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Dark FL, Amado I, Erlich MD, Ikezawa S. International Experience of Implementing Cognitive Remediation for People With Psychotic Disorders. Schizophr Bull 2024:sbae071. [PMID: 38758086 DOI: 10.1093/schbul/sbae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Cognitive remediation (CR) is an effective therapy for the cognitive impact of mental illness, especially schizophrenia. Global efforts are being made to implement CR into routine mental health services with the aim of improving functional outcomes for the population of people recovering from mental illness. Implementation and dissemination of CR in heterogeneous settings require knowledge gleaned from formal implementation research and pragmatic experiential learning. This article describes cross-cultural approaches to CR implementation, focusing on initiatives in France, the United States, Australia, and Japan. METHOD Key leaders in the implementation of CR in France, the United States, Australia, and Japan were asked to describe the implementation and dissemination process in their settings with respect to the categories of context, implementation, outcomes, facilitators, and barriers. RESULTS All 4 sites noted the role of collaboration to leverage the implementation of CR into mental health rehabilitation services. In France, high-level, government organizational backing enhanced the dissemination of CR. Academic and clinical service partnerships in the United States facilitated the dissemination of programs. The advocacy from service users, families, and carers can aid implementation. The support from international experts in the field can assist in initiating programs but maintenance and dissemination require ongoing training and supervision of staff. CONCLUSIONS CR is an effective intervention for the cognitive impact of schizophrenia. Programs can be implemented in diverse settings globally. Adaptations of CR centering upon the core components of effective CR therapy enhance outcomes and enable programs to integrate into diverse settings.
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Affiliation(s)
- Frances L Dark
- The University of Queensland Medical School, Brisbane, Australia
- Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Isabelle Amado
- Ressource Centre in Ile de France for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), GHU Paris Psychiatry Neurosciences, Paris, France
- Department for Cognitive Remediation and Rehabilitation, Paris Cité University
| | - Matthew D Erlich
- New York State Office of Mental Health, New York, NY, USA
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Satoru Ikezawa
- Department of Psychiatry, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
- Department of Psychiatry, National Centre of Neurology and Psychiatry, Tokyo, Japan
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Dysregulation of peripheral expression of the YWHA genes during conversion to psychosis. Sci Rep 2020; 10:9863. [PMID: 32555255 PMCID: PMC7299951 DOI: 10.1038/s41598-020-66901-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/04/2020] [Indexed: 12/01/2022] Open
Abstract
The seven human 14-3-3 proteins are encoded by the YWHA-gene family. They are expressed in the brain where they play multiple roles including the modulation of synaptic plasticity and neuronal development. Previous studies have provided arguments for their involvement in schizophrenia, but their role during disease onset is unknown. We explored the peripheral-blood expression level of the seven YWHA genes in 92 young individuals at ultra-high risk for psychosis (UHR). During the study, 36 participants converted to psychosis (converters) while 56 did not (non-converters). YWHA genes expression was evaluated at baseline and after a mean follow-up of 10.3 months using multiplex quantitative PCR. Compared with non-converters, the converters had a significantly higher baseline expression levels for 5 YWHA family genes, and significantly different longitudinal changes in the expression of YWHAE, YWHAG, YWHAH, YWHAS and YWAHZ. A principal-component analysis also indicated that the YWHA expression was significantly different between converters and non-converters suggesting a dysregulation of the YWHA co-expression network. Although these results were obtained from peripheral blood which indirectly reflects brain chemistry, they indicate that this gene family may play a role in psychosis onset, opening the way to the identification of prognostic biomarkers or new drug targets.
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Treatment-resistant psychotic symptoms and the 15q11.2 BP1-BP2 (Burnside-Butler) deletion syndrome: case report and review of the literature. Transl Psychiatry 2020; 10:42. [PMID: 32066678 PMCID: PMC7026068 DOI: 10.1038/s41398-020-0725-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/17/2019] [Accepted: 01/08/2020] [Indexed: 12/25/2022] Open
Abstract
The 15q11.2 BP1-BP2 (Burnside-Butler) deletion is a rare copy number variant impacting four genes (NIPA1, NIPA2, CYFIP1, and TUBGCP5), and carries increased risks for developmental delay, intellectual disability, and neuropsychiatric disorders (attention-deficit/hyperactivity disorder, autism, and psychosis). In this case report (supported by extensive developmental information and medication history), we present the complex clinical portrait of a 44-year-old woman with 15q11.2 BP1-BP2 deletion syndrome and chronic, treatment-resistant psychotic symptoms who has resided nearly her entire adult life in a long-term state psychiatric institution. Diagnostic and treatment implications are discussed.
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Amado I, Moualla M, Jouve J, Brénugat-Herné L, Attali D, Willard D, Rigaut B, Malangin B, Kern L, Meyniel C, Gaillard R, Plaze M, Perquier F, Yannick M. Employment, Studies and Feelings: Two to Nine Years After a Personalized Program of Cognitive Remediation in Psychiatric Patients. Front Psychiatry 2020; 11:609. [PMID: 32733290 PMCID: PMC7358613 DOI: 10.3389/fpsyt.2020.00609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/11/2020] [Indexed: 11/26/2022] Open
Abstract
Employment rate in psychiatry is around 10 to 30%. Cognitive remediation (CR) associated with psychosocial rehabilitation shows good functional outcomes, with a high level of satisfaction in participants provided by tailored CR. However, few studies looked at the long-term outcome in participants who experienced such a program. This retrospective survey examines the outcome of persons having psychiatric diseases 2 to 9 years after being treated with a personalized CR program. The survey included 12 domains with questions relevant to work, studies, before CR (T1) and at the moment of the survey (T2), questions about housing, relatedness, familiar relationships and daily activities at T2. Finally, a narrative interview was included to express feelings of the participants about CR. Sixty-six participants completed the survey, and were treated with neurocognitive or social cognition programs. Their diagnosis was: schizophrenia (80.3%), neurodevelopment disorder (autism as well as genetic or metabolic disease with psychiatric expression) (15.2%) and bipolar disorder (4.5%). The comparison between T1 and T2 showed significant difference for job employment (P < 0.001), even for competitive jobs (p < 0.007), for performing studies (p = 0.033), for practicing a physical activity (0.033) or reading (0.002). Outcome was also examined in reference to the delay from CR to highlight changes in patient characteristics and service delivery over the years. Hence, the total sample was split in two subgroups: CR delivered in 2009-2013 (n = 37); CR delivered in 2014-2016 (n = 29). While in the former group more participants were working (p = 0.037), in the latter group, which was younger (p = 0.04), more participants were studying (p = 0.02). At T2, a majority of persons experienced no relapse, three years (79.1%) to 8 years (56.8%) after CR, when referring to the anamnesis. Concerning subjective perception of CR, participants expressed feelings concerning positive impact on clarity of thought, on cognitive functions, self-confidence, perceiving CR as an efficient help for work and studies. To conclude, even long years after a personalized CR program, good benefits in terms of employment or studies emerge when compared to the status before CR, with good determinants for recovery in terms of leisure or physical activity practice.
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Affiliation(s)
- Isabelle Amado
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France.,Psychiatry and Neuroscience Center, National Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France.,Inserm U 1266, Paris, France.,Cundill Center for Child and Youth Depression, Université de Paris, Paris, France
| | - Mona Moualla
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France.,Psychiatry and Neuroscience Center, National Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Julia Jouve
- Psychiatry and Neuroscience Center, National Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Lindsay Brénugat-Herné
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France.,Psychiatry and Neuroscience Center, National Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - David Attali
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France.,Psychiatry and Neuroscience Center, National Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Dominique Willard
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France.,Psychiatry and Neuroscience Center, National Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France.,Inserm U 1266, Paris, France.,Cundill Center for Child and Youth Depression, Université de Paris, Paris, France
| | - Bérangère Rigaut
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France.,Psychiatry and Neuroscience Center, National Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Brigitte Malangin
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France.,Psychiatry and Neuroscience Center, National Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Laurence Kern
- Laboratoire, CeSRM, UFR STAPS, Université Paris Nanterre, Nanterre, France
| | - Clementine Meyniel
- Laboratoire CLIPSYD, EA4430, Université Paris Nanterre, Nanterre, France
| | - Raphaël Gaillard
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France
| | - Marion Plaze
- Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Sainte Anne Hospital, Paris, France
| | | | - Morvan Yannick
- Inserm U 1266, Paris, France.,Laboratoire CLIPSYD, EA4430, Université Paris Nanterre, Nanterre, France
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Bodkin JA, Coleman MJ, Godfrey LJ, Carvalho CM, Morgan CJ, Suckow RF, Anderson T, Ongur D, Kaufman MJ, Lewandowski KE, Siegel AJ, Waldstreicher E, Grochowski CM, Javitt DC, Rujescu D, Hebbring S, Weinshilboum R, Rodriguez SB, Kirchhoff C, Visscher T, Vuckovic A, Fialkowski A, McCarthy S, Malhotra D, Sebat J, Goff DC, Hudson JI, Lupski JR, Coyle JT, Rudolph U, Levy DL. Targeted Treatment of Individuals With Psychosis Carrying a Copy Number Variant Containing a Genomic Triplication of the Glycine Decarboxylase Gene. Biol Psychiatry 2019; 86:523-535. [PMID: 31279534 PMCID: PMC6745274 DOI: 10.1016/j.biopsych.2019.04.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND The increased mutational burden for rare structural genomic variants in schizophrenia and other neurodevelopmental disorders has so far not yielded therapies targeting the biological effects of specific mutations. We identified two carriers (mother and son) of a triplication of the gene encoding glycine decarboxylase, GLDC, presumably resulting in reduced availability of the N-methyl-D-aspartate receptor coagonists glycine and D-serine and N-methyl-D-aspartate receptor hypofunction. Both carriers had a diagnosis of a psychotic disorder. METHODS We carried out two double-blind, placebo-controlled clinical trials of N-methyl-D-aspartate receptor augmentation of psychotropic drug treatment in these two individuals. Glycine was used in the first clinical trial, and D-cycloserine was used in the second one. RESULTS Glycine or D-cycloserine augmentation of psychotropic drug treatment each improved psychotic and mood symptoms in placebo-controlled trials. CONCLUSIONS These results provide two independent proof-of-principle demonstrations of symptom relief by targeting a specific genotype and explicitly link an individual mutation to the pathophysiology of psychosis and treatment response.
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Affiliation(s)
| | | | | | | | | | | | | | - Dost Ongur
- McLean Hospital, Belmont, MA.,Harvard Medical School, Boston, MA
| | - Marc J. Kaufman
- McLean Hospital, Belmont, MA.,Harvard Medical School, Boston, MA
| | | | - Arthur J. Siegel
- McLean Hospital, Belmont, MA.,Harvard Medical School, Boston, MA
| | | | | | - Daniel C. Javitt
- Columbia University Medical Center, New York, NY.,Nathan Kline Institute, Orangeburg, NY
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Scott Hebbring
- Center for Human Genetics, Marshfield Clinic Research Institute, Marshfield, WI
| | | | | | | | | | | | | | | | | | | | - Donald C. Goff
- Nathan Kline Institute, Orangeburg, NY.,Department of Psychiatry, New York University Langone Medical Center, New York, NY
| | - James I. Hudson
- McLean Hospital, Belmont, MA.,Harvard Medical School, Boston, MA
| | | | - Joseph T. Coyle
- McLean Hospital, Belmont, MA.,Harvard Medical School, Boston, MA
| | - Uwe Rudolph
- McLean Hospital, Belmont, MA.,Harvard Medical School, Boston, MA
| | - Deborah L. Levy
- McLean Hospital, Belmont, MA.,Harvard Medical School, Boston, MA
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Kuster A, Arnoux JB, Barth M, Lamireau D, Houcinat N, Goizet C, Doray B, Gobin S, Schiff M, Cano A, Amsallem D, Barnerias C, Chaumette B, Plaze M, Slama A, Ioos C, Desguerre I, Lebre AS, de Lonlay P, Christa L. Diagnostic approach to neurotransmitter monoamine disorders: experience from clinical, biochemical, and genetic profiles. J Inherit Metab Dis 2018; 41:129-139. [PMID: 28924877 DOI: 10.1007/s10545-017-0079-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 07/10/2017] [Accepted: 07/27/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIM To improve the diagnostic work-up of patients with diverse neurological diseases, we have elaborated specific clinical and CSF neurotransmitter patterns. METHODS Neurotransmitter determinations in CSF from 1200 patients revealed abnormal values in 228 (19%) cases. In 54/228 (24%) patients, a final diagnosis was identified. RESULTS We have reported primary (30/54, 56%) and secondary (24/54, 44%) monoamine neurotransmitter disorders. For primary deficiencies, the most frequently mutated gene was DDC (n = 9), and the others included PAH with neuropsychiatric features (n = 4), PTS (n = 5), QDPR (n = 3), SR (n = 1), and TH (n = 1). We have also identified mutations in SLC6A3, FOXG1 (n = 1 of each), MTHFR (n = 3), FOLR1, and MTHFD (n = 1 of each), for dopamine transporter, neuronal development, and folate metabolism disorders, respectively. For secondary deficiencies, we have identified POLG (n = 3), ACSF3 (n = 1), NFU1, and SDHD (n = 1 of each), playing a role in mitochondrial function. Other mutated genes included: ADAR, RNASEH2B, RNASET2, SLC7A2-IT1 A/B lncRNA, and EXOSC3 involved in nuclear and cytoplasmic metabolism; RanBP2 and CASK implicated in post-traductional and scaffolding modifications; SLC6A19 regulating amino acid transport; MTM1, KCNQ2 (n = 2), and ATP1A3 playing a role in nerve cell electrophysiological state. Chromosome abnormalities, del(8)(p23)/dup(12) (p23) (n = 1), del(6)(q21) (n = 1), dup(17)(p13.3) (n = 1), and non-genetic etiologies (n = 3) were also identified. CONCLUSION We have classified the final 54 diagnoses in 11 distinctive biochemical profiles and described them through 20 clinical features. To identify the specific molecular cause of abnormal NT profiles, (targeted) genomics might be used, to improve diagnosis and allow early treatment of complex and rare neurological genetic diseases.
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Affiliation(s)
- Alice Kuster
- Neurometabolism department, Nantes Hospital and University, Nantes, France
| | - Jean-Baptiste Arnoux
- Reference center for inherited metabolic diseases, Necker Enfants-Malades Hospital, Assistance Publique Hôpitaux de Paris, Imagine Institute, Paris Descartes University, Paris, France
| | - Magalie Barth
- Neurometabolism department, Angers Hospital and University, Angers, France
| | - Delphine Lamireau
- Neuropediatric and Neurogenetic department, MRGM laboratory, National institute for health and medical research U1211, Pellegrin Hospital and University, Bordeaux, France
| | - Nada Houcinat
- Neuropediatric and Neurogenetic department, MRGM laboratory, National institute for health and medical research U1211, Pellegrin Hospital and University, Bordeaux, France
| | - Cyril Goizet
- Neuropediatric and Neurogenetic department, MRGM laboratory, National institute for health and medical research U1211, Pellegrin Hospital and University, Bordeaux, France
| | - Bérénice Doray
- Genetic department, Félix Guyon Hospital and University, Saint-Denis de la Réunion, France
| | - Stéphanie Gobin
- Genetic department, Necker-Enfants Malades Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Manuel Schiff
- Neurometabolism and Biochemical department, Robert Debré Hospital and University, Paris, France
| | - Aline Cano
- Reference center for inherited metabolic diseases, la Timone-Marseille Hospital and University, Marseille, France
| | - Daniel Amsallem
- Neuropediatric department, Jean Minjoz Hospital, Besançon, France
| | - Christine Barnerias
- Neurology department, Necker Enfants Malades Hospital and Paris Descartes University, Paris, France
| | - Boris Chaumette
- Sainte Anne Hospital, University Hospital Department (SHU), Paris Descartes University and Institut National de la Santé et de la Recherche Médicale INSERM U894, CNRS GDR, 3557, Paris, France
| | - Marion Plaze
- Sainte Anne Hospital, University Hospital Department (SHU), Paris Descartes University and Institut National de la Santé et de la Recherche Médicale INSERM U894, CNRS GDR, 3557, Paris, France
| | - Abdelhamid Slama
- Biochemical department, Bicêtre Hospital, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - Christine Ioos
- Neuropediatric department, Raymond Poincaré Hospital, Garches, France
| | - Isabelle Desguerre
- Neurology department, Necker Enfants Malades Hospital and Paris Descartes University, Paris, France
| | - Anne-Sophie Lebre
- Genetic and Biological department, Reims University, Maison Blanche Hospital, F-51092, Reims, France
| | - Pascale de Lonlay
- Reference center for inherited metabolic diseases, Necker Enfants-Malades Hospital, Assistance Publique Hôpitaux de Paris, Imagine Institute, Paris Descartes University, Paris, France
| | - Laurence Christa
- Metabolomic and proteomic Biochemical department, Necker Enfants-Malades Hospital, Paris Descartes University, Paris, France.
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Chaumette B, Kebir O, Krebs MO. [Genetics and epigenetics of schizophrenia and other psychoses]. Biol Aujourdhui 2017; 211:69-82. [PMID: 28682228 DOI: 10.1051/jbio/2017015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Indexed: 06/07/2023]
Abstract
Schizophrenia and other psychoses are categorical psychiatric diagnoses corresponding to frequent and heterogeneous disorders. Their physiopathology still remains largely unknown despite numerous recent advances. In particular, the last decade has identified different types of genetic variants, thanks to emergence of high-throughput methods. These methods allow both the identification of rare variants with a large effect such as punctual mutations or copy-number variants and the identification of frequent variants with a limited effect such as polymorphisms. Many impacted genes have been identified showing a very high genetic heterogeneity of psychoses. These genes are overrepresented in synaptic and neurotransmission pathways. Only a small fraction of psychoses could be easily explained by genetics but this screening in clinical practice is important as it can lead to therapeutic challenge or genetic counselling. Nowadays, it is clear that the pathophysiology of the psychoses can only be understood by an integrative approach taking into account the interaction between genes and environment. This interaction could be mediated by the epigenome defined as the modification of gene expression without changes in DNA sequence. Epigenome is stable but could be modified by environmental factors. Several epigenetic mechanisms have been studied in psychosis, in particular the DNA methylation, the modification of histones and the microRNA. All of these mechanisms are under regulation by genetic factors and variants in these epigenetic-involved genes and cofactors have been also associated with schizophrenia. Thus, pathophysiology of psychosis is complex and morestudiesare needed before definitive conclusions. Altogether, the recent advances in the genetics and epigenetics of psychosis are promising and could open the way to a recategorization of these disorders as well as the identification of new therapeutic targets.
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Affiliation(s)
- Boris Chaumette
- Montreal Neurological Institute and Hospital, Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Oussama Kebir
- INSERM, U894, Laboratoire "Physiopathologie des maladies psychiatriques", Centre de Psychiatrie et Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, 102-108 rue de la Santé, 75014 Paris, France Institut de Psychiatrie-GDR 3557, Centre Hospitalier Sainte-Anne, Paris, France
| | - Marie-Odile Krebs
- INSERM, U894, Laboratoire "Physiopathologie des maladies psychiatriques", Centre de Psychiatrie et Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, 102-108 rue de la Santé, 75014 Paris, France Institut de Psychiatrie-GDR 3557, Centre Hospitalier Sainte-Anne, Paris, France
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