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Giuliani L, Pezzella P, Giordano GM, Fazio L, Mucci A, Perrottelli A, Blasi G, Amore M, Rocca P, Rossi A, Bertolino A, Galderisi S, Maj M. Illness-related variables and abnormalities of resting-state brain activity in schizophrenia. Front Psychiatry 2024; 15:1458624. [PMID: 39165501 PMCID: PMC11333936 DOI: 10.3389/fpsyt.2024.1458624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 07/17/2024] [Indexed: 08/22/2024] Open
Abstract
Background The development of neuroimaging biomarkers in patients with schizophrenia (SCZ) requires a refined clinical characterization. A limitation of the neuroimaging literature is the partial uptake of progress in characterizing disease-related features, particularly negative symptoms (NS) and cognitive impairment (CI). In the present study, we assessed NS and CI using up-to-date instruments and investigated the associations of abnormalities in brain resting-state (rs)-activity with disease-related features. Methods Sixty-two community-dwelling SCZ subjects participated in the study. Multiple regression analyses were performed with the rs-activity of nine regions of interest as dependent variables and disease-related features as explanatory variables. Results Attention/vigilance deficits were negatively associated with dorsal anterior cingulate rs-activity and, together with depression, were positively associated with right dorsolateral prefrontal cortex rs-activity. These deficits and impairment of Reasoning/problem-solving, together with conceptual disorganization, were associated with right inferior parietal lobule and temporal parietal junction rs-activity. Independent of other features, the NS Expressive Deficit domain was associated with the left ventral caudate, while the Motivational Deficit was associated with the dorsal caudate rs-activity. Conclusion Neurocognitive deficits and the two negative symptom domains are associated with different neural markers. Replications of these findings could foster the identification of clinically actionable biomarkers of poor functional outcomes.
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Affiliation(s)
- Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Leonardo Fazio
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, Bari, Italy
- Department of Medicine and Surgery, Libera Università Mediterranea Giuseppe Degennaro, Casamassima, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, Bari, Italy
| | - Mario Amore
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L’Aquila, L’Aquila, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, Bari, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
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2
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Chintoh A, Liu L, Braun A, Akseer S, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone W, Tsuang MT, Walker EF, Woods SW, Cannon TD, Addington J. Sex differences in clinical presentation in youth at high risk for psychosis who transition to psychosis. Schizophr Res 2024; 271:153-160. [PMID: 39029145 DOI: 10.1016/j.schres.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 06/19/2024] [Accepted: 07/13/2024] [Indexed: 07/21/2024]
Abstract
Sex differences have been observed in individuals with schizophrenia and for those at clinical high risk (CHR) for psychosis. However, specific differences in CHR individuals who transition to psychosis remain inconsistent and understudied. This study aimed to investigate sex differences in 156 CHR individuals who made the transition to psychosis. A wide range of demographics, positive and negative symptoms, depression, anxiety, social and role functioning, trauma, and substance use were assessed at baseline and symptoms and diagnoses at the time of transition. Fluctuations in positive and negative symptoms and different medications were also assessed. No sex differences were observed at baseline for those who later transitioned to psychosis. At transition, males were significantly more likely to be diagnosed as having schizophrenia or schizophreniform disorder and through the course of the study, males were more likely to be taking stimulants. Limitations in this study was the lack of longitudinal follow-up post transition. The study highlights the need for further research on sex differences in individuals who transition to psychosis. Understanding these differences can have implications for treatment and monitoring of CHR individuals.
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Affiliation(s)
- Araba Chintoh
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Amy Braun
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Selai Akseer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, United States of America
| | | | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States of America
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, SFVA Medical Center, San Francisco, CA, United States of America
| | - Thomas H McGlashan
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, CA, United States of America; Institute of Genomic Medicine, University of California, La Jolla, CA, United States of America
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States of America
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, United States of America; Department of Psychology, Yale University, New Haven, CT, United States of America
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
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3
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Alliende LM, Strauss GP, Yang LH, Mittal VA. Perceptions of stigma in youth at clinical high risk for psychosis and depressive symptomatology. Schizophr Res 2024; 269:79-85. [PMID: 38754312 PMCID: PMC11249038 DOI: 10.1016/j.schres.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/16/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
It is unclear what types of stigma youth at clinical high risk for psychosis (CHR) experience, and the relationship between them and symptomatology. 94 CHR youth, and a control group of 45 youth with no psychosis spectrum symptoms (NP) were rated for perceived devaluation (i.e. negative views from others) and internalized mental health stigma (i.e. the extent to which they would agree with said views) as well as positive and mood symptomatology. CHR youth reported stigma more frequently than the NP group (χ2(1) = 53.55, p < .001) and at higher levels (perceived devaluation: t (137) = 8.54, p < .001; internalized stigma: t (137) = 7.48, p < .001). Surprisingly, in the CHR group, positive symptoms held no significant relationship to stigma measures. However, ratings of perceived devaluation stigma were associated with depressive symptomatology (β = 0.27, t = 2.68, p = .0087) and depression scores were conversely associated with perceived devaluation stigma (β = 0.30, t = 2.05, p = .043). These findings speak to the relationship between depressive symptomatology and perceived devaluation stigma in CHR youth. Perceived devaluation stigma showed greater clinical significance and could have different mechanisms than internalized stigma in CHR youth. It is also noteworthy that while positive symptoms play a central role in defining the CHR syndrome, they seem less relevant to the experience of stigma than mood symptoms. These findings highlight the importance of interventions aimed at ameliorating youth's exposure to negative views about mental health as those managing depressive symptomatology.
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Affiliation(s)
| | | | - Lawrence H Yang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, USA
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4
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Cowan HR, Williams TF, Mittal VA, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Keshevan M, Perkins DO, Mathalon DH, Stone W, Woods SW, Walker EF. The Complex Latent Structure of Attenuated Psychotic Symptoms: Hierarchical and Bifactor Models of SIPS Symptoms Replicated in Two Large Samples at Clinical High Risk for Psychosis. Schizophr Bull 2024:sbae042. [PMID: 38728417 DOI: 10.1093/schbul/sbae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
BACKGROUND AND HYPOTHESIS The Structured Interview for Psychosis-Risk Syndromes (SIPS) and other assessments of psychosis risk define clinical high risk for psychosis (CHR) by the presence of attenuated psychotic symptoms. Despite extensive research on attenuated psychotic symptoms, substantial questions remain about their internal psychometric structure and relationships to comorbid non-psychotic symptoms. STUDY DESIGN Hierarchical and bifactor models were developed for the SIPS in a large CHR sample (NAPLS-3, N = 787) and confirmed through preregistered replication in an independent sample (NAPLS-2, N = 1043). Criterion validity was tested through relationships with CHR status, comorbid symptoms/diagnoses, functional impairment, demographics, neurocognition, and conversion to psychotic disorders. STUDY RESULTS Most variance in SIPS items (75%-77%) was attributable to a general factor. Hierarchical and bifactor models included a general factor and five specific/lower-order factors (positive symptoms, eccentricity, avolition, lack of emotion, and deteriorated thought process). CHR participants were elevated on the general factor and the positive symptoms factor. The general factor was associated with depressive symptoms; functional impairment; and mood, anxiety, and schizotypal personality diagnoses. The general factor was the best predictor of psychotic disorders (d ≥ 0.50). Positive symptoms and eccentricity had specific effects on conversion outcomes. The deteriorated thought process was least meaningful/replicable. CONCLUSIONS Attenuated psychotic symptoms, measured by the SIPS, have a complex hierarchical structure with a strong general factor. The general factor relates to internalizing symptoms and functional impairment, emphasizing the roles of general psychopathological distress/impairment in psychosis risk. Shared symptom variance complicates the interpretation of raw symptom scores. Broad transdiagnostic assessment is warranted to model psychosis risk accurately.
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Affiliation(s)
- Henry R Cowan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Trevor F Williams
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Departments of Psychiatry and Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Barbara A Cornblatt
- Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Matcheri Keshevan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
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5
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Biswas T, Mishra BR, Maiti R, Padhy SK, Mishra A. Efficacy and safety of low-dose amisulpride versus olanzapine-fluoxetine combination in post-schizophrenic depression: A randomized controlled trial. J Psychiatr Res 2024; 173:302-308. [PMID: 38560960 DOI: 10.1016/j.jpsychires.2024.03.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/27/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
Post-schizophrenic depression (PSD) increases the morbidity, mortality, and health burden in patients with schizophrenia. However, treatment of PSD is challenging due to the lack of substantial evidence of standard clinical practice. This study was aimed at comparing the efficacy and safety of low-dose amisulpride versus olanzapine-fluoxetine combination (OFC) in PSD. This was a randomized controlled trial conducted in sixty patients with PSD fulfilling the eligibility criteria. Recruited patients were randomized to receive either amisulpride at low dose (i.e., 100-300 mg/day) or OFC (5/10 mg + 20 mg) for eight weeks. The Calgary Depression Scale for Schizophrenia (CDSS), the Clinical Global Impression-Severity (CGI-S) and serum BDNF levels were assessed at baseline and after eight weeks of treatment. The change in the CDSS scores from baseline over eight weeks was significant in both the amisulpride and OFC groups. However, the changes were not significant when compared between the groups. Similarly, the changes in CGI-S scores and serum BDNF levels were significant in each group; but non-significant between the groups. A significant negative correlation was found between the changes in the CDSS scores and the serum BDNF levels in each group. No significant adverse events were noted in either group. Thus, to conclude, low-dose amisulpride can be a potential monotherapy in PSD with a favourable clinical outcome and safety profile (ClinicalTrials.gov ID: NCT04876521).
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Affiliation(s)
- Tathagata Biswas
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - Biswa Ranjan Mishra
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rituparna Maiti
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Susanta Kumar Padhy
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Archana Mishra
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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6
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Wannan CMJ, Nelson B, Addington J, Allott K, Anticevic A, Arango C, Baker JT, Bearden CE, Billah T, Bouix S, Broome MR, Buccilli K, Cadenhead KS, Calkins ME, Cannon TD, Cecci G, Chen EYH, Cho KIK, Choi J, Clark SR, Coleman MJ, Conus P, Corcoran CM, Cornblatt BA, Diaz-Caneja CM, Dwyer D, Ebdrup BH, Ellman LM, Fusar-Poli P, Galindo L, Gaspar PA, Gerber C, Glenthøj LB, Glynn R, Harms MP, Horton LE, Kahn RS, Kambeitz J, Kambeitz-Ilankovic L, Kane JM, Kapur T, Keshavan MS, Kim SW, Koutsouleris N, Kubicki M, Kwon JS, Langbein K, Lewandowski KE, Light GA, Mamah D, Marcy PJ, Mathalon DH, McGorry PD, Mittal VA, Nordentoft M, Nunez A, Pasternak O, Pearlson GD, Perez J, Perkins DO, Powers AR, Roalf DR, Sabb FW, Schiffman J, Shah JL, Smesny S, Spark J, Stone WS, Strauss GP, Tamayo Z, Torous J, Upthegrove R, Vangel M, Verma S, Wang J, Rossum IWV, Wolf DH, Wolff P, Wood SJ, Yung AR, Agurto C, Alvarez-Jimenez M, Amminger P, Armando M, Asgari-Targhi A, Cahill J, Carrión RE, Castro E, Cetin-Karayumak S, Mallar Chakravarty M, Cho YT, Cotter D, D’Alfonso S, Ennis M, Fadnavis S, Fonteneau C, Gao C, Gupta T, Gur RE, Gur RC, Hamilton HK, Hoftman GD, Jacobs GR, Jarcho J, Ji JL, Kohler CG, Lalousis PA, Lavoie S, Lepage M, Liebenthal E, Mervis J, Murty V, Nicholas SC, Ning L, Penzel N, Poldrack R, Polosecki P, Pratt DN, Rabin R, Rahimi Eichi H, Rathi Y, Reichenberg A, Reinen J, Rogers J, Ruiz-Yu B, Scott I, Seitz-Holland J, Srihari VH, Srivastava A, Thompson A, Turetsky BI, Walsh BC, Whitford T, Wigman JTW, Yao B, Yuen HP, Ahmed U, Byun A(JS, Chung Y, Do K, Hendricks L, Huynh K, Jeffries C, Lane E, Langholm C, Lin E, Mantua V, Santorelli G, Ruparel K, Zoupou E, Adasme T, Addamo L, Adery L, Ali M, Auther A, Aversa S, Baek SH, Bates K, Bathery A, Bayer JMM, Beedham R, Bilgrami Z, Birch S, Bonoldi I, Borders O, Borgatti R, Brown L, Bruna A, Carrington H, Castillo-Passi RI, Chen J, Cheng N, Ching AE, Clifford C, Colton BL, Contreras P, Corral S, Damiani S, Done M, Estradé A, Etuka BA, Formica M, Furlan R, Geljic M, Germano C, Getachew R, Goncalves M, Haidar A, Hartmann J, Jo A, John O, Kerins S, Kerr M, Kesselring I, Kim H, Kim N, Kinney K, Krcmar M, Kotler E, Lafanechere M, Lee C, Llerena J, Markiewicz C, Matnejl P, Maturana A, Mavambu A, Mayol-Troncoso R, McDonnell A, McGowan A, McLaughlin D, McIlhenny R, McQueen B, Mebrahtu Y, Mensi M, Hui CLM, Suen YN, Wong SMY, Morrell N, Omar M, Partridge A, Phassouliotis C, Pichiecchio A, Politi P, Porter C, Provenzani U, Prunier N, Raj J, Ray S, Rayner V, Reyes M, Reynolds K, Rush S, Salinas C, Shetty J, Snowball C, Tod S, Turra-Fariña G, Valle D, Veale S, Whitson S, Wickham A, Youn S, Zamorano F, Zavaglia E, Zinberg J, Woods SW, Shenton ME. Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis. Schizophr Bull 2024; 50:496-512. [PMID: 38451304 PMCID: PMC11059785 DOI: 10.1093/schbul/sbae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
This article describes the rationale, aims, and methodology of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). This is the largest international collaboration to date that will develop algorithms to predict trajectories and outcomes of individuals at clinical high risk (CHR) for psychosis and to advance the development and use of novel pharmacological interventions for CHR individuals. We present a description of the participating research networks and the data processing analysis and coordination center, their processes for data harmonization across 43 sites from 13 participating countries (recruitment across North America, Australia, Europe, Asia, and South America), data flow and quality assessment processes, data analyses, and the transfer of data to the National Institute of Mental Health (NIMH) Data Archive (NDA) for use by the research community. In an expected sample of approximately 2000 CHR individuals and 640 matched healthy controls, AMP SCZ will collect clinical, environmental, and cognitive data along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech and facial expression samples, novel measures derived from digital health technologies including smartphone-based daily surveys, and passive sensing as well as actigraphy. The study will investigate a range of clinical outcomes over a 2-year period, including transition to psychosis, remission or persistence of CHR status, attenuated positive symptoms, persistent negative symptoms, mood and anxiety symptoms, and psychosocial functioning. The global reach of AMP SCZ and its harmonized innovative methods promise to catalyze the development of new treatments to address critical unmet clinical and public health needs in CHR individuals.
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Affiliation(s)
- Cassandra M J Wannan
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Kelly Allott
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Justin T Baker
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Carrie E Bearden
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tashrif Billah
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Canada
| | - Matthew R Broome
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
- Early Intervention for Psychosis Services, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Kate Buccilli
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Kang Ik K Cho
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jimmy Choi
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, USA
| | - Scott R Clark
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Basil Hetzel Institute, Woodville, SA, Australia
| | - Michael J Coleman
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Philippe Conus
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP–Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara A Cornblatt
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Covadonga M Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Dominic Dwyer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research, CNSR Mental Health Centre, Glostrup, Copenhagen, Denmark
| | - Lauren M Ellman
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Liliana Galindo
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pablo A Gaspar
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Carla Gerber
- Behavioral Health Services, PeaceHealth Medical Group, Eugene, OR, USA
| | - Louise Birkedal Glenthøj
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Robert Glynn
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health and Harvard Medical School, Boston, MA, USA
| | - Michael P Harms
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Leslie E Horton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph Kambeitz
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - John M Kane
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Tina Kapur
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marek Kubicki
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Kathryn E Lewandowski
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Health Care System, San Diego, CA, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | | | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116D, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Patrick D McGorry
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Angela Nunez
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Ofer Pasternak
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, USA
| | - Jesus Perez
- CAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Medicine, Institute of Biomedical Research (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Albert R Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - David R Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fred W Sabb
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jai L Shah
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jessica Spark
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | | | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - John Torous
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Rachel Upthegrove
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Canada
- Birmingham Womens and Childrens, NHS Foundation Trust, Birmingham, UK
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Inge Winter-van Rossum
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Phillip Wolff
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Stephen J Wood
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Alison R Yung
- Institute of Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Carla Agurto
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Paul Amminger
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Marco Armando
- Youth Early Detection/Intervention in Psychosis Platform (Plateforme ERA), Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and The University of Lausanne, Lausanne, Switzerland
| | | | - John Cahill
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Ricardo E Carrión
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Eduardo Castro
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Suheyla Cetin-Karayumak
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Youngsun T Cho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - David Cotter
- Department Psychiatry, Beaumont Hospital, Dublin 9, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Simon D’Alfonso
- School of Computing and Information Systems, The University of Melbourne, Parkville, VIC, Australia
| | - Michaela Ennis
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Shreyas Fadnavis
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Caroline Gao
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Tina Gupta
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Holly K Hamilton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Gil D Hoftman
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Grace R Jacobs
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Johanna Jarcho
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Christian G Kohler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paris Alexandros Lalousis
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Suzie Lavoie
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Einat Liebenthal
- Program for Specialized Treatment Early in Psychosis (STEP), CMHC, New Haven, CT, USA
| | - Josh Mervis
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Vishnu Murty
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Spero C Nicholas
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Lipeng Ning
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Nora Penzel
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Russell Poldrack
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | - Danielle N Pratt
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Rachel Rabin
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | | | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Avraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jenna Reinen
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Jack Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Bernalyn Ruiz-Yu
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Isabelle Scott
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Vinod H Srihari
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Program for Specialized Treatment Early in Psychosis (STEP), CMHC, New Haven, CT, USA
| | - Agrima Srivastava
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew Thompson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Bruce I Turetsky
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara C Walsh
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Thomas Whitford
- Orygen, Parkville, VIC, Australia
- School of Psychology, University of New South Wales (UNSW), Kensington, NSW, Australia
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center,Groningen, Netherlands
| | - Beier Yao
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Hok Pan Yuen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Andrew (Jin Soo) Byun
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Yoonho Chung
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Kim Do
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
| | - Larry Hendricks
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Kevin Huynh
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Erlend Lane
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Carsten Langholm
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Eric Lin
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
- Medical Informatics Fellowship, Veteran Affairs Boston Healthcare System, Boston, MA, USA
- Food and Drug Administration, Silver Spring, MD, USA
| | - Valentina Mantua
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Gennarina Santorelli
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Kosha Ruparel
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Eirini Zoupou
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Tatiana Adasme
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Lauren Addamo
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Laura Adery
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Munaza Ali
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Andrea Auther
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Samantha Aversa
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | - Seon-Hwa Baek
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Kelly Bates
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Alyssa Bathery
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Johanna M M Bayer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Rebecca Beedham
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Zarina Bilgrami
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sonia Birch
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ilaria Bonoldi
- Department of Psychosis Studies, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Owen Borders
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Lisa Brown
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Alejandro Bruna
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Holly Carrington
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Rolando I Castillo-Passi
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana—Universidad del Desarrollo, Santiago, Chile
| | - Justine Chen
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicholas Cheng
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ann Ee Ching
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Chloe Clifford
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Beau-Luke Colton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Pamela Contreras
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Sebastián Corral
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Monica Done
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrés Estradé
- Early Psychosis Detection and Clinical Intervention (EPIC) Lab, Department of Psychosis Studies, King’s College London, London, UK
| | - Brandon Asika Etuka
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Melanie Formica
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Rachel Furlan
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Mia Geljic
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Carmela Germano
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ruth Getachew
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Anastasia Haidar
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica Hartmann
- Department of Public Mental Health, Central Institute of Mental Health, Heidelberg Univeristy, Mannheim, Germany
| | - Anna Jo
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Omar John
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Kerins
- Early Psychosis Detection and Clinical Intervention (EPIC) Lab, Department of Psychosis Studies, King’s College London, London, UK
| | - Melissa Kerr
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Irena Kesselring
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Nicholas Kim
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Kyle Kinney
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Marija Krcmar
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Elana Kotler
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Melanie Lafanechere
- School of Psychology, University of Birmingham, Edgbaston, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Clarice Lee
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Joshua Llerena
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | | | | | - Aissata Mavambu
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | | | - Amelia McDonnell
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Alessia McGowan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Rebecca McIlhenny
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brittany McQueen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Yohannes Mebrahtu
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Martina Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | | | - Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Neal Morrell
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Mariam Omar
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alice Partridge
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Christina Phassouliotis
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Anna Pichiecchio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Christian Porter
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Umberto Provenzani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Nicholas Prunier
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jasmine Raj
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Susan Ray
- Northwell Health, Glen Oaks, NY, USA
| | - Victoria Rayner
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Manuel Reyes
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana—Universidad del Desarrollo, Santiago, Chile
| | - Kate Reynolds
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sage Rush
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Cesar Salinas
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Jashmina Shetty
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Callum Snowball
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sophie Tod
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Daniela Valle
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Simone Veale
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Whitson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alana Wickham
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Youn
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Francisco Zamorano
- Unidad de imágenes cuantitativas avanzadas, departamento de imágenes, clínica alemana, universidad del Desarrollo, Santiago, Chile
- Facultad de ciencias para el cuidado de la salud, Universidad San Sebastián, Campus Los Leones, Santiago, Chile
| | - Elissa Zavaglia
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | - Jamie Zinberg
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Martin JC, Clark SR, Hartmann S, Schubert KO. A Tale of Three Spectra: Basic Symptoms in Clinical-High-Risk of Psychosis Vary Across Autism Spectrum Disorder, Schizotypal Personality Disorder, and Borderline Personality Disorder. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae017. [PMID: 39183768 PMCID: PMC11341945 DOI: 10.1093/schizbullopen/sgae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Background and Hypothesis The clinical-high-risk (CHR) approach was developed to prevent psychosis through the detection of psychosis risk. CHR services are transdiagnostic in nature, therefore the appropriate management of comorbidity is a central part of care. Differential diagnosis is particularly challenging across 3 common comorbidities, schizotypal personality disorder (SPD), autism spectrum disorder (ASD), and borderline personality disorder (BPD). Phenomenological research indicates a disturbance of "basic self" may differentiate between these commonly comorbid disorders and can be captured by Huber's basic symptoms (BS) concept. We investigated whether BS vary across these disorders and may inform differential diagnosis in young person's meeting CHR criteria. Study Design A total of 685 participants meeting CHR criteria from the NAPLS-3 cohort completed the COGDIS items of the schizophrenia proneness instrument, a measure of BS, as well as the structured interview for DSM-5 (SCID-5). A logistic regression model was used to investigate the variation of COGDIS across SPD, ASD, and BPD, while controlling for age and SIPs positive severity. Study Results Meeting COGDIS criteria was positively associated with SPD (OR = 1.72, CI = [1.31-2.28], P = .001) but not ASD nor BPD. Conclusions Our results indicate that "basic self-disturbance" as indicated by COGDIS differs across SPD, ASD, and BPD. COGDIS may be useful to inform the management of comorbidities in CHR services, by providing insight into subtle subjective experiences that may benefit from disorder-specific interventions.
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Affiliation(s)
- James C Martin
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Scott R Clark
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
- Discipline of Psychiatry, Basil Hetzel Institute, Woodville, South Australia, Australia
| | - Simon Hartmann
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - K Oliver Schubert
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
- Division of Mental Health, Northern Adelaide Local Health Network, SA Health, South Australia
- Headspace Early Psychosis, Sonder, South Australia
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8
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Fond G, Mallet J, Urbach M, Benros ME, Berk M, Billeci M, Boyer L, Correll CU, Fornaro M, Kulkarni J, Leboyer M, Llorca PM, Misdrahi D, Rey R, Schürhoff F, Solmi M, Sommer IEC, Stahl SM, Pignon B, Berna F. Adjunctive agents to antipsychotics in schizophrenia: a systematic umbrella review and recommendations for amino acids, hormonal therapies and anti-inflammatory drugs. BMJ MENTAL HEALTH 2023; 26:e300771. [PMID: 37852631 PMCID: PMC10583081 DOI: 10.1136/bmjment-2023-300771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/02/2023] [Indexed: 10/20/2023]
Abstract
QUESTION This umbrella review and guidelines aimed to provide evidence to support the rational choice of selected adjunctive therapies for schizophrenia. STUDY SELECTION AND ANALYSIS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and World Federation of Societies of Biological Psychiatry (WFSBP)-grading recommendations, 63 randomised control trials (RCTs) (of which 4219 unique participants have completed the RCTs) and 29 meta-analyses were analysed. FINDINGS Provisional recommendations (WFSBP-grade 1) could be made for two molecules in augmentation to antipsychotics: (1) N-acetyl-cysteine (NAC, 1200-3600 mg/day, for >12 consecutive weeks) in improving negative symptoms, general psychopathology (positive and negative syndrome scale for schizophrenia (PANSS) general psychopathology factor (G)-G subscale), with the RCTs with the longer duration showing the most robust findings; (2) polyunsaturated fatty acids (3000 mg/day of eicosapentaenoic acid, for >12 weeks) in improving general psychopathology. Weaker recommendations (ie, WFSBP-grade 2) could be drawn for sarcosine (2 g/day) and minocycline (200-300 mg/day) for improving negative symptoms in chronic schizophrenia (not early schizophrenia), and NAC for improving positive symptoms and cognition. Weak recommendations are not ready for clinical practice. There is provisional evidence that oestrogens and raloxifene are effective in some patients, but further research is needed to determine their benefit/risk ratio. CONCLUSIONS The results of this umbrella review should be interpreted with caution as the number of RCTs included in the meta-analyses was generally small and the effect sizes were weak or medium. For NAC, two RCTs with low risk of bias have provided conflicting results and the WFSBP-grade recommendation included also the results of meta-analyses. These drugs could be provisionally prescribed for patients for whom no other treatments have been effective, but they should be discontinued if they prove ineffective.
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Affiliation(s)
- Guillaume Fond
- Department of psychiatry, Assistance Publique des Hôpitaux de Marseille, Marseille, France
- Fondation FondaMental, Creteil, France
- CEReSS-Health Service Research and Quality of Life Center, AMU, Marseille, France
| | - Jasmina Mallet
- Fondation FondaMental, Creteil, France
- Department of Psychiatry, Louis Mourier Hospital, Colombes, France
| | - Mathieu Urbach
- Fondation FondaMental, Creteil, France
- Department of Adult Psychiatry and Addictology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Michael Eriksen Benros
- Copenhagen Research Center for Biological and Precision Psychiatry, Mental Health Centre Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Berk
- Deakin University, School of Medicine, and Barwon Health; IMPACT, the Institute for Mental and Physical Health and Clinical Translation; Orygen The National Centre of Excellence in Youth Mental Health, The Florey Institute of Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne and the Department of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Martina Billeci
- Department of Neuroscience, Reproductive Sciences, and Dentistry, Section of Psychiatry, Federico II University of Naples, Naples, Italy
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, AMU, Marseille, France
- Département d'information médicale, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - Christoph U Correll
- Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany
| | - Michele Fornaro
- Department of Neuroscience, Reproductive Sciences, and Dentistry, Section of Psychiatry, Federico II University of Naples, Naples, Italy
| | - Jayashri Kulkarni
- Department of Psychiatry, Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University,607StKildaRd, Level4, Melbourne, Victoria, Australia 3004, Melbourne, Victoria, Australia
| | - Marion Leboyer
- Fondation FondaMental, Creteil, France
- Department of psychiatry, Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM U955, IMRB, translational Neuropsychiatry, F-94010 Creteil, France, Créteil, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, Creteil, France
- Département de psychiatrie, Université Clermont Auvergne, CMP-B CHU, CNRS,Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand, France
| | - David Misdrahi
- Fondation FondaMental, Creteil, France
- Departement de Psychiatrie Générale et Universitaire, Centre Hospitalier Charles Perrens; Univ. Bordeaux, CNRS, UMR 5287, F-33000, INCIA, Bordeaux, France
| | - Romain Rey
- Fondation FondaMental, Creteil, France
- Schizophrenia Expert Centre, Le Vinatier Hospital; INSERM, U1028; CNRS, UMR5292; University Lyon 1; Lyon Neuroscience Research Center, PSYR2 Team, Lyon, France
| | - Franck Schürhoff
- Fondation FondaMental, Creteil, France
- Department of psychiatry, Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM U955, IMRB, translational Neuropsychiatry, F-94010 Creteil, France, Créteil, France
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
- Department of Mental Health, The Champlain First Episode Psychosis Program, The Ottawa Hospital, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Iris E C Sommer
- Department of Psychiatry, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Stephen M Stahl
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Baptiste Pignon
- Fondation FondaMental, Creteil, France
- Department of psychiatry, Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM U955, IMRB, translational Neuropsychiatry, F-94010 Creteil, France, Créteil, France
| | - Fabrice Berna
- Fondation FondaMental, Creteil, France
- Psychiatry, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France
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Rucci P, Caporusso E, Sanmarchi F, Giordano GM, Mucci A, Giuliani L, Pezzella P, Perrottelli A, Bucci P, Rocca P, Rossi A, Bertolino A, Galderisi S, Maj M. The structure stability of negative symptoms: longitudinal network analysis of the Brief Negative Symptom Scale in people with schizophrenia. BJPsych Open 2023; 9:e168. [PMID: 37674282 PMCID: PMC10594087 DOI: 10.1192/bjo.2023.541] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/23/2023] [Accepted: 07/06/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND The structure of negative symptoms of schizophrenia is still a matter of controversy. Although a two-dimensional model (comprising the expressive deficit dimension and the motivation and pleasure dimension) has gained a large consensus, it has been questioned by recent investigations. AIMS To investigate the latent structure of negative symptoms and its stability over time in people with schizophrenia using network analysis. METHOD Negative symptoms were assessed in 612 people with schizophrenia using the Brief Negative Symptom Scale (BNSS) at baseline and at 4-year follow-up. A network invariance analysis was conducted to investigate changes in the network structure and strength of connections between the two time points. RESULTS The network analysis carried out at baseline and follow-up, supported by community detection analysis, indicated that the BNSS's items aggregate to form four or five distinct domains (avolition/asociality, anhedonia, blunted affect and alogia). The network invariance test indicated that the network structure remained unchanged over time (network invariance test score 0.13; P = 0.169), although its overall strength decreased (6.28 at baseline, 5.79 at follow-up; global strength invariance test score 0.48; P = 0.016). CONCLUSIONS The results lend support to a four- or five-factor model of negative symptoms and indicate overall stability over time. These data have implications for the study of pathophysiological mechanisms and the development of targeted treatments for negative symptoms.
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Affiliation(s)
- Paola Rucci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Edoardo Caporusso
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giulia M. Giordano
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Paola Bucci
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L'Aquila, L'Aquila, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, Bari, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
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10
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Cairns AJJ, Kelly J, Taylor CDJ. Assessing the delivering of iMAgery-focused therapy for PSychosis (iMAPS) via telehealth. Psychol Psychother 2023; 96:678-696. [PMID: 37002818 DOI: 10.1111/papt.12463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES To examine the feasibility and acceptability of a novel telehealth (video-conferencing software and telephone calls) imagery-based therapeutic intervention for people experiencing persecutory delusions. Utilising a multiple baseline case series design and exploring imagery-focused therapy for psychosis (iMAPS). DESIGN A non-concurrent A-B multiple baseline design was used. METHODS Participants experiencing persecutory delusions and self-reporting a psychosis or schizophrenia-spectrum diagnosis were recruited through online adverts. On completion of assessments, participants were randomly assigned to multiple baseline assessments, of between three and five sessions. Six therapy sessions followed, consisting of imagery formulation, safe-place imagery creation, compassionate imagery, imagery manipulation and rescripting. Participants completed pre- and post-measures and sessional measures via an online survey software or in semi-structured interviews. Two weeks post-intervention, a final measure was completed exploring any potential adverse effects of psychotherapy. RESULTS Five female participants completed all baseline and therapeutic sessions, suggesting the therapy was and mode of delivery was feasible and acceptable. Results indicate strong effect sizes across PANSS positive subscale and mood, as well as participants reporting a clinically significant change in at least one measure, for example, PSYRATS. All participants reported a reduction in the realness and compelling nature of distressing imagery. CONCLUSIONS Results suggest delivering a telehealth imagery-focused therapy is acceptable and feasibly delivered via telehealth. A control group and blinding of assessments would strengthen the methodological limitations present.
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Affiliation(s)
- Aimee J J Cairns
- Clinical Psychology, Lancaster University, Health Innovation Campus, Bailrigg, Lancaster, LA1 4YW, UK
| | - James Kelly
- Clinical Psychology, Lancaster University, Health Innovation Campus, Bailrigg, Lancaster, LA1 4YW, UK
- North Manchester General Hospital, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Christopher D J Taylor
- Community Mental Health Team, Pennine Care NHS Foundation Trust, Humphrey House, Angouleme Way, Bury, Bl9 0EQ, UK
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
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11
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Nisha Aji K, Hafizi S, Da Silva T, Kiang M, Rusjan PM, Weickert CS, Mizrahi R. Interaction between peripheral and central immune markers in clinical high risk for psychosis. Brain Behav Immun Health 2023; 30:100636. [PMID: 37293440 PMCID: PMC10244662 DOI: 10.1016/j.bbih.2023.100636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 06/10/2023] Open
Abstract
Neuroinflammatory events prior to the diagnosis of schizophrenia may play a role in transition to illness. To date only one in-vivo study has investigated this association between peripheral proinflammatory cytokines and brain markers of inflammation (e.g., mitochondrial 18 kDa translocator protein, TSPO) in schizophrenia, but none in its putative prodrome. In this study, we primarily aimed to (Barron et al., 2017) test study group (clinical high-risk (CHR) and healthy controls) differences in peripheral inflammatory markers and test for any associations with symptom measures, (Hafizi et al., 2017a) investigate the interaction between brain TSPO levels (dorsolateral prefrontal cortex (DLPFC) and hippocampus) and peripheral inflammatory clusters (entire cohort and (CHR) group independently) within a relatively large group of individuals at CHR for psychosis (N = 38) and healthy controls (N = 20). Participants underwent structural brain magnetic resonance imaging (MRI) and TSPO [18F]FEPPA positron emission tomography (PET) scans. Serum samples were assessed for peripheral inflammatory markers (i.e., CRP and interleukins). For exploratory analysis, we aimed to examine cluster differences for symptom measures and identify independent peripheral predictors of brain TSPO expression. Here, we report increased IL-8 levels that are positively correlated with prodromal general symptom severity and showed trend-level association with apathy in CHR. We identified distinct inflammatory clusters characterized by inflammatory markers (IL-1 β, IL-2, IFN-γ) that were comparable between entire cohort and CHR. TSPO levels did not differ between inflammatory clusters (entire cohort or CHR). Finally, we show that CRP, IL-1 β, TNF-α, and IFN-γ levels were the independent peripheral predictors of brain TSPO expression. Thus, alterations in brain TSPO expression in response to inflammatory processes are not evident in CHR. Taken together, clustering by inflammatory status is a promising strategy to characterize the interaction between brain TSPO and peripheral markers of inflammation.
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Affiliation(s)
- Kankana Nisha Aji
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Douglas Research Centre, Clinical and Translational Sciences Lab, Montreal, Quebec, Canada
| | - Sina Hafizi
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tania Da Silva
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Kiang
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Pablo M. Rusjan
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Douglas Research Centre, Clinical and Translational Sciences Lab, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Romina Mizrahi
- Research Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Douglas Research Centre, Clinical and Translational Sciences Lab, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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12
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Reznik AM, Syunyakov TS, Mudrak AV, Zakharov NB, Popova ZB, Khoroshilova AN, Khurbatova IG, Saifulina AM, Eliseenko AM, Matvievskaya TK, Khannanova AN. Treatment of Depression with Vortioxetine and Second Generation Antipsychotics During the Period of Remission Formation in Schizophrenia (Interim Data Analysis). CONSORTIUM PSYCHIATRICUM 2023; 4:18-36. [PMID: 38239568 PMCID: PMC10790730 DOI: 10.17816/cp3728] [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: 02/14/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Depression in patients with schizophrenia worsens the course of the disease by increasing the risk of suicide, by complicating the clinical picture of the disorder, and by reducing the quality of the social functioning; its treatment is difficult, since monotherapy, even when involving modern antipsychotics, does not always prove successful. While the prescription of additional antidepressants (ADs) can improve the likelihood of a better outcome, the effectiveness of such augmentation in many cases is yet to be proven. Therefore, it is still important that one weighs the effectiveness of various combinations between most of the known ADs and some second-generation antipsychotic (SGA) in the treatment of depression that occurs at different stages of schizophrenia. In previous studies, the use of vortioxetine as an adjunct to an antipsychotic yielded a reduction in negative symptoms, a clinically significant improvement in cognitive functions that differed from its antidepressant effect, and good tolerability, which affects how committed to treatment a patient remains. AIM To study the changes that occur over time in the clinical manifestations of depression, negative and cognitive impairment, as well as the social adequacy of patients receiving a combination therapy with second-generation antipsychotics and vortioxetine, which were prescribed in real clinical practice at doses approved in the Russian Federation. METHODS We performed a comparative analysis of the changes in depression symptoms and negative symptoms, cognitive impairment, as well as function of 78 patients with severe manifestations of depression at the stage of exacerbation reduction and subsequent remission of paranoid schizophrenia. Combination treatment with SGA and vortioxetine was used in 39 patients, and 39 patients who had similar clinical manifestations received just SGA. During the observation period, the mental disorder severity and depression symptom severity were assessed 3 times (before the start of treatment, after three months, and after six months) using the Clinical Global Impression (CGI) scale and Calgary Depression Scale for Schizophrenia (CDSS), respectively; patients were also assessed using the Negative Symptoms Assessment-5 (NSA-5) scale, Perceived Deficits Questionnaire-20 items (PDQ-20) scale, and Personal and Social Performance (PSP) scale. RESULTS According to the ANOVA results, by the end of the observation period, patients, regardless of their therapeutic group, showed a statistically significant decrease in the level of depression on the CDSS scale, the severity of negative symptoms on the NSA-5 scale, cognitive symptoms on the PDQ-20 scale, as well as an improvement in personality and society, judging by the increase in the total PSP scores. There were also significant differences between the compared main (SGA + vortioxetine) and control (SGA) groups in terms of the changes in the total score on the CDSS and PSP scales. An interesting aspect of the changes in the clinical scores was a noticeable improvement in the SGA + vortioxetine group after 3 months of treatment, in the absence of a similar improvement in the control group, and the achievement of approximately the same scores in both groups after 6 months. In particular, there were significant differences between the SGA + vortioxetine and SGA groups in terms of the mean CDSS (p 0.001), NSA-5 (p=0.003), PDQ-20 (p 0.001), and PSP (p=0.004) scores after 3 months. Analysis of the time before early withdrawal from the study showed that significantly more patients in the SGA + vortioxetine group completed the study program (n=27, 69.23%) compared with the SGA group (n=13, 33.33%) (2 =14.618, df=1, p 0.001, log-rank test. The mean survival time in the SGA group was significantly (p 0.001) less and amounted to 101.436 days (95% CI: 81.518121.354), and in the SGA + vortioxetine group it amounted to 161.744 days (147.981175.506). The relative risk of full study completion in the vortioxetine + SGA group compared with that in SGA was 3.618 (1.8716.994). CONCLUSION The addition of vortioxetine to the SGA therapy accelerates the reduction of the depression symptoms that occur at the stage of psychosis regression and early remission, contributes to the accelerated reduction in negative symptoms, positively affects the subjective assessment of cognitive impairment severity, and has a significant positive effect on the level of psychosocial functioning.
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Affiliation(s)
- Aleksandr M. Reznik
- Mental-health Clinic No. 1 named after N.A. Alexeev
- Russian Biotechnological University (ROSBIOTECH)
- Mental-health Clinic No. 4 named after P.B. Gannushkin
| | - Timur S. Syunyakov
- Mental-health Clinic No. 1 named after N.A. Alexeev
- Republican Specialized Scientific-Practical Medical Center of Narcology
- Samara State Medical University
| | | | | | | | | | | | | | | | | | - Angelina N. Khannanova
- Russian Biotechnological University (ROSBIOTECH)
- Mental-health Clinic No. 4 named after P.B. Gannushkin
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13
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Aas M, Ueland T, Lagerberg TV, Melle I, Aminoff SR, Hoegh MC, Lunding SH, Laskemoen JF, Steen NE, Andreassen OA. Retrospectively assessed childhood trauma experiences are associated with illness severity in mental disorders adjusted for symptom state. Psychiatry Res 2023; 320:115045. [PMID: 36621206 DOI: 10.1016/j.psychres.2022.115045] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 12/13/2022] [Accepted: 12/27/2022] [Indexed: 12/30/2022]
Abstract
Converging evidence suggests that childhood trauma is a causal factor in schizophrenia (SZ) and in bipolar disorders (BD). Here, we investigated whether retrospective reports are associated with severity of illness, independent of current symptom state in a large sample of participants with SZ or BD. We included 1260 individuals (SZ [n = 461], BD [n = 352]), and healthy controls; HC [n = 447]) recruited from the same catchment area. A history of childhood trauma was obtained with the Childhood Trauma Questionnaire (CTQ). Diagnosis and episodes were obtained with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Clinical symptoms (state) were assessed with the Positive and Negative Syndrome scale (PANSS), the Calgary Depression Scale (CDSS). Trait related illness characteristics were assessed with age at illness onset, number of episodes, and lifetime suicide attempts. Patients who reported multiple types of childhood trauma experiences had significantly more severe illness course including an earlier illness onset, more mood episodes, and increased risk of at least one suicide attempt, also after adjusting for current symptom state. Retrospective assessed childhood trauma experiences are associated with illness severity in mental disorders adjusted for symptom state. Our results strengthen the role of childhood trauma in development of psychopathology.
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Affiliation(s)
- Monica Aas
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Torill Ueland
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Trine V Lagerberg
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Ingrid Melle
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Sofie R Aminoff
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Margrethe C Hoegh
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Synve Hoffart Lunding
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Jannicke F Laskemoen
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Nils Eiel Steen
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
| | - Ole A Andreassen
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Norway
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14
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Byrne MK, Easpaig BNG, Gray R, Creek R, Jones M, Brown E, Mitchell D, Zhai J, Tan JY, Denis S, Bressington D. Behavioural activation for depressive symptoms in young people with emerging or early psychosis: A pilot study protocol. PLoS One 2023; 18:e0280559. [PMID: 36662764 PMCID: PMC9858082 DOI: 10.1371/journal.pone.0280559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/20/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Theoretically, behavioural activation may have a valuable role to play in the treatment of depression among young people with emerging/early psychosis, however we lack trial evidence concerning its acceptability and feasibility. This study will establish the feasibility of clinician-delivered behavioural activation as an adjunct to standard care for this population. We aim to train and support clinicians in delivering behavioural activation to improve depressive symptoms in young people with early/emerging psychosis. Our objectives are to: Establish the number of young people with early/emerging psychosis with clinically meaningful depression symptoms.Establish the proportion of clinicians that complete the behavioural activation training and are deemed to be competent.Determine the proportion of eligible participants approached who agree to consent to the research.Determine the proportion of participants that complete baseline measures, complete behavioural activation treatment (attending for at least fifteen minutes in a minimum of eight sessions), and complete follow-up measures (immediately post-intervention and at 3 months follow-up).Establish clinicians' fidelity to treatment (by recording randomly selected treatment sessions and completing a fidelity checklist).Calculate preliminary efficacy of behavioural activation against primary and secondary outcomes.Explore participants' experiences of facilitating behavioural activation (clinicians) and receiving behavioural activation (young people with emerging/early psychosis). METHOD This is a pilot controlled clinical trial with a two-arm parallel-group study. Approximately 60 young people with emerging/early psychosis will be randomly allocated to either behavioural activation treatment plus standard care or standard care alone. The primary outcome: depressive symptoms; and secondary outcomes: negative symptoms, overall psychiatric symptoms, medication side effects and functioning, will be assessed at baseline, post-intervention and at 3-months follow-up. The protocol is registered with the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12622000756729). DISCUSSION The findings will inform the design of a full-scale randomised controlled trial.
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Affiliation(s)
- Mitchell K. Byrne
- College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Bróna Nic Giolla Easpaig
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Richard Gray
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Rebecca Creek
- Headspace Darwin, Casuarina, Northern Territory, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla, Australia
| | - Ellie Brown
- Centre for Youth Mental Health, Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - David Mitchell
- Northern Territory Top End Health Service, Casuarina, Northern Territory, Australia
| | - Jianxia Zhai
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jing-Yu Tan
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Shaun Denis
- Whyalla Health Services, Whyalla, South Australia, Australia
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
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Giordano GM, Pezzella P, Giuliani L, Fazio L, Mucci A, Perrottelli A, Blasi G, Amore M, Rocca P, Rossi A, Bertolino A, Galderisi S. Resting-State Brain Activity Dysfunctions in Schizophrenia and Their Associations with Negative Symptom Domains: An fMRI Study. Brain Sci 2023; 13:brainsci13010083. [PMID: 36672064 PMCID: PMC9856573 DOI: 10.3390/brainsci13010083] [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: 11/21/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
The aim of the present study was to examine the neurobiological correlates of the two negative symptom domains of schizophrenia, the Motivational Deficit domain (including avolition, anhedonia, and asociality) and the Expressive Deficit domain (including blunted affect and alogia), focusing on brain areas that are most commonly found to be associated with negative symptoms in previous literature. Resting-state (rs) fMRI data were analyzed in 62 subjects affected by schizophrenia (SZs) and 46 healthy controls (HCs). The SZs, compared to the HCs, showed higher rs brain activity in the right inferior parietal lobule and the right temporoparietal junction, and lower rs brain activity in the right dorsolateral prefrontal cortex, the bilateral anterior dorsal cingulate cortex, and the ventral and dorsal caudate. Furthermore, in the SZs, the rs brain activity in the left orbitofrontal cortex correlated with negative symptoms (r = -0.436, p = 0.006), in particular with the Motivational Deficit domain (r = -0.424, p = 0.002), even after controlling for confounding factors. The left ventral caudate correlated with negative symptoms (r = -0.407, p = 0.003), especially with the Expressive Deficit domain (r = -0.401, p = 0.003); however, these results seemed to be affected by confounding factors. In line with the literature, our results demonstrated that the two negative symptom domains might be underpinned by different neurobiological mechanisms.
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Affiliation(s)
- Giulia Maria Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-0815666512
| | - Leonardo Fazio
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
- Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
| | - Mario Amore
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, 10126 Turin, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L’Aquila, 67100 L’Aquila, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari ‘Aldo Moro’, 70124 Bari, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Laraki Y, Bayard S, Decombe A, Capdevielle D, Raffard S. Preliminary evidence that fatigue contributes to anhedonia in stable individuals diagnosed with schizophrenia. Front Psychiatry 2023; 14:1098932. [PMID: 36778632 PMCID: PMC9911435 DOI: 10.3389/fpsyt.2023.1098932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Anhedonia and fatigue are trans-diagnostic symptoms commonly observed in schizophrenia. Anhedonia is a core negative symptom with a strong relationship with depression and is associated with diminished global functioning. Similarly, fatigue is also associated to depression and research across psychiatric illnesses indicate that fatigue may persist even when primary symptoms are treated. Although fatigue is common in people diagnosed with schizophrenia, it is under studied within this population. The objective of this exploratory study was to investigate the association of fatigue and anhedonia by controlling for depression in a sample of individuals diagnosed with schizophrenia. METHOD Fifty-one stable individuals diagnosed with schizophrenia from the University Department of Adult Psychiatry in Montpellier took part in this study. Participants completed questionnaires on fatigue impact and depression, and were assessed for symptom severity. Following data collection, statistical analyses were conducted in order to explore associations between clinical variables and fatigue impact. Based on the results obtained, a hierarchical linear regression was conducted in order to investigate whether fatigue impact contributed to the variance of negative symptoms. RESULTS The hierarchical linear regression indicated that when controlling for depression, fatigue impact contributes to ~20% of the variance of anhedonia. Together the social impact of fatigue and depression contribute to 24% of the variation of anhedonia. CONCLUSION To the best of our knowledge, this exploratory study is the first to investigate and show that fatigue impact may contribute to anhedonia. We recommend further research to investigate fatigue, its impact on symptomatology, and better categorization of negative symptoms in hopes of developing targeted fatigue treatment interventions.
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Affiliation(s)
- Yasmine Laraki
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France.,Université Paul Valéry Montpellier 3, EPSYLON EA, Bouisson Bertrand, Montpellier, France
| | - Sophie Bayard
- Université Paul Valéry Montpellier 3, EPSYLON EA, Bouisson Bertrand, Montpellier, France
| | - Amandine Decombe
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France
| | - Delphine Capdevielle
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France.,IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Stéphane Raffard
- University Department of Adult Psychiatry, CHU Montpellier, University of Montpellier, Hôpital la Colombière, Montpellier, France.,Université Paul Valéry Montpellier 3, EPSYLON EA, Bouisson Bertrand, Montpellier, France
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17
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Töbelmann L, Hahne I, Schulze T, Bergmann N, Fuchs L, Zierhut M, Hahn E, Böge K. Mechanisms of action and processes of yoga-based group intervention for inpatients with schizophrenia spectrum disorders-A longitudinal qualitative study. Front Psychiatry 2023; 14:1086468. [PMID: 36824673 PMCID: PMC9941680 DOI: 10.3389/fpsyt.2023.1086468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Research exploring the effects of yoga therapy (YT) on individuals with schizophrenia spectrum disorders (SSD) is scarce. Therefore, the current study aimed to explore possible mechanisms of actions and processes, as well as adverse effects of a novel yoga-based group intervention (YoGI) for in-patients with SSD in a German university hospital setting. MATERIAL AND METHODS A longitudinal qualitative study was integrated into a rater-blinded randomized controlled trial, exploring the impact of a 4-week YoGI as add-on treatment. In-depth interviews were conducted with participants receiving YoGI (n = 19) in addition to treatment as usual (TAU) and a control group (n = 14) which only received TAU. Interviews were conducted at baseline (n = 33) and 4 weeks post-intervention (N = 28) to assess the participant's experiences and how they changed over time. The interviews (N = 61) were audio-taped, translated, coded, and analyzed by means of inductive thematic analysis. Separate case summaries were prepared for each participant to analyze longitudinal changes within subjects. The research team members collaboratively discussed the final list of themes and subcodes. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Personal and Social Performance Scale (PSP) were administered at baseline to assess clinical outcomes. RESULTS At baseline, participants reported a desire to improve their stress- and symptom management. A minority of participants expressed reservations toward yoga, and several psychosocial barriers were named, including worries about symptom exacerbation. At post-intervention, four mechanisms of change became evident from the interviews: (1) acquiring competence in relaxation, (2) increased interoceptive awareness, (3) feeling connected, and (4) a sense of spiritual wellbeing. A small number of participants reported difficulties with YoGI. CONCLUSION Generally, YoGI positively influenced participants' experiences of their inpatient stay, regarding distress, self- and body awareness, social connectedness, and spiritual wellbeing. However, participants also illuminated necessary adjustments to improve the intervention. YoGI will therefore be adapted and further developed in an iterative process based on a participant involvement approach. The efficacy regarding outcomes and processes needs to be investigated in a future larger-scaled randomized controlled trial.
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Affiliation(s)
- Laura Töbelmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Theresa Schulze
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Lukas Fuchs
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Marco Zierhut
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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18
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Addington J, Liu L, Braun A, Brummitt K, Cadenhead KS, Cornblatt BA, Holden JL, Granholm E. Cognitive-Behavioral Social Skills Training: Outcome of a Randomized Controlled Trial for Youth at Risk of Psychosis. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgad020. [PMID: 37601286 PMCID: PMC10439516 DOI: 10.1093/schizbullopen/sgad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Aim Difficulties in social functioning have been observed in youth at clinical high-risk (CHR) of psychosis even in those who do not go on to develop a psychotic illness. Few treatment studies have attempted to improve social functioning in this population. The aim of this study was to conduct a randomized trial comparing the effects of Cognitive-Behavioral Social Skills Training (CBSST) with a supportive therapy (ST). Methods Both CBSST and ST were weekly group therapies, delivered over 18 weeks. This was a 2-arm trial with single-blinded ratings and intention-to-treat analyses. Assessments occurred at baseline, end-of-treatment, and 12 months after the baseline assessment. The primary outcome was social and role functioning and defeatist performance attitudes were the secondary outcome. Attenuated positive and negative symptoms, anxiety, depression, self-efficacy, and beliefs about self and others were examined as exploratory outcomes. Results There were no significant differences between the 2 groups at baseline or either of the 2 follow-ups. However, at follow-ups, in each group there were significant improvements in clinical symptoms. These could not be attributed to group treatment since there was no control or wait-list group. Conclusions Since poor social functioning is one of the most observed difficulties in CHR individuals, and a decline in social functioning may be a significant predictor of later transition to psychosis, future work will be needed to find effective treatments for this decline in functioning for CHR youth.
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Affiliation(s)
- Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Amy Braun
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kali Brummitt
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | | | - Jason L Holden
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Eric Granholm
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
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Arumugham SS, Praharaj SK, Shreekantiah U, Sreeraj VS, Roy C, Shenoy S, Purohith AN, Chithra U, Bagali KB, Venkataramaiah S, Nanjundaiah GKK, Thennarasu K, Kumar CN, Goyal N, Das B, Mehta UM, Muralidharan K, Venkatasubramanian G, Sinha P, Thirthalli J. Clinical efficacy and neurobiological correlates of electroconvulsive therapy in patients with clozapine-resistant/intolerant schizophrenia: study protocol of multi-site parallel arm double-blind randomized sham-controlled study. Wellcome Open Res 2022; 7:212. [PMID: 37953926 PMCID: PMC10636350 DOI: 10.12688/wellcomeopenres.18028.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 11/14/2023] Open
Abstract
Background: A substantial proportion of patients with treatment resistant schizophrenia do not respond well or partially to clozapine, with a subset that does not tolerate an adequate trial of clozapine. Electroconvulsive therapy (ECT) is regarded as one of the augmenting options, but there is a lack of high-quality evidence for this practice. This protocol describes a double-blind randomised sham-controlled modified-ECT trial to evaluate its efficacy in patients with clozapine resistant/intolerant schizophrenia. The study also involves multimodal investigations to identify the response predictors and the mechanistic basis of modified ECT in this population. Methods: One hundred consenting schizophrenia patients with resistance/intolerance to clozapine referred by clinicians for ECT would be randomly assigned to receive true ECT or sham ECT at three study centers. Sham ECT would mimic all the procedures of modified ECT including anaesthesia and muscle relaxation, except the electrical stimulation. After a blinded course, non-responders to sham ECT would be offered open-label true ECT. Clinical assessments, neurocognitive assessments and multimodal investigations (magnetic resonance imaging [MRI], electroencephalography, heart rate variability, investigative transcranial magnetic stimulation-transcranial direct current stimulation, gene polymorphism) would be conducted at baseline and repeated after the end of the trial, as well as open-label ECT course. The trial would evaluate the improvement in positive symptoms (scale for assessment of positive symptoms) of schizophrenia as the primary outcome measure with prediction of this change by resting-state functional-MRI based brain-connectivity as the second primary objective. Registration: Clinical Trial Registry of India (Reg no: CTRI/2021/05/033775) on 24 th May 2021.
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Affiliation(s)
- Shyam Sundar Arumugham
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Samir K. Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | | | - Vanteemar S. Sreeraj
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Chandramouli Roy
- Central Institute of Psychiatry, Ranchi, Jharkhand, 834006, India
| | - Sonia Shenoy
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Abhiram Narasimhan Purohith
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Uppinkudru Chithra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Kiran Basawaraj Bagali
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Sudhir Venkataramaiah
- Department of Neuroanaesthsia and Neuro Critical Care, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, 560029, India
| | - Gopala Krishna Kadarapura Nanjundaiah
- Department of Neuroanaesthsia and Neuro Critical Care, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, 560029, India
| | - Kandavel Thennarasu
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, 560029, India
| | - Channaveerachari Naveen Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Nishant Goyal
- Central Institute of Psychiatry, Ranchi, Jharkhand, 834006, India
| | - Basudeb Das
- Central Institute of Psychiatry, Ranchi, Jharkhand, 834006, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Kesavan Muralidharan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Preeti Sinha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, India, Bengaluru, Karnataka, India, 560029, India
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Reznik A, Syunyakov T, Akhmerova I, Butylin D, Vasilenko A, Gvozdetckii A, Gizatullin T, Gilmanshina G, Golosov E, Kolchev S, Linova L, Miron D, Mudrak A, Oleichik I, Sizov S, Tarakanova E, Chesnokova O. Clinical Effectiveness of Lurasidone Monotherapy in Patients with Acute Episodes of Schizophrenia and Associated Symptoms of Depression. CONSORTIUM PSYCHIATRICUM 2022; 3:56-70. [PMID: 39044917 PMCID: PMC11262118 DOI: 10.17816/cp172] [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: 03/30/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022] Open
Abstract
AIM We endeavored to evaluate the efficacy of Lurasidone at doses of 40-160 mg per day on symptoms of schizophrenia associated with symptoms of depression in real clinical practice in a Russian patient population. METHODS One hundred sixty eight patients aged 18-65 years old, who at the time of the start of the observation were being treated in a hospital or day hospital due to an exacerbation of paranoid schizophrenia accompanied by symptoms of depression, were prescribed lurasidone. Treatment with lurasidone and other concomitant drugs, their prescription, withdrawal, selection, and dose modifications were determined based on the indications for the use of those drugs and the recommended doses in the instructions, clinical need, and patient interests, rather than by the goals of the study. During the observation period, the severity of depressive symptoms according to the Calgary Depression Scale (CDSS) and that of psychotic symptoms according to the Positive and Negative Syndrome Scale (PANSS) were assessed six times (before the start of treatment and then on the 4th, 7th, 14th, 28th, and 42nd days). RESULTS A statistically significant reduction in the severity of the symptoms was observed with the use of lurasidone in doses ranging from 40 mg to 160 mg per day. The fastest and most significant (p <0.001) reductions in the total PANSS and CDSS scores were observed with lurasidone 120 mg. A somewhat lower efficacy of lurasidone was observed at a dose of 160 mg. The largest reductions in the total PANSS and CDSS scores with lurasidone 120 mg were associated with the highest survival rate and the longest median time from treatment initiation to discontinuation or follow-up. The most commonly reported side effects with lurasidone in this study (nausea, akathisia, tremor and drowsiness) were consistent with the known safety profile of the drug. Adverse events in most cases were assessed as mild, or occasionally moderate. CONCLUSION A six-week prospective observational study of the real-world clinical effectiveness of lurasidone in doses ranging from 40 mg to 160 mg per day established statistically and clinically significant improvements in both psychotic and depressive symptoms in patients with acute exacerbation of schizophrenia and associated symptoms of depression.
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Low goal-directed behavior in negative symptoms is explained by goal setting - Results of a diary study. J Behav Ther Exp Psychiatry 2022; 76:101740. [PMID: 35738687 DOI: 10.1016/j.jbtep.2022.101740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/09/2021] [Accepted: 03/16/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Engaging in goal-directed activities is a core difficulty of people with negative symptoms in schizophrenia. A previously developed goal pursuit model of negative symptoms (Schlier et al. 2017) postulates that negative symptom severity correlates with a tendency to set more avoidance- than approach-oriented goals. This shift in goal orientation correlates with low levels of goal expectancy, goal importance, and goal commitment. We explored whether these alterations translate into reduced goal-directed behavior (i.e., reduced goal striving and goal attainment). METHODS We conducted a one-week diary-study in a population sample (N=91). Participants were assessed for subclinical negative symptoms at baseline. Next, they set a daily goal and completed an online survey measuring goal orientation, goal characteristics, goal pursuit, and goal attainment once per day for one week. RESULTS Multilevel regression analyses and structural equation models showed that negative symptoms correlated with a tendency to set less approach-oriented goals with reduced goal expectancy and goal commitment. Goal orientation, expectancy, and commitment mediated the association between negative symptoms and reduced goal pursuit and attainment. LIMITATIONS We used a community sample, thus our results need to be replicated in a clinical sample of people with motivational negative symptoms. CONCLUSIONS Our results support the hypothesis that dysfunctional goal pursuit processes explain why negative symptoms lead to reduced goal-directed behavior. Interventions focusing on goal setting and goal expectations could be promising in improving goal-directed behavior in people with negative symptoms.
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22
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Enhancing future-directed thinking in people with first-episode psychosis using a guided imagery intervention. J Behav Ther Exp Psychiatry 2022; 76:101738. [PMID: 35738685 DOI: 10.1016/j.jbtep.2022.101738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 01/03/2022] [Accepted: 02/12/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Future-directed thinking (FDT) is associated with goal directed behaviour and may differ in people with psychosis compared to non-clinical controls. This study investigated whether guided imagery could enhance positive FDT in people with psychosis. METHOD Participants were 44 people experiencing a first episode of psychosis. They were assessed for negative and positive symptoms, FDT on the Future Thinking Task (FTT), depression, anxiety, autobiographical memory, verbal fluency and spontaneous use of imagery. They were randomised to either a positive or neutral imagery condition, before being retested on the FTT. Outcomes on the FTT were number of events generated, anticipated likelihood, anticipated affect and a composite score. RESULTS Participants in the positive imagery condition generated significantly more positive events on the FTT compared with those in the neutral (F (1, 42) = 19.916, p < .001, ηp2 = 0.322). In both imagery conditions, likelihood ratings of positive events increased post-intervention. Positive and negative events were both perceived as less likely to occur the further into the future they were, and positive events were anticipated to be more positive and negative events more negative, the further into the future they were. LIMITATIONS The participants in this study experienced relatively low levels of symptoms, and therefore caution should be used when applying these results to people with greater symptomatology. CONCLUSIONS Positive guided imagery shows promise for enhancing positive FDT in people with first-episode psychosis. This intervention may offer a simple and effective method of enhancing engagement with the future, with potential implications for goal-directed behaviour.
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23
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Arumugham SS, Praharaj SK, Shreekantiah U, Sreeraj VS, Roy C, Shenoy S, Purohith AN, Chithra U, Bagali KB, Venkataramaiah S, Nanjundaiah GKK, Thennarasu K, Kumar CN, Goyal N, Das B, Mehta UM, Muralidharan K, Venkatasubramanian G, Sinha P, Thirthalli J. Clinical efficacy and neurobiological correlates of electroconvulsive therapy in patients with clozapine-resistant/intolerant schizophrenia: study protocol of multi-site parallel arm double-blind randomized sham-controlled study. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18028.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: A substantial proportion of patients with treatment resistant schizophrenia do not respond well or partially to clozapine, with a subset that does not tolerate an adequate trial of clozapine. Electroconvulsive therapy (ECT) is regarded as one of the augmenting options, but there is a lack of high-quality evidence for this practice. This protocol describes a double-blind randomised sham-controlled modified-ECT trial to evaluate its efficacy in patients with clozapine resistant/intolerant schizophrenia. The study also involves multimodal investigations to identify the response predictors and the mechanistic basis of modified ECT in this population. Methods: One hundred consenting schizophrenia patients with resistance/intolerance to clozapine referred by clinicians for ECT would be randomly assigned to receive true ECT or sham ECT at three study centers. Sham ECT would mimic all the procedures of modified ECT including anaesthesia and muscle relaxation, except the electrical stimulation. After a blinded course, non-responders to sham ECT would be offered open-label true ECT. Clinical assessments, neurocognitive assessments and multimodal investigations (magnetic resonance imaging [MRI], electroencephalography, heart rate variability, investigative transcranial magnetic stimulation-transcranial direct current stimulation, gene polymorphism) would be conducted at baseline and repeated after the end of the trial, as well as open-label ECT course. The trial would evaluate the improvement in positive symptoms (scale for assessment of positive symptoms) of schizophrenia as the primary outcome measure with prediction of this change by resting-state functional-MRI based brain-connectivity as the second primary objective. Registration: Clinical Trial Registry of India (Reg no: CTRI/2021/05/033775) on 24th May 2021.
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Braun A, Liu L, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone W, Tsuang MT, Walker EF, Woods SW, Cannon TD, Addington J. Bullying in clinical high risk for psychosis participants from the NAPLS-3 cohort. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1379-1388. [PMID: 35113189 DOI: 10.1007/s00127-022-02239-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/22/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Bullying is associated with a heightened risk for poor outcomes, including psychosis. This study aimed to replicate previous findings on bullying prevalence in clinical high-risk (CHR) individuals, to assess the longitudinal course of clinical and functional variables between bullied and non-bullied CHR and the association of bullying with premorbid functioning, clinical outcome, transition to psychosis and risk of violence. METHODS The sample consisted of 691 CHR participants and 96 healthy controls. Participants reported whether they had experienced bullying and how long it had lasted. Assessments included DSM-5 diagnoses, attenuated psychotic symptoms, negative symptoms, social and role functioning, depression, stress, premorbid functioning, and risk of violence. The bullied and non-bullied CHR groups were compared at baseline and further longitudinally on clinical and functioning variables and transition to psychosis. RESULTS Bullying was more prevalent among CHR individuals than healthy controls. Bullied CHR had a higher prevalence of PTSD and more severe depression and stress at baseline than non-bullied CHR. There was no impact of bullying on clinical and functional variables over time. Bullying was not related to final clinical status or transition to psychosis. However, bullied participants had poorer premorbid functioning and a greater risk of violence. CONCLUSION While bullying may not impact the likelihood of CHR individuals to transition to psychosis, it may be a risk factor for development of the at-risk state and may be related to a greater risk of violence. Future studies should consider bullying perpetration among CHR individuals.
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Affiliation(s)
- Amy Braun
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | | | | | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA, USA
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, CA, USA.,Institute of Genomic Medicine, University of California, La Jolla, CA, USA
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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25
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Korann V, Jacob A, Lu B, Devi P, Thonse U, Nagendra B, Maria Chacko D, Dey A, Padmanabha A, Shivakumar V, Dawn Bharath R, Kumar V, Varambally S, Venkatasubramanian G, Deshpande G, Rao NP. Effect of Intranasal Oxytocin on Resting-state Effective Connectivity in Schizophrenia. Schizophr Bull 2022; 48:1115-1124. [PMID: 35759349 PMCID: PMC9434443 DOI: 10.1093/schbul/sbac066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Evidence from several lines of research suggests the critical role of neuropeptide oxytocin in social cognition and social behavior. Though a few studies have examined the effect of oxytocin on clinical symptoms of schizophrenia, the underlying neurobiological changes are underexamined. Hence, in this study, we examined the effect of oxytocin on the brain's effective connectivity in schizophrenia. METHODS 31 male patients with schizophrenia (SCZ) and 21 healthy male volunteers (HV) underwent resting functional magnetic resonance imaging scans with intra-nasal oxytocin (24 IU) and placebo administered in counterbalanced order. We conducted a whole-brain effective connectivity analysis using a multivariate vector autoregressive granger causality model. We performed a conjunction analysis to control for spurious changes and canonical correlation analysis between changes in connectivity and clinical and demographic variables. RESULTS Three connections, sourced from the left caudate survived the FDR correction threshold with the conjunction analysis; connections to the left supplementary motor area, left precentral gyrus, and left frontal inferior triangular gyrus. At baseline, SCZ patients had significantly weaker connectivity from caudate to these three regions. Oxytocin, but not placebo, significantly increased the strength of connectivity in these connections. Better cognitive insight and lower negative symptoms were associated with a greater increase in connectivity with oxytocin. CONCLUSIONS These findings provide a preliminary mechanistic understanding of the effect of oxytocin on brain connectivity in schizophrenia. The study findings provide the rationale to examine the potential utility of oxytocin for social cognitive deficits in schizophrenia.
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Affiliation(s)
| | | | - Bonian Lu
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - Priyanka Devi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Umesh Thonse
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Bhargavi Nagendra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Dona Maria Chacko
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Avyarthana Dey
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Anantha Padmanabha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Venkataram Shivakumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Rose Dawn Bharath
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Vijay Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | | | - Naren P Rao
- To whom correspondence should be addressed; tel: +91-80-26995879, e-mail:
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26
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Ritunnano R, Humpston C, Broome MR. Finding order within the disorder: a case study exploring the meaningfulness of delusions. BJPsych Bull 2022; 46:109-115. [PMID: 33431098 PMCID: PMC9074152 DOI: 10.1192/bjb.2020.151] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Can delusions, in the context of psychosis, enhance a person's sense of meaningfulness? The case described here suggests that, in some circumstances, they can. This prompts further questions into the complexities of delusion as a lived phenomenon, with important implications for the clinical encounter. While assumptions of meaninglessness are often associated with concepts of 'disorder', 'harm' and 'dysfunction', we suggest that meaning can nonetheless be found within what is commonly taken to be incomprehensible or even meaningless. A phenomenological and value-based approach appears indispensable for clinicians facing the seemingly paradoxical coexistence of harmfulness and meaningfulness.
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Affiliation(s)
- Rosa Ritunnano
- Institute for Mental Health, University of Birmingham, UK.,Early Intervention in Psychosis Service, Coventry and Warwickshire NHS Partnership Trust, UK
| | - Clara Humpston
- Institute for Mental Health, University of Birmingham, UK
| | - Matthew R Broome
- Institute for Mental Health, University of Birmingham, UK.,Early Intervention in Psychosis Service, Birmingham Women's and Children's NHS Foundation Trust, UK
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27
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Giordano GM, Giuliani L, Perrottelli A, Bucci P, Di Lorenzo G, Siracusano A, Brando F, Pezzella P, Fabrazzo M, Altamura M, Bellomo A, Cascino G, Comparelli A, Monteleone P, Pompili M, Galderisi S, Maj M. Mismatch Negativity and P3a Impairment through Different Phases of Schizophrenia and Their Association with Real-Life Functioning. J Clin Med 2021; 10:5838. [PMID: 34945138 PMCID: PMC8707866 DOI: 10.3390/jcm10245838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/18/2022] Open
Abstract
Impairment in functioning since the onset of psychosis and further deterioration over time is a key aspect of subjects with schizophrenia (SCZ). Mismatch negativity (MMN) and P3a, indices of early attention processing that are often impaired in schizophrenia, might represent optimal electrophysiological candidate biomarkers of illness progression and poor outcome. However, contrasting findings are reported about the relationships between MMN-P3a and functioning. The study aimed to investigate in SCZ the influence of illness duration on MMN-P3a and the relationship of MMN-P3a with functioning. Pitch (p) and duration (d) MMN-P3a were investigated in 117 SCZ and 61 healthy controls (HCs). SCZ were divided into four illness duration groups: ≤ 5, 6 to 13, 14 to 18, and 19 to 32 years. p-MMN and d-MMN amplitude was reduced in SCZ compared to HCs, independently from illness duration, psychopathology, and neurocognitive deficits. p-MMN reduction was associated with lower "Work skills". The p-P3a amplitude was reduced in the SCZ group with longest illness duration compared to HCs. No relationship between P3a and functioning was found. Our results suggested that MMN amplitude reduction might represent a biomarker of poor functioning in SCZ.
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Affiliation(s)
- Giulia M. Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Luigi Giuliani
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Paola Bucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.D.L.); (A.S.)
| | - Alberto Siracusano
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.D.L.); (A.S.)
| | - Francesco Brando
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Michele Fabrazzo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Mario Altamura
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.A.); (A.B.)
| | - Antonello Bellomo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.A.); (A.B.)
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Section of Neurosciences, University of Salerno, 84133 Salerno, Italy; (G.C.); (P.M.)
| | - Anna Comparelli
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy; (A.C.); (M.P.)
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Section of Neurosciences, University of Salerno, 84133 Salerno, Italy; (G.C.); (P.M.)
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy; (A.C.); (M.P.)
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
| | - Mario Maj
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (L.G.); (A.P.); (P.B.); (F.B.); (P.P.); (M.F.); (S.G.); (M.M.)
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28
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Addington J, Liu L, Santesteban-Echarri O, Brummitt K, Braun A, Cadenhead KS, Cornblatt BA, Holden JL, Granholm E. Cognitive behavioural social skills training: Methods of a randomized controlled trial for youth at risk of psychosis. Early Interv Psychiatry 2021; 15:1626-1636. [PMID: 33398922 DOI: 10.1111/eip.13102] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/16/2020] [Accepted: 12/13/2020] [Indexed: 11/30/2022]
Abstract
AIM Poor functioning has become a hallmark of many youth at clinical high-risk (CHR) of psychosis. Even for those who do not make the transition to psychosis remain troubled by functional deficits and a decline in functioning increases the odds of transitioning to psychosis. There are very few treatment studies that have attempted to improve social and role functioning. The aim of this paper is to describe the methods of a treatment study to address social and role functioning in CHR. METHODS This was a randomized controlled trial of cognitive-behavioural social skills training (CBSST) versus a supportive therapy. CBSST combines elements of cognitive behaviour therapy (CBT) and social skills training (SST), two evidence-based treatments for schizophrenia. By adding CBT to SST to target functioning outcomes, SST can be used to train new social skills, and thoughts that interfere with skilled performance in the real world can be addressed using CBT. We developed an adapted version of CBSST, more appropriate for the age range and illness severity of typical CHR individuals, to attempt to show improvements in social and role functioning for these young people. RESULTS Two hundred and three participants were recruited for this study. Results include initial baseline data. CONCLUSION This article describes the baseline methodology of a CHR youth who have difficulties in social and/or role functioning. It is one of the first clinical trials to address this significant problem.
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Affiliation(s)
- Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Olga Santesteban-Echarri
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kali Brummitt
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Amy Braun
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, New York, USA
| | - Jason L Holden
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA
| | - Eric Granholm
- Department of Psychiatry, University of California, San Diego, San Diego, California, USA.,Veterans Affairs San Diego Healthcare System, San Diego, California, USA
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29
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Li Z, Xue M, Zhao L, Zhou Y, Wu X, Xie X, Lang X, Zhang X. Comorbid major depression in first-episode drug-naïve patients with schizophrenia: Analysis of the Depression in Schizophrenia in China (DISC) study. J Affect Disord 2021; 294:33-38. [PMID: 34265669 DOI: 10.1016/j.jad.2021.06.075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Depression is very common in patients with schizophrenia, but few studies have investigated the diagnosed major depressive episode (MDE) in first episode and drug naive (FEDN) schizophrenia. To our best knowledge, this is the first large sample study to examine the prevalence, clinical correlates and associated factors of diagnosed MDE in FEDN schizophrenia, as well as the relationship between depressive symptoms and psychopathological symptoms in these schizophrenia patients. METHODS A total of 996 FEDN schizophrenia patients were recruited. The 17-item Hamilton Depression Rating Scale (HAMD17) and Positive and Negative Syndrome Scale (PANSS) were used to assess the severity of depression and psychopathology, respectively. RESULTS Our results demonstrated that MDE coexisted in nearly half (49.30%) of FEDN schizophrenia patients. Male gender, smoking, PANSS general psychopathology and early age of onset were associated with MDE in patients with FEDN schizophrenia (all p<0.05). In schizophrenia patients with MDE, oridinal logistic regression showed that men (OR=6.65, 95%CI: 4.12-10.45, p<0.001) and smoking (OR=1.94, 95%CI: 1.25-3.01, p=0.003) were positively associated with severity category of depression (all p<0.05), while multivariate regression showed that HAMD17 total score was significantly associated with the PANSS general psychopathology (B=0.06, t=2.72, p=0.007) and total scores (B=0.04, t=2.57, p=0.01). CONCLUSION Our study shows that the prevalence of comorbid MDE is high in FEDN schizophrenia patients. Some demographic and clinical variables are associated with the severity of depression in these schizophrenia patients.
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Affiliation(s)
- Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mei Xue
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | - Lei Zhao
- Qingdao Mental Health Center, Qingdao University, Qingdao, China
| | | | - Xi Wu
- Department of Neurosurgery, Shanghai Changhai Hospital, Shanghai, China
| | - Xiaoxian Xie
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Xiaoe Lang
- Department of Psychiatry, The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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30
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Hosseininasab M, Zarghami M, Mazhari S, Salehifar E, Moosazadeh M, Fariborzifar A, Babaeirad S, Hendouei N. Nanocurcumin as an Add-on to Antipsychotic Drugs for Treatment of Negative Symptoms in Patients With Chronic Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Study. J Clin Psychopharmacol 2021; 41:25-30. [PMID: 33347019 DOI: 10.1097/jcp.0000000000001324] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE/BACKGROUND It is well documented that one of the pathophysiological mechanisms of negative symptoms in patients with schizophrenia is hypofunction of N-methyl-d-aspartate receptors. This double-blind, placebo-controlled clinical trial was designed to assess the efficacy and safety of nanocurcumin as an adjuvant agent on psychotic symptoms, especially negative symptoms, in patients with chronic schizophrenia. METHODS/PROCEDURES Fifty-six inpatients with stable chronic schizophrenia and predominant negative symptoms were randomized in a 1:1 ratio to nanocurcumin soft gel capsule (160 mg/d) and control groups, along with their antipsychotic regimen for 16 weeks. The efficacy of treatment was assessed by Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, Clinical Global Impressions-Severity, and Clinical Global Impressions-Improvement scales. Extrapyramidal symptoms were evaluated by Simpson-Angus Scale and Barnes Akathisia Rating Scale. Patients were assessed at baseline and weeks 4, 8, 12, and 16 after the medication started. FINDINGS/RESULTS No significant differences were observed in demographic or clinical variables between both groups at baseline. The nanocurcumin group showed significantly greater improvement on the negative subscale (P = 0.05), the general psychopathology subscale (P < 0.001), the positive subscale (P = 0.004), total Positive and Negative Syndrome Scale (P < 0.001), Clinical Global Impressions-Severity (P < 0.001), and Clinical Global Impressions-Improvement scores (P < 0.001) in comparison with the control group at the endpoint. Extrapyramidal symptom rating scales and Calgary Depression Scale for Schizophrenia and frequency of other adverse effects were comparable between 2 groups. IMPLICATIONS/CONCLUSIONS The present study indicates nanocurcumin as a safe and potential adjunctive treatment strategy for treatment of primary negative symptoms of schizophrenia.
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Affiliation(s)
- Masumeh Hosseininasab
- From the Department of Pharmacotherapy, Student Research Committee, Faculty of Pharmacy, Mazandaran University of Medical Sciences
| | | | - Shahrzad Mazhari
- Neuroscience Research Center; Psychiatric Department, School of Medicine, Kerman University of Medical Sciences, Kerman
| | - Ebrahim Salehifar
- Department of Pharmacotherapy, Faculty of Pharmacy, Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences
| | - Mahmood Moosazadeh
- Epidemiology, Gastrointestinal Cancer Research Center, Health Sciences Research Center, Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences
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31
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LoPilato AM, Zhang Y, Pike M, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Mathalon DH, McGlashan TH, Seidman L, Perkins DO, Tsuang MT, Woods SW, Walker EF. Associations between childhood adversity, cognitive schemas and attenuated psychotic symptoms. Early Interv Psychiatry 2021; 15:818-827. [PMID: 32770658 DOI: 10.1111/eip.13017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/29/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
AIM Childhood Adversity (CA) is strongly linked to psychotic-like symptoms across the clinical spectrum, though the mechanisms underlying these associations remain poorly understood. Negative cognitive schemas are associated with both CA exposure and psychotic symptoms, highlighting the possibility that cognitive schemas may be a key risk pathway. The purpose of this study was to determine whether negative cognitive schemas mediate the association between CA and specific attenuated psychotic symptoms in a large sample of clinical-high risk youth. Given the variability in experiences that encompass CA (eg, abuse, neglect and poverty) and attenuated psychotic symptoms (eg, suspiciousness and perceptual abnormalities), we also tested whether these associations differ by CA type (threat vs deprivation) and attenuated positive psychotic symptom domain. METHODS Data were collected from 531 clinical-high risk youth between 12 and 35 years of age (mean = 18.80, SD = 4.21) who completed a clinical assessment that included the Structured Interview of Prodromal Syndromes (SIPS), Childhood Trauma and Abuse scale and questionnaires on cognitive schemas and depressive symptoms. RESULTS No direct effects of threat or deprivation exposure on any of the psychotic symptom domains were found. However, there was a unique indirect effect of threat, but not deprivation, on delusional thinking and suspiciousness through negative cognitive schemas about others. CONCLUSION Cognitive vulnerability in the form of negative schemas about others may be one mechanism linking childhood threat experiences and attenuated psychotic symptoms. The results underscore the importance of targeting negative schemas in interventions to mitigate psychosis risk.
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Affiliation(s)
- Allison M LoPilato
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Yinghao Zhang
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Madeline Pike
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Department of Psychology, Semel Institute for Neuroscience and Human Behaviour, UCLA, Los Angeles, California, USA
| | | | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA.,Department of Psychology, Yale University, New Haven, Connecticut, USA
| | | | | | | | - Larry Seidman
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Diana O Perkins
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, La Jolla, California, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA
| | - Elaine F Walker
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA.,Department of Psychology, Emory University, Atlanta, Georgia, USA
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32
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Qi W, Blessing E, Li C, Ardekani BA, Hart KL, Marx J, Freudenreich O, Cather C, Holt D, Bello I, Diminich ED, Tang Y, Worthington M, Zeng B, Wu R, Fan X, Troxel A, Zhao J, Wang J, Goff DC. Effect of citalopram on hippocampal volume in first-episode schizophrenia: Structural MRI results from the DECIFER trial. Psychiatry Res Neuroimaging 2021; 312:111286. [PMID: 33857750 PMCID: PMC8231472 DOI: 10.1016/j.pscychresns.2021.111286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/18/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
Hippocampal volume loss is prominent in first episode schizophrenia (FES) and has been associated with poor clinical outcomes and with BDNF genotype; antidepressants are believed to reverse hippocampal volume loss via release of BDNF. In a 12-month, placebo-controlled add-on trial of the antidepressant, citalopram, during the maintenance phase of FES, negative symptoms were improved with citalopram. We now report results of structural brain imaging at baseline and 6 months in 63 FES patients (34 in citalopram group) from the trial to assess whether protection against hippocampal volume loss contributed to improved negative symptoms with citalopram. Hippocampal volumetric integrity (HVI) did not change significantly in the citalopram or placebo group and did not differ between treatment groups, whereas citalopram was associated with greater volume loss of the right CA1 subfield. Change in cortical thickness was associated with SANS change in 4 regions (left rostral anterior cingulate, right frontal pole, right cuneus, and right transverse temporal) but none differed between treatment groups. Our findings suggest that minimal hippocampal volume loss occurs after stabilization on antipsychotic treatment and that citalopram's potential benefit for negative symptoms is unlikely to result from protection against hippocampal volume loss or cortical thinning.
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Affiliation(s)
- Wei Qi
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Esther Blessing
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Chenxiang Li
- Division of Biostatistics, Department of Population Health, NYU School of Medicine, 180 Madison Avenue, New York, NY 10016, United States of America
| | - Babak A Ardekani
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States of America
| | - Kamber L Hart
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Julia Marx
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Oliver Freudenreich
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Corinne Cather
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Daphne Holt
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, United States of America
| | - Iruma Bello
- New York State Psychiatric Institute, Columbia University Medical Center, 601 West 168th St., New York, NY 10032, United States of America; Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, United States of America
| | - Erica D Diminich
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Stony Brook School of Medicine, Health Sciences Center, Stony Brook, NY 11794, United States of America
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wanping S Road, Shanghai, China, 200030
| | - Michelle Worthington
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America
| | - Botao Zeng
- Department of Psychiatry, Qingdao Mental Health Center, 9 Dongguan Road, Qingdao, Shandong, China, 266034
| | - Renrong Wu
- National Clinical Research Center for Mental Disorders, Mental Health Institute, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, China, 410005
| | - Xiaoduo Fan
- Department of Psychiatry, UMass Memorial Healthcare/University of Massachusetts Medical School, 365 Plantation Street, Worcester, MA 01605, United States of America
| | - Andrea Troxel
- Division of Biostatistics, Department of Population Health, NYU School of Medicine, 180 Madison Avenue, New York, NY 10016, United States of America
| | - Jingping Zhao
- National Clinical Research Center for Mental Disorders, Mental Health Institute, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, China, 410005
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wanping S Road, Shanghai, China, 200030
| | - Donald C Goff
- Department of Psychiatry, NYU Langone Health, 1 Park Avenue, New York, NY 10016, United States of America; Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States of America.
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Rao NP, Ramachandran P, Jacob A, Joseph A, Thonse U, Nagendra B, Chako DM, Shiri S, Hassan H, Sreenivas V, Maran S, Durgam D, Nandakumar K, Varambally S, Gangadhar BN. Add on yoga treatment for negative symptoms of schizophrenia: A multi-centric, randomized controlled trial. Schizophr Res 2021; 231:90-97. [PMID: 33831770 DOI: 10.1016/j.schres.2021.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/28/2021] [Accepted: 03/27/2021] [Indexed: 11/18/2022]
Abstract
The efficacy of antipsychotic medications in the treatment of negative symptoms of schizophrenia is modest at best. Preliminary studies suggest the beneficial effects of add on Yoga, a traditional Indian practice, in the treatment of schizophrenia. Hence, in this study, we examined the efficacy of yoga as an add-on treatment for negative symptoms of schizophrenia in a randomized, wait-list controlled design from two clinical institutes in south India. 89 patients (age - 34.20 ± 8.06 years; education - 14.22 ± 2.69 years; 28 females) were randomized into the add-on yoga or treatment as usual (TAU - wait-list control) group. Patients had a mean illness duration of 10.97 ± 7.24 years with an age at onset of 23.34 ± 5.81 years. Central block randomization was followed to ensure concealed allocation. Participants randomized to the yoga treatment group attended 12 supervised yoga training sessions over two weeks and practiced yoga sessions at home for the subsequent 10 weeks. 64 patients completed the trial. An intent to treat analysis was conducted with 89 participants using a linear mixed model. Improvement in negative symptoms was our primary outcome measure. The two groups were matched on demographic variables and baseline psychopathology severity. Participants in the add-on yoga group had significantly greater improvement in negative symptoms (SANS baseline: 49.13 ± 2.30; 12-weeks follow up: 31.55 ± 2.53) compared to the TAU group (SANS baseline: 51.22 ± 2.40; 12-weeks follow up: 45.30 ± 2.93; t = 3.36; p = 0.006; Cohen's d-0.65). The current study findings suggest the efficacy of yoga as an add-on treatment for negative symptoms of schizophrenia. The effectiveness of yoga practice as a regular clinical intervention for patients needs to be explored in future studies by integrating yoga services along with other clinical services.
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Affiliation(s)
- Naren P Rao
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | | | - Arpitha Jacob
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Albert Joseph
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Umesh Thonse
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Bhargavi Nagendra
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Dona M Chako
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sahana Shiri
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Habla Hassan
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | | | - Sindhu Maran
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | | | | | - Shivarama Varambally
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Fraguas D, Díaz-Caneja CM, Pina-Camacho L, Winter van Rossum I, Baandrup L, Sommer IE, Glenthøj B, Kahn RS, Leucht S, Arango C. The role of depression in the prediction of a "late" remission in first-episode psychosis: An analysis of the OPTiMiSE study. Schizophr Res 2021; 231:100-107. [PMID: 33838518 DOI: 10.1016/j.schres.2021.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 03/09/2021] [Accepted: 03/28/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The identification of predictors of psychosis remission could guide early clinical decision-making for treatment of first-episode schizophrenia (FES). METHODS We analyzed two non-independent subsamples of patients with FES ages 18-40 years from the OPTiMiSE study dataset to investigate the demographic and clinical factors that might help to differentiate "late" remitters (i.e., not in remission at week 2 or 4, but achieving remission within a 10-week follow-up period) from non-remitters within the same period. RESULTS Subsample 1 included 216 individuals (55 females, mean age 25.9 years) treated with amisulpride in an open-label design who were not in remission at week 2. Early symptomatic response between baseline and week 2 (odds ratio (OR) = 4.186, 95% confidence interval (CI) = 2.082-8.416, p < 0.001) and older age (OR = 1.081, 95% CI = 1.026-1.138, p = 0.003) were the only variables significantly associated with a higher probability of psychosis remission at week 4. Subsample 2 was composed of the 72 participants (19 females, mean age 25.1 years) who were not in remission at week 4 and completed a 6-week double-blind randomized trial comparing continuation of amisulpride with switch to olanzapine. Depression at baseline (as measured with the Calgary Depression Scale for Schizophrenia) was significantly associated with a nearly 3-fold lower likelihood of psychosis remission during the 10-week follow-up (hazard ratio = 2.865, 95% CI = 1.187-6.916, p = 0.019). CONCLUSION Our results reinforce the importance of assessing depressive symptoms in people with FES and support the relevance of an early response (as early as 2 weeks) as a predictor of clinical outcome in this population. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identifier: NCT01248195, https://clinicaltrials.gov/ct2/show/NCT01248195.
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Affiliation(s)
- David Fraguas
- "Centro" Mental Health Center, Institute of Psychiatry and Mental Health, IdISSC, Hospital Clínico San Carlos, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain.
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Laura Pina-Camacho
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Inge Winter van Rossum
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Lone Baandrup
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Iris E Sommer
- Department of Neuroscience, University Medical Center, Groningen, the Netherlands
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, University of Copenhagen, Glostrup, Denmark
| | - René S Kahn
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
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Association of Aripiprazole With Reduced Hippocampal Atrophy During Maintenance Treatment of First-Episode Schizophrenia. J Clin Psychopharmacol 2021; 41:244-249. [PMID: 33814546 DOI: 10.1097/jcp.0000000000001391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE/BACKGROUND Hippocampal volume loss in early schizophrenia has been linked with markers of inflammation and oxidative stress, and with less response of negative symptoms. Aripiprazole has been reported to preserve hippocampal volume and to reduce inflammation. METHODS/PROCEDURES Study 1 was a 12-month multicenter randomized placebo-controlled trial of citalopram added to clinician-determined second-generation antipsychotic medication in 95 patients with first-episode schizophrenia (FES), 19 of whom received aripiprazole. We compared participants taking aripiprazole with those on other antipsychotics to determine whether those on aripiprazole had less hippocampal volume loss. We also examined peripheral biomarker data from medication-naive patients with schizophrenia receiving 8 weeks of antipsychotic treatment (n = 24) to see whether markers of inflammation and oxidative stress that previously predicted hippocampal volume differed between aripiprazole (n = 9) and other antipsychotics (study 2). FINDINGS/RESULTS Aripiprazole was associated with a mean increase in hippocampal volume of 0.35% (SD, 0.80%) compared with a 0.53% decrease (SD, 1.2%) with other antipsychotics during the first year of maintenance treatment in patients with FES. This difference was significant after adjusting for age, sex, citalopram treatment, and baseline Brief Psychiatric Rating Scale score (B = 0.0079, P = 0.03). Aripiprazole was also associated with reduced concentrations of the inflammatory cytokines interleukin-8 and tumor necrosis factor (P < 0.01) during the first 8 weeks of treatment in medication-naive patients with FES. IMPLICATIONS/CONCLUSIONS These results suggest that aripiprazole may protect against hippocampal atrophy via an anti-inflammatory mechanism, but these results require replication in larger, randomized trials, and the clinical relevance of hippocampal volume loss is not established.
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O'Neill C, Pratt D, Kilshaw M, Ward K, Kelly J, Haddock G. The relationship between self-criticism and suicide probability. Clin Psychol Psychother 2021; 28:1445-1456. [PMID: 33847028 DOI: 10.1002/cpp.2593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 03/25/2021] [Indexed: 11/07/2022]
Abstract
The relationship of self-to-self relating and suicide has received attention in explanatory models of suicide. However, exploration of specific types of self-relationships, namely feelings of inadequacy (associated with perfectionism), self-attacking and the ability to be kind and nurturing towards the self has received limited attention in a suicidal population. The present study assessed the relative contribution of self-criticism to suicide probability, alongside established predictors of suicidal ideation; hopelessness, depression, defeat and entrapment. Participants completed measures of inadequacy, self-attacking, self-reassurance, defeat, entrapment, depression and hopelessness (N = 101). A correlation, regression and mediation analysis was undertaken. Results demonstrated that self-attacking has a direct relationship with suicide probability, alongside established predictors; entrapment and hopelessness. Depressive symptomology was not found to be a significant predictor of suicide probability in this population. Addressing particularly hostile forms of self-criticism may be a promising area in terms of future research and clinical practice. Entrapment continues to be a significant predictor of suicide risk and interventions that target this experience should be explored.
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Affiliation(s)
- Catherine O'Neill
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
| | - Daniel Pratt
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
| | - Meryl Kilshaw
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
| | - Kate Ward
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
| | - James Kelly
- Early Intervention in Psychosis Team, Lancashire Care NHS Trust, Preston, UK
| | - Gillian Haddock
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, England, UK
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Rinne GR, O'Brien MP, Miklowitz DJ, Addington JM, Cannon TD. Depression, family interaction and family intervention in adolescents at clinical-high risk for psychosis. Early Interv Psychiatry 2021; 15:360-366. [PMID: 32232954 PMCID: PMC8175016 DOI: 10.1111/eip.12954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/21/2020] [Accepted: 03/15/2020] [Indexed: 11/28/2022]
Abstract
AIM The relationship between family behaviour and depression in adolescents at clinical high risk (CHR) for psychosis remains understudied despite high rates of depression in this population. This study examines the relationship between family problem-solving behaviours and depression in CHR adolescents and the impact of family interventions targeting subthreshold symptoms of psychosis on reducing symptoms of depression over 2-years. METHODS Participants were a subset of the North American Prodrome Longitudinal Study who were randomized to 6-months of family focused therapy for individuals at CHR or family psychoeducational treatment. We evaluated the relationship between communication during family conflict discussion and adolescents' symptoms of depression before treatment. At follow-up assessments the family treatment groups were compared on depression. Finally, we compared those in family treatment with matched controls. RESULTS Adolescents' constructive communication was associated with less severe symptoms of depression before treatment. Symptoms of depression improved for adolescents in both family treatment groups. However, there were no significant group by treatment interactions. When adolescents who participated in either type of family intervention were compared to CHR adolescent controls, symptoms of depression improved for adolescents in treatment and control groups, but there were no significant time by treatment interactions. CONCLUSIONS The communication skills of CHR adolescents are related to both depression and their parents' communication skills pre-treatment. However, reductions in depression over the course of the treatment trial cannot be attributed to family treatment. It is imperative to incorporate interventions that directly target depression into future family treatment studies.
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Affiliation(s)
- Gabrielle R Rinne
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Mary P O'Brien
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - David J Miklowitz
- Semel Institute, University of California, Los Angeles, California, USA
| | - Jean M Addington
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, Connecticut, USA.,Department of Psychiatry, Yale University, New Haven, Connecticut, USA
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Monsonet M, Kwapil TR, Barrantes-Vidal N. Exploring the Psychometric Properties and the Factor Structure of the Calgary Depression Scale for Schizophrenia Across the Schizotypy Continuum. Assessment 2021; 29:686-699. [PMID: 33522263 DOI: 10.1177/1073191120986622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study evaluated the psychometric properties and factor structure of the Calgary Depression Scale for Schizophrenia (CDSS) across different levels of the schizotypy continuum. A combined sample of high-schizotypy, at-risk mental states, and patients with first-episode psychosis was assessed for depression and other clinical and functional outcomes. Additionally, experience sampling methodology was used to assess depressive and psychotic-like experiences in daily life. The CDSS exhibited solid internal consistency, validity, and discrimination between depressed and nondepressed participants. Confirmatory factor analyses and the associations of the resulting factors with clinical and functional measures supported a two-factor structure that included general depression and guilt factors. Furthermore, both factors of the CDSS were differentially related to positive and negative symptoms of psychosis in daily life. The CDSS appears to have two underlying psychopathological dimensions and to be a reliable and valid measure for assessing depression across the schizotypy continuum.
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Affiliation(s)
- Manel Monsonet
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Thomas R Kwapil
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Neus Barrantes-Vidal
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain.,Sant Pere Claver-Fundació Sanitària, Barcelona, Spain.,Instituto de Salud Carlos III, Madrid, Spain
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Addington J, Farris MS, Liu L, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Bearden CE, Mathalon DH, Stone WS, Keshevan M, Woods SW. Depression: An actionable outcome for those at clinical high-risk. Schizophr Res 2021; 227:38-43. [PMID: 33129638 PMCID: PMC7854482 DOI: 10.1016/j.schres.2020.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/29/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
Comorbid diagnoses are common in youth who are at clinical high-risk (CHR) for developing psychosis, with depression being the most common. The aim of this paper is to examine depression over two years in a large sample of CHR youth who do not make the transition to psychosis, considering both categorical and dimensional ratings of depression severity. The sample consisted of 267 CHR youth who were followed for two years. Based on DSM-IV diagnoses over this time period, 100 CHR individuals never received a diagnosis of depression, 64 individuals continuously met criteria for depression, 92 individuals received a diagnosis of depression at one or more timepoints, and 11 participants had a diagnosis of depression only at 24-months. These groupings were supported by six-monthly ratings on the Calgary Depression Scale. The majority of this sample experienced a major depressive episode on more than one occasion, suggesting that depression and depressive symptoms identify a domain of substantial unmet clinical need. Recommendations are that depression in CHR youth and young adults should be monitored more frequently and that there is a need for clinical trials to address depression systematically in this vulnerable population.
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Affiliation(s)
- Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
| | - Megan S Farris
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Lu Liu
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, United States of America
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States of America
| | - Thomas H McGlashan
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, La Jolla, CA, United States of America
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States of America
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, United States of America
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States of America
| | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - Matcheri Keshevan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States of America
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
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Devoe DJ, Lu L, Cannon TD, Cadenhead KS, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Woods SW, Walker EF, Mathalon DH, Bearden CE, Addington J. Persistent negative symptoms in youth at clinical high risk for psychosis: A longitudinal study. Schizophr Res 2021; 227:28-37. [PMID: 32362460 PMCID: PMC7606256 DOI: 10.1016/j.schres.2020.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 01/29/2020] [Accepted: 04/03/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Severity of negative symptoms has been associated with poor functioning, cognitive deficits, and defeatist beliefs in schizophrenia patients. However, one area that remains understudied is persistent negative symptoms (PNS). Negative symptoms, including PNS, have been observed in those at clinical high-risk (CHR) for psychosis. The aim of this study was to determine if PNS were associated with functioning, neurocognition, and defeatist beliefs in a CHR sample. METHOD CHR participants (n = 764) were recruited for the North American Prodrome Longitudinal Study. Negative symptoms were rated on the Scale of Psychosis-risk Symptoms. Generalized linear mixed models for repeated measures were used to examine changes over time between and within groups (PNS vs non-PNS). RESULTS The PNS group (n = 67) had significant deficits in functioning at baseline, 6, 12, 18, and 24-months compared to the non-PNS group (n = 673). Functioning improved over time in the non-PNS group, while functioning in the PNS group remained relatively stable and poor over a two-year period. A consistent trend emerged demonstrating higher defeatist beliefs in the PNS group; however, this result was lost when controlling for persistent depressive symptoms. There were no significant differences between the groups on neurocognition, social cognition, and transition to psychosis. CONCLUSIONS PNS exist in youth at CHR for psychosis, resulting in significant and persistent functional impairment, which remains when controlling for persistent depressive symptoms. PNS remain even in CHR youth who do not transition to psychosis. Thus, PNS may represent an unmet therapeutic need in CHR populations for which there are currently no effective treatments.
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Affiliation(s)
- D J Devoe
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - L Lu
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - T D Cannon
- Department of Psychology, Yale University, New Haven, CT, United States
| | - K S Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - B A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Queens, NY, United States
| | - T H McGlashan
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - D O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - L J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States
| | - M T Tsuang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Institute of Genomic Medicine, University of California, La Jolla, CA, United States
| | - S W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - E F Walker
- Department of Psychology, Emory University, Atlanta, GA, United States
| | - D H Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, United States; Psychiatry Service, San Francisco, CA, United States
| | - C E Bearden
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, United States; Department Biobehavioral Sciences and Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - J Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
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Abstract
BACKGROUND Schizophrenia (SCZ) is a neurodevelopmental disorder that leads to poor social function. Oxytocin (OXT), a neuropeptide involved in social cognition, is a potential therapeutic agent for alleviating social dysfunction. Therefore, we investigated the effects of intranasal oxytocin (IN-OXT) on emotional processes in experimental interactive social contexts in individuals with SCZ. METHODS In a male-only parallel randomized placebo-controlled double-blind trial, we investigated the effects of IN-OXT (24 IU) on visual fixation on pictures of faces and emotion recognition in an interactive ball-tossing game that probed processing of social and nonsocial stimuli. RESULTS Intranasal oxytocin enhanced the recognition of emotions during an emotion-based ball-tossing game. This improvement was specific to the game that included social cue processing. Intranasal oxytocin did not affect eye gaze duration or gaze dwell time on faces in these patients. CONCLUSIONS An acute low dose of IN-OXT had a modest effect on social cue processing and was limited to emotion recognition. Higher doses and long-term trials targeting emotional processing in SCZ may lead to improved social function.
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Depression among Patients with Schizophrenia in Ethiopian Mental Health Hospital: Association with Sociodemographic and Clinical Variables: A Cross-Sectional Study. DEPRESSION RESEARCH AND TREATMENT 2021; 2021:6697339. [PMID: 33628500 PMCID: PMC7886508 DOI: 10.1155/2021/6697339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Depression is a significant contributor to the global burden of disease and affects all individuals throughout their lifetime. Patients with schizophrenia are frequently attacked by depression during their total illness duration. Presence of comorbid depression in schizophrenia makes the patients more deteriorating and disabling course and poor outcome. Aim of the Study. To determine the prevalence of depression and highlight the associated sociodemographic and clinical factors in patients with schizophrenia in a specialized hospital in Addis Ababa, Ethiopia. Setting. This study was conducted at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. METHODS An institutional based cross-sectional study was conducted from May to June 2018. Depression was measured by Calgary Depression Scale for Schizophrenia on 455 samples of patient with schizophrenia and systematic sampling was used to select the study participants. Oslo Social Support Scale and Alcohol, Smoking, and Substance Involvement Screening Test were used to assess social support and substance use factors, respectively. A bivariable and multivariable logistic regression analysis model was performed to control the confounding factors. Odds ratio (OR) with the corresponding 95% confidence interval (95% CI) was determined to evaluate the strength of association. RESULTS A total of 445 patients responded to the questionnaire, which yields a response rate of 97.8%. The Magnitude of depression among schizophrenia patients was 24.9%. A multivariable logistic regression analysis model showed that being female [AOR 2.00, 95% CI: 1.25-3.18], divorced/widowed [AOR 2.39, 95% CI: 1.04-5.49], current substance use [AOR 1.95, 95% CI: 1.17-3.25], and poor social support [AOR 2.75, 95% CI: 1.35-5.61] were significantly associated with depression in schizophrenia. CONCLUSION The magnitude of depression among schizophrenia was 24.9%. Being female, divorced/widowed, current substance use, and poor social support were associated with depression among patients with schizophrenia. Regular screening and prompt management of depressive symptoms among patients with schizophrenia is of particular importance to reduce the burden of the condition.
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Joa I, Bjornestad J, Johannessen JO, Langeveld J, Stain HJ, Weibell M, Hegelstad WTV. Early Detection of Ultra High Risk for Psychosis in a Norwegian Catchment Area: The Two Year Follow-Up of the Prevention of Psychosis Study. Front Psychiatry 2021; 12:573905. [PMID: 33716805 PMCID: PMC7943837 DOI: 10.3389/fpsyt.2021.573905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 02/03/2021] [Indexed: 02/02/2023] Open
Abstract
Objectives: Most individuals experience a relatively long period of sub-clinical psychotic like symptoms, known as the ultra high risk (UHR) or at risk mental states (ARMS), prior to a first episode of psychosis. Approximately 95% of individuals who will later develop psychosis are not referred to specialized clinical services and assessed during the UHR phase. The study aimed to investigate whether a systematic early detection program, modeled after the successful early detection of psychosis program TIPS, would improve the detection of help-seeking UHR individuals. The secondary aim was to examine the rates and predictors of conversion to psychosis after 2 years. Method: The overall study design was a prospective (2012-2018), follow- up study of individuals fulfilling UHR inclusion criteria as assessed by the structural interview for prodromal syndromes (SIPS). Help-seeking UHR individuals were recruited through systematic early detection strategies in a Norwegian catchment area and treated in the public mental health services. Results: In the study period 141 UHR help-seeking individuals were identified. This averages an incidence of 7 per 100,000 people per year. The baseline assessment was completed by 99 of these and the 2 year psychosis conversion rate was 20%. A linear mixed-model regression analysis found that the significant predictors of conversion were the course of positive (0.038) and negative symptoms (0.017). Age was also a significant predictor and showed an interaction with female gender (<0.000). Conclusion: We managed to detect a proportion of UHR individuals in the upper range of the expected prediction by the population statistics and further case enrichment would improve this rate. Negative symptoms were significant predictors. As a risk factor for adverse functional outcomes and social marginalization, this could offer opportunities for earlier psychosocial intervention.
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Affiliation(s)
- Inge Joa
- TIPS-Network for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health, Network for Medical Sciences, University of Stavanger, Stavanger, Norway
| | - Jone Bjornestad
- TIPS-Network for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.,Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Jan Olav Johannessen
- TIPS-Network for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health, Network for Medical Sciences, University of Stavanger, Stavanger, Norway
| | - Johannes Langeveld
- TIPS-Network for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health, Network for Medical Sciences, University of Stavanger, Stavanger, Norway
| | - Helen J Stain
- TIPS-Network for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,School of Arts and Humanities, Edith Cowan University, Joondalup, WA, Australia
| | - Melissa Weibell
- TIPS-Network for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health, Network for Medical Sciences, University of Stavanger, Stavanger, Norway
| | - Wenche Ten Velden Hegelstad
- TIPS-Network for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
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Liu R, Fang X, Yu L, Wang D, Wu Z, Guo C, Teng X, Ren J, Zhang C. Gender Differences of Schizophrenia Patients With and Without Depressive Symptoms in Clinical Characteristics. Front Psychiatry 2021; 12:792019. [PMID: 35095605 PMCID: PMC8792946 DOI: 10.3389/fpsyt.2021.792019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
Objectives: To investigate the differences in psychotic symptoms and cognitive function in schizophrenics with and without depression and to compare gender differences in the correlation between depressive symptoms and clinical characteristics in those patients. Methods: A total of 190 schizophrenia patients and 200 healthy controls were recruited in the study. We used the Positive and Negative Symptom Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to evaluate the psychiatric symptoms, depressive symptoms and cognitive function, respectively. Patients with CDSS score ≥7 were divided into depression group, and CDSS < 7 was viewed as without depression. Results: Patients with schizophrenia had lower total scores of RBANS and five subscale (immediate memory, visual span, verbal function, attention, and delayed memory) scores compared to healthy controls. In the case group, patients who concomitant with depression had higher PANSS scores (Ps < 0.001) and lower RBANS (Ps < 0.05) scores than those without depression. After gender stratification, PANSS total scores and subscale scores were significantly different between schizophrenics with and without depressive symptoms in both male and female groups (Ps < 0.001). For cognitive function, there were significant differences in RBANS total score and subscale scores except attention between female patients with and without schizophrenia but not in male schizophrenia patients. Furthermore, the correlation analysis showed that the total CDSS score was positively correlated with PANSS score (P < 0.001) and RBANS score in male and female groups (male: P = 0.010, female: P = 0.001). Conclusion: Our findings provided evidence supporting the gender differences in psychiatric symptoms and cognitive function between schizophrenia patients with and without depressive symptoms.
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Affiliation(s)
- Ruimei Liu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyu Fang
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Lingfang Yu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dandan Wang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zenan Wu
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chaoyue Guo
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyue Teng
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Juanjuan Ren
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Biochemical Pharmacology Laboratory, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Chong BTW, Wahab S, Muthukrishnan A, Tan KL, Ch'ng ML, Yoong MT. Prevalence and Factors Associated with Suicidal Ideation in Institutionalized Patients with Schizophrenia. Psychol Res Behav Manag 2020; 13:949-962. [PMID: 33204188 PMCID: PMC7667143 DOI: 10.2147/prbm.s266976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/21/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose The shorter life expectancy and increased risk of suicide in patients with schizophrenia have been well documented. However, study outcomes on suicidality in this special population have been few to date. This study investigated the prevalence and factors associated with suicidal ideation in a population of institutionalized patients with schizophrenia. Methods Two hundred fifty-six patients with schizophrenia between the age of 18 and 65 years were randomly recruited. This cross-sectional study utilised the Calgary Depression Scale for Schizophrenia (CDSS), the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scale (PSYRATS-AH). Univariate analysis was performed using an independent t-test or chi-square test, followed by binary logistic regression to determine the factors associated with increased suicidal risks. Results The socio-demographic factors associated with suicidal ideation included level of education (p=0.039); secondary-level education (OR=5.76, 95% CI:1.49, 22.34, p=0.011) and tertiary-level education (OR=9.30, 95% CI: 1.80, 48.12, p=0.008) posed a greater risk. A history of attempted suicide (OR=2.09, 95% CI: 1.01, 4.36, p=0.049) and the presence of co-morbid physical illnesses (OR=2.07, 95% CI: 1.02, 4.21, p=0.044) were also found to be associated with a suicidal ideation. Other significant factors associated with suicidal thoughts were concurrent depression (OR=9.68, 95% CI: 3.74, 25.05, p<0.001) and a higher PSYRATS score in emotional characteristics of auditory hallucinations (OR=1.13, 95% CI: 1.06, 1.21, p<0.001). Conclusion Suicide in schizophrenia appears to be more closely associated with certain socio-demographic factors and affective symptoms. Appropriate screening and treatment addressing these challenges must be emphasized if suicidal thoughts and actions are to be reduced.
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Affiliation(s)
- Benedict Tak Wai Chong
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Wilayah Persekutuan 56000, Malaysia
| | - Suzaily Wahab
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Wilayah Persekutuan 56000, Malaysia
| | - Arunakiri Muthukrishnan
- Department of Psychiatry, Hospital Bahagia Ulu Kinta, Tanjung Rambutan, Perak Darul Ridzwan 31250, Malaysia
| | - Kok Leong Tan
- Department of Community Medicine, School of Medicine, International Medical University (IMU), Kuala Lumpur, Wilayah Persekutuan 57000, Malaysia
| | - May Lee Ch'ng
- Department of Community Medicine, School of Medicine, International Medical University (IMU), Kuala Lumpur, Wilayah Persekutuan 57000, Malaysia
| | - Mei Theng Yoong
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Wilayah Persekutuan 56000, Malaysia
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Zhuo C, Xu X, Lin X, Chen M, Ji F, Jiang D, Xu Y, Wang L, Li Y, Tian H, Wang W, Zhou C. Depressive symptoms combined with auditory hallucinations are accompanied with severe gray matter brain impairments in patients with first-episode untreated schizophrenia - A pilot study in China. Neurosci Lett 2020; 730:135033. [PMID: 32417389 DOI: 10.1016/j.neulet.2020.135033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/07/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Depressive symptoms and auditory hallucinations (AHs) are often accompanied by gray matter volume (GMV) alterations in schizophrenia. However, little is known about the effects of concurrent depressive symptoms and AHs on the GMV of patients with schizophrenia. AIM To investigate the pathological features of gray brain matter in patients with first-episode untreated schizophrenia (FUSCH) who have concurrent moderate-to-severe depressive symptoms and AHs (FUSCH-DAH). METHODS The Calgary Depression Scale for Schizophrenia (CDSS) and Auditory Hallucinations Rating Scale (AHRS) were adopted. Voxel-based morphometry (VBM)-based GMV analyses were used to measure cortical alterations. FUSCH-DAH patients were compared to FUSCH patients with depressive symptoms but without AHs, denoted as FUSCH-D, along with healthy controls. RESULTS GMV reductions were more substantial in the FUSCH-DAH patients than FUSCH-D patients or healthy controls. Both FUSCH-DAH and FUSCH-D groups showed GMV reductions of the parietal, frontal, and temporal lobes, which were not apparent in the healthy controls. Compared to FUSCH-D patients, FUSCH-DAH patients demonstrated more substantial GMV reductions in the Broca area, Wernicke region, insular lobe, and prefrontal lobe. The GMV reductions were 1.06% and 0.58% in FUSCH-DAH and FUSCH-D patients, respectively, as compared with the healthy controls. CONCLUSIONS This is the first report showing that concurrent depressive symptoms and AHs leads to severe GMV deterioration in FUSCH-DAH patients. Hence, there is a reciprocal relationship between AHs and depressive symptoms in FUSCH-DAH patients. However, the potential additive effects of concurrent AHs and depressive symptoms require further investigation in order to identify future targeted therapies for schizophrenia.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China; Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China; Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China.
| | - Xuexin Xu
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin 300444, China
| | - Xiaodong Lin
- Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China
| | - Min Chen
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China
| | - Feng Ji
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China
| | - Deguo Jiang
- Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Lina Wang
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Yancheng Li
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Wenqiang Wang
- Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen 361000, Fujian Province, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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Goldsmith DR, Rapaport MH. Inflammation and Negative Symptoms of Schizophrenia: Implications for Reward Processing and Motivational Deficits. Front Psychiatry 2020; 11:46. [PMID: 32153436 PMCID: PMC7044128 DOI: 10.3389/fpsyt.2020.00046] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/20/2020] [Indexed: 01/08/2023] Open
Abstract
Negative symptoms of schizophrenia are debilitating and chronic in nature, are difficult to treat, and contribute to poor functional outcomes. Motivational deficits are a core negative symptom and may involve alterations in reward processing, which involve subcortical regions such as the basal ganglia. More specifically, dopamine-rich regions like the ventral striatum, have been implicated in these reward-processing deficits. Inflammation is one mechanism that may underlie negative symptoms, and specifically motivational deficits, via the effects of inflammatory cytokines on the basal ganglia. Previous work has demonstrated that inflammatory stimuli decrease neural activity in the ventral striatum and decrease connectivity in reward-relevant neural circuitry. The immune system has been shown to be involved in the pathophysiology of schizophrenia, and inflammatory cytokines have been shown to be altered in patients with the disorder. This paper reviews the literature on associations between inflammatory markers and negative symptoms of schizophrenia as well as the role of anti-inflammatory drugs to target negative symptoms. We also review the literature on the role of inflammation and reward processing deficits in both healthy controls and individuals with depression. We use the literature on inflammation and depression as a basis for a model that explores potential mechanisms responsible for inflammation modulating certain aspects of negative symptoms in patients with schizophrenia. This approach may offer novel targets to treat these symptoms of the disorder that are significant barriers to functional recovery and do not respond well to available antipsychotic medications.
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Affiliation(s)
- David R Goldsmith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Mark Hyman Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
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Goines KB, LoPilato AM, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Mathalon DH, McGlashan TH, Perkins DO, Tsuang MT, Woods SW, Walker EF. Sleep problems and attenuated psychotic symptoms in youth at clinical high-risk for psychosis. Psychiatry Res 2019; 282:112492. [PMID: 31387769 PMCID: PMC6888892 DOI: 10.1016/j.psychres.2019.112492] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 11/17/2022]
Abstract
There has been growing interest on the effect of sleep problems on psychotic and prodromal symptoms. The current study investigated cross-sectional relations between sleep problems and attenuated psychotic symptoms in a large sample of 740 youth at Clinical High Risk (CHR) for psychosis in an attempt to replicate previous findings and assess whether findings from general population samples and psychotic samples extend to this CHR sample. Sleep problems were found to be significantly positively associated with attenuated psychotic symptom severity. Sleep problems were also found to be more closely associated with certain specific prodromal symptoms (e.g., suspiciousness and perceptual abnormalities) than other attenuated psychotic symptoms. Further, we found that depression mediated the cross-sectional association between sleep problems and paranoid symptoms only. This adds to a growing body of evidence suggesting the mediation role of depression is more pronounced for paranoid-type psychotic symptoms as compared to other psychotic symptoms (e.g., hallucinations).
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Affiliation(s)
- Katrina B Goines
- Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA 30322, USA.
| | - Allison M LoPilato
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA, USA; Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA 30322, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior & Department of Psychology, University of California, Los Angeles, USA
| | | | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, CT, USA; Department of Psychology, Yale University, New Haven, CT, USA
| | | | - Daniel H Mathalon
- Department of Psychiatry, UCSF, San Francisco, CA, USA; San Francisco VA Medical Center, San Francisco, CA, USA
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | | | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Elaine F Walker
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, GA, USA; Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA 30322, USA
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Depp CA, Bashem J, Moore RC, Holden JL, Mikhael T, Swendsen J, Harvey PD, Granholm EL. GPS mobility as a digital biomarker of negative symptoms in schizophrenia: a case control study. NPJ Digit Med 2019; 2:108. [PMID: 31728415 PMCID: PMC6841669 DOI: 10.1038/s41746-019-0182-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022] Open
Abstract
Mobility is an important correlate of physical, cognitive, and mental health in chronic illness, and can be measured passively with mobile phone global positional satellite (GPS) sensors. To date, GPS data have been reported in a few studies of schizophrenia, yet it is unclear whether these data correlate with concurrent momentary reports of location, vary by people with schizophrenia and healthy comparison subjects, or associate with symptom clusters in schizophrenia. A total of 142 participants with schizophrenia (n = 86) or healthy comparison subjects (n = 56) completed 7 days of ecological momentary assessment (EMA) reports of location and behavior, and simultaneous GPS locations were tracked every five minutes. We found that GPS-derived indicators of average distance travelled overall and distance from home, as well as percent of GPS samples at home were highly correlated with EMA reports of location at the day- and week-averaged level. GPS-based mobility indicators were lower in schizophrenia with medium to large effect sizes. Less GPS mobility was related to greater negative symptom severity, particularly diminished motivation, whereas greater GPS mobility was weakly associated with more community functioning. Neurocognition, depression, and positive symptoms were not associated with mobility indicators. Therefore, passive GPS sensing could provide a low-burden proxy measure of important outcomes in schizophrenia, including negative symptoms and possibly of functioning. As such, passive GPS sensing could be used for monitoring and timely interventions for negative symptoms in young persons at high risk for schizophrenia.
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Affiliation(s)
- Colin A Depp
- 1Department of Psychiatry, UC San Diego, La Jolla, CA USA.,Psychology Service, VA San Diego, San Diego, CA USA
| | - Jesse Bashem
- Psychology Service, VA San Diego, San Diego, CA USA
| | - Raeanne C Moore
- 1Department of Psychiatry, UC San Diego, La Jolla, CA USA.,Psychology Service, VA San Diego, San Diego, CA USA
| | - Jason L Holden
- 1Department of Psychiatry, UC San Diego, La Jolla, CA USA
| | | | - Joel Swendsen
- 4National Center for Scientific Research, University of Bordeaux (UMR 5287); EPHE PSL Research University, Bordeaux, France
| | - Philip D Harvey
- 5Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL USA
| | - Eric L Granholm
- 1Department of Psychiatry, UC San Diego, La Jolla, CA USA.,Psychology Service, VA San Diego, San Diego, CA USA
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Vargas T, Ahmed AO, Strauss GP, Brandes CM, Walker EF, Buchanan RW, Gold JM, Mittal VA. The latent structure of depressive symptoms across clinical high risk and chronic phases of psychotic illness. Transl Psychiatry 2019; 9:229. [PMID: 31527596 PMCID: PMC6746855 DOI: 10.1038/s41398-019-0563-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/27/2019] [Accepted: 07/07/2019] [Indexed: 11/21/2022] Open
Abstract
Depressive symptoms are highly prevalent in psychotic populations and result in significant functional impairment. Limited knowledge of whether depressive symptoms are invariant across stages of illness curtails our ability to understand how these relate to illness progression. Clarifying the latent structure of depressive symptoms across stages of illness progression would aid etiological conceptualizations and preventive models. In the present study, one-factor (including all items) and two-factor (depression/hopelessness and guilt/self-depreciation) solutions were specified through confirmatory factor analysis (CFA). Measurement invariance analyses were undertaken across schizophrenia (SCZ; n = 312) and clinical high-risk (CHR; n = 175) groups to estimate whether the same construct is being measured across groups. Clinical correlates of the factors were examined. Results indicated that CHR individuals had a greater proportion of mood disorder diagnoses. Metric invariance held for the one-factor solution, and scalar invariance held for the two-factor solution. Notably, negative symptoms did not correlate with depressive symptoms in the SCZ group, though strong correlations were observed in CHR individuals. Positive symptoms were comparably associated with depressive symptoms in both groups. Results suggest depressive symptoms are more prevalent in CHR individuals. Targeting these symptoms may aid future efforts to identify risk of conversion. Further, some depressive symptoms may be systematically more endorsed in CHR individuals. Separating into depression/hopelessness and guilt/self-depreciation scores may aid comparability across stages of illness progression, though this issue deserves careful attention and future study.
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Affiliation(s)
- Teresa Vargas
- Northwestern University Department of Psychology, Evanston, IL, 60208, USA.
| | | | | | | | | | | | - James M Gold
- University of Maryland, Baltimore County, MD, 20742, USA
| | - Vijay A Mittal
- Northwestern University Department of Psychology, Department of Psychiatry, Department of Medical Social Sciences, Institute for Policy Research, and Institute for Innovations in Developmental Sciences, Evanston, IL, 60208, USA
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