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Sun W, Jin T, Yang H, Li J, Tian Q, Gao J, Peng R, Zhang G, Zhang X. Alterations of serum neuropeptide levels and their relationship to cognitive impairment and psychopathology in male patients with chronic schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:3. [PMID: 38172494 PMCID: PMC10851704 DOI: 10.1038/s41537-023-00425-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
Serum neuropeptide levels may be linked to schizophrenia (SCZ) pathogenesis. This study aims to examine the relation between five serum neuropeptide levels and the cognition of patients with treatment-resistant schizophrenia (TRS), chronic stable schizophrenia (CSS), and in healthy controls (HC). Three groups were assessed: 29 TRS and 48 CSS patients who were hospitalized in regional psychiatric hospitals, and 53 HC. After the above participants were enrolled, we examined the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the blood serum levels of α-melanocyte stimulating hormone (α-MSH), β-endorphin (BE), neurotensin (NT), oxytocin (OT) and substance.P (S.P). Psychiatric symptoms in patients with SCZ were assessed with the Positive and Negative Syndrome Scale. SCZ patients performed worse than HC in total score and all subscales of the RBANS. The levels of the above five serum neuropeptides were significantly higher in SCZ than in HC. The levels of OT and S.P were significantly higher in CSS than in TRS patients. The α-MSH levels in TRS patients were significantly and negatively correlated with the language scores of RBANS. However, the BE and NT levels in CSS patients were significantly and positively correlated with the visuospatial/constructional scores of RBANS. Moreover, the interaction effect of NT and BE levels was positively associated with the visuospatial/constructional scores of RBANS. Therefore, abnormally increased serum neuropeptide levels may be associated with the physiology of SCZ, and may cause cognitive impairment and psychiatric symptoms, especially in patients with TRS.
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Affiliation(s)
- Wenxi Sun
- Suzhou Medical College of Soochow University, Suzhou, 215031, Jiangsu, China
- Psychiatry Department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China
| | - Tingting Jin
- Psychiatry Department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China
| | - Haidong Yang
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, The Affiliated KangDa College of Nanjing Medical University, Lianyungang, 222003, PR China
| | - Jin Li
- Psychiatry Department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China
| | - Qing Tian
- Psychiatry Department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China
| | - Ju Gao
- Psychiatry Department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China
| | - Ruijie Peng
- Suzhou Medical College of Soochow University, Suzhou, 215031, Jiangsu, China
| | - Guangya Zhang
- Psychiatry Department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China.
| | - Xiaobin Zhang
- Psychiatry Department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu, China.
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2
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Rammos A, Kirov G, Hubbard L, Walters JTR, Holmans P, Owen MJ, O'Donovan MC, Rees E. Family-based analysis of the contribution of rare and common genetic variants to school performance in schizophrenia. Mol Psychiatry 2023; 28:2081-2087. [PMID: 36914811 PMCID: PMC10575776 DOI: 10.1038/s41380-023-02013-2] [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: 11/09/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/16/2023]
Abstract
Impaired cognition in schizophrenia is associated with worse functional outcomes. While genetic factors are known to contribute to variation in cognition in schizophrenia, few rare coding variants with strong effects have been identified, and the relative effects from de novo, inherited and non-transmitted alleles are unknown. We used array and exome sequencing data from 656 proband-parent trios to examine the contribution of common and rare variants to school performance, and by implication cognitive function, in schizophrenia. Parental transmission of common alleles contributing to higher educational attainment (p value = 0.00015; OR = 2.63) and intelligence (p value = 0.00009; OR = 2.80), but not to schizophrenia, were associated with higher proband school performance. No significant effects were seen for non-transmitted parental common alleles. Probands with lower school performance were enriched for damaging de novo coding variants in genes associated with developmental disorders (DD) (p value = 0.00026; OR = 11.6). Damaging, ultra-rare coding variants in DD genes that were transmitted or non-transmitted from parents, had no effects on school performance. Among probands with lower school performance, those with damaging de novo coding variants in DD genes had a higher rate of comorbid mild intellectual disability (p value = 0.0002; OR = 15.6). Overall, we provide evidence for rare and common genetic contributions to school performance in schizophrenia. The strong effects for damaging de novo coding variants in DD genes provide further evidence that cognitive impairment in schizophrenia has a shared aetiology with developmental disorders. Furthermore, we report no evidence in this sample that non-transmitted parental common alleles for cognitive traits contributed to school performance in schizophrenia via indirect effects on the environment.
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Affiliation(s)
- Alexandros Rammos
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
| | - George Kirov
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Leon Hubbard
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - James T R Walters
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Peter Holmans
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael J Owen
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael C O'Donovan
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Elliott Rees
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
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3
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Riel H, Rudolph ED, MacPhee C, Tibbo PG, Fisher DJ. Reduced duration mismatch negativity elicited by the multi-feature 'optimal' paradigm in early-phase psychosis. Biol Psychol 2023; 180:108570. [PMID: 37116608 DOI: 10.1016/j.biopsycho.2023.108570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 03/30/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND MMN and P3a are EEG-derived event related potentials that are thought to be prospective biomarkers for schizophrenia and, potentially, early-phase psychosis (EPP). METHODS EPP (n = 12) and healthy control (n = 35) participants listened to a multi-feature optimal paradigm with five deviant types (gap, duration, location, intensity, and frequency). RESULTS There was a significant amplitude difference between the EPP and HC group with duration MMN (p =.02). No significant amplitude differences between groups were found for the P3a waveform. There were several correlations for the EPP group with the BNSS, SOFAS, and PANSS-general questionnaires. Length of illness was not associated with MMN or P3a. CONCLUSIONS The optimal paradigm is suitable for eliciting multiple deviant types within a short amount of time in both clinical and healthy populations. This study confirms duration MMN deficits within an EPP group and that MMN is related to functional outcomes and positive and negative symptomology.
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Affiliation(s)
- Hayley Riel
- Department of Psychiatry, Dalhousie University, Halifax NS, Canada
| | - Erica D Rudolph
- Department of Psychology, Saint Mary's University, Halifax NS, Canada
| | - Catrina MacPhee
- Department of Psychiatry, Dalhousie University, Halifax NS, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Halifax NS, Canada
| | - Derek J Fisher
- Department of Psychiatry, Dalhousie University, Halifax NS, Canada; Department of Psychology, Saint Mary's University, Halifax NS, Canada; Department of Psychology, Mount Saint Vincent University, Halifax NS, Canada.
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4
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Environmental Risk Factors and Cognitive Outcomes in Psychosis: Pre-, Perinatal, and Early Life Adversity. Curr Top Behav Neurosci 2023; 63:205-240. [PMID: 35915384 PMCID: PMC9892366 DOI: 10.1007/7854_2022_378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Risk for psychosis begins to accumulate as early as the fetal period through exposure to obstetric complications like fetal hypoxia, maternal stress, and prenatal infection. Stressors in the postnatal period, such as childhood trauma, peer victimization, and neighborhood-level adversity, further increase susceptibility for psychosis. Cognitive difficulties are among the first symptoms to emerge in individuals who go on to develop a psychotic disorder. We review the relationship between pre-, perinatal, and early childhood adversities and cognitive outcomes in individuals with psychosis. Current evidence shows that the aforementioned environmental risk factors may be linked to lower overall intelligence and executive dysfunction, beginning in the premorbid period and persisting into adulthood in individuals with psychosis. It is likely that early life stress contributes to cognitive difficulties in psychosis through dysregulation of the body's response to stress, causing changes such as increased cortisol levels and chronic immune activation, which can negatively impact neurodevelopment. Intersectional aspects of identity (e.g., sex/gender, race/ethnicity), as well as gene-environment interactions, likely inform the developmental cascade to cognitive difficulties throughout the course of psychotic disorders and are reviewed below. Prospective studies of birth cohorts will serve to further clarify the relationship between early-life environmental risk factors and cognitive outcomes in the developmental course of psychotic disorders. Specific methodological recommendations are provided for future research.
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5
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Romanowska S, Best MW, Bowie CR, Depp CA, Patterson TL, Penn DL, Pinkham AE, Harvey PD. Examining the association of life course neurocognitive ability with real-world functioning in schizophrenia-spectrum disorders. Schizophr Res Cogn 2022; 29:100254. [PMID: 35521291 PMCID: PMC9062312 DOI: 10.1016/j.scog.2022.100254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022] Open
Abstract
There is considerable variability in neurocognitive functioning within schizophrenia-spectrum disorders, and neurocognitive performance ranges from severe global impairment to normative performance. Few investigations of neurocognitive clusters have considered the degree to which deterioration relative to premorbid neurocognitive abilities is related to key illness characteristics. Moreover, while neurocognition and community functioning are strongly related, understanding of the sources of variability in the association between these two domains is also limited; it is unknown what proportion of participants would over-perform or under-perform the level of functioning expected based on current neurocognitive performance vs. lifelong attainment. This study examined data from 954 outpatients with schizophrenia-spectrum disorders across three previous studies. Neurocognition, community functioning, and symptoms were assessed. Neurocognitive subgroups were created based on current neurocognition, estimated premorbid IQ, and degree of deterioration from premorbid using z-score cut-offs; functional subgroups were created with cluster analysis based on the Specific Level of Functioning Scale and current neurocognition. The sample was neurocognitively heterogeneous; 65% displayed current neurocognitive impairment and 84% experienced some level of deterioration. Thirty percent of our sample was relatively higher functioning despite significant neurocognitive impairment. Individuals with better community functioning, regardless of neurocognitive performance, had lower symptom severity compared to those with worse functioning. These results highlight the variability in neurocognition and its role in functioning. Understanding individual differences in neurocognitive and functional profiles and the interaction between prior and current cognitive functioning can guide individualized treatment and selection of participants for clinical treatment studies.
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Affiliation(s)
- Sylvia Romanowska
- Department of Psychological Science, University of Toronto Scarborough, Toronto, ON, Canada
| | - Michael W Best
- Department of Psychological Science, University of Toronto Scarborough, Toronto, ON, Canada
| | | | - Colin A Depp
- Department of Psychiatry, UCSD Medical Center, La Jolla, CA, United States.,San Diego VA Healthcare System, San Diego, CA, United States
| | - Thomas L Patterson
- Department of Psychiatry, UCSD Medical Center, La Jolla, CA, United States
| | - David L Penn
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Amy E Pinkham
- Department of Psychology, University of Texas at Dallas, Dallas, TX, United States.,Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami VA Healthcare System, United States
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6
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Fett AKJ, Reichenberg A, Velthorst E. Lifespan evolution of neurocognitive impairment in schizophrenia - A narrative review. Schizophr Res Cogn 2022; 28:100237. [PMID: 35242606 PMCID: PMC8861413 DOI: 10.1016/j.scog.2022.100237] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 01/28/2023]
Abstract
Cognitive impairment is a well-recognized key feature of schizophrenia. Here we review the evidence on (1) the onset and sensitive periods of change in cognitive impairment before and after the first psychotic episode, and (2) heterogeneity in neurocognitive presentations across cognitive domains between and within individuals. Overall, studies suggest that mild cognitive impairment in individuals who develop schizophrenia or related disorders is already present during early childhood. Cross-sectional studies further suggest increasing cognitive impairments from pre- to post-psychosis onset, with the greatest declines between adolescence, the prodrome, and the first psychotic episode and with some variability between domains. Longitudinal studies with more than 10 years of observation time are scarce but support mild cognitive declines after psychosis onset until late adulthood. Whether and how much this cognitive decline exceeds normal aging, proceeds further in older patients, and is specific to certain cognitive domains and subpopulations of patients remains to be investigated. Finally, studies show substantial heterogeneity in cognitive performance in schizophrenia and suggest a variety of impairment profiles. This review highlights a clear need for long-term studies that include a control group and individuals from adolescence to old age to better understand critical windows of cognitive change and their predictors. The available evidence stresses the importance of interventions that aim to counter cognitive decline during the prodromal years, as well as careful assessment of cognition in order to determine who will profit most from which cognitive training.
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Affiliation(s)
- Anne-Kathrin J Fett
- Department of Psychology, City, University of London, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, NY, USA
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7
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Catalan A, Radua J, McCutcheon R, Aymerich C, Pedruzo B, González-Torres MÁ, Baldwin H, Stone WS, Giuliano AJ, McGuire P, Fusar-Poli P. Examining the variability of neurocognitive functioning in individuals at clinical high risk for psychosis: a meta-analysis. Transl Psychiatry 2022; 12:198. [PMID: 35551176 PMCID: PMC9098884 DOI: 10.1038/s41398-022-01961-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/18/2022] [Accepted: 04/27/2022] [Indexed: 11/09/2022] Open
Abstract
This study aims to meta-analytically characterize the presence and magnitude of within-group variability across neurocognitive functioning in young people at Clinical High-Risk for psychosis (CHR-P) and comparison groups. Multistep, PRISMA/MOOSE-compliant systematic review (PROSPERO-CRD42020192826) of the Web of Science database, Cochrane Central Register of Reviews and Ovid/PsycINFO and trial registries up to July 1, 2020. The risk of bias was assessed using a modified version of the NOS for cohort and cross-sectional studies. Original studies reporting neurocognitive functioning in individuals at CHR-P compared to healthy controls (HC) or first-episode psychosis (FEP) patients were included. The primary outcome was the random-effect meta-analytic variability ratios (VR). Secondary outcomes included the coefficient of variation ratios (CVR). Seventy-eight studies were included, relating to 5162 CHR-P individuals, 2865 HC and 486 FEP. The CHR-P group demonstrated higher variability compared to HC (in descending order of magnitude) in visual memory (VR: 1.41, 95% CI 1.02-1.94), executive functioning (VR: 1.31, 95% CI 1.18-1.45), verbal learning (VR: 1.29, 95% CI 1.15-1.45), premorbid IQ (VR: 1.27, 95% CI 1.09-1.49), processing speed (VR: 1.26, 95% CI 1.07-1.48), visual learning (VR: 1.20, 95% CI 1.07-1.34), and reasoning and problem solving (VR: 1.17, 95% CI 1.03-1.34). In the CVR analyses the variability in CHR-P population remains in the previous neurocognitive domains and emerged in attention/vigilance, working memory, social cognition, and visuospatial ability. The CHR-P group transitioning to psychosis showed greater VR in executive functioning compared to those not developing psychosis and compared to FEP groups. Clinical high risk for psychosis subjects shows increased variability in neurocognitive performance compared to HC. The main limitation of this study is the validity of the VR and CVR as an index of variability which has received debate. This finding should be explored by further individual-participant data research and support precision medicine approaches.
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Affiliation(s)
- Ana Catalan
- Mental Health Department. Basurto University Hospital. Biocruces Bizkaia Health Research Institute. Department of Neuroscience, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia, Spain. .,Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Joaquim Radua
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.10403.360000000091771775Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Mental Health Research Networking Center (CIBERSAM), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Robert McCutcheon
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, King’s College London, London, UK
| | - Claudia Aymerich
- grid.414269.c0000 0001 0667 6181Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Borja Pedruzo
- grid.414269.c0000 0001 0667 6181Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Miguel Ángel González-Torres
- grid.11480.3c0000000121671098Mental Health Department. Basurto University Hospital. Biocruces Bizkaia Health Research Institute. Department of Neuroscience, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia Spain
| | - Helen Baldwin
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - William S. Stone
- grid.239395.70000 0000 9011 8547Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
| | - Anthony J. Giuliano
- grid.435881.30000 0001 0394 0960Worcester Recovery Center & Hospital, Massachusetts Department of Mental Health, Boston, MA USA
| | - Philip McGuire
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paolo Fusar-Poli
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.8982.b0000 0004 1762 5736Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy ,grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK ,grid.37640.360000 0000 9439 0839Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, London, UK
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8
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Zanelli J, Reichenberg A, Sandin S, Morgan C, Dazzan P, Pilecka I, Marques TR, Morgan K, Young AH, Mollon J. Dynamic and Static Cognitive Deficits in Schizophrenia and Bipolar Disorder After the First Episode. Schizophr Bull 2022; 48:590-598. [PMID: 35064259 PMCID: PMC9077411 DOI: 10.1093/schbul/sbab150] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Few studies have comprehensively examined the profile of cognitive functioning in first episode psychosis patients throughout the lifespan, and from first episode to chronic stage. We assessed functioning in general and specific cognitive functions, comparing both schizophrenia (N = 64) and bipolar I (N = 19) patients to controls (N = 103). Participants were from a population-based, case-control study of first episode psychosis patients, who were followed prospectively up to 10 years post first admission. A cognitive battery was administered at baseline and follow-up. By combining longitudinal and cross-sectional data, we were able to examine the cognitive profile of patients and controls throughout the entire age range of our sample (16-65). Schizophrenia patients exhibited widespread declines in IQ, executive function, visual memory, language ability, and verbal knowledge. However, the ages at which these declines occurred differed between functions. Deficits in verbal memory, working memory, processing speed, and visuospatial ability, on the other hand, were present at the first episode, and remained relatively static thereafter. Bipolar I patients also showed declines in IQ, verbal knowledge, and language ability, albeit at different ages to schizophrenia patients and only in verbal functions. Deficits on measures of verbal memory, processing speed, and executive function remained relatively static. Thus, both schizophrenia and bipolar I patients experienced cognitive decline in general and specific functions after the first episode, but the age at which these declines occurred differed between disorder and function. Cognitive remediation efforts may be most fruitful when targeting individual functions during specific time periods throughout adulthood.
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Affiliation(s)
- Jolanta Zanelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sven Sandin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Craig Morgan
- Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Izabela Pilecka
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Kevin Morgan
- Department of Psychology, University of Westminster, London, UK
| | - Allan H Young
- Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Josephine Mollon
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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9
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Johnson MC, Sathappan A, Hanly JG, Ross GS, Hauptman AJ, Stone WS, Simon KM. From the Blood-Brain Barrier to Childhood Development: A Case of Acute-Onset Psychosis and Cognitive Impairment Attributed to Systemic Lupus Erythematosus in an Adolescent Female. Harv Rev Psychiatry 2022; 30:71-82. [PMID: 34995037 DOI: 10.1097/hrp.0000000000000315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
LEARNING OBJECTIVES After participating in this CME activity, the clinician will be better able to:• Interpret classifications of neuropsychiatric systemic lupus erythematosus (NPSLE).• Identify determining factors of neuropsychiatric events.• Analyze current evidence regarding disease pathways for NPSLE.
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Affiliation(s)
- Matthew C Johnson
- From Harvard Medical School (Drs. Johnson, Sathappan, Hauptman, Stone, and Simon); Beth Israel Deaconess Medical Center (Drs. Johnson, Sathappan, and Stone); Dalhousie University (Dr. Hanly); Department of Medicine, Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia; Weill Cornell Medical College (Dr. Ross); Brigham and Women's Hospital, Boston, MA (Dr. Hauptman); Boston Children's Hospital, Boston, MA (Dr. Simon)
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10
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Adanty C, Qian J, Al-Chalabi N, Fatemi AB, Gerretsen P, Graff A, De Luca V. Sex differences in schizophrenia: a longitudinal methylome analysis. J Neural Transm (Vienna) 2021; 129:105-114. [PMID: 34966975 DOI: 10.1007/s00702-021-02439-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/04/2021] [Indexed: 11/27/2022]
Abstract
DNA methylation analysis at the genome-wide level is a useful tool to explore potential sex differences in SCZ patients. The primary aim of the current study was to identify differentially methylated regions of DNA between males and females with schizophrenia. We collected DNA samples from 134 schizophrenia patients to measure genome-wide methylation at single-base resolution in 96 males and 38 females. We further repeated the analysis in 13 subjects (9 females, 4 males) to confirm the sex differences and to reduce the effect of potential confounders. The longitudinal methylation analysis found significant replication of several genes across the genome. These genes included RFTN1, TLE1, DAZL, PRR4, UTP14C, RNU12, and LOC644649. The overall results showed robust association between autosomal CpG sites and sex. Longitudinal methylation analysis can be used as internal replication to confirm epigenetic variants that are stable over time.
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Affiliation(s)
- Christopher Adanty
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College St, Toronto, M5T1R8, Canada
| | - Jessica Qian
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College St, Toronto, M5T1R8, Canada
| | - Nzaar Al-Chalabi
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College St, Toronto, M5T1R8, Canada
| | - Ali Bani Fatemi
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College St, Toronto, M5T1R8, Canada
| | - Philip Gerretsen
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College St, Toronto, M5T1R8, Canada
| | - Ariel Graff
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College St, Toronto, M5T1R8, Canada
| | - Vincenzo De Luca
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, 250 College St, Toronto, M5T1R8, Canada.
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11
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Valerio KE, Jonas KG, Perlman G, Bromet EJ, Kotov R. A comparison of cognitive performance in the Suffolk County cohort and their unaffected siblings. Psychiatry Res 2021; 303:114111. [PMID: 34284308 PMCID: PMC8409437 DOI: 10.1016/j.psychres.2021.114111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 06/29/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
People diagnosed with schizophrenia and other psychoses demonstrate impaired neuropsychological performance. Their unaffected siblings exhibit mild impairments relative to unrelated controls, suggesting genetic and shared environmental risk for psychosis account for some portion of cognitive impairments observed in cases. However, most sibling studies were conducted early in illness course. Studying cases and unaffected siblings later in life is valuable because diagnostic misclassification is common early in illness, possibly leading to spurious conclusions. This study compared neuropsychological performance of individuals with psychotic disorders (schizophrenia and other psychoses), their unaffected siblings, and controls. Assessments were conducted 20 years after case enrollment in the Suffolk County Mental Health Project, when siblings and controls were added to the protocol. Results showed individuals with schizophrenia and other psychoses performed worse than their matched siblings across domains. Relative to controls, siblings of participants with schizophrenia showed mild deficits in executive function and processing speed, while no significant differences were observed between siblings of those with other psychoses and controls. These findings suggest pre- and post-onset factors impact cognitive deficits in psychosis, but pre-onset factors are more salient in schizophrenia. Additionally, schizophrenia and other psychoses exist on a neurodevelopmental continuum, with schizophrenia being a more severe manifestation.
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12
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Aryutova K, Stoyanov D. Pharmaco-Magnetic Resonance as a Tool for Monitoring the Medication-Related Effects in the Brain May Provide Potential Biomarkers for Psychotic Disorders. Int J Mol Sci 2021; 22:9309. [PMID: 34502214 PMCID: PMC8430741 DOI: 10.3390/ijms22179309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 01/04/2023] Open
Abstract
The neurodegenerative and neurodevelopmental hypotheses represent the basic etiological framework for the origin of schizophrenia. Additionally, the dopamine hypothesis, adopted more than two decades ago, has repeatedly asserted the position of dopamine as a pathobiochemical substrate through the action of psychostimulants and neuroleptics on the mesolimbic and mesocortical systems, giving insight into the origin of positive and negative schizophrenic symptoms. Meanwhile, cognitive impairments in schizophrenia remain incompletely understood but are thought to be present during all stages of the disease, as well as in the prodromal, interictal and residual phases. On the other hand, observations on the effects of NMDA antagonists, such as ketamine and phencyclidine, reveal that hypoglutamatergic neurotransmission causes not only positive and negative but also cognitive schizophrenic symptoms. This review aims to summarize the different hypotheses about the origin of psychoses and to identify the optimal neuroimaging method that can serve to unite them in an integral etiological framework. We systematically searched Google scholar (with no concern to the date published) to identify studies investigating the etiology of schizophrenia, with a focus on impaired central neurotransmission. The complex interaction between the dopamine and glutamate neurotransmitter systems provides the long-needed etiological concept, which combines the neurodegenerative hypothesis with the hypothesis of impaired neurodevelopment in schizophrenia. Pharmaco-magnetic resonance imaging is a neuroimaging method that can provide a translation of scientific knowledge about the neural networks and the disruptions in and between different brain regions, into clinically applicable and effective therapeutic results in the management of severe psychotic disorders.
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Affiliation(s)
| | - Drozdstoy Stoyanov
- Department of Psychiatry and Medical Psychology, Research Institute, Medical University Plovdiv, 4002 Plovdiv, Bulgaria;
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13
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Stone WS, Cai B, Liu X, Grivel MMR, Yu G, Xu Y, Ouyang X, Chen H, Deng F, Xue F, Li H, Lieberman JA, Keshavan MS, Susser ES, Yang LH, Phillips MR. Association Between the Duration of Untreated Psychosis and Selective Cognitive Performance in Community-Dwelling Individuals With Chronic Untreated Schizophrenia in Rural China. JAMA Psychiatry 2020; 77:1116-1126. [PMID: 32639517 PMCID: PMC7344798 DOI: 10.1001/jamapsychiatry.2020.1619] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
IMPORTANCE Cognitive deficits constitute core features of schizophrenia, but the trajectories of cognitive difficulties in chronic untreated schizophrenia remain unclear. OBJECTIVE To assess the association of neuropsychological deficits with duration of untreated psychosis in individuals with chronic untreated schizophrenia. DESIGN, SETTING, AND PARTICIPANTS Community-dwelling individuals with chronic untreated schizophrenia (untreated patient group) and individuals without mental illness (control group) were recruited from predominantly rural communities in Ningxia, China between June 20, 2016, and August 6, 2019, and administered the Structured Clinical Interview for DSM-IV, the Mini-Mental State Examination, an 8-test version of the MATRICS Consensus Cognition Battery adapted for use in individuals with low levels of education, and a measure of social cognition. MAIN OUTCOMES AND MEASURES Comparison of cognitive test scores between the two groups and association of cognitive test scores with duration of untreated schizophrenia. RESULTS The patient group included 197 individuals with chronic untreated schizophrenia (101 men [51.3%]; mean [SD] age, 52.1 [11.8] years; median [interquartile range] years of schooling, 3 [0-6] years; median [interquartile range] years of untreated psychosis, 22.9 [14.9-32.8] years). The control group included 220 individuals (118 men [53.6%]; mean [SD] age, 52.1 [11.2] years; median [interquartile range] years of schooling, 4 [0-6] years). The untreated patient group performed significantly worse than the control group on all cognitive measures (adjusted partial Spearman correlation coefficient [Spearman ρ] ranged from -0.35 for the revised Chinese version of the Reading the Mind in the Eyes Test to -0.60 for the Brief Visuospatial Memory Test-Revised; P < .001 for all comparisons). Longer durations of untreated psychosis were associated with lower performance in 3 MATRICS Consensus Cognition Battery measures assessing different aspects of executive functioning (Brief Visuospatial Memory Test-Revised [ρ = -0.20; P = .04]; Brief Assessment of Cognition in Schizophrenia, Symbol Coding subtest [ρ = -0.35; P < .001]; and Neuropsychological Assessment Battery, Mazes subtest [ρ = -0.24; P = .01]). The median duration of untreated psychosis (22.9 years) was associated with estimated score reductions in the 3 measures of 34% (95% CI, 10%-52%), 43% (95% CI, 28%-55%), and 57% (95% CI, 31%-73%), respectively. CONCLUSIONS AND RELEVANCE The findings of this study suggest that long-term untreated schizophrenia was associated with decreases in selective cognitive abilities; both neurodegenerative pathology and neurodevelopmental dysfunction may be factors in cognition in persistent psychosis. Expanding research to include cohorts of patients from underserved rural communities in low- and middle-income countries may provide new insights about the etiological factors, disease course, and management of schizophrenia.
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Affiliation(s)
- William S. Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Bing Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China
| | - Xinhua Liu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Margaux M.-R. Grivel
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, New York
| | - Gary Yu
- Rory Meyers College of Nursing, New York University, New York, New York
| | - Yangmu Xu
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Xinyi Ouyang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China
| | - Hanhui Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China
| | - Fei Deng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China
| | - Fang Xue
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China
| | - Huijun Li
- Department of Psychology, Florida A&M University, Tallahassee
| | - Jeffrey A. Lieberman
- Department of Psychiatry, Columbia University, New York, New York,New York State Psychiatric Institute, New York
| | - Matcheri S. Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Ezra S. Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Lawrence H. Yang
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, New York,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Michael R. Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China,Department of Psychiatry, Columbia University, New York, New York,New York State Psychiatric Institute, New York,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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14
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Pandina G, Nuamah I, Petersen T, Singh J, Savitz A, Hough D. Cognitive functioning in adolescents with schizophrenia treated with paliperidone extended-release: 6-Month exploratory analysis from an open-label, single-arm safety study. SCHIZOPHRENIA RESEARCH-COGNITION 2020; 20:100173. [PMID: 32154123 PMCID: PMC7052566 DOI: 10.1016/j.scog.2020.100173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 02/04/2020] [Accepted: 02/17/2020] [Indexed: 11/17/2022]
Abstract
Objective To assess cognitive functioning in adolescents (12-17 years old) with schizophrenia during open-label treatment with paliperidone extended-release (pali ER). Methods In this exploratory analysis, adolescents treated with pali ER (oral, flexibly dosed, 1.5-12 mg/day) underwent cognitive assessments at baseline and month 6 using a battery of cognitive tests validated in adolescents. Correlation analysis was used to explore the relationship between cognitive assessments and clinical symptoms (Positive and Negative Syndrome Scales [PANSS] and factors) and functionality (Children Global Assessment Scale [CGAS]) at baseline and at 6 months. Results A total of 324 of 393 patients had evaluable neurocognitive data. Changes in cognition function tests from baseline to endpoint were generally small to modest, with improvement noted for most cognitive domains (motor speed, attention/working memory, verbal learning and memory, social cognition, speed of processing, executive functioning). No improvement was noted for visual learning and memory. At baseline, there were modest negative correlations between disorganized thoughts and most cognitive domains; these correlations persisted at 6 months. Other significant negative correlations at 6 months were between speed of processing and PANSS total score, positive symptoms, negative symptoms and uncontrolled hostility (p < 0.05). At 6 months, higher CGAS scores (improved functioning) positively correlated with speed of processing and executive functioning, especially among pali ER responders. Conclusions In this large sample of adolescents with schizophrenia, frank cognitive deficits across multiple domains were observed. Treatment with pali ER over 6 months did not worsen neurocognitive functioning and was possibly associated with positive improvement in certain domains.
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Affiliation(s)
- Gahan Pandina
- Janssen Research & Development LLC, NJ, USA
- Corresponding author at: Janssen Research & Development, LLC, Raritan, NJ 08560, USA.
| | | | - Timothy Petersen
- Massachusetts General Hospital Department of Psychiatry, MA, USA
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15
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Coulon N, Godin O, Bulzacka E, Dubertret C, Mallet J, Fond G, Brunel L, Andrianarisoa M, Anderson G, Chereau I, Denizot H, Rey R, Dorey JM, Lançon C, Faget C, Roux P, Passerieux C, Dubreucq J, Leignier S, Capdevielle D, André M, Aouizerate B, Misdrahi D, Berna F, Vidailhet P, Leboyer M, Schürhoff F. Early and very early-onset schizophrenia compared with adult-onset schizophrenia: French FACE-SZ database. Brain Behav 2020; 10:e01495. [PMID: 31908151 PMCID: PMC7010576 DOI: 10.1002/brb3.1495] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To compare the clinical symptomatology in patients with Early-Onset Schizophrenia (EOS, N = 176), especially the subgroup Very Early Onset Schizophrenia (VEOS) and Adult Onset Schizophrenia (AOS, N = 551). METHOD In a large French multicentric sample, 727 stable schizophrenia patients, classified by age at onset of the disorder, were assessed using standardized and extensive clinical and neuropsychological batteries: AOS with onset ≥ 18 years and EOS with onset < 18 years (including 22 VEOS < 13 years). RESULTS The importance of better diagnosing EOS group, and in particularly VEOS, appeared in a longer DUP Duration of Untreated Psychosis (respectively, 2.6 years ± 4.1 and 8.1 years ± 5.7 vs. 1.0 years ± 2.5), more severe symptomatology (PANSS Positive And Negative Syndrome Scale scores), and lower educational level than the AOS group. In addition, the VEOS subgroup had a more frequent childhood history of learning disabilities and lower prevalence of right-handedness quotient than the AOS. CONCLUSION The study demonstrates the existence of an increased gradient of clinical severity from AOS to VEOS. In order to improve the prognosis of the early forms of schizophrenia and to reduce the DUP, clinicians need to pay attention to the prodromal manifestations of the disease.
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Affiliation(s)
- Nathalie Coulon
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France.,INSERM U894, AP-HP, Department of Psychiatry, Louis Mourier Hospital, Paris Diderot University, Sorbonne Paris Cité, Faculté de médecine, Colombes, France
| | - Ophélia Godin
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Ewa Bulzacka
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Caroline Dubertret
- Fondation FondaMental, Créteil, France.,INSERM U894, AP-HP, Department of Psychiatry, Louis Mourier Hospital, Paris Diderot University, Sorbonne Paris Cité, Faculté de médecine, Colombes, France
| | - Jasmina Mallet
- Fondation FondaMental, Créteil, France.,INSERM U894, AP-HP, Department of Psychiatry, Louis Mourier Hospital, Paris Diderot University, Sorbonne Paris Cité, Faculté de médecine, Colombes, France
| | - Guillaume Fond
- Fondation FondaMental, Créteil, France.,EA 3279 : CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ, Faculté de Médecine, Marseille, France
| | - Lore Brunel
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Méja Andrianarisoa
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | | | - Isabelle Chereau
- Fondation FondaMental, Créteil, France.,Clermont-Ferrand University Hospital, EA 7280 Auvergne University, BP 69, Clermont-Ferrand, France
| | - Hélène Denizot
- Fondation FondaMental, Créteil, France.,Clermont-Ferrand University Hospital, EA 7280 Auvergne University, BP 69, Clermont-Ferrand, France
| | - Romain Rey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR 5292, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, Claude Bernard Lyon 1 University, Bron Cedex, France
| | - Jean-Michel Dorey
- Fondation FondaMental, Créteil, France.,INSERM U1028, CNRS UMR 5292, Centre de Recherche en Neurosciences de Lyon, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, Claude Bernard Lyon 1 University, Bron Cedex, France
| | - Christophe Lançon
- Fondation FondaMental, Créteil, France.,Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | - Catherine Faget
- Fondation FondaMental, Créteil, France.,Department of Psychiatry (AP-HM), Sainte-Marguerite University Hospital, Marseille, France
| | - Paul Roux
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France
| | - Christine Passerieux
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France
| | - Julien Dubreucq
- Fondation FondaMental, Créteil, France.,Psychosocial Rehabilitation Reference Center, Alpes Isère Hospital, Grenoble, France
| | - Sylvain Leignier
- Fondation FondaMental, Créteil, France.,Psychosocial Rehabilitation Reference Center, Alpes Isère Hospital, Grenoble, France
| | - Delphine Capdevielle
- Fondation FondaMental, Créteil, France.,INSERM 1061, University Department of Adult Psychiatry, La Colombiere Hospital, CHU Montpellier, University of Montpellier 1, Montpellier, France
| | - Myrtille André
- Fondation FondaMental, Créteil, France.,INSERM 1061, University Department of Adult Psychiatry, La Colombiere Hospital, CHU Montpellier, University of Montpellier 1, Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, University of Bordeaux, Bordeaux, France
| | - David Misdrahi
- Fondation FondaMental, Créteil, France.,Department of Adult Psychiatry, Charles Perrens Hospital, University of Bordeaux, Bordeaux, France
| | - Fabrice Berna
- Fondation FondaMental, Créteil, France.,INSERM U1114, Strasbourg University Hospital, University of Strasbourg, Federation of Translational Psychiatry, Strasbourg, France
| | - Pierre Vidailhet
- Fondation FondaMental, Créteil, France.,INSERM U1114, Strasbourg University Hospital, University of Strasbourg, Federation of Translational Psychiatry, Strasbourg, France
| | - Marion Leboyer
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Franck Schürhoff
- Fondation FondaMental, Créteil, France.,INSERM U955, Translational Psychiatry laboratory, AP-HP, DHU Pe-PSY, Centre Expert Schizophrénie, Pôle de Psychiatrie et d'Addictologie des Hôpitaux Universitaires Henri Mondor, Université Paris Est Créteil, Créteil, France
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16
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Effect of multi-session prefrontal transcranial direct current stimulation on cognition in schizophrenia: A systematic review and meta-analysis. Schizophr Res 2020; 216:367-373. [PMID: 31822431 DOI: 10.1016/j.schres.2019.11.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 12/21/2022]
Abstract
Patients with schizophrenia experience cognitive deficits that play a central role in predicting functional outcomes. In this study, we sought to evaluate the effect of transcranial direct current stimulation (tDCS) on cognition using meta-analysis. A search was performed from inception to 8 January 2019, to identify randomized controlled trials assessing the ability of tDCS to ameliorate cognitive deficits in patients with schizophrenia and schizoaffective disorder. The effect size, calculated as the standardized mean difference (Hedge's g), was obtained with a random effect model. We analyzed mean effects on specific cognitive domains that were evaluated in four or more studies. Nine articles were included in the systematic review, which encompassed 270 patients: 133 in the active stimulation group and 137 in the sham stimulation group. Meta-analysis demonstrated a significant mean effect of tDCS on working memory (SMD = 0.49, 95% CI = 0.16 to 0.83), while non-significant results were produced for other domains. These findings were supported by sensitivity analyses indicating that the results would not change in a meaningful way after the exclusion of each single study, and meta-regression analyses verifying the consistent effect irrespective of any moderators. Thus, tDCS may provide a potential option to improve working memory deficits in individuals with schizophrenia. Further trials examining the cognitive benefit of tDCS with medication or other adjunctive treatments are warranted.
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17
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Zanelli J, Mollon J, Sandin S, Morgan C, Dazzan P, Pilecka I, Reis Marques T, David AS, Morgan K, Fearon P, Doody GA, Jones PB, Murray RM, Reichenberg A. Cognitive Change in Schizophrenia and Other Psychoses in the Decade Following the First Episode. Am J Psychiatry 2019; 176:811-819. [PMID: 31256609 DOI: 10.1176/appi.ajp.2019.18091088] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Schizophrenia is associated with a marked cognitive impairment that is widely believed to remain stable after illness onset. Yet, to date, 10-year prospective studies of cognitive functioning following the first episode with good methodology are rare. The authors examined whether schizophrenia patients experience cognitive decline after the first episode, whether this decline is generalized or confined to individual neuropsychological functions, and whether decline is specific to schizophrenia. METHODS Participants were from a population-based case-control study of patients with first-episode psychosis who were followed prospectively up to 10 years after first admission. A neuropsychological battery was administered at index presentation and at follow-up to patients with a diagnosis of schizophrenia (N=65) or other psychoses (N=41) as well as to healthy comparison subjects (N=103). RESULTS The schizophrenia group exhibited declines in IQ and in measures of verbal knowledge and of memory, but not processing speed or executive functions. Processing speed and executive function impairments were already present at the first episode and remained stable thereafter. The magnitude of declines ranged between 0.28 and 0.66 standard deviations. Decline in measures of memory was not specific to schizophrenia and was also apparent in the group of patients with other psychoses. Healthy individuals with low IQ showed no evidence of decline, suggesting that a decline is specific to psychosis. CONCLUSIONS Patients with schizophrenia and other psychoses experience cognitive decline after illness onset, but the magnitude of decline varies across cognitive functions. Distinct mechanisms consequent to the illness and/or psychosocial factors may underlie impairments across different cognitive functions.
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Affiliation(s)
- Jolanta Zanelli
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Josephine Mollon
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Sven Sandin
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Craig Morgan
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Paola Dazzan
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Izabela Pilecka
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Tiago Reis Marques
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Anthony S David
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Kevin Morgan
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Paul Fearon
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Gillian A Doody
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Peter B Jones
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Robin M Murray
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
| | - Abraham Reichenberg
- The Department of Psychosis Studies (Zanelli, Dazzan, Pilecka, Reis Marques, David, Murray, Reichenberg) and the Department of Psychology (Pilecka), Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Harvard Medical School, Boston (Mollon); the Department of Psychiatry (Sandin, Reichenberg), the Department of Environmental Medicine and Public Health, and the Friedman Brain Institute (Reichenberg), Icahn School of Medicine at Mount Sinai, New York; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Sandin); the Centre for Public Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (C. Morgan); the Department of Psychology, University of Westminster, London (K. Morgan); the Department of Psychiatry, Trinity College, Dublin (Fearon); the Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, U.K. (Doody); and the Department of Psychiatry, University of Cambridge, Cambridge, U.K., and the Institute of Mental Health, University College London (Jones)
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18
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Zöller D, Sandini C, Karahanoğlu FI, Padula MC, Schaer M, Eliez S, Van De Ville D. Large-Scale Brain Network Dynamics Provide a Measure of Psychosis and Anxiety in 22q11.2 Deletion Syndrome. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:881-892. [DOI: 10.1016/j.bpsc.2019.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/06/2019] [Indexed: 12/21/2022]
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19
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Intelligence decline between present and premorbid IQ in schizophrenia: Schizophrenia Non-Affected Relative Project (SNARP). Eur Neuropsychopharmacol 2019; 29:653-661. [PMID: 30885440 DOI: 10.1016/j.euroneuro.2019.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 02/04/2019] [Accepted: 03/02/2019] [Indexed: 01/30/2023]
Abstract
Schizophrenia patients (SCZ) display widespread cognitive deficits that are strongly associated with functional outcomes. Cognitive impairments occur along a genetic continuum among SCZ, their unaffected first-degree relatives (FRs) and healthy controls (HCs). Although SCZ impairs the premorbid intelligence quotient (IQ) and causes a subsequent intelligence decline (ID), a decrease in present IQ from the premorbid level, it remains unclear when during the illness course these impairments develop. Differences in premorbid and present IQ and ID were investigated among 125 SCZ, 61 FRs and 107 HCs, using analysis of covariance and a paired t-test. Furthermore, these subjects were classified into preserved and deteriorated IQ groups based on the degree of ID, and we investigated which factors contribute to this classification. We found significant differences in premorbid and present IQ among the diagnostic groups. Compared with HCs, SCZ and FRs displayed lower premorbid and present IQ. There was no significant difference in premorbid IQ between SCZ and FRs, but SCZ had a significantly lower present IQ than FRs. Only SCZ showed a significant ID. As most FRs and HCs did not display an ID, there were fewer subjects with deteriorated IQ among FRs and HCs than among SCZ. Subjects with preserved IQ showed higher educational attainment than those with deteriorated IQ among SCZ and FRs. These findings suggest that the impairment of premorbid IQ and the ID in SCZ become evident before and around the time of onset, respectively, and different pathophysiological mechanisms might be related to these impairments.
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20
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Ohi K, Sumiyoshi C, Fujino H, Yasuda Y, Yamamori H, Fujimoto M, Shiino T, Sumiyoshi T, Hashimoto R. Genetic Overlap between General Cognitive Function and Schizophrenia: A Review of Cognitive GWASs. Int J Mol Sci 2018; 19:E3822. [PMID: 30513630 PMCID: PMC6320986 DOI: 10.3390/ijms19123822] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/25/2018] [Accepted: 11/26/2018] [Indexed: 11/17/2022] Open
Abstract
General cognitive (intelligence) function is substantially heritable, and is a major determinant of economic and health-related life outcomes. Cognitive impairments and intelligence decline are core features of schizophrenia which are evident before the onset of the illness. Genetic overlaps between cognitive impairments and the vulnerability for the illness have been suggested. Here, we review the literature on recent large-scale genome-wide association studies (GWASs) of general cognitive function and correlations between cognitive function and genetic susceptibility to schizophrenia. In the last decade, large-scale GWASs (n > 30,000) of general cognitive function and schizophrenia have demonstrated that substantial proportions of the heritability of the cognitive function and schizophrenia are explained by a polygenic component consisting of many common genetic variants with small effects. To date, GWASs have identified more than 100 loci linked to general cognitive function and 108 loci linked to schizophrenia. These genetic variants are mostly intronic or intergenic. Genes identified around these genetic variants are densely expressed in brain tissues. Schizophrenia-related genetic risks are consistently correlated with lower general cognitive function (rg = -0.20) and higher educational attainment (rg = 0.08). Cognitive functions are associated with many of the socioeconomic and health-related outcomes. Current treatment strategies largely fail to improve cognitive impairments of schizophrenia. Therefore, further study is needed to understand the molecular mechanisms underlying both cognition and schizophrenia.
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Affiliation(s)
- Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Uchinada, Ishikawa 920-0293, Japan.
- Medical Research Institute, Kanazawa Medical University, Ishikawa 920-0293, Japan.
| | - Chika Sumiyoshi
- Faculty of Human Development and Culture, Fukushima University, Fukushima 960-1296, Japan.
| | - Haruo Fujino
- Graduate School of Education, Oita University, Oita 870-1192, Japan.
| | - Yuka Yasuda
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan.
| | - Hidenaga Yamamori
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan.
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
| | - Tomoko Shiino
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan.
| | - Tomiki Sumiyoshi
- Department of Preventive Interventions for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8553, Japan.
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan.
- Osaka University, Suita, Osaka 565-0871, Japan.
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21
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Sheffield JM, Karcher NR, Barch DM. Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. Neuropsychol Rev 2018; 28:509-533. [PMID: 30343458 DOI: 10.1007/s11065-018-9388-2] [Citation(s) in RCA: 254] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/15/2018] [Indexed: 12/15/2022]
Abstract
Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with poorer functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.
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Affiliation(s)
- Julia M Sheffield
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Nashville, TN, 37212, USA.
| | - Nicole R Karcher
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
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22
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Narita Z, Noda T, Setoyama S, Sueyoshi K, Inagawa T, Sumiyoshi T. The effect of transcranial direct current stimulation on psychotic symptoms of schizophrenia is associated with oxy-hemoglobin concentrations in the brain as measured by near-infrared spectroscopy: A pilot study. J Psychiatr Res 2018; 103:5-9. [PMID: 29754106 DOI: 10.1016/j.jpsychires.2018.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/29/2018] [Accepted: 05/05/2018] [Indexed: 11/20/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been shown to be effective in treating some of the symptoms of schizophrenia. In the current study, we sought to determine whether oxy-hemoglobin ([oxy-Hb]), measured by near-infrared spectroscopy (NIRS), is associated with effects of transcranial direct current stimulation (tDCS) on psychotic symptoms of schizophrenia. Twenty-six patients underwent tDCS (2 mA × 20 min) two times per day for five consecutive days. The anodal electrode was placed over the left dorsolateral prefrontal cortex while the cathodal electrode was placed over the right supraorbital region. One month after the last administration of tDCS, positive, but not negative symptoms, evaluated by the Positive and Negative Syndrome Scale (PANSS), were significantly improved. At baseline, regional [oxy-Hb] concentrations in the brain were measured by a 52-channel NIRS instrument. Significant negative correlation was demonstrated between [oxy-Hb] concentrations of left temporoparietal regions throughout verbal fluency tasks vs. changes of PANSS Positive and Negative subscale scores. This is the first study to demonstrate the correlation between the response of neural activity to cognitive tasks at baseline and the ability of tDCS to improve positive and negative psychotic symptoms. Our observations suggest that NIRS provides a marker to predict the response to treatment with tDCS in schizophrenia.
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Affiliation(s)
- Zui Narita
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
| | - Takamasa Noda
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Shiori Setoyama
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Kazuki Sueyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Takuma Inagawa
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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23
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Sandini C, Zöller D, Scariati E, Padula MC, Schneider M, Schaer M, Van De Ville D, Eliez S. Development of Structural Covariance From Childhood to Adolescence: A Longitudinal Study in 22q11.2DS. Front Neurosci 2018; 12:327. [PMID: 29867336 PMCID: PMC5968113 DOI: 10.3389/fnins.2018.00327] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 04/26/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Schizophrenia is currently considered a neurodevelopmental disorder of connectivity. Still few studies have investigated how brain networks develop in children and adolescents who are at risk for developing psychosis. 22q11.2 Deletion Syndrome (22q11DS) offers a unique opportunity to investigate the pathogenesis of schizophrenia from a neurodevelopmental perspective. Structural covariance (SC) is a powerful approach to explore morphometric relations between brain regions that can furthermore detect biomarkers of psychosis, both in 22q11DS and in the general population. Methods: Here we implement a state-of-the-art sliding-window approach to characterize maturation of SC network architecture in a large longitudinal cohort of patients with 22q11DS (110 with 221 visits) and healthy controls (117 with 211 visits). We furthermore propose a new clustering-based approach to group regions according to trajectories of structural connectivity maturation. We correlate measures of SC with development of working memory, a core executive function that is highly affected in both idiopathic psychosis and 22q11DS. Finally, in 22q11DS we explore correlations between SC dysconnectivity and severity of internalizing psychopathology. Results: In HCs network architecture underwent a quadratic developmental trajectory maturing up to mid-adolescence. Late-childhood maturation was particularly evident for fronto-parietal cortices, while Default-Mode-Network-related regions showed a more protracted linear development. Working memory performance was positively correlated with network segregation and fronto-parietal connectivity. In 22q11DS, we demonstrate aberrant maturation of SC with disturbed architecture selectively emerging during adolescence and correlating more severe internalizing psychopathology. Patients also presented a lack of typical network development during late-childhood, that was particularly prominent for frontal connectivity. Conclusions: Our results suggest that SC maturation may underlie critical cognitive development occurring during late-childhood in healthy controls. Aberrant trajectories of SC maturation may reflect core developmental features of 22q11DS, including disturbed cognitive maturation during childhood and predisposition to internalizing psychopathology and psychosis during adolescence.
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Affiliation(s)
- Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Elisa Scariati
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Maria C Padula
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Neuroscience, Center for Contextual Psychiatry, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Marie Schaer
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Dimitri Van De Ville
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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24
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Abstract
Schizophrenia patients commonly exhibit substantial and diffuse cognitive impairment. Evidence suggests that subtle cognitive deficits are already apparent in childhood and adolescence, many years prior to onset of psychosis. While there is almost unequivocal evidence of some degree of cognitive impairment in individuals who later develop schizophrenia, the literature remains inconclusive regarding the exact nature of this impairment and warrants careful review and interpretation. Meta-analytic findings suggest that individuals who later develop schizophrenia, but not related disorders, such as bipolar disorder, exhibit a premorbid IQ deficit of around 8 points. Several studies have also found evidence for premorbid deficits across most cognitive domains, such as language, processing speed and executive functions. Longitudinal studies, although rare, suggest that individuals who go on to develop schizophrenia may show a course of increasing cognitive impairment prior to onset of psychosis. While evidence regarding the etiology of premorbid deficits is scarce, common and rare genetic variants, as well as environmental factors such as obstetric complications and cannabis use may play an important role and warrant further examination. In this selected review, we give an overview of population-based studies on premorbid cognitive deficits in schizophrenia, with a special focus on evidence regarding the specificity, profile and course of these deficits.
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Affiliation(s)
- J Mollon
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - A Reichenberg
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
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25
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Ohi K, Sumiyoshi C, Fujino H, Yasuda Y, Yamamori H, Fujimoto M, Sumiyoshi T, Hashimoto R. A Brief Assessment of Intelligence Decline in Schizophrenia As Represented by the Difference between Current and Premorbid Intellectual Quotient. Front Psychiatry 2017; 8:293. [PMID: 29312019 PMCID: PMC5743746 DOI: 10.3389/fpsyt.2017.00293] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/11/2017] [Indexed: 01/25/2023] Open
Abstract
Patients with schizophrenia elicit several clinical features, such as psychotic symptoms, cognitive impairment, and subtle decline of intelligence. The latter two features become evident around the onset of the illness, although they may exist even before the disease onset in a substantial proportion of cases. Here, we review the literature concerning intelligence decline (ID) during the progression of schizophrenia. ID can be estimated by comparing premorbid and current intellectual quotient (IQ) by means of the Adult Reading Test and Wechsler Adult Intelligence Scale (WAIS), respectively. For the purpose of brief assessment, we have recently developed the WAIS-Short Form, which consists of Similarities and Symbol Search and well reflects functional outcomes. According to the degree of ID, patients were classified into three distinct subgroups; deteriorated, preserved, and compromised groups. Patients who show deteriorated IQ (deteriorated group) elicit ID from a premorbid level (≥10-point difference between current and premorbid IQ), while patients who show preserved or compromised IQ do not show such decline (<10-point difference). Furthermore, the latter patients were divided into patients with preserved and compromised IQ based on an estimated premorbid IQ score >90 or below 90, respectively. We have recently shown the distribution of ID in a large cohort of schizophrenia patients. Consistent with previous studies, approximately 30% of schizophrenia patients had a decline of less than 10 points, i.e., normal intellectual performance. In contrast, approximately 70% of patients showed deterioration of IQ. These results indicate that there is a subgroup of schizophrenia patients who have mild or minimal intellectual deficits, following the onset of the disorder. Therefore, a careful assessment of ID is important in identifying appropriate interventions, including medications, cognitive remediation, and social/community services.
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Affiliation(s)
- Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Uchinada, Japan
| | - Chika Sumiyoshi
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
| | - Haruo Fujino
- Graduate School of Education, Oita University, Oita, Japan
| | - Yuka Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan
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Abstract
We review the changing conceptions of schizophrenia over the past 50 years as it became understood as a disorder of brain function and structure in which neurocognitive dysfunction was identified at different illness phases. The centrality of neurocognition has been recognized, especially because neurocognitive deficits are strongly related to social and role functioning in the illness, and as a result neurocognitive measures are used routinely in clinical assessment of individuals with schizophrenia. From the original definitions of the syndrome of schizophrenia in the early 20th century, impaired cognition, especially attention, was considered to be important. Neurocognitive impairments are found in the vast majority of individuals with schizophrenia, and they vary from mild, relatively restricted deficits, to dementia-like syndromes, as early as the first psychotic episode. Neurocognitive deficits are found in the premorbid phase in a substantial minority of pre-teenage youth who later develop schizophrenia, and they apparently worsen by the prodromal, high-risk phase in a majority of those who develop the illness. While there is limited evidence for reversibility of impairments from pharmacological interventions in schizophrenia, promising results have emerged from cognitive remediation studies. Thus, we expect cognitive interventions to play a larger role in schizophrenia in the coming years. Moreover, because youth at risk for schizophrenia can be identified by an emergent high-risk syndrome, earlier interventions might be applied in a pre-emptive way to reduce disability and improve adaptation. The notion of schizophrenia as a developmental neurocognitive disorder with stages opens up a window of possibilities for earlier interventions. (JINS, 2017, 23, 881-892).
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Fujino H, Sumiyoshi C, Yasuda Y, Yamamori H, Fujimoto M, Fukunaga M, Miura K, Takebayashi Y, Okada N, Isomura S, Kawano N, Toyomaki A, Kuga H, Isobe M, Oya K, Okahisa Y, Takaki M, Hashimoto N, Kato M, Onitsuka T, Ueno T, Ohnuma T, Kasai K, Ozaki N, Sumiyoshi T, Imura O, Hashimoto R. Estimated cognitive decline in patients with schizophrenia: A multicenter study. Psychiatry Clin Neurosci 2017; 71:294-300. [PMID: 27804186 DOI: 10.1111/pcn.12474] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/05/2016] [Accepted: 10/20/2016] [Indexed: 12/30/2022]
Abstract
AIM Studies have reported that cognitive decline occurs after the onset of schizophrenia despite heterogeneity in cognitive function among patients. The aim of this study was to investigate the degree of estimated cognitive decline in patients with schizophrenia by comparing estimated premorbid intellectual functioning and current intellectual functioning. METHODS A total of 446 patients with schizophrenia (228 male, 218 female), consisting of three sample sets obtained from 11 psychiatric facilities, and 686 healthy controls participated in this study. The Wechsler Adult Intelligence Scale-III (WAIS-III) was used to measure the participants' current full-scale IQ (FSIQ). The premorbid IQ was estimated using the Japanese Adult Reading Test-25. Estimated cognitive decline (difference score) was defined as the difference between the estimated premorbid IQ and the current FSIQ. RESULTS Patients with schizophrenia showed greater estimated cognitive decline, a lower FSIQ, and a lower premorbid IQ compared with the healthy controls. The mean difference score, FSIQ, and estimated premorbid IQ were -16.3, 84.2, and 100.5, respectively, in patients with schizophrenia. Furthermore, 39.7% of the patients had a difference score of 20 points or greater decline. A discriminant analysis showed that the difference score accurately predicted 81.6% of the patients and healthy controls. CONCLUSION These results show the distribution of difference score in patients with schizophrenia. These findings may contribute to assessing the severity of estimated cognitive decline and identifying patients with schizophrenia who suffer from cognitive decline.
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Affiliation(s)
- Haruo Fujino
- Graduate School of Human Sciences, Osaka University, Osaka, Japan.,Graduate School of Education, Oita University, Oita, Japan
| | - Chika Sumiyoshi
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
| | - Yuka Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - Kenichiro Miura
- Graduate School of Medicine, Department of Integrative Brain Science, Kyoto University, Kyoto, Japan
| | - Yuto Takebayashi
- Department of Psychiatry, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Naohiro Okada
- Graduate School of Medicine, Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
| | - Shuichi Isomura
- Graduate School of Medical Sciences, Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Naoko Kawano
- Green Mobility Research Institute, Institutes of Innovation for Future Society, Nagoya University, Aichi, Japan.,Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Atsuhito Toyomaki
- Graduate School of Medicine, Department of Psychiatry, Hokkaido University, Sapporo, Japan
| | - Hironori Kuga
- Graduate School of Medical Sciences, Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.,Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, Saga, Japan
| | - Masanori Isobe
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuto Oya
- Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan
| | - Yuko Okahisa
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Takaki
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naoki Hashimoto
- Graduate School of Medicine, Department of Psychiatry, Hokkaido University, Sapporo, Japan
| | - Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Toshiaki Onitsuka
- Graduate School of Medical Sciences, Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Takefumi Ueno
- Graduate School of Medical Sciences, Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.,Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, Saga, Japan
| | - Tohru Ohnuma
- Department of Psychiatry, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Kiyoto Kasai
- Graduate School of Medicine, Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan.,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
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Omi T, Ito H, Riku K, Kanai K, Takada H, Fujimi S, Matsunaga H, Ohi K. Possible factors influencing the duration of hospital stay in patients with psychiatric disorders attempting suicide by jumping. BMC Psychiatry 2017; 17:99. [PMID: 28320371 PMCID: PMC5359942 DOI: 10.1186/s12888-017-1267-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 03/11/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Patients with psychiatric disorders have a high rate of suicide. The present study investigated factors influencing hospital stays for Japanese patients with psychiatric disorders attempting suicide by jumping. METHODS We diagnosed all suicide attempts (n = 113) by jumping based on the International Classification of Diseases 10th Revision (ICD-10) and investigated the mean hospital stays of patients with each diagnosis based on the ICD-10 code. We then analyzed differences in the demographic and clinical characteristics between the diagnostic groups to identify factors influencing the duration of hospital stay. RESULTS Patients diagnosed with schizophrenia (F2 code) were the most frequent (32.7%) of all diagnoses; therefore, we divided the diagnostic groups into schizophrenia group (n = 37) and other psychiatric diagnoses group (n = 76). The patients with schizophrenia showed a significantly longer hospital stay (125.7 ± 63.9 days) compared with the patients with other psychiatric diagnoses (83.6 ± 63.2) (β ± SE = 42.1 ± 12.7, p = 0.0013), whereas there was no difference in the jump height between the two groups (the average was the 3rd to 4th floor; p > 0.05). The number of injured parts, particularly lower-limb fractures, was significantly higher (p = 0.017) in patients with schizophrenia than in patients with other psychiatric diagnoses. The duration of psychiatric treatment in patients with schizophrenia were significantly longer (z = 3.4, p = 0.001) than in patients with other psychiatric diagnoses. CONCLUSION Our findings indicate that the number of injuries and the body parts injured in patients with schizophrenia are associated with a longer duration of hospital stay following a suicide attempt by jumping. The current use of antipsychotics and a longer duration of taking antipsychotics might contribute to the risk of bone fracture via hyperprolactinemia. Further cognitive impairment in patients with schizophrenia might prevent rehabilitation for the management of lower-limb fractures. From these results, we suggest that clinicians should monitor the level of prolactin and cognitive function in patients with schizophrenia in future studies on managing of lower-limb fractures.
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Affiliation(s)
- Tsubasa Omi
- Department of Psychiatry, Osaka General Medical Center, Osaka, Japan.
| | - Hiroshi Ito
- Department of Emergency Medicine, Osaka General Medical Center, Osaka, Japan
| | - Keisen Riku
- Department of Psychiatry, Osaka General Medical Center, Osaka, Japan
| | - Koji Kanai
- Department of Psychiatry, Osaka General Medical Center, Osaka, Japan
| | - Hiromune Takada
- Department of Psychiatry, Osaka General Medical Center, Osaka, Japan
| | - Satoshi Fujimi
- Department of Emergency Medicine, Osaka General Medical Center, Osaka, Japan
| | | | - Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan.
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29
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Narita Z, Inagawa T, Sueyoshi K, Lin C, Sumiyoshi T. Possible Facilitative Effects of Repeated Anodal Transcranial Direct Current Stimulation on Functional Outcome 1 Month Later in Schizophrenia: An Open Trial. Front Psychiatry 2017; 8:184. [PMID: 29033856 PMCID: PMC5626815 DOI: 10.3389/fpsyt.2017.00184] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/11/2017] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED Recent research on neuromodulation techniques, such as transcranial direct current stimulation (tDCS), for the treatment of schizophrenia has mainly focused on psychotic symptoms. We aimed to determine whether repetitive tDCS is efficacious in improving determinants of outcome, such as cognitive function, daily living skills, and depressive mood in patients with schizophrenia. Twenty-eight patients underwent tDCS (2 mA × 20 min) two times per day for 5 consecutive days. The anodal electrode was placed over the left dorsolateral prefrontal cortex while the cathodal electrode was placed over the right supraorbital region. One month after the last stimulation, there was a significant improvement on cognitive function, measured by the brief assessment of cognition in schizophrenia (d = 0.49). Significant effects were also shown on daily living skills (functional capacity), measured by the UCSD performance-based skills assessment-brief (d = 0.70). Depressive symptoms, measured by the Calgary depression rating scale, as well as psychotic symptoms measured by on the positive and negative syndrome scale positive and general psychopathology subscales also responded to the treatment (d = 0.38, d = 0.48, and d = 0.50, respectively). This is the first study to suggest that tDCS with the anodal electrode on the left prefrontal cortex improves functional capacity and depressive symptoms in patients with schizophrenia. These results may add to the concept that tDCS provides a strategy to enhance functional outcomes in patients with schizophrenia. TRIAL REGISTRATION https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000018556, UMIN000015953.
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Affiliation(s)
- Zui Narita
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takuma Inagawa
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kazuki Sueyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Crystal Lin
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
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30
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Smith RC, Boules S, Mattiuz S, Youssef M, Tobe RH, Sershen H, Lajtha A, Nolan K, Amiaz R, Davis JM. Effects of transcranial direct current stimulation (tDCS) on cognition, symptoms, and smoking in schizophrenia: A randomized controlled study. Schizophr Res 2015; 168:260-6. [PMID: 26190299 DOI: 10.1016/j.schres.2015.06.011] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/10/2015] [Accepted: 06/12/2015] [Indexed: 12/11/2022]
Abstract
Schizophrenia is characterized by cognitive deficits which persist after acute symptoms have been treated or resolved. Transcranial direct current stimulation (tDCS) has been reported to improve cognition and reduce smoking craving in healthy subjects but has not been as carefully evaluated in a randomized controlled study for these effects in schizophrenia. We conducted a randomized double-blind, sham-controlled study of the effects of 5 sessions of tDCS (2 milliamps for 20minutes) on cognition, psychiatric symptoms, and smoking and cigarette craving in 37 outpatients with schizophrenia or schizoaffective disorder who were current smokers. Thirty subjects provided evaluable data on the MATRICS Consensus Cognitive Battery (MCCB), with the primary outcome measure, the MCCB Composite score. Active compared to sham tDCS subjects showed significant improvements after the fifth tDCS session in MCCB Composite score (p=0.008) and on the MCCB Working Memory (p=0.002) and Attention-Vigilance (p=0.027) domain scores, with large effect sizes. MCCB Composite and Working Memory domain scores remained significant at Benjamini-Hochberg corrected significance levels (α=0.05). There were no statistically significant effects on secondary outcome measures of psychiatric symptoms (PANSS scores), hallucinations, cigarette craving, or cigarettes smoked. The positive effects of tDCS on cognitive performance suggest a potential efficacious treatment for cognitive deficits in partially recovered chronic schizophrenia outpatients that should be further investigated.
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Affiliation(s)
- Robert C Smith
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states; Department of Psychiatry NYU Langone Medical Center, United States.
| | - Sylvia Boules
- Staten Island University Hospital, Staten Island, New York, United States.
| | - Sanela Mattiuz
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Mary Youssef
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Russell H Tobe
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Henry Sershen
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Abel Lajtha
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Karen Nolan
- Nathan S. Kline institute for Psychiatric Research, Orangeburg, New York, United states.
| | - Revital Amiaz
- Psychiatry Clinic, The Haim Sheba Medical Center, Affiliated to the Tel - Aviv University Sackler School of Medicine TEL-HASHOMER 52621, Israel.
| | - John M Davis
- University of Illinois College of Medicine Psychiatric Institute, Chicago, Illinois, United States.
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31
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Laurens KR, Luo L, Matheson SL, Carr VJ, Raudino A, Harris F, Green MJ. Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psychiatry 2015; 15:205. [PMID: 26302744 PMCID: PMC4548447 DOI: 10.1186/s12888-015-0562-2] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 07/14/2015] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Identifying the unique and shared premorbid indicators of risk for the schizophrenia spectrum disorders (SSD) and affective psychoses (AP) may refine aetiological hypotheses and inform the delivery of universal versus targeted preventive interventions. This systematic review synthesises the available evidence concerning developmental risk factors and antecedents of SSD and AP to identify those with the most robust support, and to highlight remaining evidence gaps. METHODS A systematic search of prospective birth, population, high-risk, and case-control cohorts was conducted in Medline and supplemented by hand searching, incorporating published studies in English with full text available. Inclusion/exclusion decisions and data extraction were completed in duplicate. Exposures included three categories of risk factors and four categories of antecedents, with case and comparison groups defined by adult psychiatric diagnosis. Effect sizes and prevalence rates were extracted, where available, and the strength of evidence synthesised and evaluated qualitatively across the study designs. RESULTS Of 1775 studies identified by the search, 127 provided data to the review. Individuals who develop SSD experience a diversity of subtle premorbid developmental deficits and risk exposures, spanning the prenatal period through early adolescence. Those of greatest magnitude (or observed most consistently) included obstetric complications, maternal illness during pregnancy (especially infections), other maternal physical factors, negative family emotional environment, psychopathology and psychotic symptoms, and cognitive and motor dysfunctions. Relatively less evidence has accumulated to implicate this diversity of exposures in AP, and many yet remain unexamined, with the most consistent or strongest evidence to date being for obstetric complications, psychopathology, cognitive indicators and motor dysfunction. Among the few investigations affording direct comparison between SSD and AP, larger effect sizes and a greater number of significant associations are commonly reported for SSD relative to AP. CONCLUSIONS Shared risk factors for SSD and AP may include obstetric complications, childhood psychopathology, cognitive markers and motor dysfunction, but the capacity to distinguish common versus distinct risk factors/antecedents for SSD and AP is limited by the scant availability of prospective data for AP, and inconsistency in replication. Further studies considering both diagnoses concurrently are needed. Nonetheless, the prevalence of the risk factors/antecedents observed in cases and controls helps demarcate potential targets for preventative interventions for these disorders.
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Affiliation(s)
- Kristin R. Laurens
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Luming Luo
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Sandra L. Matheson
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia
| | - Vaughan J. Carr
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Department of Psychiatry, Monash University, Melbourne, Australia
| | - Alessandra Raudino
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Felicity Harris
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia. .,Schizophrenia Research Institute, Sydney, Australia.
| | - Melissa J. Green
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia ,Schizophrenia Research Institute, Sydney, Australia ,Black Dog Institute, Prince of Wales Hospital, Sydney, Australia ,Neuroscience Research Australia, Sydney, Australia
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32
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Kobayashi H, Isohanni M, Jääskeläinen E, Miettunen J, Veijola J, Haapea M, Järvelin MR, Jones PB, Murray GK. Linking the developmental and degenerative theories of schizophrenia: association between infant development and adult cognitive decline. Schizophr Bull 2014; 40:1319-27. [PMID: 24583905 PMCID: PMC4193708 DOI: 10.1093/schbul/sbu010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neurodevelopmental and neurodegenerative theories may be viewed as incompatible accounts that compete to explain the pathogenesis of schizophrenia. However, it is possible that neurodevelopmental and neurodegenerative processes could both reflect common underlying causal mechanisms. We hypothesized that cognitive dysfunction would gradually deteriorate over time in schizophrenia and the degree of this deterioration in adulthood would be predicted by an infant measure of neurodevelopment. We aimed to examine the association between age of learning to stand in infancy and deterioration of cognitive function in adulthood. Participants were nonpsychotic control subjects (n = 76) and participants with schizophrenia (n = 36) drawn from the Northern Finland 1966 Birth Cohort study. The schizophrenia group showed greater deterioration in abstraction with memory than controls, but there were no differences between schizophrenia and controls in rate of change of other cognitive measures. Age of learning to stand in infancy significantly inversely predicted later deterioration of abstraction with memory in adult schizophrenia (later infant development linked to greater subsequent cognitive deterioration during adulthood), possibly suggesting a link between abnormal neurodevelopmental and neurodegenerative processes in schizophrenia.
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Affiliation(s)
- Hiroyuki Kobayashi
- Department of Psychiatry, University of Cambridge, Cambridge, UK;,Department of Neuropsychiatry, School of Medicine, Toho University, Tokyo, Japan
| | - Matti Isohanni
- Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Erika Jääskeläinen
- Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Juha Veijola
- Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Marianne Haapea
- Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC-HPA Centre for Environment and Health, Imperial College London, London, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK;,Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK,*To whom correspondence should be addressed; Department of Psychiatry, University of Cambridge, Box 189, Level 4, Addenbrooke’s Hospital Hills Road, Cambridge CB2 2QQ, UK; tel: +44-1223-764-678, fax: +44-1223-336-968, e-mail:
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33
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Doherty JL, Owen MJ. Genomic insights into the overlap between psychiatric disorders: implications for research and clinical practice. Genome Med 2014; 6:29. [PMID: 24944580 PMCID: PMC4062063 DOI: 10.1186/gm546] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Psychiatric disorders such as schizophrenia, bipolar disorder, major depressive disorder, attention-deficit/hyperactivity disorder and autism spectrum disorder are common and result in significant morbidity and mortality. Although currently classified into distinct disorder categories, they show clinical overlap and familial co-aggregation, and share genetic risk factors. Recent advances in psychiatric genomics have provided insight into the potential mechanisms underlying the overlap between these disorders, implicating genes involved in neurodevelopment, synaptic plasticity, learning and memory. Furthermore, evidence from copy number variant, exome sequencing and genome-wide association studies supports a gradient of neurodevelopmental psychopathology indexed by mutational load or mutational severity, and cognitive impairment. These findings have important implications for psychiatric research, highlighting the need for new approaches to stratifying patients for research. They also point the way for work aiming to advance our understanding of the pathways from genotype to clinical phenotype, which will be required in order to inform new classification systems and to develop novel therapeutic strategies.
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Affiliation(s)
- Joanne L Doherty
- The MRC Centre for Neuropsychiatric Genetics and Genomics and The Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Buildin, Maindy Road, Cardiff CF24 4HQ, UK
| | - Michael J Owen
- The MRC Centre for Neuropsychiatric Genetics and Genomics and The Neuroscience and Mental Health Research Institute, Cardiff University, Hadyn Ellis Buildin, Maindy Road, Cardiff CF24 4HQ, UK
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Meier MH, Caspi A, Reichenberg A, Keefe RS, Fisher H, Harrington H, Houts R, Poulton R, Moffitt T. Neuropsychological decline in schizophrenia from the premorbid to the postonset period: evidence from a population-representative longitudinal study. Am J Psychiatry 2014; 171:91-101. [PMID: 24030246 PMCID: PMC3947263 DOI: 10.1176/appi.ajp.2013.12111438] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Despite the widespread belief that neuropsychological decline is a cardinal feature of the progression from the premorbid stage to the chronic form of schizophrenia, few longitudinal studies have examined change in neuropsychological functioning from before to after illness onset. The authors examined whether neuropsychological decline is unique to schizophrenia, whether it is generalized or confined to particular mental functions, and whether individuals with schizophrenia also have cognitive problems in everyday life. METHOD Participants were members of a representative cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972 and 1973 and followed prospectively to age 38, with 95% retention. Assessment of IQ and specific neuropsychological functions was conducted at ages 7, 9, 11, and 13, and again at age 38. Informants also reported on any cognitive problems at age 38. RESULTS Individuals with schizophrenia exhibited declines in IQ and in a range of mental functions, particularly those tapping processing speed, learning, executive function, and motor function. There was little evidence of decline in verbal abilities or delayed memory, however, and the developmental progression of deficits in schizophrenia differed across mental functions. Processing speed deficits increased gradually from childhood to beyond the early teen years, whereas verbal deficits emerged early but remained static thereafter. Neuropsychological decline was specific to schizophrenia, as no evidence of decline was apparent among individuals with persistent depression, children with mild cognitive impairment, individuals matched on childhood risk factors for schizophrenia, and psychiatrically healthy individuals. Informants also noticed more cognitive problems in individuals with schizophrenia. CONCLUSIONS There is substantial neuropsychological decline in schizophrenia from the premorbid to the postonset period, but the extent and developmental progression of decline varies across mental functions. Findings suggest that different pathophysiological mechanisms may underlie deficits in different mental functions.
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Affiliation(s)
- Madeline H. Meier
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
,Duke Transdisciplinary Prevention Research Center, Center for Child and Family Policy, Duke University, Durham, NC, USA
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
,Duke Transdisciplinary Prevention Research Center, Center for Child and Family Policy, Duke University, Durham, NC, USA
,Institute for Genome Sciences × Policy, Duke University, Durham, NC, USA
,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
,Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, UK
| | - Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, UK
| | - Richard S.E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Helen Fisher
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, UK
| | - HonaLee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
,Institute for Genome Sciences × Policy, Duke University, Durham, NC, USA
,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Renate Houts
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
,Institute for Genome Sciences × Policy, Duke University, Durham, NC, USA
,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, School of Medicine, University of Otago, Dunedin, New Zealand
| | - Terrie Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
,Duke Transdisciplinary Prevention Research Center, Center for Child and Family Policy, Duke University, Durham, NC, USA
,Institute for Genome Sciences × Policy, Duke University, Durham, NC, USA
,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
,Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, UK
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Müller M, Vetter S, Weiser M, Frey F, Ajdacic-Gross V, Stieglitz RD, Rössler W. Precursors of cognitive impairments in psychotic disorders: a population-based study. Psychiatry Res 2013; 210:329-37. [PMID: 23876280 DOI: 10.1016/j.psychres.2013.05.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 05/21/2013] [Accepted: 05/27/2013] [Indexed: 11/30/2022]
Abstract
Cognitive deficits have been found to be more prevalent in psychotic than in other disorders. Longitudinal research has shown that these deficits were generally already existent before onset of illness and are therefore not necessarily attributable to neurodegenerative processes. This study investigated whether both low IQ and markers of premorbid cognitive dysfunction independently contribute to an increased risk for psychoses. In a cross-sectional study about 50,000 young Swiss males completed a survey of intellectual problems in childhood/adolescence and other vulnerability factors during military call-up in 2005/2006. Subsequently, military IQ assessments were carried out on the entire sample. Diagnostic assessments were conducted according to International Classification of Diseases-10th edition (ICD-10). Low, especially performance, IQ was highly associated with an increased risk for psychotic disorders after adjusting for preexisting cognitive deficits and covariates, while in other disorders this association was less marked. Furthermore, preexisting intellectual problems emerged as important risk factors for psychoses. Our results confirm the importance of low IQ as characteristic of psychoses. Although premorbid intellectual deficits are common in people who go on to develop psychosis, neurodegenerative disease processes may also precipitate further declines in fluid cognitive functions. Assessment of cognitive functioning should be taken into account in early detection of psychoses.
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Affiliation(s)
- Mario Müller
- Centre for Disaster and Military Psychiatry, University of Zurich, Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, Switzerland.
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Rodríguez-Sánchez JM, Ayesa-Arriola R, Pérez-Iglesias R, Periañez JA, Martinez-Garcia O, Gomez-Ruiz E, Tabares-Seisdedos R, Crespo-Facorro B. Course of cognitive deficits in first episode of non-affective psychosis: a 3-year follow-up study. Schizophr Res 2013; 150:121-8. [PMID: 23899999 DOI: 10.1016/j.schres.2013.06.042] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 06/01/2013] [Accepted: 06/29/2013] [Indexed: 10/26/2022]
Abstract
Cognitive dysfunctions are critical determinants of the quality of life and functionality in schizophrenia. Whether the cognitive deficits present at an early stage, are static or change across one's lifespan is still under debate. This study aims to investigate the long-term (3 years) course of cognitive deficits in a large and representative cohort of first episode schizophrenia spectrum patients (N=155),and evaluate their influence on disability. In addition, a healthy control sample (N=43) was also studied for comparison. This study evaluates the performance of patients and controls in a battery of cognitive assessments using baseline, 1-year and 3-year follow-up designs. The results show that, although cognitively outperformed by the controls at any time, the cognitive performance of the patients improved similar to the controls in all cognitive functions except verbal and visual memory. Even though the course of cognitive performance across the sample as a whole was stable, the subgroup of patients who experienced a cognitive decline had worse functionality and lesser amelioration of negative symptoms. Overall, there is no significant deterioration in the cognitive function in a group of first episode schizophrenia spectrum disorder patients, with the possible exception of tasks that were associated with episodic memory. However, patients whose cognitive performance demonstrated a declining trend may present with a poorer progression in terms of clinical and disability variables.
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Affiliation(s)
- José Manuel Rodríguez-Sánchez
- University Hospital Marqués de Valdecilla, IFIMAV, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.
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Ernst Nielsen R, Haugaard C, Olrik Wallenstein Jensen S, Munk-Jørgensen P, Østergaard Christensen T. Prediction of patient contacts by cognition in schizophrenia. Aust N Z J Psychiatry 2013; 47:637-45. [PMID: 23574875 DOI: 10.1177/0004867413484093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the correlations between cognitive function and clinical outcome variables. METHOD Patients diagnosed for the first time with schizophrenia between January 2004 and June 2010 were cognitively tested in conjunction with diagnostic procedures. Cognitive test data were connected to Danish healthcare registers and patients were followed in the registers from their first contact with psychiatric in- and outpatient care until October 2011. RESULTS Patients had impaired attention, processing speed and executive function as measured by Trail Making Test part B; their executive functions, as measured by the Wisconsin Card Sorting Test (WCST), and working memory, as measured by Rigshospitalet's digit span test, were unaffected as compared to norms. The admission rate, from schizophrenia diagnosis to the end of the study, was predicted by Trail Making Test part A, Rey's Auditory Verbal Learning Test (RAVLT), RAVLT (total learning), RAVLT (memory), d2 Test of Attention (total) and d2 type 2 error (error of commission), independent of gender, age and schizophrenia subtype. The length of hospitalization after the schizophrenia diagnosis was mainly determined by the schizophrenia subtype (schizophrenia simplex: incidence rate ratio (IRR) 0.24; 95% confidence interval (CI) 0.15-0.40, p < 0.001). Diagnosis was secondarily determined by deficits in attention and executive function, Trail Making Test part B, d2 Test of Attention (total), d2 type 1 error (error of omission), d2 type 2 error, and also by age and substance use disorder. The outpatient contact rate from schizophrenia diagnosis to the end of the study was predicted by d2 Test of Attention, Trail Making Test part A, and d2 type 2 error. The annual rate of criminal conviction, institutionalization and social retirement pension was mainly predicted by substance misuse. CONCLUSION Cognitive function only predicted hospitalization and outpatient contacts to a minor degree in a cohort of newly diagnosed patients with schizophrenia.
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Affiliation(s)
- René Ernst Nielsen
- Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Aalborg, Denmark.
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Freedman D, Bao Y, Kremen WS, Vinogradov S, McKeague IW, Brown AS. Birth weight and neurocognition in schizophrenia spectrum disorders. Schizophr Bull 2013; 39:592-600. [PMID: 22378899 PMCID: PMC3627778 DOI: 10.1093/schbul/sbs008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Low birth weight is associated with both schizophrenia and neurocognitive impairment. Yet, to our knowledge, no previous study has examined the relationship between lower birth weight and neurocognitive deficits in schizophrenia spectrum disorders (SSD). In this preliminary study, we investigated the relationship using a broad neuropsychological battery in cases with SSD and matched control subjects. The sample consisted of all subjects in the Developmental Insult and Brain Anomaly in Schizophrenia study, a nested case-control investigation developed from a large birth cohort, which followed subjects longitudinally. Case ascertainment was based on computerized record linkages between the birth cohort members and the Kaiser Permanente Medical Care Plan, and all diagnoses were confirmed by consensus diagnosis following the Diagnostic Interview for Genetic Studies. Lower birth weight was associated with impairment in executive function, working memory, generalized intellectual function, and neuromotor function in cases with SSD but not in control subjects. No deficits were observed in verbal memory for either group. These results support the hypothesis that lower birth weight plays a role in neuropsychological disruptions in SSD and that the antecedents of lower birth weight may have a greater impact on these disruptions in SSD than in controls. These data may facilitate a better understanding of the etiopathogenesis of the cognitive underpinnings of SSD.
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Affiliation(s)
- David Freedman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, 7th Floor, New York, NY 10032, USA.
| | - Yuanyuan Bao
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, New York, NY
| | - William S. Kremen
- Department of Psychiatry, Center for Behavioral Genomics, University of California, San Diego, CA,VA San Diego Healthcare System, La Jolla, CA
| | - Sophia Vinogradov
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Ian W. McKeague
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Alan S. Brown
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, 7th Floor, New York, NY 10032,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, New York, NY
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Maziade M, Rouleau N, Cellard C, Battaglia M, Paccalet T, Moreau I, Gagnon V, Gingras N, Marino C, Gilbert E, Roy MA, Mérette C. Young offspring at genetic risk of adult psychoses: the form of the trajectory of IQ or memory may orient to the right dysfunction at the right time. PLoS One 2011; 6:e19153. [PMID: 21559460 PMCID: PMC3084759 DOI: 10.1371/journal.pone.0019153] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 03/18/2011] [Indexed: 02/04/2023] Open
Abstract
Objective Neurocognitive dysfunctions analogous to those of adult patients have been detected in children at risk of schizophrenia and bipolar disorder. This led to the following developmental question: Do IQ and memory impairments exhibit different developmental courses from childhood to young adulthood in terms of stability or fluctuations? Methods In a high risk sample, we used a step by step sampling approach to narrow-down the early disease mechanisms. Upstream, we started with a 20-year follow-up of 48 densely affected multigenerational kindreds, including 1500 clinically characterized adult members. We then identified 400 adult members affected by a DSM-IV schizophrenia or bipolar disorder. Downstream, we finally focused on 65 offspring (of an affected parent) aged 7 to 22, who were administered a neuropsychological battery. We then constructed cross-sectional trajectories that were compared to those of controls. Results The childhood IQ deficit displayed a stability until young adulthood. The delay in visual memory exhibited a non-linear two-stage trajectory: a lagging period during childhood followed by a recuperation period from adolescence until adulthood, as supported by a significant Group x Age Periods interaction. No data suggested deterioration between 7 and 22. Conclusion In these offspring at genetic risk, the developmental trajectory of global IQ impairment may not apply to specific domains of cognition such as episodic memory. Different cognitive dysfunctions would mark different developmental courses. The shape of the trajectories might itself have a meaning and provide empirical leads for targeting the right dysfunction at the right time in future prevention research.
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Affiliation(s)
- Michel Maziade
- Laval University and Centre de Recherche Université Laval Robert-Giffard, Laval, Québec, Canada.
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Abstract
How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world's population. After a century of studying schizophrenia, the cause of the disorder remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current unsatisfactory outcomes may change as we approach schizophrenia as a neurodevelopmental disorder with psychosis as a late, potentially preventable stage of the illness. This 'rethinking' of schizophrenia as a neurodevelopmental disorder, which is profoundly different from the way we have seen this illness for the past century, yields new hope for prevention and cure over the next two decades.
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Bespalova IN, Durner M, Ritter BP, Angelo GW, Rossy-Fullana E, Carrion-Baralt J, Schmeidler J, Silverman JM. Non-synonymous variants in the AMACR gene are associated with schizophrenia. Schizophr Res 2010; 124:208-15. [PMID: 20875727 PMCID: PMC2981684 DOI: 10.1016/j.schres.2010.08.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 08/24/2010] [Accepted: 08/31/2010] [Indexed: 11/15/2022]
Abstract
BACKGROUND The AMACR gene is located in the schizophrenia susceptibility locus on chromosome 5p13, previously identified in a large Puerto Rican pedigree of Spanish origin. The AMACR-encoded protein is an enzyme involved in the metabolism of branched-chain fatty and bile acids. The enzyme deficiency causes structural and functional brain changes, and disturbances in fatty acid and oxidative phosphorylation pathways observed in individuals with schizophrenia. Therefore, AMACR is both a positional and functional candidate gene for susceptibility to schizophrenia. METHODS The study had a two-step design: we performed mutation analysis of the coding and flanking regions of AMACR in affected members of the pedigree, and tested the detected sequence variants for association with schizophrenia in a Puerto Rican case-control sample (n=383) of Spanish descent. RESULTS AND CONCLUSION We identified three missense variants segregating with the disorder in the family, rs2278008, rs2287939 and rs10941112. Two of them, rs2278008 and rs2287939, demonstrated significant differences in genotype (P = 4 × 10-4, P = 4 × 10-4) and allele (P = 1 × 10-4, P = 9.5 × 10-5) frequencies in unrelated male patients compare to controls, with the odds ratios (OR) 2.24 (95% CI: 1.48-3.40) and 2.25 (95% CI: 1.49-3.38), respectively. The G-C-G haplotype of rs2278008-rs2287939-rs10941112 revealed the most significant association with schizophrenia (P = 4.25 × 10-6, OR = 2.96; 95% CI: 1.85-4.76) in male subjects. There were no statistically significant differences in genotype, allele, and haplotype frequencies between female schizophrenia subjects and controls. Our results suggest that AMACR may play a significant role in susceptibility to schizophrenia in male patients.
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Affiliation(s)
- Irina N Bespalova
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Freedman D, Brown AS. The developmental course of executive functioning in schizophrenia. Int J Dev Neurosci 2010; 29:237-43. [PMID: 21111039 DOI: 10.1016/j.ijdevneu.2010.11.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 11/15/2010] [Accepted: 11/15/2010] [Indexed: 11/18/2022] Open
Abstract
Executive dysfunction is a core feature of schizophrenia, but our understanding of the developmental course of this neuropsychological domain in the disease remains largely unexplored. A review of the research evidence points to a number of persistent debates about the course of executive functioning and its relation to illness course. A better understanding of the neurocognitive trajectories of executive functioning in schizophrenia could help identify the risk and modifying factors that influence the onset, severity and course of disease, and the chance to re-direct or re-shape that course and improve outcomes. To accomplish this requires assessment of the diverse and integrated nature of those abilities, and the changes over time in those abilities requires multiple instruments and techniques in order to improve the research methods and understanding of an important area of impairment in schizophrenia.
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Affiliation(s)
- David Freedman
- Department of Epidemiology, Mailman School of Public Health of Columbia University, New York, NY 10032, USA.
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