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Carrión RE, Ku BS, Dorvil S, Auther AM, McLaughlin D, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Keshavan M, Mathalon DH, Perkins DO, Stone WS, Tsuang MT, Walker EF, Woods SW, Cornblatt BA. Neurocognition in adolescents and young adults at clinical high risk for psychosis: Predictive stability for social and role functioning. Schizophr Res 2024; 271:129-137. [PMID: 39024961 DOI: 10.1016/j.schres.2024.06.054] [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: 12/14/2023] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/20/2024]
Abstract
The prodromal phase of schizophrenia provides an optimal opportunity to mitigate the profound functional disability that is often associated with fully expressed psychosis. Considerable evidence supports the importance of neurocognition in the development of interpersonal (social) and academic (role) skills. Further findings from adolescents and young adults at clinical high risk for developing psychosis (CHRP) suggest that treatment for functioning might be most effective when targeting early and specific neurocognitive deficits. The current study addresses this critical intervention issue by examining the potential of neurocognitive deficits at intake for predicting social and role functioning over time in CHR-P youth. The study included 345 CHR-P participants from the second phase of the North American Prodrome Longitudinal Study (NAPLS2) with baseline neurocognition and 2-year follow-up data on social and role functioning. Slower baseline processing speed consistently predicted poor social functioning over time, while attention deficits predicted poor role functioning at baseline and follow-up. In addition, the impact of processing speed and attention impairments on social and role functioning, respectively, persisted even when adjusting the regression models for attenuated positive, negative, and disorganized symptoms, and transition status. The current study demonstrates for, arguably the first time, that processing speed and attention are strongly predictive of social and role functioning over time, respectively, above and beyond the impact of symptoms and those CHR-P individuals that develop psychosis over the course of the study. These findings imply that early neurocognition is a critical treatment target linked to the developmental trajectory of social and role functioning.
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Affiliation(s)
- Ricardo E Carrión
- Northwell Health, New Hyde Park, NY, United States; Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.
| | - Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Sarah Dorvil
- Department of Psychology, Queens College, New York, United States
| | - Andrea M Auther
- Northwell Health, New Hyde Park, NY, United States; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | | | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States; Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Tyrone D Cannon
- Department of Psychology, Yale University, School of Medicine, New Haven, CT, United States; Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States
| | - Daniel H Mathalon
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, United States; Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States
| | - Ming T Tsuang
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States
| | - Elaine F Walker
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.; Department of Psychology, Emory University, Atlanta, GA, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, United States
| | - Barbara A Cornblatt
- Northwell Health, New Hyde Park, NY, United States; Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Department of Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
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Tor J, Baeza I, Sintes-Estevez A, De la Serna E, Puig O, Muñoz-Samons D, Álvarez-Subiela J, Sugranyes G, Dolz M. Cognitive predictors of transition and remission of psychosis risk syndrome in a child and adolescent sample: longitudinal findings from the CAPRIS study. Eur Child Adolesc Psychiatry 2024; 33:89-104. [PMID: 36598585 DOI: 10.1007/s00787-022-02137-w] [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: 10/24/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
Cognitive impairments are proposed as predictors in the differentiation between subjects with psychosis risk syndrome (PRS) who will develop a psychotic disorder (PRS-P) and those who will not (PRS-NP). More in-depth study of the PRS-NP group could contribute to defining the role of cognitive alterations in psychosis. This study aims to analyze cognition of children and adolescents with PRS in terms of their clinical outcome at 18-month follow-up (psychosis, remission, and non-remission) and of determinate predictors of transition to psychosis and remission of PRS. The method is two-site, naturalistic, longitudinal study design, with 98 help-seeking adolescents with PRS and 64 healthy controls (HC). PRS-P (n = 24) and PRS-NP (n = 74) participants were clinically and cognitively assessed at baseline, and when full-blown psychotic disorder had developed or at 18-month follow-up. PRS-P subjects showed lower scores at baseline in processing speed, visuospatial memory, attention, and executive function (cognitive flexibility/processing speed) compared to HC. PRS-NP subjects showed lower baseline scores in verbal working memory and verbal fluency compared to HC. This deficit is also observed in the PRS group of participants still presenting attenuated psychotic symptoms at 18-month follow-up, while PRS subjects in remission showed a similar cognitive profile to HC subjects. Baseline score on processing speed, measured with a coding task, appeared to be a predictive variable for the development of a psychotic disorder. Performance in verbal working memory was predictive of remission in the PRS-NP. Post hoc comparisons indicate the need for careful interpretation of cognitive markers as predictors of psychosis. Cognitive impairments are present in both PRS-P and PRS-NP. Those individuals who recover from PRS show baseline cognitive performance comparable to the HC group. Together with sociodemographic variables, this observation could help in the differentiation of a variety of PRS trajectories in children and adolescents.
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Affiliation(s)
- Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain.
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain.
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
- Health Sciences Division, Department of Psychiatry and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Anna Sintes-Estevez
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Elena De la Serna
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Olga Puig
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
| | - Daniel Muñoz-Samons
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Javier Álvarez-Subiela
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, (2017SGR881), Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi Sunyer (CERCA-IDIBAPS), Barcelona, Spain
| | - Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, 08950, Esplugues de Llobregat, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, 08950, Esplugues de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Montaner-Ferrer MJ, Gadea M, Sanjuán J. Cognition and social functioning in first episode psychosis: A systematic review of longitudinal studies. Front Psychiatry 2023; 14:1055012. [PMID: 36950257 PMCID: PMC10025326 DOI: 10.3389/fpsyt.2023.1055012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/03/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction This systematic review aimed to answer whether we can predict subsequent social functioning in first episode psychosis (FEP) by means of an initial cognitive examination. In order to do this, we gathered longitudinal studies which evaluated neurocognition and/or social cognition regarding their impact on long-term social functioning of FEP patients. Methods The MOOSE method was employed and 28 studies covering data from a total of 2572 patients with longitudinal trajectories from 2 months to 5 years were reviewed. Results In general, cognitive deficits impacted on the social functioning of the FEP patients across the time. The neurocognitive domains which most closely predicted social functioning were processing speed, sustained attention and working memory. An overall cognitive dysfunction, low IQ and the academic trajectory were also found predictive. Regarding social cognition, the findings were not unanimous. Discussion In addition of the impact of each variable, several of the articles found a complex relationship between social cognition, neurocognition, social functioning and negative symptoms, pointing social cognition as a modulator of neurocognition but being modulated as well by negative symptoms. The principal clinical implication of this review is that the initial assessment of FEP patients and their rehabilitation must take cognition into account.
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Affiliation(s)
| | - Marien Gadea
- Department of Psychobiology, Faculty of Psychology, Universitat de València, Valencia, Spain
- CIBERSAM-Mental Health, Madrid, Spain
- *Correspondence: Marien Gadea,
| | - Julio Sanjuán
- CIBERSAM-Mental Health, Madrid, Spain
- Department of Psychiatry, Faculty of Medicine, Universitat de València, Valencia, Spain
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Aizza A, Porter BM, Church JA. Youth pre-pandemic executive function relates to year one COVID-19 difficulties. Front Psychol 2023; 14:1033282. [PMID: 37151319 PMCID: PMC10156991 DOI: 10.3389/fpsyg.2023.1033282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction The first year of the COVID-19 pandemic presented a series of stressors that could relate to psychological difficulties in children and adolescents. Executive functioning (EF) supports goal achievement and is associated with life success, and better outcomes following early life adversity. EF is also strongly related to processing speed, another predictor of life outcomes. Methods This longitudinal study examined 149 youths' pre-pandemic EF and processing speed abilities as predictors of self-reported emotional, cognitive, and social experiences during the first year of the COVID-19 pandemic. EF and processing speed were measured with a total of 11 behavioral tasks. The COVID-era data was collected during two timepoints, during early (May-July 2020) and mid- (January-March of 2021) pandemic. Results Better pre-pandemic EF skills and processing speed abilities predicted more mid-COVID-19 pandemic emotional and cognitive difficulties. On the other hand, better switching (a subcomponent of EF) and processing speed abilities predicted more mid-pandemic social interactions. EF and processing speed abilities did not relate to the well-being reports from the initial months of the pandemic. Our EF - but not processing speed - results were largely maintained when controlling for pre-pandemic mental health burden, socioeconomic status (SES), and gender. Discussion Better cognitive abilities may have contributed to worse mid-pandemic functioning by supporting the meta-cognition needed for attending to the chaotic and ever-changing pandemic news and advice, leading to higher stress-induced worry and rumination. Our study highlights a potential downside of higher EF - often largely viewed as a protective factor - in youth.
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Squarcina L, Kambeitz-Ilankovic L, Bonivento C, Prunas C, Oldani L, Wenzel J, Ruef A, Dwyer D, Ferro A, Borgwardt S, Kambeitz J, Lichtenstein TK, Meisenzahl E, Pantelis C, Rosen M, Upthegrove R, Antonucci LA, Bertolino A, Lencer R, Ruhrmann S, Salokangas RRK, Schultze-Lutter F, Chisholm K, Stainton A, Wood SJ, Koutsouleris N, Brambilla P. Relationships between global functioning and neuropsychological predictors in subjects at high risk of psychosis or with a recent onset of depression. World J Biol Psychiatry 2022; 23:573-581. [PMID: 35048791 DOI: 10.1080/15622975.2021.2014955] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Psychotic disorders are frequently associated with decline in functioning and cognitive difficulties are observed in subjects at clinical high risk (CHR) for psychosis. In this work, we applied automatic approaches to neurocognitive and functioning measures, with the aim of investigating the link between global, social and occupational functioning, and cognition. METHODS 102 CHR subjects and 110 patients with recent onset depression (ROD) were recruited. Global assessment of functioning (GAF) related to symptoms (GAF-S) and disability (GAF-D). and global functioning social (GF-S) and role (GF-R), at baseline and of the previous month and year, and a set of neurocognitive measures, were used for classification and regression. RESULTS Neurocognitive measures related to GF-R at baseline (r = 0.20, p = 0.004), GF-S at present (r = 0.14, p = 0.042) and of the past year (r = 0.19, p = 0.005), for GAF-F of the past month (r = 0.24, p < 0.001) and GAF-D of the past year (r = 0.28, p = 0.002). Classification reached values of balanced accuracy of 61% for GF-R and GAF-D. CONCLUSION We found that neurocognition was related to psychosocial functioning. More specifically, a deficit in executive functions was associated to poor social and occupational functioning.
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Affiliation(s)
- Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefan Borgwardt
- Department of Psychiatry, (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, University of Lubeck, Lubeck, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Theresa Katharina Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Linda A Antonucci
- Department of Education, Psychology and Communication, University of Bari "Aldo Moro" - Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lubeck, Lubeck, Germany.,Institute for Translational Psychiatry, Westfalische-Wilhelms-University Munster, Munster, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Katharine Chisholm
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Alexandra Stainton
- Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.,Orygen, Melbourne, Australia.,Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Damme KSF, Park JS, Walther S, Vargas T, Shankman SA, Mittal VA. Depression and Psychosis Risk Shared Vulnerability for Motor Signs Across Development, Symptom Dimensions, and Familial Risk. Schizophr Bull 2022; 48:752-762. [PMID: 35554607 PMCID: PMC9212095 DOI: 10.1093/schbul/sbab133] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Motor abnormalities are strong transdiagnostic indicators of psychopathology risk that reflect emerging neural network abnormalities. Indeed, motor signs, such as motor slowing and agitation, are widely recognized as core features of both psychosis and depression. However, it is unclear whether these reflect shared or distinct etiology. METHODS A sample of 11 878 adolescents completed self-reported clinical measures of rated psychotic-like experiences (PLEs) and depression. Familial risk for psychopathology and the presence of motor signs were drawn from parental reports, including developmental motor delays (eg, sitting, walking), and adolescent motor signs (eg, dyscoordination, psychomotor retardation, and psychomotor agitation). Finally, motor network connectivity in theoretically relevant networks (cortico-striatal, cortico-thalamic, and cortico-cerebellar) were related to symptoms and familial risk for psychopathology. RESULTS Developmental motor delays related to increased PLEs, increased depression symptoms, and greater familial risk. Familial risk for both PLEs and depression showed higher rates of developmental motor delays than all other groups. Adolescent motor signs, however, showed unique patterns of relationships to symptoms and familial risk such that dyscoordination reflected risk for PLEs, both psychomotor agitation and retardation reflected depression risk, and psychomotor agitation reflected transdiagnostic risk. Cortico-striatal connectivity was related to depression and PLEs, but cortico-cerebellar connectivity was linked to PLEs only. CONCLUSIONS Motor signs may be a transdiagnostic marker of vulnerability for psychopathology. Early developmental motor delays could belie pluripotent, familial risk features. Unique items, eg, dyscoordination specifically related to PLEs, possibly reflecting processes inherent in distinct emerging forms of psychopathology.
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Affiliation(s)
- Katherine S F Damme
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA
| | - Jadyn S Park
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
| | - Sebastian Walther
- University Hospital of Psychiatry, Translational Research Center, University of Bern, Bern, Switzerland
| | - Teresa Vargas
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
| | | | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston/Chicago, IL, USA
- Department of Psychiatry, Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, USA
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7
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Hua LL, Alderman EM, Chung RJ, Grubb LK, Lee J, Powers ME, Upadhya KK, Wallace SB. Collaborative Care in the Identification and Management of Psychosis in Adolescents and Young Adults. Pediatrics 2021; 147:peds.2021-051486. [PMID: 34031232 DOI: 10.1542/peds.2021-051486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Pediatricians are often the first physicians to encounter adolescents and young adults presenting with psychotic symptoms. Although pediatricians would ideally be able to refer these patients immediately into psychiatric care, the shortage of child and adolescent psychiatry services may sometimes require pediatricians to make an initial assessment or continue care after recommendations are made by a specialist. Knowing how to identify and further evaluate these symptoms in pediatric patients and how to collaborate with and refer to specialty care is critical in helping to minimize the duration of untreated psychosis and to optimize outcomes. Because not all patients presenting with psychotic-like symptoms will convert to a psychotic disorder, pediatricians should avoid prematurely assigning a diagnosis when possible. Other contributing factors, such as co-occurring substance abuse or trauma, should also be considered. This clinical report describes psychotic and psychotic-like symptoms in the pediatric age group as well as etiology, risk factors, and recommendations for pediatricians, who may be among the first health care providers to identify youth at risk.
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Affiliation(s)
- Liwei L. Hua
- Catholic Charities of Baltimore, Baltimore, Maryland
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8
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Harris M, Blanco EA, Rempfer M. Cognition and daily life functioning among persons with serious mental illness: A cluster analytic examination of heterogeneity on the Test of Grocery Shopping Skills. Neuropsychology 2021; 35:57-68. [PMID: 33393800 PMCID: PMC8376210 DOI: 10.1037/neu0000700] [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] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To characterize variability in daily life functioning among individuals with serious mental illness based on a naturalistic performance measure of grocery shopping and standard neuropsychological tasks using cluster analytic methods. METHODS A naturalistic performance measure, the Test of Grocery Shopping Skills (TOGSS), and standard neuropsychological tasks, were completed by 191 participants with serious mental illness. Hierarchical cluster analytic techniques were used to explore functional subgroups based on naturalistic performance measure variables. Multivariate analyses of variance were utilized to compare subgroups on TOGSS variables and neuropsychological measures, respectively. RESULTS Two distinct functional subgroups emerged from the cluster analysis. On average, participants in cluster one were faster, more efficient, and more accurate compared to cluster two. Based on performance on neuropsychological tasks, cluster one had better verbal memory, visual attention, and processing speed, and executive functioning scores, compared to cluster two. The clusters did not differ on a measure of auditory working memory. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Naturalistic performance measures can assist with characterizing the heterogeneity in real life functioning among people with serious mental illness. Further work to illuminate the relationship between specific cognitive abilities and specific functional abilities is warranted and may assist with targeting effective treatment plans for functional recovery. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Siu AMH, Ng RSH, Poon MYC, Chong CSY, Siu CMW, Lau SPK. Evaluation of a computer-assisted cognitive remediation program for young people with psychosis: A pilot study. SCHIZOPHRENIA RESEARCH-COGNITION 2020; 23:100188. [PMID: 32983917 PMCID: PMC7493079 DOI: 10.1016/j.scog.2020.100188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/26/2020] [Accepted: 08/31/2020] [Indexed: 01/10/2023]
Abstract
Background People with psychosis have a range of neuropsychological impairments that impact their functional abilities and rehabilitation outcomes. We designed a Computer-Assisted Cognitive Remediation (CACR) program to help young people with psychosis to restore their cognitive function. The program combines the drill-and-practice approach and the strategic approach to remediation, with sixteen sessions of computerized cognitive training, two sessions of psychoeducation, and four session of coaching on applying cognitive skills to daily life. Method This was a randomized, single-blind, controlled study in which the outcomes of the CACR program were compared with outcomes of a treatment-as-usual (TAU) control group. Pre-intervention and post-intervention measures were compared. Results When compared with the control group, the intervention group had significant increases in their MCCB neurocognitive composite scores, and specifically in the areas of verbal learning and speed of processing at posttest. They also had significant increases in their secondary outcome measures of mental well-being and perceived occupational competence. There were no significant differences in functional status between the two groups at post-test. Conclusions The CACR program was effective in improving overall cognitive function and in the specific domains of verbal learning, speed of processing, and effect sizes were small. Participants also experienced positive changes in mental well-being and perceived competence.
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10
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Kilciksiz CM, Keefe R, Benoit J, Öngür D, Torous J. Verbal memory measurement towards digital perspectives in first-episode psychosis: A review. Schizophr Res Cogn 2020; 21:100177. [PMID: 32322540 PMCID: PMC7163058 DOI: 10.1016/j.scog.2020.100177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/20/2020] [Accepted: 03/21/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Even in the early phases of psychotic spectrum illnesses such as schizophrenia, patients can experience cognitive decline or deficits prior to the onset of psychotic symptoms such as delusions and hallucinations. In this systematic review, we assessed which verbal memory assessments are most widely used in first-episode psychosis and may be applied via digital technologies (smartphone applications, etc.) for use in early detection. METHODS In November 2019, we searched for studies measuring verbal memory in first episode psychosis or schizophrenia over the past 10 years on PubMed and PsycINFO. We screened abstracts of these studies and excluded review studies. Full-texts of included studies were used to identify the verbal memory measurement tests, follow-up frequencies, and sample sizes. RESULTS We screened 233 reports and found that 120 original research studies measured verbal memory in first episode psychosis over the past 10 years. Four of these studies specified using a computer, 24 (20%) used a paper-pen format, 1(1%) used both, and 91 (76%) studies did not specify their administration tools or suggest there were offered in digital formats. Thirty-five (30%) studies had follow-up measurements of verbal memory, while 85 (70%) had only a single verbal memory measurement. DISCUSSION While many scales are commonly used to measure verbal memory in first episode psychosis, they are not often administered via digital technology. There is an emerging opportunity to administer these and other tests via digital technologies for expanding access to early detection of cognitive decline in clinical high risk and first-episode psychosis.
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Affiliation(s)
- Can Mişel Kilciksiz
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Richard Keefe
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States of America
| | - James Benoit
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Dost Öngür
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States of America
| | - John Torous
- Digital Psychiatry Division, Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
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11
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Adolescent trajectories of fine motor and coordination skills and risk for schizophrenia. Schizophr Res 2020; 215:263-269. [PMID: 31672386 DOI: 10.1016/j.schres.2019.10.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/09/2019] [Accepted: 10/03/2019] [Indexed: 12/31/2022]
Abstract
Premorbid motor dysfunction is one of the earliest of developmental antecedents identified among individuals who develop schizophrenia in adulthood. However, among individuals with schizophrenia, premorbid motor dysfunction is not apparent at all stages of childhood development and may reduce with increasing age. Currently, little is known about the trajectories of motor development during adolescence among youth at-risk for the disorder. One hundred and one participants were assessed repeatedly, at approximately 24-month intervals (time 1, aged 9-12 years; time 2, 11-14 years; and time 3, 13-16 years), on the Purdue Pegboard assessment, comprising four subtests: Dominant Hand (DH), Non-Dominant Hand (NDH), Both Hands (BH), and Assembly. Fine motor and coordination skills development between ages 9-16 years was compared between youth characterised by a triad of developmental antecedents of schizophrenia (ASz, N = 32); youth with at least one affected relative with schizophrenia/schizoaffective disorder (FHx; N = 26); and typically developing youth without antecedents or family history (TD, N = 43). Longitudinal mixed models for repeated measures indicated significant motor skills improvements with age in TD youth on the Assembly subtest only. Relative to TD youth, we found evidence for developmental deficits (i.e., dysfunction that emerged early and remained stable) among ASz youth on DH and BH subtests, and among FHx youth on the Assembly subtest. ASz youth were characterised by a developmental delay on the Assembly subtest (i.e., initial performance decrement in middle childhood that caught up with peers' performance during adolescence). These divergences from normative motor development may reflect differences in structural and functional neural correlates.
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12
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Carrión RE, Auther AM, McLaughlin D, Olsen R, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Cornblatt BA. The Global Functioning: Social and Role Scales-Further Validation in a Large Sample of Adolescents and Young Adults at Clinical High Risk for Psychosis. Schizophr Bull 2019; 45:763-772. [PMID: 30351423 PMCID: PMC6581127 DOI: 10.1093/schbul/sby126] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Traditional measures for assessing functioning with adult patients with schizophrenia have been shown to be insufficient for assessing the issues that occur in adolescents and young adults at clinical high risk (CHR) for psychosis. The current study provides an expanded validation of the Global Functioning: Social (GF:Social) and Role (GF:Role) scales developed specifically for use with CHR individuals and explores the reliability and accuracy of the ratings, the validity of the scores in comparison to other established clinical measures, stability of functioning over a 2-year period, and psychosis predictive ability. METHODS Seven hundred fifty-five CHR individuals and 277 healthy control (HC) participants completed the GF:Social and Role scales at baseline as part of the North American Prodrome Longitudinal Study (NAPLS2). RESULTS Inter-rater reliability and accuracy were high for both scales. Correlations between the GF scores and other established clinical measures demonstrated acceptable convergent and discriminant validity. In addition, GF:Social and Role scores were unrelated to positive symptoms. CHR participants showed large impairments in social and role functioning over 2-years, relative to the HCs, even after adjusting for age, IQ, and attenuated positive symptoms. Finally, social decline prior to baseline was more pronounced in CHR converters, relative to non-converters. CONCLUSIONS The GF scales can be administered in a large-scale multi-site study with excellent inter-rater reliability and accuracy. CHR individuals showed social and role functioning impairments over time that were not confounded by positive symptom severity levels. The results of this study demonstrate that social decline is a particularly effective predictor of conversion outcome.
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Affiliation(s)
- Ricardo E Carrión
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY,Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY,To whom correspondence should be addressed; Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 75-59, 263rd Street, Glen Oaks, NY 11004, US; tel: 718-470-8878, fax: 718-470-8131, e-mail:
| | - Andrea M Auther
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Danielle McLaughlin
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY
| | - Ruth Olsen
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY
| | - Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California, Los Angeles, Los Angeles, CA
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, School of Medicine, New Haven, CT,Department of Psychiatry, Yale University, School of Medicine, New Haven, CT
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, CA
| | - Thomas H McGlashan
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA
| | - Ming T Tsuang
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA
| | | | - Scott W Woods
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT
| | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY,Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY,Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
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Knowles EEM, Mathias SR, Mollon J, Rodrigue A, Koenis MMG, Dyer TD, Goring HHH, Curran JE, Olvera RL, Duggirala R, Almasy L, Blangero J, Glahn DC. A QTL on chromosome 3q23 influences processing speed in humans. GENES, BRAIN, AND BEHAVIOR 2019; 18:e12530. [PMID: 30379395 PMCID: PMC6458095 DOI: 10.1111/gbb.12530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/24/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022]
Abstract
Processing speed is a psychological construct that refers to the speed with which an individual can perform any cognitive operation. Processing speed correlates strongly with general cognitive ability, declines sharply with age and is impaired across a number of neurological and psychiatric disorders. Thus, identifying genes that influence processing speed will likely improve understanding of the genetics of intelligence, biological aging and the etiologies of numerous disorders. Previous genetics studies of processing speed have relied on simple phenotypes (eg, mean reaction time) derived from single tasks. This strategy assumes, erroneously, that processing speed is a unitary construct. In the present study, we aimed to characterize the genetic architecture of processing speed by using a multidimensional model applied to a battery of cognitive tasks. Linkage and QTL-specific association analyses were performed on the factors from this model. The randomly ascertained sample comprised 1291 Mexican-American individuals from extended pedigrees. We found that performance on all three distinct processing-speed factors (Psychomotor Speed; Sequencing and Shifting and Verbal Fluency) were moderately and significantly heritable. We identified a genome-wide significant quantitative trait locus (QTL) on chromosome 3q23 for Psychomotor Speed (LOD = 4.83). Within this locus, we identified a plausible and interesting candidate gene for Psychomotor Speed (Z = 2.90, P = 1.86 × 10-03 ).
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Affiliation(s)
- Emma E. M. Knowles
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Samuel R. Mathias
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Josephine Mollon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Amanda Rodrigue
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marinka M. G. Koenis
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Thomas D. Dyer
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas of the Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Harald H. H. Goring
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas of the Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Joanne E. Curran
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas of the Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Rene L. Olvera
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ravi Duggirala
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas of the Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Laura Almasy
- Department of Genetics at University of Pennsylvania and Department of Biomedical and Health Informatics at Children’s Hospital of Philadelphia, PA, USA
| | - John Blangero
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas of the Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - David C. Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatric Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
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Neurocognitive and neuroanatomical maturation in the clinical high-risk states for psychosis: A pattern recognition study. NEUROIMAGE-CLINICAL 2018; 21:101624. [PMID: 30528960 PMCID: PMC6413470 DOI: 10.1016/j.nicl.2018.101624] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/14/2018] [Accepted: 12/01/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Findings from neurodevelopmental studies indicate that adolescents with psychosis spectrum disorders have delayed neurocognitive performance relative to the maturational state of their healthy peers. Using machine learning, we generated a model of neurocognitive age in healthy adults and investigated whether individuals in clinical high risk (CHR) for psychosis showed systematic neurocognitive age deviations that were accompanied by specific structural brain alterations. METHODS First, a Support Vector Regression-based age prediction model was trained and cross-validated on the neurocognitive data of 36 healthy controls (HC). This produced Cognitive Age Gap Estimates (CogAGE) that measured each participant's deviation from the normal cognitive maturation as the difference between estimated neurocognitive and chronological age. Second, we employed voxel-based morphometry to explore the neuroanatomical gray and white matter correlates of CogAGE in HC, in CHR individuals with early (CHR-E) and late (CHR-L) high risk states. RESULTS The age prediction model estimated age in HC subjects with a mean absolute error of ±2.2 years (SD = 3.3; R2 = 0.33, P < .001). Mean (SD) CogAGE measured +4.3 (8.1) years in CHR individuals compared to HC (-0.1 (5.5) years, P = .006). CHR-L individuals differed significantly from HC subjects while this was not the case for the CHR-E group. CogAGE was associated with a distributed bilateral pattern of increased GM volume in the temporal and frontal areas and diffuse pattern of WM reductions. CONCLUSION Although the generalizability of our findings might be limited due to the relatively small number of participants, CHR individuals exhibit a disturbed neurocognitive development as compared to healthy peers, which may be independent of conversion to psychosis and paralleled by an altered structural maturation process.
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15
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Zheng Y, Ning Y, She S, Deng Y, Chen Y, Yi W, Lu X, Chen X, Li J, Li R, Zhang J, Xiao D, Wu H, Wu C. Psychotic Symptoms and Attitudes toward Medication Mediate the Effect of Insight on Personal-Social Functions in Patients with Schizophrenia: One-Year Randomized Controlled Trial and Follow-Up. Psychopathology 2018; 51:167-176. [PMID: 29444522 DOI: 10.1159/000486558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 12/26/2017] [Indexed: 01/26/2023]
Abstract
AIMS This study aimed to investigate the mediating pathway of 3 factors (psychotic symptoms, attitude toward medication, and cognitive processing speed) on the effect of insight on personal-social functioning in patients with schizophrenia. METHODS Chinese inpatients with schizophrenia (n = 168; mean age 18 ± 50 years) diagnosed according to the DSM-IV were randomly assigned to treatment with antipsychotic medication alone or combined treatment. Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory (DAI), Assessment of Insight (SAI), and Social-Personal Performance Scale (PSPS) scores were evaluated at baseline and at 3, 6, and 12 months. Cognitive function was assessed at baseline. Multiple mediation analyses were conducted with baseline data, end point data, and changes-in-scale scores between baseline and the end point, respectively. RESULTS At baseline and at 12 months, only psychotic symptoms mediated the effect of insight on personal-social functioning. For changes-in-scale scores over the 12-month follow-up, in patients receiving treatment with medication alone, the effect of improved insight on improved personal-social function was mediated by psychotic symptoms only; in patients receiving a combined treatment, the effect of improved insight on improved personal-social functioning was mediated by both psychotic symptoms and attitudes toward medication, independently. CONCLUSIONS The link between insight and personal-social functions is mainly mediated by psychotic symptoms. Psychosocial intervention improves the predicting effect of insight on personal-social function by improving both the attitude toward medication and psychotic symptoms independently.
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Affiliation(s)
- Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yongjie Deng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuwei Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Wenying Yi
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xiaodan Lu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Xinrui Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Juanhua Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Ruikeng Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jie Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Di Xiao
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Haibo Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Chao Wu
- Faculty of Psychology, Beijing Normal University, Beijing, China
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16
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Cairns AJ, Kavanagh DJ, Dark F, McPhail SM. Prediction of vocational participation and global role functioning in help-seeking young adults, from neurocognitive, demographic and clinical variables. J Affect Disord 2017. [PMID: 28646712 DOI: 10.1016/j.jad.2017.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of this study was to investigate neurocognitive, demographic and clinical correlates of vocational participation among a sample of young help-seeking adults. METHODS Young people (18-25 years) accessing an early intervention youth health service participated. The Global Functioning: Role scale and level of vocational participation, participant characteristics (age, gender, socioeconomic background and family history of serious mental illness), distress, psychotic-like experiences, substance use, and mental health diagnoses were recorded. The Cambridge Neuropsychological Testing Automated Battery was used to assess sustained attention, visual memory and executive function. RESULTS Of the 107 participants, 33 (31%) were not working or studying and 52 (49%) had a diagnosis of affective disorder. Impairments in neurocognitive tests were evidenced in attention shift, sustained attention target sensitivity, impulsivity and spatial working memory errors. Univariate analyses indicated that information processing and target impulsivity were associated with both vocational participation and global functioning, and that spatial working memory strategy was also associated with vocational participation. After controlling for significant demographic and clinical predictors, strategy formation remained a significant correlate of vocational participation (coefficient (95%CI) = -0.08 (-0.17, -0.01)), but no neurocognitive measures remained significant in the multivariate prediction of global functioning. LIMITATIONS Neurocognitive outcomes were assessed at a single time point, factors such as fluctuations in motivation could impact on test results. CONCLUSIONS Interventions targeting work and education participation should consider the capacity of vulnerable young people to develop appropriate plans for role success and provide support accordingly. The study also emphasised the importance of high school completion and avoidance of cannabis use, especially in males.
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Affiliation(s)
- Alice J Cairns
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; Mount Isa Centre for Rural and Remote Health, James Cook University, Australia.
| | - David J Kavanagh
- Centre for Children's Health Research, School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Frances Dark
- Rehabilitation Academic Clinical Unit, Metro South Addiction and Mental Health Services, Metro South Health, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
| | - Steven M McPhail
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
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Eckfeld A, Karlsgodt KH, Haut KM, Bachman P, Jalbrzikowski M, Zinberg J, van Erp TGM, Cannon TD, Bearden CE. Disrupted Working Memory Circuitry in Adolescent Psychosis. Front Hum Neurosci 2017; 11:394. [PMID: 28848413 PMCID: PMC5550407 DOI: 10.3389/fnhum.2017.00394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/17/2017] [Indexed: 12/02/2022] Open
Abstract
Individuals with schizophrenia (SZ) consistently show deficits in spatial working memory (WM) and associated atypical patterns of neural activity within key WM regions, including the dorsolateral prefrontal cortex (dlPFC) and parietal cortices. However, little research has focused on adolescent psychosis (AP) and potential age-associated disruptions of WM circuitry that may occur in youth with this severe form of illness. Here we utilized each subject's individual spatial WM capacity to investigate task-based neural dysfunction in 17 patients with AP (16.58 ± 2.60 years old) as compared to 17 typically developing, demographically comparable adolescents (18.07 ± 3.26 years old). AP patients showed lower behavioral performance at higher WM loads and lower overall WM capacity compared to healthy controls. Whole-brain activation analyses revealed greater bilateral precentral and right postcentral activity in controls relative to AP patients, when controlling for individual WM capacity. Seed-based psychophysiological interaction (PPI) analyses revealed significantly greater co-activation between the left dlPFC and left frontal pole in controls relative to AP patients. Significant group-by-age interactions were observed in both whole-brain and PPI analyses, with AP patients showing atypically greater neural activity and stronger coupling between WM task activated brain regions as a function of increasing age. Additionally, AP patients demonstrated positive relationships between right dlPFC neural activity and task performance, but unlike healthy controls, failed to show associations between neural activity and out-of-scanner neurocognitive performance. Collectively, these findings are consistent with atypical WM-related functioning and disrupted developmental processes in youth with AP.
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Affiliation(s)
- Ariel Eckfeld
- Department of Psychology, UCLALos Angeles, CA, United States
| | | | - Kristen M. Haut
- Department of Psychiatry, Rush University Medical CenterChicago, IL, United States
| | - Peter Bachman
- Department of Psychiatry, University of PittsburghPittsburgh, PA, United States
| | - Maria Jalbrzikowski
- Department of Psychiatry, University of PittsburghPittsburgh, PA, United States
| | - Jamie Zinberg
- Semel Institute for Neuroscience and Human Behavior, UCLALos Angeles, CA, United States
| | - Theo G. M. van Erp
- Department of Psychiatry and Human Behavior, University of California, IrvineIrvine, CA, United States
| | - Tyrone D. Cannon
- Departments of Psychology and Psychiatry, Yale UniversityNew Haven, CT, United States
| | - Carrie E. Bearden
- Department of Psychology, UCLALos Angeles, CA, United States
- Semel Institute for Neuroscience and Human Behavior, UCLALos Angeles, CA, United States
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18
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Lindenmayer JP, Fregenti S, Kang G, Ozog V, Ljuri I, Khan A, Goldring A, McGurk SR. The relationship of cognitive improvement after cognitive remediation with social functioning in patients with schizophrenia and severe cognitive deficits. Schizophr Res 2017; 185:154-160. [PMID: 28094171 DOI: 10.1016/j.schres.2017.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/29/2016] [Accepted: 01/04/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study aims to examine the effects of change in neurocognition on functional outcomes and to examine predictors of change in social functions following a 12-week course of cognitive remediation in patients with schizophrenia and schizoaffective disorder with severe cognitive impairments. METHOD Level of social functioning was assessed using a performance based measure of functional capacity (PSP) in patients prior to and after the completion of 12-week cognitive remediation treatment (CRT). Participants completed a neuropsychological battery (MCCB-MATRICS) and clinical measures at both time points. RESULTS 63 subjects with a mean age of 41.4 (SD=12.2) and with 12.2years of education (SD=2.4) were enrolled. There were significant improvements in overall PSP score from baseline to endpoint (p=0.021) as well as in PSP domain A (socially useful activities) (p≤0.001), domain B (personal and social relationships) (p=0.009), and domain D (disturbing and aggressive behaviors) (p=0.003). There was a significant improvement in the composite MCCB score (p=0.020) and the Working Memory (p<0.046). Stepwise logistic regression yielded a significant association for baseline Visual Learning (Wald=6.537, p=0.011, OR=1.195), Speed of Processing (Wald=4.112, p=0.043, OR=0.850) and level of PANSS positive symptoms (Wald=4.087, p=0.043, OR=0.739) with PSP overall improvement. CONCLUSIONS Faster speed of processing, better visual and verbal learning and less prominent positive symptoms were associated with greater functional improvement after a systematic cognitive intervention within a rehabilitative setting.
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Affiliation(s)
- J P Lindenmayer
- Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States; New York University, Department of Psychiatry, New York, NY, United States.
| | - Samantha Fregenti
- Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States.
| | - Guoxin Kang
- Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States.
| | - Veronica Ozog
- Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States.
| | - Isidora Ljuri
- Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States.
| | - Anzalee Khan
- Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY 10962, United States.
| | - A Goldring
- Manhattan Psychiatric Center, 600 E 125th Street, New York, NY 10035, United States.
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Jalbrzikowski M, Ahmed KH, Patel A, Jonas R, Kushan L, Chow C, Bearden CE. Categorical versus dimensional approaches to autism-associated intermediate phenotypes in 22q11.2 microdeletion syndrome. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:53-65. [PMID: 28367513 PMCID: PMC5373800 DOI: 10.1016/j.bpsc.2016.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND 22q11.2 Microdeletion syndrome (22q11DS) is associated with elevated rates of autism spectrum disorders (ASDs), although the diagnosis is controversial. In order to determine whether there is a biological substrate of ASD in 22q11DS, we examined neurocognitive and structural neuroanatomic differences between those with 22q11DS and an ASD diagnosis (22q11DS-ASD+) and those with 22q11DS without ASD (22q11DS-ASD-); we then determined whether these differences were better characterized within a categorical or dimensional framework. METHODS We collected multiple neurocognitive measures and high-resolution T1-weighted scans on 116 individuals (29 22q11DS-ASD+, 32 22q11DS-ASD-, 55 typically developing controls) between 6 and 26 years of age. Measures of subcortical volume, cortical thickness (CT), and surface area were extracted using the FreeSurfer image analysis suite. Group differences in neurocognitive and neuroanatomic measures were assessed; regression analyses were then performed to determine whether a categorical or dimensional measure of ASD was a better predictor of neurocognitive impairment and/or neuroanatomic abnormalities observed in 22q11DS-ASD+. RESULTS In comparison to 22q11DS-ASD-, 22q11DS-ASD+ participants exhibited decreased bilateral hippocampal CT and decreased right amygdala volumes. Those with 22q11DS-ASD+ also showed slowed processing speed and impairments in visuospatial and facial memory. Neurocognitive impairments fit a dimensional model of ASD, whereas reductions in parahippocampal CT were best explained by a categorical measure of ASD. CONCLUSIONS A combination of categorical and dimensional measures of ASD may provide the most comprehensive understanding of ASDs in 22q11DS.
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Affiliation(s)
| | - Khwaja Hamzah Ahmed
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Arati Patel
- University of Southern California, Keck School of Medicine
| | - Rachel Jonas
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
- University of California, Los Angeles, Interdepartmental Neuroscience Program
| | - Leila Kushan
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Carolyn Chow
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Carrie E. Bearden
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
- University of California, Los Angeles, Department of Psychology
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20
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Social functioning in patients with a psychotic disorder and first rank symptoms. Psychiatry Res 2016; 237:147-52. [PMID: 26892072 DOI: 10.1016/j.psychres.2016.01.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 11/30/2015] [Accepted: 01/21/2016] [Indexed: 11/20/2022]
Abstract
There have been suggestions that a sense of self emerges through social interaction, which requires an intact capability to distinguish self from others. Here we investigated the contribution of first rank delusions and hallucinations, i.e. symptom expressions of a disturbed sense of self, to social functioning in patients with a psychotic disorder. Life-time and present-state positive symptom clusters (e.g. first rank delusions and hallucinations) and present-state negative symptoms were submitted to hierarchical multiple-regression analyses with (different domains of) social functioning as dependent variable. In addition to negative symptoms (β=-0.48), the life-time presence of first rank delusions is significantly negative associated with level of social functioning, in particular with the quality of interpersonal interactions, with a modest standardized regression coefficient (β=-0.14). We reconfirmed the well-established relationship between negative symptoms and social functioning, but the life-time presence of first rank delusions may also have an subtle ongoing effect on the quality of the interaction with others. We propose that the experience of first rank delusions may be an expression of enduring self-disturbances, leaving patients unsure on how to behave in social interactions.
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21
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Intact speed of processing in a community-based sample of adults with high schizotypy: A marker of reduced psychosis risk? Psychiatry Res 2015; 228:531-7. [PMID: 26117248 DOI: 10.1016/j.psychres.2015.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/23/2015] [Accepted: 06/04/2015] [Indexed: 11/22/2022]
Abstract
Speed of processing is impaired in schizophrenia but intact in schizotypal college students. In view of this disparity, we investigated whether deficient processing speed was associated with schizotypy in adults from the general community. Data were drawn from the Western Australian Family Study of Schizophrenia, including 216 (non-clinical) adults from the general community, and a reference group with schizophrenia spectrum disorder (N=224). Schizotypal traits were assessed with the Schizotypal Personality Questionnaire, whilst processing speed was assessed with a digit-symbol coding task. Community controls had significantly higher digit symbol coding scores than patients with psychosis. However, both correlational and hierarchical regression analysis indicated a lack of association between Cognitive-perceptual, Interpersonal or Disorganized schizotypy traits and digit symbol coding performance. Relative to Australian norms there was also no evidence of a non-linear decline in coding in high schizotypes in young, mature or senior age groups. The results show that speed of information processing is unimpaired in high schizotypes from the general community. The possibility that intact processing speed in at-risk groups confers protection to psychosis onset is discussed. Assessing the trajectory of processing speed throughout development may provide a useful clinical screening tool to distinguish those at heightened risk of developing psychosis.
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22
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Wright SN, Hong LE, Winkler AM, Chiappelli J, Nugent K, Muellerklein F, Du X, Rowland LM, Wang DJJ, Kochunov P. Perfusion shift from white to gray matter may account for processing speed deficits in schizophrenia. Hum Brain Mapp 2015; 36:3793-804. [PMID: 26108347 DOI: 10.1002/hbm.22878] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 05/23/2015] [Accepted: 06/04/2015] [Indexed: 12/16/2022] Open
Abstract
Reduced speed of cerebral information processing is a cognitive deficit associated with schizophrenia. Normal information processing speed (PS) requires intact white matter (WM) physiology to support information transfer. In a cohort of 107 subjects (47/60 patients/controls), we demonstrate that PS deficits in schizophrenia patients are explained by reduced WM integrity, which is measured using diffusion tensor imaging, mediated by the mismatch in WM/gray matter blood perfusion, and measured using arterial spin labeling. Our findings are specific to PS, and testing this hypothesis for patient-control differences in working memory produces no explanation. We demonstrate that PS deficits in schizophrenia can be explained by neurophysiological alterations in cerebral WM. Whether the disproportionately low WM integrity in schizophrenia is due to illness or secondary due to this disorder deserves further examination.
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Affiliation(s)
- Susan N Wright
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - L Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Anderson M Winkler
- Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, University of Oxford, Oxford, United Kingdom
| | - Joshua Chiappelli
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Katie Nugent
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Florian Muellerklein
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Xioming Du
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - Laura M Rowland
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.,Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Psychology, University of Maryland, Baltimore County, Maryland
| | - Danny J J Wang
- Department of Neurology, University of California, Los Angeles, California
| | - Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, Maryland.,Department of Physics, University of Maryland, Baltimore County, Maryland
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Díaz-Caneja CM, Pina-Camacho L, Rodríguez-Quiroga A, Fraguas D, Parellada M, Arango C. Predictors of outcome in early-onset psychosis: a systematic review. NPJ SCHIZOPHRENIA 2015; 1:14005. [PMID: 27336027 PMCID: PMC4849440 DOI: 10.1038/npjschz.2014.5] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/11/2014] [Accepted: 11/12/2014] [Indexed: 01/31/2023]
Abstract
Given the global burden of psychotic disorders, the identification of patients with early-onset psychosis (EOP; that is, onset before the age of 18) at higher risk of adverse outcome should be a priority. A systematic search of Pubmed, Embase, and PsycInfo (1980 through August 2014) was performed to identify longitudinal observational studies assessing correlates and/or predictors of clinical, functional, cognitive, and biological outcomes in EOP. Seventy-five studies were included in the review. Using multivariate models, the most replicated predictors of worse clinical, functional, cognitive, and biological outcomes in EOP were premorbid difficulties and symptom severity (especially of negative symptoms) at baseline. Longer duration of untreated psychosis (DUP) predicted worse clinical, functional, and cognitive outcomes. Higher risk of attempting suicide was predicted by greater severity of psychotic illness and of depressive symptoms at the first episode of psychosis. Age at onset and sex were not found to be relevant predictors of outcome in most multivariate models, whereas studies using bivariate analyses yielded inconsistent results. Lower intelligence quotient at baseline predicted lower insight at follow-up, worse functional outcomes, and a diagnostic outcome of schizophrenia. Biological predictors of outcome in EOP have been little studied and have not been replicated. Lower levels of antioxidants at baseline predicted greater brain volume changes and worse cognitive functioning at follow-up, whereas neuroimaging markers such as regional cortical thickness and gray matter volume at baseline predicted remission and better insight at follow-up, respectively. EOP patients with poorer premorbid adjustment and prominent negative symptoms at initial presentation are at risk of poor outcome. They should therefore be the target of careful monitoring and more intensive interventions to address whether the disease course can be modified in this especially severely affected group. Early intervention strategies to reduce DUP may also improve outcome in EOP.
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Affiliation(s)
- Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain
| | - Laura Pina-Camacho
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Alberto Rodríguez-Quiroga
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain
| | - David Fraguas
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense de Madrid , Madrid, Spain
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Mukkala S, Ilonen T, Koskela J, Nordström T, Loukkola J, Miettunen J, Barnett JH, Murray GK, Jones PB, Heinimaa M, Jääskeläinen E, Mäki P, Moilanen I, Veijola J. Response initiation in young adults at risk for psychosis in the Northern Finland 1986 Birth Cohort. Cogn Neuropsychiatry 2014; 19:226-40. [PMID: 24131203 DOI: 10.1080/13546805.2013.840569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION This is one of the very few studies to investigate the specific executive function/processing speed component of response initiation in subjects at familial risk (FR) for psychosis, and the first such study in subjects at clinical risk (CR) for psychosis. METHODS Participants (N = 177) were members of the general population-based Northern Finland 1986 Birth Cohort in the following four groups: FR for psychosis (n = 62), CR for psychosis (n = 21), psychosis (n = 25) and control subjects (n = 69). The response initiation of these groups was compared in three different tests: Semantic fluency, Stockings of Cambridge and Spatial working memory. RESULTS The two risk groups did not differ significantly from control group, but differed from, and outperformed the psychosis group in semantic fluency response initiation. CONCLUSIONS Response initiation deficits were not evident in a non-help seeking psychosis high-risk sample.
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Affiliation(s)
- S Mukkala
- a Department of Psychiatry , Institute of Clinical Medicine, University of Oulu , Oulu , Finland
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25
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Bauman MD, Iosif AM, Smith SE, Bregere C, Amaral DG, Patterson PH. Activation of the maternal immune system during pregnancy alters behavioral development of rhesus monkey offspring. Biol Psychiatry 2014; 75:332-41. [PMID: 24011823 PMCID: PMC6782053 DOI: 10.1016/j.biopsych.2013.06.025] [Citation(s) in RCA: 210] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 06/22/2013] [Accepted: 06/29/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Maternal infection during pregnancy is associated with an increased risk of schizophrenia and autism in the offspring. Supporting this correlation, experimentally activating the maternal immune system during pregnancy in rodents produces offspring with abnormal brain and behavioral development. We have developed a nonhuman primate model to bridge the gap between clinical populations and rodent models of maternal immune activation (MIA). METHODS A modified form of the viral mimic, synthetic double-stranded RNA (polyinosinic:polycytidylic acid stabilized with poly-L-lysine) was delivered to two separate groups of pregnant rhesus monkeys to induce MIA: 1) late first trimester MIA (n = 6), and 2) late second trimester MIA (n = 7). Control animals (n = 11) received saline injections at the same first or second trimester time points or were untreated. Sickness behavior, temperature, and cytokine profiles of the pregnant monkeys confirmed a strong inflammatory response to MIA. RESULTS Behavioral development of the offspring was studied for 24 months. Following weaning at 6 months of age, MIA offspring exhibited abnormal responses to separation from their mothers. As the animals matured, MIA offspring displayed increased repetitive behaviors and decreased affiliative vocalizations. When evaluated with unfamiliar conspecifics, first trimester MIA offspring deviated from species-typical macaque social behavior by inappropriately approaching and remaining in immediate proximity of an unfamiliar animal. CONCLUSIONS In this rhesus monkey model, MIA yields offspring with abnormal repetitive behaviors, communication, and social interactions. These results extended the findings in rodent MIA models to more human-like behaviors resembling those in both autism and schizophrenia.
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Affiliation(s)
- Melissa D. Bauman
- Department of Psychiatry and Behavioral Sciences, California National Primate Research Center, University of California, Davis, Davis; The M.I.N.D. Institute, University of California, Davis, Sacramento, Center for Neuroscience, University of California, Davis, Davis, California
| | - Ana-Maria Iosif
- Department of Public Health Sciences, Division of Biostatistics, University of California, Davis, Davis
| | | | | | - David G. Amaral
- Department of Psychiatry and Behavioral Sciences, California National Primate Research Center, University of California, Davis, Davis; The M.I.N.D. Institute, University of California, Davis, Sacramento; Center for Neuroscience, University of California, Davis, Davis, California
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26
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Erus G, Battapady H, Satterthwaite TD, Hakonarson H, Gur RE, Davatzikos C, Gur RC. Imaging patterns of brain development and their relationship to cognition. Cereb Cortex 2014; 25:1676-84. [PMID: 24421175 DOI: 10.1093/cercor/bht425] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We present a brain development index (BDI) that concisely summarizes complex imaging patterns of structural brain maturation along a single dimension using a machine learning methodology. The brain was found to follow a remarkably consistent developmental trajectory in a sample of 621 subjects of ages 8-22 participating in the Philadelphia Neurodevelopmental Cohort, reflected by a cross-validated correlation coefficient between chronologic age and the BDI of r = 0.89. Critically, deviations from this trajectory related to cognitive performance. Specifically, subjects whose BDI was higher than their chronological age displayed significantly superior cognitive processing speed compared with subjects whose BDI was lower than their actual age. These results indicate that the multiparametric imaging patterns summarized by the BDI can accurately delineate trajectories of brain development and identify individuals with cognitive precocity or delay.
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Affiliation(s)
- Guray Erus
- Section of Biomedical Image Analysis, Department of Radiology, and Center for Biomedical Image Computing and Analytics
| | - Harsha Battapady
- Section of Biomedical Image Analysis, Department of Radiology, and Center for Biomedical Image Computing and Analytics
| | - Theodore D Satterthwaite
- Section of Biomedical Image Analysis, Department of Radiology, and Center for Biomedical Image Computing and Analytics Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christos Davatzikos
- Section of Biomedical Image Analysis, Department of Radiology, and Center for Biomedical Image Computing and Analytics
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
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27
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Bratlien U, Øie M, Lien L, Agartz I, Lie Romm K, Vaskinn A, Ueland T, Andreassen OA, Melle I. Social dysfunction in first-episode psychosis and relations to neurocognition, duration of untreated psychosis and clinical symptoms. Psychiatry Res 2013; 207:33-9. [PMID: 23153893 DOI: 10.1016/j.psychres.2012.10.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 10/12/2012] [Accepted: 10/22/2012] [Indexed: 01/06/2023]
Abstract
Signs of social dysfunction are present early in the course of psychotic disorders. There is a lack of knowledge about how premorbid function, illness history, psychotic symptoms and neurocognitive characteristics are related to social function in patients with first episode psychosis (FEP). The relationship between these factors could provide important information about the psychopathology underlying social dysfunction and have implications for future prevention and treatment efforts. Our objective is to identify early predictors of social functioning in patients with FEP. We examined 166 patients and 166 age- and gender-matched healthy controls (HC). We used a validated and comprehensive measure of social functioning (the Social Functioning Scale), a comprehensive neurocognitive test battery, in addition to measures of psychotic symptoms, duration of untreated psychosis (DUP) and premorbid adjustment (the Premorbid Adjustment Scale). Lower childhood level of social adjustment and lower psychomotor speed had the strongest influence across measures of social functioning while symptoms and DUP had a weaker influence. The main result of the current study is that premorbid social adjustment and psychomotor speed had the strongest association with measures of social functioning in patients with FEP.
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Affiliation(s)
- Unni Bratlien
- Innlandet Hospital Trust, Division of Mental Health, Ottestad, Norway.
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28
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Bachman P, Jalbrzikowski M, Bearden CE. The voices go, but the song remains the same: how can we rescue cognition in early-onset schizophrenia? J Am Acad Child Adolesc Psychiatry 2012; 51:464-6. [PMID: 22525952 PMCID: PMC4074878 DOI: 10.1016/j.jaac.2012.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 02/02/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Peter Bachman
- Semel Institute for Neuroscience and Human Behavior, University of
California, Los Angeles
| | | | - Carrie E. Bearden
- Semel Institute for Neuroscience and Human Behavior, University of
California, Los Angeles,University of California, Los Angeles
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