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Waszczuk K, Kucharska-Mazur J, Tyburski E, Rek-Owodziń K, Plichta P, Rudkowski K, Podwalski P, Grąźlewski T, Mak M, Misiak B, Michalczyk A, Tarnowski M, Sielatycka K, Szczęśniak A, Łuczkowska K, Dołęgowska B, Budkowska M, Ratajczak MZ, Samochowiec J. Psychopathology and Stem Cell Mobilization in Ultra-High Risk of Psychosis and First-Episode Psychosis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106001. [PMID: 35627537 PMCID: PMC9141672 DOI: 10.3390/ijerph19106001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 02/04/2023]
Abstract
Although regenerative and inflammatory processes are involved in the etiopathogenesis of many psychiatric disorders, their roles are poorly understood. We investigate the potential role of stem cells (SC) and factors influencing the trafficking thereof, such as complement cascade (CC) components, phospholipid substrates, and chemokines, in the etiology of schizophrenia. We measured sphingosine-1-phosphate (S1P), stromal-derived factor 1 (SDF-1), and CC cleavage fragments (C3a, C5a, and C5b-C9; also known as the membrane attack complex) in the peripheral blood of 49 unrelated patients: 9 patients with ultra-high risk of psychosis (UHR), 22 patients with first-episode psychosis (FEP), and 18 healthy controls (HC). When compared with the HC group, the UHR and FEP groups had higher levels of C3a. We found no significant differences in hematopoietic SC, very small embryonic-like stem cell (VSEL), C5a, S1P, or SDF-1 levels in the UHR and FEP groups. However, among FEP patients, there was a significant positive correlation between VSELs (CD133+) and negative symptoms. These preliminary findings support the role of the immune system and regenerative processes in the etiology of schizophrenia. To establish the relevance of SC and other factors affecting the trafficking thereof as potential biomarkers of schizophrenia, more studies on larger groups of individuals from across the disease spectrum are needed.
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Affiliation(s)
- Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
- Correspondence: ; Tel./Fax: +48-91-35-11-322
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (E.T.); (K.R.-O.); (P.P.); (M.M.)
| | - Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (E.T.); (K.R.-O.); (P.P.); (M.M.)
| | - Piotr Plichta
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (E.T.); (K.R.-O.); (P.P.); (M.M.)
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Tomasz Grąźlewski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (E.T.); (K.R.-O.); (P.P.); (M.M.)
| | - Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
| | - Maciej Tarnowski
- Department of Physiology, Pomeranian University of Medicine, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Katarzyna Sielatycka
- Institute of Biology, Faculty of Exact and Natural Sciences, University of Szczecin, Felczaka 3c, 71-415 Szczecin, Poland;
| | - Angelika Szczęśniak
- Department of Laboratory Medicine, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.S.); (B.D.)
| | - Karolina Łuczkowska
- Department of General Pathology, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Barbara Dołęgowska
- Department of Laboratory Medicine, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (A.S.); (B.D.)
| | - Marta Budkowska
- Department of Medical Analytics, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Mariusz Z. Ratajczak
- Stem Cell Institute at James Graham Brown Cancer Center, University of Louisville, Louisville, KY 40292, USA;
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26, 71-460 Szczecin, Poland; (J.K.-M.); (K.R.); (P.P.); (T.G.); (A.M.); (J.S.)
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Rek-Owodziń K, Tyburski E, Plichta P, Waszczuk K, Bielecki M, Wietrzyński K, Podwalski P, Rudkowski K, Michalczyk A, Grąźlewski T, Sagan L, Kucharska-Mazur J, Samochowiec J, Mak M. The Relationship between Cognitive Functions and Psychopathological Symptoms in First Episode Psychosis and Chronic Schizophrenia. J Clin Med 2022; 11:jcm11092619. [PMID: 35566742 PMCID: PMC9102246 DOI: 10.3390/jcm11092619] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/31/2022] [Accepted: 04/26/2022] [Indexed: 11/22/2022] Open
Abstract
Impairments in cognitive functions are one of the main features of schizophrenia. A variety of factors can influence the extent of cognitive deficits. In our study, we examined the severity of cognitive deficits at different stages of the disease and the relationship between psychopathological symptoms and cognitive functions. We recruited 32 patients with first-episode psychosis (FEP), 70 with chronic schizophrenia (CS), and 39 healthy controls (HC). Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS) and cognitive functions were measured with the MATRICS Cognitive Consensus Battery (MCCB). Cognitive deficits were present in both FEP and CS participants. CS individuals had lower overall scores and poorer working memory; however, clinical variables appeared to play a significant role in these scores. In FEP, disorganization correlated negatively with verbal and visual learning and memory, social cognition, and overall score; negative symptoms negatively correlated with social cognition. In CS participants, disorganization correlated negatively with speed of processing, reasoning, problem solving, and overall score; negative symptoms were negatively correlated with speed of processing, visual learning, memory, and overall score; positive symptoms were negatively correlated with reasoning and problem solving. Our findings indicate that psychopathological symptoms have a significant impact on cognitive functions in FEP and CS patients.
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Affiliation(s)
- Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (E.T.); (P.P.); (M.B.); (K.W.); (M.M.)
- Correspondence: ; Tel.: +48-91-351-13-00
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (E.T.); (P.P.); (M.B.); (K.W.); (M.M.)
| | - Piotr Plichta
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (E.T.); (P.P.); (M.B.); (K.W.); (M.M.)
| | - Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (K.W.); (P.P.); (K.R.); (A.M.); (T.G.); (J.K.-M.); (J.S.)
| | - Maksymilian Bielecki
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (E.T.); (P.P.); (M.B.); (K.W.); (M.M.)
| | - Krzysztof Wietrzyński
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (E.T.); (P.P.); (M.B.); (K.W.); (M.M.)
| | - Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (K.W.); (P.P.); (K.R.); (A.M.); (T.G.); (J.K.-M.); (J.S.)
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (K.W.); (P.P.); (K.R.); (A.M.); (T.G.); (J.K.-M.); (J.S.)
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (K.W.); (P.P.); (K.R.); (A.M.); (T.G.); (J.K.-M.); (J.S.)
| | - Tomasz Grąźlewski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (K.W.); (P.P.); (K.R.); (A.M.); (T.G.); (J.K.-M.); (J.S.)
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland;
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (K.W.); (P.P.); (K.R.); (A.M.); (T.G.); (J.K.-M.); (J.S.)
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (K.W.); (P.P.); (K.R.); (A.M.); (T.G.); (J.K.-M.); (J.S.)
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (E.T.); (P.P.); (M.B.); (K.W.); (M.M.)
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Phahladira L, Asmal L, Lückhoff HK, du Plessis S, Scheffler F, Smit R, Chiliza B, Emsley R. The trajectories and correlates of two negative symptom subdomains in first-episode schizophrenia. Schizophr Res 2022; 243:17-23. [PMID: 35228035 DOI: 10.1016/j.schres.2022.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Recent studies suggest a two-factor structure for negative symptoms as assessed by the Positive and Negative Syndrome Scale (PANSS) in schizophrenia, namely experiential and expressive subdomains. Little is known about their clinical correlates and treatment trajectories. OBJECTIVES We sought to replicate the two factor-analysis derived subdomains for PANSS negative symptoms in schizophrenia and to assess their independent demographic, premorbid and treatment-related characteristics. METHODS This was a longitudinal study of 106 minimally treated participants with a first episode of a schizophrenia spectrum disorder who received treatment with flupenthixol decanoate 2-weekly injections over two years. Factor analysis was used to characterize the PANSS negative symptom subdomains and linear mixed-effect models for continuous repeated measures were constructed to assess the temporal relations between the negative symptom subdomains and premorbid and treatment related variables. RESULTS Factor analysis confirmed a two-factor solution for experiential and expressive subdomains of negative symptoms, although they were strongly correlated. The treatment response trajectories for the two subdomains did not differ significantly, and neither subdomain was significantly associated with our premorbid variables. We found significant main effects for disorganised symptoms and extrapyramidal symptoms on the expressive subdomain, and for disorganised symptoms and depressive symptoms on the experiential subdomain. Post-hoc testing indicated that reductions in HDL-cholesterol levels were associated with less improvement in both expressive and experiential subdomain scores. CONCLUSION The two negative symptom subdomains are closely related, have similar premorbid correlates and respond similarly to antipsychotic treatment. Depression affects the experiential subdomain, whereas extrapyramidal symptoms affect the expressive subdomain.
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Affiliation(s)
| | - Laila Asmal
- Department of Psychiatry, Stellenbosch University, South Africa
| | | | | | - Freda Scheffler
- Department of Psychiatry, Stellenbosch University, South Africa
| | - Retha Smit
- Department of Psychiatry, Stellenbosch University, South Africa
| | - Bonginkosi Chiliza
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of Kwazulu-Natal, South Africa
| | - Robin Emsley
- Department of Psychiatry, Stellenbosch University, South Africa
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Higuchi CH, Cogo-Moreira H, Fonseca L, Ortiz BB, Correll CU, Noto C, Cordeiro Q, de Freitas R, Elkis H, Belangero SI, Bressan RA, Gadelha A. Identifying strategies to improve PANSS based dimensional models in schizophrenia: Accounting for multilevel structure, Bayesian model and clinical staging. Schizophr Res 2022; 243:424-430. [PMID: 34304964 DOI: 10.1016/j.schres.2021.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/10/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Dimensional approaches can decompose a construct in a set of continuous variables, improving the characterization of complex phenotypes, such as schizophrenia. However, the five-factor model of the Positive and Negative Syndrome Scale (PANSS), the most used instrument in schizophrenia research, yielded poor fits in most confirmatory factor analysis (CFA) studies, raising concerns about its applications. Thus, we aimed to identify dimensional PANSS CFA models with good psychometric properties by comparing the traditional CFA with three methodological approaches: Bayesian CFA, multilevel modeling, and Multiple Indicators Multiple Causes (MIMIC) modeling. METHODS Clinical data of 700 schizophrenia patients from four centers were analyzed. We first performed a traditional CFA. Next, we tested the three techniques: 1) a Bayesian CFA; 2) a multilevel analysis using the centers as level; and 3) a MIMIC modeling to evaluate the impact of clinical staging on PANSS factors and items. RESULTS CFA and Bayesian CFA produced poor fit models. However, when adding a multilevel structure to the CFA model, a good fit model emerged. MIMIC modeling yielded significant differences in the factor structure between the clinical stages of schizophrenia. Sex, age, age of onset, and duration of illness did not significantly affect the model fit. CONCLUSION Our comparison of different CFA methods highlights the need for multilevel structure to achieve a good fit model and the potential utility of staging models (rather than the duration of illness) to deal with clinical heterogeneity in schizophrenia. Large prospective samples with biological data should help to understand the interplay between psychometrics concerns and neurobiology research.
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Affiliation(s)
- Cinthia H Higuchi
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil
| | | | - Lais Fonseca
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil
| | - Bruno B Ortiz
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil
| | - Christoph U Correll
- The Zucker Hillside Hospital, Psychiatry Research, Glen Oaks, NY, USA; Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA; Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany
| | - Cristiano Noto
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil
| | - Quirino Cordeiro
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, SP, Brazil
| | - Rosana de Freitas
- Schizophrenia Research Program (PROJESQ), Department and Institute of Psychiatry, Universidade de São Paulo (USP), SP, Brazil
| | - Helio Elkis
- Schizophrenia Research Program (PROJESQ), Department and Institute of Psychiatry, Universidade de São Paulo (USP), SP, Brazil
| | - Sintia I Belangero
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Department of Morphology and Genetics, Universidade Federal de São Paulo, SP, Brazil
| | - Rodrigo A Bressan
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Ary Gadelha
- Laboratory of Integrative Neuroscience (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, SP, Brazil; Programa de Esquizofrenia da Universidade Federal de São Paulo (PROESQ), SP, Brazil.
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Pelizza L, Leuci E, Maestri D, Quattrone E, Azzali S, Paulillo G, Pellegrini P. Examining disorganization in patients with first episode psychosis: Findings from a 1-year follow-up of the 'Parma early psychosis' program. Early Interv Psychiatry 2022; 16:552-560. [PMID: 34279049 DOI: 10.1111/eip.13198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/09/2021] [Accepted: 07/04/2021] [Indexed: 12/22/2022]
Abstract
AIM Disorganization has been considered as a clinical domain close to the core of psychosis. However, it has received poor attention, especially at the illness onset. Moreover, most of the studies examining disorganized symptoms have been conducted in patients with chronic psychosis and research in the early stages of illness is still relatively scarce. Thus, the aims of this study were (a) to longitudinally monitor the stability of disorganization in patients with first episode psychosis (FEP) across a 1-year follow-up period, and (b) to investigate any relevant association of disorganized symptoms with functioning, psychopathology and the specific treatment components of an 'early intervention in psychosis' (EIP) program along the 1 year of follow-up. METHODS At baseline, 312 FEP participants (aged 12-35 years) completed the positive and negative syndrome scale (PANSS) and the global assessment of functioning (GAF). Spearman's correlations and multiple linear regression analysis were used. RESULTS At baseline, disorganization showed significant associations with all PANSS subscores, and a relevant negative correlation with GAF score. Across the follow-up, FEP individuals showed a significant improvement in disorganization severity. This decrease was specifically related to both baseline antipsychotic dosage and the number of individual cognitive-behavioural therapy sessions offered across the 1-year follow-up period. CONCLUSIONS Disorganization is clinically relevant in FEP patients, already ate the enrollment in an EIP program. However, it tends to improve over time together with the delivery of specialized, person-tailored FEP interventions within a specific EIP protocol.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Davide Maestri
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
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Ordak M, Libman-Sokolowska M, Nasierowski T, Badyra B, Kaczmarek L, Muszynska E, Bujalska-Zadrozny M. Matrix metalloproteinase-3 serum levels in schizophrenic patients. Int J Psychiatry Clin Pract 2022; 27:1-7. [PMID: 35357267 DOI: 10.1080/13651501.2022.2057332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES It has been reported that matrix metalloproteinase, MMP-3 may play a significant role in the pathophysiology of mental disorders. However, there are no data on the level of MMP-3 in people suffering from schizophrenia, or its influence on the mental state of these people. The aim of this study was to investigate the effect of an antipsychotic treatment on the blood levels of MMP-3, as well as investigating its relationship with insight into schizophrenia. METHODS Thirty people with schizophrenia were included in the study. The concentration of MMP-3 in the blood serum was assessed using enzyme-linked immunosorbent assay. Insight into the disease was assessed using the Beck Cognitive Insight Scale. RESULTS The antipsychotic treatment applied decreased the levels of MMP-3 in patients with schizophrenia (p = 0.005), however, the statistically significant interaction (p = 0.02) indicates that the decrease only concerned men. There was also a statistically significant correlation between the level of MMP-3 and insight into the disease (p = 0.02). CONCLUSION MMP-3 may be associated with gender, treatment and symptoms in schizophrenic patients.KEY POINTSMMP3 could be used as a potential biomarker for schizophrenia.The level of MMP-3 decreased due to the applied antipsychotic treatment.The higher the level of MMP-3 in a group of people with schizophrenia, the better insight into their disease.
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Affiliation(s)
- Michal Ordak
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | | | | | - Bogna Badyra
- Laboratory of Neurobiology, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Leszek Kaczmarek
- Laboratory of Neurobiology, Nencki-EMBL Center of Excellence for Neural Plasticity and Brain Disorders: BRAINCITY, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, Warsaw, Poland
| | - Elzbieta Muszynska
- Department of Medical Biology, Medical University of Bialystok, Bialystok, Poland
| | - Magdalena Bujalska-Zadrozny
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
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Panayi P, Berry K, Sellwood W, Campodonico C, Bentall RP, Varese F. The Role and Clinical Correlates of Complex Post-traumatic Stress Disorder in People With Psychosis. Front Psychol 2022; 13:791996. [PMID: 35369153 PMCID: PMC8967251 DOI: 10.3389/fpsyg.2022.791996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Traumatic experiences and post-traumatic stress are highly prevalent in people with psychosis, increasing symptom burden, decreasing quality of life and moderating treatment response. A range of post-traumatic sequelae have been found to mediate the relationship between trauma and psychotic experiences, including the "traditional" symptoms of post-traumatic stress disorder (PTSD). The International Classification of Diseases-11th Edition recognizes a more complex post-traumatic presentation, complex PTSD (cPTSD), which captures both the characteristic symptoms of PTSD alongside more pervasive post-traumatic sequelae known as 'disturbances in self-organization' (DSOs). The prevalence and impact of cPTSD and DSOs in psychosis remains to be explored. In the first study of this kind, 144 participants with psychosis recruited from North West United Kingdom mental health services completed measures assessing trauma, PTSD and cPTSD symptoms and symptoms of psychosis. Forty-percent of the sample met criteria for cPTSD, compared to 10% who met diagnostic criteria for PTSD. PTSD and DSOs mediated the relationship between trauma and positive symptoms, controlling for dataset membership. Both PTSD and DSOs mediated the relationship between trauma and affective symptoms but did not explain a significant proportion of variance in negative symptoms. Cognitive and excitative symptoms of psychosis did not correlate with trauma, PTSD or DSO scores. These findings indicate the possible value of adjunct therapies to manage cPTSD symptoms in people with psychosis, pending replication in larger epidemiological samples and longitudinal studies.
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Affiliation(s)
- Peter Panayi
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Katherine Berry
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - William Sellwood
- Faculty of Health & Medicine, Division of Health Research, University of Lancaster, Lancaster, United Kingdom
| | - Carolina Campodonico
- School of Psychology and Computer Science, University of Central Lancashire, Lancashire, United Kingdom
| | - Richard P. Bentall
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Filippo Varese
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Waszczuk K, Tyburski E, Rek-Owodziń K, Plichta P, Rudkowski K, Podwalski P, Bielecki M, Mak M, Bober A, Misiak B, Sagan L, Michalczyk A, Kucharska-Mazur J, Samochowiec J. Relationship between White Matter Alterations and Pathophysiological Symptoms in Patients with Ultra-High Risk of Psychosis, First-Episode, and Chronic Schizophrenia. Brain Sci 2022; 12:brainsci12030354. [PMID: 35326310 PMCID: PMC8946295 DOI: 10.3390/brainsci12030354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/20/2022] [Accepted: 03/03/2022] [Indexed: 12/03/2022] Open
Abstract
Some symptoms of schizophrenia might be present before full-blown psychosis, so white matter changes must be studied both in individuals with emerging psychosis and chronic schizophrenia. A total of 86 patients—12 ultra-high risk of psychosis (UHR), 20 first episode psychosis (FEP), 54 chronic schizophrenia (CS), and 33 healthy controls (HC)—underwent psychiatric examination and diffusion tensor imaging (DTI) in a 3-Tesla MRI scanner. We assessed fractional anisotropy (FA) and mean diffusivity (MD) of the superior longitudinal fasciculus (SLF) and inferior longitudinal fasciculus (ILS). We found that CS patients had lower FA than FEP patients (p = 0.025) and HC (p = 0.088), and higher MD than HC (p = 0.037) in the right SLF. In the CS group, we found positive correlations of MD in both right ILF (rho = 0.39, p < 0.05) and SLF (rho = 0.43, p < 0.01) with disorganization symptoms, as well as negative correlation of FA in the right ILF with disorganization symptoms (rho = −0.43, p < 0.05). Among UHR individuals, we found significant negative correlations between MD in the left ILF and negative (r = −0.74, p < 0.05) and general symptoms (r = −0.77, p < 0.05). However promising, these findings should be treated as preliminary, and further research must verify whether they can be treated as potential biomarkers of psychosis.
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Affiliation(s)
- Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Piotr Plichta
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Maksymilian Bielecki
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Adrianna Bober
- Institute of Psychology, University of Szczecin, Krakowska 69 Street, 71-017 Szczecin, Poland
| | - Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1 Street, 71-252 Szczecin, Poland
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Broniewskiego 26 Street, 71-460 Szczecin, Poland
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Increased cingulo-orbital connectivity is associated with violent behaviours in schizophrenia. J Psychiatr Res 2022; 147:183-189. [PMID: 35051717 DOI: 10.1016/j.jpsychires.2022.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Although schizophrenia patients are at a heightened risk of exhibiting violent behaviours compared to the general population, few functional neuroimaging studies have explored the aberrant neurocircuitry underpinning such behaviours. This study aimed to identify disrupted resting-state activity and functional connectivity in schizophrenia patients with a history of violence. METHODS Resting state functional magnetic resonance imaging data was collected from 62 schizophrenia patients and 25 healthy controls. Voxel-wise analyses of fractional amplitude of low frequency fluctuations (fALFF) were implemented to investigate disrupted regional patterns of spontaneous brain activity. Brain regions which yielded significant differences between groups were subsequently used as data-driven seeds for functional connectivity analyses. Finally, significant alterations (activity and connectivity) were correlated with lifetime violent behaviours. RESULTS When compared to healthy controls, schizophrenia patients exhibited reduced fALFF in multiple brain regions including the (subgenual) anterior cingulate cortex (ACC), posterior cingulate cortex, precuneus cortex and left lateral orbitofrontal cortex (OFC). Seed-to-voxel analyses yielded significantly enhanced connectivity between the ACC and left OFC. The heightened functional connectivity between the latter two regions predicted the number of violent behaviours reported by schizophrenia patients. CONCLUSION The current study demonstrated that the functional connectivity of brain regions associated with emotion regulation is impaired in schizophrenia and associated with violent antecedents among patients. This result is consistent with predominant theoretical models proposing that the OFC plays a critical role in the neurobiology of violence.
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Podwalski P, Tyburski E, Szczygieł K, Rudkowski K, Waszczuk K, Andrusewicz W, Kucharska-Mazur J, Michalczyk A, Mak M, Cyranka K, Misiak B, Sagan L, Samochowiec J. Psychopathology and Integrity of the Superior Longitudinal Fasciculus in Deficit and Nondeficit Schizophrenia. Brain Sci 2022; 12:brainsci12020267. [PMID: 35204030 PMCID: PMC8870217 DOI: 10.3390/brainsci12020267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 01/27/2023] Open
Abstract
The superior longitudinal fasciculus (SLF) is a white matter bundle that connects the frontal areas with the parietal areas. As part of the visuospatial attentional network, it may be involved in the development of schizophrenia. Deficit syndrome (DS) is characterized by primary and enduring negative symptoms. The present study assessed SLF integrity in DS and nondeficit schizophrenia (NDS) patients and examined possible relationships between it and psychopathology. Twenty-six DS patients, 42 NDS patients, and 36 healthy controls (HC) underwent psychiatric evaluation and diffusion tensor imaging (DTI). After post-processing, fractional anisotropy (FA) values within the SLF were analyzed. Psychopathology was assessed with the Positive and Negative Syndrome Scale, Brief Negative Symptom Scale, and Self-evaluation of Negative Symptoms. The PANSS proxy for the deficit syndrome was used to diagnose DS. NDS patients had lower FA values than HC. DS patients had greater negative symptoms than NDS patients. After differentiating clinical groups and HC, we found no significant correlations between DTI measures and psychopathological dimensions. These results suggest that changes in SLF integrity are related to schizophrenia, and frontoparietal dysconnection plays a role in its etiopathogenesis. We confirmed that DS patients have greater negative psychopathology than NDS patients. These results are preliminary; further studies are needed.
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Affiliation(s)
- Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.R.); (K.W.); (J.K.-M.); (A.M.); (J.S.)
- Correspondence:
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (E.T.); (M.M.)
| | - Krzysztof Szczygieł
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.R.); (K.W.); (J.K.-M.); (A.M.); (J.S.)
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.R.); (K.W.); (J.K.-M.); (A.M.); (J.S.)
| | - Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.R.); (K.W.); (J.K.-M.); (A.M.); (J.S.)
| | - Wojciech Andrusewicz
- Department of Neurosurgery, Pomeranian Medical University, 71-252 Szczecin, Poland; (W.A.); (L.S.)
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.R.); (K.W.); (J.K.-M.); (A.M.); (J.S.)
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.R.); (K.W.); (J.K.-M.); (A.M.); (J.S.)
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (E.T.); (M.M.)
| | - Katarzyna Cyranka
- Department of Psychiatry, Jagiellonian University Medical College, 31-501 Krakow, Poland;
- Department of Metabolic Diseases, Jagiellonian University Medical College, 31-501 Krakow, Poland
| | - Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University, 71-252 Szczecin, Poland; (W.A.); (L.S.)
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.R.); (K.W.); (J.K.-M.); (A.M.); (J.S.)
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Abstract
Schizophrenia, characterised by psychotic symptoms and in many cases social and occupational decline, remains an aetiological and therapeutic challenge. Contrary to popular belief, the disorder is modestly more common in men than in women. Nor is the outcome uniformly poor. A division of symptoms into positive, negative, and disorganisation syndromes is supported by factor analysis. Catatonic symptoms are not specific to schizophrenia and so-called first rank symptoms are no longer considered diagnostically important. Cognitive impairment is now recognised as a further clinical feature of the disorder. Lateral ventricular enlargement and brain volume reductions of around 2% are established findings. Brain functional changes occur in different subregions of the frontal cortex and might ultimately be understandable in terms of disturbed interaction among large-scale brain networks. Neurochemical disturbance, involving dopamine function and glutamatergic N-methyl-D-aspartate receptor function, is supported by indirect and direct evidence. The genetic contribution to schizophrenia is now recognised to be largely polygenic. Birth and early life factors also have an important aetiological role. The mainstay of treatment remains dopamine receptor-blocking drugs; a psychological intervention, cognitive behavioural therapy, has relatively small effects on symptoms. The idea that schizophrenia is better regarded as the extreme end of a continuum of psychotic symptoms is currently influential. Other areas of debate include cannabis and childhood adversity as causative factors, whether there is progressive brain change after onset, and the long-term success of early intervention initiatives.
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Affiliation(s)
- Sameer Jauhar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - Mandy Johnstone
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK; National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Peter J McKenna
- FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
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Rambeau S, Del Goleto S, Pignon B, Lajnef M, Petrucci J, Szöke A, Fond G, Lançon C, Dorey JM, Rey R, Garbisson A, Capdevielle D, Leignier S, Dubreucq J, Mallet J, Dubertret C, Urbach M, Brunet-Gouet E, Aouizerate B, Misdrahi D, Zinetti-Bertschy A, Clauss J, Llorca PM, Chereau I, Leboyer M, Roux P, Schürhoff F. Relationship between neurocognition and theory of mind as a function of symptomatic profile in schizophrenia: results from the national FACE-SZ cohort. Cogn Neuropsychiatry 2022; 27:49-68. [PMID: 34882065 DOI: 10.1080/13546805.2021.2011184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Deficits in theory of mind (ToM) can vary depending on the predominant schizophrenia symptoms, and though most neurocognitive functions are involved in ToM, all may not be associated with the same symptoms. With consideration to the relationships between symptoms, neurocognition and ToM, the aim of the present study is to identify the neurocognitive functions influencing ToM capacities according to symptomatic profile. METHODS The study is based on a sample of 124 adults with schizophrenia from a French national cohort. Patients were divided into two groups according to their scores on the five Wallwork factors of the Positive and Negative Syndrome Scale using hierarchical clustering before carrying out multivariable analyses. RESULTS The "disorganised group" (n = 89) showed high scores on the disorganised factor, and had a ToM associated with reasoning, visual recognition and speed of processing. The "positive group" (n = 35) showed high scores on the positive and depressive factors, and had a ToM associated with working memory. CONCLUSIONS These results suggest that neurocognitive predictors of ToM in schizophrenia are different according to the predominant clinical dimension, thus refining our knowledge of the relationship between symptoms, neurocognition and ToM, and acknowledging their status as important predictors of patients' functional status.
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Affiliation(s)
- Sébastien Rambeau
- Université Paris Est Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Neuropsychiatrie translationnelle, Fondation FondaMental, Créteil, France
| | - Sarah Del Goleto
- Université Paris Est Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Neuropsychiatrie translationnelle, Fondation FondaMental, Créteil, France
| | - Baptiste Pignon
- Université Paris Est Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Neuropsychiatrie translationnelle, Fondation FondaMental, Créteil, France
| | - Mohamed Lajnef
- Université Paris Est Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Neuropsychiatrie translationnelle, Fondation FondaMental, Créteil, France
| | - Jean Petrucci
- Université Paris Est Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Neuropsychiatrie translationnelle, Fondation FondaMental, Créteil, France
| | - Andreï Szöke
- Université Paris Est Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Neuropsychiatrie translationnelle, Fondation FondaMental, Créteil, France
| | - Guillaume Fond
- AP-HM, Université Aix-Marseille, Ecole de médecine - La Timone Medical Campus, EA 3279: CEReSS - Centre d'Études et de Recherche sur les Services de Santé et la Qualité de Vie, Marseille, France
| | - Christophe Lançon
- AP-HM, Université Aix-Marseille, Ecole de médecine - La Timone Medical Campus, EA 3279: CEReSS - Centre d'Études et de Recherche sur les Services de Santé et la Qualité de Vie, Marseille, France
| | - Jean-Michel Dorey
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, Bron Cedex, France
| | - Romain Rey
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, Bron Cedex, France
| | - Amandine Garbisson
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Delphine Capdevielle
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Sylvain Leignier
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Julien Dubreucq
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Jasmina Mallet
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France.,Université de Paris, INSERM UMR1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Caroline Dubertret
- AP-HP, Groupe Hospitalo-Universitaire AP-HP Nord, service de Psychiatrie et Addictologie. Hôpital Louis Mourier, Colombes, France.,Université de Paris, INSERM UMR1266, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Mathieu Urbach
- Service Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, Le Chesnay, France.,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, Villejuif, France
| | - Eric Brunet-Gouet
- Service Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, Le Chesnay, France.,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, Villejuif, France
| | - Bruno Aouizerate
- Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux, France.,INRA, NutriNeuro, Université de Bordeaux, U1286, Bordeaux, France
| | - David Misdrahi
- Centre Hospitalier Charles Perrens, Université de Bordeaux, Bordeaux, France.,INRA, NutriNeuro, Université de Bordeaux, U1286, Bordeaux, France
| | - Anna Zinetti-Bertschy
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Julie Clauss
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Pierre-Michel Llorca
- CHU Clermont-Ferrand, Département de Psychiatrie, Université de Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Isabelle Chereau
- CHU Clermont-Ferrand, Département de Psychiatrie, Université de Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | | | - Marion Leboyer
- Université Paris Est Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Neuropsychiatrie translationnelle, Fondation FondaMental, Créteil, France
| | - Paul Roux
- Service Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, Le Chesnay, France.,DisAP-DevPsy-CESP, INSERM UMR1018, Université Paris-Saclay, Université Versailles Saint-Quentin-En-Yvelines, Villejuif, France
| | - Franck Schürhoff
- Université Paris Est Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Neuropsychiatrie translationnelle, Fondation FondaMental, Créteil, France
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Zhuo C, Chen G, Chen J, Yang L, Zhang Q, Li Q, Wang L, Ma X, Sun Y, Jia F, Tian H, Jiang D. Baseline global brain structural and functional alterations at the time of symptom onset can predict subsequent cognitive deterioration in drug-naïve first-episode schizophrenia patients: Evidence from a follow-up study. Front Psychiatry 2022; 13:1012428. [PMID: 36311504 PMCID: PMC9615917 DOI: 10.3389/fpsyt.2022.1012428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/26/2022] [Indexed: 01/10/2023] Open
Abstract
Alterations in the global brain gray matter volume (gGMV) and global functional connectivity density (gFCD) play a pivotal role in the cognitive impairment and further deterioration in schizophrenia. This study aimed to assess the correlation between alterations in the gGMV and gFCD at baseline (ΔgGMV and ΔgFCD), and the subsequent alterations of cognitive function in schizophrenia patients after 2-year antipsychotic treatment. Global-brain magnetic resonance imaging scans were acquired from 877 drug-naïve, first-episode schizophrenia patients at baseline and after two years of antipsychotic treatment with adequate dosage and duration, and 200 healthy controls. According to ΔgGMV at baseline, schizophrenia patients were divided into mild, moderate, and severe alteration groups. The MATRICS consensus cognitive battery and Global Deficit Score (GDS) were used to assess cognitive impairment. We found that ΔgGMV and ΔgFCD at baseline were significantly correlated with the severity of the cognitive deterioration (ΔGDS). The correlation coefficient indicated a significant positive correlation between baseline ΔgFCD and subsequent cognitive deterioration, with a relatively stronger relation in the mild alteration group (r = 0.31). In addition, there was a significant positive correlation between baseline ΔgGMV and subsequent cognitive deterioration, with a stronger relation in the moderate and severe alteration groups (r = 0.303; r = 0.302, respectively). Our results showed that ΔgGMV and ΔgFCD are correlated with the severity of cognitive deterioration after completion of a 2-year antipsychotic treatment in schizophrenia patients. These findings suggest that baseline alterations in gGMV and gFCD hold potential for predicting subsequent cognitive decline in schizophrenia.
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Affiliation(s)
- Chuanjun Zhuo
- Key Laboratory of Sensory Information Processing Abnormalities in Schizophrenia (SIPAS_Lab), Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Medical University Affiliated of Tianjin Fourth Center Hospital, Tianjin, China.,Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China.,Department of Psychiatry, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Nankai University Affiliated Tianjin Anding Hospital, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jiayue Chen
- Key Laboratory of Sensory Information Processing Abnormalities in Schizophrenia (SIPAS_Lab), Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Medical University Affiliated of Tianjin Fourth Center Hospital, Tianjin, China
| | - Lei Yang
- Key Laboratory of Sensory Information Processing Abnormalities in Schizophrenia (SIPAS_Lab), Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Medical University Affiliated of Tianjin Fourth Center Hospital, Tianjin, China
| | - Qiuyu Zhang
- Key Laboratory of Sensory Information Processing Abnormalities in Schizophrenia (SIPAS_Lab), Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Medical University Affiliated of Tianjin Fourth Center Hospital, Tianjin, China
| | - Qianchen Li
- Key Laboratory of Sensory Information Processing Abnormalities in Schizophrenia (SIPAS_Lab), Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Medical University Affiliated of Tianjin Fourth Center Hospital, Tianjin, China
| | - Lina Wang
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Nankai University Affiliated Tianjin Anding Hospital, Tianjin, China
| | - Xiaoyan Ma
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Nankai University Affiliated Tianjin Anding Hospital, Tianjin, China
| | - Yun Sun
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Nankai University Affiliated Tianjin Anding Hospital, Tianjin, China
| | - Feng Jia
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Nankai University Affiliated Tianjin Anding Hospital, Tianjin, China
| | - Hongjun Tian
- Key Laboratory of Sensory Information Processing Abnormalities in Schizophrenia (SIPAS_Lab), Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin Medical University Affiliated of Tianjin Fourth Center Hospital, Tianjin, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
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Zong X, Zhang Q, He C, Huang X, Zhang J, Wang G, Lv L, Sang D, Zou X, Chen H, Zheng J, Hu M. DNA Methylation Basis in the Effect of White Matter Integrity Deficits on Cognitive Impairments and Psychopathological Symptoms in Drug-Naive First-Episode Schizophrenia. Front Psychiatry 2021; 12:777407. [PMID: 34966308 PMCID: PMC8710603 DOI: 10.3389/fpsyt.2021.777407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mounting evidence from diffusion tensor imaging (DTI) and epigenetic studies, respectively, confirmed the abnormal alterations of brain white matter integrity and DNA methylation (DNAm) in schizophrenia. However, few studies have been carried out in the same sample to simultaneously explore the WM pathology relating to clinical behaviors, as well as the DNA methylation basis underlying the WM deficits. Methods: We performed DTI scans in 42 treatment-naïve first-episode schizophrenia patients and 38 healthy controls. Voxel-based method of fractional anisotropy (FA) derived from DTI was used to assess WM integrity. Participants' peripheral blood genomic DNAm status, quantified by using Infinium® Human Methylation 450K BeadChip, was examined in parallel with DTI scanning. Participants completed Digit Span test and Trail Making test, as well as Positive and Negative Syndrome Scale measurement. We acquired genes that are differentially expressed in the brain regions with abnormal FA values according to the Allen anatomically comprehensive atlas, obtained DNAm levels of the corresponding genes, and then performed Z-test to compare the differential epigenetic-imaging associations (DEIAs) between the two groups. Results: Significant decreases of FA values in the patient group were in the right middle temporal lobe WM, right cuneus WM, right anterior cingulate WM, and right inferior parietal lobe WM, while the significant increases were in the bilateral middle cingulate WM (Ps < 0.01, GRF correction). Abnormal FA values were correlated with patients' clinical symptoms and cognitive impairments. In the DEIAs, patients showed abnormal couple patterns between altered FA and DNAm components, for which the enriched biological processes and pathways could be largely grouped into three biological procedures: the neurocognition, immune, and nervous system. Conclusion: Schizophrenia may not cause widespread neuropathological changes, but subtle alterations affecting local cingulum WM, which may play a critical role in positive symptoms and cognitive impairments. This imaging-epigenetics study revealed for the first time that DNAm of genes enriched in neuronal, immunologic, and cognitive processes may serve as the basis in the effect of WM deficits on clinical behaviors in schizophrenia.
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Affiliation(s)
- Xiaofen Zong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qinran Zhang
- School of Mathematics and Statistics, Wuhan University, Wuhan, China
- Hubei Key Laboratory of Computational Science, Wuhan University, Wuhan, China
| | - Changchun He
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinyue Huang
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiangbo Zhang
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Deen Sang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xiufen Zou
- School of Mathematics and Statistics, Wuhan University, Wuhan, China
- Hubei Key Laboratory of Computational Science, Wuhan University, Wuhan, China
| | - Huafu Chen
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Junjie Zheng
- Early Intervention Unit, Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute, Nanjing Medical University, Nanjing, China
| | - Maolin Hu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
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Belvederi Murri M, Bertelli R, Carozza P, Berardi L, Cantarelli L, Croce E, Antenora F, Curtarello EMA, Simonelli G, Recla E, Girotto B, Grassi L. First-episode psychosis in the Ferrara Mental Health Department: Incidence and clinical course within the first 2 years. Early Interv Psychiatry 2021; 15:1738-1748. [PMID: 33264815 DOI: 10.1111/eip.13095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 01/26/2023]
Abstract
AIM To examine the incidence of with first-episode psychosis (FEP) in the Integrated Department of Mental Health and Pathological Addictions in Ferrara, Italy, and to examine the association between the Duration of Untreated Psychosis (DUP) and the clinical course. METHODS Participants recruited in 2013-2019 were assessed with the Health of the Nation Outcome Scale (HoNOS) every 6 months for 24 months. Hierarchical growth models analysed changes of global severity (HoNOS total scores) and symptom dimensions. Regression modelled factors associated with remission (HoNOS < 8) and clinical improvement (<12). RESULTS The incidence of FEP was 21.5 (95%CI: 21.2-21.9) cases per 100 000 person year. Among participants (n = 86, mean age 23, 76% males), baseline HoNOS scores were higher for those with a longer DUP. More than half subjects reached clinical remission (61.6%) or improvement (82.6%), while very few (2.3%) were re-hospitalized. HoNOS total scores decayed with a mixed linear/quadratic trend, with a slower decay among migrants. A longer DUP was associated with reduced improvements of positive symptoms and lower likelihood of clinical improvement (OR: 0.84; 95%CI: 0.73-0.96). CONCLUSIONS Patients from the FEP program of Ferrara reached good clinical outcomes. Nonetheless, individuals with a longer DUP may need additional clinical attention. Systematic monitoring of clinical outcomes may be an optimal strategy to improve the outcomes of FEP in the real world.
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Affiliation(s)
- Martino Belvederi Murri
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Integrated Department of Mental Health and Pathological Addictions, Ferrara, Italy
| | - Raffaella Bertelli
- Integrated Department of Mental Health and Pathological Addictions, Ferrara, Italy
| | - Paola Carozza
- Integrated Department of Mental Health and Pathological Addictions, Ferrara, Italy
| | - Lorenzo Berardi
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Luca Cantarelli
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Enrico Croce
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Fabio Antenora
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | | | - Gabriele Simonelli
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Elisabetta Recla
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Barbara Girotto
- Integrated Department of Mental Health and Pathological Addictions, Ferrara, Italy
| | - Luigi Grassi
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Integrated Department of Mental Health and Pathological Addictions, Ferrara, Italy
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66
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Banazadeh M, Mehrabani M, Banazadeh N, Dabaghzadeh F, Shahabi F. Evaluating the effect of black myrobalan on cognitive, positive, and negative symptoms in patients with chronic schizophrenia: A randomized, double-blind, placebo-controlled trial. Phytother Res 2021; 36:543-550. [PMID: 34814232 DOI: 10.1002/ptr.7340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/07/2021] [Accepted: 11/07/2021] [Indexed: 11/06/2022]
Abstract
Schizophrenia, as a chronic and disabling mental disorder, causes a wide range of symptoms, including cognitive impairments, positive, negative, and mood symptoms. There are no effective treatments for cognitive symptoms. Black myrobalan (Terminalia chebula Retz.), a medicinal plant of the Combretaceae family, exerts antioxidant, antiacetylcholinesterase, and anti-inflammatory effects. These effects can lessen the symptoms of schizophrenia. So, this study was conducted to evaluate black myrobalan's impact on cognitive impairments and negative/positive symptoms in patients with chronic schizophrenia. This was a randomized, double-blind, placebo-controlled clinical trial in which participants were divided into treatment and placebo groups. They received six 500 mg capsules of black myrobalan or placebo in two divided doses for 4 weeks. Patients' cognitive impairments, positive, negative, depression/anxiety, and excitement/activity symptoms were assessed using the Screen for Cognitive Impairments in Psychiatry (SCIP) and the relevant subscales of the Positive and Negative Syndrome Scale (PANSS) pretreatment and 4 weeks after treatment. Cognitive impairments (SCIP) (p value .004), negative symptoms (PANSS subscale) (p value .017), and excitement/activity (PANSS subscale) (p value .003) were significantly improved in the black myrobalan group compared with the control group after 4 weeks. No serious adverse effects were reported. Black myrobalan could improve cognitive impairments, negative and excitement/activity symptoms in chronic schizophrenic patients.
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Affiliation(s)
- Mohammad Banazadeh
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mitra Mehrabani
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Nabi Banazadeh
- Department of Psychiatry, School of Medicine AND Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Dabaghzadeh
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.,Department of Clinical Pharmacy, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Farzad Shahabi
- School of Engineering, University of South Florida, Tampa, Florida, USA
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67
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Grot S, Giguère CÉ, Smine S, Mongeau-Pérusse V, Nguyen DD, Preda A, Potvin S, van Erp TGM, Fbirn, Orban P. Converting scores between the PANSS and SAPS/SANS beyond the positive/negative dichotomy. Psychiatry Res 2021; 305:114199. [PMID: 34536695 DOI: 10.1016/j.psychres.2021.114199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
Previous work provided conversion equations for overall indices of positive and negative symptomatology between the Positive and Negative Syndrome Scale (PANSS) and the Scales for the Assessment of Positive/Negative Symptoms (SAPS/SANS). Our objective was to provide such conversion equations for subdomains of positive and negative symptomatology in order to better account for the diversity of symptom profiles in schizophrenia. Symptoms severity was assessed using both the PANSS and SAPS/SANS in 205 patients with schizophrenia. Two exploratory factor analyses combining items from both scales were first performed separately in the positive and negative symptom domains. Positive factors were termed 'Hallucinations', 'Delusions' and 'Disorganization', while negative factors were associated with 'Expressivity', 'Amotivation' and 'Cognition', consistent with current descriptions of symptom dimensions in schizophrenia. For each factor, linear regression analyses were conducted on 80% of the data to obtain conversion equations from the PANSS to the SAPS/SANS and vice versa. Reliability was then evaluated on the 20% remaining data, with good to excellent intra-class correlation coefficients between the original and predicted scores for all but the cognition factor. These findings show that symptom severity scores can be converted with good accuracy between clinical scales beyond the positive/negative symptom dichotomy.
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Affiliation(s)
- Stéphanie Grot
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
| | - Charles-Édouard Giguère
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada
| | - Salima Smine
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada
| | | | - Dana Diem Nguyen
- Department of Pediatrics, University of California Irvine, Irvine, California, USA
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, California, USA
| | - Stéphane Potvin
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, California, USA; Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, California, USA
| | - Fbirn
- Function Biomedical Informatics Research Network, USA
| | - Pierre Orban
- Research Center of the Montreal Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada.
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68
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Wei W, Yin Y, Zhang Y, Li X, Li M, Guo W, Wang Q, Deng W, Ma X, Zhao L, Palaniyappan L, Li T. Structural Covariance of Depth-Dependent Intracortical Myelination in the Human Brain and Its Application to Drug-Naïve Schizophrenia: A T1w/T2w MRI Study. Cereb Cortex 2021; 32:2373-2384. [PMID: 34581399 DOI: 10.1093/cercor/bhab337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 02/05/2023] Open
Abstract
Aberrations in intracortical myelination are increasingly being considered as a cardinal feature in the pathophysiology of schizophrenia. We investigated the network-level distribution of intracortical myelination across various cortex depths. We enrolled 126 healthy subjects and 106 first-episode drug-naïve schizophrenia patients. We used T1w/T2w ratio as a proxy of intracortical myelination, parcellated cortex into several equivolumetric surfaces based on cortical depths and mapped T1w/T2w ratios to each surface. Non-negative matrix factorization was used to generate depth-dependent structural covariance networks (dSCNs) of intracortical myelination from 2 healthy controls datasets-one from our study and another from 100-unrelated dataset of the Human Connectome Project. For patient versus control comparisons, partial least squares approach was used; we also related myelination to clinical features of schizophrenia. We found that dSCNs were highly reproducible in 2 independent samples. Network-level myelination was reduced in prefrontal and cingulate cortex and increased in perisylvian cortex in schizophrenia. The abnormal network-level myelination had a canonical correlation with symptom burden in schizophrenia. Moreover, myelination of prefrontal cortex correlated with duration of untreated psychosis. In conclusion, we offer a feasible and sensitive framework to study depth-dependent myelination and its relationship with clinical features.
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Affiliation(s)
- Wei Wei
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Yubing Yin
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Yamin Zhang
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Xiaojing Li
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Mingli Li
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Wanjun Guo
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Qiang Wang
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Wei Deng
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Liansheng Zhao
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Lena Palaniyappan
- Department of Psychiatry, University of Western Ontario, London, Ontario N6A 3K7, Canada.,Robarts Research Institute, University of Western Ontario, London, Ontario N6A 3K7, Canada.,Lawson Health Research Institute, London, Ontario N6C 2R5, Canada
| | - Tao Li
- Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan 610000, China.,Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China
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69
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Uscătescu LC, Kronbichler L, Stelzig-Schöler R, Pearce BG, Said-Yürekli S, Reich LA, Weber S, Aichhorn W, Kronbichler M. Effective Connectivity of the Hippocampus Can Differentiate Patients with Schizophrenia from Healthy Controls: A Spectral DCM Approach. Brain Topogr 2021; 34:762-778. [PMID: 34482503 PMCID: PMC8556208 DOI: 10.1007/s10548-021-00868-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/22/2021] [Indexed: 12/01/2022]
Abstract
We applied spectral dynamic causal modelling (Friston et al. in Neuroimage 94:396–407. 10.1016/j.neuroimage.2013.12.009, 2014) to analyze the effective connectivity differences between the nodes of three resting state networks (i.e. default mode network, salience network and dorsal attention network) in a dataset of 31 male healthy controls (HC) and 25 male patients with a diagnosis of schizophrenia (SZ). Patients showed increased directed connectivity from the left hippocampus (LHC) to the: dorsal anterior cingulate cortex (DACC), right anterior insula (RAI), left frontal eye fields and the bilateral inferior parietal sulcus (LIPS & RIPS), as well as increased connectivity from the right hippocampus (RHC) to the: bilateral anterior insula (LAI & RAI), right frontal eye fields and RIPS. In SZ, negative symptoms predicted the connectivity strengths from the LHC to: the DACC, the left inferior parietal sulcus (LIPAR) and the RHC, while positive symptoms predicted the connectivity strengths from the LHC to the LIPAR and from the RHC to the LHC. These results reinforce the crucial role of hippocampus dysconnectivity in SZ pathology and its potential as a biomarker of disease severity.
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Affiliation(s)
- Lavinia Carmen Uscătescu
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Lisa Kronbichler
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Renate Stelzig-Schöler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Brandy-Gale Pearce
- Department of Psychiatry, Psychotherapy and Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Sarah Said-Yürekli
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | | | - Stefanie Weber
- Department of Psychiatry, Psychotherapy and Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Wolfgang Aichhorn
- Department of Psychiatry, Psychotherapy and Psychosomatics, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - Martin Kronbichler
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
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Pelizza L, Maestri D, Leuci E, Quattrone E, Azzali S, Paulillo G, Pellegrini P. Negative symptom configuration in patients with first episode affective psychosis: findings from the 1-year follow-up of the "Parma Early Psychosis" program. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021224. [PMID: 34487088 PMCID: PMC8477119 DOI: 10.23750/abm.v92i4.11115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022]
Abstract
Background and aim: Evidence on discrete dimensions underlining negative symptoms in First Episode Affective Psychosis (FEAP) may be useful for their treatment strategy, but is still relatively scarce. Aim of this study was to examine the negative symptom configuration in patients with FEAP using both exploratory and confirmatory factor analysis methods on the Positive And Negative Syndrome Scale (PANSS). Methods: Seventy-eight participants, aged 13-35 years, completed the PANSS within the “Parma Early Psychosis” (Pr-EP) program, a specialized protocol of early detection and intervention in psychosis implemented since January 2013 in all public adolescent and adult mental health services of the Parma Department of Mental Health (Northern Italy). Results: A 3-factor model (i.e. “Alogia”, “Social Withdrawal” and “Motor/Affective Expression Poverty” domains) was identified. As an alternative, a 2-factor solution previously proposed in patients with first episode schizophrenia (always within the Pr-EP program) also showed good fit indices in our FEAP sample. Conclusions: Our results suggest the crucial importance of identifying discrete negative symptom domains already at the onset of affective psychosis in order to implement specific early intervention strategies aiming to improve prognosis and long-term outcomes also in this young FEAP help-seeking population.
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Affiliation(s)
- Lorenzo Pelizza
- Parma Department of Mental Health and Pathological Addiction, Azienda USL di Parma.
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71
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Disorganization in first episode schizophrenia: Treatment response and psychopathological findings from the 2-year follow-up of the "Parma Early Psychosis" program. J Psychiatr Res 2021; 141:293-300. [PMID: 34274840 DOI: 10.1016/j.jpsychires.2021.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/12/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Disorganization is a core dimension of schizophrenia, yet it is relatively under-investigated compared to positive and negative ones, especially at the illness onset. Indeed, most of the empirical studies investigating the disorganized domain included patients with prolonged schizophrenia. Therefore, the aims of this research were (1) to monitor the longitudinal stability of disorganized symptoms in young patients with First Episode Schizophrenia (FES) along a 2-year follow-up period, and (2) to examine any significant association of disorganization with functioning, psychopathology and the specific treatment components of an "Early Intervention in Psychosis" (EIP) program across the 2 years of follow-up. METHODS At baseline, 159 FES individuals (aged 12-35 years) completed the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). Spearman's correlation coefficients and multiple linear regression analysis were carried out. RESULTS During the follow-up period, disorganization had relevant enduring positive associations with PANSS negative symptoms, lack of judgment/insight and positive symptoms representing delusional thought contents, as well as significant enduring negative correlation with GAF scores. Along the 2 years of follow-up, FES patients also showed a relevant improvement in disorganization symptoms. This reduction was specifically associated with the number of individual psychotherapy sessions provided during the first year of treatment. CONCLUSION Disorganization is a prominent clinical feature in FES at the recruitment in specialized EIP services, but its temporal trajectory reveals a decrease over time, together with the delivery of specific, patient-tailored EIP interventions.
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72
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Relationship of Corpus Callosum Integrity with Working Memory, Planning, and Speed of Processing in Patients with First-Episode and Chronic Schizophrenia. J Clin Med 2021; 10:jcm10143158. [PMID: 34300325 PMCID: PMC8304050 DOI: 10.3390/jcm10143158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/16/2022] Open
Abstract
There is a paucity of reports examining the relationship between the integrity of the corpus callosum (CC) and different aspects of cognitive functioning in patients with first-episode (FES) and chronic schizophrenia (CS) simultaneously; furthermore, what results exist are inconclusive. We used diffusion tensor imaging tractography to investigate differences in integrity in five regions of the CC between FES, CS, and healthy controls (HC). Additionally, we analyzed correlations between these regions' integrity and working memory, planning, and speed of processing. Eighteen patients with FES, 55 patients with CS, and 30 HC took part in the study. We assessed cognitive functions with four tasks from Measurement and Treatment Research to Improve Cognition in Schizophrenia. Patients with CS showed lower fractional anisotropy (FA) in Region 5 (statistical trend) and higher mean diffusivity (MD) in Regions 4 and 5 than HC, and patients with FES had higher MD in Region 3 (statistical trend) than HC. Both clinical groups performed worse on working memory and speed of processing tasks than HC, and patients with CS scored worse than HC on independent planning, and worse than FES and HC on dependent planning. Moreover, in patients with CS, MD in Region 3 was correlated with verbal working memory. Our results suggest that patients with FES and CS are characterized by impaired integrity of the middle and posterior CC, respectively. We confirmed that both clinical groups have cognitive impairments. Moreover, the integrity of the middle CC may influence planning in patients with CS.
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73
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Tyburski E, Mak M, Sokołowski A, Starkowska A, Karabanowicz E, Kerestey M, Lebiecka Z, Preś J, Sagan L, Samochowiec J, Jansari AS. Executive Dysfunctions in Schizophrenia: A Critical Review of Traditional, Ecological, and Virtual Reality Assessments. J Clin Med 2021; 10:jcm10132782. [PMID: 34202881 PMCID: PMC8267962 DOI: 10.3390/jcm10132782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/11/2021] [Accepted: 06/18/2021] [Indexed: 01/19/2023] Open
Abstract
In recent years, interest has grown in measuring executive function in schizophrenia with ecological and virtual reality (VR) tools. However, there is a lack of critical analysis comparing those tools with traditional ones. This paper aims to characterize executive dysfunction in schizophrenia by comparing ecological and virtual reality assessments with traditional tools, and to describe the neurobiological and psychopathological correlates. The analysis revealed that ecological and VR tests have higher levels of verisimilitude and similar levels of veridicality compared to traditional tools. Both negative symptoms and disorganization correlate significantly with executive dysfunction as measured by traditional tools, but their relationships with measures based on ecological and VR methods are still unclear. Although there is much research on brain correlates of executive impairments in schizophrenia with traditional tools, it is uncertain if these results will be confirmed with the use of ecological and VR tools. In the diagnosis of executive dysfunction, it is important to use a variety of neuropsychological methods—especially those with confirmed ecological validity—to properly recognize the underlying characteristics of the observed deficits and to implement effective forms of therapy.
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Affiliation(s)
- Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 61-719 Poznań, Poland
- Correspondence: ; Tel.: +48-61-271-12-22
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (M.M.); (Z.L.); (J.P.)
| | - Andrzej Sokołowski
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94143, USA;
| | - Anna Starkowska
- Faculty of Psychology in Wrocław, SWPS University of Social Sciences and Humanities, 53-238 Wrocław, Poland;
| | - Ewa Karabanowicz
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (E.K.); (M.K.)
| | - Magdalena Kerestey
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (E.K.); (M.K.)
| | - Zofia Lebiecka
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (M.M.); (Z.L.); (J.P.)
| | - Joanna Preś
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (M.M.); (Z.L.); (J.P.)
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland;
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland;
| | - Ashok S. Jansari
- Department of Psychology, Goldsmiths, University of London, New Cross, London SE14 6NW, UK;
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Shafer A, Dazzi F. Meta-analytic exploration of the joint factors of the Brief Psychiatric Rating Scale - Expanded (BPRS-E) and the positive and negative symptoms scales (PANSS). J Psychiatr Res 2021; 138:519-527. [PMID: 33979704 DOI: 10.1016/j.jpsychires.2021.04.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Previous meta-analyses of the BPRS-E and PANSS were combined to analyze the joint factors across 77 factor analyses from 68 studies of 32,896 individuals. The BPRS-E and PANSS share the 18 original BPRS items and each has additional unique items (6 BPRS-E and 12 PANSS). Based on the combined data across the BPRS-E and PANSS four separate sets of factor analyses were conducted using sample weighting (weighted and unweighted) and matrix type (similarity coefficients and reproduced correlations). Five factors: Positive Symptoms, Affect, Negative Symptoms, Disorganization and Activation-Mania were consistent across all solutions. The factors Positive Symptoms and Affect were defined primarily by the original 18 BPRS items. The factors Negative Symptoms and Disorganization were largely defined by the PANSS additional items. The Activation-Mania factor was largely defined by the additional BPRS-E items. The results were similar to those found in previous meta-analyses but the current factors were substantially more comprehensive and better defined because they included all the items from both the BPRS-E and the PANSS. Future research should consider using all the items from both the PANSS and BPRS-E as the unique items from each scale improve the assessment and measurement of these factors.
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Affiliation(s)
| | - Federico Dazzi
- Department of Human Sciences, Lumsa University, Rome, Italy
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75
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Podwalski P, Tyburski E, Szczygieł K, Waszczuk K, Rek-Owodziń K, Mak M, Plichta P, Bielecki M, Rudkowski K, Kucharska-Mazur J, Andrusewicz W, Misiak B, Szulc A, Michalczyk A, Michałowska S, Sagan L, Samochowiec J. White Matter Integrity of the Corpus Callosum and Psychopathological Dimensions in Deficit and Non-Deficit Schizophrenia Patients. J Clin Med 2021; 10:jcm10112225. [PMID: 34063845 PMCID: PMC8196621 DOI: 10.3390/jcm10112225] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/04/2021] [Accepted: 05/19/2021] [Indexed: 12/19/2022] Open
Abstract
Deficit syndrome (DS) is a subtype of schizophrenia characterized by primary persistent negative symptoms. The corpus callosum (CC) appears to be related to psychopathology in schizophrenia. This study assessed white matter integrity in the CC using diffusion tensor imaging (DTI) in deficit and non-deficit schizophrenia (NDS) patients. We also investigated the psychopathological dimensions of schizophrenia and their relationship to CC integrity. Fifteen DS patients, 40 NDS patients, and 30 healthy controls (HC) underwent psychiatric evaluation and neuroimaging. We divided the CC into five regions and assessed their fractional anisotropy (FA) and mean diffusivity (MD). Psychopathology was assessed with the Positive and Negative Syndrome Scale. DS patients had lower FA than NDS patients and HC, and higher MD in Region 5 of the CC than did HC. NDS patients had higher MD in Region 4 of the CC. The patient groups differed in terms of negative symptoms. After differentiating clinical groups and HC, no significant correlations were observed between DTI measures and psychopathological symptoms. Our results suggest that DS and NDS are characterized by minor impairments of the posterior CC. We confirmed that DS patients have greater negative psychopathology than NDS patients. Our results are preliminary, and further studies are needed.
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Affiliation(s)
- Piotr Podwalski
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
- Correspondence:
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 61-719 Poznan, Poland;
| | - Krzysztof Szczygieł
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Katarzyna Rek-Owodziń
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Piotr Plichta
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Maksymilian Bielecki
- Department of Health Psychology, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.R.-O.); (M.M.); (P.P.); (M.B.)
| | - Krzysztof Rudkowski
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Jolanta Kucharska-Mazur
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Wojciech Andrusewicz
- Department of Neurosurgery, Pomeranian Medical University, 71-252 Szczecin, Poland; (W.A.); (L.S.)
| | - Błażej Misiak
- Department of Genetics, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Agata Szulc
- Department of Psychiatry, Faculty of Health Sciences, Medical University in Warsaw, 05-802 Warsaw, Poland;
| | - Anna Michalczyk
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
| | - Sylwia Michałowska
- Department of Clinical Psychology, Institute of Psychology, University of Szczecin, 71-004 Szczecin, Poland;
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University, 71-252 Szczecin, Poland; (W.A.); (L.S.)
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, 71-460 Szczecin, Poland; (K.S.); (K.W.); (K.R.); (J.K.-M.); (A.M.); (J.S.)
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Athanassiou M, Dumais A, Iammatteo V, De Benedictis L, Dubreucq JL, Potvin S. The processing of angry faces in schizophrenia patients with a history of suicide: An fMRI study examining brain activity and connectivity. Prog Neuropsychopharmacol Biol Psychiatry 2021; 107:110253. [PMID: 33485961 DOI: 10.1016/j.pnpbp.2021.110253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/05/2021] [Accepted: 01/14/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The high rate of suicidal behaviours (SBs) in psychiatric populations remain an important preoccupation to address. The literature reveals emotional instability as an important risk factor for SBs. However, the neural mechanisms underpinning this risk factor have never been investigated in schizophrenia patients with SBs. The following study implemented a task-based emotional processing functional magnetic resonance imaging (fMRI) paradigm to evaluate the activation and connectivity differences exhibited by schizophrenia patients with a history of suicide attempt (SA). METHOD A sample of 62 schizophrenia patients with and without SA and 22 controls completed an fMRI emotional processing task, which included the visualization of dynamic angry facial expressions. Task-based connectivity was assessed using generalized psychophysical interaction analyses. RESULTS During the processing of angry faces, suicidal schizophrenia patients displayed increased activation of the left median cingulate gyrus, left middle frontal gyrus, and left precuneus when compared to nonsuicidal schizophrenia patients and healthy controls. Whole-brain connectivity analyses yielded an increased coupling of the right amygdala and right superior frontal gyrus, as well as between the left precuneus and median cingulate gyrus, in suicidal schizophrenia patients. Schizophrenia patients' hostility scores on the Positive and Negative Symptom Scale (PANSS) were significantly and positively correlated with the activity of the left median cingulate gyrus. CONCLUSION When exposed to angry faces, suicidal schizophrenia patients demonstrate elevated activation of brain regions associated to executive functioning and self-processing, as well as aberrant fronto-limbic connectivity involved in emotion regulation. Our results highlight the neglected role of anger when investigating the neural alterations underpinning SBs in schizophrenia.
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Affiliation(s)
- Maria Athanassiou
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Alexandre Dumais
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada; Philippe-Pinel National Institute of Legal Psychiatry, Montreal, Canada
| | - Veronica Iammatteo
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Luigi De Benedictis
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Jean-Luc Dubreucq
- Philippe-Pinel National Institute of Legal Psychiatry, Montreal, Canada
| | - Stéphane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada.
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77
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Vass E, Simon V, Fekete Z, Kis B, Simon L. Case Report: Feasibility of a Novel Virtual Reality-Based Intervention for Patients With Schizophrenia. Front Psychol 2021; 12:642590. [PMID: 33716911 PMCID: PMC7952447 DOI: 10.3389/fpsyg.2021.642590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/08/2021] [Indexed: 11/16/2022] Open
Abstract
Schizophrenia is a severe and disabling mental illness, associated with persistent difficulties in social functioning. While gaining and retaining a job or staying socially integrated can be very difficult for the patients, the treatment of poor functionality remains challenging with limited options in pharmacotherapy. To address the limitations of medical treatment, several interesting and innovative approaches have been introduced in the field of psychotherapy. Recent approaches incorporate modern technology as well, such as virtual reality. A potential therapeutic benefit of virtual reality is particularly significant when an interpersonal dimension of the problem needs to be addressed. One example is a Virtual Reality based Theory of Mind Intervention (VR-ToMIS), a novel method, which enables patients to practice complex social interactions without the burden of real-life consequences. Our paper presents a case report showing promising results of VR-ToMIS. Ms. Smith is a 50- year-old patient who has been suffering from schizophrenia for 20 years. Although in her case there was no problem with compliance throughout the years, she had severe problems regarding social functionality. With VR-ToMIS, she improved in ToM and communicative-pragmatic skills. The effects of the intervention went beyond the increased scores of the tests. Before the intervention there was a risk of the patient becoming unemployed as she was unable to follow the main principles of communicative exchange. Usually, her contribution was more informative than was required. After the intervention her communication became more balanced and she could retain her job. This case suggests that VR-ToMIS may be a promising tool for treating social disfunction in schizophrenia.
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Affiliation(s)
- Edit Vass
- Department of Psychiatry and Psychotherapy, Faculty of Health, Semmelweis University, Budapest, Hungary
| | - Viktória Simon
- Department of Psychiatry and Psychotherapy, Faculty of Health, Semmelweis University, Budapest, Hungary
| | - Zita Fekete
- Institute of Behavioral Sciences, University of Debrecen, Debrecen, Hungary
| | - Balázs Kis
- Department of Psychiatry, Szabolcs-Szatmar-Bereg County Hospital and University Teaching Hospital, Nyíregyháza, Hungary
| | - Lajos Simon
- Department of Psychiatry and Psychotherapy, Faculty of Health, Semmelweis University, Budapest, Hungary
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78
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Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by markedly impaired social interaction, impaired communication, and restricted/repetitive patterns of behavior, interests, and activities. In addition to challenges caused by core symptoms, maladaptive behaviors such as aggression can be associated with ASD and can further disrupt functioning and quality of life. For adults with ASD, these behaviors can portend adverse outcomes (e.g., harm to others or to the individual with ASD, hindering of employment opportunities, criminal justice system involvement). This article reviews the scientific literature to provide an update on evidence-based interventions for aggression in adults with ASD. METHOD A search of the electronic databases CINAHL, EMBASE, and PsycINFO was conducted using relevant search terms. After reviewing titles, abstracts, full-length articles, and reference lists, 70 articles were identified and reviewed. RESULTS The strongest (controlled trial) evidence suggests beneficial effects of risperidone, propranolol, fluvoxamine, vigorous aerobic exercise, and dextromethorphan/quinidine for treating aggression in adults with ASD, with lower levels of evidence supporting behavioral interventions, multisensory environments, yokukansan, and other treatments. CONCLUSIONS Additional randomized, controlled trials using consistent methodology that adequately addresses sources of bias are needed to determine which treatments are reliably effective in addressing aggression in adults with ASD. In the meantime, considering efficacy and adverse effect/long-term risk profiles, a practical approach could start with functional assessment-informed behavioral interventions along with encouragement of regular, vigorous aerobic exercise to target aggression in adults with ASD, with pharmacotherapy employed if these interventions are unavailable or inadequate based on symptom acuity.
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Affiliation(s)
- David S. Im
- From the University of Michigan Hospital, Department of Psychiatry, University of Michigan Medical School
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79
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Gascoyne LE, Brookes MJ, Rathnaiah M, Katshu MZUH, Koelewijn L, Williams G, Kumar J, Walters JTR, Seedat ZA, Palaniyappan L, Deakin JFW, Singh KD, Liddle PF, Morris PG. Motor-related oscillatory activity in schizophrenia according to phase of illness and clinical symptom severity. Neuroimage Clin 2020; 29:102524. [PMID: 33340975 PMCID: PMC7750164 DOI: 10.1016/j.nicl.2020.102524] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/12/2020] [Accepted: 12/01/2020] [Indexed: 11/19/2022]
Abstract
Magnetoencephalography (MEG) measures magnetic fields generated by synchronised neural current flow and provides direct inference on brain electrophysiology and connectivity, with high spatial and temporal resolution. The movement-related beta decrease (MRBD) and the post-movement beta rebound (PMBR) are well-characterised effects in magnetoencephalography (MEG), with the latter having been shown to relate to long-range network integrity. Our previous work has shown that the PMBR is diminished (relative to controls) in a group of schizophrenia patients. However, little is known about how this effect might differ in patients at different stages of illness and degrees of clinical severity. Here, we extend our previous findings showing that the MEG derived PMBR abnormality in schizophrenia exists in 29 recent-onset and 35 established cases (i.e., chronic patients), compared to 42 control cases. In established cases, PMBR is negatively correlated with severity of disorganization symptoms. Further, using a hidden Markov model analysis, we show that transient pan-spectral oscillatory "bursts", which underlie the PMBR, differ between healthy controls and patients. Results corroborate that PMBR is associated with disorganization of mental activity in schizophrenia.
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Affiliation(s)
- Lauren E Gascoyne
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom.
| | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - Mohanbabu Rathnaiah
- Institute of Mental Health, University of Nottingham, Jubilee Campus, Nottingham NG7 2TU, United Kingdom; Nottinghamshire Healthcare NHS Foundation Trust, Nottingham NG3 6AA, United Kingdom
| | - Mohammad Zia Ul Haq Katshu
- Institute of Mental Health, University of Nottingham, Jubilee Campus, Nottingham NG7 2TU, United Kingdom; Nottinghamshire Healthcare NHS Foundation Trust, Nottingham NG3 6AA, United Kingdom
| | - Loes Koelewijn
- CUBRIC, School of Psychology, College of Biomedical and Life Sciences, Cardiff, Cardiff University CF24 4HQ, United Kingdom
| | - Gemma Williams
- CUBRIC, School of Psychology, College of Biomedical and Life Sciences, Cardiff, Cardiff University CF24 4HQ, United Kingdom
| | - Jyothika Kumar
- Institute of Mental Health, University of Nottingham, Jubilee Campus, Nottingham NG7 2TU, United Kingdom
| | - James T R Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, CF24 4HQ, United Kingdom
| | - Zelekha A Seedat
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
| | - Lena Palaniyappan
- Department of Psychiatry & Robarts Research Institute, University of Western Ontario & Lawson Health Research Institute, London ON, Canada
| | - J F William Deakin
- Division of Neuroscience and Experimental Psychology, University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - Krish D Singh
- CUBRIC, School of Psychology, College of Biomedical and Life Sciences, Cardiff, Cardiff University CF24 4HQ, United Kingdom
| | - Peter F Liddle
- Institute of Mental Health, University of Nottingham, Jubilee Campus, Nottingham NG7 2TU, United Kingdom
| | - Peter G Morris
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, United Kingdom
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80
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Vass E, Simon V, Fekete Z, Lencse L, Ecseri M, Kis B, Simon L. A novel virtual reality-based theory of mind intervention for outpatients with schizophrenia: A proof-of-concept pilot study. Clin Psychol Psychother 2020; 28:727-738. [PMID: 32978836 DOI: 10.1002/cpp.2519] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 11/08/2022]
Abstract
Schizophrenia is a severe and highly disabling mental illness. Although several pharmacological solutions are available to alleviate symptoms of schizophrenia, they do not seem to provide solution for accompanying social dysfunctions. To handle this unmet clinical need, many innovative interventions have been developed recently. Considering the promising results on this field and the development trend, characterized by the growing proportion of included interactive technology, our research team developed a novel virtual reality (VR)-based targeted theory of mind (ToM) intervention (VR-ToMIS) for stable outpatients with schizophrenia. VR-ToMIS is a nine-session long structured and individualized method that uses cognitive and behavioural therapeutic techniques in an immersive VR environment. Our study was a randomized, controlled pilot study. Twenty-one patients have been recruited and randomly allocated to either VR-ToMIS or passive VR condition. Patients assigned to passive VR condition could use the same VR software as the VR-ToMIS group, but without any interventions. Effects on psychiatric symptoms, neurocognitive and social cognitive functions, pragmatic language skills and quality of life were evaluated by using analysis of covariance. According to our results, VR-ToMIS was associated with improvements in negative symptoms, in one neurocognitive field (immediate memory), ToM and pragmatic language skills, but no significant change in quality of life scores was detected. Significant changes in VR-ToMIS group were associated with moderate to large therapeutic effects (ηp 2 = .24-.46, φ = .55-.67). On the background of the presented pilot results, VR-ToMIS is concluded to be feasible and tolerable.
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Affiliation(s)
- Edit Vass
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Viktória Simon
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zita Fekete
- Institute of Behavioral Sciences, University of Debrecen, Debrecen, Hungary
| | - Laura Lencse
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Mária Ecseri
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Balázs Kis
- Department of Psychiatry, Szabolcs Szatmár Bereg County Hospitals and University Teaching Hospital, Nyíregyháza, Hungary
| | - Lajos Simon
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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81
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Kotov R, Jonas KG, Carpenter WT, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Hobbs K, Reininghaus U, Slade T, South SC, Sunderland M, Waszczuk MA, Widiger TA, Wright A, Zald DH, Krueger RF, Watson D. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): I. Psychosis superspectrum. World Psychiatry 2020; 19:151-172. [PMID: 32394571 PMCID: PMC7214958 DOI: 10.1002/wps.20730] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a scientific effort to address shortcomings of traditional mental disorder diagnoses, which suffer from arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. This paper synthesizes evidence on the validity and utility of the thought disorder and detachment spectra of HiTOP. These spectra are composed of symptoms and maladaptive traits currently subsumed within schizophrenia, other psychotic disorders, and schizotypal, paranoid and schizoid personality disorders. Thought disorder ranges from normal reality testing, to maladaptive trait psychoticism, to hallucinations and delusions. Detachment ranges from introversion, to maladaptive detachment, to blunted affect and avolition. Extensive evidence supports the validity of thought disorder and detachment spectra, as each spectrum reflects common genetics, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, biomarkers, and treatment response. Some of these characteristics are specific to one spectrum and others are shared, suggesting the existence of an overarching psychosis superspectrum. Further research is needed to extend this model, such as clarifying whether mania and dissociation belong to thought disorder, and explicating processes that drive development of the spectra and their subdimensions. Compared to traditional diagnoses, the thought disorder and detachment spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and higher acceptability to clinicians. Validated measures are available to implement the system in practice. The more informative, reliable and valid characterization of psychosis-related psychopathology offered by HiTOP can make diagnosis more useful for research and clinical care.
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Affiliation(s)
- Roman Kotov
- Department of PsychiatryStony Brook UniversityStony BrookNYUSA
| | | | | | - Michael N. Dretsch
- Walter Reed Army Institute of Research, US Army Medical Research Directorate ‐ WestSilver SpringMDUSA
| | | | | | | | - Kelsey Hobbs
- Department of PsychologyUniversity of MinnesotaMinneapolisMNUSA
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty MannheimUniversity of HeidelbergGermany,ESRC Centre for Society and Mental HealthKing's College LondonLondonUK,Centre for Epidemiology and Public HealthInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance AbuseUniversity of SydneySydneyNSWAustralia
| | - Susan C. South
- Department of Psychological SciencesPurdue UniversityWest LafayetteINUSA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance AbuseUniversity of SydneySydneyNSWAustralia
| | | | | | | | - David H. Zald
- Department of PsychologyVanderbilt UniversityNashvilleTNUSA
| | | | - David Watson
- Department of PsychologyUniversity of Notre DameSouth BendINUSA
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Ortiz BB, Higuchi CH, Noto C, Joyce DW, Correll CU, Bressan RA, Gadelha A. A symptom combination predicting treatment-resistant schizophrenia - A strategy for real-world clinical practice. Schizophr Res 2020; 218:195-200. [PMID: 31956005 DOI: 10.1016/j.schres.2020.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 01/01/2020] [Accepted: 01/06/2020] [Indexed: 01/24/2023]
Abstract
Early identification of symptoms that can predict treatment-resistant schizophrenia (TRS) could help clinicians to avoid delays in clozapine therapy. This study aims to investigate symptom patterns that could predict TRS using a discovery/replication study design. First, we followed a cohort of inpatients with schizophrenia (n = 164) in which the most discriminative items at baseline of the Positive and Negative Syndrome Scale (PANSS) were determined using logistic regression with TRS status as an outcome. Using Receiver Operating Characteristic (ROC) curves, we tested the prediction performance of multiple combinations of the identified items. The same items' combination was tested in an independent replication sample of (n = 207) outpatients with schizophrenia. In the discovery sample, the best combination to predict TRS at the discharge was the sum of three baseline PANSS items - conceptual disorganization (P2), difficulty in abstract thinking (N5), and unusual thought content (G9). The P2 + N5 + G9 model yielded an area under the curve (AUC) of 0.881, a sensitivity of 77.8%, and a specificity of 83.3%. In the outpatient sample, the model P2 + N5 + G9 predictive accuracy for TRS was only in the range of "acceptable" with an AUC of 0.756 and sensitivity of 72.3% and a specificity of 74.4%. Overall, the P2 + N5 + G9 model corresponds to the construct of formal thought disorder composed of disorganized thinking, concrete thinking, and bizarre-idiosyncratic thinking. Pronounced levels of these symptoms are easily identifiable in clinical practice and may be a feasible strategy in TRS. Replicating in first-episode cohorts is desirable to understand the likely clinical utility.
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Affiliation(s)
- Bruno B Ortiz
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Cinthia H Higuchi
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Cristiano Noto
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Dan W Joyce
- Cognition, Schizophrenia & Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Christoph U Correll
- Department of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA; Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, New York, USA
| | - Rodrigo A Bressan
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Cognition, Schizophrenia & Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ary Gadelha
- Interdisciplinary Laboratory of Clinical Neurosciences (LiNC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Schizophrenia Program (Proesq), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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83
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Valiengo LDCL, Goerigk S, Gordon PC, Padberg F, Serpa MH, Koebe S, dos Santos LA, Lovera RAM, de Carvalho JB, van de Bilt M, Lacerda ALT, Elkis H, Gattaz WF, Brunoni AR. Efficacy and Safety of Transcranial Direct Current Stimulation for Treating Negative Symptoms in Schizophrenia: A Randomized Clinical Trial. JAMA Psychiatry 2020; 77:121-129. [PMID: 31617873 PMCID: PMC6802484 DOI: 10.1001/jamapsychiatry.2019.3199] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Negative symptoms represent a substantial burden in schizophrenia. Although preliminary studies have suggested that transcranial direct current stimulation (tDCS) is effective for some clusters of symptoms, the clinical benefits for negative symptoms are unclear. OBJECTIVE To determine the efficacy and safety of tDCS vs sham as an add-on treatment for patients with schizophrenia and predominant negative symptoms. DESIGN, SETTING, AND PARTICIPANTS The double-blind Schizophrenia Treatment With Electric Transcranial Stimulation (STARTS) randomized clinical trial was conducted from September 2014 to March 2018 in 2 outpatient clinics in the state of São Paulo, Brazil. Patients with schizophrenia with stable negative and positive symptoms and a minimum score of 20 points in the negative symptoms subscale of the Positive and Negative Syndrome Scale (PANSS) were included. INTERVENTIONS Ten sessions of tDCS performed twice a day for 5 days or a sham procedure. The anode and the cathode were positioned over the left prefrontal cortex and the left temporoparietal junction, respectively. MAIN OUTCOMES AND MEASURES Change in the PANSS negative symptoms subscale score at week 6 was the primary outcome. Patients were followed-up for an additional 6 weeks. RESULTS Of the 100 included patients, 20 (20.0%) were female, and the mean (SD) age was 35.3 (9.3) years. A total of 95 patients (95.0%) finished the trial. In the intention-to-treat analysis, patients receiving active tDCS showed a significantly greater improvement in PANSS score compared with those receiving the sham procedure (difference, 2.65; 95% CI, 1.51-3.79; number needed to treat, 3.18; 95% CI, 2.12-6.99; P < .001). Response rates for negative symptoms (20% improvement or greater) were also higher in the active group (20 of 50 [40%]) vs the sham group (2 of 50 [4%]) (P < .001). These effects persisted at follow-up. Transcranial direct current stimulation was well tolerated, and adverse effects did not differ between groups, except for burning sensation over the scalp in the active group (43.8%) vs the sham group (14.3%) (P = .003). CONCLUSIONS AND RELEVANCE Transcranial direct current stimulation was effective and safe in ameliorating negative symptoms in patients with schizophrenia. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02535676.
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Affiliation(s)
- Leandro da Costa Lane Valiengo
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany,Department of Psychological Methodology and Assessment, Ludwig Maximilian University of Munich, Munich, Germany,Hochschule Fresenius, University of Applied Sciences, Munich, Germany
| | - Pedro Caldana Gordon
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil,Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Mauricio Henriques Serpa
- Laboratory of Neuroimaging (LIM-21), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Stephanie Koebe
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Juliana Barbosa de Carvalho
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Martinus van de Bilt
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Acioly L. T. Lacerda
- Programa de Transtornos Afetivos, Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Helio Elkis
- Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Wagner Farid Gattaz
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Andre R. Brunoni
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil,Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo and Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
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84
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Lee BJ, Kim SW, Kim JJ, Yu JC, Lee KY, Won SH, Lee SH, Kim SH, Kang SH, Kim E, Kim K, Piao YH, Chung YC. Defining Treatment Response, Remission, Relapse, and Recovery in First-Episode Psychosis: A Survey among Korean Experts. Psychiatry Investig 2020; 17:163-174. [PMID: 32093460 PMCID: PMC7046996 DOI: 10.30773/pi.2019.0240] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/17/2019] [Accepted: 12/02/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE For the proper treatment of first-episode psychosis, assessment of treatment response, remission, relapse, and recovery is important. Therefore, the present study aimed to develop operational definitions of clinical outcomes in first-episode psychosis. METHODS A questionnaire was developed by a panel of experts and underwent three revisions. The final survey was presented to 150 psychiatrists who were members of the Korean Society for Schizophrenia Research. Respondents selected factors that they believed were important to consider while defining treatment response, remission, relapse, and recovery using a 6-point Likert scale. Selected factors that constituted each definition were statistically extracted, and operational definitions were developed. RESULTS A total of 91 experts responded to the survey. The extent of reduction in psychopathology, socio-occupational functioning, and duration of each state were the core factors of each definition. Outcomes obtained from discussions and consultations by experts have been summarized and proposed. CONCLUSION The criteria developed in this survey tended to be somewhat stricter than those used by other studies. The fundamental reason for this is that this survey focused on first-episode psychosis. A better understanding of each definition in first-episode psychosis is necessary to improve effective treatment outcomes.
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Affiliation(s)
- Bong Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jung Jin Kim
- Department of Psychiatry, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Republic of Korea
| | - Je-Chun Yu
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - Kyu Young Lee
- Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Republic of Korea
| | - Seung-Hee Won
- Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Goyang, Republic of Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Republic of Korea
| | - Shi Hyun Kang
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Euitae Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kunhyung Kim
- Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| | - Yang Hong Piao
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
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85
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Brunet-Gouet E, Urbach M, Ramos V, Ehrminger M, Aouizerate B, Brunel L, Capdevielle D, Chereau I, Dubertret C, Dubreucq J, Fond G, Lançon C, Leignier S, Mallet J, Misdrahi D, Pires S, Schneider P, Schürhoff F, Yazbek H, Zinetti-Bertschy A, Bazin N, Passerieux C, Roux P. Assessing metacognitive and help-seeking strategies in schizophrenia: design and psychometric validation of the Versailles Metacognitive Strategies Evaluation Questionnaire. Clin Rehabil 2019; 34:263-275. [PMID: 31795759 DOI: 10.1177/0269215519888784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study is to design a questionnaire, the Versailles Metacognitive Strategies Evaluation Questionnaire, for assessing the use of metacognitive and help-seeking strategies in three key-domains of impaired daily functioning in schizophrenia. To evaluate its psychometric properties (internal consistency, factor structure, convergent and divergent validity, and stability). DESIGN Development of a questionnaire and psychometric validation procedure in patients with schizophrenia compared with healthy controls. Stability over one year was assessed in the patient group. SETTING Schizophrenia Centers of Expertise (French FondaMental Network). SUBJECTS A total of 141 patients with schizophrenia, among whom 77 participated in the second evaluation; 97 healthy subjects. MAIN MEASURES The Versailles Metacognitive Strategies Evaluation Questionnaire, Positive and Negative Symptoms Scale, Personal and Social Performance Scale, Evaluation of Cognitive Processes involved in Disability in Schizophrenia Scale, Schizophrenia Quality of Life Questionnaire, and Stages of Recovery Instrument. RESULTS From the 36-items version, stepwise exploratory factor analysis (oblimin) produced a 25-items scale which had a 3-factors structure (hygiene concern, social relationships, and hygiene help-seeking). Cronbach's were respectively equal to 0.91, 0.82, and 0.78. One-year stability was good (intra-class correlation coefficient = 0.7). The three factors showed good convergent validity with measures of quality of life (rho = 0.34, P ⩽ 0.001). The first two factors correlated with recovery (N = 34, rho = 0.53, P ⩽ 0.001). On the contrary, the factors exhibited divergent validity, with no significant correlation, with symptoms and cognitive and psychosocial functioning (P > 0.05). Factor structure in healthy controls did not match with that of patients, all items but one were found significantly different among groups. CONCLUSION The Versailles Metacognitive Strategies Evaluation Questionnaire provides a simple and valid means to assess metacognitive strategies in individuals with schizophrenia.
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Affiliation(s)
- Eric Brunet-Gouet
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Mathieu Urbach
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Veronica Ramos
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Mickael Ehrminger
- HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France.,University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Lore Brunel
- Fondation FondaMental, Créteil, France.,Translational Psychiatry Team, INSERM U955, Creteil, France.,AP-HP Mondor University Hospital, DHU Pe-PSY, Schizophrenia Expert Center, Creteil, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France.,Inserm U1061, Service Universitaire de Psychiatrie adulte, Hôpital la Colombière, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Isabelle Chereau
- Fondation FondaMental, Créteil, France.,CHU Clermont-Ferrand, Service de psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France.,Inserm U894, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Paris, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France.,Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Guillaume Fond
- Fondation FondaMental, Créteil, France.,Hopital de la conception, AMU CEReSS u 3729, Marseille, France
| | - Christophe Lançon
- Fondation FondaMental, Créteil, France.,Hopital Sainte-Marguerite, Marseille, France
| | - Sylvain Leignier
- Fondation FondaMental, Créteil, France.,Psychosocial Rehabilitation Reference Centre, Alpes Isère Hospital, Grenoble, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France.,AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France.,Inserm U894, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Paris, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France.,University of Bordeaux, CNRS UMR 5287-INCIA, Bordeaux, France
| | - Sylvie Pires
- Fondation FondaMental, Créteil, France.,CHU Clermont-Ferrand, Service de psychiatrie B, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Priscille Schneider
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France.,University of Strasbourg, Strasbourg, France.,Inserm U1114, Strasbourg, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France.,Translational Psychiatry Team, INSERM U955, Creteil, France.,AP-HP Mondor University Hospital, DHU Pe-PSY, Schizophrenia Expert Center, Creteil, France
| | - Hanan Yazbek
- Fondation FondaMental, Créteil, France.,Inserm U1061, Service Universitaire de Psychiatrie adulte, Hôpital la Colombière, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Anna Zinetti-Bertschy
- Fondation FondaMental, Créteil, France.,Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France.,University of Strasbourg, Strasbourg, France.,Inserm U1114, Strasbourg, France
| | - Nadine Bazin
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Centre Hospitalier de Versailles, Le Chesnay, France.,HandiRESP Laboratory, EA4047, Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France
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