A Abi-Dargham
- Department of Psychiatry, School of Medicine, Stony Brook University, New York, USA
| | - D A Lewis
- Department of Psychiatry, University of Pittsburg, PA, USA
| | - M Di Forti
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - C Davies
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - M Sherif
- Department of Psychiatry, Yale University School of Medicine, CT, USA
| | - P McGuire
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - D C D'Souza
- Department of Psychiatry, Yale University School of Medicine, CT, USA
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28
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Stone J, Koychev I, Reilly T, McGuire P. Reply to: Letter to the Editor: Sodium nitroprusside for schizophrenia: could methodological variables account for the different results obtained? Psychol Med 2017; 47:983. [PMID: 28112079 DOI: 10.1017/s0033291716003470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- J Stone
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - I Koychev
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK
| | - T Reilly
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
| | - P McGuire
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK
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29
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Schmidt A, Antoniades M, Allen P, Egerton A, Chaddock CA, Borgwardt S, Fusar-Poli P, Roiser JP, Howes O, McGuire P. Longitudinal alterations in motivational salience processing in ultra-high-risk subjects for psychosis. Psychol Med 2017; 47:243-254. [PMID: 27697078 PMCID: PMC5216461 DOI: 10.1017/s0033291716002439] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/18/2016] [Accepted: 08/23/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Impairments in the attribution of salience are thought to be fundamental to the development of psychotic symptoms and the onset of psychotic disorders. The aim of the present study was to explore longitudinal alterations in salience processing in ultra-high-risk subjects for psychosis. METHOD A total of 23 ultra-high-risk subjects and 13 healthy controls underwent functional magnetic resonance imaging at two time points (mean interval of 17 months) while performing the Salience Attribution Test to assess neural responses to task-relevant (adaptive salience) and task-irrelevant (aberrant salience) stimulus features. RESULTS At presentation, high-risk subjects were less likely than controls to attribute salience to relevant features, and more likely to attribute salience to irrelevant stimulus features. These behavioural differences were no longer evident at follow-up. When attributing salience to relevant cue features, ultra-high-risk subjects showed less activation than controls in the ventral striatum at both baseline and follow-up. Within the high-risk sample, amelioration of abnormal beliefs over the follow-up period was correlated with an increase in right ventral striatum activation during the attribution of salience to relevant cue features. CONCLUSIONS These findings confirm that salience processing is perturbed in ultra-high-risk subjects for psychosis, that this is linked to alterations in ventral striatum function, and that clinical outcomes are related to longitudinal changes in ventral striatum function during salience processing.
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Affiliation(s)
- A. Schmidt
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
| | - M. Antoniades
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
| | - P. Allen
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
- Department of Psychology,
University of Roehampton, London,
UK
| | - A. Egerton
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
| | - C. A. Chaddock
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
| | - S. Borgwardt
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
- Department of Psychiatry (UPK),
University of Basel, Basel,
Switzerland
| | - P. Fusar-Poli
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
- OASIS Clinic, SLaM NHS Foundation
Trust, London, UK
| | - J. P. Roiser
- Institute of Cognitive Neuroscience, University
College London, London, UK
| | - O. Howes
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
- Psychiatric Imaging, MRC Clinical Sciences Centre,
Hammersmith Hospital, London, UK
| | - P. McGuire
- Department of Psychosis Studies,
King's College London, Institute of Psychiatry, Psychology and
Neuroscience, London, UK
- OASIS Clinic, SLaM NHS Foundation
Trust, London, UK
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30
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Fusar-Poli P, Tantardini M, De Simone S, Ramella-Cravaro V, Oliver D, Kingdon J, Kotlicka-Antczak M, Valmaggia L, Lee J, Millan M, Galderisi S, Balottin U, Ricca V, McGuire P. Deconstructing Vulnerability for Psychosis: Meta-Analysis of Environmental Risk Factors for Psychosis in Subjects at Ultra High-Risk. Eur Psychiatry 2016; 40:65-75. [DOI: 10.1016/j.eurpsy.2016.09.003] [Citation(s) in RCA: 184] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 01/13/2023] Open
Abstract
AbstractBackgroundSubjects at ultra high-risk (UHR) for psychosis have an enhanced vulnerability to develop the disorder but the risk factors accounting for this accrued risk are undetermined.MethodSystematic review of associations between genetic or environmental risk factors for psychosis that are widely established in the literature and UHR state, based on comparisons to controls.ResultsForty-four studies encompassing 170 independent datasets and 54 risk factors were included. There were no studies on association between genetic or epigenetic risk factors and the UHR state that met the inclusion criteria. UHR subjects were more likely to show obstetric complications, tobacco use, physical inactivity, childhood trauma/emotional abuse/physical neglect, high perceived stress, childhood and adolescent low functioning, affective comorbidities, male gender, single status, unemployment and low educational level as compared to controls.ConclusionsThe increased vulnerability of UHR subjects can be related to environmental risk factors like childhood trauma, adverse life events and affective dysfunction. The role of genetic and epigenetic risk factors awaits clarification.
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31
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Reininghaus U, Gayer-Anderson C, Valmaggia L, Kempton MJ, Calem M, Onyejiaka A, Hubbard K, Dazzan P, Beards S, Fisher HL, Mills JG, McGuire P, Craig TKJ, Garety P, van Os J, Murray RM, Wykes T, Myin-Germeys I, Morgan C. Psychological processes underlying the association between childhood trauma and psychosis in daily life: an experience sampling study. Psychol Med 2016; 46:2799-2813. [PMID: 27400863 PMCID: PMC5358473 DOI: 10.1017/s003329171600146x] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/20/2016] [Accepted: 05/24/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Evidence has accumulated that implicates childhood trauma in the aetiology of psychosis, but our understanding of the putative psychological processes and mechanisms through which childhood trauma impacts on individuals and contributes to the development of psychosis remains limited. We aimed to investigate whether stress sensitivity and threat anticipation underlie the association between childhood abuse and psychosis. METHOD We used the Experience Sampling Method to measure stress, threat anticipation, negative affect, and psychotic experiences in 50 first-episode psychosis (FEP) patients, 44 At-Risk Mental State (ARMS) participants, and 52 controls. Childhood abuse was assessed using the Childhood Trauma Questionnaire. RESULTS Associations of minor socio-environmental stress in daily life with negative affect and psychotic experiences were modified by sexual abuse and group (all p FWE < 0.05). While there was strong evidence that these associations were greater in FEP exposed to high levels of sexual abuse, and some evidence of greater associations in ARMS exposed to high levels of sexual abuse, controls exposed to high levels of sexual abuse were more resilient and reported less intense negative emotional reactions to socio-environmental stress. A similar pattern was evident for threat anticipation. CONCLUSIONS Elevated sensitivity and lack of resilience to socio-environmental stress and enhanced threat anticipation in daily life may be important psychological processes underlying the association between childhood sexual abuse and psychosis.
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Affiliation(s)
- U. Reininghaus
- Department of Psychiatry and Psychology,
School for Mental Health and Neuroscience, Maastricht
University, Maastricht, The
Netherlands
- Health Service and Population Research
Department, Centre for Epidemiology and Public Health,
Institute of Psychiatry, Psychology & Neuroscience, King's College
London, London, UK
| | - C. Gayer-Anderson
- Health Service and Population Research
Department, Centre for Epidemiology and Public Health,
Institute of Psychiatry, Psychology & Neuroscience, King's College
London, London, UK
| | - L. Valmaggia
- Psychology Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
| | - M. J. Kempton
- Psychosis Studies Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
| | - M. Calem
- Psychosis Studies Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
| | - A. Onyejiaka
- Psychology Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
| | - K. Hubbard
- Health Service and Population Research
Department, Centre for Epidemiology and Public Health,
Institute of Psychiatry, Psychology & Neuroscience, King's College
London, London, UK
| | - P. Dazzan
- Psychosis Studies Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation
Trust and King's College London, London,
UK
| | - S. Beards
- Health Service and Population Research
Department, Centre for Epidemiology and Public Health,
Institute of Psychiatry, Psychology & Neuroscience, King's College
London, London, UK
| | - H. L. Fisher
- MRC Social, Genetic &
Developmental Psychiatry Centre, Institute of Psychiatry,
Psychology & Neuroscience, King's College London,
London, UK
| | - J. G. Mills
- Psychosis Studies Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
| | - P. McGuire
- Psychosis Studies Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation
Trust and King's College London, London,
UK
| | - T. K. J. Craig
- Health Service and Population Research
Department, Centre for Epidemiology and Public Health,
Institute of Psychiatry, Psychology & Neuroscience, King's College
London, London, UK
| | - P. Garety
- Psychology Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
| | - J. van Os
- Department of Psychiatry and Psychology,
School for Mental Health and Neuroscience, Maastricht
University, Maastricht, The
Netherlands
- Psychosis Studies Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
| | - R. M. Murray
- Psychosis Studies Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation
Trust and King's College London, London,
UK
| | - T. Wykes
- Psychology Department,
Institute of Psychiatry, Psychology & Neuroscience, King's
College, London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation
Trust and King's College London, London,
UK
| | - I. Myin-Germeys
- Department of Medicine,
Psychiatry Research Group, Catholic University of
Leuven, Leuven, Belgium
| | - C. Morgan
- Health Service and Population Research
Department, Centre for Epidemiology and Public Health,
Institute of Psychiatry, Psychology & Neuroscience, King's College
London, London, UK
- National Institute for Health Research (NIHR)
Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation
Trust and King's College London, London,
UK
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32
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Abstract
Self-disorders (SDs) (from the German Ichstörungen) are alterations of the first-person perspective, long associated with schizophrenia, particularly in early phases. Although psychopathological features of SDs continue to be studied, their neurobiological underpinnings are unknown. This makes it difficult to integrate SDs into contemporary models of psychosis. The present review aims to address this issue, starting from an historical excursus revealing an interconnection between neuroscientific models and the origin of the psychopathological concept of SDs. Subsequently, the more recent neurobiological models related to SDs are discussed, particularly with respect to the onset of schizophrenia.
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Affiliation(s)
- A. Mishara
- Department of Clinical Psychology, Chicago School of Professional Psychology, Southern California Campus, Los Angeles, CA;,Joint first authors
| | - I. Bonoldi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College of London, London, UK;,OASIS service, South London and the Maudsley NHS Foundation Trust, London, UK;,Department of Brain and Behavioural Sciences, University of Pavia, Italy;,*To whom correspondence should be addressed; Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College of London, PO Box 63, 16 De Crespigny Park, London SE5 8AF, UK; tel: 020-7848-0801; fax: 020-7848-0976; e-mail:
| | - P. Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College of London, London, UK;,Department of Psychology, University of Roehampton, Whitgelands College, London, UK
| | - G. Rutigliano
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College of London, London, UK;,Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - J. Perez
- CAMEO Early Intervention Services, Fulbourn Hospital, Fulbourn, Cambridge, UK;,Department of Psychiatry, Cambridge University, Cambridge, UK
| | - P. Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College of London, London, UK;,OASIS service, South London and the Maudsley NHS Foundation Trust, London, UK;,Department of Brain and Behavioural Sciences, University of Pavia, Italy;,Joint last authors
| | - P. McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College of London, London, UK;,Joint last authors
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Leucht S, Rossum IWV, Heres S, Arango C, Fleischhacker WW, Glenthøj B, Leboyer M, Leweke FM, Lewis S, McGuire P, Meyer-Lindenberg A, Rujescu D, Kapur S, Kahn RS, Sommer IE. The Optimization of Treatment and Management of Schizophrenia in Europe (OPTiMiSE) Trial: Rationale for Its Methodology and a Review of the Effectiveness of Switching Antipsychotics. Focus (Am Psychiatr Publ) 2016; 14:378-386. [PMID: 31997959 PMCID: PMC6526795 DOI: 10.1176/appi.focus.140302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
(Reprinted with permission from Schizophrenia Bulletin 2015; 41(3):549-558).
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Shakoor S, Zavos HMS, Haworth CMA, McGuire P, Cardno AG, Freeman D, Ronald A. Association between stressful life events and psychotic experiences in adolescence: evidence for gene-environment correlations. Br J Psychiatry 2016; 208:532-8. [PMID: 27056622 PMCID: PMC4887723 DOI: 10.1192/bjp.bp.114.159079] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 10/08/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Stressful life events (SLEs) are associated with psychotic experiences. SLEs might act as an environmental risk factor, but may also share a genetic propensity with psychotic experiences. AIMS To estimate the extent to which genetic and environmental factors influence the relationship between SLEs and psychotic experiences. METHOD Self- and parent reports from a community-based twin sample (4830 16-year-old pairs) were analysed using structural equation model fitting. RESULTS SLEs correlated with positive psychotic experiences (r = 0.12-0.14, all P<0.001). Modest heritability was shown for psychotic experiences (25-57%) and dependent SLEs (32%). Genetic influences explained the majority of the modest covariation between dependent SLEs and paranoia and cognitive disorganisation (bivariate heritabilities 74-86%). The relationship between SLEs and hallucinations and grandiosity was explained by both genetic and common environmental effects. CONCLUSIONS Further to dependent SLEs being an environmental risk factor, individuals may have an underlying genetic propensity increasing their risk of dependent SLEs and positive psychotic experiences.
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Affiliation(s)
- Sania Shakoor
- Sania Shakoor, PhD, Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London; Helena M. S. Zavos, PhD, King's College London, MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London; Claire M. A. Haworth, Department of Psychology, University of Warwick, Coventry;, Phillip McGuire, PhD, MD, FRCPsych, King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London; Alastair G. Cardno, PhD, MMedSc, FRCPsych, MBChB, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds; Daniel Freeman, PhD, DClinPsy, CPsychol, FBPsS, Department of Psychiatry, University of Oxford, Oxford; Angelica Ronald, PhD, Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Moura LM, Crossley NA, Zugman A, Pan PM, Gadelha A, Del Aquilla MAG, Picon FA, Anés M, Amaro E, de Jesus Mari J, Miguel EC, Rohde LA, Bressan RA, McGuire P, Sato JR, Jackowski AP. Coordinated brain development: exploring the synchrony between changes in grey and white matter during childhood maturation. Brain Imaging Behav 2016; 11:808-817. [DOI: 10.1007/s11682-016-9555-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Patel R, Reiss P, Shetty H, Broadbent M, Stewart R, McGuire P, Taylor M. Which antidepressants are associated with increased risk of developing mania? A retrospective electronic case register cohort study. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionThe symptoms of bipolar disorder are sometimes misrecognised for unipolar depression and inappropriately treated with antidepressants. This may be associated with increased risk of developing mania. However, the extent to which this depends on what type of antidepressant is prescribed remains unclear.AimsTo investigate the association between different classes of antidepressants and subsequent onset of mania/bipolar disorder in a real-world clinical setting.MethodsData on prior antidepressant therapy were extracted from 21,012 adults with unipolar depression receiving care from the South London and Maudsley NHS Foundation Trust (SLaM). multivariable Cox regression analysis (with age and gender as covariates) was used to investigate the association of antidepressant therapy with risk of developing mania/bipolar disorder.ResultsIn total, 91,110 person-years of follow-up data were analysed (mean follow-up: 4.3 years). The overall incidence rate of mania/bipolar disorder was 10.9 per 1000 person-years. The peak incidence of mania/bipolar disorder was seen in patients aged between 26 and 35 years (12.3 per 1000 person-years). The most frequently prescribed antidepressants were SSRIs (35.5%), mirtazapine (9.4%), venlafaxine (5.6%) and TCAs (4.7%). Prior antidepressant treatment was associated with an increased incidence of mania/bipolar disorder ranging from 13.1 to 19.1 per 1000 person-years. Multivariable analysis indicated a significant association with SSRIs (hazard ratio 1.34, 95% CI 1.18–1.52) and venlafaxine (1.35, 1.07–1.70).ConclusionsIn people with unipolar depression, antidepressant treatment is associated with an increased risk of subsequent mania/bipolar disorder. These findings highlight the importance of considering risk factors for mania when treating people with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Patel R, Shetty H, Jackson R, Broadbent M, Stewart R, Boydell J, McGuire P, Taylor M. Delays to diagnosis and treatment in patients presenting to mental health services with bipolar disorder. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionThere are often substantial delays before diagnosis and initiation of treatment in people bipolar disorder. Increased delays are a source of considerable morbidity among affected individuals.AimsTo investigate the factors associated with delays to diagnosis and treatment in people with bipolar disorder.MethodsRetrospective cohort study using electronic health record data from the South London and Maudsley NHS Foundation Trust (SLaM) from 1364 adults diagnosed with bipolar disorder. The following predictor variables were analysed in a multivariable Cox regression analysis on diagnostic delay and treatment delay from first presentation to SLaM: age, gender, ethnicity, compulsory admission to hospital under the UK Mental Health Act, marital status and other diagnoses prior to bipolar disorder.ResultsThe median diagnostic delay was 62 days (interquartile range: 17–243) and median treatment delay was 31 days (4–122). Compulsory hospital admission was associated with a significant reduction in both diagnostic delay (hazard ratio 2.58, 95% CI 2.18–3.06) and treatment delay (4.40, 3.63–5.62). Prior diagnoses of other psychiatric disorders were associated with increased diagnostic delay, particularly alcohol (0.48, 0.33–0.41) and substance misuse disorders (0.44, 0.31–0.61). Prior diagnosis of schizophrenia and psychotic depression were associated with reduced treatment delay.ConclusionsSome individuals experience a significant delay in diagnosis and treatment of bipolar disorder, particularly those with alcohol/substance misuse disorders. These findings highlight a need to better identify the symptoms of bipolar disorder and offer appropriate treatment sooner in order to facilitate improved clinical outcomes. This may include the development of specialist early intervention services.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Fusar-Poli P, Cappucciati M, Rutigliano G, Lee TY, Beverly Q, Bonoldi I, Lelli J, Kaar SJ, Gago E, Rocchetti M, Patel R, Bhavsar V, Tognin S, Badger S, Calem M, Lim K, Kwon JS, Perez J, McGuire P. Towards a Standard Psychometric Diagnostic Interview for Subjects at Ultra High Risk of Psychosis: CAARMS versus SIPS. Psychiatry J 2016; 2016:7146341. [PMID: 27314005 PMCID: PMC4904115 DOI: 10.1155/2016/7146341] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/29/2016] [Indexed: 02/05/2023]
Abstract
Background. Several psychometric instruments are available for the diagnostic interview of subjects at ultra high risk (UHR) of psychosis. Their diagnostic comparability is unknown. Methods. All referrals to the OASIS (London) or CAMEO (Cambridgeshire) UHR services from May 13 to Dec 14 were interviewed for a UHR state using both the CAARMS 12/2006 and the SIPS 5.0. Percent overall agreement, kappa, the McNemar-Bowker χ (2) test, equipercentile methods, and residual analyses were used to investigate diagnostic outcomes and symptoms severity or frequency. A conversion algorithm (CONVERT) was validated in an independent UHR sample from the Seoul Youth Clinic (Seoul). Results. There was overall substantial CAARMS-versus-SIPS agreement in the identification of UHR subjects (n = 212, percent overall agreement = 86%; kappa = 0.781, 95% CI from 0.684 to 0.878; McNemar-Bowker test = 0.069), with the exception of the brief limited intermittent psychotic symptoms (BLIPS) subgroup. Equipercentile-linking table linked symptoms severity and frequency across the CAARMS and SIPS. The conversion algorithm was validated in 93 UHR subjects, showing excellent diagnostic accuracy (CAARMS to SIPS: ROC area 0.929; SIPS to CAARMS: ROC area 0.903). Conclusions. This study provides initial comparability data between CAARMS and SIPS and will inform ongoing multicentre studies and clinical guidelines for the UHR psychometric diagnostic interview.
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Affiliation(s)
- P. Fusar-Poli
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
- *P. Fusar-Poli:
| | - M. Cappucciati
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
| | - G. Rutigliano
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
| | - T. Y. Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 08826, Republic of Korea
| | - Q. Beverly
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5HH, UK
| | - I. Bonoldi
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
| | - J. Lelli
- Real-Time Systems Laboratory, Scuola Superiore Sant'Anna, 56124 Pisa, Italy
| | - S. J. Kaar
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
| | - E. Gago
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
| | - M. Rocchetti
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
| | - R. Patel
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
| | - V. Bhavsar
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
| | - S. Tognin
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
| | - S. Badger
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
| | - M. Calem
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
| | - K. Lim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 08826, Republic of Korea
| | - J. S. Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 08826, Republic of Korea
| | - J. Perez
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5HH, UK
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - P. McGuire
- Institute of Psychiatry Psychology and Neuroscience (IoPPN), King's College London, London SE5 8AF, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11, UK
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Fusar‐Poli P, Díaz‐Caneja CM, Patel R, Valmaggia L, Byrne M, Garety P, Shetty H, Broadbent M, Stewart R, McGuire P. Services for people at high risk improve outcomes in patients with first episode psychosis. Acta Psychiatr Scand 2016; 133:76-85. [PMID: 26358300 PMCID: PMC4950045 DOI: 10.1111/acps.12480] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [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] [Accepted: 08/04/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE About one-third of patients referred to services for people at high risk for psychosis may have already developed a first episode of psychosis (FEP). We compared clinical outcomes in FEP patients who presented to either high risk or conventional mental health services. METHOD Retrospective study comparing duration of hospital admission, referral-to-diagnosis time, need for compulsory hospital admission and frequency of admission in patients with FEP who initially presented to a high-risk service (n = 164) to patients with FEP who initially presented to conventional mental health services (n = 2779). Regression models were performed, controlling for several confounders. RESULTS FEP patients who had presented to a high-risk service spent 17 fewer days in hospital [95% CI: -33.7 to (-0.3)], had a shorter referral-to-diagnosis time [B coefficient -74.5 days, 95% CI: -101.9 to -(47.1)], a lower frequency of admission [IRR: 0.49 (95% CI: 0.39-0.61)] and a lower likelihood of compulsory admission [OR: 0.52 (95% CI: 0.34-0.81)] in the 24 months following referral, as compared to FEP patients who were first diagnosed at conventional services. CONCLUSION Services for people at high risk for psychosis are associated with better clinical outcomes in patients who are already psychotic.
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Affiliation(s)
- P. Fusar‐Poli
- King's College LondonDepartment of Psychosis StudiesInstitute of Psychiatry, Psychology & NeuroscienceLondonUK,South London and Maudsley NHS Foundation TrustOASISLondonUK,Department of Brain and Behavioural SciencesUniversity of PaviaPaviaItaly
| | - C. M. Díaz‐Caneja
- King's College LondonDepartment of Psychosis StudiesInstitute of Psychiatry, Psychology & NeuroscienceLondonUK,School of MedicineChild and Adolescent Psychiatry DepartmentHospital General Universitario Gregorio MarañónIiSGMCIBERSAMUniversidad ComplutenseMadridSpain
| | - R. Patel
- King's College LondonDepartment of Psychosis StudiesInstitute of Psychiatry, Psychology & NeuroscienceLondonUK
| | - L. Valmaggia
- South London and Maudsley NHS Foundation TrustOASISLondonUK,King's College LondonDepartment of PsychologyInstitute of Psychiatry, Psychology & NeuroscienceLondonUK
| | - M. Byrne
- King's College LondonDepartment of Psychosis StudiesInstitute of Psychiatry, Psychology & NeuroscienceLondonUK,South London and Maudsley NHS Foundation TrustOASISLondonUK
| | - P. Garety
- King's College LondonDepartment of PsychologyInstitute of Psychiatry, Psychology & NeuroscienceLondonUK
| | - H. Shetty
- South London and Maudsley NHS Foundation TrustBiomedical Research Centre NucleusLondonUK
| | - M. Broadbent
- South London and Maudsley NHS Foundation TrustBiomedical Research Centre NucleusLondonUK
| | - R. Stewart
- King's College LondonDepartment of Psychological MedicineInstitute of Psychiatry, Psychology & NeuroscienceLondonUK
| | - P. McGuire
- King's College LondonDepartment of Psychosis StudiesInstitute of Psychiatry, Psychology & NeuroscienceLondonUK,South London and Maudsley NHS Foundation TrustOASISLondonUK
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40
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Abstract
The aim of this article is to summarize current evidence regarding alterations in the neuroendocrine stress response system and endocannabinoid system and their relationship in psychotic disorders such as schizophrenia. Exposure to stress is linked to the development of a number of psychiatric disorders including psychosis. However, the precise role of stress in the development of psychosis and the possible mechanisms that might underlie this are not well understood. Recently the cannabinoid hypothesis of schizophrenia has emerged as a potential line of enquiry. Endocannabinoid levels are increased in patients with psychosis compared with healthy volunteers; furthermore, they increase in response to stress, which suggests another potential mechanism for how stress might be a causal factor in the development of psychosis. However, research regarding the links between stress and the endocannabinoid system is in its infancy. Evidence summarized here points to an alteration in the baseline tone and reactivity of the hypothalamic-pituitary-adrenal (HPA) axis as well as in various components of the endocannabinoid system in patients with psychosis. Moreover, the precise nature of the inter-relationship between these two systems is unclear in man, especially their biological relevance in the context of psychosis. Future studies need to simultaneously investigate HPA axis and endocannabinoid alterations both at baseline and following experimental perturbation in healthy individuals and those with psychosis to understand how they interact with each other in health and disease and obtain mechanistic insight as to their relevance to the pathophysiology of schizophrenia.
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Affiliation(s)
- E Appiah-Kusi
- Department of Psychosis Studies,King's College London,Institute of Psychiatry,Psychology & Neuroscience (IoPPN),PO Box 63,De Crespigny Park,Denmark Hill,London SE5 8AF,UK
| | - E Leyden
- Department of Psychosis Studies,King's College London,Institute of Psychiatry,Psychology & Neuroscience (IoPPN),PO Box 63,De Crespigny Park,Denmark Hill,London SE5 8AF,UK
| | - S Parmar
- Department of Psychosis Studies,King's College London,Institute of Psychiatry,Psychology & Neuroscience (IoPPN),PO Box 63,De Crespigny Park,Denmark Hill,London SE5 8AF,UK
| | - V Mondelli
- Department of Psychological Medicine,King's College London,Institute of Psychiatry,Psychology & Neuroscience (IoPPN),PO Box 92,De Crespigny Park,Denmark Hill,London SE5 8AF,UK
| | - P McGuire
- Department of Psychosis Studies,King's College London,Institute of Psychiatry,Psychology & Neuroscience (IoPPN),PO Box 63,De Crespigny Park,Denmark Hill,London SE5 8AF,UK
| | - S Bhattacharyya
- Department of Psychosis Studies,King's College London,Institute of Psychiatry,Psychology & Neuroscience (IoPPN),PO Box 63,De Crespigny Park,Denmark Hill,London SE5 8AF,UK
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Valmaggia LR, Day FL, Kroll J, Laing J, Byrne M, Fusar-Poli P, McGuire P. Bullying victimisation and paranoid ideation in people at ultra high risk for psychosis. Schizophr Res 2015; 168:68-73. [PMID: 26351160 DOI: 10.1016/j.schres.2015.08.029] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 08/17/2015] [Accepted: 08/20/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bullying victimisation has been suggested to contribute to paranoid ideation in general population samples and recent evidence found that individuals with an ultra high risk (UHR) for psychosis are twice as likely to have been bullied than controls. AIMS This study sought to examine whether a history of bullying would be associated with higher levels of paranoid ideation in individuals with an UHR and in healthy controls (HCs). METHOD The study included 64 UHR and 43 HC participants. Following the baseline assessment, participants entered a Virtual Reality (VR) London Underground train. Paranoid ideation was measured immediately after the end of the VR experience. RESULTS Compared to HCs, UHR participants described higher levels of childhood bullying (OR 5.19, 95% CI=2.21-12.19, p<.001) and experienced more paranoid ideation during VR (χ(2)(1)=21.06, p<.001). Childhood bullying was associated with paranoid ideation during VR in both groups (χ(2)(1)=5.931, p=,021) but prolonged exposure to bullying was not associated with increased paranoid ideation. CONCLUSION A history of bullying in childhood is particularly common in young adults at high risk for psychosis. However bullying is associated with paranoid ideation in later life, independent of clinical status, consistent with dimensional models of psychotic phenomena.
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Affiliation(s)
- L R Valmaggia
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS, South London and Maudsley NHS Trust, London, United Kingdom.
| | - F L Day
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - J Kroll
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - J Laing
- OASIS, South London and Maudsley NHS Trust, London, United Kingdom
| | - M Byrne
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS, South London and Maudsley NHS Trust, London, United Kingdom
| | - P Fusar-Poli
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS, South London and Maudsley NHS Trust, London, United Kingdom
| | - P McGuire
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS, South London and Maudsley NHS Trust, London, United Kingdom
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42
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Brandizzi M, Valmaggia L, Byrne M, Jones C, Iwegbu N, Badger S, McGuire P, Fusar-Poli P. Predictors of functional outcome in individuals at high clinical risk for psychosis at six years follow-up. J Psychiatr Res 2015; 65:115-23. [PMID: 25837413 DOI: 10.1016/j.jpsychires.2015.03.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [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: 10/24/2014] [Revised: 02/02/2015] [Accepted: 03/09/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The long-term functional status of subjects at ultra high risk for psychosis (HR) is relatively under investigated. This study explores baseline predictors of long-term functional outcome in HR subjects who did not convert to psychosis during a 6 years follow-up period. METHODS A total of 154 HR were followed up for an average of 6 years. The primary outcome variable was global assessment of functioning at the last follow-up visit as assessed with the Global Assessment of Functioning tool. A multinomial logistic regression was performed to identify potential predictors of functional outcome. RESULTS Baseline and follow-up data on functioning was available for 92 HR. Twenty-four (43%) individuals who did not convert to psychosis reported poor functioning at follow-up. Baseline scores in the GAF (Exp(b) = 0.857; 95% CIs: 0.75/0.97), employment status (Exp(b) = 0.029; 95% CIs: 0.00/0.268), and CAARMS total scores (Exp(b) = 1.976; 95% CIs: 1.00/1.14) predicted functional outcome in HR subjects at 6 years. CONCLUSIONS Despite the preventive treatments received, many individuals who did not convert to full-blown psychosis in the longer term do not functionally remit. These individuals are lower functioning, unemployed and have higher symptom loading at the time of their presentation to the prodromal clinic. Our study suggests the need for innovative treatments targeting long term functional status beyond the prevention of psychosis onset in the HR population.
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Affiliation(s)
- M Brandizzi
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, via di Grottarossa 1035, Rome, Italy
| | - L Valmaggia
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS Team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom.
| | - M Byrne
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - C Jones
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - N Iwegbu
- OASIS Team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom
| | - S Badger
- OASIS Team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom
| | - P McGuire
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS Team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom
| | - P Fusar-Poli
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS Team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom
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Fond G, d'Albis MA, Jamain S, Tamouza R, Arango C, Fleischhacker WW, Glenthøj B, Leweke M, Lewis S, McGuire P, Meyer-Lindenberg A, Sommer IE, Winter-van Rossum I, Kapur S, Kahn RS, Rujescu D, Leboyer M. The promise of biological markers for treatment response in first-episode psychosis: a systematic review. Schizophr Bull 2015; 41:559-73. [PMID: 25759473 PMCID: PMC4393702 DOI: 10.1093/schbul/sbv002] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [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: 12/12/2022]
Abstract
Successful treatment of first-episode psychosis is one of the major factors that impacts long-term prognosis. Currently, there are no satisfactory biological markers (biomarkers) to predict which patients with a first-episode psychosis will respond to which treatment. In addition, a non-negligible rate of patients does not respond to any treatment or may develop side effects that affect adherence to the treatments as well as negatively impact physical health. Thus, there clearly is a pressing need for defining biomarkers that may be helpful to predict response to treatment and sensitivity to side effects in first-episode psychosis. The present systematic review provides (1) trials that assessed biological markers associated with antipsychotic response or side effects in first-episode psychosis and (2) potential biomarkers associated with biological disturbances that may guide the choice of conventional treatments or the prescription of innovative treatments. Trials including first-episode psychoses are few in number. Most of the available data focused on pharmacogenetics markers with so far only preliminary results. To date, these studies yielded-beside markers for metabolism of antipsychotics-no or only a few biomarkers for response or side effects, none of which have been implemented in daily clinical practice. Other biomarkers exploring immunoinflammatory, oxidative, and hormonal disturbances emerged as biomarkers of first-episode psychoses in the last decades, and some of them have been associated with treatment response. In addition to pharmacogenetics, further efforts should focus on the association of emergent biomarkers with conventional treatments or with innovative therapies efficacy, where some preliminary data suggest promising results.
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Affiliation(s)
| | | | | | - Ryad Tamouza
- Jean Dausset Laboratory & INSERM, UMRS 940, Hôpital Saint Louis, Paris, France
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | | | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Psychiatric Hospital Center Glostrup, University of Copenhagen, Faculty of Health and Medical Sciences, Denmark
| | - Markus Leweke
- Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Shôn Lewis
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Phillip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Iris E Sommer
- Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - Inge Winter-van Rossum
- Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - Shitij Kapur
- Institute of Psychiatry, King's College London, London, UK
| | - René S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - Dan Rujescu
- Department of Psychiatry, University of Halle, Halle, Germany
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44
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Leucht S, Winter-van Rossum I, Heres S, Arango C, Fleischhacker WW, Glenthøj B, Leboyer M, Leweke FM, Lewis S, McGuire P, Meyer-Lindenberg A, Rujescu D, Kapur S, Kahn RS, Sommer IE. The optimization of treatment and management of schizophrenia in Europe (OPTiMiSE) trial: rationale for its methodology and a review of the effectiveness of switching antipsychotics. Schizophr Bull 2015; 41:549-58. [PMID: 25786408 PMCID: PMC4393704 DOI: 10.1093/schbul/sbv019] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Most of the 13 542 trials contained in the Cochrane Schizophrenia Group's register just tested the general efficacy of pharmacological or psychosocial interventions. Studies on the subsequent treatment steps, which are essential to guide clinicians, are largely missing. This knowledge gap leaves important questions unanswered. For example, when a first antipsychotic failed, is switching to another drug effective? And when should we use clozapine? The aim of this article is to review the efficacy of switching antipsychotics in case of nonresponse. We also present the European Commission sponsored "Optimization of Treatment and Management of Schizophrenia in Europe" (OPTiMiSE) trial which aims to provide a treatment algorithm for patients with a first episode of schizophrenia. METHODS We searched Pubmed (October 29, 2014) for randomized controlled trials (RCTs) that examined switching the drug in nonresponders to another antipsychotic. We described important methodological choices of the OPTiMiSE trial. RESULTS We found 10 RCTs on switching antipsychotic drugs. No trial was conclusive and none was concerned with first-episode schizophrenia. In OPTiMiSE, 500 first episode patients are treated with amisulpride for 4 weeks, followed by a 6-week double-blind RCT comparing continuation of amisulpride with switching to olanzapine and ultimately a 12-week clozapine treatment in nonremitters. A subsequent 1-year RCT validates psychosocial interventions to enhance adherence. DISCUSSION Current literature fails to provide basic guidance for the pharmacological treatment of schizophrenia. The OPTiMiSE trial is expected to provide a basis for clinical guidelines to treat patients with a first episode of schizophrenia.
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Affiliation(s)
- Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, München, Germany;
| | | | - Stephan Heres
- Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, München, Germany
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - W. Wolfgang Fleischhacker
- Biological Psychiatry Division, Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria
| | - Birte Glenthøj
- Center for Neuropsychiatric Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Psychiatric Hospital Center Glostrup, Glostrup, Denmark
| | - Marion Leboyer
- INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France, Fondation FondaMental
| | - F. Markus Leweke
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Shôn Lewis
- University of Manchester, Manchester, UK
| | - Phillip McGuire
- Department of Psychological Medicine, King’s College London, Institute of Psychiatry, London, UK
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Shitij Kapur
- Department of Psychological Medicine, King’s College London, Institute of Psychiatry, London, UK
| | - René S. Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Iris E. Sommer
- Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands
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45
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Shakoor S, McGuire P, Cardno AG, Freeman D, Plomin R, Ronald A. A shared genetic propensity underlies experiences of bullying victimization in late childhood and self-rated paranoid thinking in adolescence. Schizophr Bull 2015; 41:754-63. [PMID: 25323579 PMCID: PMC4393686 DOI: 10.1093/schbul/sbu142] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Bullying is a risk factor for developing psychotic experiences (PEs). Whether bullying is associated with particular PEs, and the extent to which genes and environments influence the association, are unknown. This study investigated which specific PEs in adolescence are associated with earlier bullying victimization and the genetic and environmental contributions underlying their association. METHOD Participants were 4826 twin pairs from a longitudinal community-based twin study in England and Wales who reported on their bullying victimization at the age of 12 years. Measures of specific PEs (self-rated Paranoia, Hallucinations, Cognitive disorganization, Grandiosity, Anhedonia, and parent-rated Negative Symptoms) were recorded at age of 16 years. RESULTS Childhood bullying victimization was most strongly associated with Paranoia in adolescence (r = .26; P < .01), with weaker associations with Hallucinations, Cognitive Disorganization, parent-rated Negative Symptoms (r = .12-.20; P < .01), Grandiosity (r = .04; P < .05), and Anhedonia (r = .00, n.s.). Bivariate twin model-fitting demonstrated that bullying victimization and Paranoia were both heritable (35% and 52%, respectively) with unique environmental influences (39% and 48%, respectively), and bullying victimization showed common environmental influences (26%). The association between bullying victimization and Paranoia operated almost entirely via genetic influences (bivariate heritability = 93%), with considerable genetic overlap (genetic correlation = .55). CONCLUSION In contrast to the assumed role of bullying victimization as an environmental trigger, these data suggest that bullying victimization in late childhood is particularly linked to self-rated Paranoia in adolescence via a shared genetic propensity. Clinically, individuals with a history of bullying victimization are predicted to be particularly susceptible to paranoid symptoms.
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Affiliation(s)
- Sania Shakoor
- Department of Psychological Sciences, Centre for Brain and Cognitive Development, Birkbeck, University of London, UK;
| | - Phillip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, UK
| | - Alastair G. Cardno
- Academic Unit of Psychiatry and Behavioral Sciences, University of Leeds, UK
| | | | - Robert Plomin
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, UK
| | - Angelica Ronald
- Department of Psychological Sciences, Centre for Brain and Cognitive Development, Birkbeck, University of London, UK
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46
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Winton-Brown T, Kumari V, Windler F, Moscoso A, Stone J, Kapur S, McGuire P. Sensorimotor gating, cannabis use and the risk of psychosis. Schizophr Res 2015; 164:21-7. [PMID: 25801237 PMCID: PMC4435667 DOI: 10.1016/j.schres.2015.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 06/09/2014] [Revised: 02/16/2015] [Accepted: 02/21/2015] [Indexed: 12/13/2022]
Abstract
Sensorimotor gating, measured as the modification of eye blink startle reflexes to loud acoustic stimuli by quieter preceding stimuli, is altered in those with psychosis, their relatives and those at high clinical risk for psychosis. Alterations have also been shown in cannabis users, albeit to a lesser extent, and cannabis is a known risk factor for the onset of psychosis in clinically and genetically susceptible individuals. We examined the interaction between clinical risk for psychosis and cannabis use on sensorimotor gating, both Prepulse Inhibition (PPI) and Prepulse Facilitation (PPF). We tested PPI and PPF in participants with an At Risk Mental State (ARMS) for psychosis and a matched control group. Both groups included a proportion of subjects who had recently used cannabis, as confirmed by urinary drug screening (UDS) on the day of testing. We found that ARMS participants showed reduced PPF and PPI relative to controls, the latter driven by a group by cannabis use interaction, with recent use reducing PPI in ARMS participants but not in controls. When the analysis was limited to UDS-negative participants there was significantly reduced PPF in ARMS subjects relative to controls, but no differences in PPI. Within the ARMS group reduced sensorimotor gating, measured by both PPI and PPF, related to reduced overall level of function. Cannabis use in clinical high risk individuals may increase the risk of psychosis in part through worsening PPI, while PPF is altered in ARMS individuals irrespective of cannabis use. This develops our understanding of cognitive mechanisms leading to the experience of aberrant perceptual phenomena and the subsequent development of psychotic symptoms.
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Affiliation(s)
- T. Winton-Brown
- Department of Psychosis Studies, Institute of Psychiatry, Kings College London, United Kingdom,Corresponding author at: PO 67 Institute of Psychiatry, De Crespigny Park, London, United Kingdom. Tel.: + 44 61481262243.
| | - V. Kumari
- Department of Psychology, Institute of Psychiatry, Kings College London, United Kingdom
| | - F. Windler
- Center of Advanced European Studies and Research, Bonn, Germany
| | - A. Moscoso
- Department of Child and Adolescent Psychiatry, Hospital de D. Estefânia Lisboa, Portugal
| | - J. Stone
- Department of Psychosis Studies, Institute of Psychiatry, Kings College London, United Kingdom
| | - S. Kapur
- Department of Psychosis Studies, Institute of Psychiatry, Kings College London, United Kingdom
| | - P. McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Kings College London, United Kingdom
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47
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Drake RJ, Nordentoft M, Haddock G, Arango C, Fleischhacker WW, Glenthøj B, Leboyer M, Leucht S, Leweke M, McGuire P, Meyer-Lindenberg A, Rujescu D, Sommer IE, Kahn RS, Lewis SW. Modeling determinants of medication attitudes and poor adherence in early nonaffective psychosis: implications for intervention. Schizophr Bull 2015; 41:584-96. [PMID: 25750247 PMCID: PMC4393703 DOI: 10.1093/schbul/sbv015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We aimed to design a multimodal intervention to improve adherence following first episode psychosis, consistent with current evidence. Existing literature identified medication attitudes, insight, and characteristics of support as important determinants of adherence to medication: we examined medication attitudes, self-esteem, and insight in an early psychosis cohort better to understand their relationships. Existing longitudinal data from 309 patients with early Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nonaffective psychosis (83% first episode) were analyzed to test the hypothesis that medication attitudes, while meaningfully different from "insight," correlated with insight and self-esteem, and change in each influenced the others. Rosenberg Self-Esteem Scale, Birchwood Insight Scale, and Positive and Negative Syndrome Scale insight were assessed at presentation, after 6 weeks and 3 and 18 months. Drug Attitudes Inventory (DAI) and treatment satisfaction were rated from 6 weeks onward. Structural equation models of their relationships were compared. Insight measures' and DAI's predictive validity were compared against relapse, readmission, and remission. Analysis found five latent constructs best fitted the data: medication attitudes, self-esteem, accepting need for treatment, self-rated insight, and objective insight. All were related and each affected the others as it changed, except self-esteem and medication attitudes. Low self-reported insight at presentation predicted readmission. Good 6-week insight (unlike drug attitudes) predicted remission. Literature review and data modeling indicated that a multimodal intervention using motivational interviewing, online psychoeducation, and SMS text medication reminders to enhance adherence without damaging self-concept was feasible and appropriate.
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Affiliation(s)
- Richard J Drake
- Manchester Academic Health Sciences Centre, Institute of Brain, Behaviour & Mental Health, University of Manchester, Manchester, UK; Manchester Academic Health Sciences Centre, Manchester Mental Health & Social Care NHS Trust, Manchester, UK;
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen NV, Denmark
| | - Gillian Haddock
- Manchester Academic Health Sciences Centre, Manchester Mental Health & Social Care NHS Trust, Manchester, UK; Manchester Academic Health Sciences Centre, School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Psychiatric Hospital Center Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Marion Leboyer
- INSERM U955, Laboratoire Psychopathologie et génétique des maladies mentales, et AP-HP, DHU Pe-PSY, Pole de Psychiatrie et d'addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris-Est, Créteil, France
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technische Universität München, München, Germany
| | - Markus Leweke
- Central Institute of Mental Health, Mannheim, Germany
| | | | | | - Dan Rujescu
- Psychiatry, Molecular and Clinical Neurobiology, Ludwig-Maximilians University, München, München, Germany; Department of Psychiatry, University of Halle, Halle, Germany
| | - Iris E Sommer
- Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, UMC Utrecht, Utrecht, The Netherlands
| | - Shon W Lewis
- Manchester Academic Health Sciences Centre, Institute of Brain, Behaviour & Mental Health, University of Manchester, Manchester, UK; Manchester Academic Health Sciences Centre, Manchester Mental Health & Social Care NHS Trust, Manchester, UK
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48
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Fusar-Poli P, Frascarelli M, Valmaggia L, Byrne M, Stahl D, Rocchetti M, Codjoe L, Weinberg L, Tognin S, Xenaki L, McGuire P. Antidepressant, antipsychotic and psychological interventions in subjects at high clinical risk for psychosis: OASIS 6-year naturalistic study. Psychol Med 2015; 45:1327-1339. [PMID: 25335776 DOI: 10.1017/s003329171400244x] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recent randomized controlled trials suggest some efficacy for focused interventions in subjects at high risk (HR) for psychosis. However, treating HR subjects within the real-world setting of prodromal services is hindered by several practical problems that can significantly make an impact on the effect of focused interventions. METHOD All subjects referred to Outreach and Support in South London (OASIS) and diagnosed with a HR state in the period 2001-2012 were included (n = 258). Exposure to focused interventions was correlated with sociodemographic and clinical characteristics at baseline. Their association with longitudinal clinical and functional outcomes was addressed at follow-up. RESULTS In a mean follow-up time of 6 years (s.d. = 2.5 years) a transition risk of 18% was observed. Of the sample, 33% were treated with cognitive behavioural therapy (CBT) only; 17% of subjects received antipsychotics (APs) in addition to CBT sessions. Another 17% of subjects were prescribed with antidepressants (ADs) in addition to CBT. Of the sample, 20% were exposed to a combination of interventions. Focused interventions had a significant relationship with transition to psychosis. The CBT + AD intervention was associated with a reduced risk of transition to psychosis, as compared with the CBT + AP intervention (hazards ratio = 0.129, 95% confidence interval 0.030-0.565, p = 0.007). CONCLUSIONS There were differential associations with transition outcome for AD v. AP interventions in addition to CBT in HR subjects. These effects were not secondary to baseline differences in symptom severity.
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Affiliation(s)
- P Fusar-Poli
- King's College London, Institute of Psychiatry,London,UK
| | - M Frascarelli
- King's College London, Institute of Psychiatry,London,UK
| | - L Valmaggia
- King's College London, Institute of Psychiatry,London,UK
| | - M Byrne
- King's College London, Institute of Psychiatry,London,UK
| | - D Stahl
- King's College London, Institute of Psychiatry,London,UK
| | - M Rocchetti
- King's College London, Institute of Psychiatry,London,UK
| | - L Codjoe
- King's College London, Institute of Psychiatry,London,UK
| | - L Weinberg
- King's College London, Institute of Psychiatry,London,UK
| | - S Tognin
- King's College London, Institute of Psychiatry,London,UK
| | - L Xenaki
- King's College London, Institute of Psychiatry,London,UK
| | - P McGuire
- King's College London, Institute of Psychiatry,London,UK
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49
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Falkenberg I, Chaddock C, Murray RM, McDonald C, Modinos G, Bramon E, Walshe M, Broome M, McGuire P, Allen P. Failure to deactivate medial prefrontal cortex in people at high risk for psychosis. Eur Psychiatry 2015; 30:633-40. [PMID: 25841662 DOI: 10.1016/j.eurpsy.2015.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/04/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022] Open
Abstract
Impaired working memory is a core feature of schizophrenia and is linked with altered engagement the lateral prefrontal cortex. Although altered PFC activation has been reported in people with increased risk of psychosis, at present it is not clear if this neurofunctional alteration differs between familial and clinical risk states and/or increases in line with the level of psychosis risk. We addressed this issue by using functional MRI and a working memory paradigm to study familial and clinical high-risk groups. We recruited 17 subjects at ultra-high-risk (UHR) for psychosis, 10 non-affected siblings of patients with schizophrenia (familial high risk [FHR]) and 15 healthy controls. Subjects were scanned while performing the N-back working memory task. There was a relationship between the level of task-related deactivation in the medial PFC and precuneus and the level of psychosis risk, with deactivation weakest in the UHR group, greatest in healthy controls, and at an intermediate level in the FHR group. In the high-risk groups, activation in the precuneus was associated with the level of negative symptoms. These data suggest that increased vulnerability to psychosis is associated with a failure to deactivate in the medial PFC and precuneus during a working memory task, and appears to be most evident in subjects at clinical, as opposed to familial high risk.
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Affiliation(s)
- I Falkenberg
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.
| | - C Chaddock
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - R M Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - C McDonald
- Department of Psychiatry, Clinical Science Institute, National University of Ireland, Galway, Galway, Ireland
| | - G Modinos
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - E Bramon
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, London, United Kingdom
| | - M Walshe
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - M Broome
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry, CV4 7AL, United Kingdom
| | - P McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
| | - P Allen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom
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50
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Picchioni M, Toulopoulou T, Rijsdijk F, McDonald C, Kane F, Kalidindi S, Murray R, McGuire P. Genetic and Environmental Influences On Brain Function in Schizophrenia. an FMRI Study of the Maudsley Twin and Family Cohorts. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31336-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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