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Mao Z, Tian L, Sun Y, Dong F, Wang C, Bo Q. Quality of life and its predictors in first-episode schizophrenia and individuals at clinical high-risk for psychosis. BMC Psychiatry 2023; 23:793. [PMID: 37907877 PMCID: PMC10617034 DOI: 10.1186/s12888-023-05303-9] [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: 01/07/2023] [Accepted: 10/23/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND This is a cross-sectional study comparing the degree of subjective quality of life (QOL) impairment and its predictive factors in first-episode schizophrenia (FES) and individuals at clinical high-risk (CHR) for psychosis. METHODS Seventy-seven FES, 59 CHR, and 64 healthy controls (HC) were included. The QOL of all participants was assessed using the World Health Organization Quality of Life (WHOQOL)-Brief Form (BREF). Psychiatric symptoms of individuals with FES were assessed with the Positive and Negative Syndrome Scale (PANSS), five factors were further identified through factor analysis; for individuals with CHR and HC, the Scale of Prodromal Symptoms (SOPS) was used. RESULTS The total and four sub-domain scores of the WHOQOL-BREF in the FES and CHR groups were lower than those of the HC group. The overall and psychological health scores in the CHR group were lowest. In the FES group, after applying Bonferroni's correction, there is a negative correlation between the total QOL scores and anxiety/depressive symptom scores (r = -0.34, P = 0.003). The stepwise multiple regression analysis showed that the QOL of both FES and CHR group were negatively affected by anxiety/depressive symptoms and unemployment (P < 0.05). CONCLUSIONS Compared with FES, CHR individuals are more dissatisfied with their QOL. Although diagnostic assessment of FES and CHR relies heavily on positive symptoms, the QOL is more affected by anxiety/depressive symptoms and social functioning.
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Affiliation(s)
- Zhen Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Lu Tian
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Fang Dong
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
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De Salve F, Rossi C, Oasi O. Mentalizing in individuals with state and trait risk for psychosis: a systematic review. Front Psychiatry 2023; 14:1214385. [PMID: 37915797 PMCID: PMC10616828 DOI: 10.3389/fpsyt.2023.1214385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Background Mentalization is an umbrella concept defined as the ability to interpret one's and others' mental states. Previous studies have hypothesized that mentalization may be a crucial resilience factor that significantly moderates the likelihood of developing psychotic disorders in individuals with both state and trait risk factors for the illness. Purpose The study reviews the role of mentalizing abilities (e.g., reflective functioning, Theory of Mind (ToM), and metacognition) in young adults with At-Risk Mental States (ARMS) and schizotypal traits. Specifically, the objective is to include articles that (a) evaluate the links between low mentalizing and both state (ARMS/CHR) and trait (schizotypy) risk for psychosis (b) compare the differences in mentalizing abilities between individuals with ARMS, schizotypy, full-blown psychosis, and healthy controls. Method Electronic databases (PsycINFO, PubMed, Scopus, and Google Scholar) were used to search for articles, while Rayyan was employed to facilitate the screening and selection of studies. Eligible studies are original English-language; peer-reviewed research articles on populations that met validated risk diagnostic criteria for psychosis, ARMS, and healthy controls; empirical studies evaluating the association or differences between psychotic risk and mentalizing abilities. Non-English language studies, the ones not considering state or trait risk for psychosis, and qualitative studies were excluded. After the application of the PRISMA checklist and the inclusion and exclusion criteria previously mentioned, 10 articles were extracted. The systematic review has been registered on Prospero (CRD42023397594). Results Low levels of reflective functioning and metacognition may predict a transition to psychosis. In addition, reflective functioning and metacognitive impairments are associated with attenuated psychotic symptoms in both state risk groups and in non-clinical individuals with schizotypal traits. Concerning ToM tasks, mixed results emerged. Conclusion The results obtained from the review suggest that the application of strategies to attenuate maladaptive metacognitive beliefs and low mentalization may be equally effective in improving psychotic symptoms. The assessment of mentalization and metacognition could potentially provide additional prognostic value over factors predisposing to psychosis. Good mentalization and metacognition functioning should be considered as protective factors able to minimize the transition to psychosis.
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Affiliation(s)
- Francesca De Salve
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Chiara Rossi
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
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Takahashi T, Sasabayashi D, Takayanagi Y, Higuchi Y, Mizukami Y, Akasaki Y, Nishiyama S, Furuichi A, Kobayashi H, Yuasa Y, Tsujii N, Noguchi K, Suzuki M. Anatomical variations in the insular cortex in individuals at a clinical high-risk state for psychosis and patients with schizophrenia. Front Psychiatry 2023; 14:1192854. [PMID: 37476540 PMCID: PMC10354273 DOI: 10.3389/fpsyt.2023.1192854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Since the number of insular gyri is higher in schizophrenia patients, it has potential as a marker of early neurodevelopmental deviations. However, it currently remains unknown whether the features of the insular gross anatomy are similar between schizophrenia patients and individuals at risk of psychosis. Furthermore, the relationship between anatomical variations in the insular cortex and cognitive function has not yet been clarified. Methods The gross anatomical features (i.e., the number of gyri and development pattern of each gyrus) of the insular cortex were examined using magnetic resonance imaging, and their relationships with clinical characteristics were investigated in 57 subjects with an at-risk mental state (ARMS) and 63 schizophrenia patients in comparison with 61 healthy controls. Results The number of insular gyri bilaterally in the anterior subdivision was higher in the ARMS and schizophrenia groups than in the control group. The schizophrenia group was also characterized by a higher number of insular gyri in the left posterior subdivision. A well-developed right middle short insular gyrus was associated with symptom severity in first-episode schizophrenia patients, whereas chronic schizophrenia patients with a well-developed left accessory gyrus were characterized by less severe cognitive impairments in motor and executive functions. The features of the insular gross anatomy were not associated with clinical characteristics in the ARMS group. Discussion The features of the insular gross anatomy that were shared in the ARMS and schizophrenia groups may reflect a vulnerability to psychosis that may be attributed to anomalies in the early stages of neurodevelopment. However, the contribution of the insular gross anatomy to the clinical characteristics of schizophrenia may differ according to illness stages.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Arisawabashi Hospital, Toyama, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yuko Mizukami
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yukiko Akasaki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Health Administration Center, Faculty of Education and Research Promotion, Academic Assembly, University of Toyama, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Haruko Kobayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yusuke Yuasa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Noa Tsujii
- Department of Child Mental Health and Development, Toyama University Hospital, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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Usui K, Kirihara K, Tada M, Fujioka M, Koshiyama D, Tani M, Tsuchiya M, Morita S, Kawakami S, Kanehara A, Morita K, Satomura Y, Koike S, Suga M, Araki T, Kasai K. The association between clinical symptoms and later subjective quality of life in individuals with ultra-high risk for psychosis and recent-onset psychotic disorder: A longitudinal investigation. Psychiatry Clin Neurosci 2022; 76:552-559. [PMID: 35352436 DOI: 10.1111/pcn.13359] [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: 07/05/2021] [Revised: 02/04/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
AIM Subjective quality of life is a clinically relevant outcome that is strongly associated with the severity of clinical symptoms in individuals with ultra-high risk for psychosis and patients with recent-onset psychotic disorder. Our objective was to examine whether longitudinal changes in clinical symptoms are associated with quality of life in ultra-high risk individuals and patients with recent-onset psychotic disorder. METHODS Individuals with ultra-high risk and patients with recent-onset psychosis disorder were recruited in the same clinical settings at baseline and were followed up with more than 6 months and less than 5 years later. We assessed five factors of clinical symptoms using the positive and negative syndrome scale, and quality of life using the World Health Organization quality of life questionnaire-short form. We used multiple regression to examine the relationships between clinical symptoms and quality of life while controlling for diagnosis, follow-up period, age, and sex. RESULTS Data were collected from 22 individuals with ultra-high risk and 27 patients with recent-onset psychosis disorder. The multiple regression analysis results indicated that the more severe anxiety/depression was at baseline, the poorer the quality of life at follow-up. Further, improvement of anxiety/depression and disorganized thoughts were associated with improvement in quality of life. The difference in diagnosis did not affect the association between clinical symptoms and quality of life. CONCLUSION These findings suggest that the improvement of anxiety/depression and disorganized thoughts is important in the early stages of psychosis before it becomes severe, affecting the quality of life.
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Affiliation(s)
- Kaori Usui
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan.,Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kenji Kirihara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Disability Services Office, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Office for Mental Health Support, Center for Research on Counseling and Support Services, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Mao Fujioka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Koshiyama
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motoko Tani
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Maiko Tsuchiya
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Susumu Morita
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shintaro Kawakami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiko Kanehara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Morita
- Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan.,University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan.,Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
| | - Motomu Suga
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Graduate school of Clinical Psychology, Teikyo Heisei University, Tokyo, Japan
| | - Tsuyoshi Araki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Teikyo University Hospital, Mizonokuchi, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan.,University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan.,UTokyo Center for Integrative Science of Human Behaviour (CiSHuB), The University of Tokyo, Tokyo, Japan
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Evaluating the tendencies of community practitioners who actively practice in child and adolescent psychiatry to diagnose and treat DSM-5 attenuated psychotic syndrome. Eur Child Adolesc Psychiatry 2022; 31:1635-1644. [PMID: 34669043 DOI: 10.1007/s00787-021-01897-1] [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: 04/17/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
The detection of individuals at clinical ultra-high risk for psychosis (CHR-P) may be a key limiting step for early interventions, and there is some uncertainty regarding the true clinical reliability of the CHR-P states. The aim of this study was to explore how practitioners who were in the direct treatment of children with psychiatric disorders [child psychiatry specialists/trainees (n = 227, n = 131), adult psychiatrists (n = 27), and child neurologists (n = 2)] perceive the DSM-5-Attenuated Psychosis Syndrome (DSM-5-APS), and their clinical routine practice in the treatment of it. Three vignettes describing fictional cases presented with symptoms of either DSM-5-Schizophrenia, DSM-5-APS, and no psychotic symptoms were created. We asked these practitioners to apply a DSM-5 diagnosis and to choose appropriate treatment(s) for these vignettes. Of the responders, 43% correctly diagnosed the APS vignette, whereas 37.4% mentioned that it had a full-blown psychotic episode. Regarding the therapeutic approach for the APS vignette, 72.1% of all practitioners chose a psychopharmacological intervention and 32% individual psychotherapy. This study showed that the diagnostic inter-rater reliability of the DSM-5-APS among child/adolescent mental health practitioners was consistent with the results from the DSM-5 field trials (Kappa = 0.46). Moreover, almost three in four practitioners endorsed psychopharmacological intervention as a treatment option for the DSM-5-APS case. The lack of evidence of psychopharmacological interventions in CHR-P situations emphasizes that the least harmful interventions should be recommended. Thus, our findings indicated a need for raising awareness regarding the CHR-P paradigm and its treatment as well as the development of solid guidelines that can be implemented in clinical practice.
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Thalamic and striato-pallidal volumes in schizophrenia patients and individuals at risk for psychosis: A multi-atlas segmentation study. Schizophr Res 2022; 243:268-275. [PMID: 32448678 DOI: 10.1016/j.schres.2020.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 02/06/2023]
Abstract
Despite previous neuroimaging studies demonstrating morphological abnormalities of the thalamus and other subcortical structures in patients with schizophrenia, the potential role of the thalamus and its subdivisions in the pathophysiology of this illness remains elusive. It is also unclear whether similar changes of these structures occur in individuals at high risk for psychosis. In this study, magnetic resonance imaging was employed with the Multiple Automatically Generated Templates (MAGeT) brain segmentation algorithm to determine volumes of the thalamic subdivisions, the striatum (caudate, putamen, and nucleus accumbens), and the globus pallidus in 62 patients with schizophrenia, 38 individuals with an at-risk mental state (ARMS) [4 of whom (10.5%) subsequently developed schizophrenia], and 61 healthy subjects. Cognitive function of the patients was assessed by using the Brief Assessment of Cognition in Schizophrenia (BACS) and the Schizophrenia Cognition Rating Scale (SCoRS). Thalamic volume (particularly the medial dorsal and ventral lateral nuclei) was smaller in the schizophrenia group than the ARMS and control groups, while there were no differences for the striatum and globus pallidus. In the schizophrenia group, the reduction of thalamic ventral lateral nucleus volume was significantly associated with lower BACS score. The pallidal volume was positively correlated with the dose of antipsychotic treatment in the schizophrenia group. These results suggest that patients with schizophrenia, but not those with ARMS, exhibit volume reduction in specific thalamic subdivisions, which may underlie core clinical features of this illness.
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Potential contribution of pineal atrophy and pineal cysts toward vulnerability and clinical characteristics of psychosis. NEUROIMAGE-CLINICAL 2021; 32:102805. [PMID: 34461434 PMCID: PMC8405969 DOI: 10.1016/j.nicl.2021.102805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/31/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) studies reported pineal gland atrophy in schizophrenia patients and individuals at a clinical high risk of developing psychosis, implicating abnormalities in melatonin secretion in the pathophysiology of psychosis. However, it currently remains unclear whether the morphology of the pineal gland contributes to symptomatology and sociocognitive functions. METHODS This MRI study examined pineal gland volumes and the prevalence of pineal cysts as well as their relationship with clinical characteristics in 57 at risk mental state (ARMS) subjects, 63 patients with schizophrenia, and 61 healthy controls. The Social and Occupational Functioning Assessment Scale (SOFAS), the Schizophrenia Cognition Rating Scale (SCoRS), and the Brief Assessment of Cognition in Schizophrenia (BACS) were used to assess sociocognitive functions, while the Positive and Negative Syndrome Scale was employed to evaluate clinical symptoms in ARMS subjects and schizophrenia patients. RESULTS Pineal gland volumes were significantly smaller in the ARMS and schizophrenia groups than in the controls, while no significant differences were observed in the prevalence of pineal cysts. Although BACS, SCoRS, and SOFAS scores were not associated with pineal morphology, patients with pineal cysts in the schizophrenia group exhibited severe positive psychotic symptoms with rather mild negative symptoms. CONCLUSION The present results indicate the potential of pineal atrophy as a vulnerability marker in various stages of psychosis and suggest that pineal cysts influence the clinical subtype of schizophrenia.
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Prados-Ojeda JL, Luque-Luque R, Gordillo-Urbano RM, Guler I, López-Medina C, Collantes-Estévez E, Escudero-Contreras A. Assessment of Subclinical Psychotic Symptoms in Patients with Rheumatoid Arthritis and Spondyloarthritis. J Clin Med 2021; 10:jcm10163461. [PMID: 34441756 PMCID: PMC8396915 DOI: 10.3390/jcm10163461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/31/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022] Open
Abstract
Inflammatory and autoimmune processes have been associated with the onset of depressive and psychotic symptoms. Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are rheumatic diseases with an inflammatory etiology. A high prevalence of depressive and anxiety-related comorbidity has been reported for both diseases, with no evidence of a greater prevalence of psychosis. The objective of the present study was to evaluate for the first time subclinical psychotic symptoms in patients with RA and SpA. This is a cross-sectional, single-center study including RA and SpA patients, as well as healthy controls. Abnormal psychotic experiences (positive, negative, and depressive symptoms) were evaluated using the Community Assessment of Psychic Experiences (CAPE-42). Functional capacity was evaluated using the Short-Form Health Survey SF-12. We compared the CAPE and SF-12 scores between the three groups. We recruited 385 individuals: 218 with RA, 100 with SpA, and 67 healthy controls. According to the CAPE scale, the frequency of subclinical psychotic symptoms was greater in patients than in healthy controls (RA, 1.90 vs. 1.63, p < 0.001; SpA, 1.88 vs. 1.63, p = 0.001). Distress was also greater in patients than in controls owing to the presence of symptoms. No differences were observed between the three groups for the mental dimension scores in the SF-12 Health Survey (43.75 in RA, 45.54 in SpA, and 43.19 in healthy controls). Our findings point to a greater prevalence of subclinical psychotic symptoms in patients with RA and patients with SpA than in the general population. The results suggest an association between inflammation and depression/subclinical psychotic symptoms.
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Affiliation(s)
- Juan L. Prados-Ojeda
- Mental Health Department, Reina Sofia University Hospital, 14004 Cordoba, Spain; (J.L.P.-O.); (R.L.-L.); (R.M.G.-U.)
- Morphological and Socio-Sanitary Sciences, University of Cordoba, 14004 Cordoba, Spain
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
| | - Rogelio Luque-Luque
- Mental Health Department, Reina Sofia University Hospital, 14004 Cordoba, Spain; (J.L.P.-O.); (R.L.-L.); (R.M.G.-U.)
- Morphological and Socio-Sanitary Sciences, University of Cordoba, 14004 Cordoba, Spain
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
| | - Rafael M. Gordillo-Urbano
- Mental Health Department, Reina Sofia University Hospital, 14004 Cordoba, Spain; (J.L.P.-O.); (R.L.-L.); (R.M.G.-U.)
| | - Ipek Guler
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
| | - Clementina López-Medina
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
- Medical and Surgical Sciences Department, University of Cordoba, 14004 Cordoba, Spain
- Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain
- Correspondence:
| | - Eduardo Collantes-Estévez
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
- Medical and Surgical Sciences Department, University of Cordoba, 14004 Cordoba, Spain
- Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain
| | - Alejandro Escudero-Contreras
- Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), 14004 Cordoba, Spain; (I.G.); (E.C.-E.); (A.E.-C.)
- Medical and Surgical Sciences Department, University of Cordoba, 14004 Cordoba, Spain
- Rheumatology Department, Reina Sofia University Hospital, 14004 Cordoba, Spain
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Reduced cortical thickness of the paracentral lobule in at-risk mental state individuals with poor 1-year functional outcomes. Transl Psychiatry 2021; 11:396. [PMID: 34282119 PMCID: PMC8289863 DOI: 10.1038/s41398-021-01516-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/26/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023] Open
Abstract
Although widespread cortical thinning centered on the fronto-temporal regions in schizophrenia has been reported, the findings in at-risk mental state (ARMS) patients have been inconsistent. In addition, it remains unclear whether abnormalities of cortical thickness (CT) in ARMS individuals, if present, are related to their functional decline irrespective of future psychosis onset. In this multicenter study in Japan, T1-weighted magnetic resonance imaging was performed at baseline in 107 individuals with ARMS, who were subdivided into resilient (77, good functional outcome) and non-resilient (13, poor functional outcome) groups based on the change in Global Assessment of Functioning scores during 1-year follow-up, and 104 age- and sex-matched healthy controls recruited at four scanning sites. We measured the CT of the entire cortex and performed group comparisons using FreeSurfer software. The relationship between the CT and cognitive functioning was examined in an ARMS subsample (n = 70). ARMS individuals as a whole relative to healthy controls exhibited a significantly reduced CT, predominantly in the fronto-temporal regions, which was partly associated with cognitive impairments, and an increased CT in the left parietal and right occipital regions. Compared with resilient ARMS individuals, non-resilient ARMS individuals exhibited a significantly reduced CT of the right paracentral lobule. These findings suggest that ARMS individuals partly share CT abnormalities with patients with overt schizophrenia, potentially representing general vulnerability to psychopathology, and also support the role of cortical thinning in the paracentral lobule as a predictive biomarker for short-term functional decline in the ARMS population.
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Takahashi T, Sasabayashi D, Takayanagi Y, Higuchi Y, Mizukami Y, Nishiyama S, Furuichi A, Kido M, Pham TV, Kobayashi H, Noguchi K, Suzuki M. Heschl's Gyrus Duplication Pattern in Individuals at Risk of Developing Psychosis and Patients With Schizophrenia. Front Behav Neurosci 2021; 15:647069. [PMID: 33958991 PMCID: PMC8093503 DOI: 10.3389/fnbeh.2021.647069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
An increased prevalence of duplicated Heschl’s gyrus (HG), which may reflect an early neurodevelopmental pathology, has been reported in schizophrenia (Sz). However, it currently remains unclear whether individuals at risk of psychosis exhibit similar brain morphological characteristics. This magnetic resonance imaging study investigated the distribution of HG gyrification patterns [i.e., single HG, common stem duplication (CSD), and complete posterior duplication (CPD)] and their relationship with clinical characteristics in 57 individuals with an at-risk mental state (ARMS) [of whom 5 (8.8%) later developed Sz], 63 patients with Sz, and 61 healthy comparisons. The prevalence of duplicated HG patterns (i.e., CSD or CPD) bilaterally was significantly higher in the ARMS and Sz groups than in the controls, whereas no significant differences were observed in HG patterns between these groups. The left CSD pattern, particularly in the Sz group, was associated with a verbal fluency deficit. In the ARMS group, left CSD pattern was related to a more severe general psychopathology. The present results suggest that an altered gyrification pattern on the superior temporal plane reflects vulnerability factors associated with Sz, which may also contribute to the clinical features of high-risk individuals, even without the onset of psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Yuko Mizukami
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Health Administration Center, Faculty of Education and Research Promotion, Academic Assembly, University of Toyama, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tien Viet Pham
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Haruko Kobayashi
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
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11
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Addington J, Farris MS, Liu L, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Bearden CE, Mathalon DH, Stone WS, Keshevan M, Woods SW. Depression: An actionable outcome for those at clinical high-risk. Schizophr Res 2021; 227:38-43. [PMID: 33129638 PMCID: PMC7854482 DOI: 10.1016/j.schres.2020.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/29/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
Comorbid diagnoses are common in youth who are at clinical high-risk (CHR) for developing psychosis, with depression being the most common. The aim of this paper is to examine depression over two years in a large sample of CHR youth who do not make the transition to psychosis, considering both categorical and dimensional ratings of depression severity. The sample consisted of 267 CHR youth who were followed for two years. Based on DSM-IV diagnoses over this time period, 100 CHR individuals never received a diagnosis of depression, 64 individuals continuously met criteria for depression, 92 individuals received a diagnosis of depression at one or more timepoints, and 11 participants had a diagnosis of depression only at 24-months. These groupings were supported by six-monthly ratings on the Calgary Depression Scale. The majority of this sample experienced a major depressive episode on more than one occasion, suggesting that depression and depressive symptoms identify a domain of substantial unmet clinical need. Recommendations are that depression in CHR youth and young adults should be monitored more frequently and that there is a need for clinical trials to address depression systematically in this vulnerable population.
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Affiliation(s)
- Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
| | - Megan S Farris
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Lu Liu
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, United States of America
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States of America
| | - Thomas H McGlashan
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, La Jolla, CA, United States of America
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States of America
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, United States of America
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
| | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - Matcheri Keshevan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
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12
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Randers L, Fagerlund B, Jepsen JRM, Nordholm D, Krakauer K, Hjorthøj C, Glenthøj B, Nordentoft M. Interview and questionnaire assessment of cognitive impairment in subjects at ultra-high risk for psychosis: Associations with cognitive test performance, psychosocial functioning, and positive symptoms. Psychiatry Res 2020; 294:113498. [PMID: 33157481 DOI: 10.1016/j.psychres.2020.113498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 10/01/2020] [Indexed: 02/01/2023]
Abstract
Impaired cognitive test performance is well-documented in subjects at ultra-high risk (UHR) for psychosis. However, assessment of cognitive deficits as manifested in real life is a neglected area of UHR research that may add to the understanding of cognitive impairment and its relationship with psychosocial functioning and positive symptomatology. This study applied the interview-based Schizophrenia Cognition Rating Scale (SCoRS) and the questionnaire-based Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A) in a cross-sectional sample of 39 UHR subjects and 50 healthy controls. Cognitive test performance, psychosocial functioning, and positive symptoms were also assessed. The UHR subjects demonstrated significant cognitive impairment, with large effect sizes for the SCoRS and BRIEF-A composite outcome variables (rs = -0.67 to -0.80) and a neurocognitive composite score (d = -0.97). Within the UHR group, several significant associations between worse cognitive ratings and worse cognitive test performance (rs = -0.210 to -0.343), poorer psychosocial functioning (rs = -0.058 to -0.728), and worse positive symptoms (rs= 0.415 to 0.478) were found. Worse cognitive test performance showed significant associations with more pronounced positive symptoms (rs = -0.299 to -0.457). Interview and questionnaire assessment may hold promise for supplementing traditional performance-based cognitive assessment in identifying treatment targets in the UHR population.
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Affiliation(s)
- Lasse Randers
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Copenhagen, Denmark.
| | - Birgitte Fagerlund
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; University of Copenhagen, Faculty of Social Sciences, Department of Psychology, Copenhagen, Denmark
| | - Jens Richardt M Jepsen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; Child and Adolescent Mental Health Center, Mental Health Services Capital Region of Denmark, Copenhagen University Hospital, Denmark
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Kristine Krakauer
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health, Section of Epidemiology, Copenhagen, Denmark
| | - Birte Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Copenhagen, Denmark
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13
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Chun CA, Cooper S, Ellman LM. Associations of psychotic-like experiences, related symptoms, and working memory with functioning. Eur Psychiatry 2020; 63:e20. [PMID: 32093801 PMCID: PMC7315866 DOI: 10.1192/j.eurpsy.2020.21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This study examined the association of spatial working memory and attenuated psychotic-like experiences and related symptoms with social and role functioning. Findings from this study suggest that symptom dimensions and working memory impairment were associated with diminished functioning across a variety of domains. Specifically, negative symptoms and working memory impairment were inversely associated with both social and role functioning, whereas positive and disorganized symptoms showed inverse associations with social functioning only. Symptom dimensions did not moderate cognitive and functional variables, although working memory and attenuated clinical symptoms had an additive effect on functioning. Post-hoc analyses examining symptom dimensions simultaneously showed negative symptoms to be the variable most strongly predictive of overall functioning. These findings suggest that even in a non-clinical sample, sub-threshold psychosis symptoms and cognition may influence people’s social and role functioning.
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Affiliation(s)
- Charlotte A Chun
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Shanna Cooper
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
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14
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Association between olfactory sulcus morphology and olfactory functioning in schizophrenia and psychosis high-risk status. Heliyon 2019; 5:e02642. [PMID: 31667432 PMCID: PMC6812217 DOI: 10.1016/j.heliyon.2019.e02642] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/07/2019] [Accepted: 10/08/2019] [Indexed: 01/15/2023] Open
Abstract
Olfactory impairment has been reported in patients with schizophrenia and individuals with a high risk of psychosis, but its neural basis is largely unknown. We used magnetic resonance imaging to investigate the morphology of the olfactory sulcus (an indicator of olfactory system development) and its relation to olfactory function in 38 persons with an at-risk mental state (ARMS), 62 patients with schizophrenia, and 61 healthy controls. Odor detection and identification were examined with a T & T olfactometer. Compared with the controls, the olfactory sulcus was significantly shallower and odor identification was inferior among the ARMS and schizophrenia subjects. Across all subjects, but not within each group, the olfactory sulcus depth was significantly related to better identification of odors. Our results support the concept that olfactory sulcus morphology reflects the neurodevelopmental process of the olfactory system.
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15
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Associations of psychosis-risk symptoms with quality of life and self-rated health in the Community. Eur Psychiatry 2019; 62:116-123. [PMID: 31586798 DOI: 10.1016/j.eurpsy.2019.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 08/12/2019] [Accepted: 08/26/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Understanding factors related to poor quality of life (QoL) and self-rated health (SRH) in clinical high-risk (CHR) for psychosis is important for both research and clinical applications. We investigated the associations of both constructs with CHR symptoms, axis-I disorders, and sociodemographic variables in a community sample. METHODS In total, 2683 (baseline) and 829 (3-year follow-up) individuals of the Swiss Canton of Bern (age-at-baseline: 16-40 years) were interviewed by telephone regarding CHR symptoms, using the Schizophrenia Proneness Instrument for basic symptoms, the Structured Interview for Psychosis-Risk Syndromes for ultra-high risk (UHR) symptoms, the Mini-International Neuropsychiatric Interview for current axis-I disorders, the Brief Multidimensional Life Satisfaction Scale for QoL, and the 3-level EQ-5D for SRH. RESULTS In cross-sectional structural equation modelling, lower SRH was exclusively significantly associated with higher age, male gender, lower education, and somatoform disorders. Poor QoL was exclusively associated only with eating disorders. In addition, both strongly interrelated constructs were each associated with affective, and anxiety disorders, UHR and, more strongly, basic symptoms. Prospectively, lower SRH was predicted by lower education and anxiety disorders at baseline, while poorer QoL was predicted by affective disorders at baseline. CONCLUSIONS When present, CHR, in particular basic symptoms are already distressful for individuals of the community and associated with poorer subjective QoL and health. Therefore, the symptoms are clinically relevant by themselves, even when criteria for a CHR state are not fulfilled. Yet, unlike affective and anxiety disorders, CHR symptoms seem to have no long-term influence on QoL and SRH.
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16
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Kaskie RE, Ferrarelli F. Sleep disturbances in schizophrenia: what we know, what still needs to be done. Curr Opin Psychol 2019; 34:68-71. [PMID: 31671368 DOI: 10.1016/j.copsyc.2019.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/31/2019] [Accepted: 09/13/2019] [Indexed: 12/18/2022]
Abstract
Sleep disturbances are commonly observed in schizophrenia (SCZ) and are associated with worse psychotic symptoms and poorer clinical outcomes. Early polysomnography studies have focused on characterizing differences in sleep architecture between patients with SCZ and healthy controls. More recently, research has focused on sleep-specific EEG oscillations, such as sleep spindles and slow waves, which reflect the integrity of underlying thalamo-cortical networks. Furthermore, high-density (hd)-EEG (≥64 channels), which affords enhanced spatial resolution, has been employed to better localize abnormalities in sleep characteristics and related thalamo-cortical circuits in patients with SCZ and related disorders. In this article, we will review the most relevant sleep abnormalities reported in SCZ, with an emphasis on recent findings, and propose directions for future research.
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17
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Abstract
The present study aims at evaluating the impact of anxiety on functional outcome in patients with schizophrenia, also taking into account the other main predictors of functioning identified by literature, to disentangle specific subcomponents which contribute to functional outcome. One hundred five patients with DSM-IV-TR schizophrenia were recruited and underwent a broad functional, psychopathological, and clinical-neuropsychological battery. A forward stepwise regression model was used to assess the predictive effect of anxiety and other factors on daily functioning, showing significant results only for global neurocognitive status and anxiety. These results confirm the role of neurocognition and are also in line with the hypothesis that trait anxiety has a direct impact on functional outcome. Overall, the findings support the role of anxiety as a core feature of schizophrenia pathology, with important implications for both research and clinical settings.
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18
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Comprehensive review of the research employing the schizophrenia cognition rating scale (SCoRS). Schizophr Res 2019; 210:30-38. [PMID: 31196736 DOI: 10.1016/j.schres.2019.05.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/16/2019] [Accepted: 05/26/2019] [Indexed: 12/30/2022]
Abstract
This review of research utilizing the Schizophrenia Cognition Rating Scale (SCoRS) outlines the development, evaluation, validation, and implementation of the SCoRS to assess whether the scale meets the criteria as a functional co-primary as defined by the MATRICS-CT initiative. Interview-based co-primary assessments should be: 1) practical and easy to administer for a clinician or researcher; 2) validated in individuals with schizophrenia; 3) contain the relevant areas of cognition and functioning applicable to schizophrenia; 4) able to assess all phases and severity levels of schizophrenia; 5) capable of monitoring disease progression; 6) minimal burden to patients; and 7) sensitive to assess treatment effects. A review of the literature was conducted to present information on the development, psychometric properties and usage of the SCoRS. Review of the development of the SCoRS followed the parameters outlined for scale development on content expert validation and feedback. The SCoRS shows good psychometric properties in various studies, and demonstrates low burden on clinicians and patients. The items measure global concepts that do not require notable cultural modification, making international use feasible. While multiple performance-based tests in cognition and functional outcomes are available, there is a need for a multi-domain, interview-based assessment of cognitive progression and treatment response in clinical trials. The SCoRS appears to meet many of the criteria for an optimal co-primary measure for schizophrenia cognition clinical trials as defined in the MATRICS-CT initiative.
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19
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Takahashi T, Suzuki M. Brain morphologic changes in early stages of psychosis: Implications for clinical application and early intervention. Psychiatry Clin Neurosci 2018; 72:556-571. [PMID: 29717522 DOI: 10.1111/pcn.12670] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 12/20/2022]
Abstract
To date, a large number of magnetic resonance imaging (MRI) studies have been conducted in schizophrenia, which generally demonstrate gray matter reduction, predominantly in the frontal and temporo-limbic regions, as well as gross brain abnormalities (e.g., a deviated sulcogyral pattern). Although the causes as well as timing and course of these findings remain elusive, these morphologic changes (especially gross brain abnormalities and medial temporal lobe atrophy) are likely present at illness onset, possibly reflecting early neurodevelopmental abnormalities. In addition, longitudinal MRI studies suggest that patients with schizophrenia and related psychoses also have progressive gray matter reduction during the transition period from prodrome to overt psychosis, as well as initial periods after psychosis onset, while such changes may become almost stable in the chronic stage. These active brain changes during the early phases seem to be relevant to the development of clinical symptoms in a region-specific manner (e.g., superior temporal gyrus atrophy and positive psychotic symptoms), but may be at least partly ameliorated by antipsychotic medication. Recently, increasing evidence from MRI findings in individuals at risk for developing psychosis has suggested that those who subsequently develop psychosis have baseline brain changes, which could be at least partly predictive of later transition into psychosis. In this article, we selectively review previous MRI findings during the course of psychosis and also refer to the possible clinical applicability of these neuroimaging research findings, especially in the diagnosis of schizophrenia and early intervention for psychosis.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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20
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Takahashi T, Higuchi Y, Komori Y, Nishiyama S, Takayanagi Y, Sasabayashi D, Kido M, Furuichi A, Nishikawa Y, Nakamura M, Noguchi K, Suzuki M. Pituitary Volume and Socio-Cognitive Functions in Individuals at Risk of Psychosis and Patients With Schizophrenia. Front Psychiatry 2018; 9:574. [PMID: 30473669 PMCID: PMC6237858 DOI: 10.3389/fpsyt.2018.00574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/19/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives: Increased pituitary volume, which probably reflects hypothalamic-pituitary-adrenal (HPA) hyperactivity, has been reported in patients with schizophrenia and individuals at risk of psychosis. On the basis of potential role of abnormal HPA axis function on cognitive impairments in psychosis, we aimed to examine possible relations between the pituitary volume and socio-cognitive impairments in these subjects. Methods: This magnetic resonance imaging study examined the pituitary gland volume in 38 subjects with at-risk mental state (ARMS) [of whom 4 (10.5%) exhibited the transition to schizophrenia], 63 patients with schizophrenia, and 61 healthy controls. Social and cognitive functions of the ARMS and schizophrenia groups were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS), the Schizophrenia Cognition Rating Scale (SCoRS), and the Social and Occupational Functioning Assessment Scale (SOFAS). Results: Both the ARMS and schizophrenia groups had a significantly larger pituitary volume compared to controls. In the schizophrenia group, the pituitary volume was negatively associated with the BACS working memory score. No association was found between the pituitary volume and clinical variables (medication, symptom severity) in either clinical group. Conclusion: Our findings support the notion of common HPA hyperactivity in the ARMS and schizophrenia groups, but abnormal HPA axis function may contribute differently to cognitive deficits according to the illness stages of schizophrenia.
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Affiliation(s)
- Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yuko Higuchi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yuko Komori
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Yumiko Nishikawa
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
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21
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Qiu H, Ren W, Yang Y, Zhu X, Mao G, Mao S, Lin Y, Shen S, Li C, Shi H, Jiang S, He J, Zhao K, Fu Y, Hu X, Gu Y, Wang K, Guo X, He J. Effects of cognitive behavioral therapy for depression on improving insomnia and quality of life in Chinese women with breast cancer: results of a randomized, controlled, multicenter trial. Neuropsychiatr Dis Treat 2018; 14:2665-2673. [PMID: 30349264 PMCID: PMC6188154 DOI: 10.2147/ndt.s171297] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Cognitive behavioral therapy (CBT) for depression had been found to be effective in reducing depressive and anxiety symptoms in breast cancer survivors. It is not known whether CBT for depression would also improve insomnia and quality of life (QOL). The aim of this study was to investigate whether CBT for depression would improve insomnia and QOL in a randomized controlled multicenter trial. PATIENTS AND METHODS In this study, breast cancer survivors (n=392) were randomly allocated to the following three groups: CBT (n=98), self-care management (SCM, n=98), and usual care (UC, n=196) in a ratio of 1:1:2. CBT and SCM received a series of nine sessions for 12 weeks, whereas UC received UC only. Insomnia and QOL were evaluated using Athens Insomnia Scale (AIS) and Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire at baseline, 4, 12, and 24 weeks. RESULTS There was a significant intergroup difference in AIS and FACT-B scores (both P<0.01). CBT showed less insomnia problems and better overall QOL compared with those in SCM and UC (both P<0.01). No significant differences were found between SCM and UC in insomnia problems and overall QOL. Moreover, the effects of CBT on insomnia and QOL were maintained during the follow-up period. CONCLUSION CBT for depression can be effective in improving insomnia problems and QOL in the Chinese breast cancer survivors.
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Affiliation(s)
- Huihua Qiu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Wenwei Ren
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Yanjie Yang
- Department of Medical Psychology, Public Health Institute of Harbin Medical University, Harbin, People's Republic of China
| | - Xiongzhao Zhu
- Medical Psychological Institute, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Guangyun Mao
- Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Shanping Mao
- Department of Neurology, RenMin Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Yan Lin
- Department of Neurology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Shanshan Shen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, People's Republic of China
| | - Changjin Li
- Department of Psychology, Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Hongying Shi
- Department of Preventive Medicine, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Suo Jiang
- Department of Psychology, Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Jingjing He
- Department of Psychiatry, Tongde Hospital of Zhejiang Province, Hangzhou, People's Republic of China
| | - Ke Zhao
- Department of Psychology, Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Ye Fu
- Yinzhou Hospital Affiliated To Medical School of Ningbo University, Ningbo, People's Republic of China
| | - Xiaoqu Hu
- Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Yingying Gu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China,
| | - Kai Wang
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Xiuchan Guo
- Key Laboratory of Laboratory Medicine, School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People's Republic of
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China, .,Department of Psychology, Wenzhou Medical University, Wenzhou, People's Republic of China,
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