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Wang B, Irizar H, Thygesen JH, Zartaloudi E, Austin-Zimmerman I, Bhat A, Harju-Seppänen J, Pain O, Bass N, Gkofa V, Alizadeh BZ, van Amelsvoort T, Arranz MJ, Bender S, Cahn W, Stella Calafato M, Crespo-Facorro B, Di Forti M, Giegling I, de Haan L, Hall J, Hall MH, van Haren N, Iyegbe C, Kahn RS, Kravariti E, Lawrie SM, Lin K, Luykx JJ, Mata I, McDonald C, McIntosh AM, Murray RM, Picchioni M, Powell J, Prata DP, Rujescu D, Rutten BPF, Shaikh M, Simons CJP, Toulopoulou T, Weisbrod M, van Winkel R, Kuchenbaecker K, McQuillin A, Bramon E. Psychosis Endophenotypes: A Gene-Set-Specific Polygenic Risk Score Analysis. Schizophr Bull 2023; 49:1625-1636. [PMID: 37582581 PMCID: PMC10686343 DOI: 10.1093/schbul/sbad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
BACKGROUND AND HYPOTHESIS Endophenotypes can help to bridge the gap between psychosis and its genetic predispositions, but their underlying mechanisms remain largely unknown. This study aims to identify biological mechanisms that are relevant to the endophenotypes for psychosis, by partitioning polygenic risk scores into specific gene sets and testing their associations with endophenotypes. STUDY DESIGN We computed polygenic risk scores for schizophrenia and bipolar disorder restricted to brain-related gene sets retrieved from public databases and previous publications. Three hundred and seventy-eight gene-set-specific polygenic risk scores were generated for 4506 participants. Seven endophenotypes were also measured in the sample. Linear mixed-effects models were fitted to test associations between each endophenotype and each gene-set-specific polygenic risk score. STUDY RESULTS After correction for multiple testing, we found that a reduced P300 amplitude was associated with a higher schizophrenia polygenic risk score of the forebrain regionalization gene set (mean difference per SD increase in the polygenic risk score: -1.15 µV; 95% CI: -1.70 to -0.59 µV; P = 6 × 10-5). The schizophrenia polygenic risk score of forebrain regionalization also explained more variance of the P300 amplitude (R2 = 0.032) than other polygenic risk scores, including the genome-wide polygenic risk scores. CONCLUSIONS Our finding on reduced P300 amplitudes suggests that certain genetic variants alter early brain development thereby increasing schizophrenia risk years later. Gene-set-specific polygenic risk scores are a useful tool to elucidate biological mechanisms of psychosis and endophenotypes, offering leads for experimental validation in cellular and animal models.
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Affiliation(s)
- Baihan Wang
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Haritz Irizar
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Johan H Thygesen
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
- Institute of Health Informatics, University College London, London, UK
| | - Eirini Zartaloudi
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
| | - Isabelle Austin-Zimmerman
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Anjali Bhat
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
| | - Jasmine Harju-Seppänen
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
| | - Oliver Pain
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nick Bass
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
| | - Vasiliki Gkofa
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
| | - Behrooz Z Alizadeh
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, The Netherlands
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Maria J Arranz
- Fundació Docència i Recerca Mutua Terrassa, Terrassa, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut de Recerca Biomédica Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Wiepke Cahn
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Altrecht, General Mental Health Care, Utrecht, The Netherlands
| | - Maria Stella Calafato
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Sevilla, Spain
- Department of Psychiatry, University Hospital Virgen del Rocio, School of Medicine, University of Sevilla–IBiS, Sevilla, Spain
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Ina Giegling
- Comprehensive Centers for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Jeremy Hall
- Neuroscience and Mental Health Innovation Institute, School of Medicine, Cardiff University, Hadyn Ellis Building, Mandy Road, Cardiff, UK
| | - Mei-Hua Hall
- Psychosis Neurobiology Laboratory, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - Neeltje van Haren
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia’s Children Hospital, Rotterdam, The Netherlands
| | - Conrad Iyegbe
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eugenia Kravariti
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Kuang Lin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jurjen J Luykx
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ignacio Mata
- Fundacion Argibide, Pamplona, Spain
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Colm McDonald
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience Centre, University of Galway, Galway, Ireland
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Robin M Murray
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Marco Picchioni
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- St Magnus Hospital, Surrey, UK
| | - John Powell
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Diana P Prata
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciencias da Universidade de Lisboa, Portugal
| | - Dan Rujescu
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Division of General Psychiatry, Medical University of Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Madiha Shaikh
- North East London Foundation Trust, London, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Claudia J P Simons
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
| | - Timothea Toulopoulou
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Interdisciplinary Program in Neuroscience, Aysel Sabuncu Brain Research Center, Bilkent University, Ankara, Türkiye
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Türkiye
- Department of Psychology, Bilkent University, Ankara, Türkiye
- School of Medicine, Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Matthias Weisbrod
- Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Germany
- SRH Klinikum, Karlsbad-Langensteinbach, Germany
| | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Leuven, Belgium
| | - Karoline Kuchenbaecker
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
- UCL Genetics Institute, Division of Biosciences, University College London, London, UK
| | - Andrew McQuillin
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
| | - Elvira Bramon
- Department of Mental Health Neuroscience, Division of Psychiatry, University College London, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
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2
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Correa-Ghisays P, Vicent Sánchez-Ortí J, Balanzá-Martínez V, Fuentes-Durá I, Martinez-Aran A, Ruiz-Bolo L, Correa-Estrada P, Ruiz-Ruiz JC, Selva-Vera G, Vila-Francés J, Macias Saint-Gerons D, San-Martín C, Ayesa-Arriola R, Tabarés-Seisdedos R. MICEmi: A method to identify cognitive endophenotypes of mental illnesses. Eur Psychiatry 2022; 65:e85. [PMID: 36440538 PMCID: PMC9807453 DOI: 10.1192/j.eurpsy.2022.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Characterizing neurocognitive endophenotypes of mental illnesses (MIs) could be useful for identifying at-risk individuals, increasing early diagnosis, improving disease subtyping, and proposing therapeutic strategies to reduce the negative effects of the symptoms, in addition to serving as a scientific basis to unravel the physiopathology of the disease. However, a standardized algorithm to determine cognitive endophenotypes has not yet been developed. The main objective of this study was to present a method for the identification of endophenotypes in MI research. METHODS For this purpose, a 14-expert working group used a scoping review methodology and designed a method that includes a scoring template with five criteria and indicators, a strategy for their verification, and a decision tree. CONCLUSIONS This work is ongoing since it is necessary to obtain external validation of the applicability of the method in future research.
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Affiliation(s)
- Patricia Correa-Ghisays
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vicent Sánchez-Ortí
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Inmaculada Fuentes-Durá
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Anabel Martinez-Aran
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Bipolar Disorders Unit, Neurosciences Institute, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Catalonia, Spain
| | - Lara Ruiz-Bolo
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | | | - Juan Carlos Ruiz-Ruiz
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- Intelligent Data Analysis Laboratory (IDAL), University of Valencia, Spain
| | - Diego Macias Saint-Gerons
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Constanza San-Martín
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Rafael Tabarés-Seisdedos
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
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3
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Pillny M, Krkovic K, Buck L, Lincoln TM. From Memories of Past Experiences to Present Motivation? A Meta-analysis on the Association Between Episodic Memory and Negative Symptoms in People With Psychosis. Schizophr Bull 2022; 48:307-324. [PMID: 34635918 PMCID: PMC8886596 DOI: 10.1093/schbul/sbab120] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Based on findings from cognitive science, it has been theorized that the reductions in motivation and goal-directed behavior in people with psychosis could stem from impaired episodic memory. In the current meta-analysis, we investigated this putative functional link between episodic memory deficits and negative symptoms. We hypothesized that episodic memory deficits in psychosis would be related to negative symptoms in general but would be more strongly related to amotivation than to reduced expressivity. We included 103 eligible studies (13,622 participants) in the analyses. Results revealed significant, moderate negative associations of episodic memory with negative symptoms in general (k = 103; r = -.23; z = -13.40; P ≤ .001; 95% CI [-.26; -.20]), with amotivation (k = 16; r = -.18; z = -6.6; P ≤ .001; 95% CI [-.23; -.13]) and with reduced expressivity (k = 15; r = -.18; z = -3.30; P ≤.001; 95% CI[-.29; -.07]). These associations were not moderated by sociodemographic characteristics, positive symptoms, depression, antipsychotic medication or type of negative symptom scale. Although these findings provide sound evidence for the association between episodic memory deficits and amotivation, the rather small magnitude and the unspecific pattern of this relationship also indicate that episodic memory deficits are unlikely to be the only factor relevant to amotivation. This implicates that future research should investigate episodic memory in conjunction with other factors that could account for the association of episodic memory deficits and amotivation in psychosis.
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Affiliation(s)
- Matthias Pillny
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Katarina Krkovic
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Laura Buck
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
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4
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Grimes KM, Foussias G, Remington G, Kalahani-Bargis K, Zakzanis KK. Stability of Verbal Fluency in Outpatients with Schizophrenia. Psychiatry Res 2021; 295:113528. [PMID: 33189369 DOI: 10.1016/j.psychres.2020.113528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/20/2020] [Indexed: 12/21/2022]
Abstract
While it is well established that individuals with schizophrenia exhibit a wide range of neurocognitive deficits, there is significant heterogeneity in this regard. Impairments in verbal fluency appear to present consistently across most individuals with the illness. The present study examined the stability of verbal fluency abilities in chronic schizophrenia longitudinally. It was hypothesized that semantic but not phonemic verbal fluency performance would be stable over one year. Data was extracted from a larger study that followed 53 outpatients (70% male; mean age = 39.2 years) diagnosed with schizophrenia or schizoaffective disorder. At each testing interval (baseline, 6, and 12 months), the Brief Assessment of Cognition in Schizophrenia was administered, which included phonemic (i.e., F, S) and semantic (i.e., animals) verbal fluency tasks. No significant differences were found across time points for semantic and phonemic verbal fluency with respect to mean number of words generated, clustering, and switching. The findings provide evidence of stability in semantic and phonemic verbal fluency abilities in chronic schizophrenia. Moving forward, it would be valuable to examine verbal fluency performance longitudinally across multiple stages of illness (i.e., clinically high-risk to chronic schizophrenia).
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Affiliation(s)
- Kyrsten M Grimes
- University of Toronto Scarborough, 1265 Military Trail, Scarborough Ontario.
| | - George Foussias
- Centre for Addiction and Mental Health, 250 College Street, Toronto Ontario
| | - Gary Remington
- Centre for Addiction and Mental Health, 250 College Street, Toronto Ontario
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5
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Luperdi SC, Tabarés-Seisdedos R, Livianos L, Vieta E, Cuesta MJ, Balanzá-Martínez V. Neurocognitive endophenotypes in schizophrenia and bipolar disorder: A systematic review of longitudinal family studies. Schizophr Res 2019; 210:21-29. [PMID: 31272906 DOI: 10.1016/j.schres.2019.06.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 03/16/2019] [Accepted: 06/17/2019] [Indexed: 01/28/2023]
Abstract
Although there is substantial evidence supporting the existence of neurocognitive impairment in patients diagnosed with schizophrenia (SZ) and bipolar disorder (BD), few studies have explored the field from an endophenotypic perspective. The present systematic review sought to identify longitudinal family studies exploring suitable neurocognitive endophenotypes in unaffected relatives of patients with SZ and/or BD. Following the PRISMA statement, only five follow-up studies met the inclusion criteria, comprising 79 SZ patients, 159 SZ unaffected relatives of SZ, 131 BD patients, 77 unaffected relatives of BD, and 248 controls. Verbal memory, auditory attention, face memory and emotion processing were found as putative endophenotypic candidates for SZ, whereas this strategy identified none for BD. Substantial heterogeneity and lack of standardization in global neurocognitive assessment within this area should be pointed out; nevertheless, several candidate endophenotypes were identified for SZ, except for executive impairment.
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Affiliation(s)
- Sussy C Luperdi
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; PhD Program in Medicine. University of Valencia, Spain
| | - Rafael Tabarés-Seisdedos
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; INCLIVA Health Research Institute, Valencia, Spain
| | - Lorenzo Livianos
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Public Health (CIBERESP-Grupo 17), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Vicent Balanzá-Martínez
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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6
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Lin SZ, Wu YK, Su YA, Si TM. Prospective memory in non-psychotic first-degree relatives of patients with schizophrenia: a meta-analysis. Neuropsychiatr Dis Treat 2019; 15:1563-1571. [PMID: 31289442 PMCID: PMC6565992 DOI: 10.2147/ndt.s203729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/04/2019] [Indexed: 12/16/2022] Open
Abstract
Prospective memory (PM) could be impaired in the non-psychotic first-degree relatives of patients with schizophrenia. This meta-analysis systematically examined the PM of non-psychotic first-degree relatives of patients with schizophrenia. Both Chinese and English databases were systematically searched for articles from the inception of the databases through November 13, 2018. Case-control studies of PM in non-psychotic first-degree relatives of patients with schizophrenia were included in the analyses. Confidence intervals (CIs) and standardized mean differences (SMDs) were calculated utilizing the random effects model. Four studies (n=268) that compared PM performance between non-psychotic first-degree relatives of patients with schizophrenia (n=136) and healthy controls (n=132) were included. Three studies were rated as "high quality", while the quality of evidence of the three outcomes included in this meta-analysis was moderate. Compared with the healthy controls, the non-psychotic first-degree relatives of patients with schizophrenia showed impairments in overall PM (two studies, n=127; SMD: -0.46; 95% CI=-0.82, -0.11, P=0.01; I=0%), event-based PM (EBPM) (four studies, n=268; SMD: -0.56; 95% CI=-0.80, -0.31, P<0.00001; I=0%), and time-based PM (TBPM) (four studies, n=268; SMD: -0.66; 95% CI=-0.90, -0.41, P<0.00001; I=0%). This meta-analysis demonstrated that the overall PM, EBPM, and TBPM might be impaired in the non-psychotic first-degree relatives of patients with schizophrenia.
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Affiliation(s)
- Shi-Ze Lin
- Quanzhou Mental Health Center, The Third Hospital of Quanzhou, Quanzhou, Fujian Province, People's Republic of China.,Institute of Mental Health, Peking University Sixth Hospital, Beijing, People's Republic of China
| | - Yan-Kun Wu
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, People's Republic of China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, People's Republic of China.,NHC Key Laboratory of Mental Health, Peking University, Beijing, People's Republic of China
| | - Yun-Ai Su
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, People's Republic of China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, People's Republic of China.,NHC Key Laboratory of Mental Health, Peking University, Beijing, People's Republic of China
| | - Tian-Mei Si
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, People's Republic of China.,National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, People's Republic of China.,NHC Key Laboratory of Mental Health, Peking University, Beijing, People's Republic of China
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7
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Blakey R, Ranlund S, Zartaloudi E, Cahn W, Calafato S, Colizzi M, Crespo-Facorro B, Daniel C, Díez-Revuelta Á, Di Forti M, Iyegbe C, Jablensky A, Jones R, Hall MH, Kahn R, Kalaydjieva L, Kravariti E, Lin K, McDonald C, McIntosh AM, Picchioni M, Powell J, Presman A, Rujescu D, Schulze K, Shaikh M, Thygesen JH, Toulopoulou T, Van Haren N, Van Os J, Walshe M, Murray RM, Bramon E. Associations between psychosis endophenotypes across brain functional, structural, and cognitive domains. Psychol Med 2018; 48:1325-1340. [PMID: 29094675 PMCID: PMC6516747 DOI: 10.1017/s0033291717002860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND A range of endophenotypes characterise psychosis, however there has been limited work understanding if and how they are inter-related. METHODS This multi-centre study includes 8754 participants: 2212 people with a psychotic disorder, 1487 unaffected relatives of probands, and 5055 healthy controls. We investigated cognition [digit span (N = 3127), block design (N = 5491), and the Rey Auditory Verbal Learning Test (N = 3543)], electrophysiology [P300 amplitude and latency (N = 1102)], and neuroanatomy [lateral ventricular volume (N = 1721)]. We used linear regression to assess the interrelationships between endophenotypes. RESULTS The P300 amplitude and latency were not associated (regression coef. -0.06, 95% CI -0.12 to 0.01, p = 0.060), and P300 amplitude was positively associated with block design (coef. 0.19, 95% CI 0.10-0.28, p 0.38). All the cognitive endophenotypes were associated with each other in the expected directions (all p < 0.001). Lastly, the relationships between pairs of endophenotypes were consistent in all three participant groups, differing for some of the cognitive pairings only in the strengths of the relationships. CONCLUSIONS The P300 amplitude and latency are independent endophenotypes; the former indexing spatial visualisation and working memory, and the latter is hypothesised to index basic processing speed. Individuals with psychotic illnesses, their unaffected relatives, and healthy controls all show similar patterns of associations between endophenotypes, endorsing the theory of a continuum of psychosis liability across the population.
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Affiliation(s)
- R. Blakey
- Division of Psychiatry, University College London, London, UK
| | - S. Ranlund
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - E. Zartaloudi
- Division of Psychiatry, University College London, London, UK
| | - W. Cahn
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S. Calafato
- Division of Psychiatry, University College London, London, UK
| | - M. Colizzi
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - B. Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria–IDIVAL, Santander, Spain
| | - C. Daniel
- Division of Psychiatry, University College London, London, UK
| | - Á. Díez-Revuelta
- Division of Psychiatry, University College London, London, UK
- Laboratory of Cognitive and Computational Neuroscience – Centre for Biomedical Technology (CTB), Complutense University and Technical University of Madrid, Madrid, Spain
| | - M. Di Forti
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | | | - C. Iyegbe
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - A. Jablensky
- Centre for Clinical Research in Neuropsychiatry, The University of Western Australia, Perth, Western Australia, Australia
| | - R. Jones
- Division of Psychiatry, University College London, London, UK
| | - M.-H. Hall
- Psychology Research Laboratory, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - R. Kahn
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L. Kalaydjieva
- Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, Australia
| | - E. Kravariti
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - K. Lin
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - C. McDonald
- Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Ireland
| | - A. M. McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
| | | | - M. Picchioni
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - J. Powell
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - A. Presman
- Division of Psychiatry, University College London, London, UK
| | - D. Rujescu
- Department of Psychiatry, Ludwig-Maximilians University of Munich, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle Wittenberg, Halle, Germany
| | - K. Schulze
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - M. Shaikh
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- North East London Foundation Trust, London, UK
| | - J. H. Thygesen
- Division of Psychiatry, University College London, London, UK
| | - T. Toulopoulou
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychology, Bilkent University, Main Campus, Bilkent, Ankara, Turkey
- Department of Psychology, the University of Hong Kong, Pokfulam Rd, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, The Hong Kong Jockey Club Building for Interdisciplinary Research, Hong Kong SAR, China
| | - N. Van Haren
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J. Van Os
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, EURON, Maastricht, The Netherlands
| | - M. Walshe
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | | | - R. M. Murray
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - E. Bramon
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
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Whalley HC, Whyte MC, Johnstone EC, Lawrie SM. Neural Correlates of Enhanced Genetic Risk for Schizophrenia. Neuroscientist 2016; 11:238-49. [PMID: 15911873 DOI: 10.1177/1073858404274111] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Schizophrenia is a disabling psychotic disorder characterized by hallucinations, delusions, and impaired functioning in many aspects of everyday life. The established condition generally becomes manifest in early adulthood, and evidence suggests that one of the most important risk factors for developing the disorder is inherited vulnerability. The established illness has been shown to be associated with deficits in many domains of cognitive function, along with structural and functional brain abnormalities, most notably in pre-frontal and temporal lobes. However, such studies have not been able to determine the extent to which such deficits relate to the presence of a schizophrenic predisposition, the presence of symptoms, and/or medication effects. A number of research groups have therefore turned to the study of relatives of affected individuals with the aim of determining if similar cognitive deficits and brain abnormalities are also found in those with increased genetic vulnerability to the disorder. In this article, studies on such individuals are discussed. It is concluded that deficits are apparent in relatives that are similar to but less marked than those seen in patients with schizophrenia.
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Affiliation(s)
- Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland.
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9
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Hesse K, Kriston L, Wittorf A, Herrlich J, Wölwer W, Klingberg S. Longitudinal relations between symptoms, neurocognition, and self-concept in schizophrenia. Front Psychol 2015; 6:917. [PMID: 26191025 PMCID: PMC4490211 DOI: 10.3389/fpsyg.2015.00917] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 06/19/2015] [Indexed: 12/18/2022] Open
Abstract
Objective: Cognitive models suggest that the self-concept of persons with psychosis can be fundamentally affected. Self-concepts were found to be related to different symptom domains when measured concurrently. Longitudinal investigations to disentangle the possible causal associations are rare. Method: We examined a sample of 160 people with a diagnosis of schizophrenia who took part in a psychotherapy study. All participants had the DSM-IV diagnosis of a schizophrenia and pronounced negative symptoms. Neurocognition, symptoms, and self-concepts were assessed at two time points 12 months apart. Structural equation modeling was used to test whether symptoms influence self-concepts (scar-model) or self-concepts affect symptoms (vulnerability model). Results: Negative symptoms correlated concurrently with self-concepts. Neurocognitive deficits are associated with more negative self-concepts 12 months later. Interpersonal self-concepts were found to be relevant for paranoia. Conclusion: The findings implicate that if deficits in neurocognition are present, fostering a positive self-concept should be an issue in therapy. Negative interpersonal self-concept indicates an increased risk for paranoid delusions in the course of 1 year. New aspects for cognitive models in schizophrenia and clinical implications are discussed.
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Affiliation(s)
- Klaus Hesse
- Department of Psychiatry and Psychotherapy, University of Tübingen Tübingen, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Andreas Wittorf
- Department of Psychiatry and Psychotherapy, University of Tübingen Tübingen, Germany
| | - Jutta Herrlich
- Department of Psychiatry and Psychotherapy, University of Frankfurt Frankfurt, Germany
| | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duesseldorf Duesseldorf, Germany
| | - Stefan Klingberg
- Department of Psychiatry and Psychotherapy, University of Tübingen Tübingen, Germany
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Wittorf A, Giel KE, Hautzinger M, Rapp A, Schönenberg M, Wolkenstein L, Zipfel S, Mehl S, Fallgatter AJ, Klingberg S. Specificity of jumping to conclusions and attributional biases: a comparison between patients with schizophrenia, depression, and anorexia nervosa. Cogn Neuropsychiatry 2012; 17:262-86. [PMID: 22224619 DOI: 10.1080/13546805.2011.633749] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The knowledge of the specificity of cognitive biases in psychiatric disorders is important in order to develop disorder-specific cognitive models and therapies. This cross-sectional study aimed to investigate the specificity of jumping to conclusions (JTC) and attributional biases (AB) for patients with schizophrenia. METHODS Twenty patients with paranoid schizophrenia were compared with patients with depression (n=20) and with anorexia nervosa (n=15) and nonclinical controls (n=55). All participants were administered a modified version of the beads task (JTC), a revised German version of the Internal, Personal, and Situational Attributions Questionnaire (AB), and several symptom and neurocognitive measures. RESULTS The proportion of patients with JTC bias in the schizophrenia group was, at the descriptive level, higher than in the depression and the anorexia groups. Regarding AB, the schizophrenia group showed a significantly stronger externalising but not personalising bias than the clinical control groups. Neither JTC nor attributional biases were significantly associated with delusions in general or persecutory delusion. CONCLUSIONS We found evidence for the specificity of an externalising bias for paranoid schizophrenia. Concerning JTC bias the evidence was less clear. Whether the modification of those biases through psychological interventions would have an effect on psychopathology should be investigated in the context of clinical trials.
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Affiliation(s)
- Andreas Wittorf
- Department of Psychiatry and Psychotherapy, University of Tübingen, and Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Tübingen, Germany.
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11
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Şevik AE, Anıl Yağcıoğlu AE, Yağcıoğlu S, Karahan S, Gürses N, Yıldız M. Neuropsychological performance and auditory event related potentials in schizophrenia patients and their siblings: a family study. Schizophr Res 2011; 130:195-202. [PMID: 21592733 DOI: 10.1016/j.schres.2011.04.018] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 04/10/2011] [Accepted: 04/17/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Various neuropsychological domains, and P300 auditory event-related potentials (ERP) and mismatch negativity (MMN) exhibit abnormalities in schizophrenia patients and their first-degree relatives. The aims of this study were to compare cognitive and P300/MMN measurements in schizophrenia patients, their siblings, and controls, and to identify the degree of familial influence on each measure. METHODS Thirty patients diagnosed with schizophrenia according to DSM-IV, 20 unaffected siblings and 25 healthy controls were able to complete all neuropsyhological and neurophysiological assessments. All participants were administered SCID-I and the patients were also evaluated regarding symptom severity and functioning. Neuropsychological battery testing results and P300/MMN measurements were obtained for all the participants. RESULTS Both schizophrenia patients and their siblings had lower working memory, as measured by the Auditory Consonant Trigram Test (ACT), and lower MMN amplitude scores than the controls. In addition, the patients had lower attention, verbal memory, executive function, visuomotor speed, and figural memory scores than both the siblings and controls, and lower verbal fluency scores than controls. MMN and P300 amplitudes were lower and P300 latency longer in the schizophrenia patients, as compared to controls. P300 latency was also longer in the schizophrenia patients as compared to siblings and, MMN amplitudes were significantly lower in the siblings compared to controls. Working memory performance measured by ACT significantly predicted inclusion in both the patient and sibling groups and showed significant familial influence. MMN amplitude significantly predicted inclusion only to the patient group and did not show significant familial influence. CONCLUSION The schizophrenia patients exhibited impairment in various cognitive domains and P300/MMN measurements, versus impairment only in working memory and MMN amplitude in their siblings. Working memory seems to have a relatively strong familial influence among all the neuropsychological and neurophysiological parameters evaluated.
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Affiliation(s)
- Ali Emre Şevik
- Başkent University, Faculty of Medicine, Department of Psychiatry, Ankara, Turkey
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12
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Chan RCK, Wang Y, Yan C, Song LL, Wang YN, Shi YF, Gong QY, Cheung EFC. Contribution of specific cognitive dysfunction to people with schizotypal personality. Psychiatry Res 2011; 186:71-5. [PMID: 20667601 DOI: 10.1016/j.psychres.2010.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 06/21/2010] [Accepted: 06/21/2010] [Indexed: 10/19/2022]
Abstract
The current study aimed to determine whether there is a specific neurocognitive deficit in individuals with schizotypal personality features. One hundred and fifty-nine healthy participants and 62 schizotypal individuals completed a comprehensive battery of cognitive tests. The cognitive functions captured by the battery could be reduced to 6 factors. Significant difference was found between participants with schizotypal features and healthy controls in allocation, verbal memory and marginally in working memory. Schizotypal traits tended to correlate with some of the cognitive factors, especially allocation, verbal memory and working memory.
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Affiliation(s)
- Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory; Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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13
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Self-concept, emotion and memory performance in schizophrenia. Psychiatry Res 2011; 186:11-7. [PMID: 20850874 DOI: 10.1016/j.psychres.2010.08.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 08/06/2010] [Accepted: 08/13/2010] [Indexed: 11/24/2022]
Abstract
The "self-reference effect" describes better memory for material someone has related to one's self previously. Schizophrenia can affect aspects of the inner self such as own thoughts or actions. Schizophrenia symptoms, therefore, might not only have an influence on the self-concept, including the self-attribution of positive or negative personality traits, but also reduce the self-reference effect. 15 schizophrenia patients and 15 matched healthy controls were asked to decide on positive and negative personality traits across three separate conditions: self-evaluation, other evaluation (of an intimate person), and during a lexical control task, respectively. An unannounced recognition task followed. Patients revealed a negative bias in the evaluation of themselves and of the well-known other person. The reference to a person (oneself, close other) increased later recognition performance. However, patients with schizophrenia revealed an overall decreased recognition performance. The amount of patients' passivity symptoms, i.e., an increase in the permeability of their "self-other boundary", correlated negatively with their recognition performance for previously self-referred characteristics and traits referred to the intimate other. This was not the case for lexically processed stimuli or an increase of negative symptoms. Our data underline the necessity of taking into account symptom subgroups when dealing with specific cognitive dysfunctions in schizophrenia.
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Abstract
BACKGROUND Memory impairment is being recognized increasingly as an important feature of the neuropsychology of schizophrenia. Dysfunction of working memory, a system for the short-term storage and manipulation of information, may relate to a number of core symptoms of schizophrenia. Many studies have examined working memory function in schizophrenia but a clear understanding of the nature and extent of any deficit has been elusive. METHOD A systematic review and meta-analysis of studies comparing working memory function in subjects with schizophrenia and healthy controls was performed. Following a comprehensive literature search, meta-analyses were conducted on 36 measures of phonological, visuospatial and central executive working memory functioning, encompassing 441 separate results from 187 different studies. RESULTS Statistically significant effect sizes were found for all working memory measures, indicating deficits in schizophrenia groups. Some of these were robust findings in the absence of evidence of significant heterogeneity or publication bias. Meta-regression analyses showed that the working memory deficit was not simply explained by discrepancies in current IQ between schizophrenia and control groups. CONCLUSIONS Large deficits in working memory were demonstrated in schizophrenia groups across all three working memory domains. There were, however, no clear differences across subdomains or between particular working memory tasks. There was substantial heterogeneity across results that could only be partly explained.
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15
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Wang Y, Chan RCK, Shi C, Cui J, Deng Y. Prospective memory deficits in subjects with schizophrenia spectrum disorders: a comparison study with schizophrenic subjects, psychometrically defined schizotypal subjects, and healthy controls. Schizophr Res 2008; 106:70-80. [PMID: 17719206 DOI: 10.1016/j.schres.2007.07.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Revised: 07/18/2007] [Accepted: 07/25/2007] [Indexed: 11/27/2022]
Abstract
Memory impairment is one of the core deficits in schizophrenia. This study explored the memory profiles of schizophrenic and psychometrically defined schizotypal subjects. The study participants included 15 patients with schizophrenia, 41 schizotypal subjects, and 20 healthy controls. All of the participants completed verbal and visual memory, working memory, and prospective memory tasks. The results showed that patients with schizophrenia were impaired in all aspects of memory function, whereas the schizotypal subjects tended to show moderate to large impairment effect sizes in prospective memory. It is suggested that prospective memory be considered a potential endophenotype of schizophrenia.
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Affiliation(s)
- Ya Wang
- Department of Psychology, Sun Yat-Sen University, Guangzhou, China; School of Life Science, Sun Yat-Sen University, Guangzhou, China
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16
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Hill SK, Harris MSH, Herbener ES, Pavuluri M, Sweeney JA. Neurocognitive allied phenotypes for schizophrenia and bipolar disorder. Schizophr Bull 2008; 34:743-59. [PMID: 18448479 PMCID: PMC2632447 DOI: 10.1093/schbul/sbn027] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psychiatric disorders are genetically complex and represent the end product of multiple biological and social factors. Links between genes and disorder-related abnormalities can be effectively captured via assessment of phenotypes that are both associated with genetic effects and potentially contributory to behavioral abnormalities. Identifying intermediate or allied phenotypes as a strategy for clarifying genetic contributions to disorders has been successful in other areas of medicine and is a promising strategy for identifying susceptibility genes in complex psychiatric disorders. There is growing evidence that schizophrenia and bipolar disorder, rather than being wholly distinct disorders, share genetic risk at several loci. Further, there is growing evidence of similarity in the pattern of cognitive and neurobiological deficits in these groups, which may be the result of the effects of these common genetic factors. This review was undertaken to identify patterns of performance on neurocognitive and affective tasks across probands with schizophrenia and bipolar disorder as well as unaffected family members, which warrant further investigation as potential intermediate trait markers. Available evidence indicates that measures of attention regulation, working memory, episodic memory, and emotion processing offer potential for identifying shared and illness-specific allied neurocognitive phenotypes for schizophrenia and bipolar disorder. However, very few studies have evaluated neurocognitive dimensions in bipolar probands or their unaffected relatives, and much work in this area is needed.
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Affiliation(s)
- S. Kristian Hill
- To whom correspondence should be addressed; tel: 312 996-2107, fax: 312 413-8837, e-mail:
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17
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Delawalla Z, Barch DM, Fisher Eastep JL, Thomason ES, Hanewinkel MJ, Thompson PA, Csernansky JG. Factors mediating cognitive deficits and psychopathology among siblings of individuals with schizophrenia. Schizophr Bull 2006; 32:525-37. [PMID: 16714471 PMCID: PMC2632255 DOI: 10.1093/schbul/sbj082] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Schizotypal traits and cognitive disturbances are known to be present in first-degree relatives of people with schizophrenia. However, there is little understanding of how these endophenotypes are related to each other. We explored the nature of this relationship in individuals with schizophrenia, their full siblings, community controls, and their siblings. All participants were assessed in the domains of working memory, attention, episodic memory, and executive function, as well as in their level of positive, negative, and disorganization symptoms. Schizophrenia probands were significantly impaired on all cognitive domains, as compared with the other 3 groups, and displayed the highest levels of positive, negative, and disorganization symptoms. Proband siblings performed significantly worse than controls on tasks of working memory, episodic memory, and executive function, and they displayed significantly more positive and negative symptoms as compared with controls. Poorer task performance across all 4 cognitive domains was most strongly correlated with increased negative symptoms. Mediation analyses revealed that working memory, episodic memory, and executive function deficits partially mediated increases in negative symptoms among proband siblings. Negative symptoms fully mediated deficits in working memory and episodic memory but only partially mediated deficits in executive function. Results suggest that there is a complex relationship between cognitive and clinical factors in this high-risk population.
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Affiliation(s)
| | | | | | | | | | - Paul A. Thompson
- Department of Radiology, Washington University
- Department of Biostatistics, Washington University
| | - John G. Csernansky
- Department of Psychiatry, Washington University
- Department of Anatomy and Neurobiology, Washington University
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18
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Abstract
PURPOSE OF REVIEW Studies of first-degree relatives of patients with schizophrenia over the past 25 years have reported a number of cognitive deficits, primarily in the domains of memory and executive function. Nevertheless, due to a number of methodological issues, such as including different types of relatives and not controlling for possible psychopathology, it is not yet clear that these findings can fully support a conclusion of heritability of cognitive dysfunction associated with a schizophrenia genotype. RECENT FINDINGS Several recent meta-analyses have shown that the most consistent deficit shown by relatives is impaired performance on 'maintenance plus' frontal-lobe tasks requiring increased effort and higher central executive processing. Studies of multiplex families (multiple diagnoses in one family) also report that family members tend to have more difficulty on executive function tasks. Another interesting trend is research on subgroups of patients and relatives displaying distinct cognitive syndromes, particularly a subgroup with a generalized cognitive deficit. SUMMARY As methodological designs improve, this field of study holds promise not only for understanding the neurobiological mechanisms of schizophrenia and the associated cognitive deficits, but also for possibly describing endophenotypes that may lead to identifying at-risk patients and relatives.
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Affiliation(s)
- Gitry Heydebrand
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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19
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Abstract
Common mental disorders such as schizophrenia, bipolar disorder, and severe major depression are highly heritable, but differ from single-gene (Mendelian) diseases in that they are the end products of multiple causes. Although this fact may help explain their prevalence from an evolutionary perspective, the complexity of the causes of these disorders makes identification of disease-promoting genes much more difficult. The "endophenotype" approach is an alternative method for measuring phenotypic variation that may facilitate the identification of susceptibility genes for complexly inherited traits. Here we examine the endophenotype construct in context of psychiatric genetics. We first develop an evolutionary theoretical framework for common mental disorders and differentiate them from simpler, single-gene disorders. We then provide a definition and description of endophenotypes, elucidating several features that will make a proposed endophenotype useful in psychiatric genetic research and evaluating the methods for detecting and validating such endophenotypes. We conclude with a review of recent results in the schizophrenia literature that illustrate the usefulness of endophenotypes in genetic analyses of mental disorders, and discuss implications of these findings for models of disease causation and nosology. Given that in mental disorders as in behavior generally, the pathways from genotypes to phenotypes are circuitous at best, discernment of endophenotypes more proximal to the effects of genetic variation will aid attempts to link genes to disorders.
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Affiliation(s)
- Tyrone D Cannon
- Department of Psychology, University of California, Los Angeles, California 90095, USA.
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20
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Bell MD, Mishara AL. Does negative symptom change relate to neurocognitive change in schizophrenia? Implications for targeted treatments. Schizophr Res 2006; 81:17-27. [PMID: 16297601 DOI: 10.1016/j.schres.2005.09.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Revised: 09/20/2005] [Accepted: 09/23/2005] [Indexed: 11/26/2022]
Abstract
Negative symptoms and cognitive dysfunction are among the most challenging obstacles in the treatment of schizophrenia. It is unknown to what extent they are overlapping or independent disease processes. In the search for targeted treatments of negative symptoms and cognitive impairments, it is imperative to determine their longitudinal relationship. 267 stable outpatients with schizophrenia in a work and cognitive rehabilitation program were evaluated using symptom measures and a comprehensive neuropsychological test battery at baseline and at the conclusion of rehabilitation, 6 months later. Baseline negative symptom, neuropsychological variables and change scores from intake to follow-up on these variables were correlated. These analyses were repeated with a subsample (n = 161) who had clinically significant negative symptoms at baseline. ANCOVA's were performed to compare patients whose negative symptoms improved by 5 points or more (n = 69) with those whose negative symptoms got worse by 5 points or more (n = 26) on their neurocognitive performance at follow-up. Intake negative symptoms were significantly associated with theory of mind and visuomotor processing. Results failed to support a lawful relationship between change in negative symptoms and neurocognition. These findings suggest that negative symptoms and neurocognition should be viewed as relatively independent targets for intervention.
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Affiliation(s)
- Morris D Bell
- Psychology Service, Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516, USA.
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21
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Cannon TD. Clinical and genetic high-risk strategies in understanding vulnerability to psychosis. Schizophr Res 2005; 79:35-44. [PMID: 16054805 DOI: 10.1016/j.schres.2005.06.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Revised: 06/08/2005] [Accepted: 06/09/2005] [Indexed: 11/20/2022]
Abstract
Neurodevelopmental processes active during the adolescent period have been hypothesized to participate in the deterioration in functioning associated with the onset of schizophrenia. A number of studies are now underway evaluating individuals in an ultra high-risk clinical state with neuroimaging assessments repeatedly over time, to determine whether particular neural changes predict an imminent onset of psychosis. However, the results of such studies will be difficult to interpret without reference to studies examining the distribution of these neural indicators in the non-clinically-affected first-degree relatives of patients with schizophrenia. Recent work deriving primarily from twin and family studies (i.e., genetic high-risk designs) indicates that some of the alterations in brain function and structure in schizophrenia are primarily genetically mediated and also appear in some of their unaffected first-degree relatives, while other alterations are present in individuals who manifest the illness phenotype but not in relatives at genetic risk. Whereas the primarily genetically mediated deficits shared by at-risk but non-symptomatic relatives are not likely to show differential change in the premorbid period, and may be necessary but clearly not sufficient for the development of psychotic symptoms, the deficits specific to patients who manifest the illness phenotype are good candidates for marking the neurobiological processes associated with the emergence of psychotic symptoms at the time of schizophrenia onset. Preliminary results from longitudinal studies of individuals ascertained initially in a prodromal (i.e., "clinical high-risk") state appear to be interpretable within this framework.
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Affiliation(s)
- Tyrone D Cannon
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, CA 90095, USA.
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22
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Whyte MC, McIntosh AM, Johnstone EC, Lawrie SM. Declarative memory in unaffected adult relatives of patients with schizophrenia: a systematic review and meta-analysis. Schizophr Res 2005; 78:13-26. [PMID: 16006102 DOI: 10.1016/j.schres.2005.05.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2005] [Revised: 05/16/2005] [Accepted: 05/24/2005] [Indexed: 11/22/2022]
Abstract
Despite evidence for diverse neuropsychological impairment in schizophrenia, verbal declarative memory has emerged as a core deficit in the disorder. Similar but less marked impairments have been demonstrated in unaffected biological relatives of patients with schizophrenia, but the nature and extent of the memory impairment in relatives compared to controls is unclear. We have conducted a systematic review and meta-analysis of the literature investigating declarative memory in unaffected biological relatives of schizophrenics and controls, with the aim of quantifying memory deficits in relatives. The standardised mean difference between groups was calculated for nine measures of declarative memory and two measures of intellectual ability, based on 21 studies of several hundred relatives of schizophrenics and controls. Unaffected relatives showed poorer performance relative to controls on all tests of memory examined. Small to moderate effect sizes, with overlapping 95% confidence intervals, were greatest on immediate (trial 1) list recall (0.65), followed by immediate (0.53) and delayed story recall (0.52). Verbal and general IQ showed smaller standardised mean differences as the latter tests, while the smallest standardised mean difference was shown on delayed visual recall (0.32). Results suggest greater deficits on tests of increasing memory load or which place demands on effective encoding processes but more studies with these tasks are needed. Investigation of sub-groups within these cohorts (e.g. age groups within or beyond the maximum age of risk) is recommended in order to identify deficits specific to the disease process.
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Affiliation(s)
- Marie-Claire Whyte
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
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Abstract
PURPOSE OF REVIEW While schizophrenia is substantially heritable, the mode of inheritance is complex, involving numerous genes of small effect and a non-trivial environmental component. The 'endophenotype' approach is an alternative method for measuring phenotypic variation that may facilitate the identification of susceptibility genes in the context of complexly inherited traits. Here we review recent studies applying this method to measures of brain structure, physiology, and function in samples of schizophrenia patients and their non-ill first-degree relatives (siblings and co-twins). RECENT FINDINGS The results suggest that there are multiple heritable dimensions of central nervous system pathology in schizophrenia, including disturbances in the structure and functioning of frontal lobe systems involved in working memory and executive processes, temporal lobe systems involved in episodic memory, auditory perception, and language processing, and cortical and sub-cortical systems mediating smooth pursuit eye movements and sensorimotor gating. A number of genetic loci that are suspected to play a role in predisposing to schizophrenia, including the DISC1, COMT, neuregulin, dysbindin, and alpha-7 nicotinic receptor genes, appear to affect quantitative variation on one or more of these indicators. SUMMARY Future work is encouraged to address whether each of these neural system dysfunctions are under the influence of a partially distinct set of genes, to elucidate the manner in which multiple genes may coalesce in determining schizophrenia-promoting dysfunction in each neurobehavioral domain, and to clarify the degree of overlap in these quantitative trait loci-endophenotype relationships with other forms of psychosis, particularly bipolar disorder.
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Affiliation(s)
- Tyrone D Cannon
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Los Angeles, California 90095-1563, USA.
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