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Zollicoffer A, Strauss G, Luther L, Schiffman J, Sims B, Kambui H, Li H. The relationship between perceived family support and subclinical positive symptoms of psychosis among Black college students. Early Interv Psychiatry 2024. [PMID: 38769063 DOI: 10.1111/eip.13554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/24/2024] [Accepted: 05/09/2024] [Indexed: 05/22/2024]
Abstract
AIM Black individuals in the Unites States endure compounded and unique experiences of discrimination and structural racism that may not be as overtly evident in other countries. These distinctive forms of discrimination and racism can impact the mental health of Black individuals in the Unites States, in this case, their risk for psychosis. Adolescence and early adulthood are vulnerable periods in life where mental illness typically begins to manifest. Understanding the factors contributing to an increased likelihood of specific mental illnesses, such as psychosis, among youth in these vulnerable periods can inform intervention development. This is particularly important for those from minoritized backgrounds Unites States; this group is especially important to study given that Black American youth tend to experience higher psychosis rates and different symptom presentations than non-Black groups. METHODS This study examined the associations between perceived family support, a critical environmental factor known to be associated with full-psychosis, and attenuated positive symptoms and distress levels in a sample of 155 Black students from a Historically Black College and University (HBCU). Participants completed the Prodromal Questionnaire-Brief that assessed psychosis risk and the Family Environment Scale that assessed three dimensions of family support (family cohesion, expressiveness, and conflict). RESULTS AND CONCLUSION Positive symptom intensity (r = .30, p < .001) and distress (r = .34, p < .001) were significantly associated with higher family conflict for Black individuals in the Unites States. The findings inform novel intervention targets for psychoeducation and family therapy that have potential to reduce psychosis risk.
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Affiliation(s)
| | - Gregory Strauss
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Jason Schiffman
- Department of Psychology, UC Irvine, Irvine, California, USA
| | - Brian Sims
- Department of Psychology, Florida A&M University, Tallahassee, Florida, USA
| | - Hasseim Kambui
- Department of Psychology, Florida A&M University, Tallahassee, Florida, USA
| | - Huijun Li
- Department of Psychology, Florida A&M University, Tallahassee, Florida, USA
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2
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Jonas KG, Cannon TD, Docherty AR, Dwyer D, Gur RC, Gur RE, Nelson B, Reininghaus U, Kotov R. Psychosis superspectrum I: Nosology, etiology, and lifespan development. Mol Psychiatry 2024; 29:1005-1019. [PMID: 38200290 DOI: 10.1038/s41380-023-02388-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024]
Abstract
This review describes the Hierarchical Taxonomy of Psychopathology (HiTOP) model of psychosis-related psychopathology, the psychosis superspectrum. The HiTOP psychosis superspectrum was developed to address shortcomings of traditional diagnoses for psychotic disorders and related conditions including low reliability, arbitrary boundaries between psychopathology and normality, high symptom co-occurrence, and heterogeneity within diagnostic categories. The psychosis superspectrum is a transdiagnostic dimensional model comprising two spectra-psychoticism and detachment-which are in turn broken down into fourteen narrow components, and two auxiliary domains-cognition and functional impairment. The structure of the spectra and their components are shown to parallel the genetic structure of psychosis and related traits. Psychoticism and detachment have distinct patterns of association with urbanicity, migrant and ethnic minority status, childhood adversity, and cannabis use. The superspectrum also provides a useful model for describing the emergence and course of psychosis, as components of the superspectrum are relatively stable over time. Changes in psychoticism predict the onset of psychosis-related psychopathology, whereas changes in detachment and cognition define later course. Implications of the superspectrum for genetic, socio-environmental, and longitudinal research are discussed. A companion review focuses on neurobiology, treatment response, and clinical utility of the superspectrum, and future research directions.
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Affiliation(s)
- Katherine G Jonas
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA.
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Anna R Docherty
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ruben C Gur
- Brain Behavior Laboratory, Department of Psychiatry and the Penn-CHOP Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Raquel E Gur
- Brain Behavior Laboratory, Department of Psychiatry and the Penn-CHOP Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
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3
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Armstrong MJ, Barnes LL. Under-Diagnosis of Dementia with Lewy Bodies in Individuals Racialized as Black: Hypotheses Regarding Potential Contributors. J Alzheimers Dis 2024; 97:1571-1580. [PMID: 38277299 PMCID: PMC10894581 DOI: 10.3233/jad-231177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/28/2024]
Abstract
Dementia with Lewy bodies (DLB) is one of the most common degenerative dementias after Alzheimer's disease (AD) dementia. DLB is under-diagnosed across populations but may be particularly missed in older Black adults. The object of this review was to examine key features of DLB and potential associations with race in order to hypothesize why DLB may be under-diagnosed in Black adults in the U.S. In terms of dementia, symptoms associated with high rates of co-pathology (e.g., AD, vascular disease) in older Black adults may obscure the clinical picture that might suggest Lewy body pathology. Research also suggests that clinicians may be predisposed to give AD dementia diagnoses to Black adults, potentially missing contributions of Lewy body pathology. Hallucinations in Black adults may be misattributed to AD or primary psychiatric disease rather than Lewy body pathology. Research on the prevalence of REM sleep behavior in diverse populations is lacking, but REM sleep behavior disorder could be under-diagnosed in Black adults due to sleep patterns or reporting by caregivers who are not bed partners. Recognition of parkinsonism could be reduced in Black adults due to clinician biases, cultural effects on self-report, and potentially underlying differences in the frequency of parkinsonism. These considerations are superimposed on structural and systemic contributions to health (e.g., socioeconomic status, education, structural racism) and individual-level social exposures (e.g., social interactions, discrimination). Improving DLB recognition in Black adults will require research to investigate reasons for diagnostic disparities and education to increase identification of core symptoms in this population.
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Affiliation(s)
- Melissa J. Armstrong
- Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA
- 1Florida Alzheimer Disease Research Center, Gainesville, FL, USA
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
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4
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Anderson KK, Rodrigues R. Differences in clinical presentation at first hospitalization and the impact on involuntary admissions among first-generation migrant groups with non-affective psychotic disorders. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1329-1341. [PMID: 36922459 DOI: 10.1007/s00127-023-02465-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Some migrant and ethnic minority groups have a higher risk of coercive pathways to care; however, it is unclear whether differences in clinical presentation contribute to this risk. We sought to assess: (i) whether there were differences in clinician-rated symptoms and behaviours across first-generation immigrant and refugee groups at the first psychiatric hospitalization after psychosis diagnosis, and (ii) whether these differences accounted for disparities in involuntary admission. METHODS Using population-based health administrative data from Ontario, Canada, we constructed a sample (2009-2013) of incident cases of non-affective psychotic disorder followed for two years to identify first psychiatric hospitalization. We compared clinician-rated symptoms and behaviours at admission between first-generation immigrants and refugees and the general population, and adjusted for these variables to ascertain whether the elevated prevalence of involuntary admission persisted. RESULTS Immigrants and refugee groups tended to have lower ratings for affective symptoms, self-harm behaviours, and substance use, as well as higher levels of medication nonadherence and poor insight. Immigrant groups were more likely to be perceived as aggressive and a risk of harm to others, and both groups were perceived as having self-care issues. Adjustment for perceived differences in clinical presentation at admission did not attenuate the higher prevalence of involuntary admission for immigrant and refugee groups. CONCLUSIONS First-generation migrant groups may differ in clinical presentation during the early course of psychotic illness, although these perceived differences did not explain the elevated rates of involuntary admission. Further research using outpatient samples and tools with established cross-cultural validity are warranted.
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Affiliation(s)
- Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, 1465 Richmond Street, PHFM 3135, London, ON, N6G 2M1, Canada.
- Department of Psychiatry, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
- ICES, London, ON, Canada.
| | - Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, 1465 Richmond Street, PHFM 3135, London, ON, N6G 2M1, Canada
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5
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Carr G, Cunningham R, Petrović-van der Deen FS, Manuel J, Gibb S, Porter RJ, Pitama S, Crowe M, Crengle S, Lacey C. Evolution of first episode psychosis diagnoses and health service use among young Māori and non-Māori-A New Zealand national cohort study. Early Interv Psychiatry 2023; 17:290-298. [PMID: 35733282 DOI: 10.1111/eip.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/06/2022] [Accepted: 05/29/2022] [Indexed: 11/24/2022]
Abstract
AIMS The validity of diagnostic classification in early psychosis has important implications for early intervention; however, it is unknown if previously found disparities between Māori (Indigenous people of New Zealand) and non-Māori in first episode diagnoses persist over time, or how these differences impact service use. METHODS We used anonymized routine mental health service data and a previously established cohort of over 2400 13-25-year-old youth diagnosed with FEP between 2009 and 2012, to explore differences in diagnostic stability of psychosis diagnoses, comorbid (non-psychosis) diagnoses, and mental health service contacts between Māori and non-Māori in the five-year period following diagnosis. RESULTS Differences in schizophrenia and affective psychosis diagnoses between Māori and non-Māori were maintained in the five-year period, with Māori being more likely to be diagnosed with schizophrenia (51% vs. 35%), and non-Māori with bipolar disorder (28% vs. 18%). Stability of diagnosis was similar (schizophrenia 75% Māori vs. 67% non-Maori; bipolar disorder 55% Māori vs. 48% non-Māori) and those with no stable diagnosis at FEP were most likely to move towards a schizophrenia disorder diagnosis in both groups. Māori had a lower rate of diagnosed co-morbid affective and anxiety symptoms and higher rates of continued face to face contact and inpatient admission across all diagnoses. CONCLUSIONS Indigenous differences in schizophrenia and affective psychosis diagnoses could be related to differential exposure to socio-environmental risk or assessor bias. The lower rate of co-morbid affective and anxiety disorders indicates a potential under-appreciation of affective symptoms in Māori youth with first episode psychosis.
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Affiliation(s)
- Gawen Carr
- Capital and Coast District Health Board, Wellington, New Zealand
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Frederieke S Petrović-van der Deen
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
- Department of Māori/Indigenous Health Innovation (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Jenni Manuel
- Department of Māori/Indigenous Health Innovation (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Sheree Gibb
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
- Canterbury District Health Board, Christchurch, New Zealand
| | - Suzanne Pitama
- Department of Māori/Indigenous Health Innovation (MIHI), University of Otago Christchurch, Christchurch, New Zealand
| | - Marie Crowe
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Sue Crengle
- Department of Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand
| | - Cameron Lacey
- Department of Māori/Indigenous Health Innovation (MIHI), University of Otago Christchurch, Christchurch, New Zealand
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
- Canterbury District Health Board, Christchurch, New Zealand
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6
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Duncan L, Shen H, Schulmann A, Li T, Kolachana B, Mandal A, Feng N, Auluck P, Marenco S. Polygenic scores for psychiatric disorders in a diverse postmortem brain tissue cohort. Neuropsychopharmacology 2023; 48:764-772. [PMID: 36694041 PMCID: PMC10066241 DOI: 10.1038/s41386-022-01524-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/25/2023]
Abstract
A new era of human postmortem tissue research has emerged thanks to the development of 'omics technologies that measure genes, proteins, and spatial parameters in unprecedented detail. Also newly possible is the ability to construct polygenic scores, individual-level metrics of genetic risk (also known as polygenic risk scores/PRS), based on genome-wide association studies, GWAS. Here, we report on clinical, educational, and brain gene expression correlates of polygenic scores in ancestrally diverse samples from the Human Brain Collection Core (HBCC). Genotypes from 1418 donors were subjected to quality control filters, imputed, and used to construct polygenic scores. Polygenic scores for schizophrenia predicted schizophrenia status in donors of European ancestry (p = 4.7 × 10-8, 17.2%) and in donors with African ancestry (p = 1.6 × 10-5, 10.4% of phenotypic variance explained). This pattern of higher variance explained among European ancestry samples was also observed for other psychiatric disorders (depression, bipolar disorder, substance use disorders, anxiety disorders) and for height, body mass index, and years of education. For a subset of 223 samples, gene expression from dorsolateral prefrontal cortex (DLPFC) was available through the CommonMind Consortium. In this subgroup, schizophrenia polygenic scores also predicted an aggregate gene expression score for schizophrenia (European ancestry: p = 0.0032, African ancestry: p = 0.15). Overall, polygenic scores performed as expected in ancestrally diverse samples, given historical biases toward use of European ancestry samples and variable predictive power of polygenic scores across phenotypes. The transcriptomic results reported here suggest that inherited schizophrenia genetic risk influences gene expression, even in adulthood. For future research, these and additional polygenic scores are being made available for analyses, and for selecting samples, using postmortem tissue from the Human Brain Collection Core.
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Affiliation(s)
- Laramie Duncan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA. .,Wu Tsai Neuroscience Institute, Stanford University, Stanford, CA, USA.
| | - Hanyang Shen
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA.,Epidemiology and Clinical Research Graduate Program, Stanford University, Stanford, CA, USA
| | | | - Tayden Li
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Bhaskar Kolachana
- Human Brain Collection Core (HBCC), NIMH-IRP, Bethesda, MD, 20892, USA
| | - Ajeet Mandal
- Human Brain Collection Core (HBCC), NIMH-IRP, Bethesda, MD, 20892, USA
| | - Ningping Feng
- Human Brain Collection Core (HBCC), NIMH-IRP, Bethesda, MD, 20892, USA
| | - Pavan Auluck
- Human Brain Collection Core (HBCC), NIMH-IRP, Bethesda, MD, 20892, USA
| | - Stefano Marenco
- Human Brain Collection Core (HBCC), NIMH-IRP, Bethesda, MD, 20892, USA
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7
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Chakrabarti S, Singh N. Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review. World J Psychiatry 2022; 12:1204-1232. [PMID: 36186500 PMCID: PMC9521535 DOI: 10.5498/wjp.v12.i9.1204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/02/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder (BD) and can have an adverse effect on its course, outcome, and treatment. However, despite a considerable amount of research, the impact of psychotic symptoms on BD remains unclear, and there are very few systematic reviews on the subject.
AIM To examine the extent of psychotic symptoms in BD and their impact on several aspects of the illness.
METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. An electronic literature search of six English-language databases and a manual search was undertaken to identify published articles on psychotic symptoms in BD from January 1940 to December 2021. Combinations of the relevant Medical Subject Headings terms were used to search for these studies. Articles were selected after a screening phase, followed by a review of the full texts of the articles. Assessment of the methodological quality of the studies and the risk of bias was conducted using standard tools.
RESULTS This systematic review included 339 studies of patients with BD. Lifetime psychosis was found in more than a half to two-thirds of the patients, while current psychosis was found in a little less than half of them. Delusions were more common than hallucinations in all phases of BD. About a third of the patients reported first-rank symptoms or mood-incongruent psychotic symptoms, particularly during manic episodes. Psychotic symptoms were more frequent in bipolar type I compared to bipolar type II disorder and in mania or mixed episodes compared to bipolar depression. Although psychotic symptoms were not more severe in BD, the severity of the illness in psychotic BD was consistently greater. Psychosis was usually associated with poor insight and a higher frequency of agitation, anxiety, and hostility but not with psychiatric comorbidity. Psychosis was consistently linked with increased rates and the duration of hospitalizations, switching among patients with depression, and poorer outcomes with mood-incongruent symptoms. In contrast, psychosis was less likely to be accompanied by a rapid-cycling course, longer illness duration, and heightened suicidal risk. There was no significant impact of psychosis on the other parameters of course and outcome.
CONCLUSION Though psychotic symptoms are very common in BD, they are not always associated with an adverse impact on BD and its course and outcome.
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Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
| | - Navdeep Singh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
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Buizza C, Bazzoli L, Ghilardi A. Changes in College Students Mental Health and Lifestyle During the COVID-19 Pandemic: A Systematic Review of Longitudinal Studies. ADOLESCENT RESEARCH REVIEW 2022; 7:537-550. [PMID: 35966832 PMCID: PMC9362152 DOI: 10.1007/s40894-022-00192-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/20/2022] [Indexed: 05/31/2023]
Abstract
UNLABELLED College students have poorer mental health than their peers. Their poorer health conditions seem to be caused by the greater number of stressors to which they are exposed, which can increase the risk of the onset of mental disorders. The pandemic has been an additional stressor that may have further compromised the mental health of college students and changed their lifestyles with important consequences for their well-being. Although research has recognized the impact of COVID-19 on college students, only longitudinal studies can improve knowledge on this topic. This review summarizes the data from 17 longitudinal studies examining changes in mental health and lifestyle among college students during the COVID-19 pandemic, in order to improve understanding of the effects of the outbreak on this population. Following PRISMA statements, the following databases were searched PubMed, EBSCO, SCOPUS and Web of Science. The overall sample included 20,108 students. The results show an increase in anxiety, mood disorders, alcohol use, sedentary behavior, and Internet use and a decrease in physical activity. Female students and sexual and gender minority youth reported poorer mental health conditions. Further research is needed to clarify the impact of the COVID-19 pandemic on vulnerable subgroups of college students. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40894-022-00192-7.
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Affiliation(s)
- Chiara Buizza
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Luciano Bazzoli
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
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9
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Monette MA, Lysaker PH, Minor KS. Comparing symptoms and emotion recognition in African American and White samples with schizophrenia. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2021; 56:865-869. [PMID: 33855716 PMCID: PMC10942670 DOI: 10.1002/ijop.12765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 03/24/2021] [Indexed: 11/06/2022]
Abstract
Racial status has an important role in schizophrenia, with African American samples being rated lower than White participants on a range of constructs. In many studies, however, demographic factors are not accounted for. In the present study, African American (n = 106) and White participants (n = 81) were compared on symptom severity and emotion recognition scales while controlling for other demographic factors. Contrary to our hypothesis, there were no differences in symptoms between racial groups. However, White participants performed better on an emotion recognition measure than African Americans. These differences were most prominent in response to negatively-valenced stimuli. This study replicated previous findings of racial differences in emotion recognition but not symptom severity. Future research should assess the role of racial identity on symptom severity. In addition, further research is needed to assess if utilising multi-ethnic stimuli improves performance by racial minorities on emotion recognition measures.
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Affiliation(s)
- Mahogany A. Monette
- Department of Psychology, Indiana University- Purdue University Indianapolis, Indianapolis, IN, United States
| | - Paul H. Lysaker
- Roudebush VA Medical Center, Indianapolis, IN, United States
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Kyle S. Minor
- Department of Psychology, Indiana University- Purdue University Indianapolis, Indianapolis, IN, United States
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10
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Mamah D, Mutiso VN, Ndetei DM. Neurocognition in Kenyan youth at clinical high risk for psychosis. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 25:100198. [PMID: 34094888 PMCID: PMC8167199 DOI: 10.1016/j.scog.2021.100198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 11/27/2022]
Abstract
Introduction Cognitive deficits are typically seen in schizophrenia and in the prodrome, and are a major predictor of functional outcomes in patients. In Africa, few studies have investigated neurocognition in psychosis, which presents a gap in our understanding of the heterogeneity of the illness. In this study, we assessed neurocognition among the largest sample of psychosis-risk participants recruited in the continent to date. Methods The study was conducted in Kenya, and involved 295 psychiatric medication-naïve participants at clinical high-risk (CHR) for psychosis and healthy controls, aged 15–25 yrs. Psychosis-risk status was determined separately using the Structured Interview of Psychosis-Risk Syndromes (i.e. CHR) and by self-report with the Washington Early Recognition Center Affectivity and Psychosis Screen. Eleven tests were administered using the University of Pennsylvania Computerized Neurocognitive Battery. Test performance across groups were investigated, as well as demographic and clinical effects. Results Fewer participants were designated as being at psychosis-risk with structured interview (n = 47; CHR) than with self-report (n = 155). A MANOVA of cognitive test performance was significant only when groups were ascertained based on self-report (p = 0.03), with decreased performance in the risk group on verbal intelligence (p = 0.003; d = 0.39), emotion recognition (p = 0.003; d = 0.36), sensorimotor processing (p = 0.01; d = 0.31) and verbal memory (p = 0.035; d = 0.21). Only verbal intelligence was significantly worse in the CHR group compared to controls (p = 0.036; d = 0.45). There were no significant age and gender relationships. Conclusion Deficits across multiple cognitive domains are present in Kenyan psychosis-risk youth, most significantly in verbal intelligence. The pattern of cognitive deficits and an absence of gender effects may represent ethnicity-specific phenotypes of the psychosis-risk state. Longitudinal studies of neurocognition in Kenyan patients who convert to psychosis may enhance risk prediction in this population, and facilitate targeted interventions.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, United States of America
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya.,Department of Psychiatry, University of Nairobi, Kenya
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11
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Izakova L, Breznoscakova D. Differences in Treatment of Schizoaffective Disorder and Schizophrenia in Real Clinical Practice in Slovakia. Health (London) 2021. [DOI: 10.4236/health.2021.131007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Mansolf M, Vreeker A, Reise SP, Freimer NB, Glahn DC, Gur RE, Moore TM, Pato CN, Pato MT, Palotie A, Holm M, Suvisaari J, Partonen T, Kieseppä T, Paunio T, Boks M, Kahn R, Ophoff RA, Bearden CE, Loohuis LO, Teshiba T, deGeorge D, Bilder RM. Extensions of Multiple-Group Item Response Theory Alignment: Application to Psychiatric Phenotypes in an International Genomics Consortium. EDUCATIONAL AND PSYCHOLOGICAL MEASUREMENT 2020; 80:870-909. [PMID: 32855563 PMCID: PMC7425327 DOI: 10.1177/0013164419897307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Large-scale studies spanning diverse project sites, populations, languages, and measurements are increasingly important to relate psychological to biological variables. National and international consortia already are collecting and executing mega-analyses on aggregated data from individuals, with different measures on each person. In this research, we show that Asparouhov and Muthén's alignment method can be adapted to align data from disparate item sets and response formats. We argue that with these adaptations, the alignment method is well suited for combining data across multiple sites even when they use different measurement instruments. The approach is illustrated using data from the Whole Genome Sequencing in Psychiatric Disorders consortium and a real-data-based simulation is used to verify accurate parameter recovery. Factor alignment appears to increase precision of measurement and validity of scores with respect to external criteria. The resulting parameter estimates may further inform development of more effective and efficient methods to assess the same constructs in prospectively designed studies.
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Affiliation(s)
- Maxwell Mansolf
- University of California, Los Angeles, Los Angeles, CA, USA
- Maxwell Mansolf, Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA.
| | | | | | | | | | | | | | - Carlos N. Pato
- SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Michele T. Pato
- SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Aarno Palotie
- Massachusetts Institute of Technology, Cambridge, MA, USA
- Harvard University, Boston, MA, USA
- University of Helsinki, Helsinki, Finland
| | - Minna Holm
- National Institute for Health and Welfare, Finland, Helsinki
| | - Jaana Suvisaari
- National Institute for Health and Welfare, Finland, Helsinki
| | - Timo Partonen
- National Institute for Health and Welfare, Finland, Helsinki
| | | | - Tiina Paunio
- University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare, Finland, Helsinki
| | - Marco Boks
- University Medical Center Utrecht, Utrecht, Netherlands
| | - René Kahn
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roel A. Ophoff
- University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | - Terri Teshiba
- University of California, Los Angeles, Los Angeles, CA, USA
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13
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Kotov R, Jonas KG, Carpenter WT, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Hobbs K, Reininghaus U, Slade T, South SC, Sunderland M, Waszczuk MA, Widiger TA, Wright AGC, Zald DH, Krueger RF, Watson D. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): I. Psychosis superspectrum. World Psychiatry 2020; 19:151-172. [PMID: 32394571 PMCID: PMC7214958 DOI: 10.1002/wps.20730] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a scientific effort to address shortcomings of traditional mental disorder diagnoses, which suffer from arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. This paper synthesizes evidence on the validity and utility of the thought disorder and detachment spectra of HiTOP. These spectra are composed of symptoms and maladaptive traits currently subsumed within schizophrenia, other psychotic disorders, and schizotypal, paranoid and schizoid personality disorders. Thought disorder ranges from normal reality testing, to maladaptive trait psychoticism, to hallucinations and delusions. Detachment ranges from introversion, to maladaptive detachment, to blunted affect and avolition. Extensive evidence supports the validity of thought disorder and detachment spectra, as each spectrum reflects common genetics, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, biomarkers, and treatment response. Some of these characteristics are specific to one spectrum and others are shared, suggesting the existence of an overarching psychosis superspectrum. Further research is needed to extend this model, such as clarifying whether mania and dissociation belong to thought disorder, and explicating processes that drive development of the spectra and their subdimensions. Compared to traditional diagnoses, the thought disorder and detachment spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and higher acceptability to clinicians. Validated measures are available to implement the system in practice. The more informative, reliable and valid characterization of psychosis-related psychopathology offered by HiTOP can make diagnosis more useful for research and clinical care.
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Affiliation(s)
- Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Katherine G Jonas
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | | | - Michael N Dretsch
- Walter Reed Army Institute of Research, US Army Medical Research Directorate - West, Silver Spring, MD, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Miriam K Forbes
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsey Hobbs
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
- ESRC Centre for Society and Mental Health, King's College London, London, UK
- Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Abuse, University of Sydney, Sydney, NSW, Australia
| | - Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Abuse, University of Sydney, Sydney, NSW, Australia
| | - Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Thomas A Widiger
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, South Bend, IN, USA
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14
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Akinhanmi M, El-Amin S, Balls-Berry JE, Vallender EJ, Ladner M, Geske J, Coombes B, Biernacka J, Kelsoe J, Frye MA. Decreased core symptoms of mania and utilization of lithium/mood stabilizing anticonvulsants in U.S. bipolar I patients of African vs European ancestry. J Affect Disord 2020; 260:361-365. [PMID: 31539671 DOI: 10.1016/j.jad.2019.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/06/2019] [Accepted: 09/03/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Misdiagnosis is common in bipolar disorder and disproportionally affects racial and ethnic minorities. There is interest in better understanding the contribution of differential symptomatic illness presentation to misdiagnosis. METHODS Utilizing the Genetic Association Information Network (GAIN) public database, this study compared clinical phenomenology between bipolar patients of African vs European ancestry (AA = 415 vs EA = 480). The Diagnostic Interview for Genetic Studies (DIGS) was utilized to evaluate symptom endorsement contributing to diagnostic confirmation of bipolar I disorder (BPI) and lifetime medication use. RESULTS Elevated/euphoric mood was less endorsed in AA vs EA participants (p = 0.03). During the most severe episode of mania, AA participants, in comparison to EA participants, had a lower sum of manic symptoms (p = 0.006) and a higher rate of hallucinations (p = 0.01). During lifetime psychosis, AA participants, in comparison to EA participants, had a higher lifetime sum of delusions (p = 0.01) and hallucinations (p < 0.0001). AA participants reported lower use of lithium (p < 0.0001) and mood stabilizing anticonvulsants (p = 0.0003). CONCLUSIONS The differential rate of manic and psychotic symptom endorsement from a semi-structured diagnostic interview may represent differential illness presentation based on biological differences or racial or study biases (e.g. ascertainment). Increased minority recruitment in bipolar research is therefore a necessary future direction. LIMITATIONS Recall and interviewer bias may affect study results, but are likely diminished by the alignment of symptom endorsement and medication use.
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Affiliation(s)
- Margaret Akinhanmi
- Clinical & Translational Science, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, USA
| | - Suliman El-Amin
- Department of Psychiatry & Psychology, Mayo Clinic, 200 First ST SW, Rochester, MN, 55905, USA
| | - Joyce E Balls-Berry
- Mayo Clinic College of Medicine and Science, Rochester, MN,; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Eric J Vallender
- Department of Psychiatry & Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Mark Ladner
- Department of Psychiatry & Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jennifer Geske
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Brandon Coombes
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Joanna Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic, 200 First ST SW, Rochester, MN, 55905, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - John Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, 200 First ST SW, Rochester, MN, 55905, USA.
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15
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Schoonover KE, Farmer CB, Cash AE, Roberts RC. Pathology of white matter integrity in three major white matter fasciculi: A post-mortem study of schizophrenia and treatment status. Br J Pharmacol 2019; 176:1143-1155. [PMID: 30735241 DOI: 10.1111/bph.14612] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/05/2018] [Accepted: 12/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Imaging studies have shown that people with schizophrenia exhibit abnormal connectivity termed "dysconnectivity" in several white matter tracts, including the cingulum bundle (CB), corpus callosum (CC), and arcuate fasciculus (AF). This study aimed to elucidate potential contributors to schizophrenia "dysconnectivity." EXPERIMENTAL APPROACH Western blot analysis was used to compare protein levels of myelin basic protein, neurofilament heavy, autophagosome marker LC3, and microtubule marker α-tubulin in post-mortem human CB, CC, and AF in schizophrenia subjects (SZ) and matched normal controls (NC). Additionally, SZ cases were subdivided by treatment status: off-medication (OFF) or on-medication (ON). KEY RESULTS In the CC, the combined SZ group exhibited less neurofilament heavy protein than the NCs. In the CB, the combined SZ group had similar levels of α-tubulin protein versus NC, but OFF subjects had increased α-tubulin protein versus ON and NCs. There were significant correlations between α-tubulin and all other proteins but only in the CB. The strong negative relationship between α-tubulin versus myelin basic protein and α-tubulin versus LC3 in NCs was absent in SZs; coefficients comparison showed significant differences. Preliminary race analyses revealed that African American SZ had less AF α-tubulin than Caucasian SZ and African American normal controls. CONCLUSIONS AND IMPLICATIONS The results show a relationship between tract- and protein-specific abnormalities and diagnosis, treatment, and race. These data suggest there is a dysregulation of the relationship between α-tubulin and the other markers of white matter integrity observed in the CB in schizophrenia.
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Affiliation(s)
- Kirsten E Schoonover
- Department of Psychology and Behavioral Neuroscience, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Charlene B Farmer
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrew E Cash
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rosalinda C Roberts
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
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16
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Psychopathological and demographic characteristics of hallucinating patients with schizophrenia and schizoaffective disorder: an analysis based on AMDP data. Eur Arch Psychiatry Clin Neurosci 2017; 267:295-301. [PMID: 27752826 DOI: 10.1007/s00406-016-0738-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 09/25/2016] [Indexed: 01/19/2023]
Abstract
Hallucinations are at the core of the diagnosis of schizophrenia and schizoaffective disorders, and many neuroscience studies focus on hallucinations. However, there is a lack of data on prevalence, subtyping, and clinical correlates of hallucinations as well as on the comparison of hallucinating schizophrenia versus hallucinating schizoaffective patients. Analysis of all psychopathology evaluations is based on the AMDP scale in a German psychiatric university hospital between 2007 and 2013 regarding patients with schizophrenia or schizoaffective disorder (diagnosed according to ICD-10). Hallucinating versus non-hallucinating patients and age- and gender-matched hallucinating schizophrenic versus schizoaffective patients were compared with regard to key psychopathological and demographic characteristics. Relative to patients with schizoaffective disorder, patients with schizophrenia more often hallucinated at admission (36.6 vs. 16.2 %, RR: 2.3, p < 0.001). By subtype, frequency of hallucinations ranked auditory verbal > other auditory > visual > somatic/tactile > olfactory/gustatory. Hallucinating patients of either disorder were more often affected with respect to delusions (83 vs. 62 % and 81 vs. 48 % among patients with schizophrenia and schizoaffective disorder, respectively [both p < 0.0001]) and anxiety. Hallucinating patients with schizoaffective disorder did not differ from hallucinating patients with schizophrenia. This is one of the few studies providing data on hallucinations in a routine clinical care setting. Hallucinations are a sign and likely a cause of greater illness severity. Patients with schizoaffective disorder less often experience hallucinations than patients with schizophrenia, but if they do, they seem to resemble patients with schizophrenia with regard to illness severity.
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17
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Alvaro N, Miyao Y, Collier N. TwiMed: Twitter and PubMed Comparable Corpus of Drugs, Diseases, Symptoms, and Their Relations. JMIR Public Health Surveill 2017; 3:e24. [PMID: 28468748 PMCID: PMC5438461 DOI: 10.2196/publichealth.6396] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/24/2016] [Accepted: 03/20/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Work on pharmacovigilance systems using texts from PubMed and Twitter typically target at different elements and use different annotation guidelines resulting in a scenario where there is no comparable set of documents from both Twitter and PubMed annotated in the same manner. OBJECTIVE This study aimed to provide a comparable corpus of texts from PubMed and Twitter that can be used to study drug reports from these two sources of information, allowing researchers in the area of pharmacovigilance using natural language processing (NLP) to perform experiments to better understand the similarities and differences between drug reports in Twitter and PubMed. METHODS We produced a corpus comprising 1000 tweets and 1000 PubMed sentences selected using the same strategy and annotated at entity level by the same experts (pharmacists) using the same set of guidelines. RESULTS The resulting corpus, annotated by two pharmacists, comprises semantically correct annotations for a set of drugs, diseases, and symptoms. This corpus contains the annotations for 3144 entities, 2749 relations, and 5003 attributes. CONCLUSIONS We present a corpus that is unique in its characteristics as this is the first corpus for pharmacovigilance curated from Twitter messages and PubMed sentences using the same data selection and annotation strategies. We believe this corpus will be of particular interest for researchers willing to compare results from pharmacovigilance systems (eg, classifiers and named entity recognition systems) when using data from Twitter and from PubMed. We hope that given the comprehensive set of drug names and the annotated entities and relations, this corpus becomes a standard resource to compare results from different pharmacovigilance studies in the area of NLP.
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Affiliation(s)
- Nestor Alvaro
- National Institute of Informatics, Department of Informatics, Tokyo, Japan
- The Graduate University for Advanced Studies (SOKENDAI), Kanagawa, Japan
| | - Yusuke Miyao
- National Institute of Informatics, Department of Informatics, Tokyo, Japan
- The Graduate University for Advanced Studies (SOKENDAI), Kanagawa, Japan
| | - Nigel Collier
- Faculty of Modern & Medieval Languages, Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge, United Kingdom
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