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Arya S, Kamyab A, Sanatkar SA, Pourmehdiardebili M, Ebrahimi A, Kamyab P, Alavi K, Zarei Z, Ahmadkhaniha HR. Evaluating the association of vitamin D3, parathyroid hormone, and C-reactive protein serum levels in patients with an acute psychotic episode: a cross-sectional study in tertiary centre in Iran. BMC Psychiatry 2023; 23:724. [PMID: 37803327 PMCID: PMC10557165 DOI: 10.1186/s12888-023-05234-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND The high impact of vitamin D on brain development and its relationship with inflammatory markers in the clinical course of psychiatric disorders have compelled researchers to investigate the potential association between vitamin D levels, C-reactive protein (CRP) levels, and the incidence of mental disorders. In the present study, we aimed to compare the serum levels of vitamin D and its related markers, including calcium, phosphorus, and parathyroid hormone (PTH), along with CRP, in 3 groups of patients with acute psychotic episodes, including schizophrenia, bipolar disorder, and methamphetamine-induced psychosis, with a standard control group of the Iranian population. METHODS This descriptive cross-sectional study was conducted at a psychiatric hospital in Tehran, Iran, and involved a total of 185 subjects. The subjects included four groups: acute phase of schizophrenia (n = 49), acute manic episodes of bipolar disorder (n = 43), methamphetamine-induced psychotic disorder (n = 46), and control group (n = 47). Among 138 patients in acute psychotic episodes, 33 patients were in their first episode of psychosis, while 105 patients were in acute exacerbation of their chronic psychotic disorders. The Brief Psychiatric Rating Scale (BPRS) was measured by an expert attending psychiatrist for all patients. Then, serum levels of calcium, phosphorus, parathormone, vitamin D, and CRP were assessed in all study groups. RESULTS Among our 185 study subjects, it was observed that individuals with higher education levels and those who were married had a lower prevalence of mental disorders. In all patient groups, the serum levels of CRP were significantly higher, and PTH levels were significantly lower than in the control group (p < 0.001). The serum levels of calcium, phosphorus, and vitamin D were not statistically significantly different between the patient and control groups of the study. In chronic psychotic patients, CRP levels were significantly higher (p < 0.031), and vitamin D levels were significantly lower (p < 0.044) compared to first-episode psychotic patients. CONCLUSION This study suggests that CRP levels are significantly higher and PHT level is significantly lower in acute psychotic patients. Moreover, vitamin D levels were significantly lower in chronic psychotic patients compared to first-episode psychotic patients.
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Affiliation(s)
- Shahrzad Arya
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Alireza Ebrahimi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parnia Kamyab
- Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Kaveh Alavi
- Department of Psychiatry, Mental Health Research Center, School of Behavioral Sciences & Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Zhina Zarei
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Ahmadkhaniha
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran.
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Protsenko M, Kerkelä M, Miettunen J, Auvinen J, Järvelin MR, Jones PB, Gissler M, Veijola J. Insulin resistance and lipid levels in the middle-aged offspring of parents with severe mental illness. Schizophr Res 2023; 252:271-278. [PMID: 36696701 DOI: 10.1016/j.schres.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/28/2022] [Accepted: 01/07/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Type 2 diabetes and dyslipidemias co-occur frequently with severe mental illnesses (SMI). However, less is known about serum insulin and lipid levels and prevalence of Insulin Resistance (IR) in offspring with familial risk for SMI. METHOD The Northern Finland Birth Cohort 1966 consists of 12,068 mothers, 11,068 fathers, and 12,231 children from the two northernmost provinces in Finland. At age 46 they participated in clinical examination including measurements of glucose, lipids, and IR and answered a questionnaire including information about their nutrition and physical activity. The information on parental SMI was obtained from the Hospital Discharge Register. Parents with SMI were those who had been treated in hospital for any psychiatric disorder during 1969-1982 (ICD-8 codes 290-315). The final study group included 334 (7.3 %) offspring who had a parent with SMI and 4249 (92.7 %) offspring in the comparison group. RESULTS We did not find increased risk for disturbances in lipid levels, insulin levels, or IR levels between the study group (offspring of either parent with SMI) compared with the comparison group. All offspring, especially female offspring of either parent with SMI, had an increased risk for higher glucose levels and waist circumference. The results remained the same after excluding offspring with SMI. CONCLUSION Our findings suggest that offspring of parents with SMI, especially female offspring, have partly increased risk for disturbances in cardiometabolic risk factors. Disturbances in glucose metabolism may have an effect via familial risk of severe mental illness.
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Affiliation(s)
- Maria Protsenko
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland.
| | - Martta Kerkelä
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Juha Auvinen
- Research Unit of Population Health, University of Oulu, Finland
| | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, UK
| | - Mika Gissler
- THL, Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland; University of Turku, Research Centre for Child Psychiatry, Turku, Finland; Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, University Hospital of Oulu, Finland
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Ayesa-Arriola R, Miguel-Corredera M, de la Foz VOG, Neergaard KD, Correa-Ghisays P, Setién-Suero E, Crespo-Facorro B. Education and long-term outcomes in first episode psychosis: 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:66-77. [PMID: 33952364 DOI: 10.1017/s0033291721001112] [Citation(s) in RCA: 3] [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: 01/16/2023]
Abstract
BACKGROUND Lower levels of education have been associated with the development of psychosis. Investigating educational achievement in the first episode of psychosis (FEP) patients may shed light on the origins of the alterations and on the variability of outcomes in psychotic disorders. METHODS Education achievement was explored in a large sample (n = 659) of FEP patients enrolled in programa de atención a fases iniciales de psicosis (PAFIP), a research and assistance program conducted in Spain. Patients were stratified according to the Spanish educational system according to their attendance in primary (low), secondary (medium) or university studies (high). The three groups were compared on available premorbid, clinical and neuropsychological variables. A subgroup of patients (n = 209), comprising the 10-year follow-up PAFIP cohort, were again compared. RESULTS Overall, 49% and 37% of FEP patients had low and medium levels of education, respectively. In total, 13% of the patients with a higher level of education were more frequently women (64%) and older at illness onset (36 years old), reported better premorbid adjustment, presented less severe positive symptoms and better functioning; and showed higher premorbid intelligence quotient and better performance on all the explored cognitive domains. Ten years later the FEP patients in the medium- and high-education groups had good global functioning and a neurocognitive performance within the normal limits. CONCLUSIONS Higher education is associated with better initial conditions and more favourable outcomes after an FEP. Sharing this information with the world's educational systems is essential to targeting resources and designing innovative programs or strategies to compensate for student difficulties.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Margarita Miguel-Corredera
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | | | - Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Psychology and TMAP, Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Valencia, Spain
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Instituto de Investigacion Sanitaria de Sevilla, IBiS, Sevilla, Spain
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Tarricone I, D'Andrea G, Jongsma HE, Tosato S, Gayer-Anderson C, Stilo SA, Suprani F, Iyegbe C, van der Ven E, Quattrone D, di Forti M, Velthorst E, Rossi Menezes P, Arango C, Parellada M, Lasalvia A, La Cascia C, Ferraro L, Bobes J, Bernardo M, Sanjuán I, Santos JL, Arrojo M, Del-Ben CM, Tripoli G, Llorca PM, de Haan L, Selten JP, Tortelli A, Szöke A, Muratori R, Rutten BP, van Os J, Jones PB, Kirkbride JB, Berardi D, Murray RM, Morgan C. Migration history and risk of psychosis: results from the multinational EU-GEI study. Psychol Med 2022; 52:2972-2984. [PMID: 33563347 PMCID: PMC9693676 DOI: 10.1017/s003329172000495x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 11/18/2020] [Accepted: 11/25/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration. METHODS We used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case-control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models. RESULTS In total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06-2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02-3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03-1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672-2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose-response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06-96.47, p = 0.007). CONCLUSIONS The cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants.
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Affiliation(s)
- Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Hannah E. Jongsma
- PsyLife Group, Division of Psychiatry, UCL, London, England
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - Simona A. Stilo
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Federico Suprani
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Els van der Ven
- Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Marta di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Paulo Rossi Menezes
- University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129, Palermo, Italy
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129, Palermo, Italy
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Iulio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital ‘Virgen de la Luz’, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Department of Biomedicine, neurosciences, and advanced diagnostics, University of Palermo, Italy
| | | | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Andrei Szöke
- Univ Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Fondation FondaMental, F-94010 Creteil, France
| | - Roberto Muratori
- Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy
| | - Bart P. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | | | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
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Korann V, Jacob A, Lu B, Devi P, Thonse U, Nagendra B, Maria Chacko D, Dey A, Padmanabha A, Shivakumar V, Dawn Bharath R, Kumar V, Varambally S, Venkatasubramanian G, Deshpande G, Rao NP. Effect of Intranasal Oxytocin on Resting-state Effective Connectivity in Schizophrenia. Schizophr Bull 2022; 48:1115-1124. [PMID: 35759349 PMCID: PMC9434443 DOI: 10.1093/schbul/sbac066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Evidence from several lines of research suggests the critical role of neuropeptide oxytocin in social cognition and social behavior. Though a few studies have examined the effect of oxytocin on clinical symptoms of schizophrenia, the underlying neurobiological changes are underexamined. Hence, in this study, we examined the effect of oxytocin on the brain's effective connectivity in schizophrenia. METHODS 31 male patients with schizophrenia (SCZ) and 21 healthy male volunteers (HV) underwent resting functional magnetic resonance imaging scans with intra-nasal oxytocin (24 IU) and placebo administered in counterbalanced order. We conducted a whole-brain effective connectivity analysis using a multivariate vector autoregressive granger causality model. We performed a conjunction analysis to control for spurious changes and canonical correlation analysis between changes in connectivity and clinical and demographic variables. RESULTS Three connections, sourced from the left caudate survived the FDR correction threshold with the conjunction analysis; connections to the left supplementary motor area, left precentral gyrus, and left frontal inferior triangular gyrus. At baseline, SCZ patients had significantly weaker connectivity from caudate to these three regions. Oxytocin, but not placebo, significantly increased the strength of connectivity in these connections. Better cognitive insight and lower negative symptoms were associated with a greater increase in connectivity with oxytocin. CONCLUSIONS These findings provide a preliminary mechanistic understanding of the effect of oxytocin on brain connectivity in schizophrenia. The study findings provide the rationale to examine the potential utility of oxytocin for social cognitive deficits in schizophrenia.
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Affiliation(s)
| | | | - Bonian Lu
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - Priyanka Devi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Umesh Thonse
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Bhargavi Nagendra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Dona Maria Chacko
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Avyarthana Dey
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Anantha Padmanabha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Venkataram Shivakumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Rose Dawn Bharath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | | | - Naren P Rao
- To whom correspondence should be addressed; tel: +91-80-26995879, e-mail:
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6
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Sideli L, Schimmenti A, La Barbera D, La Cascia C, Ferraro L, Aas M, Alameda L, Velthorst E, Fisher HL, Caretti V, Trotta G, Tripoli G, Quattrone D, Gayer-Anderson C, Seminerio F, Sartorio C, Marrazzo G, Lasalvia A, Tosato S, Tarricone I, Berardi D, D’Andrea G, Arango C, Arrojo M, Bernardo M, Bobes J, Sanjuán J, Santos JL, Menezes PR, Del-Ben CM, Jongsma HE, Jones PB, Kirkbride JB, Llorca PM, Tortelli A, Pignon B, de Haan L, Selten JP, Van Os J, Rutten BP, Di Forti M, Morgan C, Murray RM. Childhood Maltreatment, Educational Attainment, and IQ: Findings From a Multicentric Case-control Study of First-episode Psychosis (EU-GEI). Schizophr Bull 2022; 48:575-589. [PMID: 35137235 PMCID: PMC9077421 DOI: 10.1093/schbul/sbac004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND HYPOTHESIS Evidence suggests that childhood maltreatment (ie, childhood abuse and childhood neglect) affects educational attainment and cognition. However, the association between childhood maltreatment and Intelligence Quotient (IQ) seems stronger among controls compared to people with psychosis. We hypothesised that: the association between childhood maltreatment and poor cognition would be stronger among community controls than among people with first-episode of psychosis (FEP); compared to abuse, neglect would show stronger associations with educational attainment and cognition; the association between childhood maltreatment and IQ would be partially accounted for by other risk factors; and the association between childhood maltreatment, educational attainment, and IQ would be stronger among patients with affective psychoses compared to those with nonaffective psychoses. STUDY DESIGN 829 patients with FEP and 1283 community controls from 16 EU-GEI sites were assessed for child maltreatment, education attainment, and IQ. STUDY RESULTS In both the FEP and control group, childhood maltreatment was associated with lower educational attainment. The association between childhood maltreatment and lower IQ was robust to adjustment for confounders only among controls. Whereas childhood neglect was consistently associated with lower attainment and IQ in both groups, childhood abuse was associated with IQ only in controls. Among both patients with affective and nonaffective psychoses, negative associations between childhood maltreatment and educational attainment were observed, but the crude association with IQ was only evident in affective psychoses. CONCLUSIONS Our findings underscore the role of childhood maltreatment in shaping academic outcomes and cognition of people with FEP as well as controls.
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Affiliation(s)
- Lucia Sideli
- To whom correspondence should be addressed; Department of Human Science, LUMSA University, Piazza delle Vaschette, 101 – 00193 Rome, Italy; tel: +39 06 684 221, e-mail:
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,NORMENT, Centre for Research On Mental Disorders, Oslo University Hospital and University of Oslo, Norway,Department of Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Norway
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Departamento de Psiquiatria, Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA,Early Psychosis Section, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Helen L Fisher
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England,ESRC Centre for Society and Mental Health, King’s College London, London, UK
| | | | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Diego Quattrone
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England
| | - Charlotte Gayer-Anderson
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England,Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Giovanna Marrazzo
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Italy
| | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Giuseppe D’Andrea
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de
Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Department of Medicine, Neuroscience Institute, University of Barcelona, Institut d’Investigacions Biomèdiques, August Pi I Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Hospital “Virgen de la Luz”, Cuenca, Spain
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, Universidade de São Paulo, São Paulo, Brazil
| | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, England,Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England,EA 7280 Npsydo, Université Clermont Auvergne, Clermont-Ferrand, France
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, England
| | | | - Andrea Tortelli
- Establissement Public de Santé, Maison Blanche, Paris, France
| | - Baptiste Pignon
- AP-HP, Groupe Hospitalier “Mondor,” Pôle de Psychiatrie, Créteil, France,Institut National de la Santé et de la Recherche Médicale, U955, Créteil, France,Fondation Fondamental, Créteil, France
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands,Department Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marta Di Forti
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King’s College London, London, UK,Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
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7
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Abstract
AbstractResearch on malingering detection has not yet taken full advantage of eye tracking technology. In particular, while several studies indicate that patients with schizophrenia behave notably differently from controls on specific oculomotor tasks, no study has yet investigated whether experimental participants instructed to feign could reproduce those behaviors, if coached to do so. Due to the automatic nature of eye movements, we anticipated that eye tracking analyses would help detect feigned schizophrenic problems. To test this hypothesis, we recorded the eye movements of 83 adult UK volunteers, and tested whether eye movements of healthy volunteers instructed to feign schizophrenia (n = 43) would differ from those of honest controls (n = 40), while engaging in smooth pursuit and pro- and anti-saccade tasks. Additionally, results from our investigation were also compared against previously published data observed in patients with schizophrenia performing similar oculomotor tasks. Data analysis showed that eye movements of experimental participants instructed to feign (a) only partially differed from those of controls and (b) did not closely resemble those from patients with schizophrenia reported in previously published papers. Taken together, these results suggest that examination of eye movements does have the potential to help detecting feigned schizophrenia.
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8
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Raju VB, Shukla A, Jacob A, Bharath RD, Kumar VK, Varambally S, Venkatasubramanian G, Rao NP. The frontal pole and cognitive insight in schizophrenia. Psychiatry Res Neuroimaging 2021; 308:111236. [PMID: 33340961 DOI: 10.1016/j.pscychresns.2020.111236] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/23/2020] [Accepted: 12/11/2020] [Indexed: 12/22/2022]
Abstract
Absence of insight owing to impaired self-reflection and lack of touch with reality is a hallmark of schizophrenia. Functional imaging studies in healthy individuals have implicated the frontal pole (FP), sub-division of the prefrontal cortex in self-reflective processes. Despite the significance of self-referential processing in the pathogenesis of schizophrenia, the relationship between FP volume and cognitive insight in this disorder is underexplored. We examined the relationship between cognitive insight and volume of FP using precise manual morphometry of high resolution magnetic resonance images in 19 schizophrenia patients (SCZ) and 21 healthy-volunteers (HV). The manual morphometry technique was replicated from a previous study based on a cytoarchitectonically and functionally valid definition of FP and cognitive insight was measured using Beck's cognitive insight scale. Left frontal pole volume was a significant predictor of self-reflection sub-score of Beck's cognitive insight scale (β=0.68; t = 2.86; p = 0.01). A significant inverse relationship between age and bilateral FP volumes was noted in HV (left FP - r=-0.45; p = 0.04; right FP - r=-0.57; p = 0.008) but not in SCZ (p>0.05). Our findings provide anatomical substrates to devise intervention strategies targeting cognitive insight, thereby improving treatment adherence and functional outcomes.
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Affiliation(s)
- Vikas B Raju
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ayushi Shukla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Arpitha Jacob
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vijay Kg Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
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9
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Hermans K, van der Steen Y, Kasanova Z, van Winkel R, Reininghaus U, Lataster T, Bechdolf A, Gimpel-Drees J, Wagner M, Myin-Germeys I. Temporal dynamics of suspiciousness and hallucinations in clinical high risk and first episode psychosis. Psychiatry Res 2020; 290:113039. [PMID: 32460186 DOI: 10.1016/j.psychres.2020.113039] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 12/23/2022]
Abstract
The objective of the current study is to elucidate the temporal dynamics of suspiciousness and hallucinations as they occur in daily life in the early stages of psychosis. Their prevalence and co-occurrence, as well as their temporal relation to affect and delusions, were compared between patients with a first psychotic episode (FEP) and individuals at clinical high risk for psychosis (CHRp). The Experience Sampling Method was used to investigate suspiciousness and hallucinatory experiences, delusions, and affect at semi-random moments throughout six days in 33 CHRp and 34 FEP. Overall, 91% of CHRp and 59% of FEP reported suspiciousness, and 24% and 39% reported hallucinations, respectively. Hallucinations almost always co-occurred with suspiciousness, whereas suspiciousness was often present without hallucinations. Suspicious episodes in CHRp occurred with marked increases in delusional intensity, while hallucinatory experiences were mostly absent. In FEP, a decrease of positive affect preceded suspicious episodes, while an increase of negative affect preceded hallucinatory episodes. Our results indicated the presence of a delusional mood (atmosphere) in CHRp as an experience in itself, without co-occurring or following hallucinations, thus refuting the anomalous experience hypothesis of psychosis. The co-occurrence of hallucinations, on the other hand, indicates a more severe stage of symptomatology.
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Affiliation(s)
- Karlijn Hermans
- Catholic University Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium.
| | - Yori van der Steen
- Catholic University Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium; Maastricht University, School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry & Neuropsychology, Maastricht, The Netherlands; GGzE, Institute for Mental Health Care Eindhoven en de Kempen, Eindhoven, The Netherlands
| | - Zuzana Kasanova
- Catholic University Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Ruud van Winkel
- University Psychiatric Center, Catholic University Leuven, Campus Kortenberg, Leuvensesteenweg, Kortenberg, Belgium; Catholic University Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Clinical Psychiatry, Leuven, Belgium
| | - Ulrich Reininghaus
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Tineke Lataster
- Maastricht University, School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry & Neuropsychology, Maastricht, The Netherlands
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Centre (FRITZ), Vivantes Klinikum Am Urban, Charité-Universitätsmedizin, Berlin, Germany; Vivantes Klinikum im Friedrichshain, Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Charité-Universitätsmedizin, Berlin, Germany; ORYGEN, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Judith Gimpel-Drees
- University of Bonn, Department of Psychiatry and Psychotherapy, Bonn, Germany
| | - Michael Wagner
- University of Bonn, Department of Neurodegenerative Diseases and Geriatric Psychiatry, Bonn, Germany
| | - Inez Myin-Germeys
- Catholic University Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
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10
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Patil VA, Jacob AA, Chacko DM, Chakrabarti D, Devi P, Thonse U, Kumar V, Varambally S, Venkatasubramanian G, Rao NP. Examination of social decision making in patients with schizophrenia using ultimatum game. Asian J Psychiatr 2020; 50:101937. [PMID: 32109802 DOI: 10.1016/j.ajp.2020.101937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/08/2020] [Indexed: 10/25/2022]
Abstract
Intact decision-making skills in the social context are essential for optimal functioning in the community. Despite its significance, social decision making in schizophrenia (SCZ) has not been adequately examined. Hence, we examined social decision making in SCZ using the Ultimatum Game(UG), a neuroeconomic paradigm that involves financial transactions between a proposer and a responder to split a sum of money between them. Thirty male patients with a diagnosis of schizophrenia as per DSM-IV (age = 30 ± 7.08) and thirty age-matched healthy male volunteers (HV;age = 28.48 ± 3.74) participated in the study. All participants functioned as responders and had to either accept or reject offers made by an anonymous proposer. We also examined whether the gender or emotional expression of the proposer influenced acceptance rates. SCZ had significantly lower acceptance rates than HV for slightly unequal offers (t = 3.94, p = < 0.0001). However, there was no significant difference between SCZ and HV for other offers. Gender and emotional expression of the proposer did not significantly influence the outcome. These results suggest aberrant social decision making and increased inequity aversion in patients with SCZ. The difficulty in incorporating social components while engaging in financial interactions could have important implications for rehabilitation, functional recovery, and successful community living in SCZ.
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Affiliation(s)
- Vaishnavi A Patil
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Arpitha Anna Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Dona Maria Chacko
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | | | - Priyanka Devi
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Umesh Thonse
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vijay Kumar
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | | | - Naren P Rao
- National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
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11
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Lassila M, Nordström T, Hurtig T, Mäki P, Jääskeläinen E, Oinas E, Miettunen J. School success in childhood and subsequent prodromal symptoms and psychoses in the Northern Finland Birth Cohort 1986. Psychol Med 2020; 50:948-955. [PMID: 31010450 DOI: 10.1017/s0033291719000825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Low IQ is a risk factor for psychosis, but the effect of high IQ is more controversial. The aim was to explore the association of childhood school success with prodromal symptoms in adolescence and psychoses in adulthood. METHODS In the general population-based Northern Finland Birth Cohort 1986 (n = 8 229), we studied the relationship between teacher-assessed learning deficits, special talents and general school success at age 8 years and both prodromal symptoms (PROD-screen) at age 15-16 years and the occurrence of psychoses by age 30 years. RESULTS More prodromal symptoms were experienced by those talented in oral presentation [boys: adjusted odds ratio (OR) 1.49; 95% confidence interval 1.14-1.96; girls: 1.23; 1.00-1.52] or drawing (boys: 1.44; 1.10-1.87). Conversely, being talented in athletics decreased the probability of psychotic-like symptoms (boys: OR 0.72; 0.58-0.90). School success below average predicted less prodromal symptoms with boys (OR 0.68; 0.48-0.97), whereas above-average success predicted more prodromal symptoms with girls (OR 1.22; 1.03-1.44). The occurrence of psychoses was not affected. Learning deficits did not associate with prodromal symptoms or psychoses. CONCLUSIONS Learning deficits in childhood did not increase the risk of prodromal symptoms in adolescence or later psychosis in this large birth cohort. Learning deficits are not always associated with increased risk of psychosis, which might be due to, e.g. special support given in schools. The higher prevalence of prodromal symptoms in talented children may reflect a different kind of relationship of school success with prodromal symptoms compared to full psychoses.
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Affiliation(s)
- M Lassila
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - T Nordström
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - T Hurtig
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- PEDEGO Research Unit, Child Psychiatry, University of Oulu, Oulu, Finland
- Clinic of Child Psychiatry, Oulu University Hospital, Oulu, Finland
| | - P Mäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Department of Psychiatry, Länsi-Pohja healthcare district Department of Psychiatry, The Middle Ostrobothnia Central Hospital, Soite; Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District; Mental Health Services and Basic Health Care District of Kallio, Finland
- Department of Psychiatry, Kainuu Central Hospital, Kainuu Social and Healthcare District, Finland
| | - E Jääskeläinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - E Oinas
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - J Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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12
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Shinn AK, Cawkwell PB, Bolton K, Healy BC, Karmacharya R, Yip AG, Öngür D, Pinder-Amaker S. Return to College After a First Episode of Psychosis. SCHIZOPHRENIA BULLETIN OPEN 2020; 1:sgaa041. [PMID: 32984820 PMCID: PMC7503481 DOI: 10.1093/schizbullopen/sgaa041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A first episode of psychosis (FEP) can derail a patient’s educational goals, including attainment of a college education, and this can have lasting ramifications for socioeconomic and health outcomes. Despite this, few studies have examined return to college, which is an important index of real-world educational success after a FEP. In this study, we conducted a longitudinal medical record review of patients in a transdiagnostic outpatient FEP program and performed survival analysis, setting return to college as the endpoint, among the subset of patients whose college education was interrupted. We found that 82% (93/114) of college-enrolled FEP individuals experienced disruptions to their education after FEP, but that return to college also occurred in a substantial proportion (49/88, 56%) among those on leave who had follow-up data. In this sample, the median time to college return was 18 months. When separated by baseline diagnostic category, FEP patients with affective psychotic disorders (FEAP, n = 45) showed faster time to college return than those with primary psychotic disorders (FEPP, n = 43) (median 12 vs 24 mo; P = .024, unadjusted). When adjusted for having no more than 1 psychiatric hospitalization at intake and absence of cannabis use in the 6 months prior to intake (which were also significant predictors), differences by diagnostic category were more significant (hazard ratio 2.66, 95% CI 1.43–4.94, P = .002). Participation in education is an important outcome for stakeholders, and students with FEP can be successful in accomplishing this goal.
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Affiliation(s)
- Ann K Shinn
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | | | - Kirsten Bolton
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
| | - Brian C Healy
- Ann Romney Center for Neurologic Diseases, Brigham & Women’s Hospital, Boston, MA
- Department of Neurology, Harvard Medical School, Boston, MA
| | - Rakesh Karmacharya
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Agustin G Yip
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Stephanie Pinder-Amaker
- Department of Psychiatry, Harvard Medical School, Boston, MA
- College Mental Health Program, McLean Hospital, Belmont, MA
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13
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Evidence for interaction between genetic liability and childhood trauma in the development of psychotic symptoms. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1045-1054. [PMID: 31209522 DOI: 10.1007/s00127-019-01711-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 04/08/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Whilst childhood trauma (CT) is a known risk factor across the spectrum of psychosis expression, little is known about possible interplay with genetic liability. METHODS The TwinssCan Study collected data in general population twins, focussing on expression of psychosis at the level of subthreshold psychotic experiences. A multilevel mixed-effects linear regression analysis was performed including 745 subjects to assess the interaction between genetic liability and CT. The Symptom Checklist-90 (SCL-90-R) score of the co-twin was used as an indirect measure of genetic liability to psychopathology, while the Childhood Trauma Questionnaire Short-Form (CTQ-SF) was used to assess CT in the domains of physical, emotional and sexual abuse, as well as physical and emotional neglect. The Community Assessment of Psychic Experience (CAPE) questionnaire was used to phenotypically characterize psychosis expression. RESULTS In the model using the CAPE total score, the interaction between CT and genetic liability was close to statistical significance (χ2 = 5.6, df = 2, p = 0.06). Analyses of CAPE subscales revealed a significant interaction between CT and genetic liability (χ2 = 8.8, df = 2, p = 0.012) for the CAPE-negative symptoms subscale, but not for the other two subscales (i.e. positive and depressive). CONCLUSION The results suggest that the impact of CT on subthreshold expression of psychosis, particularly in the negative subdomain, may be larger in the co-presence of significant genetic liability for psychopathology.
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14
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The burden of clinically significant symptoms of common and severe mental disorders among adults in Vietnam: a population-based cross-sectional survey. BMC Public Health 2019; 19:1173. [PMID: 31455304 PMCID: PMC6712743 DOI: 10.1186/s12889-019-7513-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 08/19/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Vietnam has limited evidence about the burden of common and severe mental disorders among adults to inform policy. The aim of this paper was to estimate the prevalence of common and severe mental disorders among adults and factors associated with them in Vietnam. METHODS We conducted a cross-sectional household survey among people aged at least 16 years in Thanh Hoa and Ben Tre provinces which are nationally representative of the North and the South of Vietnam. The World Health Organization Self-Reporting Questionnaire 24 was used to screen for clinically significant symptoms of common and severe mental disorders at the individual level. Household characteristics were obtained in face-to-face interviews with the household heads. A multilevel mixed-effects logistic regression model was used to identify associated factors of the common and severe mental disorders. RESULTS Among 611 households which included 1528 adults, the point prevalence of clinically significant symptoms was 14.4% for common mental disorders and 8.2% for severe mental disorders after weighting by age groups. Common mental disorders were associated with social factors including lived in a Northern rather than a Southern province, disadvantaged household economic status, in which a family member(s) misused alcohol, the family lacking links to social organisations able to provide instrumental support, and the individual not having completed primary school. Severe mental disorders had fewer associations with social factors compared to common mental disorders, but were associated with living in the Northern province, disadvantaged household economic status, family violence and being older than 50 years. CONCLUSIONS The prevalence of clinically significant symptoms of common and severe mental disorders among adults in Vietnam was higher than in high income countries and had a strong association with household characteristics. The result indicates that a community-based approach to reduce household risk factors and to provide instrumental support might be an effective strategy to alleviate the burden of mental health problems in Vietnam.
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15
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Jacob A, Shukla A, Thonse U, Nagendra B, Chacko DM, Hiremath C, Devi P, Korann V, Dey A, Kunte M, Philip M, Bharath RD, Varambally S, Venkatasubramanian G, Rao NP. Cultural differences and neural correlates of cognitive insight in schizophrenia. Schizophr Res 2019; 209:98-104. [PMID: 31101512 DOI: 10.1016/j.schres.2019.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 02/23/2019] [Accepted: 05/05/2019] [Indexed: 10/26/2022]
Abstract
Cognitive insight refers to a person's ability to examine their psychotic experiences and the inferences they draw from these experiences. Several studies suggest that cultural factors influence cognitive insight and the processes involved therein; a few studies have suggested differences between Western and Asian societies. However, there are no studies on cognitive insight and its neural correlates in non-Western populations. Hence, we examined factor structure of Beck's cognitive insight scale (BCIS) in a large sample of patients with schizophrenia (SCZ) and healthy volunteers (HV) from India and assessed the relationship between cortical thickness and cognitive insight. We recruited 240 participants (SCZ-140; HV-100). Of these, 58 participants (SCZ-33; HV-25) underwent magnetic resonance imaging. We found a three-factor structure for BCIS which is different from the original two factor structure; self-reflection (SR) of original two-factor structure was sub-divided into- SR1, introspection and SR2, openness to feedback. There was a significant difference between HV and SCZ in the new factors, SR1 and SR2 but not in the original SR factor. Difference was also seen on MRI analysis; while there was a significant positive correlation between original SR factor and thickness of right posterior cingulate cortex, SR2 was positively correlated with thickness of left ventrolateral prefrontal cortex. The difference in factor structure in Indian participants and their distinct neural correlates point to cultural differences in cognitive insight. While in western societies the constructs of introspection and openness to feedback might integrate, they might be separate entities in Asian population.
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Affiliation(s)
- Arpitha Jacob
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Ayushi Shukla
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Umesh Thonse
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Bhargavi Nagendra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Dona Maria Chacko
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Chaitra Hiremath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Priyanka Devi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Vittal Korann
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Avyarthana Dey
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Mugdha Kunte
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Mariamma Philip
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Rose Dawn Bharath
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka 560029, India.
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Siddi S, Ochoa S, Farreny A, Brébion G, Larøi F, Cuevas-Esteban J, Haro JM, Stephan-Otto C, Preti A. Measurement invariance of the Spanish Launay-Slade Hallucinations Scale-Extended version between putatively healthy controls and people diagnosed with a mental disorder. Int J Methods Psychiatr Res 2018; 27:e1741. [PMID: 30238666 PMCID: PMC6877181 DOI: 10.1002/mpr.1741] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/19/2018] [Accepted: 07/30/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The current study aimed at evaluating the reliability, convergent and divergent validity, and factor structure of the Spanish Launay-Slade Hallucinations Scale-Extended version (LSHS-E) in people with mental disorders and healthy controls. METHODS Four hundred and twenty-two individuals completed the Spanish LSHS-E and the Spanish Community Assessment of Psychic Experiences. The convergent and divergent validity of the LSHS-E was assessed with the three dimensions of the Community Assessment of Psychic Experiences (positive, negative, and depressive dimensions) in healthy controls and people with a mental disorder. Factor structure of the LSHS-E was assessed using confirmatory factor analysis and measurement invariance. RESULTS The LSHS-E had a good reliability in healthy controls and people with a mental disorder (Cronbach's = 0.83 and 0.91, respectively). The LSHS-E was more strongly associated with positive psychotic-like experiences than with depressive and negative symptoms. Four factors were found: (a) "intrusive thoughts"; (b) "vivid daydreams"; (c) "multisensory hallucination-like experiences"; and (d) "auditory-visual hallucination-like experiences" that were invariant between the group of healthy controls and people with a mental disorder. CONCLUSION The Spanish version of the LSHS-E possesses adequate psychometric properties, and the confirmatory factor analysis findings provide further support for the multidimensionality of proneness to hallucination in clinical and nonclinical samples.
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Affiliation(s)
- Sara Siddi
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Aida Farreny
- East London NHS Foundation Trust, Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, London, UK
| | - Gildas Brébion
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Frank Larøi
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,NORMENT-Norwegian Center of Excellence for Mental Disorders, Research, University of Oslo, Oslo, Norway.,Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Jorge Cuevas-Esteban
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Servei de Psiquiatria, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Christian Stephan-Otto
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Preti
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy.,Center of Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
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Mikkonen J, Moustgaard H, Remes H, Martikainen P. The Population Impact of Childhood Health Conditions on Dropout from Upper-Secondary Education. J Pediatr 2018; 196:283-290.e4. [PMID: 29551321 DOI: 10.1016/j.jpeds.2018.01.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/08/2017] [Accepted: 01/11/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To quantify how large a part of educational dropout is due to adverse childhood health conditions and to estimate the risk of dropout across various physical and mental health conditions. STUDY DESIGN A registry-based cohort study was conducted on a 20% random sample of Finns born in 1988-1995 (n = 101 284) followed for school dropout at ages 17 and 21. Four broad groups of health conditions (any, somatic, mental, and injury) and 25 specific health conditions were assessed from inpatient and outpatient care records at ages 10-16 years. We estimated the immediate and more persistent risks of dropout due to health conditions and calculated population-attributable fractions to quantify the population impact of childhood health on educational dropout, while accounting for a wide array of sociodemographic confounders and comorbidity. RESULTS Children with any health condition requiring inpatient or outpatient care at ages 10-16 years were more likely to be dropouts at ages 17 years (risk ratio 1.71, 95% CI 1.61-1.81) and 21 years (1.46, 1.37-1.54) following adjustment for individual and family sociodemographic factors. A total of 30% of school dropout was attributable to health conditions at age 17 years and 21% at age 21 years. Mental disorders alone had an attributable fraction of 11% at age 21 years, compared with 5% for both somatic conditions and injuries. Adjusting for the presence of mental disorders reduced the effects of somatic conditions. CONCLUSIONS More than one fifth of educational dropout is attributable to childhood health conditions. Early-onset mental disorders emerge as key targets in reducing dropout.
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Affiliation(s)
- Janne Mikkonen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
| | - Heta Moustgaard
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Hanna Remes
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland; Center for Health Equity Studies (CHESS), Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; The Max Planck Institute for Demographic Research, Rostock, Germany
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