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Colizzi M, Bortoletto R, Antolini G, Bhattacharyya S, Balestrieri M, Solmi M. Biobehavioral Interactions between Endocannabinoid and Hypothalamicpituitary- adrenal Systems in Psychosis: A Systematic Review. Curr Neuropharmacol 2024; 22:495-520. [PMID: 37533248 PMCID: PMC10845076 DOI: 10.2174/1570159x21666230801150032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The diathesis-stress paradigm and the cannabinoid-hypothesis have been proposed as possible pathophysiological models of schizophrenia. However, they have historically been studied independently of each other. OBJECTIVE This PRISMA 2020-compliant systematic review aimed at reappraising the interplay between the hypothalamic-pituitary-adrenal (HPA) axis and the endocannabinoid (eCB) system in psychosis- spectrum disorder risk and outcome. METHODS All pathophysiological and outcome clinical studies, concomitantly evaluating the two systems in psychosis-spectrum disorder risk and different stages of illness, were gathered from electronic databases (Pubmed, Web of Science, and Scopus), and discussed. RESULTS 41 eligible outputs were extracted, focusing on at least a biological measure (9 HPA-related studies: 4 eCB-interventional, 1 HPA-interventional, 1 both HPA-interventional and non-interventional, 3 non-interventional; 2 eCB-related studies: non-interventional), environmental measures only (29 studies: 1 eCB- interventional, 28 non-interventional), and genetic measures (1 study: non-interventional). Independent contributions of aberrancies in the two systems to the physiopathology and outcome of psychosis were confirmed. Also, concomitant alterations in the two systems, either genetically defined (e.g., CNR1 genetic variation), biologically determined (e.g., dysfunctional HPA axis or endocannabinoid signaling), or behaviorally imputed (e.g., cannabis use, stress exposure, and response), were consistently reported in psychosis. Further, a complex biobehavioral perturbation was revealed not only within each system (e.g., cannabis use affecting the eCB tone, stress exposure affecting the HPA axis), but also across the two systems (e.g., THC affecting the HPA axis, childhood trauma affecting the endocannabinoid signaling). CONCLUSION There is a need to concomitantly study the two systems' mechanistic contribution to psychosis in order to establish more refined biological relevance.
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Affiliation(s)
- Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine 33100, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Riccardo Bortoletto
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine 33100, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Giulia Antolini
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Verona 37126, Italy
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine 33100, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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Bortoletto R, Bassani L, Garzitto M, Lamberti M, Simonati A, Darra F, Bhattacharyya S, Comacchio C, Balestrieri M, Arcangeli D, Colizzi M. Risk of psychosis in autism spectrum disorder individuals exposed to psychosocial stressors: A 9-year chart review study. Autism Res 2023; 16:2139-2149. [PMID: 37929657 DOI: 10.1002/aur.3042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
Psychosocial stressors have been suggested to precipitate psychotic episodes in patients with pre-existing psychosis and otherwise healthy subjects. However, such a risk has never been formally investigated in individuals with autism spectrum disorder (ASD). Sixty-nine autistic adolescents hospitalized for psychotic/manic symptoms (PSY) and other mental health issues (NPSY) over a 9-year period were compared with reference to their previous exposure to psychosocial stressors. ASD diagnoses satisfied the International Classification of Diseases (ICD)-10 criteria. Psychotic/manic symptom assessment followed the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Psychosocial stressor exposure was collected separately at each admission. Preliminarily, univariate between-group comparisons were conducted. Then, a binomial model was adopted to investigate associations with previous exposure to psychosocial stressors. Results were reported with a change in AIC (ΔAIC). PSY patients presented with higher previous exposure to adverse life events (30.43% vs. 6.52%, OR = 6.079 [1.209, 40.926], p = 0.013) and school/work difficulties (30.43% vs. 8.70%, OR = 4.478 [0.984, 23.846], p = 0.034) than NPSY ones. Admissions for psychotic/manic symptoms occurred more likely in the context of family disturbances (OR = 2.275 [1.045, 5.045], p = 0.030) and adverse life events (OR = 3.489 [1.194, 11.161], p = 0.014). The fitted binomial model was found to be significant compared to the random effects model (ΔAIC = -1.962; χ2 10 = 21.96, p = 0.015), with the risk of presenting psychotic/manic symptoms being increased by family disturbances (z = +4.118) and school/work difficulties (z = +2.455). The results suggest a potential psychosis-inducing effect of psychosocial stressors in ASD, which has clinical and policy implications.
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Affiliation(s)
- Riccardo Bortoletto
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Lorenzo Bassani
- Department of Child and Adolescent Psychiatry, Hospital of Merano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medizinischen Privatuniversität (PMU), Merano-Meran, Italy
| | - Marco Garzitto
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Marco Lamberti
- Department of Child and Adolescent Psychiatry, Hospital of Merano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medizinischen Privatuniversität (PMU), Merano-Meran, Italy
| | - Alessandro Simonati
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Francesca Darra
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Carla Comacchio
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Donatella Arcangeli
- Department of Child and Adolescent Psychiatry, Hospital of Merano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medizinischen Privatuniversität (PMU), Merano-Meran, Italy
| | - Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Gong J, Zhang T, Zhou L, Mo Y, Yu F, Liu M, Yang L, Liu J. Gender divergent effect of COMT gene rs4680 polymorphism on the association between executive dysfunction and psychotic-like experiences. Behav Brain Res 2023; 439:114215. [PMID: 36372244 DOI: 10.1016/j.bbr.2022.114215] [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: 01/29/2021] [Revised: 09/29/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
AIM Premorbid cognitive impairments are observed prior to the onset of schizophrenia. Catechol-O-methyltransferase (COMT) rs4680 is associated with psychosis and plays a crucial role in the development of the executive function. In addition, genetic COMT variations and gender affect its enzymatic activity. Therefore, the aim of this study was to evaluate the impact of COMT rs4680 on the relationship between executive dysfunction and psychotic-like experiences (PLEs) in college students, with the additional investigation of the gender difference. METHODS A total of 463 students provided biological samples for DNA analysis and the COMT gene rs4680 polymorphism was discriminated by the improved multiplex ligase detection reaction method. They also completed the Prodromal Questionnaire and the Dysexecutive Questionnaire. RESULTS Executive dysfunction significantly predicted positive PLEs in the total, male and female population (β = 0.515, 0.508 and 0.512, p < 0.001). The results of moderated analysis revealed that COMT rs4680 recessive genetic model ('AA genotype' versus 'G carrier') moderated the relationship between executive dysfunction and psychotic-like experience in the total and females (p = 0.002 and p <0.001, respectively), but not in males. CONCLUSION These findings revealed a female-specific effect of COMT rs4680 on the relationship between executive dysfunction and PLEs in young adults.
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Affiliation(s)
- Jingbo Gong
- Shanghai Changning Mental Health Center, Shanghai 200335, China; Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Tingting Zhang
- Department of Student Affairs, Hunan University of Technology, Zhuzhou, Hunan, China
| | - Lihua Zhou
- College of Education Science, Hengyang Normal University, Hengyang, Hunan, China
| | - Yanzi Mo
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Feifei Yu
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Min Liu
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Luobin Yang
- Department of Applied Psychology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen Institute of Mental Health, Shenzhen Key Laboratory of Mental Health, Shenzhen, China.
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Theorizing the Role of Dopaminergic Polymorphic Risk Alleles with Intermittent Explosive Disorder (IED), Violent/Aggressive Behavior and Addiction: Justification of Genetic Addiction Risk Severity (GARS) Testing. J Pers Med 2022; 12:jpm12121946. [PMID: 36556167 PMCID: PMC9784939 DOI: 10.3390/jpm12121946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 11/25/2022] Open
Abstract
Scientific studies have provided evidence that there is a relationship between violent and aggressive behaviors and addictions. Genes involved with the reward system, specifically the brain reward cascade (BRC), appear to be associated with various addictions and impulsive, aggressive, and violent behaviors. In our previous research, we examined the Taq A1 allele (variant D2 dopamine receptor gene) and the DAT-40 base repeat (a variant of the dopamine transporter gene) in 11 Caucasian boys at the Brown School in San Marcus, Texas, diagnosed with intermittent explosive disorder. Thirty supernormal controls were screened to exclude several reward-deficit behaviors, including pathological violence, and genotyped for the DRD2 gene. Additionally, 91 controls were screened to exclude ADHD, pathological violence, alcoholism, drug dependence, and tobacco abuse, and their results were compared with DAT1 genotype results. In the schoolboys vs. supercontrols, there was a significant association with the D2 variant and a trend with the dopamine transporter variant. Results support our hypothesis and the involvement of at least two gene risk alleles with adolescent violent/aggressive behaviors. This study and the research presented in this paper suggest that violent/aggressive behaviors are associated with a greater risk of addiction, mediated via various genes linked to the BRC. This review provides a contributory analysis of how gene polymorphisms, especially those related to the brain reward circuitry, are associated with violent behaviors.
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Carvalho C, Vieira-Coelho MA. Cannabis induced psychosis: a systematic review on the role of genetic polymorphisms. Pharmacol Res 2022; 181:106258. [PMID: 35588917 DOI: 10.1016/j.phrs.2022.106258] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/22/2022] [Accepted: 05/10/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Cannabis sativa is a recreational drug commonly consumed in Europe and is getting popularity for both recreational and therapeutic use. In some individuals, the use of cannabis leads to psychotic disorders. This systematic review summarizes the current evidence linking genetic polymorphisms and inter-individual susceptibility to psychosis induced by cannabis. METHOD Studies published from 2005 to 2020 were identified through Medline using PubMed, Web of Science and Scopus database and searches were conducted according to PRISMA guidelines. Initial search was performed with terms: "cannabis induced psychosis" AND "genetics". RESULTS From the initial group of 108 papers, 18 studies met our inclusion criteria. Many of the findings revealed associations with genetic polymorphisms modulations of genes involved directly (COMT, DRD2 and DAT) or indirectly (AKT1) to dopamine pathways. The most consistent finding was with COMT rs4680, where the presence of the Val allele was associated with a higher risk for cannabis-induced psychosis. This higher susceptibility was also reported for AKT1 (rs2494732) with the CC genotype. Of note, the only genome-wide association study identified a significant signal close to the cholinergic receptor muscarinic 3 represented by rs115455482 and rs74722579 predisposing to cannabis-induced hallucinations and remarkably no dopaminergic target was found. CONCLUSION Actual evidence supports the role of dopamine in cannabis induced psychosis. However, most of genetic polymorphism studies have as a starting point the pre-existing dopaminergic theoretical basis for psychosis. This alerts to the importance of more broad genetic studies. Integrate genetic results into biological systems may enhance our knowledge of cannabis induced psychosis and could help in the prevention and treatment of these patients.
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Affiliation(s)
- Cláudia Carvalho
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Maria A Vieira-Coelho
- Department of Biomedicine - Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Psychiatry and Mental Health, University Hospital Center of São João, Porto, Portugal.
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Childhood traumatic events and the dopaminergic theory of psychosis: A mini-review of studies investigating gene – environment interactions. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02650-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract
There is great body of evidence showing a relationship between childhood adversity and psychosis onset. Genetic factors moderate the association between childhood adversity and psychosis risk potentially by influencing biological and/or psychological reaction following exposure to adversity. In this review, we discuss studies identifying the specific genetic variants known to affect dopamine levels involved in this interaction. Our review shows that the catechol-O-methyltransferase (COMT), dopamine D2 receptor (DRD2), AKT1 gene play a key role in mediating the relationship between childhood adversity and development of psychosis. We have also found conflicting findings on the impact of dopamine genes on the relationship between childhood adversity and development of psychosis, suggesting that other genetic and environmental factors should be taken into account. We here discuss the implications of our findings and future directions.
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Gerra ML, Gerra MC, Tadonio L, Pellegrini P, Marchesi C, Mattfeld E, Gerra G, Ossola P. Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement. Neurosci Biobehav Rev 2021; 131:560-580. [PMID: 34606823 DOI: 10.1016/j.neubiorev.2021.09.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 12/19/2022]
Abstract
This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.
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Affiliation(s)
| | - Maria Carla Gerra
- Center for Neuroplasticity and Pain (CNAP), SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | | | | | - Carlo Marchesi
- Psychiatry Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Elizabeth Mattfeld
- Drug Prevention and Health Branch, Prevention Treatment and Rehabilitation Section, United Nations Office on Drugs and Crime, Vienna, Austria.
| | - Gilberto Gerra
- Department of Mental Health, AUSL of Parma, Parma, Italy.
| | - Paolo Ossola
- Center for Neuroplasticity and Pain (CNAP), SMI®, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
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Robinson N, Bergen SE. Environmental Risk Factors for Schizophrenia and Bipolar Disorder and Their Relationship to Genetic Risk: Current Knowledge and Future Directions. Front Genet 2021; 12:686666. [PMID: 34262598 PMCID: PMC8273311 DOI: 10.3389/fgene.2021.686666] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/20/2021] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia (SZ) and bipolar disorder (BD) are severe psychiatric disorders which result from complex interplay between genetic and environmental factors. It is well-established that they are highly heritable disorders, and considerable progress has been made identifying their shared and distinct genetic risk factors. However, the 15-40% of risk that is derived from environmental sources is less definitively known. Environmental factors that have been repeatedly investigated and often associated with SZ include: obstetric complications, infections, winter or spring birth, migration, urban living, childhood adversity, and cannabis use. There is evidence that childhood adversity and some types of infections are also associated with BD. Evidence for other risk factors in BD is weaker due to fewer studies and often smaller sample sizes. Relatively few environmental exposures have ever been examined for SZ or BD, and additional ones likely remain to be discovered. A complete picture of how genetic and environmental risk factors confer risk for these disorders requires an understanding of how they interact. Early gene-by-environment interaction studies for both SZ and BD often involved candidate genes and were underpowered. Larger samples with genome-wide data and polygenic risk scores now offer enhanced prospects to reveal genetic interactions with environmental exposures that contribute to risk for these disorders. Overall, although some environmental risk factors have been identified for SZ, few have been for BD, and the extent to which these account for the total risk from environmental sources remains unknown. For both disorders, interactions between genetic and environmental risk factors are also not well understood and merit further investigation. Questions remain regarding the mechanisms by which risk factors exert their effects, and the ways in which environmental factors differ by sex. Concurrent investigations of environmental and genetic risk factors in SZ and BD are needed as we work toward a more comprehensive understanding of the ways in which these disorders arise.
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Affiliation(s)
| | - Sarah E. Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Wei W, Lin Y, Hong T, Team GR, Luo S. Maternal rearing styles and loneliness: The moderating role of the COMT Val158Met polymorphism. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01639-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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10
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Tian T, Li J, Zhang G, Wang J, Liu D, Wan C, Fang J, Wu D, Zhou Y, Zhu W. Effects of childhood trauma experience and COMT Val158Met polymorphism on brain connectivity in a multimodal MRI study. Brain Behav 2020; 10:e01858. [PMID: 32997444 PMCID: PMC7749512 DOI: 10.1002/brb3.1858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 01/22/2023] Open
Abstract
Childhood adversity may act as a stressor to produce a cascade of neurobiological effects that irreversibly alter neural development, setting the stage for developing psychopathology in adulthood. The catechol-O-methyltransferase (COMT) Val158Met polymorphism has received much attention as a candidate gene associated with environmental adversity, modifying risk for psychopathology. In this study, we aim to see how gene × brain × environment models give a more integrative understanding of brain modifications that contribute to predicting psychopathology related to childhood adversity. A large nonclinical sample of young adults completed Childhood Trauma Questionnaire (CTQ), behavioral scores, multimodal magnetic resonance imaging (MRI) scans, and genotyping. We utilized graph-based connectivity analysis in morphometric similarity mapping and resting-state functional MRI to investigate brain alterations. Relationships among COMT genotypes, CTQ score, imaging phenotypes, and behavioral scores were identified by multiple regression and mediation effect analysis. Significant main effect of CTQ score was found in anatomic connectivity of orbitofrontal cortex that was an outstanding mediator supporting the relationship between CTQ score and anxiety/harm-avoiding personality. We also noted the main effect of childhood trauma on reorganization of functional connectivity within the language network. Additionally, we found genotype × CTQ score interactions on functional connectivity of the right frontoparietal network as well as anatomic connectivity of motor and limbic regions. Our data demonstrate childhood adversity and COMT genotypes are associated with abnormal brain connectivity, structurally and functionally. Early identification of individuals at risk, assessment of brain abnormality, and cognitive interventions may help to prevent or limit negative outcomes.
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Affiliation(s)
- Tian Tian
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guiling Zhang
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dong Liu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changhua Wan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jicheng Fang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Di Wu
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiran Zhou
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sideli L, Murray RM, Schimmenti A, Corso M, La Barbera D, Trotta A, Fisher HL. Childhood adversity and psychosis: a systematic review of bio-psycho-social mediators and moderators. Psychol Med 2020; 50:1761-1782. [PMID: 32624020 DOI: 10.1017/s0033291720002172] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The association between childhood adversity (CA) and psychosis has been extensively investigated in recent years. An increasing body of research has also focused on the mediating or moderating role of biological and psychological mechanisms, as well as other risk factors that might account for the link between CA and psychosis. We conducted a systematic search of the PsychINFO, Embase, Ovid, and Web of Science databases for original articles investigating the role of genetic vulnerabilities, environmental factors, psychological and psychopathological mechanisms in the association between CA and psychosis up to August 2019. We included studies with individuals at different stages of the psychosis continuum, from subclinical psychotic experiences to diagnosed disorders. From the 28 944 records identified, a total of 121 studies were included in this review. Only 26% of the studies identified met the criteria for methodological robustness. Overall, the current evidence suggests that CA may be associated with psychosis largely independently of genetic vulnerabilities. More consistent and robust evidence supports interaction between early and recent adversities, as well as the mediating role of attachment and mood symptoms, which is suggestive of an affective pathway between CA and psychosis across the continuum from subclinical experiences to diagnosable disorder. This review highlighted numerous methodological issues with the existing literature, including selection bias, heterogeneity of measurement instruments utilised, and lack of control for potential confounders. Future research should address these limitations to more accurately estimate mediation and moderation effects on the CA-psychosis association to inform the development of preventive interventions.
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Affiliation(s)
- Lucia Sideli
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy
| | - Robin M Murray
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy
| | | | - Mariangela Corso
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Italy
| | - Antonella Trotta
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Tony Hillis Unit, South London and Maudsley NHS Foundation Trust, London, UK
| | - Helen L Fisher
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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12
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Ragazzi TCC, Shuhama R, Sinval J, Marôco J, Corsi-Zuelli F, Roza DLD, van Os J, Menezes PR, Del-Ben CM. Validation of the Portuguese version of the Community Assessment of Psychic Experiences and characterization of psychotic experiences in a Brazilian sample. ACTA ACUST UNITED AC 2020; 42:389-397. [PMID: 32130403 PMCID: PMC7430378 DOI: 10.1590/1516-4446-2019-0611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/05/2019] [Indexed: 11/24/2022]
Abstract
Objective: We investigated: i) the reliability and validity of a Brazilian version of the Community Assessment of Psychic Experiences (CAPE), developed to detect and characterize psychotic experiences in the general population; and ii) the association between psychotic experiences, childhood adversity, and cannabis use in a population-based sample. Methods: We performed factorial analyses and generalized linear models with CAPE scores as the dependent variable in a sample composed of 217 first-episode psychosis patients, 104 unaffected biological siblings, and 319 non-psychotic population-based participants. Results: After removing seven items from its positive dimension and two items from its negative dimension, a 33-item Brazilian version of the CAPE showed acceptable adjustment indices (confirmatory fit index = 0.895; goodness of fit index = 0.822; parsimony goodness of fit index = 0.761; root mean square error of approximation [RMSEA] = 0.055, p [RMSEA ≤ 0.05] = 0.04) and internal consistency in all its dimensions (> 0.70). Childhood adversity was associated with higher scores in all three dimensions, as well as with total score. Lifetime cannabis use was associated with higher scores only in the positive dimension. Conclusion: The proposed Brazilian version of the CAPE corroborates the tridimensional approach for assessing psychosis-proneness, and the frequency and severity of psychotic manifestations are distributed as a spectrum in the general population.
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Affiliation(s)
- Taciana C C Ragazzi
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Rosana Shuhama
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jorge Sinval
- Business Research Unit (BRU-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - João Marôco
- William James Center for Research, ISPA, Instituto Universitário, Lisbon, Portugal
| | - Fabiana Corsi-Zuelli
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Daiane L da Roza
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jim van Os
- Department of Psychiatry, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Paulo R Menezes
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Cristina M Del-Ben
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
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Factors Moderating the Association Between Cannabis Use and Psychosis Risk: A Systematic Review. Brain Sci 2020; 10:brainsci10020097. [PMID: 32059350 PMCID: PMC7071602 DOI: 10.3390/brainsci10020097] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 12/11/2022] Open
Abstract
Increasing evidence indicates a relationship between cannabis use and psychosis risk. Specific factors, such as determinants of cannabis use or the genetic profile of cannabis users, appear to moderate this association. The present systematic review presents a detailed and up-to-date literature overview on factors that influence the relationship between cannabis use and psychosis risk. A systematic search was performed according to the PRISMA guidelines in MEDLINE and Embase, and 56 studies were included. The results show that, in particular, frequent cannabis use, especially daily use, and the consumption of high-potency cannabis are associated with a higher risk of developing psychosis. Moreover, several genotypes moderate the impact of cannabis use on psychosis risk, particularly those involved in the dopamine function, such as AKT1. Finally, cannabis use is associated with an earlier psychosis onset and increased risk of transition in individuals at a clinical high risk of psychosis. These findings indicate that changing cannabis use behavior could be a harm reduction strategy employed to lower the risk of developing psychosis. Future research should aim to further develop specific biomarkers and genetic profiles for psychosis, thereby contributing to the identification of individuals at the highest risk of developing a psychotic disorder.
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Kumar P, Rai V. Catechol-O-methyltransferase gene Val158Met polymorphism and obsessive compulsive disorder susceptibility: a meta-analysis. Metab Brain Dis 2020; 35:241-251. [PMID: 31879835 DOI: 10.1007/s11011-019-00495-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 09/12/2019] [Indexed: 12/14/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a common psychiatric disorder that affects approximately 1-3% of the general population. It is characterized by disabling obsessions (intrusive unwanted thoughts) and/or compulsions (ritualized repetitive behaviors). Catechol-O-methyltransferase (COMT) enzyme has an important role in inactivation of dopamine and higher dopamine levels may be implicated in OCD, hence COMT gene is a suitable candidate for OCD. Several case-control studies have evaluated the role of COMT Val 158Met (rs4680;472G- > A) polymorphism as a risk factor for OCD but the results remained inconclusive, hence present meta-analysis was designed to find out correct assessment. All studies that investigated the association of COMT gene Val158Met polymorphism with OCD risk, were considered in the present meta-analysis. Statistical analysis was performed with the software program MetaAnalyst. In the current meta-analysis, 14 case-control studies with 1435 OCD cases and 2753 healthy controls were included. The results indicated significant association between COMT Val158Met polymorphism and OCD risk using allele contrast, homozygote and dominant models (ORA vs G = 1.14; 95% CI = 1.02-1.27; p = 0.01; ORAAvs.GG = 1.33; 95% CI = 1.09-1.62, p = 0.004; ORAA + AGvs.GG = 1.14; 95% CI = 1.0-1.32; p = 0.04). In subgroup analysis based on case gender, meta-analysis of male cases showed significant association using all five genetic models (ORAAvsGG = 1.99; 95%CI = 1.42-2.59; p = <0.001; ORAA + AGvs.GG = 1.59; 95% CI = 1.20-2.10; p = 0.001), but did not show any association between COMT Val 158Met polymorphism and OCD risk in females. In conclusion, results of present meta-analysis supports that the COMT Val158Met polymorphism is a risk factor for OCD especially for males.
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Affiliation(s)
- Pradeep Kumar
- VBS Purvanchal University, Jaunpur, Jaunpur, UP, India
| | - Vandana Rai
- VBS Purvanchal University, Jaunpur, Jaunpur, UP, India.
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15
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Highs and lows of cannabinoid-dopamine interactions: effects of genetic variability and pharmacological modulation of catechol-O-methyl transferase on the acute response to delta-9-tetrahydrocannabinol in humans. Psychopharmacology (Berl) 2019; 236:3209-3219. [PMID: 31187152 DOI: 10.1007/s00213-019-05273-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 05/10/2019] [Indexed: 12/15/2022]
Abstract
RATIONALE The catechol-O-methyl transferase (COMT) enzyme has been implicated in determining dopaminergic tone and the effects of delta-9-tetrahydrocannabinol (THC) in the human brain. OBJECTIVE This study was designed to evaluate the effect of (1) a functional polymorphism and (2) acute pharmacological inhibition of COMT on the acute response to THC in humans. METHODS Sub-study I: The effect of intravenous (IV) THC (0.05 mg/kg) was investigated in 74 healthy subjects genotyped for the COMT rs4680 (Val/Met) polymorphism in a 2-test-day double-blind, randomized, placebo-controlled study. Sub-study II: COMT rs4680 homozygous subjects (Val/Val and Met/Met) from sub-study I received the COMT enzyme inhibitor tolcapone (200 mg) followed by IV THC or placebo on two additional test days. Subjective, behavioral, and cognitive data were obtained periodically on each test day. RESULTS Sub-study I: Val/Val individuals were most sensitive to THC-induced attention and working memory deficits. In contrast, the psychotomimetic and subjective effects of THC were not influenced by COMT genotype. Sub-study II: Tolcapone reduced THC-induced working memory deficits, but not THC's psychotomimetic effects. Tolcapone and COMT genotype (met/met) were associated with an increased report of feeling "mellow." CONCLUSIONS The interaction between COMT rs4680 polymorphisms and tolcapone on the cognitive, but not on the psychotomimetic and overall subjective effects of THC, suggests that modulation of dopaminergic signaling may selectively influence specific cannabinoid effects in healthy individuals. The role of dopaminergic signaling in the cognitive effects of cannabinoids should be considered in drug development efforts targeting these effects. CLINICALTRIALS.GOV REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT00678730?term=NCT00678730&rank=1 ClinicalTrials.gov Identifier: NCT00678730.
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16
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Cannabis and Psychosis Through the Lens of DSM-5. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214149. [PMID: 31661851 PMCID: PMC6861931 DOI: 10.3390/ijerph16214149] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 12/27/2022]
Abstract
Evidence for an association between cannabis and psychosis has been documented in literature in many forms including experimental studies, epidemiological data, and case series. The association has implications for psychotic outcomes ranging from mild to severe and occurring over minutes to years. Due to the huge variety of exposures and outcome measures reported, creating a coherent account of all the available information is difficult. A useful way to conceptualize these wide-ranging results is to consider the association between cannabis and psychosis as it occurs within the context of widely used DSM-5 diagnoses. In the present review we examine cannabis/psychosis associations as they pertain to Cannabis Intoxication, Cannabis-Induced Psychotic Disorder, and Schizophrenia. This allows for an understanding of the cannabis and psychosis association along something approaching a continuum. Cannabis intoxication becomes Cannabis-Induced Psychotic Disorder once certain severity and duration criteria are met and Cannabis-Induced Psychotic Disorder is heavily associated with future schizophrenia diagnoses.
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17
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Bossong MG, van Hell HH, Schubart CD, van Saane W, Iseger TA, Jager G, van Osch MJP, Jansma JM, Kahn RS, Boks MP, Ramsey NF. Acute effects of ∆9-tetrahydrocannabinol (THC) on resting state brain function and their modulation by COMT genotype. Eur Neuropsychopharmacol 2019; 29:766-776. [PMID: 30975584 DOI: 10.1016/j.euroneuro.2019.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/30/2019] [Accepted: 03/22/2019] [Indexed: 01/07/2023]
Abstract
Cannabis produces a broad range of acute, dose-dependent psychotropic effects. Only a limited number of neuroimaging studies have mapped these effects by examining the impact of cannabis on resting state brain neurophysiology. Moreover, how genetic variation influences the acute effects of cannabis on resting state brain function is unknown. Here we investigated the acute effects of ∆9-tetrahydrocannabinol (THC), the main psychoactive constituent of cannabis, on resting state brain neurophysiology, and their modulation by catechol-methyl-transferase (COMT) Val158Met genotype. Thirty-nine healthy volunteers participated in a pharmacological MRI study, where we applied Arterial Spin Labelling (ASL) to measure perfusion and functional MRI to assess resting state connectivity. THC increased perfusion in bilateral insula, medial superior frontal cortex, and left middle orbital frontal gyrus. This latter brain area showed significantly decreased connectivity with the precuneus after THC administration. THC effects on perfusion in the left insula were significantly related to subjective changes in perception and relaxation. These findings indicate that THC enhances metabolism and thus neural activity in the salience network. Furthermore, results suggest that recruitment of brain areas within this network is involved in the acute effects of THC. Resting state perfusion was modulated by COMT genotype, indicated by a significant interaction effect between drug and genotype on perfusion in the executive network, with increased perfusion after THC in Val/Met heterozygotes only. This finding suggests that prefrontal dopamine levels are involved in the susceptibility to acute effects of cannabis.
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Affiliation(s)
- Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Hendrika H van Hell
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Chris D Schubart
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Department of Psychiatry, Tergooi Hospital, Van Riebeeckweg 212, 1213 XZ Hilversum, The Netherlands
| | - Wesley van Saane
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom
| | - Tabitha A Iseger
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom; Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands; Research Institute Brainclinics, Bijleveldsingel 32, 6524 AD Nijmegen, The Netherlands
| | - Gerry Jager
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Division of Human Nutrition, Wageningen University, Bomenweg 2, 6703 HD, Wageningen, The Netherlands
| | - Matthias J P van Osch
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - J Martijn Jansma
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States
| | - Marco P Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Nick F Ramsey
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Trotta A, Iyegbe C, Yiend J, Dazzan P, David AS, Pariante C, Mondelli V, Colizzi M, Murray RM, Di Forti M, Fisher HL. Interaction between childhood adversity and functional polymorphisms in the dopamine pathway on first-episode psychosis. Schizophr Res 2019; 205:51-57. [PMID: 29653893 DOI: 10.1016/j.schres.2018.04.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/30/2018] [Accepted: 04/04/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND There is consistent evidence of a cumulative relationship between childhood adversity and psychosis, with number of adversities experienced increasing the probability of psychosis onset. It is possible that genetic factors moderate the association between childhood adversity and psychosis, potentially by influencing how an individual reacts biologically and/or psychologically following exposure to adversity, in such a way as to set them off on the path to psychosis. However, identifying the specific genetic variants involved and how they interact with childhood adversity remains challenging. We examined whether the association between cumulative exposure to childhood adversity and development of psychotic disorder was moderated by the COMT Val158Met, AKT1 rs2494732 or DRD2 rs1076560 polymorphisms, known to affect dopamine levels. METHODS Participants were 285 first-presentation psychosis cases and 256 geographically-matched controls drawn from the Genetics and Psychosis (GAP) study. Childhood adversity was assessed using the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and blood- and cheek-derived genotype data were collected. RESULTS Our findings revealed no main effect of COMT Val158Met, AKT1 rs2494732 and DRD2 rs1076560 polymorphisms on psychosis case status or reports of childhood adversity. Individuals reporting a history of multiple adversities were more likely to be psychosis patients than controls, regardless of their genetic risk. There was no evidence of candidate genotype by childhood adversity interactions in relation to psychosis onset. CONCLUSION These findings did not provide evidence of a possible role of COMT Val158Met, AKT1 rs2494732 or DRD2 rs1076560 genotypes in modifying the association between childhood adversity and onset of psychosis.
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Affiliation(s)
- Antonella Trotta
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Heather Close Rehabilitation Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jenny Yiend
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Anthony S David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Carmine Pariante
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Valeria Mondelli
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marco Colizzi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Marta Di Forti
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Helen L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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19
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Park J, Sung JY, Kim DK, Kong ID, Hughes TL, Kim N. Genetic association of human Corticotropin-Releasing Hormone Receptor 1 (CRHR1) with Internet gaming addiction in Korean male adolescents. BMC Psychiatry 2018; 18:396. [PMID: 30572854 PMCID: PMC6302290 DOI: 10.1186/s12888-018-1974-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/05/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The number of people with Internet gaming addiction (IGA) is increasing around the world. IGA is known to be associated with personal characteristics, psychosocial factors, and physiological factors. However, few studies have examined the genetic factors related to IGA. This study aimed to investigate the association between IGA and stress-related genetic variants. METHODS This cross-sectional study was conducted with 230 male high school students in a South Korean city. We selected five stress-related candidate genes: DAT1, DRD4, NET8, CHRNA4, and CRHR1. The DAT1 and DRD4 genes were genotyped by polymerase chain reaction, and the NET8, CHRNA4, and CRHR1 genes were genotyped by pyrosequencing analysis. We performed a Chi-square test to examine the relationship of these five candidate genes to IGA. RESULTS Having the AA genotype and the A allele of the CRHR1 gene (rs28364027) was associated with higher odds of belonging to the IGA participant group (p = .016 and p = .021, respectively) than to the non-IGA group. By contrast, the DAT1, DRD4, NET8, and CHRNA4 gene polymorphisms showed no significant difference between the IGA group and control group. CONCLUSIONS These results indicate that polymorphism of the CRHR1 gene may play an important role in IGA susceptibility in the Korean adolescent male population. These findings provide a justification and foundation for further investigation of genetic factors related to IGA.
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Affiliation(s)
- Jooyeon Park
- College of Nursing, Keimyung University, Daegu, Republic of Korea
| | - Jin-Young Sung
- Department of Medical Genetics, School of Medicine, Keimyung University, Daegu, Republic of Korea
| | - Dae-Kwang Kim
- Department of Medical Genetics, School of Medicine, Keimyung University, Daegu, Republic of Korea
| | - In Deok Kong
- Department of Physiology, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York City, USA
| | - Nahyun Kim
- College of Nursing, Keimyung University, Daegu, Republic of Korea.
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20
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Ragazzi TCC, Shuhama R, Menezes PR, Del-Ben CM. Cannabis use as a risk factor for psychotic-like experiences: A systematic review of non-clinical populations evaluated with the Community Assessment of Psychic Experiences. Early Interv Psychiatry 2018; 12:1013-1023. [PMID: 29927066 DOI: 10.1111/eip.12693] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/27/2018] [Accepted: 05/16/2018] [Indexed: 12/14/2022]
Abstract
AIM Epidemiological data have provided evidence that psychotic-like experiences (PLEs) can occur in the general population, not necessarily accompanied by the impairment and suffering observed in formal psychiatric diagnoses. According to the psychosis continuum hypothesis, PLEs would be subject to the same risk factors as frank psychosis. The aim of this review was to summarize observational studies that evaluated cannabis use as a risk factor for PLEs as determined by the Community Assessment of Psychic Experiences in non-clinical samples. The instrument composed of 3 dimensions-positive, negative and depressive-is a scale specifically designed to assess the occurrence, frequency and impact of PLEs in non-clinical population. METHODS We searched PubMed/Medline, Web of Science and PsycInfo electronic databases for indexed peer-reviewed studies published until September 2017. RESULTS We initially identified 100 articles. The PRISMA model for systematic reviews was used and 19 full-text articles were analysed. In general, the findings suggested that the higher the cannabis use and the younger the participants, the higher the reports of PLEs, although associations were more consistent for the positive dimension. CONCLUSIONS More attention should be paid to the understanding of the risk factors of PLEs in the general population, since these experiences are themselves a risk for psychotic disorders.
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Affiliation(s)
- Taciana C C Ragazzi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Rosana Shuhama
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Paulo R Menezes
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Cristina M Del-Ben
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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21
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Jaworska-Andryszewska P, Rybakowski JK. Childhood trauma in mood disorders: Neurobiological mechanisms and implications for treatment. Pharmacol Rep 2018; 71:112-120. [PMID: 30544098 DOI: 10.1016/j.pharep.2018.10.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/01/2018] [Accepted: 10/08/2018] [Indexed: 01/30/2023]
Abstract
A contemporary model for the pathogenesis of mood disorders (bipolar and depressive disorders) involves gene-environmental interaction, with genetic predisposition, epigenetic regulation, and environmental effects. Among multiple environmental factors, the experience of childhood trauma can be connected with the pathogenesis, course and the treatment of mood disorders. Patients with mood disorders have the greater frequency of childhood trauma compared with the general population, and adverse childhood experiences can exert a negative impact on their clinical course. In this article, the neurobiological mechanisms of childhood trauma are presented. The influence of negative childhood experiences on the central nervous system can result in many structural and functional changes of the brain, including such structures as hippocampus and amygdala, associated with the development of bipolar and depressive illnesses. Interaction of several genes with childhood trauma to produce pathological, clinical phenomena in adulthood has been demonstrated, the most important in this respect being the serotonin transporter gene and the FKBP5 gene playing an important role in the pathogenesis of mood disorders. Neurobiological effects can also involve epigenetic mechanisms such as DNA methylation which can exert an effect on brain function over long-term periods. Somatic effects of childhood trauma include disturbances of stress axis and immune-inflammatory mechanisms as well as metabolic dysregulation. Negative childhood experiences may also bear implications for the treatment of mood disorders. In the article, the impact of such experiences on the treatment of mood disorders will be discussed, especially in the context of treatment -resistance to antidepressants and mood-stabilizing drugs.
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Affiliation(s)
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznań, Poland.
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22
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Abstract
Schizophrenia and other types of psychosis incur suffering, high health care costs and loss of human potential, due to the combination of early onset and poor response to treatment. Our ability to prevent or cure psychosis depends on knowledge of causal mechanisms. Molecular genetic studies show that thousands of common and rare variants contribute to the genetic risk for psychosis. Epidemiological studies have identified many environmental factors associated with increased risk of psychosis. However, no single genetic or environmental factor is sufficient to cause psychosis on its own. The risk of developing psychosis increases with the accumulation of many genetic risk variants and exposures to multiple adverse environmental factors. Additionally, the impact of environmental exposures likely depends on genetic factors, through gene-environment interactions. Only a few specific gene-environment combinations that lead to increased risk of psychosis have been identified to date. An example of replicable gene-environment interaction is a common polymorphism in the AKT1 gene that makes its carriers sensitive to developing psychosis with regular cannabis use. A synthesis of results from twin studies, molecular genetics, and epidemiological research outlines the many genetic and environmental factors contributing to psychosis. The interplay between these factors needs to be considered to draw a complete picture of etiology. To reach a more complete explanation of psychosis that can inform preventive strategies, future research should focus on longitudinal assessments of multiple environmental exposures within large, genotyped cohorts beginning early in life.
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Affiliation(s)
- Alyson Zwicker
- Department of Pathology,Dalhousie University,Halifax,NS,Canada
| | | | - Rudolf Uher
- Department of Pathology,Dalhousie University,Halifax,NS,Canada
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23
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De Aquino JP, Sherif M, Radhakrishnan R, Cahill JD, Ranganathan M, D’Souza DC. The Psychiatric Consequences of Cannabinoids. Clin Ther 2018; 40:1448-1456. [DOI: 10.1016/j.clinthera.2018.03.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 03/15/2018] [Accepted: 03/23/2017] [Indexed: 12/14/2022]
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24
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Khan A, Powell SB. Sensorimotor gating deficits in "two-hit" models of schizophrenia risk factors. Schizophr Res 2018; 198:68-83. [PMID: 29070440 PMCID: PMC5911431 DOI: 10.1016/j.schres.2017.10.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 02/07/2023]
Abstract
Genetic and environmental models of neuropsychiatric disease have grown exponentially over the last 20years. One measure that is often used to evaluate the translational relevance of these models to human neuropsychiatric disease is prepulse inhibition of startle (PPI), an operational measure of sensorimotor gating. Deficient PPI characterizes several neuropsychiatric disorders but has been most extensively studied in schizophrenia. It has become a useful tool in translational neuropharmacological and molecular genetics studies because it can be measured across species using almost the same experimental parameters. Although initial studies of PPI in rodents were pharmacological because of the robust predictive validity of PPI for antipsychotic efficacy, more recently, PPI has become standard common behavioral measures used in genetic and neurodevelopmental models of schizophrenia. Here we review "two hit" models of schizophrenia and discuss the utility of PPI as a tool in phenotyping these models of relevant risk factors. In the review, we consider approaches to rodent models of genetic and neurodevelopmental risk factors and selectively review "two hit" models of gene×environment and environment×environment interactions in which PPI has been measured.
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Affiliation(s)
- Asma Khan
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States; Research Service, VA San Diego Healthcare System, La Jolla, CA, United States
| | - Susan B Powell
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States; Research Service, VA San Diego Healthcare System, La Jolla, CA, United States.
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25
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Misiak B, Stramecki F, Gawęda Ł, Prochwicz K, Sąsiadek MM, Moustafa AA, Frydecka D. Interactions Between Variation in Candidate Genes and Environmental Factors in the Etiology of Schizophrenia and Bipolar Disorder: a Systematic Review. Mol Neurobiol 2018; 55:5075-5100. [PMID: 28822116 PMCID: PMC5948257 DOI: 10.1007/s12035-017-0708-y] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 08/01/2017] [Indexed: 12/29/2022]
Abstract
Schizophrenia and bipolar disorder (BD) are complex and multidimensional disorders with high heritability rates. The contribution of genetic factors to the etiology of these disorders is increasingly being recognized as the action of multiple risk variants with small effect sizes, which might explain only a minor part of susceptibility. On the other site, numerous environmental factors have been found to play an important role in their causality. Therefore, in recent years, several studies focused on gene × environment interactions that are believed to bridge the gap between genetic underpinnings and environmental insults. In this article, we performed a systematic review of studies investigating gene × environment interactions in BD and schizophrenia spectrum phenotypes. In the majority of studies from this field, interacting effects of variation in genes encoding catechol-O-methyltransferase (COMT), brain-derived neurotrophic factor (BDNF), and FK506-binding protein 5 (FKBP5) have been explored. Almost consistently, these studies revealed that polymorphisms in COMT, BDNF, and FKBP5 genes might interact with early life stress and cannabis abuse or dependence, influencing various outcomes of schizophrenia spectrum disorders and BD. Other interactions still require further replication in larger clinical and non-clinical samples. In addition, future studies should address the direction of causality and potential mechanisms of the relationship between gene × environment interactions and various categories of outcomes in schizophrenia and BD.
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Affiliation(s)
- Błażej Misiak
- Department of Genetics, Wroclaw Medical University, 1 Marcinkowski Street, 50-368, Wroclaw, Poland.
| | - Filip Stramecki
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367, Wroclaw, Poland
| | - Łukasz Gawęda
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- II Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | - Maria M Sąsiadek
- Department of Genetics, Wroclaw Medical University, 1 Marcinkowski Street, 50-368, Wroclaw, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, Western Sydney University, Penrith, NSW, Australia
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367, Wroclaw, Poland
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26
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Vaessen TSJ, de Jong L, Schäfer AT, Damen T, Uittenboogaard A, Krolinski P, Nwosu CV, Pinckaers FME, Rotee ILM, Smeets APW, Ermiş A, Kennedy JL, Nieman DH, Tiwari A, van Os J, Drukker M. The interaction between cannabis use and the Val158Met polymorphism of the COMT gene in psychosis: A transdiagnostic meta - analysis. PLoS One 2018; 13:e0192658. [PMID: 29444152 PMCID: PMC5812637 DOI: 10.1371/journal.pone.0192658] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Neither environmental nor genetic factors are sufficient to predict the transdiagnostic expression of psychosis. Therefore, analysis of gene-environment interactions may be productive. OBJECTIVE A meta-analysis was performed using papers investigating the interaction between cannabis use and catechol-O-methyl transferase (COMT) polymorphism Val158Met (COMTVal158Met). DATA SOURCES PubMed, Embase, PsychInfo. STUDY ELIGIBILITY CRITERIA All observational studies assessing the interaction between COMTVal158Met and cannabis with any psychosis or psychotic symptoms measure as an outcome. STUDY APPRAISAL AND SYNTHESIS METHODS A meta-analysis was performed using the Meta-analysis of Observational Studies in Epidemiology guidelines and forest plots were generated. Thirteen articles met the selection criteria: 7 clinical studies using a case-only design, 3 clinical studies with a dichotomous outcome, and 3 studies analysing a continuous outcome of psychotic symptoms below the threshold of psychotic disorder. The three study types were analysed separately. Validity of the included studies was assessed using "A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions". RESULTS For case-only studies, a significant interaction was found between cannabis use and COMTVal158Met, with an OR of 1.45 (95% Confidence Interval = 1.05-2.00; Met/Met as the risk genotype). However, there was no evidence for interaction in either the studies including dichotomous outcomes (B = -0.51, 95% Confidence Interval -1.72, 0.70) or the studies including continuous outcomes (B = -0.04 95% Confidence Interval -0.16-0.08). LIMITATION A substantial part of the included studies used the case-only design, which has lower validity and tends to overestimate true effects. CONCLUSION The interaction term between cannabis use and COMTVal158Met was only statistically significant in the case-only studies, but not in studies using other clinical or non-clinical psychosis outcomes. Future additional high quality studies might change current perspectives, yet currently evidence for the interaction remains unconvincing.
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Affiliation(s)
| | - Lea de Jong
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Annika Theresia Schäfer
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Thomas Damen
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Aniek Uittenboogaard
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Pauline Krolinski
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Chinyere Vicky Nwosu
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Iris Leah Marije Rotee
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Ayşegül Ermiş
- Department of Psychiatry, Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Istanbul, Turkey
| | - James L. Kennedy
- Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Dorien H. Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Arun Tiwari
- Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jim van Os
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
- King's College London, King's Health Partners Department of Psychosis Studies; Institute of Psychiatry, London, United Kingdom
| | - Marjan Drukker
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- * E-mail:
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27
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Fraguas D, Díaz-Caneja CM, Corripio I, González-Pinto A, Lobo A, Bioque M, Cuesta MJ, Sanjuán J, Rodríguez-Toscano E, Arias B, Sarró S, Cabrera B, Bulbena A, Vieta E, Castro-Fornieles J, Arango C, Bernardo M, Parellada M. Gene-environment interaction as a predictor of early adjustment in first episode psychosis. Schizophr Res 2017; 189:196-203. [PMID: 28262436 DOI: 10.1016/j.schres.2017.02.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/14/2017] [Accepted: 02/16/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study aims to explore the gene-environment interaction hypothesis applied to pre-symptomatic neurodevelopmental phenotypes of first episode psychosis (FEP), that is, genetic factors might increase vulnerability to the effects of environmental adverse conditions occurring at later stages of development. METHODS We constructed a schematic 'two-hit' model, with Val/Val homozygosity for the catechol-O-methyltransferase (COMT) Val158Met polymorphism as the 'first hit' and history of obstetric complications and parental socioeconomic status as 'second hits'. Early adjustment, measured using the Premorbid Adjustment Scale, was considered the main outcome. The study population comprised 221 adolescents and adults with FEP and 191 sex- and age-matched controls. RESULTS The interaction between the Val/Val COMT genotype and a positive history of obstetric complications plus low parental socioeconomic status was significantly associated with poorer early adjustment. These results were observed both in FEP individuals and in controls, and remained significant after controlling for age, sex, and diagnosis. CONCLUSIONS Individuals carrying Val/Val seem to be more sensitive to the synergistic effect of environmental factors acting early in neurodevelopment, which leads to vulnerability phenotypes such as impaired early adjustment.
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Affiliation(s)
- David Fraguas
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona; Universitat Autònoma de Barcelona (UAB), CIBERSAM, Barcelona, Spain
| | - Ana González-Pinto
- BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), University of Zaragoza, CIBERSAM, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, CIBERSAM, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Hospital Clinic, University of Valencia, INCLIVA, CIBERSAM, Valencia, Spain
| | - Elisa Rodríguez-Toscano
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Bárbara Arias
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, IBUB, CIBERSAM, Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Hermanas Hospitalarias, CIBERSAM, Barcelona, Spain
| | - Bibiana Cabrera
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, CIBERSAM, Barcelona, Spain
| | - Antoni Bulbena
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona; Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona UAB, Bellaterra, Spain
| | - Eduard Vieta
- Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, SGR489, Institute of Neuroscience, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Hospital Clínic, Barcelona, Spain; Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
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Debost JC, Debost M, Grove J, Mors O, Hougaard DM, Børglum AD, Mortensen PB, Petersen L. COMT Val158Met and MTHFR C677T moderate risk of schizophrenia in response to childhood adversity. Acta Psychiatr Scand 2017; 136:85-95. [PMID: 28556887 DOI: 10.1111/acps.12761] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Mesolimbic dopamine sensitization has been hypothesized to be a mediating factor of childhood adversity (CA) on schizophrenia risk. Activity of catechol-O-methyltransferase (COMT) Val158Met increases mesolimbic dopamine signaling and may be further regulated by methylenetetrahydrofolate reductase (MTHFR) C677T. This study investigates the three-way interaction between CA, COMT, and MTHFR. METHODS We conducted a nested case-control study on individuals born after 1981, linking population-based registers to study the three-way interaction. We included 1699 schizophrenia cases and 1681 controls, and used conditional logistic regression to report incidence rate ratios (IRRs). RESULTS Childhood adversity was robustly associated with schizophrenia. No main genetic effects were observed. MTHFR C677T increased schizophrenia risk in a dose-dependent manner per MTHFR T allele (P = 0.005) consequent upon CA exposure. After inclusion of the significant (P = 0.03) COMT × MTHFR × CA interaction, the risk was further increased per high-activity COMT Val allele. Hence, exposed COMT Val/Val and MTHFR T/T carriers had an IRR of 2.76 (95% CI, 1.66-4.61). Additional adjustments for ancestry and parental history of mental illness attenuated the results with the interaction being only marginally significant. CONCLUSION MTHFR C677T and COMT Val158Met interact with CA to increase risk of schizophrenia.
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Affiliation(s)
- J-C Debost
- Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - M Debost
- Department of Internal Medicine, Randers Regional Hospital, Randers NØ, Denmark
| | - J Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark.,Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark.,iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - O Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,Centre for Psychiatric Research, Aarhus University Hospital Risskov, Aarhus, Denmark
| | - D M Hougaard
- Danish Centre for Neonatal Screening, Statens Serum Institut, Copenhagen, Denmark
| | - A D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark.,iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - P B Mortensen
- Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - L Petersen
- Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
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29
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Rai V, Yadav U, Kumar P. Impact of Catechol-O-Methyltransferase Val 158Met (rs4680) Polymorphism on Breast Cancer Susceptibility in Asian Population. ASIAN PACIFIC JOURNAL OF CANCER PREVENTION : APJCP 2017; 18:1243-1250. [PMID: 28610409 PMCID: PMC5555530 DOI: 10.22034/apjcp.2017.18.5.1243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background: Catechol-O-methyltransferase (COMT) is an important estrogen-metabolizing enzyme. Numerous case-control studies have evaluated the role COMT Val 158Met (rs4680;472G->A) polymorphism in the risk of breast cancer and provided inconclusive results, hence present meta-analysis was designed to get a more reliable assessment in Asian population. Methods: A total of 26 articles were identified through a search of four electronic databases-PubMed, Google Scholar, Science Direct and Springer link, up to March, 2016. Pooled odds ratios (ORs) with 95% con¬fidence intervals (CIs) were used as association measure to find out relationship between COMT Val158Metpolymorphism and the risk of breast cancer. We also assessed between study heterogeneity and publication bias. All statistical analyses were done by Open Meta-Analyst. Results: Twenty six case-control studies involving 5,971 breast cancer patients and 7,253 controls were included in the present meta-analysis. The results showed that the COMT Val158Met polymorphism was significantly associated with breast cancer risk except heterozygote model(allele contrast odds ratio (ORAvsG)= 1.13, 95%CI=1.02-1.24,p=0.01; heterozygote/co-dominant ORGAvsGG= 1.03, 95%CI=0.96-1.11,p=0.34; homozygote ORAAvsGG= 1.38, 95%CI= 1.08-1.76,p=0.009; dominant model ORAA+GAvsGG= 1.08, 95%CI=1.01-1.16,p=0.02; and recessive model ORAAvsGA+GG= 1.35, 95%CI=1.07-1.71,p=0.01). In addition, we also performed subgroup analysis based on source of controls and menopausal state of patients. Conclusions: In conclusion, the COMT Val158Met polymorphism was related to increased breast cancer susceptibility in the Asian population.
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Affiliation(s)
- Vandana Rai
- Human Molecular Genetics Laboratory, Department of Biotechnology, VBS Purvanchal University, Jaunpur-222 003, UP, India.
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30
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Levine A, Clemenza K, Rynn M, Lieberman J. Evidence for the Risks and Consequences of Adolescent Cannabis Exposure. J Am Acad Child Adolesc Psychiatry 2017; 56:214-225. [PMID: 28219487 DOI: 10.1016/j.jaac.2016.12.014] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/19/2016] [Accepted: 12/23/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This review of the scientific literature examines the potential adult sequelae of exposure to cannabis and related synthetic cannabinoids in adolescence. We examine the four neuropsychiatric outcomes that are likely most vulnerable to alteration by early cannabinoid use, as identified within both the clinical and preclinical research: cognition, emotional functioning, risk for psychosis, and addiction. METHOD A literature search was conducted through PubMed, PsychInfo, and Google Scholar with no publication date restrictions. The search terms used were "adolescent" and "adult," and either "cannabis," "marijuana," "delta-9-tetra-hydrocannabinol," or "cannabinoid," which was then crossed with one or more of the following terms: "deficit," "impairment," "alteration," "long-term," "persistent," "development," "maturation," and "pubescent." RESULTS The majority of the clinical and preclinical data point to a strong correlation between adolescent cannabinoid exposure and persistent, adverse neuropsychiatric outcomes in adulthood. Although the literature supports the hypothesis that adolescent cannabis use is connected to impaired cognition and mental health in adults, it does not conclusively demonstrate that cannabis consumption alone is sufficient to cause these deficits in humans. The animal literature, however, clearly indicates that adolescent-onset exposure to cannabinoids can catalyze molecular processes that lead to persistent functional deficits in adulthood, deficits that are not found to follow adult-onset exposure and that model some of the adverse outcomes reported in humans among adult populations of early-onset cannabis users. CONCLUSION Based on the data in the current literature, a strong association is found between early, frequent, and heavy adolescent cannabis exposure and poor cognitive and psychiatric outcomes in adulthood, yet definite conclusions cannot yet be made as to whether cannabis use alone has a negative impact on the human adolescent brain. Future research will require animal models and longitudinal studies to be carefully designed with a focus on integrating assessments of molecular, structural, and behavioral outcomes in order to elucidate the full range of potential adverse and long-term consequences of cannabinoid exposure in adolescence.
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Affiliation(s)
- Amir Levine
- College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute, New York, NY.
| | | | - Moira Rynn
- College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute, New York, NY; New York Presbyterian Hospital-Columbia University Medical Center, New York
| | - Jeffrey Lieberman
- College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute, New York, NY; New York Presbyterian Hospital-Columbia University Medical Center, New York
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31
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Misiak B, Krefft M, Bielawski T, Moustafa AA, Sąsiadek MM, Frydecka D. Toward a unified theory of childhood trauma and psychosis: A comprehensive review of epidemiological, clinical, neuropsychological and biological findings. Neurosci Biobehav Rev 2017; 75:393-406. [PMID: 28216171 DOI: 10.1016/j.neubiorev.2017.02.015] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/09/2017] [Accepted: 02/14/2017] [Indexed: 01/05/2023]
Abstract
There is a growing body of research focused on the relationship between childhood trauma and the risk of developing psychosis. Numerous studies, including many large-scale population-based studies, controlling for possible mediating variables, provide persuasive evidence of a dose-response association and are indicative of a causal relationship. Existing evidence supports the specificity model, showing differential associations between particular adversities and clinical symptoms, with cumulative adversity causing less favorable clinical and functional outcomes in psychotic patients. To date, several psychological and biological models have been proposed to search for underlying developmental trajectories leading to the onset of psychosis, influencing psychopathological manifestation and negative functional outcomes due to a history of childhood trauma. In this article, we provide a unified review on the relationship between childhood trauma and psychosis by integrating results of epidemiological, clinical, neuropsychological and biological studies. The question whether psychosis with a positive history of childhood trauma should be considered as a new psychotic phenotype, requiring specific therapeutic interventions, warrants further investigation.
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Affiliation(s)
- Błażej Misiak
- Department of Genetics, 1 Marcinkowski Street, 50-368 Wroclaw, Poland.
| | - Maja Krefft
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Tomasz Bielawski
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, University of Western Sydney, Penrith, NSW, Australia
| | - Maria M Sąsiadek
- Department of Genetics, 1 Marcinkowski Street, 50-368 Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
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32
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Halldorsdottir T, Binder EB. Gene × Environment Interactions: From Molecular Mechanisms to Behavior. Annu Rev Psychol 2017; 68:215-241. [DOI: 10.1146/annurev-psych-010416-044053] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Thorhildur Halldorsdottir
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany;
| | - Elisabeth B. Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany;
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322
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33
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Isvoranu AM, van Borkulo CD, Boyette LL, Wigman JTW, Vinkers CH, Borsboom D. A Network Approach to Psychosis: Pathways Between Childhood Trauma and Psychotic Symptoms. Schizophr Bull 2017; 43:187-196. [PMID: 27165690 PMCID: PMC5216845 DOI: 10.1093/schbul/sbw055] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Childhood trauma (CT) has been identified as a potential risk factor for the onset of psychotic disorders. However, to date, there is limited consensus with respect to which symptoms may ensue after exposure to trauma in early life, and whether specific pathways may account for these associations. The aim of the present study was to use the novel network approach to investigate how different types of traumatic childhood experiences relate to specific symptoms of psychotic disorders and to identify pathways that may be involved in the relationship between CT and psychosis. We used data of patients diagnosed with a psychotic disorder (n = 552) from the longitudinal observational study Genetic Risk and Outcome of Psychosis Project and included the 5 scales of the Childhood Trauma Questionnaire-Short Form and all original symptom dimensions of the Positive and Negative Syndrome Scale. Our results show that all 5 types of CT and positive and negative symptoms of psychosis are connected through symptoms of general psychopathology. These findings are in line with the theory of an affective pathway to psychosis after exposure to CT, with anxiety as a main connective component, but they also point to several additional connective paths between trauma and psychosis: eg, through poor impulse control (connecting abuse to grandiosity, excitement, and hostility) and motor retardation (connecting neglect to most negative symptoms). The results of the current study suggest that multiple paths may exist between trauma and psychosis and may also be useful in mapping potential transdiagnostic processes.
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Affiliation(s)
- Adela-Maria Isvoranu
- Department of Psychology, Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands;
| | - Claudia D van Borkulo
- Department of Psychology, Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lindy-Lou Boyette
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Denny Borsboom
- Department of Psychology, Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
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34
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Etain B, Lajnef M, Bellivier F, Henry C, M'bailara K, Kahn JP, Leboyer M, Fisher HL. Revisiting the association between childhood trauma and psychosis in bipolar disorder: A quasi-dimensional path-analysis. J Psychiatr Res 2017; 84:73-79. [PMID: 27705819 DOI: 10.1016/j.jpsychires.2016.09.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/05/2016] [Accepted: 09/23/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Childhood trauma has been associated with a more severe clinical expression of bipolar disorder (BD). However, the results that specifically associated traumatic events and psychotic features in BD have been inconsistent, possibly due to the low resolution of the phenotypes being used. METHODS 270 normothymic patients with BD completed the Childhood Trauma Questionnaire (CTQ) and the Peters Delusion Inventory (PDI) that assessed 21 delusional beliefs. Patients were characterized for the lifetime presence of psychotic features during episodes and cannabis misuse in accordance with DSM-IV. We performed a series of path analyses to investigate the links from three types of childhood abuse (physical, sexual and emotional) directly to delusional beliefs and psychotic features, and indirectly through cannabis misuse. RESULTS A first path analysis showed no link between any of the childhood abuse types and psychotic features when only a categorical definition of psychosis was used. When incorporating the quasi-dimensional measure of delusional beliefs in a second path analysis, we found that emotional and physical abuse and cannabis misuse were each directly associated with PDI score. PDI score and psychotic features were strongly correlated. Childhood abuse did not operate through cannabis misuse to increase delusional beliefs. Including type of BD in the model did not alter the results. CONCLUSION Emotional and physical abuse, but also cannabis misuse, increased delusional beliefs in patients with BD. Using a quasi-dimensional measure of psychotic symptoms in BD provided higher resolution of the psychosis phenotype and helped reconcile ambiguous findings from previous studies.
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Affiliation(s)
- B Etain
- AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences, Paris, France; Université Paris Diderot, UMR-S, 1144, Paris, France; Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Fondation Fondamental, Créteil, France.
| | - M Lajnef
- Inserm, U955, Equipe Psychiatrie Translationnelle, Créteil, France
| | - F Bellivier
- AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences, Paris, France; Université Paris Diderot, UMR-S, 1144, Paris, France; Fondation Fondamental, Créteil, France
| | - C Henry
- Fondation Fondamental, Créteil, France; Inserm, U955, Equipe Psychiatrie Translationnelle, Créteil, France; Université Paris Est, Faculté de Médecine, Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, DHU Pepsy, Pôle de Psychiatrie et d'Addictologie, Créteil, France; Institut Pasteur, Unité Perception et Mémoire, F-75015, Paris, France
| | - K M'bailara
- Fondation Fondamental, Créteil, France; Université de Bordeaux, Laboratoire Psychologie, EA 4139, Bordeaux, France; Hôpital Charles Perrens, Service de psychiatrie adulte, pôle 3-4-7, Bordeaux, France
| | - J P Kahn
- Fondation Fondamental, Créteil, France; Université de Lorraine, CHU de Nancy et Pôle 6 de Psychiatrie et Psychologie Clinique - Centre Psychothérapique de Nancy, 1 rue du Docteur Archambault, Laxou Cedex, France
| | - M Leboyer
- Fondation Fondamental, Créteil, France; Inserm, U955, Equipe Psychiatrie Translationnelle, Créteil, France; Université Paris Est, Faculté de Médecine, Créteil, France; AP-HP, Hôpitaux Universitaires Henri Mondor, DHU Pepsy, Pôle de Psychiatrie et d'Addictologie, Créteil, France
| | - H L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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COMT Val(158)Met genotype and cannabis use in people with an At Risk Mental State for psychosis: Exploring Gene x Environment interactions. Schizophr Res 2016; 174:24-28. [PMID: 27052366 DOI: 10.1016/j.schres.2016.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 03/09/2016] [Accepted: 03/14/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Epidemiological and retrospective studies suggest a cannabis x catechol-O-methyltransferase (COMT) Val(158)Met interaction effect on development of psychosis. The aim of this study was to examine this interaction and its association with severity of subclinical symptoms in people with an At Risk Mental State (ARMS) for psychosis. METHODS Severity of symptoms, cannabis use and genotype were assessed at baseline in 147 help-seeking young adults who met the ARMS criteria and agreed to participate in the Dutch Early Detection and Intervention (EDIE-NL) trial. RESULTS Cannabis use and COMT Val-allele showed an interaction effect in ARMS subjects. Subjects who were weekly cannabis users at some point prior to entering the study showed more severe positive symptoms. This effect increased if they were carriers of the COMT Val-allele and even more so if they were homozygous for the Val-allele. CONCLUSIONS Our results suggest that the COMT Val(158)Met polymorphism moderates the effect of regular cannabis use on severity of subclinical psychotic symptoms.
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Morgan C, Gayer‐Anderson C. Childhood adversities and psychosis: evidence, challenges, implications. World Psychiatry 2016; 15:93-102. [PMID: 27265690 PMCID: PMC4911761 DOI: 10.1002/wps.20330] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
There is a substantial body of research reporting evidence of associations between various forms of childhood adversity and psychosis, across the spectrum from experiences to disorder. This has been extended, more recently, to include studies of cumulative effects, of interactions with other factors, of specific effects, and of putative biological and psychological mechanisms. In this paper we evaluate this research and highlight the remaining methodological issues and gaps that temper, but do not dismiss, conclusions about the causal role of childhood adversity. We also consider the emerging work on cumulative, synergistic, and specific effects and on mechanisms; and discuss the broader implications of this line of research for our understanding of psychosis. We conclude that the current balance of evidence is that childhood adversities - particularly exposure to multiple adversities involving hostility and threat - do, in some people, contribute to the onset of psychotic experiences and psychotic disorders.
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Affiliation(s)
- Craig Morgan
- Society and Mental Health Research Group, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College LondonLondonUK
| | - Charlotte Gayer‐Anderson
- Society and Mental Health Research Group, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College LondonLondonUK
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Vreeker A, Boks MP, Abramovic L, Verkooijen S, van Bergen AH, Hillegers MH, Spijker AT, Hoencamp E, Regeer EJ, Riemersma-Van der Lek RF, Stevens AW, Schulte PF, Vonk R, Hoekstra R, van Beveren NJ, Kupka RW, Brouwer RM, Bearden CE, MacCabe JH, Ophoff RA. High educational performance is a distinctive feature of bipolar disorder: a study on cognition in bipolar disorder, schizophrenia patients, relatives and controls. Psychol Med 2016; 46:807-818. [PMID: 26621616 PMCID: PMC5824688 DOI: 10.1017/s0033291715002299] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Schizophrenia is associated with lower intelligence and poor educational performance relative to the general population. This is, to a lesser degree, also found in first-degree relatives of schizophrenia patients. It is unclear whether bipolar disorder I (BD-I) patients and their relatives have similar lower intellectual and educational performance as that observed in schizophrenia. METHOD This cross-sectional study investigated intelligence and educational performance in two outpatient samples [494 BD-I patients, 952 schizophrenia spectrum (SCZ) patients], 2231 relatives of BD-I and SCZ patients, 1104 healthy controls and 100 control siblings. Mixed-effects and regression models were used to compare groups on intelligence and educational performance. RESULTS BD-I patients were more likely to have completed the highest level of education (odds ratio 1.88, 95% confidence interval 1.66-2.70) despite having a lower IQ compared to controls (β = -9.09, S.E. = 1.27, p < 0.001). In contrast, SCZ patients showed both a lower IQ (β = -15.31, S.E. = 0.86, p < 0.001) and lower educational levels compared to controls. Siblings of both patient groups had significantly lower IQ than control siblings, but did not differ on educational performance. IQ scores did not differ between BD-I parents and SCZ parents, but BD-I parents had completed higher educational levels. CONCLUSIONS Although BD-I patients had a lower IQ than controls, they were more likely to have completed the highest level of education. This contrasts with SCZ patients, who showed both intellectual and educational deficits compared to healthy controls. Since relatives of BD-I patients did not demonstrate superior educational performance, our data suggest that high educational performance may be a distinctive feature of bipolar disorder patients.
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Affiliation(s)
- Annabel Vreeker
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Marco P.M. Boks
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Lucija Abramovic
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Sanne Verkooijen
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Annet H. van Bergen
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Manon H.J. Hillegers
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Annet T. Spijker
- Department of Mood Disorders, PsyQ, The Hague, The Netherlands
- Department of Mood Disorder, PsyQ Rijnmond, Rotterdam, The Netherlands
| | - Erik Hoencamp
- Parnassia BAVO Group, The Hague, The Netherlands
- Leiden University, Institute of Psychology, Leiden, The Netherlands
| | - Eline J. Regeer
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
| | | | | | | | - Ronald Vonk
- Reinier van Arkel Group, ‘s-Hertogenbosch, The Netherlands
| | - Rocco Hoekstra
- Delta Center for Mental Health Care, Rotterdam, The Netherlands
| | - Nico J.M. van Beveren
- Delta Center for Mental Health Care, Rotterdam, The Netherlands
- Erasmus University Medical Center, Department of Psychiatry, Rotterdam, The Netherlands
- Erasmus University Medical Center, Department of Neuroscience, Rotterdam, The Netherlands
| | - Ralph W. Kupka
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
- VU University Medical Center, Department of Psychiatry, Amsterdam, The Netherlands
| | - Rachel M. Brouwer
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Carrie E. Bearden
- Semel Institute For Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, California USA
- Department of Psychology, University of California-Los Angeles, Los Angeles, California USA
| | - James H. MacCabe
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Roel A. Ophoff
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California USA
| | - GROUP investigators
- Corresponding author: René S. Kahn, MD, PhD, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Heidelberglaan 100, 3508 GA Utrecht, PO box 85500, tel: 0031887556025, fax: 0031887555443 ()
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Barrigón ML, Diaz FJ, Gurpegui M, Ferrin M, Salcedo MD, Moreno-Granados J, Cervilla JA, Ruiz-Veguilla M. Childhood trauma as a risk factor for psychosis: A sib-pair study. J Psychiatr Res 2015; 70:130-6. [PMID: 26424432 DOI: 10.1016/j.jpsychires.2015.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/24/2015] [Accepted: 08/28/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND Childhood trauma, cannabis use and certain personality traits have been related to the development of psychosis. This study uses a sib-pair design to examine the association between childhood trauma and psychosis controlling for cannabis use and neuroticism. METHODS We evaluated 60 patient-sibling pairs, conformed by patients with functional psychosis in the first five years of their illness matched with a non-psychotic sibling. In univariate analyses, patients and siblings were compared with McNemar tests and paired-sample t tests. A conditional logistic regression model of the risk of developing psychosis was built. The dependent variable of this model was the patient-sibling status (patient = 1, sibling = 0). RESULTS After controlling for cannabis use and neuroticism, the odds of suffering psychosis for subjects who experienced a childhood trauma were 7.3 times higher than the odds for subjects who did not experience a childhood trauma [95% CI, (1.06-50.01); P = 0.04]. Also, after controlling for experiencing childhood trauma and neuroticism, subjects who were heavy cannabis users had odds of suffering psychosis that were 6.4 times higher than the odds of the remaining subjects [95% CI, (1.2-35.2); P = 0.03]. CONCLUSION Both childhood trauma and cannabis use were significantly associated with an increased risk of suffering functional psychosis. A neurotic personality also contributed independently to this risk. These findings might help improve the prevention of psychosis and the development of specific treatment strategies on this specific population.
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Affiliation(s)
- María Luisa Barrigón
- Department of Psychiatry, IIS-Fundación Jiménez Díaz Hospital and Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco J Diaz
- Department of Biostatistics, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Manuel Gurpegui
- Department of Psychiatry and CTS-549 Research Group, Institute of Neurosciences, Centre for Biomedical Research (CIBM), University of Granada, Granada, Spain
| | - Maite Ferrin
- Huntercombe Hospital Maidenhead, London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, London, UK; Developmental Brain-Behaviour Laboratory, University of Southampton, UK
| | - María Dolores Salcedo
- Grupo Neurodesarrollo y Psicosis, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, UGC Salud Mental HVR, Sevilla, Spain
| | - Josefa Moreno-Granados
- Grupo Neurodesarrollo y Psicosis, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, UGC Salud Mental HVR, Sevilla, Spain
| | - Jorge A Cervilla
- Cibersam Hospital Universitario San Cecilio, Universidad de Granada, Spain
| | - Miguel Ruiz-Veguilla
- Grupo Neurodesarrollo y Psicosis, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, UGC Salud Mental HVR, Sevilla, Spain.
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Tunbridge EM, Dunn G, Murray RM, Evans N, Lister R, Stumpenhorst K, Harrison PJ, Morrison PD, Freeman D. Genetic moderation of the effects of cannabis: catechol-O-methyltransferase (COMT) affects the impact of Δ9-tetrahydrocannabinol (THC) on working memory performance but not on the occurrence of psychotic experiences. J Psychopharmacol 2015; 29:1146-51. [PMID: 26464454 DOI: 10.1177/0269881115609073] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cannabis use can induce cognitive impairments and psychotic experiences. A functional polymorphism in the catechol-O-methyltransferase (COMT) gene (Val(158)Met) appears to influence the immediate cognitive and psychotic effects of cannabis, or ∆(9)-tetrahydrocannabinol (THC), its primary psychoactive ingredient. This study investigated the moderation of the impact of experimentally administered THC by COMT. Cognitive performance and psychotic experiences were studied in participants without a psychiatric diagnosis, using a between-subjects design (THC vs. placebo). The effect of COMT Val(158)Met genotype on the cognitive and psychotic effects of THC, administered intravenously in a double-blind, placebo-controlled manner to 78 participants who were vulnerable to paranoia, was examined. The results showed interactive effects of genotype and drug group (THC or placebo) on working memory, assayed using the Digit Span Backwards task. Specifically, THC impaired performance in COMT Val/Val, but not Met, carriers. In contrast, the effect of THC on psychotic experiences, measured using the Community Assessment of Psychic Experiences (CAPE) positive dimension, was unaffected by COMT genotype. This study is the largest to date examining the impact of COMT genotype on response to experimentally administered THC, and the first using a purely non-clinical cohort. The data suggest that COMT genotype moderates the cognitive, but not the psychotic, effects of acutely administered THC.
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Affiliation(s)
| | - Graham Dunn
- Centre for Biostatistics, Institute of Population Health, University of Manchester, Manchester, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Nicole Evans
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Rachel Lister
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | | | - Paul D Morrison
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
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Wilkinson ST, Yarnell S, Radhakrishnan R, Ball SA, D'Souza DC. Marijuana Legalization: Impact on Physicians and Public Health. Annu Rev Med 2015; 67:453-66. [PMID: 26515984 DOI: 10.1146/annurev-med-050214-013454] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health.
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Affiliation(s)
- Samuel T Wilkinson
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511;
| | - Stephanie Yarnell
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511;
| | - Rajiv Radhakrishnan
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511; .,VA Connecticut Healthcare System, West Haven, Connecticut 06516.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut 06511
| | - Samuel A Ball
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511; .,VA Connecticut Healthcare System, West Haven, Connecticut 06516.,The National Center on Addiction and Substance Abuse at Columbia University, New York, NY 10027
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511; .,VA Connecticut Healthcare System, West Haven, Connecticut 06516.,Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, Connecticut 06511
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Abstract
A convergence of evidence shows that use of Cannabis sativa is associated with increased risk of developing psychotic disorders, including schizophrenia, and earlier age at which psychotic symptoms first manifest. Cannabis exposure during adolescence is most strongly associated with the onset of psychosis amongst those who are particularly vulnerable, such as those who have been exposed to child abuse and those with family histories of schizophrenia. Schizophrenia that develops after cannabis use may have a unique clinical phenotype, and several genetic polymorphisms may modulate the relationship between cannabis use and psychosis. The endocannabinoid system has been implicated in psychosis both related and unrelated to cannabis exposure, and studying this system holds potential to increase understanding of the pathophysiology of schizophrenia. Anandamide signaling in the central nervous system may be particularly important. Δ(9)-Tetrahydrocannabinol in cannabis can cause symptoms of schizophrenia when acutely administered, and cannabidiol (CBD), another compound in cannabis, can counter many of these effects. CBD may have therapeutic potential for the treatment of psychosis following cannabis use, as well as schizophrenia, possibly with better tolerability than current antipsychotic treatments. CBD may also have anti-inflammatory and neuroprotective properties. Establishing the role of CBD and other CBD-based compounds in treating psychotic disorders will require further human research.
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Affiliation(s)
- Marc W Manseau
- Department of Psychiatry, New York University Langone Medical Center, New York, NY, USA
| | - Donald C Goff
- Department of Psychiatry, New York University Langone Medical Center, New York, NY, USA.
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Vinkers CH, Joëls M, Milaneschi Y, Gerritsen L, Kahn RS, Penninx BWJH, Boks MPM. Mineralocorticoid receptor haplotypes sex-dependently moderate depression susceptibility following childhood maltreatment. Psychoneuroendocrinology 2015; 54:90-102. [PMID: 25686805 DOI: 10.1016/j.psyneuen.2015.01.018] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 12/17/2014] [Accepted: 01/21/2015] [Indexed: 12/12/2022]
Abstract
The MR is an important regulator of the hypothalamic-pituitary-adrenal (HPA) axis and a prime target for corticosteroids. There is increasing evidence from both clinical and preclinical studies that the MR has different effects on behavior and mood in males and females. To investigate the hypothesis that the MR sex-dependently influences the relation between childhood maltreatment and depression, we investigated three common and functional MR haplotypes (GA, CA, and CG haplotype, based on rs5522 and rs2070951) in a population-based cohort (N = 665) and an independent clinical cohort from the Netherlands Study of Depression and Anxiety (NESDA) (N = 1639). The CA haplotype sex-dependently moderated the relation between childhood maltreatment and depressive symptoms both in the population-based sample (sex × maltreatment × haplotype: β = -4.07, P = 0.029) and in the clinical sample (sex × maltreatment × haplotype, β = -2.40, P = 0.011). Specifically, female individuals in the population-based sample were protected (β = -4.58, P = 2.0 e(-5)), whereas males in the clinical sample were at increased risk (β = 2.54, P = 0.0022). In line with these results, female GA haplotype carriers displayed increased vulnerability in the population-based sample (β = 4.58, P = 7.5 e(-5)) whereas male CG-carriers showed increased resilience in the clinical sample (β = -2.71, P = 0.016). Consistently, we found a decreased lifetime MDD risk for male GA haplotype carriers following childhood maltreatment but an increased risk for male CA haplotype carriers in the clinical sample. In both samples, sex-dependent effects were observed for GA-GA diplotype carriers. In summary, sex plays an important role in determining whether functional genetic variation in MR is beneficial or detrimental, with an apparent female advantage for the CA haplotype but male advantage for the GA and CG haplotype. These sex-dependent effects of MR on depression susceptibility following childhood maltreatment are relevant in light of the increased prevalence of mood disorders in women and point to a sex-specific role of MR in the etiology of depression following childhood maltreatment.
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Affiliation(s)
- Christiaan H Vinkers
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Marian Joëls
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Lotte Gerritsen
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - René S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Marco P M Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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de Castro-Catala M, Barrantes-Vidal N, Sheinbaum T, Moreno-Fortuny A, Kwapil TR, Rosa A. COMT-by-sex interaction effect on psychosis proneness. BIOMED RESEARCH INTERNATIONAL 2015; 2015:829237. [PMID: 25722988 PMCID: PMC4334622 DOI: 10.1155/2015/829237] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 01/16/2015] [Accepted: 01/19/2015] [Indexed: 12/11/2022]
Abstract
Schizotypy phenotypes in the general population share etiopathogenic mechanisms and risk factors with schizophrenia, supporting the notion of psychosis as a continuum ranging from nonclinical to clinical deviance. Catechol-O-methyltransferase (COMT) is a candidate susceptibility gene for schizophrenia that is involved in the regulation of dopamine in the prefrontal cortex. Several recent studies have reported a sex difference in the impact of COMT genotype on psychiatric and cognitive phenotypes and personality traits. The present study investigated the association of COMT Val158Met (rs4680) with psychometric positive and negative schizotypy and psychotic experiences in a sample of 808 nonclinical young adults. The main finding was that sex moderates the association of COMT genotype with the negative dimension of both schizotypy and psychotic experiences. Male subjects carrying the Val allele tended to score higher on the negative dimension of both trait and symptom-like measures. The results from the present study are consistent with recent work suggesting an association between negative schizotypy and diminished prefrontal dopamine availability. They support the idea that a biological differentiation underlies the positive and negative schizotypy dimensions. Additionally, these findings contribute to the growing literature on sex-specific effects of COMT on the predisposition to psychiatric disorders and personality traits.
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Affiliation(s)
- Marta de Castro-Catala
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia, Universitat de Barcelona (UB), Avinguda Diagonal 643, 08028 Barcelona, Spain
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona (UAB), Bellaterra, 08193 Barcelona, Spain ; Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA ; Sant Pere Claver-Fundació Sanitària, Carrer Vila i Vilà 16, 08004 Barcelona, Spain ; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Tamara Sheinbaum
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona (UAB), Bellaterra, 08193 Barcelona, Spain
| | - Artal Moreno-Fortuny
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia, Universitat de Barcelona (UB), Avinguda Diagonal 643, 08028 Barcelona, Spain ; Institute of Inflammation and Repair, University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA
| | - Araceli Rosa
- Unitat d'Antropologia, Departament de Biologia Animal, Facultat de Biologia, Universitat de Barcelona (UB), Avinguda Diagonal 643, 08028 Barcelona, Spain ; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Løberg EM, Helle S, Nygård M, Berle JØ, Kroken RA, Johnsen E. The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability. Front Psychiatry 2014; 5:159. [PMID: 25477825 PMCID: PMC4235385 DOI: 10.3389/fpsyt.2014.00159] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 10/24/2014] [Indexed: 12/19/2022] Open
Abstract
There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings.
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Affiliation(s)
- Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Siri Helle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Merethe Nygård
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Jan Øystein Berle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Rune A. Kroken
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Wilkinson ST, Radhakrishnan R, D'Souza DC. Impact of Cannabis Use on the Development of Psychotic Disorders. CURRENT ADDICTION REPORTS 2014; 1:115-128. [PMID: 25767748 DOI: 10.1007/s40429-014-0018-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The link between cannabis use and psychosis comprises three distinct relationships: acute psychosis associated with cannabis intoxication, acute psychosis that lasts beyond the period of acute intoxication, and persistent psychosis not time-locked to exposure. Experimental studies reveal that cannabis, tetrahydrocannabinol (THC) and synthetic cannabinoids reliably produce transient positive, negative, and cognitive symptoms in healthy volunteers. Case-studies indicate that cannabinoids can induce acute psychosis which lasts beyond the period of acute intoxication but resolves within a month. Exposure to cannabis in adolescence is associated with a risk for later psychotic disorder in adulthood; this association is consistent, temporally related, shows a dose-response, and is biologically plausible. However, cannabis is neither necessary nor sufficient to cause a persistent psychotic disorder. More likely it is a component cause that interacts with other factors to result in psychosis. The link between cannabis and psychosis is moderated by age at onset of cannabis use, childhood abuse and genetic vulnerability. While more research is needed to better characterize the relationship between cannabinoid use and the onset and persistence of psychosis, clinicians should be mindful of the potential risk of psychosis especially in vulnerable populations, including adolescents and those with a psychosis diathesis.
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Affiliation(s)
- Samuel T Wilkinson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Rajiv Radhakrishnan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA ; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA ; Schizophrenia and Neuropharmacology Research Group, VA Connecticut Healthcare System, West Haven, CT, USA
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Green MJ, Chia TY, Cairns MJ, Wu J, Tooney PA, Scott RJ, Carr VJ. Catechol-O-methyltransferase (COMT) genotype moderates the effects of childhood trauma on cognition and symptoms in schizophrenia. J Psychiatr Res 2014; 49:43-50. [PMID: 24252819 DOI: 10.1016/j.jpsychires.2013.10.018] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 10/28/2013] [Accepted: 10/29/2013] [Indexed: 01/02/2023]
Abstract
The interaction of genetic and environmental factors may affect the course and development of psychotic disorders. We examined whether the effects of childhood trauma on cognition and symptoms in schizophrenia were moderated by the Catechol-O-methyltransferase (COMT) Val(158)Met polymorphism, a common genetic variant known to affect cognition and prefrontal dopamine levels. Participants were 429 schizophrenia/schizoaffective cases from the Australian Schizophrenia Research Bank (ASRB). Cognitive performance was assessed using the Repeatable Battery for Assessment of Neuropsychological Status (RBANS), Controlled Oral Word Association Test (COWAT), Letter Number Sequencing (LNS) test, and the Wechsler Test of Adult Reading (WTAR). Hierarchical regression was used to test the main effects and additive interaction effects of genotype and childhood trauma in the domains of physical abuse, emotional abuse, and emotional neglect, on cognition and symptom profiles of clinical cases. Consistent with previous findings, COMT Val homozygotes performed worse on cognitive measures in the absence of childhood adversity. In addition, a significant interaction between COMT genotype and physical abuse was associated with better executive function in Val homozygotes, relative to those of the same genotype with no history of abuse. Finally, the severity of positive symptoms was greater in Met carriers who had experienced physical abuse, and the severity of negative symptoms in Met carriers was greater in the presence of emotional neglect. These results suggest that the possible epigenetic modulation of the expression of the COMT Val(158)Met polymorphism and consequent effects on cognition and symptoms in schizophrenia, with worse outcomes associated with adverse childhood experiences in Met carriers.
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Affiliation(s)
- Melissa J Green
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Schizophrenia Research Institute, Darlinghurst, NSW, Australia.
| | - T-Yunn Chia
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Schizophrenia Research Institute, Darlinghurst, NSW, Australia
| | - Murray J Cairns
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia; School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, Callaghan, NSW 2308, Australia; Centre for Brain and Mental Health and Centre for Information-Based Medicine, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Jingqin Wu
- School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, Callaghan, NSW 2308, Australia; Centre for Brain and Mental Health and Centre for Information-Based Medicine, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Paul A Tooney
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia; School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, Callaghan, NSW 2308, Australia; Centre for Brain and Mental Health and Centre for Information-Based Medicine, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Rodney J Scott
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia; School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, Callaghan, NSW 2308, Australia; Centre for Brain and Mental Health and Centre for Information-Based Medicine, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia; Hunter Area Pathology Service, Newcastle, NSW, Australia
| | - Vaughan J Carr
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Schizophrenia Research Institute, Darlinghurst, NSW, Australia
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van Winkel R, Kuepper R. Epidemiological, neurobiological, and genetic clues to the mechanisms linking cannabis use to risk for nonaffective psychosis. Annu Rev Clin Psychol 2014; 10:767-91. [PMID: 24471373 DOI: 10.1146/annurev-clinpsy-032813-153631] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Epidemiological studies have shown that the association between cannabis and psychosis is robust and consistent across different samples, with compelling evidence for a dose-response relationship. Because longitudinal work indicates that cannabis use precedes psychotic symptoms, it seems reasonable to assume a causal relationship. However, more work is needed to address the possibility of gene-environment correlation (for example, genetic risk for psychosis causing onset of cannabis use). Moreover, knowledge about underlying biological mechanisms linking cannabis use and psychosis is still relatively limited. In order to understand how cannabis use may lead to an increased risk for psychosis, in the present article we (a) review the epidemiological, neurobiological, and genetic evidence linking cannabinoids and psychosis, (b) assess the quality of the evidence, and finally (c) try to integrate the most robust findings into a neurodevelopmental model of cannabis-induced psychosis and identify the gaps in knowledge that are in need of further investigation.
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Affiliation(s)
- Ruud van Winkel
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, European Graduate School of Neuroscience (EURON), South Limburg Mental Health Research and Teaching Network (SEARCH), Maastricht University Medical Center, Maastricht, The Netherlands;
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Radhakrishnan R, Wilkinson ST, D'Souza DC. Gone to Pot - A Review of the Association between Cannabis and Psychosis. Front Psychiatry 2014; 5:54. [PMID: 24904437 PMCID: PMC4033190 DOI: 10.3389/fpsyt.2014.00054] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 05/02/2014] [Indexed: 01/01/2023] Open
Abstract
Cannabis is the most commonly used illicit drug worldwide, with ~5 million daily users worldwide. Emerging evidence supports a number of associations between cannabis and psychosis/psychotic disorders, including schizophrenia. These associations-based on case-studies, surveys, epidemiological studies, and experimental studies indicate that cannabinoids can produce acute, transient effects; acute, persistent effects; and delayed, persistent effects that recapitulate the psychopathology and psychophysiology seen in schizophrenia. Acute exposure to both cannabis and synthetic cannabinoids (Spice/K2) can produce a full range of transient psychotomimetic symptoms, cognitive deficits, and psychophysiological abnormalities that bear a striking resemblance to symptoms of schizophrenia. In individuals with an established psychotic disorder, cannabinoids can exacerbate symptoms, trigger relapse, and have negative consequences on the course of the illness. Several factors appear to moderate these associations, including family history, genetic factors, history of childhood abuse, and the age at onset of cannabis use. Exposure to cannabinoids in adolescence confers a higher risk for psychosis outcomes in later life and the risk is dose-related. Individuals with polymorphisms of COMT and AKT1 genes may be at increased risk for psychotic disorders in association with cannabinoids, as are individuals with a family history of psychotic disorders or a history of childhood trauma. The relationship between cannabis and schizophrenia fulfills many but not all of the standard criteria for causality, including temporality, biological gradient, biological plausibility, experimental evidence, consistency, and coherence. At the present time, the evidence indicates that cannabis may be a component cause in the emergence of psychosis, and this warrants serious consideration from the point of view of public health policy.
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Affiliation(s)
- Rajiv Radhakrishnan
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA
| | - Samuel T Wilkinson
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA
| | - Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine , New Haven, CT , USA ; Abraham Ribicoff Research Facilities, Connecticut Mental Health Center , New Haven, CT , USA ; Schizophrenia and Neuropharmacology Research Group, VA Connecticut Healthcare System , West Haven, CT , USA
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Abstract
Severe mental illness (SMI) is a broad category that includes schizophrenia, bipolar disorder, and severe depression. Both genetic disposition and environmental exposures play important roles in the development of SMI. Multiple lines of evidence suggest that the roles of genetic and environmental factors depend on each other. Gene-environment interactions may underlie the paradox of strong environmental factors for highly heritable disorders, the low estimates of shared environmental influences in twin studies of SMI, and the heritability gap between twin and molecular heritability estimates. Sons and daughters of parents with SMI are more vulnerable to the effects of prenatal and postnatal environmental exposures, suggesting that the expression of genetic liability depends on environment. In the last decade, gene-environment interactions involving specific molecular variants in candidate genes have been identified. Replicated findings include an interaction between a polymorphism in the AKT1 gene and cannabis use in the development of psychosis and an interaction between the length polymorphism of the serotonin transporter gene and childhood maltreatment in the development of persistent depressive disorder. Bipolar disorder has been underinvestigated, with only a single study showing an interaction between a functional polymorphism in the BDNF gene and stressful life events triggering bipolar depressive episodes. The first systematic search for gene-environment interactions has found that a polymorphism in CTNNA3 may sensitize the developing brain to the pathogenic effect of cytomegalovirus in utero, leading to schizophrenia in adulthood. Strategies for genome-wide investigations will likely include coordination between epidemiological and genetic research efforts, systematic assessment of multiple environmental factors in large samples, and prioritization of genetic variants.
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Affiliation(s)
- Rudolf Uher
- Department of Psychiatry, Dalhousie University , Halifax, NS , Canada ; Department of Psychology and Neuroscience, Dalhousie University , Halifax, NS , Canada ; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London , London , UK
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Ramsay H, Kelleher I, Flannery P, Clarke MC, Lynch F, Harley M, Connor D, Fitzpatrick C, Morris DW, Cannon M. Relationship between the COMT-Val158Met and BDNF-Val66Met polymorphisms, childhood trauma and psychotic experiences in an adolescent general population sample. PLoS One 2013; 8:e79741. [PMID: 24224001 PMCID: PMC3818212 DOI: 10.1371/journal.pone.0079741] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 09/23/2013] [Indexed: 01/24/2023] Open
Abstract
Objective Psychotic experiences occur at a much greater prevalence in the population than psychotic disorders. There has been little research to date, however, on genetic risk for this extended psychosis phenotype. We examined whether COMT or BDNF genotypes were associated with psychotic experiences or interacted with childhood trauma in predicting psychotic experiences. Method Psychiatric interviews and genotyping for COMT-Val158Met and BDNF-Val66Met were carried out on two population-based samples of 237 individuals aged 11-15 years. Logistic regression was used to examine for main effects by genotype and childhood trauma, controlling for important covariates. This was then compared to a model with a term for interaction between genotype and childhood trauma. Where a possible interaction was detected, this was further explored in stratified analyses. Results While childhood trauma showed a borderline association with psychotic experiences, COMT-Val158Met and BDNF-Val66Met genotypes were not directly associated with psychotic experiences in the population. Testing for gene x environment interaction was borderline significant in the case of COMT-Val158Met with individuals with the COMT-Val158Met Val-Val genotype, who had been exposed to childhood trauma borderline significantly more likely to report psychotic experiences than those with Val-Met or Met-Met genotypes. There was no similar interaction by BDNF-Val66Met genotype. Conclusion The COMT-Val158Met Val-Val genotype may be a genetic moderator of risk for psychotic experiences in individuals exposed to childhood traumatic experiences.
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Affiliation(s)
- Hugh Ramsay
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
- * E-mail:
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden
| | - Padraig Flannery
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Mary C. Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | | | - Michelle Harley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
- Department of Child and Adolescent Psychiatry, St Vincent’s Hospital, Fairview, Dublin, Ireland
| | - Dearbhla Connor
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Carol Fitzpatrick
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
| | - Derek W. Morris
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
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