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Yu SC, Hwang TJ, Liu CM, Chan HY, Kuo CJ, Yang TT, Wang JP, Liu CC, Hsieh MH, Lin YT, Chien YL, Kuo PH, Shih YW, Yu SL, Chen HY, Chen WJ. Patients with first-episode psychosis in northern Taiwan: neurocognitive performance and niacin response profile in comparison with schizophrenia patients of different familial loadings and relationship with clinical features. BMC Psychiatry 2024; 24:155. [PMID: 38389072 PMCID: PMC10885443 DOI: 10.1186/s12888-024-05598-2] [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: 11/08/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Examining patients with first-episode psychosis (FEP) provides opportunities to better understand the mechanism underlying these illnesses. By incorporating quantitative measures in FEP patients, we aimed to (1) determine the baseline distribution of clinical features; (2) examine the impairment magnitude of the quantitative measures by comparing with external controls and then the counterparts of schizophrenia patients of different familial loadings; and (3) evaluate whether these quantitative measures were associated with the baseline clinical features. METHODS Patients with FEP were recruited from one medical center, two regional psychiatric centers, and two private clinics in northern Taiwan with clinical features rated using the Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) scale. Quantitative measurements included the Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), niacin response abnormality (NRA), and minor physical anomalies and craniofacial features (MPAs). To evaluate the relative performance of the quantitative measures in our FEP patients, four external comparison groups from previous studies were used, including three independent healthy controls for the CPT, WCST, and NRA, respectively, and one group of treatment-resistant schizophrenia patients for the MPAs. Additionally, patients from simplex families and patients from multiplex families were used to assess the magnitude of FEP patients' impairment on the CPT, WCST, and NRA. RESULTS Among the 80 patients with FEP recruited in this study (58% female, mean age = 25.6 years, mean duration of untreated psychosis = 132 days), the clinical severity was mild to moderate (mean PANSS score = 67.3; mean PSP score = 61.8). Patients exhibited both neurocognitive and niacin response impairments (mean Z-scores: -1.24 for NRA, - 1.06 for undegraded d', - 0.70 for degraded d', - 0.32 for categories achieved, and 0.44 for perseverative errors) but did not show MPAs indicative of treatment resistance. Among these quantitative measures, three of the four neurocognitive indices were correlated with the baseline clinical features, whereas NRA did not show such correlation. CONCLUSIONS This FEP study of Taiwanese patients revealed the presence of neurocognitive performance and niacin response and their different relationships with clinical features, rendering this sample useful for future follow-up and incorporation of multiomics investigation.
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Affiliation(s)
- Shun-Chun Yu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Centers for Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | | | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Tsung-Tsair Yang
- Department of Social Psychology, Shih Hsin University, Taipei, Taiwan
| | | | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ting Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Ya-Wen Shih
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sung-Liang Yu
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsuan-Yu Chen
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Centers for Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
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Li Z, Liu X, Xu H, Zhao L, Zhou Y, Wu X, Huang X, Lang X, Wu F, Zhang X. Sex Difference in Comorbid Depression in First-Episode and Drug-Naive Patients With Schizophrenia: Baseline Results From the Depression in Schizophrenia in China Study. Psychosom Med 2021; 83:1082-1088. [PMID: 34419998 DOI: 10.1097/psy.0000000000000998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Comorbid depression is common in schizophrenia, and sex differences are prominent in many aspects of schizophrenia. However, few studies have investigated sex difference in comorbid depression in schizophrenia. This large sample study aimed to investigate sex differences in first-episode drug-naive (FEDN) patients with schizophrenia comorbid major depressive episode (SZ-MDE). METHODS A total of 996 FEDN patients with schizophrenia (472 males/524 females) were recruited. The 17-item Hamilton Depression Rating Scale and Positive and Negative Syndrome Scale (PANSS) were applied. RESULTS There was no difference in the prevalence of comorbid MDE between male and female patients with schizophrenia. Among SZ-MDE patients, men had more severe psychotic symptoms (scores of PANSS total scale, negative scale, and general psychopathology scale), more severe depressive symptoms, and higher proportion of severe depression than women (all p < .001). The early onset age of schizophrenia, smoking, and PANSS positive score were the risk factors for comorbid MDE only in female patients with schizophrenia (all p < .05). Furthermore, in female patients with SZ-MDE, smoking was associated with the severity category of depression (p = .001, odds ratio = 2.70). Multiple variable regression demonstrated that the Hamilton Depression Rating Scale score correlated with PANSS general psychopathology (p = .01) and total scores (p = .04) in female SZ-MDE. CONCLUSIONS Our results indicate sex differences in proportion of severe depression, clinical symptoms, and factors of comorbid MDE in FEDN patients with schizophrenia. These sex differences have clinical implications for the treatment of depression as related to the nature and severity of psychopathological symptoms in patients with schizophrenia.
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Affiliation(s)
- Zezhi Li
- From the Department of Psychiatry (Li), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou; Qingdao Mental Health Center (Liu, Xu, Zhao), Qingdao University, Qingdao; Shenzhen Kangning Hospital (Zhou), Shenzhen, Guangdong; Department of Neurosurgery (X. Wu), Shanghai Changhai Hospital; Shanghai Mental Health Center (Huang), Shanghai; Department of Psychiatry, The First Clinical Medical College (Lang), Shanxi Medical University, Taiyuan; Department of Psychiatry (F. Wu, Zhang), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou; and Department of Psychology (Zhang), University of Chinese Academy of Sciences, Beijing, China
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Türközer HB, Ivleva EI, Palka J, Clementz BA, Shafee R, Pearlson GD, Sweeney JA, Keshavan MS, Gershon ES, Tamminga CA. Biomarker Profiles in Psychosis Risk Groups Within Unaffected Relatives Based on Familiality and Age. Schizophr Bull 2021; 47:1058-1067. [PMID: 33693883 PMCID: PMC8266584 DOI: 10.1093/schbul/sbab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Investigating biomarkers in unaffected relatives (UR) of individuals with psychotic disorders has already proven productive in research on psychosis neurobiology. However, there is considerable heterogeneity among UR based on features linked to psychosis vulnerability. Here, using the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) dataset, we examined cognitive and neurophysiologic biomarkers in first-degree UR of psychosis probands, stratified by 2 widely used risk factors: familiality status of the respective proband (the presence or absence of a first- or second-degree relative with a history of psychotic disorder) and age (within or older than the common age range for developing psychosis). We investigated biomarkers that best differentiate the above specific risk subgroups. Additionally, we examined the relationship of biomarkers with Polygenic Risk Scores for Schizophrenia (PRSSCZ) in a subsample of Caucasian probands and healthy controls (HC). Our results demonstrate that the Brief Assessment of Cognition in Schizophrenia (BACS) score, antisaccade error (ASE) factor, and stop-signal task (SST) factor best differentiate UR (n = 169) from HC (n = 137) (P = .013). Biomarker profiles of UR of familial (n = 82) and non-familial (n = 83) probands were not significantly different. Furthermore, ASE and SST factors best differentiated younger UR (age ≤ 30) (n = 59) from older UR (n = 110) and HC from both age groups (age ≤ 30 years, n=49; age > 30 years, n = 88) (P < .001). In addition, BACS (r = -0.175, P = .006) and ASE factor (r = 0.188, P = .006) showed associations with PRSSCZ. Taken together, our findings indicate that cognitive biomarkers-"top-down inhibition" impairments in particular-may be of critical importance as indicators of psychosis vulnerability.
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Affiliation(s)
- Halide Bilge Türközer
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Elena I Ivleva
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Jayme Palka
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA
| | - Rebecca Shafee
- Department of Genetics, Harvard Medical School, Boston, MA
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT
- Departments of Psychiatry and Neuroscience, Yale University, New Haven, CT
| | - John A Sweeney
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Matcheri S Keshavan
- Department of Psychiatry and Cognitive Neurology, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Carol A Tamminga
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
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Lin AS, Chan HY, Peng YC, Chen WJ. Severity in sustained attention impairment and clozapine-resistant schizophrenia: a retrospective study. BMC Psychiatry 2019; 19:220. [PMID: 31299940 PMCID: PMC6626410 DOI: 10.1186/s12888-019-2204-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 07/04/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Among patients with treatment-resistant schizophrenia (TRS), some exhibited further clozapine resistance (CR). This study aimed to investigate whether greater severity of treatment resistance in schizophrenia is associated with greater impairments in sustained attention. METHODS Patients with a DSM-IV-defined schizophrenia were recruited from a psychiatric center in northern Taiwan (April 2010 to October 2010). Both TRS and CR were determined retrospectively from participants' medical records following the consensus guidelines. The patients were divided into three groups: 102 non-TRS, 48 TRS without CR, and 54 TRS with CR. They underwent both undegraded and degraded Continuous Performance Tests (CPT), and their performance scores (d') were standardized against a community sample to derive age-, sex-, and education-adjusted z scores. RESULTS The TRS with CR group had significantly lower adjusted z scores of d' on both undegraded and degraded CPTs than the other two groups. Meanwhile, the differences between the TRS without CR group and the non-TRS group were not significant. Multivariable linear regression analyses with adjustment for covariates revealed a trend of gradient impairments on the degraded CPT from non-TRS to TRS without CR and to TRS with CR. The proportions of attentional deficits (an adjusted z score of ≤ - 2.5) on the degraded CPT also exhibited a significant trend, from 36.3% in the non-TRS group to 62.5% in the TRS without CR group and to 83.3% in the TRS with CR group. CONCLUSIONS Greater severity of treatment resistance in schizophrenia was associated with greater impairments in sustained attention, indicating some common vulnerability.
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Affiliation(s)
- An-Sheng Lin
- grid.454740.6Department of General Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Hung-Yu Chan
- grid.454740.6Office of Superintendent, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan ,0000 0004 0546 0241grid.19188.39Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ying-Chieh Peng
- grid.454740.6Department of General Psychiatry, Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Wei J. Chen
- 0000 0004 0546 0241grid.19188.39Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan ,0000 0004 0546 0241grid.19188.39Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei, 100 Taiwan
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Zouraraki C, Karagiannopoulou L, Karamaouna P, Pallis EG, Giakoumaki SG. Schizotypal traits, neurocognition, and paternal age in unaffected first degree relatives of patients with familial or sporadic schizophrenia. Psychiatry Res 2019; 273:422-429. [PMID: 30684787 DOI: 10.1016/j.psychres.2018.12.142] [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: 08/15/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 10/27/2022]
Abstract
Studies comparing cognitive processes between familial and sporadic schizophrenia have yielded inconsistent findings. In this study we examined differences in neurocognition and schizotypal traits in unaffected relatives of schizophrenia-spectrum patients with either the familial (multiplex) or the sporadic (simplex) subtype of the disorder, taking paternal age at birth into consideration. Simplex (n = 65; SR), multiplex (n = 35; MR) relatives and controls (n = 114) were compared on several cognitive functions and schizotypal traits; between-group differences were evaluated with and without including paternal age in the analyses. SR and MR had higher negative and paranoid traits compared with controls, but paternal age abolished the differences between the SR and control groups. When taking into account schizotypal traits and participants' age, controls outperformed MR in strategy formation and set-shifting and SR in psychomotor speed, set-shifting and executive working memory. After including paternal age in the analyses, controls outperformed MR in strategy formation, working memory and executive working memory and both groups in psychomotor speed and set-shifting. These findings suggest that multiplex relatives present with a "riskier" personality and cognitive profile when considering the effects of paternal age. Nevertheless, simplex relatives are impaired in fundamental cognitive processes, thus highlighting the detrimental effects of paternal age on neurocognition.
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Affiliation(s)
- Chrysoula Zouraraki
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece.
| | - Leda Karagiannopoulou
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
| | - Penny Karamaouna
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
| | - Eleftherios G Pallis
- Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Stella G Giakoumaki
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
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Lin CH, Lane HY. Early Identification and Intervention of Schizophrenia: Insight From Hypotheses of Glutamate Dysfunction and Oxidative Stress. Front Psychiatry 2019; 10:93. [PMID: 30873052 PMCID: PMC6400883 DOI: 10.3389/fpsyt.2019.00093] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/08/2019] [Indexed: 12/22/2022] Open
Abstract
Schizophrenia is a severe mental disorder which leads to functional deterioration. Early detection and intervention are vital for better prognosis. However, the diagnosis of schizophrenia still depends on clinical observation to date. Without reliable biomarkers, schizophrenia is difficult to detect in its early phase. Further, there is no approved medication for prodromal schizophrenia because current antipsychotics fail to show satisfactory efficacy and safety. Therefore, to develop an effective early diagnostic and therapeutic approach for schizophrenia, especially in its prodromal phase, is crucial. Glutamate signaling dysfunction and dysregulation of oxidative stress have been considered to play important roles in schizophrenic prodrome. The N-methyl-D-aspartate receptor (NMDAR) is one of three types of ionotropic glutamate receptors. In this article, we reviewed literature regarding NMDAR hypofunction, oxidative stress, and the linkage between both in prodromal schizophrenia. The efficacy of NMDAR enhancers such as D-amino acid oxidase inhibitor was addressed. Finally, we highlighted potential biomarkers related to NMDAR and oxidative stress regulation, and therefore suggested the strategies of early detection and intervention of prodromal schizophrenia. Future larger-scale studies combining biomarkers and novel drug development for early psychosis are warranted.
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Affiliation(s)
- Chieh-Hsin Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Damaso KAM, Michie PT, Todd J. Paying attention to MMN in schizophrenia. Brain Res 2015; 1626:267-79. [PMID: 26163366 DOI: 10.1016/j.brainres.2015.06.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 05/29/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
The aim of this review is to explore the phenomenon of reduced mismatch negativity (MMN) in persons with schizophrenia and the possible relationship it has with attention impairments. In doing so we discuss (i) the prediction error account of MMN, (ii) reduced MMN as a faulty predictive processing system in persons with schizophrenia, (iii) the role of these systems in relevance filtering and attentional resource protection, (iv) attentional impairments in persons with schizophrenia, and (v) research that has explored MMN and attention in schizophrenia groups. Our review of the literature suggests that no study has appropriately examined the functional impact of smaller MMN in schizophrenia on the performance of a concurrent attention task. We conclude that future research should explore this notion further in the hope that it might embed MMN findings within outcomes of functional significance to individuals with the illness and those providing treatment. This article is part of a Special Issue entitled SI: Prediction and Attention.
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Affiliation(s)
- Karlye A M Damaso
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, NSW, Australia
| | - Patricia T Michie
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, NSW, Australia; Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Juanita Todd
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Callaghan, NSW, Australia; Schizophrenia Research Institute, Sydney, NSW, Australia.
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Wang SH, Liu CM, Hwu HG, Hsiao CK, Chen WJ. Association of older paternal age with earlier onset among co-affected schizophrenia sib-pairs. Psychol Med 2015; 45:2205-2213. [PMID: 25746410 DOI: 10.1017/s0033291715000203] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Advanced paternal age is associated with increased risk of schizophrenia. This study aimed to explore whether older paternal age is associated with earlier onset among co-affected schizophrenia sib-pairs with the same familial predisposition. METHOD A total of 1297 patients with schizophrenia from 630 families, which were ascertained to have at least two siblings affected, throughout Taiwan were interviewed using the Diagnostic Interview for Genetic Studies. Both inter-family comparisons, a hierarchical regression model allowing for familial dependence and adjusting for confounders, and within-family comparisons, examining the consistency between onset order and birth order, were performed. RESULTS An inverted U shape was observed between paternal age and onset of schizophrenia. Affected offspring with paternal age of 20-24 years had the oldest onset. As paternal age increased over 25 years, older paternal age exhibited a linear decrease in the onset of schizophrenia. On average, the onset was lowered by 1.5 years for paternal age of 25-29 years and by 5.5 years for paternal age ⩾50 years (p = 0.04; trend test). The proportion of younger siblings with earlier onset (58%) was larger than that of older siblings with earlier onset (42%) (p = 0.0002). CONCLUSIONS These findings indicate that paternal age older than 25 years and younger than 20 years were both associated with earlier onset among familial schizophrenia cases. The associations of advanced paternal age with both increased susceptibility to schizophrenia and earlier onset of schizophrenia are consistent with the rate of increases in spontaneous mutations in sperm as men age.
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Affiliation(s)
- S H Wang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,Taipei,Taiwan
| | - C M Liu
- Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University,Taipei,Taiwan
| | - H G Hwu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,Taipei,Taiwan
| | - C K Hsiao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,Taipei,Taiwan
| | - W J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,Taipei,Taiwan
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Dickson H, Cullen AE, Reichenberg A, Hodgins S, Campbell DD, Morris RG, Laurens KR. Cognitive impairment among children at-risk for schizophrenia. J Psychiatr Res 2014; 50:92-9. [PMID: 24373930 DOI: 10.1016/j.jpsychires.2013.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 09/13/2013] [Accepted: 12/03/2013] [Indexed: 11/17/2022]
Abstract
Adults with schizophrenia present cognitive impairments, as do individuals at ultra-high risk for the disorder, youth with relatives with schizophrenia spectrum disorders, and children with antecedents of schizophrenia. The present study aimed to determine if impairments in childhood differed depending on the definition of risk and/or on the degree of relatedness to an affected individual, and if impairments were explained by IQ. Four groups of children aged 9-12 years were studied: (1) 13 children with ≥1 first-degree or ≥2 second-degree affected relatives (high familial loading: FHx(H)); (2) 14 with ≥1 affected second-degree relative (lower familial loading: FHx(L)); (3) 32 with well-replicated antecedents of schizophrenia (ASz); and (4) 45 typically-developing (TD) children with neither a positive family history nor antecedents. Compared to TD children, both FHx(H) and ASz children exhibited significantly poorer verbal comprehension, scholastic achievement, and verbal working memory, while FHx(H) children additionally displayed significantly lower full-scale IQ, and verbal memory and executive function impairments. After adjusting statistical analyses for IQ, group differences were attenuated. Relative to TD children, FHx(L) children showed no significant differences in performance. The results imply that impairments in verbal comprehension, scholastic achievement, and verbal working memory may index vulnerability for schizophrenia among children with affected relatives with the disorder and among those with multiple antecedents of the disorder who have no affected relatives. More accurate identification of children at-risk for schizophrenia and the specific deficits that they present provides opportunities for interventions such as cognitive remediation that may impact the development of the illness.
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Affiliation(s)
- Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, United Kingdom.
| | - Alexis E Cullen
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, United Kingdom
| | - Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, United Kingdom; Department of Psychiatry, Ichan School of Medicine at Mount Sinai, New York, NY, USA; Department of Preventive Medicine, Ichan School of Medicine at Mount Sinai, New York, NY, USA; Freidman Brain Institute, Ichan School of Medicine at Mount Sinai, New York, NY, USA
| | - Sheilagh Hodgins
- Département de Psychiatrie, Université de Montréal, Montréal, Canada
| | | | - Robin G Morris
- Department of Psychology, Institute of Psychiatry, Kings College London, United Kingdom
| | - Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, United Kingdom; Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia; Schizophrenia Research Institute, Sydney, Australia.
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Ira E, Zanoni M, Ruggeri M, Dazzan P, Tosato S. COMT, neuropsychological function and brain structure in schizophrenia: a systematic review and neurobiological interpretation. J Psychiatry Neurosci 2013; 38:366-80. [PMID: 23527885 PMCID: PMC3819150 DOI: 10.1503/jpn.120178] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Endophenotypes in genetic psychiatry may increase our understanding of the molecular mechanisms underlying disease risk and its manifestations. We sought to investigate the link between neuropsychological impairments and brain structural abnormalities associated with the COMT Val(158)Met polymorphism in patients with schizophrenia to improve understanding of the pathophysiology of this disorder. METHODS We performed a systematic review using studies identified in PubMed and MEDLINE (from the date of the first available article to July 2012). Our review examined evidence of an association between the COMT Val(158)Met polymorphism and both neuropsychological performance and brain structure in patients with psychosis, in their relatives and in healthy individuals (step 1). The review also explored whether the neuropsychological tasks and brain structures identified in step 1 met the criteria for an endophenotype (step 2). Then we evaluated evidence that the neuropsychological endophenotypes identified in step 2 are associated with the brain structure endophenotypes identified in that step (step 3). Finally, we propose a neurobiological interpretation for this evidence. RESULTS A poorer performance on the n-back task and the Continuous Performance Test (CPT) and smaller temporal and frontal brain areas were associated with the COMT Val allele in patients with schizophrenia and their relatives and met most of the criteria for an endophenotype. It is possible that the COMT Val(158)Met polymorphism therefore contributes to the development of these neuropsychological and brain structural endophenotypes of schizophrenia, in which the prefrontal cortex may represent the neural substrate underlying both n-back and CPT performances. LIMITATIONS The association between a single genetic variant and an endophenotype does not necessarily imply a causal relationship between them. CONCLUSION This evidence and the proposed interpretation contribute to explain, at least in part, the biological substrate of 4 important endophenotypes that characterize schizophrenia.
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Affiliation(s)
- Elisa Ira
- Correspondence to: E. Ira, Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, Policlinico G.B. Rossi, P.le L.A. Scuro 10, 37134 Verona, Italy;
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Chen WJ. Taiwan Schizophrenia Linkage Study: lessons learned from endophenotype-based genome-wide linkage scans and perspective. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:636-47. [PMID: 24132895 DOI: 10.1002/ajmg.b.32166] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Accepted: 03/27/2013] [Indexed: 12/26/2022]
Abstract
Taiwan Schizophrenia Linkage Study (TSLS) was initiated with a linkage strategy for locating multiple genes, each of small to moderate effect, and aimed to recruit a large enough sample of pairs of affected siblings and their families ascertained from a multisite study. With a sample of 607 families successfully recruited, a total of 2,242 individuals (1,207 affected and 1,035 unaffected) from 557 families were genotyped using 386 microsatellite markers spaced at an average of 9-cM intervals. Here the author reviews the establishment of TSLS and initial signal derived from linkage scan using the diagnosis of schizophrenia. Based on the limited success of the initial linkage analysis, a sufficient-component causal model is proposed to incorporate endophenotypes and genes for schizophrenia. Four types of candidate endophenotype measured in TSLS, including schizotypal personality, Continuous Performance Test, Wisconsin Card Sorting Test, and niacin skin flush test, are briefly described. The author discusses different strategies of linkage analysis incorporating these endophenotypes, including quantitative trait loci (QTL) linkage analysis, clustering-derived subgroups, ordered subset analysis (OSA), and latent classes for linkage scan. Then the author summarizes the linkage signals generated from seven studies of endophenotype-based linkage analysis using TSLS, including QTL scan of neurocognitive performance, QTL scan of niacin skin flush, the family cluster of attention deficit and execution deficit, OSA by schizophrenia-schizotypy factors, nested OSA by age at onset and neurocognitive performance, and the latent class of deficit schizophrenia for linkage analysis. The perspective of combining next-generation sequencing with linkage analysis of families is also discussed.
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Affiliation(s)
- Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Genetic Epidemiology Core Laboratory, Center of Genomic Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
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Velligan D, Mintz J, Maples N, Xueying L, Gajewski S, Carr H, Sierra C. A randomized trial comparing in person and electronic interventions for improving adherence to oral medications in schizophrenia. Schizophr Bull 2013; 39:999-1007. [PMID: 23086987 PMCID: PMC3756784 DOI: 10.1093/schbul/sbs116] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Poor adherence to medication leads to symptom exacerbation and interferes with the recovery process for patients with schizophrenia. Following baseline assessment, 142 patients in medication maintenance at a community mental health center were randomized to one of 3 treatments for 9 months: (1) PharmCAT, supports including pill containers, signs, alarms, checklists and the organization of belongings established in weekly home visits from a PharmCAT therapist; (2) Med-eMonitor (MM), an electronic medication monitor that prompts use of medication, cues the taking of medication, warns patients when they are taking the wrong medication or taking it at the wrong time, record complaints, and, through modem hookup, alerts treatment staff of failures to take medication as prescribed; (3) Treatment as Usual (TAU). All patients received the Med-eMonitor device to record medication adherence. The device was programmed for intervention only in the MM group. Data on symptoms, global functioning, and contact with emergency services and police were obtained every 3 months. Repeated measures analyses of variance for mixed models indicated that adherence to medication was significantly better in both active conditions than in TAU (both p<0.0001). Adherence in active treatments ranged from 90-92% compared to 73% in TAU based on electronic monitoring. In-person and electronic interventions significantly improved adherence to medication, but that did not translate to improved clinical outcomes. Implications for treatment and health care costs are discussed.
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Tsuang HC, Chen WJ, Lin SH, Chen TY, Chang YL, Huang KH, Lane HY. Impaired impulse control is associated with a 5-HT2A receptor polymorphism in schizophrenia. Psychiatry Res 2013; 208:105-10. [PMID: 23063294 DOI: 10.1016/j.psychres.2012.09.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 07/03/2012] [Accepted: 09/20/2012] [Indexed: 11/18/2022]
Abstract
The impact of the serotonin2a (5-HT2A) receptor gene on the pathophysiology of schizophrenia is inconclusive despite accumulating evidence implicating the 5-HT2A receptor. To simplify the complexity of genetic analysis, we used an endophenotype approach. The relationship between Continuous Performance Test (CPT) performance and 5-HT2A receptor gene variance was examined. Both patients with schizophrenia (n=255) and healthy volunteers (n=380) were recruited. All were genotyped for the -1438A/G polymorphism and assessed with the CPT. The Positive and Negative Syndrome Scale and the Scale for the Assessment of Negative Symptoms were used to evaluate patients' clinical symptoms. The distribution of the 5-HT2A genotypes between patients and healthy controls was similar. Impulse control in schizophrenic patients, assessed with the false-alarm rate of the CPT, differed significantly between those with different 5-HT2A genotypes. We hypothesize that the 5-HT2A receptor gene is a modifier gene of schizophrenia and suggest that additional studies are warranted.
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Affiliation(s)
- Hui-Chun Tsuang
- Center of General Education, School of Liberal Arts Education, Chang Jung Christian University, Tainan, Taiwan
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14
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Lin SH, Liu CM, Hwang TJ, Hsieh MH, Hsiao PC, Faraone SV, Tsuang MT, Hwu HG, Chen WJ. Performance on the Wisconsin Card Sorting Test in families of schizophrenia patients with different familial loadings. Schizophr Bull 2013; 39:537-46. [PMID: 23196712 PMCID: PMC3627779 DOI: 10.1093/schbul/sbs141] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Despite the consistent presence of performance deficits on the Wisconsin Card Sorting Test (WCST) in schizophrenia patients, whether poorer performance is also present in their nonpsychotic relatives is not certain. This study aimed to estimate both the recurrence risk ratio (λs) and the heritability of WCST scores in simplex and multiplex families, respectively, and to examine the influence of familial loading on these estimates. Participants were patients with schizophrenia and their nonpsychotic first-degree relatives from 168 simplex families and 653 multiplex families as well as 440 normal comparisons. On the basis of adjusted z scores, both the λs at a series of cutoff points and heritability estimates based on variance component modeling in the nonpsychotic relatives of schizophrenia patients were estimated. The WCST deficits in schizophrenia patients were more prominent in multiplex families than in simplex ones. Among relatives, WCST deficits were limited to parents of multiplex families for most WCST scores and siblings from multiplex families for total errors, perseverative responses, and perseverative errors. Pertaining to λs, the estimates for multiplex families (highest estimates ranging from 7.9 to 11.0) were greater than those for simplex ones (<2.5). Nevertheless, the heritability estimates were very similar between simplex (ranging from 0% to 17%) and multiplex (ranging from 0% to 21%) families, with the latter having slightly greater values than the former. There is only a small-to-modest familial aggregation on part of WCST scores in families of schizophrenia patients, and this may limit its use as endophenotypic markers to schizophrenia susceptibility.
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Affiliation(s)
- Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Chang Hsiao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
| | - Stephen V. Faraone
- Department of Psychiatry and Behavioral Sciences, Medical Genetics Research Center, SUNY Upstate Medical University Syracuse, NY
| | - Ming T. Tsuang
- Departments of Epidemiology and Psychiatry, Harvard Institute of Psychiatric Epidemiology and Genetics, Harvard University, Boston, MA
- Center for Behavioral Genomics, Department of Psychiatry, University of California, San Diego, CA
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Wei J. Chen
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
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Lin CH, Tseng YL, Huang CL, Chang YC, Tsai GE, Lane HY. Synergistic effects of COMT and TPH2 on social cognition. Psychiatry 2013; 76:273-94. [PMID: 23965265 DOI: 10.1521/psyc.2013.76.3.273] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Whether genetic factors affect social cognition, particularly emotion management, requires elucidation. This study investigates whether social cognition varies with genetic variations of COMT and tryptophan hydroxylase-2 (TPH2), which modulate dopamine and serotonin neurotransmissions respectively, and thereby emotion regulation. NIMH-recommended "managing emotions branch and 2 subtasks" of MSCEIT and six neurocognition domains, and genotypes of COMT Val158Met and TPH2 G703T were measured in 150 Han-Chinese healthy adults. Subjects carrying the M allele (M group) of COMT exceeded Val/Val homozygotes (V group) in managing emotions branch (p = 0.032) and emotional relation subtask (p = 0.037). TPH2 T/T homozygotes (T group) excelled those with the G allele (G group) in emotional management subtask (p = 0.025). Subjects with M+T variation surpassed the other 3 groups (M+G, V+T and V+G) in managing emotion branch (p = 0.002), emotional relation subtask (p = 0.023), and emotional management subtask (p = 0.002). The findings remained after control for gender, age, education, and neurocognitive functions. Synergistically, the effect size of COMT-TPH2 combination surmounted the sum of separate effect sizes of COMT and TPH2. The findings suggest that genetic variations of COMT and TPH2 have synergistic effects on social cognition in the general population.
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Affiliation(s)
- Chieh-Hsin Lin
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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Scala S, Lasalvia A, Cristofalo D, Bonetto C, Ruggeri M. Neurocognitive profile and its association with psychopathology in first-degree relatives of patients with schizophrenia. a case-control study. Psychiatry Res 2012; 200:137-43. [PMID: 22652345 DOI: 10.1016/j.psychres.2012.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 04/30/2012] [Accepted: 05/05/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND People with schizophrenia show a broad range of neurocognitive deficits, which are considered as core features of the disorder and are thought to be partly heritable. Similar deficits, albeit at a lesser degree, have been also found in their healthy biological relatives. These deficits, if better characterized, might represent underlying vulnerable traits for psychosis. METHODS This case-control study compared neurocognitive functioning of adult first-degree relatives of patients with schizophrenia (SCZ-RELs) (n=55) with healthy control subjects (n=55) and explored its association with the negative symptoms. Subjects in both study and control group were assessed with an extensive neurocognitive test battery (Trail Making test, Phonemic Verbal fluency, Wisconsin Card Sorting Test, Bushke Fuld Test, Stroop Test, n-Back and Digit span) and a set of clinical measures (SANS, GAF and DAS). RESULTS SCZ-RELs were more significantly impaired on executive function tasks (i.e. Wisconsin Card Sorting Test and the Phonemic Verbal fluency) and displayed significantly more severe negative symptoms and poorer social functioning than control subjects. Significant correlations between neurocognitive measures and negative symptoms were found in the study group, whereas no significant correlations were detected among the controls. DISCUSSION Subtle executive impairments, associated with negative symptoms, are shown to be evident in healthy relatives of patients with schizophrenia. These deficits, which reflect subtle dysfunction in concept formation, flexibility and mental shifting, may be seen as potential phenotypic markers of vulnerability for schizophrenia. This raises the question of underlying prefrontal dysfunction as core feature of the disorder.
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Affiliation(s)
- Silvia Scala
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, P.le L.A. Scuro, 10 37134 Verona, Italy.
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17
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Walshe M, Schulze KK, Stahl D, Hall MH, Chaddock C, Morris R, Marshall N, McDonald C, Murray RM, Bramon E, Kravariti E. Sustained attention in bipolar I disorder patients with familial psychosis and their first-degree relatives. Psychiatry Res 2012; 199:70-3. [PMID: 22513042 DOI: 10.1016/j.psychres.2012.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 02/28/2012] [Accepted: 03/18/2012] [Indexed: 01/03/2023]
Abstract
Sustained attention (SA) was examined in patients with familial, psychotic Bipolar Disorder (BD) (n=43), their non-bipolar, non-psychotic relatives (n=44) and controls (n=47). Patients were impaired compared to relatives, but the latter did not differ from controls. Having a relative with familial, psychotic BD does not confer risk for SA deficits.
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Affiliation(s)
- Muriel Walshe
- Department of Psychosis Studies, PO Box 63, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
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Derks EM, Boks MPM, Vermunt JK. The identification of family subtype based on the assessment of subclinical levels of psychosis in relatives. BMC Psychiatry 2012; 12:71. [PMID: 22759464 PMCID: PMC3504553 DOI: 10.1186/1471-244x-12-71] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 06/08/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Schizophrenia is a complex psychiatric disorder characterized by high phenotypic heterogeneity. Previous studies have distinguished between familial and sporadic forms of schizophrenia and have suggested clinical differentiation between patients and relatives from sporadic and multiplex families. We will introduce a more refined method to distinguish between family subtypes based on psychosis dimension profiles in the relatives of schizophrenia patients. METHODS Positive, negative, disorganization, mania, and depression scores were assessed in 1,392 relatives. Mixed Model Latent Class Analysis was used to identify family subtypes. A family subtype is a relatively homogeneous group of families with similar symptom profiles in the relatives in these families. Next, we investigated in 616 schizophrenia patients whether family subtype was associated with symptom profiles, IQ, cannabis dependence/abuse, or age of onset of psychosis. RESULTS Based on the data of relatives, we identified two different family types: "healthy" and "at risk for psychiatric disorder". Patients from at risk families obtained higher positive scores compared to patients from healthy families (Wald(1) =6.6293, p=0.010). No significant differences were found in any of the remaining variables. CONCLUSIONS Our findings confirm the existence of high-risk families and although we did not establish an etiological basis for the distinction between family types, genetic studies might reveal whether family subtype is associated with genetic heterogeneity.
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Affiliation(s)
- Eske M Derks
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, AMC-APC, room PA1-179 Meibergdreef, Amsterdam, AZ 51105, The Netherlands.
| | - Marco PM Boks
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, AMC-APC, room PA1-179 Meibergdreef, Amsterdam, AZ 51105, The Netherlands
| | - Jeroen K Vermunt
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
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Hahn B, Robinson BM, Kaiser ST, Matveeva TM, Harvey AN, Luck SJ, Gold JM. Kraepelin and Bleuler had it right: people with schizophrenia have deficits sustaining attention over time. JOURNAL OF ABNORMAL PSYCHOLOGY 2012; 121:641-8. [PMID: 22686867 DOI: 10.1037/a0028492] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
An inability to sustain attention was noted in the original clinical descriptions of schizophrenia, but the vast majority of experimental studies have failed to report a performance decrement over time, calling this observation into question. To test for such deficits when task conditions conform to basic science taxonomy for the validity of sustained attention tasks, a dynamic stimulus array was presented in which targets, differing subtly from standard stimuli, were presented infrequently and unpredictably. Both people with schizophrenia (PSZ, n=40) and healthy control subjects (HCS, n=29) displayed a reduction in hit rate and an increase in reaction time (RT) from the first to the second 5-min period. Thereafter, the hit rate of HCS recovered and remained stable, while that of PSZ continued to decline. When performance at task onset was equated between groups, the decrement over time in PSZ remained of the same robust magnitude. Thus, when the nature of the task challenges sustaining attention over time, PSZ display a clear deficit in this ability.
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Affiliation(s)
- Britta Hahn
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21228, USA.
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20
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Sim M, Kim JH, Yim SJ, Cho SJ, Kim SJ. Increase in harm avoidance by genetic loading of schizophrenia. Compr Psychiatry 2012; 53:372-8. [PMID: 21696715 DOI: 10.1016/j.comppsych.2011.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 05/05/2011] [Accepted: 05/09/2011] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Schizophrenia is highly familial neuropsychiatric disorder with heritability estimated at 60% to 90%. Even unaffected first-degree relatives of schizophrenia manifested some neuropsychologic abnormalities, neurologic soft sign, and morphologic anomalies. Because personality traits are under genetic influence and considerable heritability, we intended to evaluate temperament and character of first-degree relatives of schizophrenia and the influence of schizophrenia genetic loading on their temperament and character. METHODS Temperament and Character Inventory was completed by 97 first-degree relatives of schizophrenia or schizoaffective disorder, 48 schizophrenic probands (44 patients with schizophrenia and 4 patients with schizoaffective disorder), and 106 control subjects. Within first-degree relatives, parents who have additional probands with schizophrenia spectrum disorder in their ascendant or collateral pedigree and siblings who have offspring with schizophrenia spectrum disorder were defined as presumed carriers (n = 20). Group differences in Temperament and Character Inventory scores were compared using a mixed-model analysis of variance with family as a random effect and age as a covariate. RESULTS Harm avoidance (HA) scores increased in the order of control subjects, the first-degree relatives, and probands. Among the relatives, presumed carriers, but not presumed noncarriers, had higher HA compared with control subjects. In addition, probands showed significantly low reward dependence, low self-directedness, and low cooperativeness scores compared with the first-degree relatives and control subjects. Probands had also higher self-transcendence scores than the first-degree relatives and had lower persistence scores than control subjects. CONCLUSIONS Our findings that HA increases in proportion to the genetic loading of schizophrenia suggest that it may be a potential endophenotype of schizophrenia.
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Affiliation(s)
- Minyoung Sim
- Department of Psychiatry, Seoul National Hospital, Seoul, South Korea
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Martín-Reyes M, Mendoza R, Domínguez M, Caballero A, Bravo TM, Díaz T, Gerra S, Ibáñez A, Linares AR. Depressive symptoms evaluated by the Calgary Depression Scale for Schizophrenia (CDSS): genetic vulnerability and sex effects. Psychiatry Res 2011; 189:55-61. [PMID: 21196052 DOI: 10.1016/j.psychres.2010.11.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 11/09/2010] [Accepted: 11/11/2010] [Indexed: 11/18/2022]
Abstract
The present study compares the occurrence of depressive symptoms evaluated by the Calgary Depression Scale for Schizophrenia (CDSS) in patients of Multiplex (MS) and Simplex Schizophrenia families (SS). The Positive and Negative Syndrome Scale (PANSS) was used to evaluate psychopathology. A total of 206 paranoid schizophrenia patients were studied according DSM-IV criteria. The Family Interview for Genetic Studies (FIGS) was used to study the families. A result in the FIGS for a positive family history of schizophrenia was referred as MS (patients); its lack as SS (patients). CDSS scores were compared among MS and SS patients and possible sex differences intra- and inter-groups were explored. In the analysis of our sample (30) 19% of the total persons with schizophrenia group was depressed. The depressive symptoms measured by the CDSS were higher in females and the MS males group. Males from MS group showed more depressive symptoms than males from SS group. No differences with females from both groups were found. Findings in this study underscore the importance of gender and family history in understanding the heterogeneity of schizophrenia. This study suggests that sex and familiar history are important to consider in studying depressive symptoms.
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A genome-wide linkage scan for distinct subsets of schizophrenia characterized by age at onset and neurocognitive deficits. PLoS One 2011; 6:e24103. [PMID: 21897869 PMCID: PMC3163684 DOI: 10.1371/journal.pone.0024103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 07/30/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As schizophrenia is genetically and phenotypically heterogeneous, targeting genetically informative phenotypes may help identify greater linkage signals. The aim of the study is to evaluate the genetic linkage evidence for schizophrenia in subsets of families with earlier age at onset or greater neurocognitive deficits. METHODS Patients with schizophrenia (n = 1,207) and their first-degree relatives (n = 1,035) from 557 families with schizophrenia were recruited from six data collection field research centers throughout Taiwan. Subjects completed a face-to-face semi-structured interview, the Continuous Performance Test (CPT), the Wisconsin Card Sorting Test, and were genotyped with 386 microsatellite markers across the genome. RESULTS A maximum nonparametric logarithm of odds (LOD) score of 4.17 at 2q22.1 was found in 295 families ranked by increasing age at onset, which had significant increases in the maximum LOD score compared with those obtained in initial linkage analyses using all available families. Based on this subset, a further subsetting by false alarm rate on the undegraded and degraded CPT obtained further increase in the nested subset-based LOD on 2q22.1, with a score of 7.36 in 228 families and 7.71 in 243 families, respectively. CONCLUSION We found possible evidence of linkage on chromosome 2q22.1 in families of schizophrenia patients with more CPT false alarm rates nested within the families with younger age at onset. These results highlight the importance of incorporating genetically informative phenotypes in unraveling the complex genetics of schizophrenia.
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Huang YH, Lee MH, Chen WJ, Hsiao CK. Using an uncertainty-coding matrix in Bayesian regression models for haplotype-specific risk detection in family association studies. PLoS One 2011; 6:e21890. [PMID: 21789192 PMCID: PMC3137600 DOI: 10.1371/journal.pone.0021890] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 06/08/2011] [Indexed: 11/22/2022] Open
Abstract
Haplotype association studies based on family genotype data can provide more biological information than single marker association studies. Difficulties arise, however, in the inference of haplotype phase determination and in haplotype transmission/non-transmission status. Incorporation of the uncertainty associated with haplotype inference into regression models requires special care. This task can get even more complicated when the genetic region contains a large number of haplotypes. To avoid the curse of dimensionality, we employ a clustering algorithm based on the evolutionary relationship among haplotypes and retain for regression analysis only the ancestral core haplotypes identified by it. To integrate the three sources of variation, phase ambiguity, transmission status and ancestral uncertainty, we propose an uncertainty-coding matrix which combines these three types of variability simultaneously. Next we evaluate haplotype risk with the use of such a matrix in a Bayesian conditional logistic regression model. Simulation studies and one application, a schizophrenia multiplex family study, are presented and the results are compared with those from other family based analysis tools such as FBAT. Our proposed method (Bayesian regression using uncertainty-coding matrix, BRUCM) is shown to perform better and the implementation in R is freely available.
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Affiliation(s)
- Yung-Hsiang Huang
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Mei-Hsien Lee
- Department of Mathematics and Computer Science Education, Taipei Municipal University of Education, Taipei, Taiwan
| | - Wei J. Chen
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Research Center for Genes, Environment, and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chuhsing Kate Hsiao
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Research Center for Genes, Environment, and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan
- Bioinformatics and Biostatistics Core, NTU Center for Genomic Medicine, National Taiwan University, Taipei, Taiwan
- * E-mail:
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Lin CH, Lane HY, Tsai GE. Glutamate signaling in the pathophysiology and therapy of schizophrenia. Pharmacol Biochem Behav 2011; 100:665-77. [PMID: 21463651 DOI: 10.1016/j.pbb.2011.03.023] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 03/14/2011] [Accepted: 03/28/2011] [Indexed: 11/26/2022]
Abstract
Glutamatergic neurotransmission, particularly through the N-methyl-d-aspartate (NMDA) receptor, has drawn attention for its role in the pathophysiology of schizophrenia. This paper reviews the neurodevelopmental origin and genetic susceptibility of schizophrenia relevant to NMDA neurotransmission, and discusses the relationship between NMDA hypofunction and different domains of symptom in schizophrenia as well as putative treatment modality for the disorder. A series of clinical trials and a meta-analysis which compared currently available NMDA-enhancing agents suggests that glycine, d-serine, and sarcosine are more efficacious than d-cycloserine in improving the overall psychopathology of schizophrenia without side effect or safety concern. In addition, enhancing glutamatergic neurotransmission via activating the AMPA receptor, metabotropic glutamate receptor or inhibition of d-amino acid oxidase (DAO) is also reviewed. More studies are needed to determine the NMDA vulnerability in schizophrenia and to confirm the long-term efficacy, functional outcome, and safety of these NMDA-enhancing agents in schizophrenic patients, particularly those with refractory negative and cognitive symptoms, or serious adverse effects while taking the existing antipsychotic agents.
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Affiliation(s)
- Chieh-Hsin Lin
- Department of Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Tsuang HC, Liu CM, Hwang TJ, Hsieh MH, Faraone SV, Tsuang MT, Hwu HG, Chen WJ. Handedness and schizotypy in non-psychotic relatives of patients with schizophrenia. Laterality 2011; 16:690-706. [PMID: 21308606 DOI: 10.1080/1357650x.2010.511646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Existing studies have found the relationship between handedness and schizotypy to be inconsistent, and had limited generalisability since only highly homogeneous groups have been investigated. This study aimed to examine the relation between handedness and the four schizotypal factors identified from a previous confirmatory factor analysis in a population of high familial loading for schizophrenia. Study participants consisted of non-psychotic first-degree relatives (850 parents and 334 siblings) of sib-pairs who were co-affected with schizophrenia. All participants were interviewed with the Diagnostic Interview for Genetic Studies, which contains a section of the modified Structured Interview for Schizotypy, and the Annett handedness questionnaire. Both categorical and continuous indicators for handedness were examined. Non-right-handed siblings of schizophrenia patients displayed more positive schizotypal features than their right-handed counterparts when the two-way Annett's handedness classification was adopted. No association was found when handedness was treated as continuous. The relationship between handedness and schizotypy was insignificant for parents probably due to the strong social pressure against left-handedness. We concluded that categorical non-right-handedness was associated with positive schizotypy in non-psychotic siblings of schizophrenia patients. The results indicate that an atypical cerebral lateralisation underlying non-right-handedness may be also a contributing factor to positive schizotypy.
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Impairment of emotional expression recognition in schizophrenia: a Cuban familial association study. Psychiatry Res 2011; 185:44-8. [PMID: 20580837 DOI: 10.1016/j.psychres.2009.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Revised: 10/14/2009] [Accepted: 10/19/2009] [Indexed: 12/18/2022]
Abstract
It is well established that schizophrenia is associated with difficulties in recognizing facial emotional expressions, but few studies have reported the presence of this deficit among their unaffected relatives. This study attempts to add new evidence of familial association on an emotional expression processing test. The study evaluated the performance of 93 paranoid schizophrenia patients, 110 first-degree relatives of probands from multiplex schizophrenia families, and 109 nonpsychiatric controls on a facial emotional recognition test using a computer morphing technique to present the dynamic expressions. The task entailed the recognition of a set of facial expressions depicting the six basic emotions presented in 21 successive frames of increasing intensity. The findings indicated that schizophrenia patients were consistently impaired for the recognition of the six basic facial expressions. In contrast, their unaffected relatives showed a selective impairment for the recognition of disgust and fearful expressions. Familial association of selective facial emotional expressions processing deficit may further implicate promising new endophenotypes that can advance the understanding of affective deficits in schizophrenia.
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Li CT, Su TP, Chou YH, Lee YC, Liu ME, Ku HL, Shan IK, Bai YM. Symptomatic resolution among Chinese patients with schizophrenia and associated factors. J Formos Med Assoc 2010; 109:378-88. [PMID: 20497871 DOI: 10.1016/s0929-6646(10)60066-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Revised: 05/24/2009] [Accepted: 08/22/2009] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/PURPOSE The remission and resolution criteria for schizophrenia were defined by the Remission in Schizophrenia Working Group in 2005, using eight core items of the positive and negative symptoms scale for schizophrenia. Subsequent studies of Caucasians have reported similar remission/resolution rates of approximately one-third. However, the remission/resolution rate in Chinese patients has not previously been reported. The present study assessed symptom resolution rates and associated factors among medicated and clinically stable Chinese schizophrenia patients. METHODS Chinese patients with a diagnosis of schizophrenia were followed-up 1 month after their last psychiatric hospitalization. Cross-sectional clinical assessments for psychopathology, side effect profiles, quality of life, psychosocial function, and neurocognition tests were performed. RESULTS Thirty-three (36.7%) of a total of 90 patients met the resolution criteria. They had a significantly higher level of education and lower scores for positive symptoms, negative symptoms, and general psychopathology on the positive and negative symptoms scale; they had lower scores on the Udvalg for Kliniske Undersøgelser Side Effect Rating Scale, and Simpson Angus Scale; and higher scores on the Global Assessment of Functioning and Subjective Well-being under Neuroleptics scales, compared with patients who did not meet the resolution criteria. Multiple regression analyses controlling for age, sex, duration of illness, education, duration of index hospitalization, and antipsychotic dosage revealed that a higher Udvalg for Kliniske Undersøgelser Side Effect Rating Scale score was related to lower rate of symptom resolution. The patients treated with clozapine and combinations of first generation antipsychotics and second generation antipsychotics had more severe psychopathology and side effects and showed a significantly lower resolution rate than did patients treated with first generation antipsychotics or second generation antipsychotics alone. CONCLUSION Consistent with studies of Caucasian patients, one-third of clinically stable Chinese patients met the resolution criteria, as well as having fewer general side effects, better global functioning and subjective well-being.
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Affiliation(s)
- Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
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Lien YJ, Liu CM, Faraone SV, Tsuang MT, Hwu HG, Hsiao PC, Chen WJ. A genome-wide quantitative trait loci scan of neurocognitive performances in families with schizophrenia. GENES BRAIN AND BEHAVIOR 2010; 9:695-702. [DOI: 10.1111/j.1601-183x.2010.00599.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Martín-Reyes M, Mendoza Quiñones R, Díaz de Villalvilla T, Valdés Sosa M. Perceptual/attentional anomalies in schizophrenia: a family study. Psychiatry Res 2010; 176:137-42. [PMID: 20219251 DOI: 10.1016/j.psychres.2009.03.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Revised: 03/21/2009] [Accepted: 03/23/2009] [Indexed: 11/26/2022]
Abstract
Endophenotypes have emerged as an important concept in the study of schizophrenia. Perceptual/attentional anomalies were examined as potential endophenotypes in a family study using a strategy for "multiplex/simplex schizophrenia". The sample was comprised of 797 subjects: 206 schizophrenia patients, 302 first-degree relatives and 289 controls. The Spanish versions of the Structured Interview for Assessing Perceptual/attentional Anomalies (SIAPA) and Positive and Negative Symptoms Scale (PANSS) were applied to measure the presence of perceptual/attentional anomalies, and positive and negative subscale respectively. An ANCOVA was carried out for global comparisons between groups. The multiplex schizophrenic group had significantly more frequent auditory and visual perceptual/attentional anomalies than Simplex schizophrenic and control groups. The most interesting finding was that the severity of auditory and visual perceptual/attentional anomalies and negative symptoms was significantly higher in the relatives of the multiplex schizophrenia group than in those relatives from the simplex schizophrenia and control groups. The existence of perceptual/attentional anomalies in nonaffected relatives suggests the presence of familial association for these symptoms which may therefore be a potential endophenotype suitable for genetic studies.
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Affiliation(s)
- Migdyrai Martín-Reyes
- Department of Biological Psychiatry, Cuban Neuroscience Center, Cubanacán, P.O. Box 11600, Havana City, Cuba.
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Lien YJ, Tsuang HC, Chiang A, Liu CM, Hsieh MH, Hwang TJ, Liu SK, Hsiao PC, Faraone SV, Tsuang MT, Hwu HG, Chen WJ. The multidimensionality of schizotypy in nonpsychotic relatives of patients with schizophrenia and its applications in ordered subsets linkage analysis of schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1-9. [PMID: 19326390 DOI: 10.1002/ajmg.b.30948] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study aimed to examine the multidimensionality of schizotypy and validate the structure using ordered subset linkage analyses on information from both relatives' schizotypy and probands' schizophrenia symptoms. A total of 203 and 1,310 nonpsychotic first-degree relatives from simplex and multiplex schizophrenia families, respectively, were interviewed with the Diagnostic Interview for Genetic Studies, which contains a modified Structured Interview for Schizotypy. Using Mplus program with categorical factor indicators, a four-factor model (Negative Schizotypy, Positive Schizotypy, Interpersonal Sensitivity, and Social Isolation/Introversion) was extracted by exploratory factor analysis from relatives of simplex families and was confirmed in relatives of multiplex families. The validity of each factor was supported by distinct linkage findings resulting from ordered subset analysis based on different combinations of schizophrenia-schizotypy factors. Six chromosomal regions with significant increase in nonparametric linkage z score (NPL-Z) were found as follows: 15q21.1 (NPL-Z = 3.60) for Negative Schizophrenia-Negative Schizotypy, 10q22.3 (NPL-Z = 3.83) and 15q21.3 (NPL-Z = 3.36) for Negative Schizophrenia-Social Isolation/Introversion, 5q14.2 (NPL-Z = 3.20) and 11q23.3 (NPL-Z = 3.31) for Positive Schizophrenia-Positive Schizotypy, and 4q32.1 (NPL-Z = 3.31) for Positive Schizophrenia-Interpersonal Sensitivity. The greatest NPL-Z of 3.83 on 10q22.3 in the subset was significantly higher than the greatest one of 2.88 in the whole sample (empirical P-value = 0.04). We concluded that a consistent four-factor model of schizotypy could be derived in nonpsychotic relatives across families of patients with different genetic loadings in schizophrenia. Their differential relations to linkage signals have etiological implications and provide further evidence for their validity.
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Affiliation(s)
- Yin-Ju Lien
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
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Abstract
Schizophrenia (SZ) is a complex, heterogeneous, and disabling psychiatric disorder that impairs multiple aspects of human cognitive, perceptual, emotional, and behavioral functioning. SZ is relatively frequent (prevalence around 1%), with onset usually during adolescence or early adulthood, and has a deteriorating course. The rapidly growing area of neuroimaging research has has found clear evidence of many cortical and subcortical abnormalities in individuals with SZ. In this article the most recent findings from multiple studies on neurological disorders in SZ are reviewed, and the authors make a strong argument for a neurological basis of the schizophrenic process.
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Affiliation(s)
- Arman Danielyan
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH 45244, USA
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Lin SH, Liu CM, Liu YL, Fann CSJ, Hsiao PC, Wu JY, Hung SI, Chen CH, Wu HM, Jou YS, Liu SK, Hwang TJ, Hsieh MH, Chang CC, Yang WC, Lin JJ, Chou FHC, Faraone SV, Tsuang MT, Hwu HG, Chen WJ. Clustering by neurocognition for fine mapping of the schizophrenia susceptibility loci on chromosome 6p. GENES, BRAIN, AND BEHAVIOR 2009; 8:785-94. [PMID: 19694819 PMCID: PMC4286260 DOI: 10.1111/j.1601-183x.2009.00523.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chromosome 6p is one of the most commonly implicated regions in the genome-wide linkage scans of schizophrenia, whereas further association studies for markers in this region were inconsistent likely due to heterogeneity. This study aimed to identify more homogeneous subgroups of families for fine mapping on regions around markers D6S296 and D6S309 (both in 6p24.3) as well as D6S274 (in 6p22.3) by means of similarity in neurocognitive functioning. A total of 160 families of patients with schizophrenia comprising at least two affected siblings who had data for eight neurocognitive test variables of the continuous performance test (CPT) and the Wisconsin card sorting test (WCST) were subjected to cluster analysis with data visualization using the test scores of both affected siblings. Family clusters derived were then used separately in family-based association tests for 64 single nucleotide polymorphisms (SNPs) covering the region of 6p24.3 and 6p22.3. Three clusters were derived from the family-based clustering, with deficit cluster 1 representing deficit on the CPT, deficit cluster 2 representing deficit on both the CPT and the WCST, and a third cluster of nondeficit. After adjustment using false discovery rate for multiple testing, SNP rs13873 and haplotype rs1225934-rs13873 on BMP6-TXNDC5 genes were significantly associated with schizophrenia for the deficit cluster 1 but not for the deficit cluster 2 or nondeficit cluster. Our results provide further evidence that the BMP6-TXNDC5 locus on 6p24.3 may play a role in the selective impairments on sustained attention of schizophrenia.
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Affiliation(s)
- Sheng-Hsiang Lin
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Division of Genomic Medicine, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Li Liu
- Division of Mental Health and Substance Abuse Research, National Health Research Institutes, Zhunan, Taiwan
| | | | - Po-Chang Hsiao
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Division of Genomic Medicine, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
| | - Jer-Yuarn Wu
- National Genotyping Center, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Shuen-Iu Hung
- National Genotyping Center, Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Chun-Houh Chen
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Han-Ming Wu
- Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Yuh-Shan Jou
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Shi K. Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Tzung J. Hwang
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | | | - Wei-Chih Yang
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Molecular Medicine Program, Taiwan International Graduate Program, Academia Sinica, Taipei, Taiwan
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, Taiwan
| | - Jin-Jia Lin
- Department of Psychiatry, Chimei Medical Center, Tainan, Taiwan
| | | | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ming T. Tsuang
- Harvard Institute of Psychiatric Epidemiology and Genetics, and Departments of Epidemiology and Psychiatry, Harvard University, Boston, Massachusetts, USA
- Center for Behavioral Genomics, Department of Psychiatry, University of California, San Diego, California, USA
| | - Hai-Gwo Hwu
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Wei J. Chen
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Division of Genomic Medicine, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Schirmer TN, Dorflinger JM, Marlow-O'Connor M, Pendergrass JC, Hartzell A, All SD, Charles D. FMRI indices of auditory attention in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:25-32. [PMID: 18957312 DOI: 10.1016/j.pnpbp.2008.09.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2008] [Revised: 09/24/2008] [Accepted: 09/30/2008] [Indexed: 12/21/2022]
Abstract
The present study sought to identify abnormalities in activation in several brain regions in response to an auditory attention task in patients with schizophrenia. Ten patients and twenty healthy control participants were examined using Functional Magnetic Resonance Imaging (FMRI) measures acquired during an auditory attention task. Region of interest analyses of activation of targeted regions implicated in attention included: anterior cingulate cortex (ACC), dorsolateral prefrontal cortex (DLPFC), hippocampus, parahippocampal gyrus (PHG), and superior temporal gyrus (STG). The results indicated over-activation in patients with schizophrenia. While the control group showed notable coherence in activation within and across hemispheres the schizophrenia group showed relatively less coherence overall that was only present in the right hemisphere. These findings suggest that patients with schizophrenia show both an over-engagement of brain regions during attention task as well as a lack of communication among neural regions involved.
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Affiliation(s)
- Todd N Schirmer
- Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, Illinois 60064, USA.
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Chang SS, Liu CM, Lin SH, Hwu HG, Hwang TJ, Liu SK, Hsieh MH, Guo SC, Chen WJ. Impaired flush response to niacin skin patch among schizophrenia patients and their nonpsychotic relatives: the effect of genetic loading. Schizophr Bull 2009; 35:213-21. [PMID: 18203758 PMCID: PMC2643969 DOI: 10.1093/schbul/sbm153] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We previously reported familial aggregation in flush response to niacin skin patch among schizophrenia patients and their nonpsychotic relatives. However, little is known about whether this abnormal skin response is associated with genetic loading for schizophrenia. This study compared the niacin flush response in subjects from families with only one member affected with schizophrenia (simplex families) with those from families having a sib-pair with schizophrenia (multiplex families). Subjects were patients with schizophrenia and their nonpsychotic first-degree relatives from simplex families (176 probands, 260 parents, and 80 siblings) and multiplex families (311 probands, 180 parents, and 52 siblings) as well as 94 healthy controls. Niacin patches of 3 concentrations (0.001M, 0.01M, and 0.1M) were applied to forearm skin, and the flush response was rated at 5, 10, and 15 minutes, respectively, with a 4-point scale. More attenuated flush response to topical niacin was shown in schizophrenia probands and their relatives from multiplex families than in their counterparts from simplex families, and the differentiation was better revealed using 0.1M concentration of niacin than 0.01M or 0.001M. For the highest concentration of 0.1M and the longest time lag of 15 minutes, a subgroup of probands (23%), parents (27%), and siblings (19%) still exhibited nonflush response. Flush response to niacin skin patch is more impaired in schizophrenia patients and their relatives from families with higher genetic loading for schizophrenia, and this finding has implications for future genetic dissection of schizophrenia.
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Affiliation(s)
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung J. Hwang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shi K. Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan,Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Wei J. Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan,Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan,To whom correspondence should be addressed; 17 Xuzhou Road, Taipei 100, Taiwan; tel: 886-2-33228010, fax: 886-2-33228004, e-mail:
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Liao SY, Lin SH, Liu CM, Hsieh MH, Hwang TJ, Liu SK, Guo SC, Hwu HG, Chen WJ. Genetic variants in COMT and neurocognitive impairment in families of patients with schizophrenia. GENES BRAIN AND BEHAVIOR 2008; 8:228-37. [PMID: 19077118 DOI: 10.1111/j.1601-183x.2008.00467.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study examined the relations of genetic variants in catechol-O-methyltransferase (COMT) gene, including rs737865 in intron 1, rs4680 in exon 4 (Val158Met) and downstream rs165599, to schizophrenia and its related neurocognitive functions in families of patients with schizophrenia. Totally, 680 individuals from 166 simplex (166 affected members and 354 nonpsychotic first-degree relatives) and 46 multiplex families (85 affected members and 75 nonpsychotic first-degree relatives) were interviewed using Diagnostic Interview for Genetic Studies, administered Wisconsin Card Sorting Test (WCST) and Continuous Performance Test (CPT), and drawn for venous blood. Both categorical (dichotomizing families on affected members' neurocognitive performance) and quantitative approaches toward the WCST and CPT performance scores were employed using the family-based association test and the variance components framework, respectively. Both false discovery rate and permutations were used to adjust for multiple testing. The genotypes of rs4680 were associated with both the WCST and CPT performance scores in these families, but not with schizophrenia per se in either whole sample or subgroup analyses. Meanwhile, the other two single nucleotide polymorphisms were differentially associated with the two tasks. For WCST indexes, regardless of subgroup analyses or quantitative approach, only rs737865 exhibited moderate associations. For CPT indexes, rs737865 exhibited association for the subgroup with deficit on CPT reaction time, whereas rs165599 exhibited association for the subgroup with deficit on CPT d' as well as quantitative undegraded d'. Our results indicate that the genetic variants in COMT might be involved in modulation of neurocognitive functions and hence conferring increased risk to schizophrenia.
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Affiliation(s)
- S-Y Liao
- Genetic Epidemiology Core Laboratory, Division of Genomic Medicine Research Center for Medical Excellence, School of Medicine, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
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Hill SK, Harris MSH, Herbener ES, Pavuluri M, Sweeney JA. Neurocognitive allied phenotypes for schizophrenia and bipolar disorder. Schizophr Bull 2008; 34:743-59. [PMID: 18448479 PMCID: PMC2632447 DOI: 10.1093/schbul/sbn027] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psychiatric disorders are genetically complex and represent the end product of multiple biological and social factors. Links between genes and disorder-related abnormalities can be effectively captured via assessment of phenotypes that are both associated with genetic effects and potentially contributory to behavioral abnormalities. Identifying intermediate or allied phenotypes as a strategy for clarifying genetic contributions to disorders has been successful in other areas of medicine and is a promising strategy for identifying susceptibility genes in complex psychiatric disorders. There is growing evidence that schizophrenia and bipolar disorder, rather than being wholly distinct disorders, share genetic risk at several loci. Further, there is growing evidence of similarity in the pattern of cognitive and neurobiological deficits in these groups, which may be the result of the effects of these common genetic factors. This review was undertaken to identify patterns of performance on neurocognitive and affective tasks across probands with schizophrenia and bipolar disorder as well as unaffected family members, which warrant further investigation as potential intermediate trait markers. Available evidence indicates that measures of attention regulation, working memory, episodic memory, and emotion processing offer potential for identifying shared and illness-specific allied neurocognitive phenotypes for schizophrenia and bipolar disorder. However, very few studies have evaluated neurocognitive dimensions in bipolar probands or their unaffected relatives, and much work in this area is needed.
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Affiliation(s)
- S. Kristian Hill
- To whom correspondence should be addressed; tel: 312 996-2107, fax: 312 413-8837, e-mail:
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Filbey FM, Toulopoulou T, Morris RG, McDonald C, Bramon E, Walshe M, Murray RM. Selective attention deficits reflect increased genetic vulnerability to schizophrenia. Schizophr Res 2008; 101:169-75. [PMID: 18291626 DOI: 10.1016/j.schres.2008.01.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 01/08/2008] [Accepted: 01/16/2008] [Indexed: 11/16/2022]
Abstract
BACKGROUND Impairment in attention is prominent in schizophrenia and may be a valuable genetic indicator for vulnerability to this disease. AIMS We set out to characterize the attention deficits that may be associated with genetic liability to schizophrenia. METHODS We compared attention performance in 55 people with schizophrenia, 95 of their first-degree relatives, and 61 unrelated controls. We also segregated presumed obligate carriers of genetic risk (POCs, N=12) and compared their performance with that of controls. RESULTS Although the relatives of people with schizophrenia did not significantly differ from the normal controls on the tasks of attention, their scores were significantly ordered such that patients>relatives>normal controls during tasks of sustained and selective attention as measured by the Jonckheere-Terpstra Test (p<.05). Additionally, POCs were significantly worse than normal controls during selective attention tasks such as the Stroop (p=.03) and Letter Cancellation Task (p=.04). CONCLUSIONS Heterogeneity in the first-degree relatives may have diluted the attention deficits present in those who are at genetic risk for schizophrenia. On the other hand, our findings in the more homogeneous group of POCs suggest that selective attention may be an indicator of genetic liability for schizophrenia.
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Affiliation(s)
- Francesca M Filbey
- Department of Psychiatry, Institute of Psychiatry, King's College, De Crespigny Park, SE5 8AF London, UK.
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