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Davidson M, Carpenter WT. Targeted Treatment of Schizophrenia Symptoms as They Manifest, or Continuous Treatment to Reduce the Risk of Psychosis Recurrence. Schizophr Bull 2024; 50:14-21. [PMID: 37929893 PMCID: PMC10754173 DOI: 10.1093/schbul/sbad145] [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] [Indexed: 11/07/2023]
Abstract
Current pharmacological treatment of schizophrenia employs drugs that interfere with dopamine neurotransmission, aiming to suppress acute exacerbation of psychosis and maintenance treatment to reduce the risk of psychosis recurrence. According to this treatment scheme, available psychotropic drugs intended to treat negative symptoms, cognitive impairment, or anxiety are administered as add-ons to treatment with antipsychotics. However, an alternative treatment scheme proposes a targeted or intermittent treatment approach, by which antipsychotic drugs are administered upon psychosis exacerbation and discontinued upon remission or stabilization, while negative symptoms, cognitive impairment, or anxiety are treated with specific psychotropics as monotherapy. Along these lines, antipsychotics are renewed only in the event of recurrence of psychotic symptoms. This 50-year-old debate between targeted and continuous treatment schemes arises from disagreements about interpreting scientific evidence and discordant views regarding benefit/risk assessment. Among the debate's questions are: (1) what is the percentage of individuals who can maintain stability without antipsychotic maintenance treatment, and what is the percentage of those who exacerbate despite antipsychotic treatment? (2) how to interpret results of placebo-controlled 9- to 18-month-long maintenance trials in a life-long chronic disorder, and how to interpret results of the targeted trials, some of which are open label or not randomized; (3) how to weigh the decreased risk for psychotic recurrence vs the almost certainty of adverse effects on patient's quality of life. Patients' profiles, preferences, and circumstances of the care provision should be considered as the targeted vs continuous treatment options are considered.
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Affiliation(s)
- Michael Davidson
- Department of Basic and Clinical Sciences, Psychiatry, University of Nicosia Medical School, 2414, Nicosia, Cyprus and Minerva Neurosciences, 1500 District Avenue, Burlington, MA 01803, USA
| | - William T Carpenter
- University of Maryland School of Medicine, Department of Psychiatry, Maryland Psychiatric Research Center, Baltimore, MD, USA
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2
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Taylor JY, Barcelona V, Magny-Normilus C, Wright ML, Jones-Patten A, Prescott L, Potts-Thompson S, Santos HP. A roadmap for social determinants of health and biological nursing research in the National Institute of Nursing Research 2022-2026 Strategic Plan: Optimizing health and advancing health equity using antiracist framing. Nurs Outlook 2023; 71:102059. [PMID: 37863707 PMCID: PMC10803078 DOI: 10.1016/j.outlook.2023.102059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Health equity is essential for improving the well-being of all individuals and groups, and research remains a critical element for understanding barriers to health equity. While considering how to best support research that acknowledges current health challenges, it is crucial to understand the role of social justice frameworks within health equity research and the contributions of minoritized researchers. Additionally, there should be an increased understanding of the influence of social determinants of health on biological mechanisms. PURPOSE Biological health equity research seeks to understand and address health disparities among historically excluded populations. DISCUSSION While there are examples of studies in this area led by minoritized researchers, some individuals and groups remain understudied due to underfunding. Research within minoritized populations must be prioritized to authentically achieve health equity. Furthermore, there should be increased funding from National Institutes of Health to support minoritized researchers working in this area.
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Affiliation(s)
- Jacquelyn Y Taylor
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY.
| | - Veronica Barcelona
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY
| | | | | | | | - Laura Prescott
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY
| | | | - Hudson P Santos
- School of Nursing & Health Studies, University of Miami, Coral Gables, FL
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Kochunov P, Ma Y, Hatch KS, Gao S, Jahanshad N, Thompson PM, Adhikari BM, Bruce H, Van der vaart A, Goldwaser EL, Sotiras A, Kvarta MD, Ma T, Chen S, Nichols TE, Hong LE. Brain-wide versus genome-wide vulnerability biomarkers for severe mental illnesses. Hum Brain Mapp 2022; 43:4970-4983. [PMID: 36040723 PMCID: PMC9582367 DOI: 10.1002/hbm.26056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 01/06/2023] Open
Abstract
Severe mental illnesses (SMI), including major depressive (MDD), bipolar (BD), and schizophrenia spectrum (SSD) disorders have multifactorial risk factors and capturing their complex etiopathophysiology in an individual remains challenging. Regional vulnerability index (RVI) was used to measure individual's brain-wide similarity to the expected SMI patterns derived from meta-analytical studies. It is analogous to polygenic risk scores (PRS) that measure individual's similarity to genome-wide patterns in SMI. We hypothesized that RVI is an intermediary phenotype between genome and symptoms and is sensitive to both genetic and environmental risks for SMI. UK Biobank sample of N = 17,053/19,265 M/F (age = 64.8 ± 7.4 years) and an independent sample of SSD patients and controls (N = 115/111 M/F, age = 35.2 ± 13.4) were used to test this hypothesis. UKBB participants with MDD had significantly higher RVI-MDD (Cohen's d = 0.20, p = 1 × 10-23 ) and PRS-MDD (d = 0.17, p = 1 × 10-15 ) than nonpsychiatric controls. UKBB participants with BD and SSD showed significant elevation in the respective RVIs (d = 0.65 and 0.60; p = 3 × 10-5 and .009, respectively) and PRS (d = 0.57 and 1.34; p = .002 and .002, respectively). Elevated RVI-SSD were replicated in an independent sample (d = 0.53, p = 5 × 10-5 ). RVI-MDD and RVI-SSD but not RVI-BD were associated with childhood adversity (p < .01). In nonpsychiatric controls, elevation in RVI and PRS were associated with lower cognitive performance (p < 10-5 ) in six out of seven domains and showed specificity with disorder-associated deficits. In summary, the RVI is a novel brain index for SMI and shows similar or better specificity for SMI than PRS, and together they may complement each other in the efforts to characterize the genomic to brain level risks for SMI.
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Affiliation(s)
- Peter Kochunov
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Yizhou Ma
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Kathryn S. Hatch
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Si Gao
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging & Informatics InstituteKeck School of Medicine of USCLos AngelesCaliforniaUSA
| | - Paul M. Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics InstituteKeck School of Medicine of USCLos AngelesCaliforniaUSA
| | - Bhim M. Adhikari
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Andrew Van der vaart
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Eric L. Goldwaser
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Aris Sotiras
- Institute of Informatics, University of WashingtonSchool of MedicineSt. LouisMissouriUSA
| | - Mark D. Kvarta
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Tianzhou Ma
- Department of Epidemiology and BiostatisticsUniversity of MarylandCollege ParkMarylandUSA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Thomas E. Nichols
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - L. Elliot Hong
- Maryland Psychiatric Research Center, Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
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Soldevila-Matías P, Schoretsanitis G, Tordesillas-Gutierrez D, Cuesta MJ, de Filippis R, Ayesa-Arriola R, González-Vivas C, Setién-Suero E, Verdolini N, Sanjuán J, Radua J, Crespo-Facorro B. Neuroimaging correlates of insight in non-affective psychosis: A systematic review and meta-analysis. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:117-133. [PMID: 35840278 DOI: 10.1016/j.rpsmen.2022.06.007] [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: 03/29/2021] [Accepted: 07/01/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Neurological correlates of impaired insight in non-affective psychosis remain unclear. This study aimed to review and meta-analyze the studies assessing the grey matter volumetric correlates of impaired insight in non-affective psychosis. METHODS This study consisted of a systematic review of 23 studies, and a meta-analysis with SDM-PSI of the 11 studies that were whole-brain and reported maps or peaks of correlation of studies investigating the grey matter volumetric correlates of insight assessments of non-affective psychosis, PubMed and OVID datasets were independently reviewed for articles reporting neuroimaging correlates of insight in non-affective psychosis. Quality assessment was realized following previous methodological approaches for the ABC quality assessment test of imaging studies, based on two main criteria: the statistical power and the multidimensional assessment of insight. Study peaks of correlation between grey matter volume and insight were used to recreate brain correlation maps. RESULTS A total of 418 records were identified through database searching. Of these records, twenty-three magnetic resonance imaging (MRI) studies that used different insight scales were included. The quality of the evidence was high in 11 studies, moderate in nine, and low in three. Patients with reduced insight showed decreases in the frontal, temporal (specifically in superior temporal gyrus), precuneus, cingulate, insula, and occipital lobes cortical grey matter volume. The meta-analysis indicated a positive correlation between grey matter volume and insight in the right insula (i.e., the smaller the grey matter, the lower the insight). CONCLUSION Several brain areas might be involved in impaired insight in patients with non-affective psychoses. The methodologies employed, such as the applied insight scales, may have contributed to the considerable discrepancies in the findings.
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Affiliation(s)
- Pau Soldevila-Matías
- Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain; Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain; National Reference Center for Psychosocial Care for People with Serious Mental Disorder (CREAP), Valencia, Spain
| | - Georgios Schoretsanitis
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA
| | - Diana Tordesillas-Gutierrez
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain.
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Renato de Filippis
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA; Psychiatry Unit Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Rosa Ayesa-Arriola
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Carlos González-Vivas
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain
| | - Esther Setién-Suero
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel Street, 12-0, 08036 Barcelona, Spain
| | - Julio Sanjuán
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
| | - Joaquim Radua
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Benedicto Crespo-Facorro
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
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Aytac HM, Oyaci Y, Yazar MS, Pehlivan S. Macrophage Migration Inhibitory Factor - 173 G/C Polymorphism is Associated With The Age of Onset and Insight in Schizophrenia in the Turkish Population. Neurol Res 2021; 43:977-984. [PMID: 34264160 DOI: 10.1080/01616412.2021.1948748] [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] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To evaluate the genetic variant in the macrophage migration inhibitory factor (MIF) -173 G/C in patients with schizophrenia (SCZ) by comparing genotype distributions of MIF -173 G/C between patients and healthy controls considering clinical parameters. METHODS A sample of 118 patients with SCZ and 100 healthy volunteers were included in the study. The patients were evaluated with some scales in terms of clinical features (symptom severity, level of insight, age of onset, and treatment resistance). The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine gene polymorphism. RESULTS There was a statistically significant difference between the allele frequency (G, C) distributions of SCZ patients with early- and adult-onset. The C allele frequency was significantly higher in SCZ patients with early-onset (p = .033). According to the impairment of insight, we observed statistically significant differences in genotype (GG, GC, CC) distributions between SCZ patients with good and poor insight. SCZ patients with poor insight had a higher GG genotype frequency than SCZ patients with good insight (p = .021). Again, there was a statistically significant difference between genotype groups (GG, GC/CC) regarding the age of illness onset (p = .037) and schedule for assessing the three components of insight (SATCI) score (p = .005). While the age of onset of SCZ was significantly earlier in patients with the GC/CC genotype, SATCI scores of SCZ patients with the GG genotype were significantly lower than SCZ patients with GC/CC genotype. CONCLUSIONS MIF -173 G/C polymorphism may be associated with the age of illness onset and impairment of insight in SCZ.
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Affiliation(s)
- Hasan Mervan Aytac
- Department of Psychiatry, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Yasemin Oyaci
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Menekse Sila Yazar
- Department of Psychiatry, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Sacide Pehlivan
- Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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6
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Soldevila-Matías P, Schoretsanitis G, Tordesillas-Gutierrez D, Cuesta MJ, de Filippis R, Ayesa-Arriola R, González-Vivas C, Setién-Suero E, Verdolini N, Sanjuán J, Radua J, Crespo-Facorro B. Neuroimaging correlates of insight in non-affective psychosis: A systematic review and meta-analysis. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 15:S1888-9891(21)00067-7. [PMID: 34271162 DOI: 10.1016/j.rpsm.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Neurological correlates of impaired insight in non-affective psychosis remain unclear. This study aimed to review and meta-analyze the studies assessing the grey matter volumetric correlates of impaired insight in non-affective psychosis. METHODS This study consisted of a systematic review of 23 studies, and a meta-analysis with SDM-PSI of the 11 studies that were whole-brain and reported maps or peaks of correlation of studies investigating the grey matter volumetric correlates of insight assessments of non-affective psychosis, PubMed and OVID datasets were independently reviewed for articles reporting neuroimaging correlates of insight in non-affective psychosis. Quality assessment was realized following previous methodological approaches for the ABC quality assessment test of imaging studies, based on two main criteria: the statistical power and the multidimensional assessment of insight. Study peaks of correlation between grey matter volume and insight were used to recreate brain correlation maps. RESULTS A total of 418 records were identified through database searching. Of these records, twenty-three magnetic resonance imaging (MRI) studies that used different insight scales were included. The quality of the evidence was high in 11 studies, moderate in nine, and low in three. Patients with reduced insight showed decreases in the frontal, temporal (specifically in superior temporal gyrus), precuneus, cingulate, insula, and occipital lobes cortical grey matter volume. The meta-analysis indicated a positive correlation between grey matter volume and insight in the right insula (i.e., the smaller the grey matter, the lower the insight). CONCLUSION Several brain areas might be involved in impaired insight in patients with non-affective psychoses. The methodologies employed, such as the applied insight scales, may have contributed to the considerable discrepancies in the findings.
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Affiliation(s)
- Pau Soldevila-Matías
- Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain; Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain; National Reference Center for Psychosocial Care for People with Serious Mental Disorder (CREAP), Valencia, Spain
| | - Georgios Schoretsanitis
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA
| | - Diana Tordesillas-Gutierrez
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain.
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Renato de Filippis
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA; Psychiatry Unit Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy
| | - Rosa Ayesa-Arriola
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Carlos González-Vivas
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain
| | - Esther Setién-Suero
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel Street, 12-0, 08036 Barcelona, Spain
| | - Julio Sanjuán
- Research Institute of Clinic University Hospital of Valencia (INCLIVA), Valencia, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; Department of Psychiatric, University of Valencia, School of Medicine, Valencia, Spain
| | - Joaquim Radua
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Benedicto Crespo-Facorro
- Marqués de Valdecilla University Hospital, Department of Radiology, IDIVAL, Santander, Spain; Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain; CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
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Liang Y, Wang B, Huang H, Wang M, Wu Q, Zhao Y, He Y. Silenced SOX2-OT alleviates ventricular arrhythmia associated with heart failure by inhibiting NLRP3 expression via regulating miR-2355-3p. IMMUNITY INFLAMMATION AND DISEASE 2020; 9:255-264. [PMID: 33270361 PMCID: PMC7860601 DOI: 10.1002/iid3.388] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 11/18/2020] [Indexed: 12/18/2022]
Abstract
Background Nucleotide‐binding oligomerization domain‐like receptor family pyrin domain containing 3 (NLRP3) inflammasomes are the most important factors in ventricular arrhythmia associated with heart failure (VA‐HF). However, how the relationship between lncRNA and NLRP3 inflammasomes is regulated in VA‐HF has not been investigated in detail. Thus, we aimed to determine the effects of SOX2‐overlapping transcripts (SOX2‐OT) by targeting NLRP3 in rats with VA‐HF. Methods We established rats (SPF, male, weight: 240 ± 10 g) with VA‐HF by aortic coarctation and constant‐current stimulation, then injected them with small interfering SOX2‐OT and anti‐miR‐2355‐3p. Six weeks later, SOX2‐OT and miR‐2355‐3p expression was measured using the quantitative reverse transcriptase‐polymerase chain reaction and NLRP3, ASC, caspase‐1, IL‐1β, and TGF‐β1 expression were measured by Western blot analysis; the ventricular chambers were histopathologically analyzed by staining with hematoxylin and eosin, Masson trichrome, and Picro Sirius Red and reactive oxygen species (ROS) levels were assessed by flow cytometry. The targeting relationship between miR‐2355‐3p and SOX2‐OT or NLRP3 was verified using dual‐luciferase reporter gene assays. Results The expression of SOX2‐OT and levels of NLRP3 inflammasomes gradually increased in normal rats, and in those with heart failure and with VA‐HF. Silencing SOX2‐OT expression inhibited NLRP3, ASC, caspase‐1, IL‐1β, and TGF‐β1 expression and ROS production, reduced the degrees of cardiomyocyte necrosis and fibrosis and alleviated cardiac dysfunction in rats with VA‐HF. MicroR‐2355‐3p can bind the SOX2‐OT and the 3′‐untranslated region of NLRP3. Inhibiting miR‐2355‐3p reversed the effect of SOX2‐OT in rats with VA‐HF. Conclusions Silencing SOX2‐OT alleviated cardiac dysfunction in rats by reducing the activation of NLRP3 inflammasomes via regulating miR‐2355‐3p.
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Affiliation(s)
- Yuming Liang
- Department of Geriatrics Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Boqun Wang
- Department of Geriatrics Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Huijuan Huang
- Department of Geriatrics Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Maoyun Wang
- Department of Geriatrics Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qianwen Wu
- Department of Geriatrics Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yaxin Zhao
- Department of Geriatrics Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan He
- Department of Geriatrics Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
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8
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Li W, Zhang HH, Wang Y, Zhang L, Ungvari GS, Cheung T, Xiang YT. Poor Insight in Schizophrenia Patients in China: a Meta-Analysis of Observational Studies. Psychiatr Q 2020; 91:1017-1031. [PMID: 32529379 DOI: 10.1007/s11126-020-09786-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Poor insight exists in all phases of schizophrenia and is associated with poor clinical prognosis and adverse psychosocial functioning. This is a meta-analysis examining the prevalence of poor insight and its correlates in Chinese patients with schizophrenia. Both major international (PubMed, EMBASE, PsycINFO, and Web of Science) and Chinese (WANFANG and CNKI) databases were systematically searched. The pooled prevalence of poor insight was calculated using the random-effects model. A total of 19 studies with 3112 schizophrenia patients were included. The prevalence of poor insight was 43.4% (95%CI: 36.0%-51.2%). Subgroup and meta-regression analyses revealed that the higher prevalence of poor insight was significantly associated with single-site design, smaller sample size, inpatient status, acute illness phase, higher male proportion, younger age, shorter duration of illness, lower study quality, and earlier publication year. Poor insight is common in Chinese schizophrenia patients. Considering the negative outcomes of poor insight, regular screening and effective psychosocial interventions should be delivered for this vulnerable population.
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Affiliation(s)
- Wen Li
- Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China
| | - Hong-He Zhang
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Yu Wang
- Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia.,University of Notre Dame Australia, Fremantle, Australia
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Yu-Tao Xiang
- Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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Abstract
Academic interest in the concept of insight in psychosis has increased markedly over the past 30 years, prompting this selective appraisal of the current state of the art. Considerable progress has been made in terms of measurement and confirming a number of clinical associations. More recently, the relationship between insight and involuntary treatment has been scrutinised more closely alongside the link between decision-making capacity and insight. Advances in the clinical and cognitive neurosciences have influenced conceptual development, particularly the field of 'metacognition'. New therapies, including those that are psychologically and neurophysiologically based, are being tested as ways to enhance insight.
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Affiliation(s)
- Anthony S David
- Director, UCL Institute of Mental Health, University College London, UK
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10
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Affiliation(s)
- Hannah E Brown
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Sydney Feinstein
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - David C Henderson
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
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11
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Cuellar-Barboza AB, Winham SJ, Biernacka JM, Frye MA, McElroy SL. Clinical phenotype and genetic risk factors for bipolar disorder with binge eating: an update. Expert Rev Neurother 2019; 19:867-879. [PMID: 31269819 DOI: 10.1080/14737175.2019.1638764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction: Clinical and genetic study of psychiatric conditions has underscored the co-occurrence of complex phenotypes and the need to refine them. Bipolar Disorder (BD) and Binge Eating (BE) behavior are common psychiatric conditions that have high heritability and high co-occurrence, such that at least one quarter of BD patients have BE (BD + BE). Genetic studies of BD alone and of BE alone suggest complex polygenic risk models, with many genetic risk loci yet to be identified. Areas covered: We review studies of the epidemiology of BD+BE, its clinical features (cognitive traits, psychiatric comorbidity, and role of obesity), genomic studies (of BD, eating disorders (ED) defined by BE, and BD + BE), and therapeutic implications of BD + BE. Expert opinion: Subphenotyping of complex psychiatric disorders reduces heterogeneity and increases statistical power and effect size; thus, it enhances our capacity to find missing genetic (and other) risk factors. BD + BE has a severe clinical picture and genetic studies suggests a distinct genetic architecture. Differential therapeutic interventions may be needed for patients with BD + BE compared with BD patients without BE. Recognizing the BD + BE subphenotype is an example of moving towards more precise clinical and genetic entities.
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Affiliation(s)
- Alfredo B Cuellar-Barboza
- Universidad Autonoma de Nuevo Leon, Department of Psychiatry, School of Medicine , Monterrey , NL , Mexico.,Department of Psychiatry and Psychology, Mayo Clinic , Rochester , MN , USA
| | - Stacey J Winham
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester , MN , USA.,Department of Health Sciences Research, Mayo Clinic , Rochester , MN , USA
| | - Joanna M Biernacka
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester , MN , USA.,Department of Health Sciences Research, Mayo Clinic , Rochester , MN , USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester , MN , USA.,Department of Health Sciences Research, Mayo Clinic , Rochester , MN , USA
| | - Susan L McElroy
- Lindner Center of HOPE , Mason , OH , USA.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati , Cincinnati , OH , USA
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Davidson M. The debate regarding maintenance treatment with antipsychotic drugs in schizophrenia. DIALOGUES IN CLINICAL NEUROSCIENCE 2019. [PMID: 30581291 PMCID: PMC6296388 DOI: 10.31887/dcns.2018.20.3/mdavidson] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Several large meta-analyses of maintenance trials have confirmed that patients who suffer from chronic schizophrenia, randomized to placebo, are likely to experience earlier symptomatic worsening than patients randomized to a dopamine (DA)-blocking drug. These findings led expert groups to issue treatment guidelines, which recommend treatment with DA-blocking drugs for periods ranging from several years to indefinitely. The recommendations were accepted by the majority of, but not all, the experts, some of whom proposed a targeted or intermittent therapy approach by which DA-blocking drugs are discontinued upon symptomatic remission, to be renewed in case of symptom re-emergence. The debate between continued and targeted treatment approaches arises from disagreements regarding scientific and ethical questions. Scientifically, the discussion focuses on the quality and interpretation of the supporting or detracting evidence regarding each treatment option. For example, what is the percentage of individuals who can maintain stability off drugs? What is the rate of individuals who exacerbate despite maintenance treatment? What is the percentage of individuals who experience drug-related adverse effects? How can we interpret results of open-label, nonrandomized targeted trials? Regarding ethical questions, the debating sides disagree on how to weigh the impact of the decreased risk for exacerbation versus the certainty of adverse effects on the patients quality of life, and how to reach a patient-therapist shared decision within the constraints of mental illness.
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Affiliation(s)
- Michael Davidson
- UniSackler School of Medicine, Tel Aviv, Israel; Nicosia Medical School, Nicosia, Cyprus
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13
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Abstract
The concept of insight is used to indicate the propensity of patients with schizophrenia and other severe mental disorders to recognize their illness and engage in treatment. Thus, insight may have notable consequences for the ill individual: Those who lack insight are at higher risk of nonadherence to treatments, negative clinical outcomes, and worse community functioning. Although insight is an intuitive concept, its essence remains difficult to capture. However, many rating scales are available to aid assessment, both for clinical and research purposes. Insight cannot be reduced to a symptom, a psychological mechanism, or a neuropsychological function. It is likely to have dynamic relationships with all these dimensions and with responses to personal events and contextual factors. In particular, social consequences of mental illness and explanatory models that are alternative to the medical model may fundamentally shape insight and treatment choice. Moreover, the cultural or individual stigmatization of mental illness may turn the acquisition of insight into a painful event and increase the risk of depression. Clinicians need to carefully evaluate and promote insight through a personalized approach to aid patient process of care and personal growth.
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Affiliation(s)
- Martino Belvederi Murri
- Psychiatric Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Science, University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico per l’Oncologia, Ospedale Policlinico San Martino, Genoa, Italy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Mario Amore
- Psychiatric Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Science, University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico per l’Oncologia, Ospedale Policlinico San Martino, Genoa, Italy
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Torous J, Keshavan M. Clinical Highlights in this issue. Schizophr Res 2018; 195:1-2. [PMID: 29734577 DOI: 10.1016/j.schres.2018.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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