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Li S, Liu W, Huang Z, Lin H, Ning Y, Li Z. Sex-specific associations between sex hormones and clinical symptoms in late-life schizophrenia. Schizophr Res 2024; 267:1-7. [PMID: 38492529 DOI: 10.1016/j.schres.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/14/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024]
Abstract
The prevalence of late-life schizophrenia is increasing with high burden. It is well-documented that schizophrenia affects men and women differently in terms of symptoms. Sex hormones, which play a role in the pathology and symptoms of schizophrenia, are greatly affected by aging. To the best of our knowledge, this is a study to examine the sex differences in psychiatric symptoms and their correlation with sex hormones in participants with late-life schizophrenia. Positive and Negative Syndrome Scale (PANSS) factors were evaluated. Testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, and prolactin were measured. Male participants with late-life schizophrenia had more severe negative symptoms than female participants (z = -2.56, P = 0.010), while female participants had more severe anxiety/depression compared to male participants (z = 2.64, P = 0.008). Testosterone levels in male participants were positively associated with negative symptoms (β = 0.23, t = 2.27, P = 0.025), while there was no significant association between sex hormones and symptoms in female participants. In conclusion, higher testosterone levels were associated with more severe negative symptoms in male participants with late-life schizophrenia, suggesting that attention should be paid to the sex differences in late-life schizophrenia in clinical practice.
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Affiliation(s)
- Shuyun Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province, Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Weijian Liu
- Peking University Sixth Hospital, Peking University, Beijing, China
| | - Zebin Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hong Lin
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province, Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| | - Zezhi Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province, Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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2
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Mu E, Gurvich C, Kulkarni J. Estrogen and psychosis - a review and future directions. Arch Womens Ment Health 2024:10.1007/s00737-023-01409-x. [PMID: 38221595 DOI: 10.1007/s00737-023-01409-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/02/2023] [Indexed: 01/16/2024]
Abstract
The link between sex hormones and schizophrenia has been suspected for over a century; however, scientific evidence supporting the pharmacotherapeutic effects of exogenous estrogen has only started to emerge during the past three decades. Accumulating evidence from epidemiological and basic research suggests that estrogen has a protective effect in women vulnerable to schizophrenia. Such evidence has led multiple researchers to investigate the role of estrogen in schizophrenia and its use in treatment. This narrative review provides an overview of the effects of estrogen as well as summarizes the recent work regarding estrogen as a treatment for schizophrenia, particularly the use of new-generation selective estrogen receptor modulators.
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Affiliation(s)
- Eveline Mu
- HER Centre Australia, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
| | - Caroline Gurvich
- HER Centre Australia, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jayashri Kulkarni
- HER Centre Australia, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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Peng P, Wang D, Wang Q, Zhou Y, Hao Y, Chen S, Wu Q, Liu T, Zhang X. Alexithymia in Chinese patients with chronic schizophrenia: Prevalence, clinical correlates, and relationship with neurocognition and empathy. Asia Pac Psychiatry 2023; 15:e12547. [PMID: 37635651 DOI: 10.1111/appy.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/30/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION Alexithymia is highly prevalent and strongly related to adverse consequences in patients with schizophrenia. However, its associated factors remain largely unexplored. The present study aimed to determine the prevalence of alexithymia and its association with sociocultural characteristics, clinical symptoms, neurocognition, and empathy in 854 Chinese patients with schizophrenia. METHOD Demographic information was collected through a self-designed questionnaire. Alexithymia was assessed by the Toronto Alexithymia Scale (TAS-20). We assessed clinical symptoms, neurocognition, and empathy via the following instruments: Positive and Negative Syndrome Scale, Repeatable Battery for the Assessment of Neuropsychological Status, and Interpersonal Reactivity Index. A multiple logistic regression model was conducted to determine the independent correlates of alexithymia. RESULTS Approximately one-third (n = 277, 32%) of patients with schizophrenia had alexithymia. Patients with alexithymia had significantly more severe negative symptoms, neurocognition, and empathy impairment than patients without alexithymia. Being male, negative symptoms, personal distress, empathic concern, and language functioning were independently associated with alexithymia. DISCUSSION Our findings demonstrate a high prevalence of alexithymia and its strong association with clinical symptoms, neurocognition, and empathy, which calls for timely screening and intervention for alexithymia in patients with schizophrenia. Targeting impaired language function, negative symptoms, and impaired affective empathy might help reduce alexithymia and its related negative consequences.
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Affiliation(s)
- Pu Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yanan Zhou
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China
| | - Yuzhu Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Shubao Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Carter B, Rodrigues R, Reid J, Archie S, Terry AL, Palaniyappan L, MacDougall AG, Voineskos A, Jan SH, Jaakkimainen L, Chen B, Sawh N, Anderson KK. Sex differences in the clinical presentation of early psychosis in a primary care setting. Arch Womens Ment Health 2023:10.1007/s00737-023-01329-w. [PMID: 37266694 DOI: 10.1007/s00737-023-01329-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/15/2023] [Indexed: 06/03/2023]
Abstract
Primary care is an important part of the help-seeking pathway for young people experiencing early psychosis, but sex differences in clinical presentation in these settings are unexplored. We aimed to identify sex differences in clinical presentation to primary care services in the 1-year period prior to a first diagnosis of psychotic disorder. We identified first-onset cases of non-affective psychotic disorder over a 10-year period (2005-2015) using health administrative data linked with electronic medical records (EMRs) from primary care (n = 465). Detailed information on encounters in the year prior to first diagnosis was abstracted, including psychiatric symptoms, other relevant behaviours, and diagnoses recorded by the family physician (FP). We used modified Poisson regression models to examine sex differences in the signs, symptoms, and diagnoses recorded by the FP, adjusting for various clinical and sociodemographic factors. Positive symptoms (PR = 0.76, 95%CI: 0.58, 0.98) and substance use (PR = 0.54, 95%CI: 0.40, 0.72) were less prevalent in the medical records of women. Visits by women were more likely to be assigned a diagnosis of depression or anxiety (PR = 1.18, 95%CI: 1.00, 1.38), personality disorder (PR = 5.49, 95%CI: 1.22, 24.62), psychological distress (PR = 11.29, 95%CI: 1.23, 103.91), and other mental or behavioral disorders (PR = 3.49, 95%CI: 1.14, 10.66) and less likely to be assigned a diagnosis of addiction (PR = 0.33, 95%CI: 0.13, 0.87). We identified evidence of sex differences in the clinical presentation of early psychosis and recorded diagnoses in the primary care EMR. Further research is needed to better understand sex differences in clinical presentation in the primary care context, which can facilitate better understanding, detection, and intervention for first-episode psychotic disorders.
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Affiliation(s)
- Brooke Carter
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond Street, PHFM 3135, London, ON, N6G 2M1, Canada
| | - Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond Street, PHFM 3135, London, ON, N6G 2M1, Canada
| | | | - Suzanne Archie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Amanda L Terry
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond Street, PHFM 3135, London, ON, N6G 2M1, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Lena Palaniyappan
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Arlene G MacDougall
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond Street, PHFM 3135, London, ON, N6G 2M1, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Aristotle Voineskos
- Department of Psychiatry, Campbell Family Mental Health Research Institute, CAMH, Toronto, ON, Canada
| | - Saadia Hameed Jan
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Liisa Jaakkimainen
- ICES, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | | | - Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, 1465 Richmond Street, PHFM 3135, London, ON, N6G 2M1, Canada.
- ICES, Toronto, ON, Canada.
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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Barendse MEA, Lara GA, Guyer AE, Swartz JR, Taylor SL, Shirtcliff EA, Lamb ST, Miller C, Ng J, Yu G, Tully LM. Sex and pubertal influences on the neurodevelopmental underpinnings of schizophrenia: A case for longitudinal research on adolescents. Schizophr Res 2023; 252:231-241. [PMID: 36682313 PMCID: PMC10725041 DOI: 10.1016/j.schres.2022.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 11/08/2022] [Accepted: 12/10/2022] [Indexed: 01/21/2023]
Abstract
Sex is a significant source of heterogeneity in schizophrenia, with more negative symptoms in males and more affective symptoms and internalizing comorbidity in females. In this narrative review, we argue that there are likely sex differences in the pathophysiological mechanisms of schizophrenia-spectrum disorders (SZ) that originate during puberty and relate to the sex-specific impacts of pubertal maturation on brain development. Pubertal maturation might also trigger underlying (genetic or other) vulnerabilities in at-risk individuals, influencing brain development trajectories that contribute to the emergence of SZ. This review is the first to integrate links between pubertal development and neural development with cognitive neuroscience research in SZ to form and evaluate these hypotheses, with a focus on the frontal-striatal and frontal-limbic networks and their hypothesized contribution to negative and mood symptoms respectively. To test these hypotheses, longitudinal research with human adolescents is needed that examines the role of sex and pubertal development using large cohorts or high risk samples. We provide recommendations for such studies, which will integrate the fields of psychiatry, developmental cognitive neuroscience, and developmental endocrinology towards a more nuanced understanding of the role of pubertal factors in the hypothesized sex-specific pathophysiological mechanisms of schizophrenia.
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Affiliation(s)
- M E A Barendse
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - G A Lara
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - A E Guyer
- Department of Human Ecology, UC Davis, CA, USA; Center for Mind and Brain, UC Davis, CA, USA
| | - J R Swartz
- Center for Mind and Brain, UC Davis, CA, USA
| | - S L Taylor
- Division of Biostatistics, Department of Public Health Sciences, UC Davis, CA, USA
| | - E A Shirtcliff
- Human Development and Family Studies, Iowa State University, Ames, IA, USA
| | - S T Lamb
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - C Miller
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - J Ng
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - G Yu
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA
| | - L M Tully
- Department of Psychiatry and Behavioral Sciences, UC Davis, CA, USA.
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Vogel JS, Bruins J, de Jong S, Knegtering H, Bartels-Velthuis AA, Bruggeman R, Jörg F, Pijnenborg MGHM, Veling W, Visser E, van der Gaag M, Castelein S. Satisfaction with social connectedness as a predictor for positive and negative symptoms of psychosis: A PHAMOUS study. Schizophr Res 2021; 238:121-127. [PMID: 34653741 DOI: 10.1016/j.schres.2021.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 10/02/2021] [Accepted: 10/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study examines satisfaction with social connectedness (SSC) as predictor of positive and negative symptoms in people with a psychotic disorder. METHODS Data from the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS) was used from patients assessed between 2014 and 2019, diagnosed with a psychotic disorder (N = 2109). Items about social connectedness of the Manchester short assessment of Quality of Life (ManSA) were used to measure SSC. Linear mixed models were used to estimate the association of SSC with the Positive and Negative Syndrome Scale (PANSS) after one and two years against α = 0.01. Analyses were adjusted for symptoms, time since onset, gender and age. Additionally, fluctuation of positive and negative symptom scores over time was estimated. RESULTS The mean duration of illness of the sample was 18.8 years (SD 10.7) with >65% showing only small variation in positive and negative symptoms over a two to five-year time period. After adjustment for covariates, SSC showed to be negatively associated with positive symptoms after one year (β = -0.47, p < 0.001, 95% CI = -0.70, -025) and two years (β = -0.59, p < 0.001, 95% CI = -0.88, -0.30), and for negative symptoms after one year (β = -0.52, p < 0.001, 95% CI = -0.77, -0.27). The prediction of negative symptoms was not significant at two years. CONCLUSION This research indicates that interventions on SSC might positively impact mental health for people with psychosis. SSC is a small and robust predictor of future levels of positive symptoms. Negative symptoms could be predicted by SSC at one year.
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Affiliation(s)
- Jelle Sjoerd Vogel
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands; GGZ Drenthe Mental Health Institute, Department of Psychotic Disorders, Dennenweg 9, 9404 LA Assen, the Netherlands.
| | - Jojanneke Bruins
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Steven de Jong
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Henderikus Knegtering
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Agna A Bartels-Velthuis
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | | | - Richard Bruggeman
- University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Frederike Jörg
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands; GGZ Friesland Mental Health Institute, Department of Research and Education, Sixmastraat 2, 8932 PA Leeuwarden, the Netherlands.
| | - Marieke G H M Pijnenborg
- University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; GGZ Drenthe Mental Health Institute, Department of Psychotic Disorders, Dennenweg 9, 9404 LA Assen, the Netherlands.
| | - Wim Veling
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Psychosis Department, Hanzeplein 1 (CC60), 9713 GZ, Groningen, the Netherlands.
| | - Ellen Visser
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
| | - Mark van der Gaag
- VU University Amsterdam, Department of Clinical Psychology, Van der Boechorststraat 1, 1081 BR Amsterdam, the Netherlands; Amsterdam Public Mental Health Research Institute, Van der Boechorststraat 1, 1081 BR Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN The Hague, the Netherlands
| | - Stynke Castelein
- Lentis Psychiatric Institute, Hereweg 80, 9725 AG Groningen, the Netherlands; University of Groningen, Faculty of Behavioral and Social Sciences, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, P.O. 30.001, 9700 RB, Groningen, the Netherlands.
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Prat G, Marquez-Arrico JE, Río-Martínez L, Navarro JF, Adan A. Premorbid functioning in schizophrenia spectrum disorders with comorbid substance use: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110310. [PMID: 33775743 DOI: 10.1016/j.pnpbp.2021.110310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/03/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022]
Abstract
Premorbid functioning has been related with several clinical features and prognosis of schizophrenia spectrum disorders. Comorbidity with substance use is highly prevalent and usually hinders clinical improvement in this kind of psychiatric disorders. This systematic review analyzes the differences in the premorbid functioning of subjects with a schizophrenia spectrum disorder with substance use (SSD+, dual psychosis) or without it (SSD-). A systematic review (PRISMA guidelines), including search in electronic databases (MEDLINE, Web of Science, and Cochrane Library), was performed. 118 published works were considered of which only 20 met our inclusion criteria. Although there is a great variability in methodologies, diagnoses included, and substances used, studies using the Premorbid Functioning Scale to assess the academic and/or social domains found that SSD+ subjects had a poorer academic but better social premorbid functioning than those with SSD-. Current evidence is not conclusive, so additional studies are required to integrate intervening factors in order to clarify the clinical implications of premorbid functioning to improve the course and therapeutic response of patients.
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Affiliation(s)
- Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Julia E Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Laura Río-Martínez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - José Francisco Navarro
- Department of Psychobiology, School of Psychology, University of Málaga, Campus Teatinos s/n, 29071 Málaga, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain.
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8
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Giordano GM, Bucci P, Mucci A, Pezzella P, Galderisi S. Gender Differences in Clinical and Psychosocial Features Among Persons With Schizophrenia: A Mini Review. Front Psychiatry 2021; 12:789179. [PMID: 35002807 PMCID: PMC8727372 DOI: 10.3389/fpsyt.2021.789179] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/03/2021] [Indexed: 01/10/2023] Open
Abstract
An extensive literature regarding gender differences relevant to several aspects of schizophrenia is nowadays available. It includes some robust findings as well as some inconsistencies. In the present review, we summarize the literature on gender differences in schizophrenia relevant to clinical and social outcome as well as their determinants, focusing on clinical variables, while gender differences on biological factors which may have an impact on the outcome of the disorder were not included herewith. Consistent findings include, in male with respect to female patients, an earlier age of illness onset limited to early- and middle-onset schizophrenia, a worse premorbid functioning, a greater severity of negative symptoms, a lower severity of affective symptoms and a higher rate of comorbid alcohol/substance abuse. Discrepant findings have been reported on gender differences in positive symptoms and in social and non-social cognition, as well as in functional outcome and rates of recovery. In fact, despite the overall finding of a more severe clinical picture in males, this does not seem to translate into a worse outcome. From the recent literature emerges that, although some findings on gender differences in schizophrenia are consistent, there are still aspects of clinical and functional outcome which need clarification by means of further studies taking into account several methodological issues.
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Affiliation(s)
| | - Paola Bucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
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9
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Neill E, Tan EJ, Toh WL, Selvendra A, Morgan VA, Rossell SL, Castle DJ. Examining which factors influence age of onset in males and females with schizophrenia. Schizophr Res 2020; 223:265-270. [PMID: 32883558 DOI: 10.1016/j.schres.2020.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Data from the 2010 Australian National Survey of High Impact Psychosis (SHIP) was used to examine (1) what variables influence age of onset (AOO) for males and females, and (2) whether influencing variables were different between the sexes. METHOD Data from 622 schizophrenia patients in the SHIP sample was used. These included early life factors, encompassing family psychiatric history, childhood development, trauma and parental loss. Factors occurring within 12 months of diagnosis were also used, including drug/alcohol abuse and premorbid work and social adjustment. Based on the recognised differences in symptom profiles and AOO between the sexes, these factors were regressed separately for males and females. RESULTS Stepwise linear regressions showed that a family history of psychiatric disorders was significantly associated with earlier AOO in both sexes. Other variables differed between males and females. Specifically, for females, an earlier AOO was associated with poor premorbid social adjustment and the loss of a family member in childhood. Older AOO was associated with immigrant status. For males, a younger AOO was associated with unemployment at onset, poor premorbid work adjustment, parental divorce in childhood, and lifetime cannabis use. A higher premorbid IQ was associated with an older AOO. CONCLUSION Familial predisposition to psychiatric illness is related to earlier AOO of schizophrenia independent of sex. Males appear to have more individual-based predictive factors while females seem to have more community/social-based influences. Future directions for research in schizophrenia are suggested.
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Affiliation(s)
- Erica Neill
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - Eric J Tan
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia; Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Wei Lin Toh
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Ajit Selvendra
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, WA, Australia; Centre for Clinical Research in Neuropsychiatry, Medical School, University of Western Australia, Perth, WA, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David J Castle
- Department of Psychiatry, St. Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
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Gainsford K, Fitzgibbon B, Fitzgerald PB, Hoy KE. Transforming treatments for schizophrenia: Virtual reality, brain stimulation and social cognition. Psychiatry Res 2020; 288:112974. [PMID: 32353694 DOI: 10.1016/j.psychres.2020.112974] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/16/2020] [Accepted: 03/29/2020] [Indexed: 12/13/2022]
Abstract
Schizophrenia is characterised by delusions, hallucinations, anhedonia and apathy; while impairments in social cognition are often less recognised. Poor social cognition can lead to difficulties in obtaining and maintaining employment, academic progression, interpersonal relationships, and community functioning. Current interventions are highly intensive, require significant resources and have only modest effects on functional outcomes. Virtual reality (VR) and non-invasive brain stimulation (NIBS) may have a role in addressing these limitations. VR allows treatments that are potentially more accessible, less delivery intensive, and have higher ecological validity. While NIBS is able to directly modulate activity in social brain areas in order to promote neuroplasticity, strengthen neural connections and enhance brain function related to social cognitive behaviours. Therefore, the combination of VR and NIBS may allow for more efficient and transferrable interventions than those currently available. This review will explore the potential role of these technologies in the treatment of social cognitive impairment.
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Affiliation(s)
- Kirsten Gainsford
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Bernadette Fitzgibbon
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
| | - Kate E Hoy
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Department of Psychiatry, Monash University, Melbourne, Victoria, Australia..
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Nielssen O, Jones N, Foung H, Nielssen A, Staples L, Large M. Comparison of homeless clinic attenders with and without psychotic illness. Aust N Z J Psychiatry 2020; 54:195-201. [PMID: 31823644 DOI: 10.1177/0004867419893426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To compare the characteristics of clinic attenders in inner city homeless hostels with and without a diagnosed psychotic illness. METHOD A cross-sectional study of homeless people attending psychiatric clinics in three inner city homeless hostels over a period of 8 years. The demographic characteristics, comorbid conditions, pathway to homelessness and pattern of homelessness of clinic attenders with a diagnosis of psychosis were compared with those who were not known to have psychotic illness. RESULTS 2389 homeless people attended one or more of the clinics in the 8 years of the study, of whom 1222 (51.2%) had a diagnosed psychotic illness, mostly schizophrenia. Those with psychosis were less likely to have been married (23.2% vs 45.5%), were less likely to have worked for more than a year (47.4% vs 74%) and were more likely to have been discharged from hospital to homelessness, to receive the Disability Support Pension (72.2% vs 38.3%), or be under financial management orders (12.0% vs 2.6%). Homeless people with psychosis were also more likely to have been homeless for more than a year, sleep in the open, and were less likely to have a current substance use disorder, problem gambling or a history of early life or recent trauma. A high proportion of those with psychosis (29.5%) had been released from prison to homelessness and a surprising number (22%) reported the loss of public housing tenancy. CONCLUSION The results demonstrate the homeless with psychotic illness are particularly disabled and disadvantaged, often have multiple comorbid conditions, and many have been unable to maintain public housing tenancy. The inability of many of the homeless mentally ill to maintain public housing tenancy suggests the need for more supported housing to help the chronically homeless with psychotic illness maintain tenancy.
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Affiliation(s)
- Olav Nielssen
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, Australia.,St Vincents Mental Health, St Vincents Hospital Darlinghurst, NSW, Australia
| | - Naidene Jones
- Matthew Talbot Hostel Clinic, Inner City Homeless Service, Sydney, Australia.,Faculty of Medicine, UNSW, Sydney, NSW, Australia
| | - Hayden Foung
- Faculty of Medicine, UNSW, Sydney, NSW, Australia
| | | | - Lauren Staples
- Mindspot Clinic, Macquarie University, Sydney, NSW, Australia
| | - Matthew Large
- Department of Psychiatry, Prince of Wales Hospital, Randwick., NSW, Australia
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Seeman MV. Women who suffer from schizophrenia: Critical issues. World J Psychiatry 2018; 8:125-136. [PMID: 30425943 PMCID: PMC6230925 DOI: 10.5498/wjp.v8.i5.125] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/24/2018] [Accepted: 10/11/2018] [Indexed: 02/05/2023] Open
Abstract
Many brain diseases, including schizophrenia, affect men and women unequally - either more or less frequently, or at different times in the life cycle, or to varied degrees of severity. With updates from recent findings, this paper reviews the work of my research group over the last 40 years and underscores issues that remain critical to the optimal care of women with schizophrenia, issues that overlap with, but are not identical to, the cares and concerns of men with the same diagnosis. Clinicians need to be alert not only to the overarching needs of diagnostic groups, but also to the often unique needs of women and men.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Institute of Medical Science, Toronto, ON M5P 3L6, Canada
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Abstract
BACKGROUND Though olfactory deficits are well-documented in schizophrenia, fewer studies have examined olfactory performance profiles across the psychosis spectrum. The current study examined odor identification, discrimination, and detection threshold performance in first-episode psychosis (FEP) patients diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, major depression with psychotic features, and other psychotic conditions. METHOD FEP patients (n = 97) and healthy adults (n = 98) completed birhinal assessments of odor identification, discrimination, and detection threshold sensitivity for lyral and citralva. Participants also completed measures of anticipatory pleasure, anhedonia, and empathy. Differences in olfactory performances were assessed between FEP patients and controls and within FEP subgroups. Sex-stratified post hoc analyses were employed for a complete analysis of sex differences. Relationships between self-report measures and olfactory scores were also examined. RESULTS Individuals with psychosis had poorer scores across all olfactory measures when compared to the control group. Within the psychosis cohort, patients with schizophrenia-associated psychosis had poorer odor identification, discrimination, and citralva detection threshold scores relative to controls. In schizophrenia patients, greater olfactory disturbance was associated with increased negative symptomatology, greater self-reported anhedonia, and lower self-reported anticipatory pleasure. Patients with mood-associated psychosis performed comparable to controls though men and women in this cohort showed differential olfactory profiles. CONCLUSIONS These findings indicate that olfactory deficits extend beyond measures of odor identification in FEP with greater deficits observed in schizophrenia-related subgroups of psychosis. Studies examining whether greater olfactory dysfunction confers greater risk for developing schizophrenia relative to other forms of psychosis are warranted.
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Affiliation(s)
- Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
- To whom correspondence should be addressed; Division of Medical Psychology, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 218, Baltimore, MD 21287-7218, US; tel: 410-614-6342, fax: 410-955-0504, e-mail:
| | - Patricia Lasutschinkow
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Koko Ishizuka
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
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