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de Zwarte SMC, Brouwer RM, Agartz I, Alda M, Aleman A, Alpert KI, Bearden CE, Bertolino A, Bois C, Bonvino A, Bramon E, Buimer EEL, Cahn W, Cannon DM, Cannon TD, Caseras X, Castro-Fornieles J, Chen Q, Chung Y, De la Serna E, Di Giorgio A, Doucet GE, Eker MC, Erk S, Fears SC, Foley SF, Frangou S, Frankland A, Fullerton JM, Glahn DC, Goghari VM, Goldman AL, Gonul AS, Gruber O, de Haan L, Hajek T, Hawkins EL, Heinz A, Hillegers MHJ, Hulshoff Pol HE, Hultman CM, Ingvar M, Johansson V, Jönsson EG, Kane F, Kempton MJ, Koenis MMG, Kopecek M, Krabbendam L, Krämer B, Lawrie SM, Lenroot RK, Marcelis M, Marsman JBC, Mattay VS, McDonald C, Meyer-Lindenberg A, Michielse S, Mitchell PB, Moreno D, Murray RM, Mwangi B, Najt P, Neilson E, Newport J, van Os J, Overs B, Ozerdem A, Picchioni MM, Richter A, Roberts G, Aydogan AS, Schofield PR, Simsek F, Soares JC, Sugranyes G, Toulopoulou T, Tronchin G, Walter H, Wang L, Weinberger DR, Whalley HC, Yalin N, Andreassen OA, Ching CRK, van Erp TGM, Turner JA, Jahanshad N, Thompson PM, Kahn RS, van Haren NEM. The Association Between Familial Risk and Brain Abnormalities Is Disease Specific: An ENIGMA-Relatives Study of Schizophrenia and Bipolar Disorder. Biol Psychiatry 2019; 86:545-556. [PMID: 31443932 PMCID: PMC7068800 DOI: 10.1016/j.biopsych.2019.03.985] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/19/2019] [Accepted: 03/24/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schizophrenia and bipolar disorder share genetic liability, and some structural brain abnormalities are common to both conditions. First-degree relatives of patients with schizophrenia (FDRs-SZ) show similar brain abnormalities to patients, albeit with smaller effect sizes. Imaging findings in first-degree relatives of patients with bipolar disorder (FDRs-BD) have been inconsistent in the past, but recent studies report regionally greater volumes compared with control subjects. METHODS We performed a meta-analysis of global and subcortical brain measures of 6008 individuals (1228 FDRs-SZ, 852 FDRs-BD, 2246 control subjects, 1016 patients with schizophrenia, 666 patients with bipolar disorder) from 34 schizophrenia and/or bipolar disorder family cohorts with standardized methods. Analyses were repeated with a correction for intracranial volume (ICV) and for the presence of any psychopathology in the relatives and control subjects. RESULTS FDRs-BD had significantly larger ICV (d = +0.16, q < .05 corrected), whereas FDRs-SZ showed smaller thalamic volumes than control subjects (d = -0.12, q < .05 corrected). ICV explained the enlargements in the brain measures in FDRs-BD. In FDRs-SZ, after correction for ICV, total brain, cortical gray matter, cerebral white matter, cerebellar gray and white matter, and thalamus volumes were significantly smaller; the cortex was thinner (d < -0.09, q < .05 corrected); and third ventricle was larger (d = +0.15, q < .05 corrected). The findings were not explained by psychopathology in the relatives or control subjects. CONCLUSIONS Despite shared genetic liability, FDRs-SZ and FDRs-BD show a differential pattern of structural brain abnormalities, specifically a divergent effect in ICV. This may imply that the neurodevelopmental trajectories leading to brain anomalies in schizophrenia or bipolar disorder are distinct.
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Affiliation(s)
- Sonja M C de Zwarte
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
| | - Rachel M Brouwer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research (NORMENT), K.G. Jebsen Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute of Mental Health, Klecany, Czech Republic
| | - André Aleman
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Kathryn I Alpert
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California; Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Catherine Bois
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Aurora Bonvino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Elvira Bramon
- Division of Psychiatry, Neuroscience in Mental Health Research Department, University College London, London, United Kingdom
| | - Elizabeth E L Buimer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Dara M Cannon
- Centre for Neuroimaging and Cognitive Genomics and National Centre for Biomedical Engineering (NCBES), Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, Connecticut, United Kingdom
| | - Xavier Caseras
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, United Kingdom
| | - Josefina Castro-Fornieles
- Psychology and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic of Barcelona, Institute d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Spain
| | - Qiang Chen
- Lieber Institute for Brain Development, Baltimore, Maryland
| | - Yoonho Chung
- Department of Psychology, Yale University, New Haven, Connecticut, United Kingdom
| | - Elena De la Serna
- Psychology and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic of Barcelona, Institute d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Spain
| | - Annabella Di Giorgio
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Gaelle E Doucet
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mehmet Cagdas Eker
- SoCAT LAB, Department of Psychiatry, School of Medicine, Ege University, Bornova, Izmir, Turkey; Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Susanne Erk
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Scott C Fears
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California; Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, California
| | - Sonya F Foley
- Cardiff University Brain Research Imaging Centre, Cardiff University, United Kingdom
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrew Frankland
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Janice M Fullerton
- School of Medical Sciences, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - David C Glahn
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, Connecticut; Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Vina M Goghari
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada; Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
| | | | - Ali Saffet Gonul
- SoCAT LAB, Department of Psychiatry, School of Medicine, Ege University, Bornova, Izmir, Turkey; Department of Psychiatry and Behavioral Sciences, Mercer University School of Medicine, Macon, Georgia
| | - Oliver Gruber
- Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Lieuwe de Haan
- Early Psychosis Unit, Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute of Mental Health, Klecany, Czech Republic
| | - Emma L Hawkins
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Andreas Heinz
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Manon H J Hillegers
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Hilleke E Hulshoff Pol
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Martin Ingvar
- Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Viktoria Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik G Jönsson
- Norwegian Centre for Mental Disorders Research (NORMENT), K.G. Jebsen Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Fergus Kane
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Matthew J Kempton
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Marinka M G Koenis
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, Connecticut; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Miloslav Kopecek
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lydia Krabbendam
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behaviour and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Bernd Krämer
- Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Stephen M Lawrie
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Rhoshel K Lenroot
- Neuroscience Research Australia, Sydney, Australia; Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, New Mexico
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, Maastricht, Netherlands
| | - Jan-Bernard C Marsman
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Venkata S Mattay
- Lieber Institute for Brain Development, Baltimore, Maryland; Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Colm McDonald
- Centre for Neuroimaging and Cognitive Genomics and National Centre for Biomedical Engineering (NCBES), Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - Andreas Meyer-Lindenberg
- Clinical Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, Maastricht, Netherlands
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Dolores Moreno
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Robin M Murray
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Benson Mwangi
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Pablo Najt
- Centre for Neuroimaging and Cognitive Genomics and National Centre for Biomedical Engineering (NCBES), Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - Emma Neilson
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Jason Newport
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, Maastricht, Netherlands
| | | | - Aysegul Ozerdem
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York; Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Marco M Picchioni
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Anja Richter
- Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Aybala Saricicek Aydogan
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey; Department of Psychiatry, Faculty of Medicine, Izmir Katip Çelebi University, Izmir, Turkey
| | - Peter R Schofield
- School of Medical Sciences, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - Fatma Simsek
- SoCAT LAB, Department of Psychiatry, School of Medicine, Ege University, Bornova, Izmir, Turkey; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, Cigli State Hospital, Izmir, Turkey
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Gisela Sugranyes
- Psychology and Psychology, 2017SGR881, Institute of Neuroscience, Hospital Clínic of Barcelona, Institute d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), University of Barcelona, Spain
| | - Timothea Toulopoulou
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychology, Bilkent University, Ankara, Turkey; Department of Psychology, University of Hong Kong, Hong Kong, China
| | - Giulia Tronchin
- Centre for Neuroimaging and Cognitive Genomics and National Centre for Biomedical Engineering (NCBES), Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
| | - Henrik Walter
- Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Heather C Whalley
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Nefize Yalin
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), K.G. Jebsen Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Christopher R K Ching
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California; Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California; Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California; Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, California
| | - Jessica A Turner
- Department of Psychology, Georgia State University, Atlanta, Georgia; Neuroscience Institute, Georgia State University, Atlanta, Georgia
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California
| | - René S Kahn
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Neeltje E M van Haren
- Department of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
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Christiani CJ, Jepsen JRM, Thorup A, Hemager N, Ellersgaard D, Spang KS, Burton BK, Gregersen M, Søndergaard A, Greve AN, Gantriis DL, Poulsen G, Uddin MJ, Seidman LJ, Mors O, Plessen KJ, Nordentoft M. Social Cognition, Language, and Social Behavior in 7-Year-Old Children at Familial High-Risk of Developing Schizophrenia or Bipolar Disorder: The Danish High Risk and Resilience Study VIA 7-A Population-Based Cohort Study. Schizophr Bull 2019; 45:1218-1230. [PMID: 30852621 PMCID: PMC6811824 DOI: 10.1093/schbul/sbz001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To characterize social cognition, language, and social behavior as potentially shared vulnerability markers in children at familial high-risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP). METHODS The Danish High-Risk and Resilience Study VIA7 is a multisite population-based cohort of 522 7-year-old children extracted from the Danish registries. The population-based controls were matched to the FHR-SZ children on age, sex, and municipality. The FHR-BP group followed same inclusion criteria. Data were collected blinded to familial high-risk status. Outcomes were social cognition, language, and social behavior. RESULTS The analysis included 202 FHR-SZ children (girls: 46%), 120 FHR-BP children (girls: 46.7%), and 200 controls (girls: 46.5%). FHR-SZ children displayed significant deficits in language (receptive: d = -0.27, P = .006; pragmatic: d = -0.51, P < .001), social responsiveness (d = -0.54, P < .001), and adaptive social functioning (d = -0.47, P < .001) compared to controls after Bonferroni correction. Compared to FHR-BP children, FHR-SZ children performed significantly poorer on adaptive social functioning (d = -0.29, P = .007) after Bonferroni correction. FHR-BP and FHR-SZ children showed no significant social cognitive impairments compared to controls after Bonferroni correction. CONCLUSION Language, social responsiveness, and adaptive social functioning deficits seem associated with FHR-SZ but not FHR-BP in this developmental phase. The pattern of results suggests adaptive social functioning impairments may not be shared between FHR-BP and FHR-SZ in this developmental phase and thus not reflective of the shared risk factors for schizophrenia and bipolar disorder.
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Affiliation(s)
- Camilla Jerlang Christiani
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,To whom correspondence should be addressed; Mental Health Centre Copenhagen, Research Unit, The Danish High Risk and Resilience Study VIA 7; Kildegaardsvej 28, 15., 1., 2900 Hellerup, Denmark; tel: +4520220285; e-mail:
| | - Jens R M Jepsen
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Thorup
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Nicoline Hemager
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Ditte Ellersgaard
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Katrine S Spang
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Birgitte K Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Maja Gregersen
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Anne Søndergaard
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark
| | - Aja N Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte L Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Gry Poulsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Md Jamal Uddin
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin J Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,Services of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Merete Nordentoft
- Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Abstract
BACKGROUND Schizophrenia is associated with significant cognitive impairment. However, the pathophysiological mechanisms underlying cognitive dysfunction in schizophrenia remain unclear. Brain-derived neurotrophic factor (BDNF) and C-reactive protein (CRP) are among the most commonly investigated peripheral markers of cognition in schizophrenia. METHODS A systematic review in PubMed and Scopus databases was performed until 31 January 2019 to assess the relationship between cognitive impairment, CRP and BDNF levels in schizophrenia. A random-effects meta-analysis was conducted. RESULTS Current meta-analysis included 21 studies including 2449 patients with schizophrenia-spectrum disorders. Overall, both BDNF [r = 0.12, confidence interval (CI) 0.04-0.19] and CRP (r = -0.13, CI 0.08-0.18) levels were very modestly but significantly related to cognitive functioning in schizophrenia (r = 0.12, CI 0.04-0.19). In meta-analyses of cognitive domains, BDNF levels were significantly associated with verbal memory (r = 0.16, CI 0.09-0.23), working memory (r = 0.14, CI 0.06-0.22), processing speed (r = 0.18, CI 0.10-0.26) and verbal fluency (r = 0.09, CI 0-0.18) performances. Elevated CRP levels were related to all cognitive domains (r = -0.09 to -0.13) except for fluency. Subgroup analyses suggested that the relationship between cognitive and BDNF levels were more pronounced in chronic samples. CONCLUSIONS Current findings suggest that cognitive impairment in schizophrenia is significantly related to elevated CRP and reduced BDNF levels in schizophrenia, particularly in chronic samples. However, small effect sizes of these correlations suggest that inflammation and decreased BDNF levels do not play a major role in cognitive dysfunction in most patients with schizophrenia. Further studies are needed to investigate the potential intermediating and confounding factors which can influence the level of relationship between inflammation, neurotrophic factors and cognition in schizophrenia.
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, Dokuz Eylul University Medical School, Izmir 35340, Turkey
- Department of Neuroscience, Dokuz Eylul University, Izmir 35340, Turkey
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia
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54
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Chu AOK, Chang WC, Chan SKW, Lee EHM, Hui CLM, Chen EYH. Comparison of cognitive functions between first-episode schizophrenia patients, their unaffected siblings and individuals at clinical high-risk for psychosis. Psychol Med 2019; 49:1929-1936. [PMID: 30226125 DOI: 10.1017/s0033291718002726] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cognitive impairment is a core feature of schizophrenia and has been observed in both familial (FHR) and clinical high-risk (CHR) samples. Nonetheless, there is a paucity of research directly contrasting cognitive profiles in these two high-risk states and first-episode schizophrenia. This study aimed to compare cognitive functions in patients with first-episode schizophrenia-spectrum disorder (FES), their unaffected siblings (FHR), CHR individuals and healthy controls. METHOD A standardized battery of cognitive assessments was administered to 69 FES patients, 71 help-seeking CHR individuals without family history of psychotic disorder, 50 FHR participants and 68 controls. FES and CHR participants were recruited from territory-wide early intervention service for psychosis in Hong Kong. CHR status was ascertained using Comprehensive Assessment of At-Risk Mental State. RESULTS Among four groups, FES patients displayed the largest global cognitive impairment and had medium-to-large deficits across all cognitive tests relative to controls. CHR and FHR participants significantly underperformed in most cognitive tests than controls. Among various cognitive tests, digit symbol coding demonstrated the greatest magnitude of impairment in FES and CHR groups compared with controls. No significant difference between two high-risk groups was observed in global cognition and all individual cognitive tests except digit symbol coding which showed greater deficits in CHR than in FHR participants. CONCLUSION Clinical and familial risk groups experienced largely comparable cognitive impairment that was intermediate between FES and controls. Digit symbol coding may have the greatest discriminant capacity in distinguishing FES and CHR from healthy controls, and between two high-risk samples.
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55
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Social cognitions in siblings of patients with schizophrenia: a comparison with patients with schizophrenia and healthy controls - a cross-sectional study. Asian J Psychiatr 2019; 43:24-33. [PMID: 31078092 DOI: 10.1016/j.ajp.2019.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/04/2019] [Accepted: 04/22/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND There are limited number of studies which have evaluated social cognitive deficits among the siblings of patients with schizophrenia. AIM This study aimed to evaluate the social cognitive deficits and its correlates among siblings of patients with schizophrenia. METHODOLOGY Patients of schizophrenia (N = 34), their siblings (N = 34) and healthy control subjects (N = 31) matched for age, gender, education and intelligence quotient were evaluated on social cognition rating tools in Indian setting (SOCRATIS). Patients were additionally evaluated on Positive and Negative Symptom Scale (PANSS). Siblings were assessed on Comprehensive Assessment for at risk mental state (CAARMS) scale and Short Wisconsin Schizotypy scale. Neurocognitive test battery was applied to all the groups. RESULTS Patients with schizophrenia performed the worst and the healthy controls performed the best, with siblings falling intermediate on all the subtests of social cognition (except for externalizing bias and personalized bias) and neurocognition. There were negative correlation between some of the domains of social cognition and various domains of CAARMS. Higher level of schizotypy was associated with higher level of social cognitive deficits. CONCLUSION Social cognitive deficits can act as an important endophenotype for estimating the risk of schizophrenia in at risk siblings. Further, social cognitive deficits must be considered as important target for intervention among the at risk siblings to improve their outcome.
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Müller AD, Gjøde ICT, Eigil MS, Busck H, Bonne M, Nordentoft M, Thorup AAE. VIA Family-a family-based early intervention versus treatment as usual for familial high-risk children: a study protocol for a randomized clinical trial. Trials 2019; 20:112. [PMID: 30736834 PMCID: PMC6368720 DOI: 10.1186/s13063-019-3191-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 01/10/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Children born to parents with a severe mental illness, like schizophrenia, bipolar disorder, or major recurrent depression, have an increased risk of developing a mental illness themselves during life. These children are also more likely to have developmental delays, cognitive disabilities, or social problems, and they may have a higher risk than the background population of experiencing adverse life events. This is due to both genetic and environmental factors, but despite the well-documented increased risk for children with a familial high risk, no family-based early intervention has been developed for them. This study aims to investigate the effect of an early intervention that focuses on reducing risk and increasing resilience for children in families where at least one parent has a severe mental illness. METHODS/DESIGN The study is a randomized clinical trial with 100 children aged 6-12 with familial high risk. It is performed in the context of the Danish health-care system. Families will be recruited from registers or be referred from the primary sector or hospitals. The children and their parents will be assessed at baseline and thereafter randomized and allocated to either treatment as usual or VIA Family. The intervention group will be assigned to a multidisciplinary team of specialists from adult mental health services, child and adolescent mental health services, and social services. This team will provide the basic treatment elements: case management, psychoeducation for the whole family, parental training, a safety plan, and potentially an early intervention if the child has mental problems. The study period is 18 months for both groups, and all participants will be assessed at baseline and after 18 months. The primary outcome measure will be daily functioning of the child, and the secondary measures are the psychopathology of the child, days of absence from school, family functioning, child's home environment, and parental stress. DISCUSSION This study is to our knowledge the first to explore the effects of a multidisciplinary team intervention that provides an intensive and flexible support to match the families' needs for children with a familial high risk for severe mental illness. The study will provide important knowledge about the potential for increasing resilience and reducing risk for children by supporting the whole family. However, a longer follow-up period may be needed. TRIAL REGISTRATION ClinicalTrials.gov, NCT03497663 . Registered on 13 April 2018.
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Affiliation(s)
- Anne D. Müller
- Research Unit, Child and Adolescent Mental Health Center, Lersø Parkallé 107, 1 th, 2100 Copenhagen, Capital Region of Denmark Denmark
| | - Ida C. T. Gjøde
- Research Unit, Child and Adolescent Mental Health Center, Lersø Parkallé 107, 1 th, 2100 Copenhagen, Capital Region of Denmark Denmark
| | - Mette S. Eigil
- Research Unit, Child and Adolescent Mental Health Center, Lersø Parkallé 107, 1 th, 2100 Copenhagen, Capital Region of Denmark Denmark
| | - Helle Busck
- Mental Health Center, Copenhagen, Capital Region of Denmark Denmark
| | - Merete Bonne
- Municipality of Frederiksberg, Family Department, Copenhagen, Denmark
| | - Merete Nordentoft
- Mental Health Center, Copenhagen, Capital Region of Denmark Denmark
- University of Copenhagen, Institute for Clinical Medicine, Faculty of Health Science, Copenhagen, Capital Region of Denmark Denmark
| | - Anne A. E. Thorup
- Research Unit, Child and Adolescent Mental Health Center, Lersø Parkallé 107, 1 th, 2100 Copenhagen, Capital Region of Denmark Denmark
- University of Copenhagen, Institute for Clinical Medicine, Faculty of Health Science, Copenhagen, Capital Region of Denmark Denmark
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Gilmour G, Porcelli S, Bertaina-Anglade V, Arce E, Dukart J, Hayen A, Lobo A, Lopez-Anton R, Merlo Pich E, Pemberton DJ, Havenith MN, Glennon JC, Harel BT, Dawson G, Marston H, Kozak R, Serretti A. Relating constructs of attention and working memory to social withdrawal in Alzheimer’s disease and schizophrenia: issues regarding paradigm selection. Neurosci Biobehav Rev 2019; 97:47-69. [DOI: 10.1016/j.neubiorev.2018.09.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 08/29/2018] [Accepted: 09/27/2018] [Indexed: 12/12/2022]
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Kelly S, Guimond S, Lyall A, Stone WS, Shenton ME, Keshavan M, Seidman LJ. Neural correlates of cognitive deficits across developmental phases of schizophrenia. Neurobiol Dis 2018; 131:104353. [PMID: 30582983 DOI: 10.1016/j.nbd.2018.12.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 11/21/2018] [Accepted: 12/20/2018] [Indexed: 12/28/2022] Open
Abstract
Schizophrenia is associated with cognitive deficits across all stages of the illness (i.e., high risk, first episode, early and chronic phases). Identifying the underlying neurobiological mechanisms of these deficits is an important area of scientific inquiry. Here, we selectively review evidence regarding the pattern of deficits across the developmental trajectory of schizophrenia using the five cognitive domains identified by the Research Domain Criteria (RDoC) initiative. We also report associated findings from neuroimaging studies. We suggest that most cognitive domains are affected across the developmental trajectory, with corresponding brain structural and/or functional differences. The idea of a common mechanism driving these deficits is discussed, along with implications for cognitive treatment in schizophrenia.
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Affiliation(s)
- Sinead Kelly
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Synthia Guimond
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Amanda Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - William S Stone
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
| | - Matcheri Keshavan
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Larry J Seidman
- Massachusetts Mental Health Center, Public Psychiatry Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Thorup AAE, Hemager N, Søndergaard A, Gregersen M, Prøsch ÅK, Krantz MF, Brandt JM, Carmichael L, Melau M, Ellersgaard DV, Burton BK, Greve AN, Uddin MJ, Ohland J, Nejad AB, Johnsen LK, Ver Loren van Themaat AH, Andreassen AK, Vedum L, Knudsen CB, Stadsgaard H, M. Jepsen JR, Siebner HR, Østergaard L, Bliksted VF, Plessen KJ, Mors O, Nordentoft M. The Danish High Risk and Resilience Study-VIA 11: Study Protocol for the First Follow-Up of the VIA 7 Cohort -522 Children Born to Parents With Schizophrenia Spectrum Disorders or Bipolar Disorder and Controls Being Re-examined for the First Time at Age 11. Front Psychiatry 2018; 9:661. [PMID: 30631284 PMCID: PMC6315161 DOI: 10.3389/fpsyt.2018.00661] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction: Offspring of parents with severe mental illness have an increased risk of developing mental illnesses themselves. Familial high risk cohorts give a unique opportunity for studying the development over time, both the illness that the individual is predisposed for and any other diagnoses. These studies can also increase our knowledge of etiology of severe mental illness and provide knowledge about the underlying mechanisms before illness develops. Interventions targeting this group are often proposed due to the potential possibility of prevention, but evidence about timing and content is lacking. Method: A large, representative cohort of 522 7-year old children born to parents with schizophrenia, bipolar disorder or controls was established based on Danish registers. A comprehensive baseline assessment including neurocognition, motor functioning, psychopathology, home environment, sociodemographic data, and genetic information was conducted from January 1, 2013 to January 31, 2016. This study is the first follow-up of the cohort, carried out when the children turn 11 years of age. By assessing the cohort at this age, we will evaluate the children twice before puberty. All instruments have been selected with a longitudinal perspective and most of them are identical to those used at inclusion into the study at age 7. A diagnostic interview, motor tests, and a large cognitive battery are conducted along with home visits and information from teachers. This time we examine the children's brains by magnetic resonance scans and electroencephalograms. Measures of physical activity and sleep are captured by a chip placed on the body, while we obtain biological assays by collecting blood samples from the children. Discussion: Findings from the VIA 7 study revealed large variations across domains between children born to parents with schizophrenia, bipolar and controls, respectively. This study will further determine whether the children at familial risk reveal delayed developmental courses, but catch up at age 11, or whether the discrepancies between the groups have grown even larger. We will compare subgroups within each of the familial high risk groups in order to investigate aspects of resilience. Data on brain structure and physical parameters will add a neurobiological dimension to the study.
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Affiliation(s)
- Anne A. E. Thorup
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Anne Søndergaard
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Maja Gregersen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Åsa Kremer Prøsch
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Mette F. Krantz
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Julie M. Brandt
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Line Carmichael
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Marianne Melau
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Ditte V. Ellersgaard
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte K. Burton
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
| | - Aja N. Greve
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Md Jamal Uddin
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Ohland
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
| | - Ayna B. Nejad
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance, Section 714, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Line K. Johnsen
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance, Section 714, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anna Hester Ver Loren van Themaat
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Danish Research Centre for Magnetic Resonance, Section 714, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anna K. Andreassen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Lotte Vedum
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Christina B. Knudsen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Henriette Stadsgaard
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Jens Richardt M. Jepsen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Section 714, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Leif Østergaard
- Center of Functionally Integrative Neuroscience, Aarhus University, Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Vibeke F. Bliksted
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
- Center of Functionally Integrative Neuroscience, Aarhus University, Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - Kerstin J. Plessen
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Unit, Child and Adolescent Mental Health Center, University of Copenhagen, Copenhagen, Denmark
- Division of Adolescent and Child Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Ole Mors
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Intiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Center Copenhagen, Research Unit, University of Copenhagen, Copenhagen, Denmark
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Dickson H, Cullen AE, Jones R, Reichenberg A, Roberts RE, Hodgins S, Morris RG, Laurens KR. Trajectories of cognitive development during adolescence among youth at-risk for schizophrenia. J Child Psychol Psychiatry 2018; 59:1215-1224. [PMID: 29683193 DOI: 10.1111/jcpp.12912] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Among adults with schizophrenia, evidence suggests that premorbid deficits in different cognitive domains follow distinct developmental courses during childhood and adolescence. The aim of this study was to delineate trajectories of adolescent cognitive functions prospectively among different groups of youth at-risk for schizophrenia, relative to their typically developing (TD) peers. METHOD Using linear mixed models adjusted for sex, ethnicity, parental occupation and practice effects, cognitive development between ages 9 and 16 years was compared for youth characterised by a triad of well-replicated developmental antecedents of schizophrenia (ASz; N = 32) and youth with a least one affected relative with schizophrenia or schizoaffective disorder (FHx; N = 29), relative to TD youth (N = 45). Participants completed measures of IQ, scholastic achievement, memory and executive function at three time-points, separated by approximately 24-month intervals. RESULTS Compared to TD youth, both ASz and FHx youth displayed stable developmental deficits in verbal working memory and inhibition/switching executive functions. ASz youth additionally presented with stable deficits in measures of vocabulary (IQ), word reading, numerical operations, and category fluency executive function, and a slower rate of growth (developmental lag) on spelling from 9 to 16 years than TD peers. Conversely, faster rates of growth relative to TD peers (developmental delay) were observed on visual and verbal memory, and on category fluency executive function (ASz youth only) and on matrix reasoning (IQ) and word reading (FHx youth only). CONCLUSIONS These differential patterns of deviation from normative adolescent cognitive development among at-risk youth imply potential for cognitive rehabilitation targeting of specific cognitive deficits at different developmental phases.
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Affiliation(s)
- Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
| | - Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Psychiatry and Preventive Medicine, The Freidman Brain Institute, Ichan School of Medicine at Mount Sinai, New York, NY, USA
| | - Ruth E Roberts
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sheilagh Hodgins
- Département de Psychiatrie, Université de Montréal, Montreal, QC, Canada
| | - Robin G Morris
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
| | - Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,School of Psychology, Australian Catholic University, Brisbane, QLD, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
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61
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Ranning A, Laursen T, Agerbo E, Thorup A, Hjorthøj C, Jepsen JRM, Nordentoft M. School performance from primary education in the adolescent offspring of parents with schizophrenia and bipolar disorder- a national, register-based study. Psychol Med 2018; 48:1993-2000. [PMID: 29239287 DOI: 10.1017/s0033291717003518] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Schizophrenia (SZ) and bipolar disorder (BP) are causes of severe disability worldwide and parents' severe mental illness (SMI) is associated with childhood adversity, and socio-emotional and cognitive problems in children. Yet, how parental BP and SZ affect educational attainment in offspring is still unclear. METHOD We included all children (N = 684.248) born and living in Denmark between 1986 and 1996 and their parents. Our follow-up lasted from 1986 until children's graduation in 2014. The main outcome variable was their school grades following their primary education. School outcomes were divided into four categories: not graduated, low-grade point average (GPA), medium GPA and high GPA. We then performed a multiple logistic regression with medium GPA as the reference category, with the children of parents without SZ or BP as the reference group. RESULTS Children of parents with SZ faced higher odds than their peers of not graduating primary education (OR 2.6), along with low GPA (odds ratios (OR) 1.6) and lower odds for a high GPA (OR 0.7). Moreover, it was the children of mothers rather than fathers with BP who had higher odds of not graduating primary education (OR 1.6). Lastly, child placement was associated with lower grades and lower graduation rates, and outcomes for children of parents with SMI were favorable compared with other children placed in care. CONCLUSION For children, parental SZ is associated with lower grades and lower chances for graduating primary education. In contrast, the children of parents with BP were indistinguishable from the reference group regarding school grades. This signifies that specificity of parental severe mental illness is important in relation to educational achievement of children.
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Affiliation(s)
- Anne Ranning
- Psychiatric Research Centre, Mental Health Center Copenhagen,Copenhagen,Capital Region of Denmark
| | - Thomas Laursen
- iPsych - The Lundbeck Foundation Initiative for Integrative Psychiatric Research,Denmark
| | - Esben Agerbo
- iPsych - The Lundbeck Foundation Initiative for Integrative Psychiatric Research,Denmark
| | - Anne Thorup
- Psychiatric Research Centre, Mental Health Center Copenhagen,Copenhagen,Capital Region of Denmark
| | - Carsten Hjorthøj
- Psychiatric Research Centre, Mental Health Center Copenhagen,Copenhagen,Capital Region of Denmark
| | | | - Merete Nordentoft
- Psychiatric Research Centre, Mental Health Center Copenhagen,Copenhagen,Capital Region of Denmark
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Zheng W, Zhang QE, Cai DB, Ng CH, Ungvari GS, Ning YP, Xiang YT. Neurocognitive dysfunction in subjects at clinical high risk for psychosis: A meta-analysis. J Psychiatr Res 2018; 103:38-45. [PMID: 29772485 DOI: 10.1016/j.jpsychires.2018.05.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 05/02/2018] [Accepted: 05/03/2018] [Indexed: 02/08/2023]
Abstract
Findings of neurocognitive dysfunction in subjects at Clinical High Risk for Psychosis (CHR-P) have been controversial. This meta-analysis systematically examined studies of neurocognitive functions using the MATRICS Consensus Cognitive Battery (MCCB) in CHR-P. An independent literature search of both English and Chinese databases was conducted by two reviewers. Standardized mean difference (SMD) was calculated using a random effects model to evaluate the effect size of the meta-analytic results. Six case-control studies (n = 396) comparing neurocognitive functions between CHR-P subjects (n = 197) and healthy controls (n = 199) using the MCCB were identified; 4 (66.7%) studies were rated as "high quality". Compared to healthy controls, CHR-P subjects showed impairment with large effect size in overall cognition (n = 128, SMD = -1.00, 95%CI: -1.38, -0.63, P < 0.00001; I2 = 2%), processing speed (SMD = -1.21) and attention/vigilance (SMD = -0.83), and with medium effect size in working memory (SMD = -0.76), reasoning and problem solving (SMD = -0.71), visual (SMD = -0.68) and verbal learning (SMD = -0.67). No significant difference between CHR-P subjects and controls was found regarding social cognition (SMD = -0.33, 95%CI: -0.76, 0.10, P = 0.14; I2 = 70%) with small effect size. Apart from social cognition, CHR-P subjects performed worse than healthy control in all MCCB cognitive domains, particularly in processing speed, attention/vigilance and working memory.
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Affiliation(s)
- Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Qing-E Zhang
- The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Dong-Bin Cai
- Clinics of Chinese Medicine, The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabor S Ungvari
- The University of Notre Dame Australia/Graylands Hospital, Perth, Australia
| | - Yu-Ping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Hemager N, Plessen KJ, Thorup A, Christiani C, Ellersgaard D, Spang KS, Burton BK, Gregersen M, Søndergaard A, Greve AN, Gantriis DL, Poulsen G, Seidman LJ, Mors O, Nordentoft M, Jepsen JRM. Assessment of Neurocognitive Functions in 7-Year-Old Children at Familial High Risk for Schizophrenia or Bipolar Disorder: The Danish High Risk and Resilience Study VIA 7. JAMA Psychiatry 2018; 75:844-852. [PMID: 29926086 PMCID: PMC6143091 DOI: 10.1001/jamapsychiatry.2018.1415] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
IMPORTANCE Children at familial high risk of schizophrenia spectrum disorders (FHR-SZ) or bipolar disorder (FHR-BP) exhibit neurocognitive impairments. Large studies of neurocognition in young children at familial high risk at the same age are important to differentiate the pathophysiology and developmental trajectory of these 2 groups. OBJECTIVE To characterize neurocognitive functions in 7-year-old children with FHR-SZ or FHR-BP and a control population. DESIGN, SETTING, AND PARTICIPANTS This multisite population-based cohort study collected data from January 1, 2013, to January 31, 2016, in the first wave of the Danish High Risk and Resilience Study VIA 7 at 2 university hospital research sites in Copenhagen and Aarhus using Danish registries. Participants (n = 514) included 197 children with FHR-SZ, 118 with FHR-BP, and 199 controls matched with the FHR-SZ group for age, sex, and municipality. Assessors were blinded to risk status. EXPOSURES Parents with schizophrenia, bipolar disorder, or neither diagnosis. MAIN OUTCOMES AND MEASURES Neurocognitive functions were measured across 23 tests. Four neurocognitive domains were derived by principal component analysis, including processing speed and working memory, verbal functions, executive and visuospatial functions, and declarative memory and attention. RESULTS A total of 514 children aged 7 years were included in the analysis (46.3% girls), consisting of 197 children with FHR-SZ (46.2% girls), 118 with FHR-BP (46.6% girls), and 199 controls (46.2% girls). Children with FHR-SZ were significantly impaired compared with controls on processing speed and working memory (Cohen d = 0.50; P < .001), executive and visuospatial functions (Cohen d = 0.28; P = .03), and declarative memory and attention (Cohen d = 0.29; P = .02). Compared with children with FHR-BP, children with FHR-SZ performed significantly poorer in processing speed and working memory (Cohen d = 0.40; P = .002), executive and visuospatial functions (Cohen d = 0.35; P = .008), and declarative memory and attention (Cohen d = 0.31; P = .03). Children with FHR-BP and controls did not differ. CONCLUSIONS AND RELEVANCE Children with FHR-SZ had widespread neurocognitive impairments, supporting the hypothesis of neurocognitive functions as endophenotypes of schizophrenia. The absence of neurocognitive deficits in children with FHR-BP suggests distinct neurodevelopmental manifestations in these familial high-risk groups at this age. Early detection of children with FHR-SZ and cognitive impairments is warranted to investigate associations of neurocognition with transition to psychosis, add to the knowledge of their developmental pathophysiology, and inform early intervention programs.
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Affiliation(s)
- Nicoline Hemager
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Kerstin J. Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Lausanne, Switzerland
| | - Anne Thorup
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Camilla Christiani
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Ditte Ellersgaard
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Katrine Søborg Spang
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Maja Gregersen
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Anne Søndergaard
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte Lou Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Gry Poulsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Larry J. Seidman
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen,Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark,Center for Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, Copenhagen,Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services, Capital Region of Denmark, Copenhagen
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Amaresha AC, Kalmady SV, Joseph B, Agarwal SM, Narayanaswamy JC, Venkatasubramanian G, Muralidhar D, Subbakrishna DK. Short term effects of brief need based psychoeducation on knowledge, self-stigma, and burden among siblings of persons with schizophrenia: A prospective controlled trial. Asian J Psychiatr 2018; 32:59-66. [PMID: 29216608 DOI: 10.1016/j.ajp.2017.11.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/27/2017] [Indexed: 11/29/2022]
Abstract
Siblings of persons with schizophrenia are important in providing long-term social support to the patients. Interventions addressing their needs are very sparse. Hence, this study aimed at testing the short-term effects of brief need based psychoeducation on knowledge, self-stigma, and burden among siblings of persons with schizophrenia. In this prospective controlled open label trial, 80 siblings of persons with schizophrenia were allocated in equal numbers to the brief need based psychoeducation group and the treatment-as-usual group. The outcomes were measured at baseline, and after the first and third month post-intervention. RM-ANCOVA was conducted to test the effect of the brief psychoeducation on outcome scores. The groups were similar with respect to socio-demographic, clinical, and outcome scores at the baseline. There was a significant group×time interaction effect on knowledge (F=8.71; p<0.01; ηp2=0.14) and self-stigma scores (F=14.47; p<0.001; ηp2=0.21), wherein the brief psychoeducation group showed a significant increase in knowledge and reduction in self-stigma with medium effect size through baseline to the third month follow-up as compared to the treatment as usual group. We also observed a significant main effect of time; irrespective of the group allocation, there was a significant increase in the knowledge through baseline to third month follow-up (F=5.69; p=0.02; ηp2=0.09). No main or interaction effects of group and time were observed on burden. The findings suggest that brief need based psychoeducation may increase knowledge about the illness and reduce self-stigma. Further systematic studies are warranted to test this intervention for long-term effects.
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Affiliation(s)
- Anekal C Amaresha
- Department of Social Work, Christ University, Bengaluru, 560029, India.
| | - Sunil Vasu Kalmady
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, T6G 2E8 Canada
| | - Boban Joseph
- Department of Psychiatric Social Work and the Schizophrenia Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India
| | - Sri Mahavir Agarwal
- Department of Psychiatry and the Schizophrenia Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry and the Schizophrenia Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry and the Schizophrenia Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India
| | - Daliboina Muralidhar
- Department of Psychiatric Social Work and the Schizophrenia Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India
| | - Doddaballapura K Subbakrishna
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India
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65
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Abstract
Schizophrenia patients commonly exhibit substantial and diffuse cognitive impairment. Evidence suggests that subtle cognitive deficits are already apparent in childhood and adolescence, many years prior to onset of psychosis. While there is almost unequivocal evidence of some degree of cognitive impairment in individuals who later develop schizophrenia, the literature remains inconclusive regarding the exact nature of this impairment and warrants careful review and interpretation. Meta-analytic findings suggest that individuals who later develop schizophrenia, but not related disorders, such as bipolar disorder, exhibit a premorbid IQ deficit of around 8 points. Several studies have also found evidence for premorbid deficits across most cognitive domains, such as language, processing speed and executive functions. Longitudinal studies, although rare, suggest that individuals who go on to develop schizophrenia may show a course of increasing cognitive impairment prior to onset of psychosis. While evidence regarding the etiology of premorbid deficits is scarce, common and rare genetic variants, as well as environmental factors such as obstetric complications and cannabis use may play an important role and warrant further examination. In this selected review, we give an overview of population-based studies on premorbid cognitive deficits in schizophrenia, with a special focus on evidence regarding the specificity, profile and course of these deficits.
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Affiliation(s)
- J Mollon
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - A Reichenberg
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
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66
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Abstract
OBJECTIVES Studies suggest that impairments in some of the same domains of cognition occur in different neuropsychiatric conditions, including those known to share genetic liability. Yet, direct, multi-disorder cognitive comparisons are limited, and it remains unclear whether overlapping deficits are due to comorbidity. We aimed to extend the literature by examining cognition across different neuropsychiatric conditions and addressing comorbidity. METHODS Subjects were 486 youth consecutively referred for neuropsychiatric evaluation and enrolled in the Longitudinal Study of Genetic Influences on Cognition. First, we assessed general ability, reaction time variability (RTV), and aspects of executive functions (EFs) in youth with non-comorbid forms of attention-deficit/hyperactivity disorder (ADHD), mood disorders and autism spectrum disorder (ASD), as well as in youth with psychosis. Second, we determined the impact of comorbid ADHD on cognition in youth with ASD and mood disorders. RESULTS For EFs (working memory, inhibition, and shifting/ flexibility), we observed weaknesses in all diagnostic groups when participants' own ability was the referent. Decrements were subtle in relation to published normative data. For RTV, weaknesses emerged in youth with ADHD and mood disorders, but trend-level results could not rule out decrements in other conditions. Comorbidity with ADHD did not impact the pattern of weaknesses for youth with ASD or mood disorders but increased the magnitude of the decrement in those with mood disorders. CONCLUSIONS Youth with ADHD, mood disorders, ASD, and psychosis show EF weaknesses that are not due to comorbidity. Whether such cognitive difficulties reflect genetic liability shared among these conditions requires further study. (JINS, 2018, 24, 91-103).
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Abstract
We review the changing conceptions of schizophrenia over the past 50 years as it became understood as a disorder of brain function and structure in which neurocognitive dysfunction was identified at different illness phases. The centrality of neurocognition has been recognized, especially because neurocognitive deficits are strongly related to social and role functioning in the illness, and as a result neurocognitive measures are used routinely in clinical assessment of individuals with schizophrenia. From the original definitions of the syndrome of schizophrenia in the early 20th century, impaired cognition, especially attention, was considered to be important. Neurocognitive impairments are found in the vast majority of individuals with schizophrenia, and they vary from mild, relatively restricted deficits, to dementia-like syndromes, as early as the first psychotic episode. Neurocognitive deficits are found in the premorbid phase in a substantial minority of pre-teenage youth who later develop schizophrenia, and they apparently worsen by the prodromal, high-risk phase in a majority of those who develop the illness. While there is limited evidence for reversibility of impairments from pharmacological interventions in schizophrenia, promising results have emerged from cognitive remediation studies. Thus, we expect cognitive interventions to play a larger role in schizophrenia in the coming years. Moreover, because youth at risk for schizophrenia can be identified by an emergent high-risk syndrome, earlier interventions might be applied in a pre-emptive way to reduce disability and improve adaptation. The notion of schizophrenia as a developmental neurocognitive disorder with stages opens up a window of possibilities for earlier interventions. (JINS, 2017, 23, 881-892).
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68
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Sugranyes G, de la Serna E, Borras R, Sanchez-Gistau V, Pariente JC, Romero S, Baeza I, Díaz-Caneja CM, Rodriguez-Toscano E, Moreno C, Bernardo M, Moreno D, Vieta E, Castro-Fornieles J. Clinical, Cognitive, and Neuroimaging Evidence of a Neurodevelopmental Continuum in Offspring of Probands With Schizophrenia and Bipolar Disorder. Schizophr Bull 2017; 43:1208-1219. [PMID: 28180904 PMCID: PMC5737486 DOI: 10.1093/schbul/sbx002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies in child and adolescent offspring of patients with schizophrenia or bipolar disorders may help understand the influence of neurodevelopmental factors on the premorbid phenotype of these disorders. AIMS To assess whether a combination of neurodevelopmental factors discriminates between young offspring of patients with schizophrenia (SzO) or bipolar disorder (BpO) and community controls (CcO). To assess the association between these factors and rates of psychiatric diagnoses in high risk (HR) youth. METHODS One hundred thirty-three HR offspring (47 SzO and 86 BpO) and 84 CcO, aged 6-17, underwent cross-sectional clinical, neurocognitive, and structural neuroimaging assessment. Information on perinatal events and early childhood development was also obtained. General linear mixed models were performed to assess group discrimination and association with lifetime axis I psychiatric disorders. RESULTS Multivariate analyses revealed that greater neurological soft signs (NSS), less total grey matter volume (GMV) and a higher frequency of obstetric complications discriminated HR offspring from CcO. When comparing each group individually, greater NSS and a higher frequency of obstetric complications discriminated SzO from CcO, and BpO from CcO, while lower intelligence also discriminated SzO from CcO and from BpO. Within HR offspring, lower intelligence and less total GMV were associated with lifetime incidence of psychiatric disorders. CONCLUSIONS Both SzO and BpO showed evidence of neurodevelopmental insult, although this may have a greater impact in SzO. Lower intelligence and less total GMV hold potential as biomarkers of risk for psychiatric disorders in HR youth.
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Affiliation(s)
- Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,To whom correspondence should be addressed; Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, c. Villarroel 170, 08036 Barcelona, Spain; tel: +34-93-227-9974/9970, fax: +34-93-227-9974, e-mail:
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Roger Borras
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Vanessa Sanchez-Gistau
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Early Intervention Team, Pere Mata Institute of Reus, Health Research Institute Pere Virgili (IISPV), Reus, Spain
| | - Jose C Pariente
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Soledad Romero
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Elisa Rodriguez-Toscano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Carmen Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Miguel Bernardo
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain,Department of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
| | - Dolores Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Eduard Vieta
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain,Department of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
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69
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Is the association between offspring intelligence and parents' educational attainment influenced by schizophrenia or mood disorder in parents? SCHIZOPHRENIA RESEARCH-COGNITION 2017; 9:18-22. [PMID: 28868239 PMCID: PMC5542375 DOI: 10.1016/j.scog.2017.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/02/2017] [Accepted: 07/04/2017] [Indexed: 11/22/2022]
Abstract
Results from twin, family, and adoption studies all suggest that general intelligence is highly heritable. Several studies have shown lower premorbid intelligence in individuals before the onset of both mood disorders and psychosis, as well as in children and adolescents at genetic high risk for developing schizophrenia. Based on these findings, we aim to investigate if the association between educational achievement in parents and intelligence in their offspring is influenced by schizophrenia or mood disorder in parents. In a large population-based sample of young adult male conscripts (n = 156,531) the presence of a mental disorder in the parents were associated with significantly lower offspring scores on a test of general intelligence, the Børge Priens Prøve (BPP), and higher educational attainment in parents was significantly associated with higher BPP test scores in offspring. A significant interaction suggested that the positive association between maternal education and offspring intelligence was stronger in offspring of mothers with schizophrenia compared to the control group (p = 0.03). The associations between parental education and offspring intelligence are also observed when restricting the sample to conscripts whose parents are diagnosed after 30 years of age. In conclusion, findings from this study show a more positive effect of education on offspring intelligence in mothers with schizophrenia compared to mothers from the control group. This effect could have both environmental and genetic explanations.
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70
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Blokland GAM, Mesholam-Gately RI, Toulopoulou T, del Re EC, Lam M, DeLisi LE, Donohoe G, Walters JTR, Seidman LJ, Petryshen TL. Heritability of Neuropsychological Measures in Schizophrenia and Nonpsychiatric Populations: A Systematic Review and Meta-analysis. Schizophr Bull 2017; 43:788-800. [PMID: 27872257 PMCID: PMC5472145 DOI: 10.1093/schbul/sbw146] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Schizophrenia is characterized by neuropsychological deficits across many cognitive domains. Cognitive phenotypes with high heritability and genetic overlap with schizophrenia liability can help elucidate the mechanisms leading from genes to psychopathology. We performed a meta-analysis of 170 published twin and family heritability studies of >800 000 nonpsychiatric and schizophrenia subjects to accurately estimate heritability across many neuropsychological tests and cognitive domains. The proportion of total variance of each phenotype due to additive genetic effects (A), shared environment (C), and unshared environment and error (E), was calculated by averaging A, C, and E estimates across studies and weighting by sample size. Heritability ranged across phenotypes, likely due to differences in genetic and environmental effects, with the highest heritability for General Cognitive Ability (32%-67%), Verbal Ability (43%-72%), Visuospatial Ability (20%-80%), and Attention/Processing Speed (28%-74%), while the lowest heritability was observed for Executive Function (20%-40%). These results confirm that many cognitive phenotypes are under strong genetic influences. Heritability estimates were comparable in nonpsychiatric and schizophrenia samples, suggesting that environmental factors and illness-related moderators (eg, medication) do not substantially decrease heritability in schizophrenia samples, and that genetic studies in schizophrenia samples are informative for elucidating the genetic basis of cognitive deficits. Substantial genetic overlap between cognitive phenotypes and schizophrenia liability (average rg = -.58) in twin studies supports partially shared genetic etiology. It will be important to conduct comparative studies in well-powered samples to determine whether the same or different genes and genetic variants influence cognition in schizophrenia patients and the general population.
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Affiliation(s)
- Gabriëlla A. M. Blokland
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA;,Department of Psychiatry, Harvard Medical School, Boston, MA;,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Raquelle I. Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Commonwealth Research Center, Harvard Medical School, Boston, MA;,Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA
| | - Timothea Toulopoulou
- Psychology Department, Bilkent University, Ankara, Turkey;,Department of Psychology, University of Hong Kong, Pokfulam, Hong Kong;,Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Elisabetta C. del Re
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton, MA
| | - Max Lam
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | - Lynn E. DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton, MA
| | - Gary Donohoe
- School of Psychology, National University of Ireland, Galway, Ireland;,Neuropsychiatric Genetics Group, Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - James T. R. Walters
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | | | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Commonwealth Research Center, Harvard Medical School, Boston, MA;,Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA
| | - Tracey L. Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA;,Department of Psychiatry, Harvard Medical School, Boston, MA;,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
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71
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Abstract
Evidence indicates the existence of a superordinate factor of general psychopathology, which has been termed p. Among the issues raised by this discovery is whether this factor has substantive meaning or not. This article suggests a functional interpretation of the p factor, based in part on a family of dual process models, in which an associative system and a deliberative system compete for influence over action. The associative system is frequently said to be impulsively responsive to emotions. We hypothesize that this impulsive responsivity to emotion underlies the p factor. One benefit of this view is to use the same underlying process variable to account for both internalizing and externalizing vulnerabilities, as well as aspects of thought disorder. Evidence is reviewed linking impulsive reactivity to emotion to the p factor, and (separately) to internalizing, externalizing, and thought-disorder symptoms. Alternative interpretations are considered.
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Harave VS, Shivakumar V, Kalmady SV, Narayanaswamy JC, Varambally S, Venkatasubramanian G. Neurocognitive Impairments in Unaffected First-degree Relatives of Schizophrenia. Indian J Psychol Med 2017; 39:250-253. [PMID: 28615756 PMCID: PMC5461832 DOI: 10.4103/0253-7176.207335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Neurocognitive impairments of attention and executive functioning are trait abnormalities in schizophrenia, and these are considered to be endophenotypes. These deficits have been convincingly linked to prefrontal cortical functioning. In this study, we examined the cognitive performance in the domains of attention and executive functioning among first-degree relatives of Indian people with schizophrenia (high-risk [HR] patients) compared to healthy controls (HC). MATERIALS AND METHODS Siblings of patients with DSM-IV schizophrenia, HR patients (n = 17), were compared with HC (n = 30) (matched as a group for age, sex, years of education, and handedness) using the following neurocognitive tests for attention and executive function - digit span test (DST), trail making test, letter-number sequencing (LNS), and spatial span test. RESULTS HR patients had significantly deficient performance in attention and executive function tasks (DST-forward [P < 0.001], DST-backward [P < 0.001], spatial span-forward [P < 0.001], spatial span-backward [P < 0.001], and LNS [P < 0.001]). CONCLUSIONS This study replicates the findings that neurocognitive deficits involving executive function task performance, attention, and working memory, which are considered as principal features in patients with schizophrenia, are also significantly present in the first-degree relatives of patients. Thus, these neurocognitive parameters can be considered as potential endophenotypes in schizophrenia.
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Affiliation(s)
- Virupaksha Shanmugam Harave
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Venkataram Shivakumar
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sunil V Kalmady
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, Translational Psychiatry Laboratory, The Schizophrenia Clinic, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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73
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Krkovic K, Moritz S, Lincoln TM. Neurocognitive deficits or stress overload: Why do individuals with schizophrenia show poor performance in neurocognitive tests? Schizophr Res 2017; 183:151-156. [PMID: 27838097 DOI: 10.1016/j.schres.2016.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/14/2016] [Accepted: 11/02/2016] [Indexed: 11/17/2022]
Abstract
Poor performance in neurocognitive tasks is consistently found across studies in all stages of schizophrenia spectrum disorders and is interpreted as an underlying, brain function-related, neurocognitive deficit. However, neurocognitive test performance in schizophrenia might be compromised by patients' increased stress level. We investigated group-differences in neurocognitive performance while accounting for psychophysiological (salivary cortisol, heart rate, skin conductance level) and self-reported stress. We included 35 patients with schizophrenia, 29 participants with attenuated psychotic symptoms, 26 first-degree relatives of individuals with schizophrenia and 28 healthy controls. Participants completed a neurocognitive test battery that assessed processing speed, task switching, attention, working memory, verbal episodic memory, and verbal comprehension. Multivariate analyses of covariance (MANCOVA) were calculated to test for main effects of group on neurocognitive performance thereby not accounting versus accounting for confounding effects of stress. As expected, patients with schizophrenia scored lower than the other groups in all neurocognitive domains. Participants with attenuated psychotic symptoms, first-degree relatives and healthy individuals did not differ from each other in their performance. After accounting for heart rate and self-reported stress, the multivariate effect of group on neurocognition remained significant, but was rendered non-significant for specific domains - working memory capacity, episodic memory, and long-term memory. The findings imply that stress is relevant to neurocognitive performance and this should be taken into account when interpreting the origin of performance deficits in schizophrenia patients.
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Affiliation(s)
- Katarina Krkovic
- Department of Clinical Psychology and Psychotherapy, University of Hamburg, Germany.
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Tania M Lincoln
- Department of Clinical Psychology and Psychotherapy, University of Hamburg, Germany
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Impact of Familial Loading on Prefrontal Activation in Major Psychiatric Disorders: A Near-Infrared Spectroscopy (NIRS) Study. Sci Rep 2017; 7:44268. [PMID: 28295013 PMCID: PMC5353718 DOI: 10.1038/srep44268] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/07/2017] [Indexed: 11/08/2022] Open
Abstract
Family history (FH) is predictive of the development of major psychiatric disorders (PSY). Familial psychiatric disorders are largely a consequence of genetic factors and typically exhibit more severe impairments. Decreased prefrontal activity during verbal fluency testing (VFT) may constitute an intermediate phenotype for PSY. We investigated whether familial PSY were associated with a greater severity of prefrontal dysfunction in accordance with genetic loading. We measured prefrontal activity during VFT using near-infrared spectroscopy (NIRS) in patients with schizophrenia (SCZ, n = 45), major depressive disorder (MDD, n = 26) or bipolar disorder (BIP, n = 22) and healthy controls (HC, n = 51). We compared prefrontal activity among patients with or without FH and HC. Patients in the SCZ, MDD and BIP patient groups had lower prefrontal activity than HC subjects. Patients with and without FH in all diagnostic groups had lower prefrontal activity than HC subjects. Moreover, SCZ patients with FH had lower prefrontal activity than SCZ patients without FH. When we included patients with SCZ, MDD or BIP in the group of patients with PSY, the effects of psychiatric FH on prefrontal activity were enhanced. These findings demonstrate the association of substantially more severe prefrontal dysfunction with higher genetic loading in major psychiatric disorders.
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75
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Pruessner M, Cullen AE, Aas M, Walker EF. The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities. Neurosci Biobehav Rev 2017; 73:191-218. [DOI: 10.1016/j.neubiorev.2016.12.013] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 01/29/2023]
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76
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Lin A, Di Prinzio P, Young D, Jacoby P, Whitehouse A, Waters F, Jablensky A, Morgan VA. Academic Performance in Children of Mothers With Schizophrenia and Other Severe Mental Illness, and Risk for Subsequent Development of Psychosis: A Population-Based Study. Schizophr Bull 2017; 43:205-213. [PMID: 27131155 PMCID: PMC5216844 DOI: 10.1093/schbul/sbw042] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE We examined the academic performance at age 12 years of children of mothers diagnosed with schizophrenia or other severe mental illness using a large whole-population birth cohort born in Western Australia. We investigated the association between academic performance and the subsequent development of psychotic illness. METHOD The sample comprised 3169 children of mothers with severe mental illness (schizophrenia, bipolar disorder, unipolar major depression, delusional disorder or other psychoses; ICD-9 codes 295-298), and 88 353 children of comparison mothers without known psychiatric morbidity. Academic performance of children was indexed on a mandatory state-wide test of reading, spelling, writing and numeracy. RESULTS A larger proportion of children (43.1%) of mothers with severe mental illness performed below the acceptable standard than the reference group (30.3%; children of mothers with no known severe mental illness). After adjusting for covariates, children of mothers with any severe mental illness were more likely than the reference group to perform below-benchmark on all domains except reading. For all children, poor spelling was associated with the later development of psychosis, but particularly for those at familial risk for severe mental illness (hazard ratio [HR] = 1.81; 95% CI for HR = 1.21, 2.72). CONCLUSIONS Children of mothers with a severe mental illness are at increased risk for sub-standard academic achievement at age 12 years, placing these children at disadvantage for the transition to secondary school. For children with familial risk for severe mental illness, very poor spelling skills at age 12 years may be an indicator of risk for later psychotic disorder.
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Affiliation(s)
- Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth, Australia;
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Deidra Young
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Peter Jacoby
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Andrew Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Flavie Waters
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia;,Clinical Research Centre, North Metropolitan Health Service Mental Health, Perth, Australia
| | - Assen Jablensky
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
| | - Vera A. Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia;,Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
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77
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Zai G, Robbins TW, Sahakian BJ, Kennedy JL. A review of molecular genetic studies of neurocognitive deficits in schizophrenia. Neurosci Biobehav Rev 2017; 72:50-67. [DOI: 10.1016/j.neubiorev.2016.10.024] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 10/17/2016] [Accepted: 10/27/2016] [Indexed: 02/08/2023]
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78
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Auditory Vigilance and Working Memory in Youth at Familial Risk for Schizophrenia or Affective Psychosis in the Harvard Adolescent Family High Risk Study. J Int Neuropsychol Soc 2016; 22:1026-1037. [PMID: 27903327 DOI: 10.1017/s1355617716000242] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The degree of overlap between schizophrenia (SCZ) and affective psychosis (AFF) has been a recurring question since Kraepelin's subdivision of the major psychoses. Studying nonpsychotic relatives allows a comparison of disorder-associated phenotypes, without potential confounds that can obscure distinctive features of the disorder. Because attention and working memory have been proposed as potential endophenotypes for SCZ and AFF, we compared these cognitive features in individuals at familial high-risk (FHR) for the disorders. METHODS Young, unmedicated, first-degree relatives (ages, 13-25 years) at FHR-SCZ (n=41) and FHR-AFF (n=24) and community controls (CCs, n=54) were tested using attention and working memory versions of the Auditory Continuous Performance Test. To determine if schizotypal traits or current psychopathology accounted for cognitive deficits, we evaluated psychosis proneness using three Chapman Scales, Revised Physical Anhedonia, Perceptual Aberration, and Magical Ideation, and assessed psychopathology using the Hopkins Symptom Checklist -90 Revised. RESULTS Compared to controls, the FHR-AFF sample was significantly impaired in auditory vigilance, while the FHR-SCZ sample was significantly worse in working memory. Both FHR groups showed significantly higher levels of physical anhedonia and some psychopathological dimensions than controls. Adjusting for physical anhedonia, phobic anxiety, depression, psychoticism, and obsessive-compulsive symptoms eliminated the FHR-AFF vigilance effects but not the working memory deficits in FHR-SCZ. CONCLUSIONS The working memory deficit in FHR-SZ was the more robust of the cognitive impairments after accounting for psychopathological confounds and is supported as an endophenotype. Examination of larger samples of people at familial risk for different psychoses remains necessary to confirm these findings and to clarify the role of vigilance in FHR-AFF. (JINS, 2016, 22, 1026-1037).
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79
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Green AE, Croft RJ, Maller JJ, Fitzgerald PB. White matter correlates of episodic memory encoding and retrieval in schizophrenia. Psychiatry Res Neuroimaging 2016; 254:188-198. [PMID: 27479923 DOI: 10.1016/j.pscychresns.2016.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 07/05/2016] [Indexed: 01/14/2023]
Abstract
Episodic memory (EM) impairments in schizophrenia (SZ) are predictive of functional outcome and are a potential endophenotype of the disorder. The current study investigated the neuroanatomical correlates of EM encoding and retrieval in SZ with structural magnetic resonance and diffusion tensor imaging (DTI) measures in 22 patients with SZ and 22 age- and gender-matched healthy controls. Tract-based Spatial Statistics (TBSS) was used to investigate microstructural alterations in white matter (WM), while FreeSurfer surface-based analysis was used to determine abnormalities in grey matter (GM) and WM volumetrics and cortical thickness. Compared to controls, patients demonstrated GM deficits in temporal and parietal regions and lower fractional anisotropy (FA) of WM in diffuse brain regions. Patients also demonstrated reduced functioning in both encoding and retention of auditory-verbal EM. Among patients but not controls, EM encoding correlated with WM volume in the orbitofrontal cortex and increased radial diffusivity in the fornix, whereas EM retrieval correlated with WM volume in posterior parietal cortex. These findings suggest a differential role for frontal and parietal WM in EM encoding and retrieval processes, while myelin integrity of the fornix may play a specific role in mediating EM encoding processes in SZ.
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Affiliation(s)
- Amity E Green
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Australia.
| | - Rodney J Croft
- Illawarra Health & Medical Research Institute, University of Wollongong, Australia; School of Psychology, University of Wollongong, Australia
| | - Jerome J Maller
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Australia
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80
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González-Pinto A, González-Ortega I, Alberich S, Ruiz de Azúa S, Bernardo M, Bioque M, Cabrera B, Corripio I, Arango C, Lobo A, Sánchez-Torres AM, Cuesta MJ. Opposite Cannabis-Cognition Associations in Psychotic Patients Depending on Family History. PLoS One 2016; 11:e0160949. [PMID: 27513670 PMCID: PMC4981356 DOI: 10.1371/journal.pone.0160949] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 07/27/2016] [Indexed: 11/18/2022] Open
Abstract
The objective of this study is to investigate cognitive performance in a first-episode psychosis sample, when stratifying the interaction by cannabis use and familial or non-familial psychosis. Hierarchical-regression models were used to analyse this association in a sample of 268 first-episode psychosis patients and 237 controls. We found that cannabis use was associated with worse working memory, regardless of family history. However, cannabis use was clearly associated with worse cognitive performance in patients with no family history of psychosis, in cognitive domains including verbal memory, executive function and global cognitive index, whereas cannabis users with a family history of psychosis performed better in these domains. The main finding of the study is that there is an interaction between cannabis use and a family history of psychosis in the areas of verbal memory, executive function and global cognition: that is, cannabis use is associated with a better performance in patients with a family history of psychosis and a worse performance in those with no family history of psychosis. In order to confirm this hypothesis, future research should explore the actual expression of the endocannabinoid system in patients with and without a family history of psychosis.
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Affiliation(s)
- Ana González-Pinto
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, University of the Basque Country, Vitoria, Spain
| | - Itxaso González-Ortega
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, University of the Basque Country, Vitoria, Spain
| | - Susana Alberich
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, University of the Basque Country, Vitoria, Spain
| | - Sonia Ruiz de Azúa
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Araba University Hospital, University of the Basque Country, Vitoria, Spain
| | - Miguel Bernardo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Miquel Bioque
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Bibiana Cabrera
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Iluminada Corripio
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Celso Arango
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department. Gregorio Marañón General University Hospital. School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Antonio Lobo
- Centre for Biomedical Research in the Mental Health Network (CIBERSAM), Madrid, Spain
- University of Zaragoza, Zaragoza, Spain
- Aragon Institute for Health Sciences (IIS Aragón), Zaragoza, Spain
| | - Ana M. Sánchez-Torres
- Department of Psychiatry, Navarre Hospital Complex, Pamplona, Spain. IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
| | - Manuel J. Cuesta
- Department of Psychiatry, Navarre Hospital Complex, Pamplona, Spain. IdiSNA, Navarre Institute for Health Research, Pamplona, Spain
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Paccalet T, Gilbert E, Berthelot N, Marquet P, Jomphe V, Lussier D, Bouchard RH, Cliche D, Gingras N, Maziade M. Liability indicators aggregate many years before transition to illness in offspring descending from kindreds affected by schizophrenia or bipolar disorder. Schizophr Res 2016; 175:186-192. [PMID: 27160791 DOI: 10.1016/j.schres.2016.04.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/19/2016] [Accepted: 04/23/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Offspring born to patients with affective and non-affective psychoses display indicators of brain dysfunctions that affected parents carry. Such indicators may help understand the risk trajectory. METHODS We followed up the clinical/developmental trajectories of 84 young offspring born to affected parents descending from the Quebec kindreds affected by schizophrenia or bipolar disorder. We longitudinally characterized childhood trajectories using 5 established risk indicators: cognitive impairments, psychotic-like experiences, non-psychotic DSM diagnosis and episodes of poor functioning, trauma and drug use. RESULTS Overall, offspring individually presented a high rate of risk indicators with 39% having 3 or more indicators. Thirty-three offspring progressed to an axis 1 DSM-IV disorder, 15 of whom transitioned to a major affective or non-affective disorder. The relative risks for each risk indicator were low in these vulnerable offspring (RR = 1.92 to 2.99). Remarkably, transitioners accumulated more risk indicators in childhood-adolescence than non-transitioners (Wilcoxon rank test; Z = 2.64, p = 0.008). Heterogeneity in the risk trajectories was observed. Outcome was not specific to parent's diagnosis. CONCLUSION Young offspring descending from kindreds affected by major psychoses would accumulate risk indicators many years before transition. A clustering of risk factors has also been observed in children at risk of metabolic-cardiovascular disorders and influences practice guidelines in this field. Our findings may be significant for the primary care surveillance of millions of children born to affected parents in the G7 nations. Future longitudinal risk research of children at genetic risk should explore concurrently several intrinsic and environmental risk modalities to increase predictivity.
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Affiliation(s)
- Thomas Paccalet
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada; Université du Québec à Trois-Rivières, Département des Sciences infirmières, QC, Canada
| | - Elsa Gilbert
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada; Université Laval, École de Psychologie, QC, Canada
| | - Nicolas Berthelot
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada; Université du Québec à Trois-Rivières, Département des Sciences infirmières, QC, Canada
| | - Pierre Marquet
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada; Université Laval, Faculté de Médecine, QC, Canada
| | - Valérie Jomphe
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada
| | - Daphné Lussier
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada
| | - Roch-Hugo Bouchard
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada; Université Laval, Faculté de Médecine, QC, Canada
| | - Denis Cliche
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada; Université Laval, Faculté de Médecine, QC, Canada
| | - Nathalie Gingras
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada; Université Laval, Faculté de Médecine, QC, Canada
| | - Michel Maziade
- Centre de recherche, Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, QC, Canada; Université Laval, Faculté de Médecine, QC, Canada.
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82
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Hou CL, Xiang YT, Wang ZL, Everall I, Tang Y, Yang C, Xu MZ, Correll CU, Jia FJ. Cognitive functioning in individuals at ultra-high risk for psychosis, first-degree relatives of patients with psychosis and patients with first-episode schizophrenia. Schizophr Res 2016; 174:71-76. [PMID: 27197904 DOI: 10.1016/j.schres.2016.04.034] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate and compare cognitive functioning of first-degree relatives of people with schizophrenia who were also at ultra-high risk (UHR) for psychosis with patients with first-episode (FE) schizophrenia, first degree relatives of patients not fulfilling UHR criteria (FDR), and healthy control (HC) subjects. METHOD Forty subjects in each group were included, underwent a face-to-face interview and completed a neurocognitive test battery, including the Trail Making Test-A (TMT-A, psychomotor functions), Stroop Color Word Test (attention), Digit Symbol Coding Test (DST, processing speed and working memory) and Hopkins Verbal Leaning Test-Revised (HVLT-R, verbal memory). RESULTS Functioning in all the cognitive test domains displayed a gradual decrease from the HC, FDR, UHR to FE groups. After controlling for covariates, there were still significant differences in TMT-A (F(7160)=35.4, P<0.001), DST (F(7160)=38.9, P<0.001), Stroop Color Word Test (F(7160)=35.0, P<0.001), Stroop Word Test (F(7160)=36.2, P<0.001), Stroop Color Test (F(7160)=40.9, P<0.001) and HVLT-R (F(7160)=62.5, P<0.001) between the four groups, indicating that the cognitive functioning in the UHR group was intermediate between the FE and FDR groups, while the FDR group had poorer performance than the HC group, and the FE group had the poorest cognitive functioning across all four examined domains. CONCLUSION The results indicate that impairments in processing speed, attention, working memory and verbal memory exist in both UHR and FDR subjects. In order to clarify the associations between cognitive functioning and UHR and schizophrenia, longitudinal studies are warranted.
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Affiliation(s)
- Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
| | - Zhong-Lei Wang
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Ian Everall
- Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Yi Tang
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Chengjia Yang
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Ming-Zhi Xu
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Christoph U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China.
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Rossi R, Zammit S, Button KS, Munafò MR, Lewis G, David AS. Psychotic Experiences and Working Memory: A Population-Based Study Using Signal-Detection Analysis. PLoS One 2016; 11:e0153148. [PMID: 27120349 PMCID: PMC4847914 DOI: 10.1371/journal.pone.0153148] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 03/24/2016] [Indexed: 01/15/2023] Open
Abstract
Psychotic Experiences (PEs) during adolescence index increased risk for psychotic disorders and schizophrenia in adult life. Working memory (WM) deficits are a core feature of these disorders. Our objective was to examine the relationship between PEs and WM in a general population sample of young people in a case control study. 4744 individuals of age 17–18 from Bristol and surrounding areas (UK) were analyzed in a cross-sectional study nested within the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. The dependent variable was PEs, assessed using the semi-structured Psychosis-Like Symptom Interview (PLIKSi). The independent variable was performance on a computerized numerical n-back working memory task. Signal-Detection Theory indices, including standardized hits rate, false alarms rate, discriminability index (d’) and response bias (c) from 2-Back and 3-Back tasks were calculated. 3576 and 3527 individuals had complete data for 2-Back and 3-Back respectively. Suspected/definite PEs prevalence was 7.9% (N = 374). Strongest evidence of association was seen between PEs and false alarms on the 2-Back, (odds ratio (OR) = 1.17 [95% confidence intervals (CI) 1.01, 1.35]) and 3-back (OR = 1.35 [1.18, 1.54]) and with c (OR = 1.59 [1.09, 2.34]), and lower d’ (OR = 0.76 [0.65, 0.89]), on the 3-Back. Adjustment for several potential confounders, including general IQ, drug exposure and different psycho-social factors, and subsequent multiple imputation of missing data did not materially alter the results. WM is impaired in young people with PEs in the general population. False alarms, rather than poor accuracy, are more closely related to PEs. Such impairment is consistent with different neuropsychological models of psychosis focusing on signal-to-noise discrimination, probabilistic reasoning and impaired reality monitoring as a basis of psychotic symptoms.
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Affiliation(s)
- Rodolfo Rossi
- Section of Psychiatry, University School of Medicine Federico II, Naples, Italy
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
- * E-mail:
| | - Stanley Zammit
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | | | - Marcus R. Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, United Kingdom
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, United Kingdom
| | - Anthony S. David
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
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84
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Laurens KR, Cullen AE. Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study. Soc Psychiatry Psychiatr Epidemiol 2016; 51:475-91. [PMID: 26670311 PMCID: PMC4823320 DOI: 10.1007/s00127-015-1151-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/08/2015] [Indexed: 11/02/2022]
Abstract
PURPOSE The London Child Health and Development Study (CHADS) is a prospective, longitudinal investigation of children, sampled from the general community aged 9-11 years and assessed biennially, who present premorbid risk markers for schizophrenia. The study aims to characterise developmental trajectories of psychological, cognitive, and biological functioning in at-risk children and identify potential targets for early preventative intervention. This review summarises CHADS findings, discusses these in the context of recent theory regarding aetiology and prevention of schizophrenia, and highlights challenges to be addressed with future research. METHODS We review (1) epidemiological information on the prevalence and correlates of developmental antecedents of schizophrenia in the general child population, (2) evidence of psychosocial, cognitive, and biological dysfunctions in at-risk children presenting multiple antecedents of schizophrenia and at-risk children with a family history of schizophrenia, and (3) related findings from an associated sample of help-seeking children receiving intervention. RESULTS Community-based screening of 9-11-year olds identified ~9 % with a triad of antecedents of schizophrenia [including psychotic-like experiences (PLEs)] who are putatively at-risk of psychosis; these children reported greater exposure and responsivity to stressors, impairments in general intelligence and specific cognitive functions, brain structure and function abnormalities, and neuromotor dysfunction. Preliminary evidence suggests distressing PLEs are a viable target for cognitive-behavioural intervention in at-risk children. CONCLUSIONS Intervention in early, premorbid phases of illness might alleviate current difficulties and avert future schizophrenia using benign treatments. The CHADS programme has identified several markers that may index early pathophysiology and constitute potential targets for preventative intervention.
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Affiliation(s)
- Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia.
- Schizophrenia Research Institute, Sydney, Australia.
| | - Alexis E Cullen
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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85
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Woodberry KA, Shapiro DI, Bryant C, Seidman LJ. Progress and Future Directions in Research on the Psychosis Prodrome: A Review for Clinicians. Harv Rev Psychiatry 2016; 24:87-103. [PMID: 26954594 PMCID: PMC4870599 DOI: 10.1097/hrp.0000000000000109] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
LEARNING OBJECTIVES After participating in this activity, learners should be better able to: ABSTRACT The psychosis prodrome, or period of clinical and functional decline leading up to acute psychosis, offers a unique opportunity for identifying mechanisms of psychosis onset and for testing early-intervention strategies. We summarize major findings and emerging directions in prodromal research and provide recommendations for clinicians working with individuals suspected to be at high risk for psychosis. The past two decades of research have led to three major advances. First, tools and criteria have been developed that can reliably identify imminent risk for a psychotic disorder. Second, longitudinal clinical and psychobiological data from large multisite studies are strengthening individual risk assessment and offering insights into potential mechanisms of illness onset. Third, psychosocial and pharmacological interventions are demonstrating promise for delaying or preventing the onset of psychosis in help-seeking, high-risk individuals. The dynamic psychobiological processes implicated in both risk and onset of psychosis, including altered gene expression, cognitive dysfunction, inflammation, gray and white matter brain changes, and vulnerability-stress interactions suggest a wide range of potential treatment targets and strategies. The expansion of resources devoted to early intervention and prodromal research worldwide raises hope for investigating them. Future directions include identifying psychosis-specific risk and resilience factors in children, adolescents, and non-help-seeking community samples, improving study designs to test hypothesized mechanisms of change, and intervening with strategies that, in order to improve functional outcomes, better engage youth, address their environmental contexts, and focus on evidence-based neurodevelopmental targets. Prospective research on putatively prodromal samples has the potential to substantially reshape our understanding of mental illness and our efforts to combat it.
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Affiliation(s)
- Kristen A Woodberry
- From Harvard Medical School (Drs. Woodberry, Shapiro, and Seidman) and Beth Israel Deaconess Medical Center (Drs. Woodberry, Shapiro, and Seidman, and Ms. Bryant)
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de la Serna E, Vila M, Sanchez-Gistau V, Moreno D, Romero S, Sugranyes G, Baeza I, Llorente C, Rodriguez-Toscano E, Sánchez-Gutierrez T, Castro-Fornieles J. Neuropsychological characteristics of child and adolescent offspring of patients with bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:54-9. [PMID: 26343306 DOI: 10.1016/j.pnpbp.2015.08.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/07/2015] [Accepted: 08/28/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe mental disorder with a strong genetic component. The assessment of child and adolescent offspring of patients diagnosed with BD (BDoff) provides an opportunity to investigate vulnerability factors and the first abnormalities associated with the disorder. Previous literature in child and adolescent BDoff is scarce and controversial. However, some studies concur in identifying significant impairment in executive functions, memory and attention. The present study aims to compare global neuropsychological characteristics of child and adolescent offspring of patients with bipolar disorder with a group of offspring of parentswith no history of psychotic disorder, and to assess the influence of psychopathology on neuropsychological performance. METHODS This research was part of The Bipolar and Schizophrenia Young Offspring Study (BASYS). A group of BDoff (N= 90) and a group of offspring of parents with no history of psychotic disorder (CC) (N = 107) were assessed with a complete neuropsychological battery. Intellectual quotient, working memory, processing speed, verbal memory and learning, visual memory, attention and executive functions were included in the cognitive assessment. RESULTS BDoff showed significantly worse performance in processing speed and immediate recall of visual memory relative to CC. When the presence of any lifetime psychopathology was analysed, the results showed that belonging to the BDoff group was the main explicative factor for the scores obtained in both processing speed and visual memory immediate recall, regardless of the presence of psychopathology. CONCLUSIONS These findings suggest that processing speed and visualmemory should be taken into consideration in future research on vulnerability markers of BD.
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Affiliation(s)
- Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain..
| | - Monserrat Vila
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain
| | - Vanessa Sanchez-Gistau
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain
| | - Dolores Moreno
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Soledad Romero
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain.; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain
| | - Immaculada Baeza
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain
| | - Cloe Llorente
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Elisa Rodriguez-Toscano
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Teresa Sánchez-Gutierrez
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Josefina Castro-Fornieles
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, Spain.; Institut d'Investigació Biomèdica August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Department of Psychiatry and Clinical Psychology, University of Barcelona, Spain
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87
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Cognitive intermediate phenotype and genetic risk for psychosis. Curr Opin Neurobiol 2016; 36:23-30. [DOI: 10.1016/j.conb.2015.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/11/2015] [Accepted: 08/26/2015] [Indexed: 12/26/2022]
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Brent BK, Rosso IM, Thermenos HW, Holt DJ, Faraone SV, Makris N, Tsuang MT, Seidman LJ. Alterations of lateral temporal cortical gray matter and facial memory as vulnerability indicators for schizophrenia: An MRI study in youth at familial high-risk for schizophrenia. Schizophr Res 2016; 170:123-9. [PMID: 26621001 PMCID: PMC4707114 DOI: 10.1016/j.schres.2015.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 11/11/2015] [Accepted: 11/14/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Structural alterations of the lateral temporal cortex (LTC) in association with memory impairments have been reported in schizophrenia. This study investigated whether alterations of LTC structure were linked with impaired facial and/or verbal memory in young first-degree relatives of people with schizophrenia and, thus, may be indicators of vulnerability to the illness. METHODS Subjects included 27 non-psychotic, first-degree relatives of schizophrenia patients, and 48 healthy controls, between the ages of 13 and 28. Participants underwent high-resolution magnetic resonance imaging (MRI) at 1.5Tesla. The LTC was parcellated into superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus, and temporal pole. Total cerebral and LTC volumes were measured using semi-automated morphometry. The Wechsler Memory Scale - Third Edition and the Children's Memory Scale - Third Edition assessed facial and verbal memory. General linear models tested for associations among LTC subregion volumes, familial risk and memory. RESULTS Compared with controls, relatives had significantly smaller bilateral middle temporal gyri. Moreover, right middle temporal gyral volume showed a significant positive association with delayed facial memory in relatives. CONCLUSION These results support the hypothesis that smaller middle temporal gyri are related to the genetic liability to schizophrenia and may be linked with reduced facial memory in persons at genetic risk for the illness. The findings add to the growing evidence that children at risk for schizophrenia on the basis of positive family history have cortical and subcortical structural brain abnormalities well before psychotic illness occurs.
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Affiliation(s)
- Benjamin K. Brent
- Harvard Medical School, Department of Psychiatry at Massachusetts General Hospital, Boston, MA 02114,Harvard Medical School, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA 02115, United States
| | - Isabelle M. Rosso
- Harvard Medical School Department of Psychiatry at McLean Hospital, Belmont, MA 02478, United States
| | - Heidi W. Thermenos
- Harvard Medical School, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA 02115, United States,The HST-MIT Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, United States
| | - Daphne J. Holt
- Harvard Medical School, Department of Psychiatry at Massachusetts General Hospital, Boston, MA 02114,The HST-MIT Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, United States
| | - Stephen V. Faraone
- Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY 13210, United States; K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Nikos Makris
- Harvard Medical School, Department of Psychiatry at Massachusetts General Hospital, Boston, MA 02114,The HST-MIT Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, United States,Harvard Medical School Department of Neurology and Radiology Services, Center for Morphometric Analysis, Massachusetts General Hospital, Boston, MA 02120, United States
| | - Ming T. Tsuang
- Center for Behavioral Genomics, Department of Psychiatry; Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, United States
| | - Larry J. Seidman
- Harvard Medical School, Department of Psychiatry at Massachusetts General Hospital, Boston, MA 02114,Harvard Medical School, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA 02115, United States,The HST-MIT Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA 02129, United States
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Nehra R, Grover S, Sharma S, Sharma A, Kate N. Neurocognitive Functioning in Schizophrenia, their Unaffected Siblings and Healthy Controls: A Comparison. Indian J Psychol Med 2016; 38:50-5. [PMID: 27011403 PMCID: PMC4782445 DOI: 10.4103/0253-7176.175114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM Neurocognitive functions are considered to be reliable endophenotypes for schizophrenia. This study aimed to study the neurocognitive functioning of unaffected siblings of patients with schizophrenia and compare the same with a group of patients with schizophrenia and a group of healthy controls. MATERIALS AND METHODS Three study groups, that is, unaffected siblings of patients with schizophrenia, patients of schizophrenia and healthy controls, each group comprising of 20 participants were evaluated on Wisconsin Card Sorting Test, Brief Visuospatial Memory Test-Revised, Hopkins Verbal Learning Test-Revised, Wechsler Adult Intelligence Scale and Digit Symbol Test. RESULTS Compared to healthy controls, unaffected siblings of patients with schizophrenia performed poorly on the tests of short-term verbal learning and memory, but no significant differences were seen between the two groups for executive functions, visual learning and psychomotor speed, concentration and graphomotor abilities. However, when compared with patients with schizophrenia, unaffected siblings performed poorly on the tests of executive functions, visual memory, verbal memory, psychomotor speed, concentration and graphomotor abilities. CONCLUSION Cognitive markers like verbal memory deficits can distinguish unaffected siblings of schizophrenia from healthy controls and serve as an endophenotype for schizophrenia.
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Affiliation(s)
- Ritu Nehra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Sharma
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditi Sharma
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Natasha Kate
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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van Erp TGM, Preda A, Turner JA, Callahan S, Calhoun VD, Bustillo JR, Lim KO, Mueller B, Brown GG, Vaidya JG, McEwen S, Belger A, Voyvodic J, Mathalon DH, Nguyen D, Ford JM, Potkin SG. Neuropsychological profile in adult schizophrenia measured with the CMINDS. Psychiatry Res 2015; 230:826-34. [PMID: 26586142 PMCID: PMC4692593 DOI: 10.1016/j.psychres.2015.10.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 10/19/2015] [Accepted: 10/24/2015] [Indexed: 12/21/2022]
Abstract
Schizophrenia neurocognitive domain profiles are predominantly based on paper-and-pencil batteries. This study presents the first schizophrenia domain profile based on the Computerized Multiphasic Interactive Neurocognitive System (CMINDS(®)). Neurocognitive domain z-scores were computed from computerized neuropsychological tests, similar to those in the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB), administered to 175 patients with schizophrenia and 169 demographically similar healthy volunteers. The schizophrenia domain profile order by effect size was Speed of Processing (d=-1.14), Attention/Vigilance (d=-1.04), Working Memory (d=-1.03), Verbal Learning (d=-1.02), Visual Learning (d=-0.91), and Reasoning/Problem Solving (d=-0.67). There were no significant group by sex interactions, but overall women, compared to men, showed advantages on Attention/Vigilance, Verbal Learning, and Visual Learning compared to Reasoning/Problem Solving on which men showed an advantage over women. The CMINDS can readily be employed in the assessment of cognitive deficits in neuropsychiatric disorders; particularly in large-scale studies that may benefit most from electronic data capture.
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Affiliation(s)
- Theo G M van Erp
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA.
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA
| | - Jessica A Turner
- Departments of Psychology and Neuroscience, Georgia State University, Atlanta, GA 30303, USA; Mind Research Network, Albuquerque, NM 87106, USA
| | - Shawn Callahan
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA
| | - Vince D Calhoun
- Mind Research Network, Albuquerque, NM 87106, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM 97106, USA; Departments of Psychiatry & Neuroscience, University of New Mexico, Albuquerque, NM 87131, USA
| | - Juan R Bustillo
- Departments of Psychiatry & Neuroscience, University of New Mexico, Albuquerque, NM 87131, USA
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
| | - Bryon Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
| | - Gregory G Brown
- VA San Diego Healthcare System and Department of Psychiatry, University of California San Diego, CA 92161, USA
| | - Jatin G Vaidya
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA
| | - Sarah McEwen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Aysenil Belger
- Departments of Psychiatry and Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - James Voyvodic
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27710, USA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Dana Nguyen
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA
| | - Judith M Ford
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Steven G Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA
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Memory systems in schizophrenia: Modularity is preserved but deficits are generalized. Schizophr Res 2015; 168:223-30. [PMID: 26299707 PMCID: PMC4591239 DOI: 10.1016/j.schres.2015.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/06/2015] [Accepted: 08/10/2015] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Schizophrenia patients exhibit impaired working and episodic memory, but this may represent generalized impairment across memory modalities or performance deficits restricted to particular memory systems in subgroups of patients. Furthermore, it is unclear whether deficits are unique from those associated with other disorders. METHOD Healthy controls (n=1101) and patients with schizophrenia (n=58), bipolar disorder (n=49) and attention-deficit-hyperactivity-disorder (n=46) performed 18 tasks addressing primarily verbal and spatial episodic and working memory. Effect sizes for group contrasts were compared across tasks and the consistency of subjects' distributional positions across memory domains was measured. RESULTS Schizophrenia patients performed poorly relative to the other groups on every test. While low to moderate correlation was found between memory domains (r=.320), supporting modularity of these systems, there was limited agreement between measures regarding each individual's task performance (ICC=.292) and in identifying those individuals falling into the lowest quintile (kappa=0.259). A general ability factor accounted for nearly all of the group differences in performance and agreement across measures in classifying low performers. CONCLUSIONS Pathophysiological processes involved in schizophrenia appear to act primarily on general abilities required in all tasks rather than on specific abilities within different memory domains and modalities. These effects represent a general shift in the overall distribution of general ability (i.e., each case functioning at a lower level than they would have if not for the illness), rather than presence of a generally low-performing subgroup of patients. There is little evidence that memory impairments in schizophrenia are shared with bipolar disorder and ADHD.
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92
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Amaresha AC, Joseph B, Agarwal SM, Narayanaswamy JC, Venkatasubramanian G, Muralidhar D, Subbakrishna DK. Assessing the needs of siblings of persons with schizophrenia: A qualitative study from India. Asian J Psychiatr 2015; 17:16-23. [PMID: 26272276 DOI: 10.1016/j.ajp.2015.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/23/2015] [Accepted: 07/18/2015] [Indexed: 01/16/2023]
Abstract
There is a lack of studies on siblings of persons with schizophrenia (SOPS) in Asia. This study aims to explore the needs of SOPS in India. 15 SOPS participated in this qualitative explorative study. All the interviews were audio recorded and later transcribed. Data analysis was carried out using General Inductive Approach. Five themes emerged from the data: managing illness or socio-occupational functioning; follow up services; informational needs; personal needs; and miscellaneous needs. SOPS in India have some distinctive needs. Identifying these needs might help in developing and designing specific psychosocial interventions for better management.
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Affiliation(s)
- Anekal C Amaresha
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India.
| | - Boban Joseph
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Sri Mahavir Agarwal
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Daliboina Muralidhar
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
| | - Doddaballapura K Subbakrishna
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560029, India
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Brandt CL, Doan NT, Tønnesen S, Agartz I, Hugdahl K, Melle I, Andreassen OA, Westlye LT. Assessing brain structural associations with working-memory related brain patterns in schizophrenia and healthy controls using linked independent component analysis. Neuroimage Clin 2015; 9:253-63. [PMID: 26509112 PMCID: PMC4576364 DOI: 10.1016/j.nicl.2015.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/17/2015] [Accepted: 08/17/2015] [Indexed: 01/01/2023]
Abstract
Schizophrenia (SZ) is a psychotic disorder with significant cognitive dysfunction. Abnormal brain activation during cognitive processing has been reported, both in task-positive and task-negative networks. Further, structural cortical and subcortical brain abnormalities have been documented, but little is known about how task-related brain activation is associated with brain anatomy in SZ compared to healthy controls (HC). Utilizing linked independent component analysis (LICA), a data-driven multimodal analysis approach, we investigated structure-function associations in a large sample of SZ (n = 96) and HC (n = 142). We tested for associations between task-positive (fronto-parietal) and task-negative (default-mode) brain networks derived from fMRI activation during an n-back working memory task, and brain structural measures of surface area, cortical thickness, and gray matter volume, and to what extent these associations differed in SZ compared to HC. A significant association (p < .05, corrected for multiple comparisons) was found between a component reflecting the task-positive fronto-parietal network and another component reflecting cortical thickness in fronto-temporal brain regions in SZ, indicating increased activation with increased thickness. Other structure-function associations across, between and within groups were generally moderate and significant at a nominal p-level only, with more numerous and stronger associations in SZ compared to HC. These results indicate a complex pattern of moderate associations between brain activation during cognitive processing and brain morphometry, and extend previous findings of fronto-temporal brain abnormalities in SZ by suggesting a coupling between cortical thickness of these brain regions and working memory-related brain activation.
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Affiliation(s)
- Christine Lycke Brandt
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nhat Trung Doan
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Siren Tønnesen
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Agartz
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway ; Department of Psychiatric Research, Diakonhjemmet Hospital, Diakonhjemmet, Norway ; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth Hugdahl
- Norwegian Centre for Mental Disorders Research, Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway ; Division of Psychiatry, Haukeland University Hospital, Haukeland, Norway ; Department of Radiology, Haukeland University Hospital, Haukeland, Norway ; KG Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway ; Department of Psychology, University of Oslo, Oslo, Norway
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Liu CH, Keshavan MS, Tronick E, Seidman LJ. Perinatal Risks and Childhood Premorbid Indicators of Later Psychosis: Next Steps for Early Psychosocial Interventions. Schizophr Bull 2015; 41:801-16. [PMID: 25904724 PMCID: PMC4466191 DOI: 10.1093/schbul/sbv047] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Schizophrenia and affective psychoses are debilitating disorders that together affect 2%-3% of the adult population. Approximately 50%-70% of the offspring of parents with schizophrenia manifest a range of observable difficulties including socioemotional, cognitive, neuromotor, speech-language problems, and psychopathology, and roughly 10% will develop psychosis. Despite the voluminous work on premorbid vulnerabilities to psychosis, especially on schizophrenia, the work on premorbid intervention approaches is scarce. While later interventions during the clinical high-risk (CHR) phase of psychosis, characterized primarily by attenuated positive symptoms, are promising, the CHR period is a relatively late phase of developmental derailment. This article reviews and proposes potential targets for psychosocial interventions during the premorbid period, complementing biological interventions described by others in this Special Theme issue. Beginning with pregnancy, parents with psychoses may benefit from enhanced prenatal care, social support, parenting skills, reduction of symptoms, and programs that are family-centered. For children at risk, we propose preemptive early intervention and cognitive remediation. Empirical research is needed to evaluate these interventions for parents and determine whether interventions for parents and children positively influence the developmental course of the offspring.
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Affiliation(s)
- Cindy H Liu
- Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA; Department of Psychology, University of Massachusetts, Boston, MA;
| | - Matcheri S Keshavan
- Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ed Tronick
- Department of Psychology, University of Massachusetts, Boston, MA; Department of Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA
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95
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Seidman LJ, Nordentoft M. New Targets for Prevention of Schizophrenia: Is It Time for Interventions in the Premorbid Phase? Schizophr Bull 2015; 41:795-800. [PMID: 25925393 PMCID: PMC4466192 DOI: 10.1093/schbul/sbv050] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A number of influences have converged that make this Special Theme Issue timely: "A New Direction: Considering Developmentally Sensitive Targets for Very Early Intervention in Schizophrenia". These factors include: 1. the substantial knowledge about premorbid developmental vulnerabilities to psychosis, especially regarding schizophrenia; 2. the promising results emerging from interventions during the clinical high-risk (CHR) phase of psychosis and; 3. the recognition that the CHR period is a relatively late phase of developmental derailment. These factors have together led to a perspective that even earlier intervention is warranted. This paper briefly summarizes the articles comprising the Special Theme including new data on early neurocognitive development, proposed potential targets for psychosocial and psychopharmacological interventions during the premorbid period as early as pregnancy, and ethical challenges. These thought experiments must be empirically tested, and the ethical challenges overcome as posed by the various interventions, which range from relatively low risk, supportive, psychosocial to higher risk, experimental, pharmacological interventions. All of the interventions proposed require careful study of ethics, safety, potential stigma, feasibility, efficacy and tolerability, and the meaning to the people involved.
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Affiliation(s)
- Larry J Seidman
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA;
| | - Merete Nordentoft
- Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; The Mental Health Services in the Capital Region of Denmark, Mental Health Center of Copenhagen, Copenhagen, Denmark
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96
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Stone WS, Mesholam-Gately RI, Braff DL, Calkins ME, Freedman R, Green MF, Greenwood TA, Gur RE, Gur RC, Lazzeroni LC, Light GA, Nuechterlein KH, Olincy A, Radant AD, Siever LJ, Silverman JM, Sprock J, Sugar CA, Swerdlow NR, Tsuang DW, Tsuang MT, Turetsky BI, Seidman LJ. California Verbal Learning Test-II performance in schizophrenia as a function of ascertainment strategy: comparing the first and second phases of the Consortium on the Genetics of Schizophrenia (COGS). Schizophr Res 2015; 163:32-7. [PMID: 25497440 PMCID: PMC5954831 DOI: 10.1016/j.schres.2014.10.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 10/16/2014] [Accepted: 10/19/2014] [Indexed: 12/21/2022]
Abstract
The first phase of the Consortium on the Genetics of Schizophrenia (COGS-1) showed performance deficits in learning and memory on the California Verbal Learning Test, Second Edition (CVLT-II) in individuals with schizophrenia (SZ), compared to healthy comparison subjects (HCS). A question is whether the COGS-1 study, which used a family study design (i.e. studying relatively intact families), yielded "milder" SZ phenotypes than those acquired subsequently in the COGS-2 case-control design that did not recruit unaffected family members. CVLT-II performance was compared for the COGS-1 and COGS-2 samples. Analyses focused on learning, recall and recognition variables, with age, gender and education as covariates. Analyses of COGS-2 data explored effects of additional covariates and moderating factors in CVLT-II performance. 324 SZ subjects and 510 HCS had complete CVLT-II and covariate data in COGS-1, while 1356 SZ and 1036 HCS had complete data in COGS-2. Except for recognition memory, analysis of covariance showed significantly worse performance in COGS-2 on all CVLT-II variables for SZ and HCS, and remained significant in the presence of the covariates. Performance in each of the 5 learning trials differed significantly. However, effect sizes comparing cases and controls were comparable across the two studies. COGS-2 analyses confirmed SZ performance deficits despite effects of multiple significant covariates and moderating factors. CVLT-II performance was worse in COGS-2 than in COGS-1 for both the SZ and the HCS in this large cohort, likely due to cohort effects. Demographically corrected data yield a consistent pattern of performance across the two studies in SZ.
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Affiliation(s)
- William S Stone
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States.
| | - Raquelle I Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - David L Braff
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, United States
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Health Sciences Center, Denver, CO, United States
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Laura C Lazzeroni
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States; Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Gregory A Light
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, United States
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Health Sciences Center, Denver, CO, United States
| | - Allen D Radant
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States; VA Puget Sound Health Care System, Seattle, WA, United States
| | - Larry J Siever
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY, United States; James J. Peters VA Medical Center, New York, NY, United States
| | - Jeremy M Silverman
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY, United States; James J. Peters VA Medical Center, New York, NY, United States
| | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Catherine A Sugar
- Department of Biostatistics, University of California Los Angeles School of Public Health, Los Angeles, CA, United States
| | - Neal R Swerdlow
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Debby W Tsuang
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States; VA Puget Sound Health Care System, Seattle, WA, United States
| | - Ming T Tsuang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, MA, United States; VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, United States; Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, United States
| | - Bruce I Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States
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97
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Nuechterlein KH, Green MF, Calkins ME, Greenwood TA, Gur RE, Gur RC, Lazzeroni LC, Light GA, Radant AD, Seidman LJ, Siever LJ, Silverman JM, Sprock J, Stone WS, Sugar CA, Swerdlow NR, Tsuang DW, Tsuang MT, Turetsky BI, Braff DL. Attention/vigilance in schizophrenia: performance results from a large multi-site study of the Consortium on the Genetics of Schizophrenia (COGS). Schizophr Res 2015; 163:38-46. [PMID: 25749017 PMCID: PMC4382444 DOI: 10.1016/j.schres.2015.01.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 01/07/2015] [Accepted: 01/09/2015] [Indexed: 12/31/2022]
Abstract
Attention/vigilance impairments are present in individuals with schizophrenia across psychotic and remitted states and in their first-degree relatives. An important question is whether deficits in attention/vigilance can be consistently and reliably measured across sites varying in many participant demographic, clinical, and functional characteristics, as needed for large-scale genetic studies of endophenotypes. We examined Continuous Performance Test (CPT) data from phase 2 of the Consortium on the Genetics of Schizophrenia (COGS-2), the largest-scale assessment of cognitive and psychophysiological endophenotypes relevant to schizophrenia. The CPT data from 2251 participants from five sites were examined. A perceptual-load vigilance task (the Degraded Stimulus CPT or DS-CPT) and a memory-load vigilance task (CPT-Identical Pairs or CPT-IP) were utilized. Schizophrenia patients performed more poorly than healthy comparison subjects (HCS) across sites, despite significant site differences in participant age, sex, education, and racial distribution. Patient-HCS differences in signal/noise discrimination (d') in the DS-CPT varied significantly across sites, but averaged a medium effect size. CPT-IP performance showed large patient-HCS differences across sites. Poor CPT performance was independent of or weakly correlated with symptom severity, but was significantly associated with lower educational achievement and functional capacity. Current smoking was associated with poorer CPT-IP d'. Patients taking both atypical and typical antipsychotic medication performed more poorly than those on no or atypical antipsychotic medications, likely reflecting their greater severity of illness. We conclude that CPT deficits in schizophrenia can be reliably detected across sites, are relatively independent of current symptom severity, and are related to functional capacity.
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Affiliation(s)
- Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California, Los Angeles, CA, United States,Corresponding author: Keith H. Nuechterlein, Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine at UCLA, 300 UCLA Medical Plaza, Room 2240, Los Angeles, CA 90095-6968.
| | - Michael F. Green
- Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California, Los Angeles, CA, United States, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Monica E. Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - Tiffany A. Greenwood
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - Laura C. Lazzeroni
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, CA United States, Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Gregory A. Light
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States, VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - Allen D. Radant
- Department of Psychiatry and Behavioral Science, University of Washington, Seattle, WA, United States, VA Puget Sound Healthcare System, Seattle, WA, United States
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Larry J. Siever
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY, United States, James J. Peters VA Medical Center, New York, NY, United States
| | - Jeremy M. Silverman
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY, United States, James J. Peters VA Medical Center, New York, NY, United States
| | - Joyce Sprock
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States, VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - William S. Stone
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States, Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Catherine A. Sugar
- Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California, Los Angeles, CA, United States, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States, Department of Biostatistics, University of California, Los Angeles, CA, United States
| | - Neal R. Swerdlow
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Debby W. Tsuang
- Department of Psychiatry and Behavioral Science, University of Washington, Seattle, WA, United States, VA Puget Sound Healthcare System, Seattle, WA, United States
| | - Ming T. Tsuang
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States, Institute for Genomic Medicine, University of California, San Diego, CA, United States,The Center for Behavioral Genomics, Department of Psychiatry, University of California, San Diego, CA, United States, Harvard Institute of Psychiatry Epidemiology and Genetics, Boston, MA, United States
| | - Bruce I. Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - David L. Braff
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States, VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
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98
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Gur RC, Braff DL, Calkins ME, Dobie DJ, Freedman R, Green MF, Greenwood TA, Lazzeroni LC, Light GA, Nuechterlein KH, Olincy A, Radant AD, Seidman LJ, Siever LJ, Silverman JM, Sprock J, Stone WS, Sugar CA, Swerdlow NR, Tsuang DW, Tsuang MT, Turetsky BI, Gur RE. Neurocognitive performance in family-based and case-control studies of schizophrenia. Schizophr Res 2015; 163:17-23. [PMID: 25432636 PMCID: PMC4441547 DOI: 10.1016/j.schres.2014.10.049] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 10/19/2014] [Accepted: 10/21/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neurocognitive deficits in schizophrenia (SZ) are established and the Consortium on the Genetics of Schizophrenia (COGS) investigated such measures as endophenotypes in family-based (COGS-1) and case-control (COGS-2) studies. By requiring family participation, family-based sampling may result in samples that vary demographically and perform better on neurocognitive measures. METHODS The Penn computerized neurocognitive battery (CNB) evaluates accuracy and speed of performance for several domains and was administered across sites in COGS-1 and COGS-2. Most tests were included in both studies. COGS-1 included 328 patients with SZ and 497 healthy comparison subjects (HCS) and COGS-2 included 1195 patients and 1009 HCS. RESULTS Demographically, COGS-1 participants were younger, more educated, with more educated parents and higher estimated IQ compared to COGS-2 participants. After controlling for demographics, the two samples produced very similar performance profiles compared to their respective controls. As expected, performance was better and with smaller effect sizes compared to controls in COGS-1 relative to COGS-2. Better performance was most pronounced for spatial processing while emotion identification had large effect sizes for both accuracy and speed in both samples. Performance was positively correlated with functioning and negatively with negative and positive symptoms in both samples, but correlations were attenuated in COGS-2, especially with positive symptoms. CONCLUSIONS Patients ascertained through family-based design have more favorable demographics and better performance on some neurocognitive domains. Thus, studies that use case-control ascertainment may tap into populations with more severe forms of illness that are exposed to less favorable factors compared to those ascertained with family-based designs.
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Affiliation(s)
- Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania,
Philadelphia, PA
| | - David L. Braff
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Monica E. Calkins
- Department of Psychiatry, University of Pennsylvania,
Philadelphia, PA
| | - Dorcas J. Dobie
- Department of Psychiatry and Behavioral Sciences,
University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle,
WA
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver,
Aurora, CO
| | - Michael F. Green
- Department of Psychiatry and Biobehavioral Sciences, Geffen
School of Medicine, University of California Los Angeles, Los Angeles, CA; VA
Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Tiffany A. Greenwood
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | | | - Gregory A. Light
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Geffen
School of Medicine, University of California Los Angeles, Los Angeles, CA; VA
Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Denver,
Aurora, CO
| | - Allen D. Radant
- Department of Psychiatry and Behavioral Sciences,
University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle,
WA
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston,
MA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel
Deaconess Medical Center, Boston, MA
| | - Larry J. Siever
- Department of Psychiatry, The Mount Sinai School of
Medicine, New York, NY; 13James J. Peters VA Medical Center, New York, NY
| | - Jeremy M. Silverman
- Department of Psychiatry, The Mount Sinai School of
Medicine, New York, NY; 13James J. Peters VA Medical Center, New York, NY
| | - Joyce Sprock
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - William S. Stone
- Department of Psychiatry, Harvard Medical School, Boston,
MA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel
Deaconess Medical Center, Boston, MA
| | - Catherine A. Sugar
- Department of Biostatistics, University of California Los
Angeles School of Public Health, Los Angeles, CA
| | - Neal R. Swerdlow
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Debby W. Tsuang
- Department of Psychiatry and Behavioral Sciences,
University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle,
WA
| | - Ming T. Tsuang
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Bruce I. Turetsky
- Department of Psychiatry, University of Pennsylvania,
Philadelphia, PA
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania,
Philadelphia, PA
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99
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Andreou C, Leicht G, Nolte G, Polomac N, Moritz S, Karow A, Hanganu-Opatz IL, Engel AK, Mulert C. Resting-state theta-band connectivity and verbal memory in schizophrenia and in the high-risk state. Schizophr Res 2015; 161:299-307. [PMID: 25553979 DOI: 10.1016/j.schres.2014.12.018] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/08/2014] [Accepted: 12/10/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Disturbed functional connectivity is assumed to underlie neurocognitive deficits in patients with schizophrenia. As neurocognitive deficits are already present in the high-risk state, identification of the neural networks involved in this core feature of schizophrenia is essential to our understanding of the disorder. Resting-state studies enable such investigations, while at the same time avoiding the known confounder of impaired task performance in patients. The aim of the present study was to investigate EEG resting-state connectivity in high-risk individuals (HR) compared to first episode patients with schizophrenia (SZ) and to healthy controls (HC), and its association with cognitive deficits. METHODS 64-channel resting-state EEG recordings (eyes closed) were obtained for 28 HR, 19 stable SZ, and 23 HC, matched for age, education, and parental education. The imaginary coherence-based multivariate interaction measure (MIM) was used as a measure of connectivity across 80 cortical regions and six frequency bands. Mean connectivity at each region was compared across groups using the non-parametric randomization approach. Additionally, the network-based statistic was applied to identify affected networks in patients. RESULTS SZ displayed increased theta-band resting-state MIM connectivity across midline, sensorimotor, orbitofrontal regions and the left temporoparietal junction. HR displayed intermediate theta-band connectivity patterns that did not differ from either SZ or HC. Mean theta-band connectivity within the above network partially mediated verbal memory deficits in SZ and HR. CONCLUSIONS Aberrant theta-band connectivity may represent a trait characteristic of schizophrenia associated with neurocognitive deficits. As such, it might constitute a promising target for novel treatment applications.
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Affiliation(s)
- Christina Andreou
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Gregor Leicht
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Nolte
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nenad Polomac
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Karow
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ileana L Hanganu-Opatz
- Developmental Neurophysiology, Institute of Neuroanatomy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas K Engel
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Mulert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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100
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Bortolato B, Miskowiak KW, Köhler CA, Vieta E, Carvalho AF. Cognitive dysfunction in bipolar disorder and schizophrenia: a systematic review of meta-analyses. Neuropsychiatr Dis Treat 2015; 11:3111-25. [PMID: 26719696 PMCID: PMC4689290 DOI: 10.2147/ndt.s76700] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Cognitive impairment is a core feature of schizophrenia (SZ) and bipolar disorder (BD). A neurocognitive profile characterized by widespread cognitive deficits across multiple domains in the context of substantial intellectual impairment, which appears to antedate illness onset, is a replicated finding in SZ. There is no specific neuropsychological signature that can facilitate the diagnostic differentiation of SZ and BD, notwithstanding, neuropsychological deficits appear more severe in SZ. The literature in this field has provided contradictory results due to methodological differences across studies. Meta-analytic techniques may offer an opportunity to synthesize findings and to control for potential sources of heterogeneity. Here, we performed a systematic review of meta-analyses of neuropsychological findings in SZ and BD. While there is no conclusive evidence for progressive cognitive deterioration in either SZ or BD, some findings point to more severe cognitive deficits in patients with early illness onset across both disorders. A compromised pattern of cognitive functioning in individuals at familiar and/or clinical risk to psychosis as well as in first-degree relatives of BD patients suggests that early neurodevelopmental factors may play a role in the emergence of cognitive deficits in both disorders. Premorbid intellectual impairment in SZ and at least in a subgroup of patients with BD may be related to a shared genetically determined influence on neurodevelopment.
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Affiliation(s)
| | - Kamilla W Miskowiak
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Cristiano A Köhler
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Eduard Vieta
- Bipolar Disorders Program, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain
| | - André F Carvalho
- Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
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