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Díaz-Pons A, Soler-Andrés M, Ortiz-García de la Foz V, Murillo-García N, Yorca-Ruiz A, Magdaleno Herrero R, Castaño-Castaño S, González-Rodríguez A, Setién-Suero E, Ayesa-Arriola R. Exploring parenthood in first episode of psychosis: the potential role of the offspring in the outcome of women. Arch Womens Ment Health 2024; 27:693-703. [PMID: 38512467 DOI: 10.1007/s00737-024-01457-x] [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: 10/31/2023] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE The study aimed to explore the role of parenthood at first episode of psychosis (FEP) on recovery, with a focus on potential sex differences. METHODS Sociodemographic, clinical, and neurocognitive information was considered on 610 FEP patients form the PAFIP cohort (Spain). Baseline and three-year follow-up comparisons were carried out. Chi-square tests and ANCOVA analysis were performed controlling for the effect of age and years of education. RESULTS Men comprised 57.54% of the sample, with only 5.41% having offspring when compared to 36.29% of women. Parenthood was related to shorter duration of untreated illness (DUI) in women with children (12.08 months mothers vs. 27.61 months no mothers), showing mothers better premorbid adjustment as well. Childless men presented the worst premorbid adjustment and the highest cannabis and tobacco consumption rates. Mothers presented better global cognitive function, particularly in attention, motor dexterity and executive function at three-year follow-up. CONCLUSIONS Diminished parental rates among FEP men could be suggested as a consequence of a younger age of illness onset. Sex roles in caregiving may explain the potential role of parenthood on premorbid phase, with a better and heathier profile, and a more favorable long-term outcome in women. These characteristics may be relevant when adjusting treatment specific needs in men and women with and without offspring.
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Affiliation(s)
- Alexandre Díaz-Pons
- Mental Illness Research Department, Valdecilla Biomedical Research Institute (IDIVAL), 39011, Santander, Spain
- Department of Medicine and Health Sciences, Faculty of Medicine, University of Cantabria (UC), 39011, Santander, Spain
- Faculty of Psychology, National University of Distance Education (UNED), 28015, Madrid, Spain
- Department of Psychology, Faculty of Health Sciences, European University of the Atlantic (UNEAT), 39011, Santander, Spain
| | - Marina Soler-Andrés
- Mental Illness Research Department, Valdecilla Biomedical Research Institute (IDIVAL), 39011, Santander, Spain
- Department of Psychology, Faculty of Health Sciences, European University of the Atlantic (UNEAT), 39011, Santander, Spain
- Faculty of Psychology, University of Oviedo (UO), 33003, Oviedo, Spain
| | | | - Nancy Murillo-García
- Mental Illness Research Department, Valdecilla Biomedical Research Institute (IDIVAL), 39011, Santander, Spain
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria (UC), 39011, Santander, Spain
| | - Angel Yorca-Ruiz
- Mental Illness Research Department, Valdecilla Biomedical Research Institute (IDIVAL), 39011, Santander, Spain
- Department of Psychology, Faculty of Health Sciences, European University of the Atlantic (UNEAT), 39011, Santander, Spain
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria (UC), 39011, Santander, Spain
| | - Rebeca Magdaleno Herrero
- Mental Illness Research Department, Valdecilla Biomedical Research Institute (IDIVAL), 39011, Santander, Spain
- Department of Psychology, Faculty of Health Sciences, European University of the Atlantic (UNEAT), 39011, Santander, Spain
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria (UC), 39011, Santander, Spain
| | - Sergio Castaño-Castaño
- Department of Psychobiology, Faculty of Psychology, University of Oviedo (UO), 33003, Oviedo, Spain
| | - Alexandre González-Rodríguez
- Department of Mental Health, Mutua Terrassa University Hospital, Fundació Docència I Recerca Mutua Terrassa, University of Barcelona (UB), 08221, Terrassa, Spain
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029, Madrid, Spain
| | - Esther Setién-Suero
- Mental Illness Research Department, Valdecilla Biomedical Research Institute (IDIVAL), 39011, Santander, Spain
- Faculty of Psychology, National University of Distance Education (UNED), 28015, Madrid, Spain
- Department of Psychology, Faculty of Health Sciences, European University of the Atlantic (UNEAT), 39011, Santander, Spain
| | - Rosa Ayesa-Arriola
- Mental Illness Research Department, Valdecilla Biomedical Research Institute (IDIVAL), 39011, Santander, Spain.
- Department of Medicine and Health Sciences, Faculty of Medicine, University of Cantabria (UC), 39011, Santander, Spain.
- Faculty of Psychology, National University of Distance Education (UNED), 28015, Madrid, Spain.
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029, Madrid, Spain.
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Vita A, Barlati S, Ceraso A, Nibbio G, Durante F, Facchi M, Deste G, Wykes T. Durability of Effects of Cognitive Remediation on Cognition and Psychosocial Functioning in Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Am J Psychiatry 2024; 181:520-531. [PMID: 38476043 DOI: 10.1176/appi.ajp.20230396] [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: 03/14/2024]
Abstract
OBJECTIVE Cognitive remediation provides substantial improvements in cognitive performance and real-world functioning for people living with schizophrenia, but the durability of these benefits needs to be reassessed and better defined. The aims of this study were to provide a comprehensive assessment of the durability of the benefits of cognitive remediation for cognition and functioning in people living with schizophrenia and evaluating potential moderators of effects. METHODS A systematic search was conducted in PubMed, Scopus, and PsycINFO, and reference lists of included articles and Google Scholar were inspected. Eligible studies were randomized clinical trials of cognitive remediation in patients diagnosed with schizophrenia spectrum disorders in which follow-up assessments were included. Screening and data extraction were performed by at least two independent reviewers. Cohen's d was used to measure outcomes. Primary outcomes were changes in cognition and functioning from baseline to conclusion of follow-up. Moderators of the durability of effects were assessed. RESULTS Of 2,840 identified reports, 281 full texts were assessed and 130 reports on 67 studies with 5,334 participants were included. Cognitive remediation produced statistically significant positive effects that persisted at the end of follow-up in global cognition (d=0.23) and in global functioning (d=0.26). Smaller study samples and single-center studies were associated with better cognitive outcomes; longer treatment and follow-up duration, techniques for transferring cognitive gains to the real world, integration with psychiatric rehabilitation, group format of delivery, and more female participants in the sample were associated with better functional outcomes. CONCLUSIONS Cognitive remediation provides durable improvements in cognition and functioning in schizophrenia. This finding corroborates the notion that cognitive remediation should be implemented more widely in clinical and rehabilitation practice.
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Affiliation(s)
- Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Vita, Barlati, Nibbio, Facchi, Deste); Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy (Vita, Barlati, Ceraso, Durante, Deste); Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London (Wykes)
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Vita, Barlati, Nibbio, Facchi, Deste); Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy (Vita, Barlati, Ceraso, Durante, Deste); Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London (Wykes)
| | - Anna Ceraso
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Vita, Barlati, Nibbio, Facchi, Deste); Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy (Vita, Barlati, Ceraso, Durante, Deste); Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London (Wykes)
| | - Gabriele Nibbio
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Vita, Barlati, Nibbio, Facchi, Deste); Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy (Vita, Barlati, Ceraso, Durante, Deste); Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London (Wykes)
| | - Francesca Durante
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Vita, Barlati, Nibbio, Facchi, Deste); Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy (Vita, Barlati, Ceraso, Durante, Deste); Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London (Wykes)
| | - Michele Facchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Vita, Barlati, Nibbio, Facchi, Deste); Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy (Vita, Barlati, Ceraso, Durante, Deste); Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London (Wykes)
| | - Giacomo Deste
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Vita, Barlati, Nibbio, Facchi, Deste); Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy (Vita, Barlati, Ceraso, Durante, Deste); Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London (Wykes)
| | - Til Wykes
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy (Vita, Barlati, Nibbio, Facchi, Deste); Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy (Vita, Barlati, Ceraso, Durante, Deste); Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London (Wykes)
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Espinosa V, Bagaeva A, López-Carrilero R, Barajas A, Barrigón ML, Birulés I, Frígola-Capell E, Díaz-Cutraro L, González-Higueras F, Grasa E, Gutiérrez-Zotes A, Lorente-Rovira E, Pélaez T, Pousa E, Ruiz-Delgado I, Verdaguer-Rodríguez M, Ochoa S. Neuropsychological profiles in first-episodes psychosis and their relationship with clinical, metacognition and social cognition variables. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01813-z. [PMID: 38806850 DOI: 10.1007/s00406-024-01813-z] [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: 07/26/2023] [Accepted: 04/19/2024] [Indexed: 05/30/2024]
Abstract
An increasing interest in the assessment of neuropsychological performance variability in people with first-episode psychosis (FEP) has emerged. However, its association with clinical and functional outcomes requires further study. Furthermore, FEP neuropsychological subgroups have not been characterized by clinical insight or metacognition and social cognition domains. The aim of this exploratory study was to identify specific groups of patients with FEP based on neuropsychological variables and to compare their sociodemographic, clinical, metacognition and social cognition profiles. A sample of 149 FEP was recruited from adult mental health services. Neuropsychological performance was assessed by a neuropsychological battery (WAIS-III; TMT; WSCT; Stroop Test; TAVEC). The assessment also included sociodemographic characteristics, clinical, functional, metacognition and social cognition variables. Two distinct neuropsychological profiles emerged: one neuropsychological impaired cluster (N = 56) and one relatively intact cluster (N = 93). Significant differences were found between both profiles in terms of sociodemographic characteristics (age and level of education) (p = 0.001), clinical symptoms (negative, positive, disorganized, excitement and anxiety) (p = 0.041-0.001), clinical insight (p = 0.038-0.017), global functioning (p = 0.014), as well as in social cognition domains (emotional processing and theory of mind) (p = 0.001; p = 0.002). No significant differences were found in metacognitive variables (cognitive insight and 'jumping to conclusions' bias). Relationship between neurocognitive impairment, social cognition and metacognition deficits are discussed. Early identifying of neuropsychological profiles in FEP, characterized by significant differences in clinical and social cognition variables, could provide insight into the prognosis and guide the implementation of tailored early-intervention.
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Affiliation(s)
- Victoria Espinosa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
- Etiopatogènia I Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
| | - Alana Bagaeva
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia I Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia I Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Ana Barajas
- Departament de Psicologia, Facultat de Psicologia Clínica I de la Salut. Serra Húnter Programme, Universitat Autònoma de Barcelona, Barcelona, Spain
- Departament of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain
| | - María Luisa Barrigón
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament of Psychiatry, University Hospital Virgen del Rocio, Sevilla, Spain
- Psychiatry Service, Area de Gestión Sanitaria Sur Granada, Motril, Granada, Spain
| | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Facultat de Psicologia Departament de Cognició, Desenvolupament i Psicologia de l'Educació, Universitat de Barcelona, Barcelona, Spain
- Etiopatogènia I Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Eva Frígola-Capell
- Mental Health and Addiction Research Group, Fundació Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta (IDIBGI), Girona, Spain
- Institut d'Assistencia Sanitària, Girona, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia I Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | | | - Eva Grasa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Hospital de La Santa Creu I Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Alfonso Gutiérrez-Zotes
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili-CERCA, Universitat Rovira I Virgili, Reus, Spain
| | - Ester Lorente-Rovira
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Psychiatry Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Trinidad Pélaez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Etiopatogènia I Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Esther Pousa
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Hospital de La Santa Creu I Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | | | - Marina Verdaguer-Rodríguez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Etiopatogènia I Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Barcelona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Etiopatogènia I Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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Murillo-García N, Papiol S, Fernández-Cacho LM, Fatjó-Vilas M, Ayesa-Arriola R. Studying the relationship between intelligence quotient and schizophrenia polygenic scores in a family design with first-episode psychosis population. Eur Psychiatry 2024; 67:e31. [PMID: 38465374 PMCID: PMC11059248 DOI: 10.1192/j.eurpsy.2024.24] [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: 11/13/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The intelligence quotient (IQ) of patients with first-episode psychosis (FEP) and their unaffected relatives may be related to the genetic burden of schizophrenia (SCZ). The polygenic score approach can be useful for testing this question. AIM To assess the contribution of the polygenic risk scores for SCZ (PGS-SCZ) and polygenic scores for IQ (PGS-IQ) to the individual IQ and its difference from the mean IQ of the family (named family-IQ) through a family-based design in an FEP sample. METHODS The PAFIP-FAMILIES sample (Spain) consists of 122 FEP patients, 131 parents, 94 siblings, and 176 controls. They all completed the WAIS Vocabulary subtest for IQ estimation and provided a DNA sample. We calculated PGS-SCZ and PGS-IQ using the continuous shrinkage method. To account for relatedness in our sample, we performed linear mixed models. We controlled for covariates potentially related to IQ, including age, years of education, sex, and ancestry principal components. RESULTS FEP patients significantly deviated from their family-IQ. FEP patients had higher PGS-SCZ than other groups, whereas the relatives had intermediate scores between patients and controls. PGS-IQ did not differ between groups. PGS-SCZ significantly predicted the deviation from family-IQ, whereas PGS-IQ significantly predicted individual IQ. CONCLUSIONS PGS-SCZ discriminated between different levels of genetic risk for the disorder and was specifically related to patients' lower IQ in relation to family-IQ. The genetic background of the disorder may affect neurocognition through complex pathological processes interacting with environmental factors that prevent the individual from reaching their familial cognitive potential.
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Affiliation(s)
- Nancy Murillo-García
- Research Group on Mental Illnesses, Valdecilla Biomedical Research (IDIVAL), Santander, Spain
- Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain
| | - Sergi Papiol
- Department of Falkai, Max Planck Institute of Psychiatry,Munich, Germany
- Biomedical Research Networking Center for Mental Health (CIBERSAM), Health Institute Carlos III, Madrid, Spain
| | - Luis Manuel Fernández-Cacho
- Department of Radiology, Marqués de Valdecilla University Hospital, Santander, Spain
- Faculty of Nursing, University of Cantabria, Santander, Spain
| | - Mar Fatjó-Vilas
- Biomedical Research Networking Center for Mental Health (CIBERSAM), Health Institute Carlos III, Madrid, Spain
- FIDMAG Sisters Hospitallers Research Foundation, Barcelona, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Research Group on Mental Illnesses, Valdecilla Biomedical Research (IDIVAL), Santander, Spain
- Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain
- Biomedical Research Networking Center for Mental Health (CIBERSAM), Health Institute Carlos III, Madrid, Spain
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5
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Magdaleno Herrero R, Ortiz-García de la Foz V, Murillo-García N, Vázquez-Bourgon J, Setién-Suero E, Crespo-Facorro B, Ayesa-Arriola R. Sex differences in cognitive reserve among first episode of psychosis patients. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:143-150. [PMID: 38520113 DOI: 10.1016/j.rpsm.2021.11.008] [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: 09/20/2021] [Revised: 11/09/2021] [Accepted: 11/27/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cognitive reserve (CR) has recently been considered a key factor in the onset of a first episode of psychosis (FEP). However, the differences in CR in FEP patients according to sex have not yet been investigated. MATERIAL AND METHODS CR was estimated among 443 FEP patients (246 men and 197 women) and 156 healthy controls (96 men and 60 women) by using the proxies premorbid IQ, years of education and employment status. A neuropsychological battery was administrated to measure neurocognitive specific domains. Analyses of variance were used to make comparisons between groups. RESULTS FEP women had greater CR than FEP men. This circumstance was not observed in healthy controls. Among the group of patients with low CR, FEP women outperformed FEP men in the cognitive domains verbal memory and processing speed. Meanwhile, among the FEP patients with high CR, men showed better performance in attention than women. CONCLUSIONS Differences in CR observed between FEP men and women could be related to a number of specific factors, such as, age at illness onset, education level, and variability in performance in verbal memory, processing speed, and attention domains. These results provide background information about CR in FEP patients that will be useful in the design of sex specific cognitive remediation interventions.
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Affiliation(s)
- Rebeca Magdaleno Herrero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Nancy Murillo-García
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Esther Setién-Suero
- Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain; Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain; Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain; Instituto de Investigación Sanitaria de Sevilla, IBiS, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain.
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6
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Soler-Andrés M, Díaz-Pons A, Ortiz-García de la Foz V, Murillo-García N, Barrio-Martínez S, Miguel-Corredera M, Yorca-Ruiz A, Magdaleno Herrero R, Moya-Higueras J, Setién-Suero E, Ayesa-Arriola R. A Proxy Approach to Family Involvement and Neurocognitive Function in First Episode of Non-Affective Psychosis: Sex-Related Differences. Healthcare (Basel) 2023; 11:1902. [PMID: 37444735 DOI: 10.3390/healthcare11131902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/14/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Schizophrenia spectrum disorders (SSD) often show cognitive deficits (CD) impacting daily life. Family support has been shown to be protective against CD, yet the relationship between these in psychotic patients remains complex and not fully understood. This study investigated the association between a subdomain of family support, namely, family involvement (estimated through a proxy measure), cognitive functioning, and sex in first-episode psychosis (FEP) patients. The sample included 308 patients enrolled in the Program for Early Phases of Psychosis (PAFIP), divided into 4 groups based on their estimated family involvement (eFI) level and sex, and compared on various variables. Women presented lower rates of eFI than men (37.1% and 48.8%). Higher eFI was associated with better cognitive functioning, particularly in verbal memory. This association was stronger in women. The findings suggest that eFI may be an important factor in FEP patients' cognitive functioning. This highlights the importance of including families in treatment plans for psychotic patients to prevent CD. Further research is needed to better understand the complex interplay between family support, sex, and cognitive functioning in psychotic patients and develop effective interventions that target these factors.
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Affiliation(s)
- Marina Soler-Andrés
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Faculty of Psychology, University of Oviedo, 33003 Oviedo, Spain
- Faculty of Psychology, European University of the Atlantic, 39011 Santander, Spain
| | - Alexandre Díaz-Pons
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Faculty of Psychology, European University of the Atlantic, 39011 Santander, Spain
- Faculty of Psychology, National University of Distance Education (UNED), 28015 Madrid, Spain
| | - Víctor Ortiz-García de la Foz
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029 Madrid, Spain
| | - Nancy Murillo-García
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029 Madrid, Spain
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, 39011 Santander, Spain
| | - Sara Barrio-Martínez
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029 Madrid, Spain
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain
| | - Margarita Miguel-Corredera
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029 Madrid, Spain
| | - Angel Yorca-Ruiz
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Faculty of Psychology, European University of the Atlantic, 39011 Santander, Spain
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029 Madrid, Spain
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, 39011 Santander, Spain
| | - Rebeca Magdaleno Herrero
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Faculty of Psychology, European University of the Atlantic, 39011 Santander, Spain
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029 Madrid, Spain
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, 39011 Santander, Spain
| | - Jorge Moya-Higueras
- Biomedical Research Center in Mental Health Network (CIBERSAM), Health Institute Carlos III, 28029 Madrid, Spain
- Department of Psychology, University of Lleida, 25001 Lleida, Spain
| | - Esther Setién-Suero
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Faculty of Psychology, European University of the Atlantic, 39011 Santander, Spain
- Faculty of Psychology, National University of Distance Education (UNED), 28015 Madrid, Spain
- Department of Psychology, University of Lleida, 25001 Lleida, Spain
| | - Rosa Ayesa-Arriola
- Mental Illness Research Department, Valdecilla Biomedical Research Institute, 39011 Santander, Spain
- Faculty of Psychology, National University of Distance Education (UNED), 28015 Madrid, Spain
- Department of Psychology, University of Lleida, 25001 Lleida, Spain
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7
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Ayesa-Arriola R, de la Foz VOG, Murillo-García N, Vázquez-Bourgon J, Juncal-Ruiz M, Gómez-Revuelta M, Suárez-Pinilla P, Setién-Suero E, Crespo-Facorro B. Cognitive reserve as a moderator of outcomes in five clusters of first episode psychosis patients: a 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:1891-1905. [PMID: 37310335 DOI: 10.1017/s0033291721003536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive reserve (CR) has been associated with the development and prognosis of psychosis. Different proxies have been used to estimate CR among individuals. A composite score of these proxies could elucidate the role of CR at illness onset on the variability of clinical and neurocognitive outcomes. METHODS Premorbid intelligence quotient (IQ), years of education and premorbid adjustment were explored as proxies of CR in a large sample (N = 424) of first-episode psychosis (FEP) non-affective patients. Clusters of patients were identified and compared based on premorbid, clinical and neurocognitive variables at baseline. Additionally, the clusters were compared at 3-year (N = 362) and 10-year (N = 150) follow-ups. RESULTS The FEP patients were grouped into five CR clusters: C1 (low premorbid IQ, low education and poor premorbid) 14%; C2 (low premorbid IQ, low education and good premorbid adjustment) 29%; C3 (normal premorbid IQ, low education and poor premorbid adjustment) 17%; C4 (normal premorbid IQ, medium education and good premorbid adjustment) 25%; and C5 (normal premorbid IQ, higher education and good premorbid adjustment) 15%. In general, positive and negative symptoms were more severe in the FEP patients with the lowest CR at baseline and follow-up assessments, while those with high CR presented and maintained higher levels of cognitive functioning. CONCLUSIONS CR could be considered a key factor at illness onset and a moderator of outcomes in FEP patients. A high CR could function as a protective factor against cognitive impairment and severe symptomatology. Clinical interventions focused on increasing CR and documenting long-term benefits are interesting and desirable.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Nancy Murillo-García
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - María Juncal-Ruiz
- Department of Psychiatry, Sierrallana Hospital, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Marcos Gómez-Revuelta
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Paula Suárez-Pinilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Esther Setién-Suero
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
- Instituto de Investigación Sanitaria de Sevilla, IBiS, Sevilla, Spain
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8
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Murillo-García N, Ortíz-García de la Foz V, Miguel-Corredera M, Vázquez-Bourgon J, Setién-Suero E, Neergaard K, Moya-Higueras J, Crespo-Facorro B, Ayesa-Arriola R. Intelligence quotient changes over 10 years: Diversity of cognitive profiles in first episode of psychosis and healthy controls. Schizophr Res 2023; 254:163-172. [PMID: 36905766 DOI: 10.1016/j.schres.2023.02.025] [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: 04/05/2022] [Revised: 11/24/2022] [Accepted: 02/23/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE This study aimed to analyse whether intelligence quotient (IQ) improves, declines, or remains stable over 10 years among FEP patients and healthy subjects. METHODS A group of FEP patients enrolled in a Program of First Episode Psychosis in Spain called PAFIP, and a sample of Healthy Controls (HC) completed the same neuropsychological battery at baseline and approximately 10 years later, which included the WAIS vocabulary subtest to estimate premorbid IQ and 10-year IQ. Cluster analysis was performed separately in the patient group and the HC group to determine their profiles of intellectual change. RESULTS One hundred and thirty-seven FEP patients were grouped into five clusters: "Improved low IQ" (9.49 % of patients), "Improved average IQ" (14.6 %), "Preserved low IQ" (17.52 %), "Preserved average IQ" (43.06 %), and "Preserved high IQ" (15.33 %). Ninety HC were grouped into three clusters: "Preserved low IQ" (32.22 % of the HC), "Preserved average IQ" (44.44 %), and "Preserved high IQ" (23.33 %). The first two clusters of FEP patients, characterized by a low IQ, earlier age at illness onset, and lower educational attainment, showed a substantial cognitive improvement. The remaining clusters demonstrated cognitive stability. CONCLUSIONS The FEP patients showed intellectual improvement or stability, but no decline post-onset of psychosis. However, their profiles of intellectual change are more heterogeneous than that of HC over 10 years. Particularly, there is a subgroup of FEP patients with a significant potential for long-term cognitive enhancement.
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Affiliation(s)
- Nancy Murillo-García
- Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain
| | - Víctor Ortíz-García de la Foz
- Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Center for Biomedical Research Network on Mental Health (CIBERSAM), Spain
| | | | - Javier Vázquez-Bourgon
- Center for Biomedical Research Network on Mental Health (CIBERSAM), Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla, Santander, Spain
| | - Esther Setién-Suero
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Karl Neergaard
- Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | | | - Benedicto Crespo-Facorro
- Center for Biomedical Research Network on Mental Health (CIBERSAM), Spain; Department of Psychiatry, University Hospital Virgen del Rocío, University of Seville, Seville, Spain
| | - Rosa Ayesa-Arriola
- Research Group on Mental Illnesses, Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain; Department of Molecular Biology, School of Medicine, University of Cantabria, Santander, Spain; Center for Biomedical Research Network on Mental Health (CIBERSAM), Spain.
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9
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Sex-Specific Neurocognitive Impairment. Neurol Clin 2023; 41:359-369. [PMID: 37030963 DOI: 10.1016/j.ncl.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
This article explores sex-specific neurocognitive impairment. It first defines relevant terms such as gender and sex. Next, it describes the nature of the problem including under-representation of women and other gender and sexual minorities in neuroscience research, including cognitive studies. A biopsychosocial framework is employed to account for structural and social determinants of health in sex/gender-specific neurocognitive impairment. Issues in assessment including the use of gender/sex-specific normative data are also discussed. Lastly, the article covers the current state of research as it relates to sex/gender-specific neurocognitive impairment across a range of medical conditions including neurodegenerative diseases and coronavirus disease-2019.
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10
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Ayesa-Arriola R, Miguel-Corredera M, de la Foz VOG, Neergaard KD, Correa-Ghisays P, Setién-Suero E, Crespo-Facorro B. Education and long-term outcomes in first episode psychosis: 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:66-77. [PMID: 33952364 DOI: 10.1017/s0033291721001112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Lower levels of education have been associated with the development of psychosis. Investigating educational achievement in the first episode of psychosis (FEP) patients may shed light on the origins of the alterations and on the variability of outcomes in psychotic disorders. METHODS Education achievement was explored in a large sample (n = 659) of FEP patients enrolled in programa de atención a fases iniciales de psicosis (PAFIP), a research and assistance program conducted in Spain. Patients were stratified according to the Spanish educational system according to their attendance in primary (low), secondary (medium) or university studies (high). The three groups were compared on available premorbid, clinical and neuropsychological variables. A subgroup of patients (n = 209), comprising the 10-year follow-up PAFIP cohort, were again compared. RESULTS Overall, 49% and 37% of FEP patients had low and medium levels of education, respectively. In total, 13% of the patients with a higher level of education were more frequently women (64%) and older at illness onset (36 years old), reported better premorbid adjustment, presented less severe positive symptoms and better functioning; and showed higher premorbid intelligence quotient and better performance on all the explored cognitive domains. Ten years later the FEP patients in the medium- and high-education groups had good global functioning and a neurocognitive performance within the normal limits. CONCLUSIONS Higher education is associated with better initial conditions and more favourable outcomes after an FEP. Sharing this information with the world's educational systems is essential to targeting resources and designing innovative programs or strategies to compensate for student difficulties.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Margarita Miguel-Corredera
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | | | - Patricia Correa-Ghisays
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Psychology and TMAP, Department of Medicine, University of Valencia, INCLIVA Health Research Institute, Valencia, Spain
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Instituto de Investigacion Sanitaria de Sevilla, IBiS, Sevilla, Spain
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11
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Hidalgo-Figueroa M, Salazar A, Romero-López-Alberca C, MacDowell KS, García-Bueno B, Bioque M, Bernardo M, Parellada M, González-Pinto A, García Portilla MP, Lobo A, Rodriguez-Jimenez R, Berrocoso E, Leza JC. The Influence of Oxytocin and Prolactin During a First Episode of Psychosis: The Implication of Sex Differences, Clinical Features, and Cognitive Performance. Int J Neuropsychopharmacol 2022; 25:666-677. [PMID: 35353882 PMCID: PMC9380712 DOI: 10.1093/ijnp/pyac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/10/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Approximately 3% of the population suffers a first episode of psychosis (FEP), and a high percentage of these patients subsequently relapse. Because the clinical course following a FEP is hard to predict, it is of interest to identify cognitive and biological markers that will help improve the diagnosis, treatment, and outcome of such events and to define new therapeutic targets. Here we analyzed the plasma oxytocin and prolactin levels during an FEP, assessing their correlation with clinical and cognitive features. METHODS The oxytocin and prolactin in plasma was measured in 120 FEP patients and 106 healthy controls, all of whom were subjected to a clinical and neuropsychological assessment. Most patients were under antipsychotics. Statistical analyses aimed to identify factors associated with the FEP and to search for associations between the variables. This study is preliminary and exploratory because the P-values were not corrected for multiple comparisons. RESULTS FEP patients had less oxytocin, more prolactin, and a poor premorbid IQ, and they performed worse in sustained attention. Male patients with higher prolactin levels experienced more severe psychotic symptoms and required higher doses of antipsychotics. Low oxytocin was associated with poor sustained attention in women, whereas low oxytocin and high prolactin in men correlated with better performance in sustained attention. CONCLUSION Low oxytocin, high prolactin, and poor premorbid IQ and sustained attention are factors associated with an FEP, representing potential therapeutic targets in these patients. These biological factors and cognitive domains might play an important role during a FEP, which could help us to develop new strategies that improve the outcomes of this disorder and that should perhaps be gender specific.
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Affiliation(s)
| | | | - Cristina Romero-López-Alberca
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, Cádiz, Spain,Personality, Evaluation and Psychological Treatment Area, Department of Psychology, Universidad de Cádiz, Puerto Real (Cádiz), Spain
| | - Karina S MacDowell
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | - Borja García-Bueno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | - Miquel Bioque
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miquel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, EHU, Vitoria-Gasteiz, Spain
| | - María Paz García Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Psychiatry, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto de Neurociencias del Principado de Asturias (INEUROPA), Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Medicine and Psychiatry, Universidad de Zaragoza, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Department of Psychiatry, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12)/Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Esther Berrocoso
- Correspondence: Esther Berrocoso, PhD, Neuropsychopharmacology Psychobiology Research Group, Psychobiology Area, Department of Psychology, University of Cádiz, 11510 Cádiz, Spain ()
| | - Juan C Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain,Departamento de Farmacología y Toxicología, Facultad de Medicina, Univ. Complutense de Madrid, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | | | - CIBERSAM
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
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12
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Díaz-Pons A, González-Rodríguez A, Ortiz-García de la Foz V, Seeman MV, Crespo-Facorro B, Ayesa-Arriola R. Disentangling early and late onset of psychosis in women: identifying new targets for treatment. Arch Womens Ment Health 2022; 25:335-344. [PMID: 35179650 DOI: 10.1007/s00737-022-01210-2] [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: 10/10/2021] [Accepted: 01/27/2022] [Indexed: 11/29/2022]
Abstract
Women present a second peak of incidence of psychosis during the menopausal transition, partially explained by the loss of estrogen protection conferred during the reproductive years. In view of the lack of studies comparing sociodemographic, biological, and clinical variables and neurocognitive performance between women with early onset of psychosis (EOP) and those with late onset of psychosis (LOP), our aim was to characterize both groups in a large sample of 294 first-episode psychosis (FEP) patients and 85 healthy controls (HC). In this cross-sectional study, the participants were interviewed to gather information on sociodemographic variables. We assessed laboratory features of interest and conducted a clinical assessment of psychopathological symptoms and neurocognitive abilities. From the latter, we derived a global cognitive functioning score. Analysis of covariance (ANCOVA) was used to compare EOP and LOP groups, and each group with age-comparable HC. EOP women were more frequently single and unemployed than HC age peers. While cholesterol levels in LOP women were higher than those in EOP women, no statistically significant differences were found in leptin levels. Women with LOP presented with less severe negative symptoms and higher cognitive processing speed scores than women with EOP. Cannabis and alcohol use was greater in EOP than in LOP women. Within the total FEP group, there was a history of significantly more recent traumatic events than in the HC group. Women with EOP and LOP show several sociodemographic and clinical differences, which may be valuable for planning personalized treatment.
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Affiliation(s)
- Alexandre Díaz-Pons
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Avda Valdecilla s/n, 39008, Santander, Spain.,National University of Distance Education (UNED), Faculty of Psychology, Madrid, Spain
| | | | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Avda Valdecilla s/n, 39008, Santander, Spain.,Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Avda Valdecilla s/n, 39008, Santander, Spain. .,National University of Distance Education (UNED), Faculty of Psychology, Madrid, Spain. .,Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain.
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13
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Murillo-García N, Díaz-Pons A, Fernández-Cacho LM, Miguel-Corredera M, Martínez-Barrio S, Ortiz-García de la Foz V, Neergaard K, Ayesa-Arriola R. A family study on first episode of psychosis patients: Exploring neuropsychological performance as an endophenotype. Acta Psychiatr Scand 2022; 145:384-396. [PMID: 35080005 DOI: 10.1111/acps.13404] [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: 10/08/2021] [Revised: 01/14/2022] [Accepted: 01/23/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Family studies provide a suitable approach to analyzing candidate endophenotypes of schizophrenia, including cognitive features. OBJECTIVE To characterize different neurocognitive functions in a group of patients with first episode of psychosis (FEP), their first-degree relatives (parents and siblings), and healthy controls (HC), in order to identify potential endophenotypes for schizophrenia spectrum disorders (SSD). METHODS Participants were assessed in the context of a national project in Spain called PAFIP-FAMILIAS. They completed the same neuropsychological battery, which included tests of verbal memory, visual memory, processing speed, working memory, executive functions, motor dexterity, attention, and theory of mind. Group comparisons were performed using one-way ANOVA, followed by tests of multiple comparisons when appropriate. RESULTS One hundred thirty-three FEP patients were included, as well as 244 of their first-degree relatives (146 parents and 98 siblings) and 202 HC. In general, relatives showed an intermediate performance between the HC and the FEP patients in all neurocognitive domains. However, the domains of executive functions and attention stood out, as relatives (especially parents) showed similar performance to FEP patients. This was replicated when selecting patients subsequently diagnosed with schizophrenia and their relatives. CONCLUSION These findings suggest that executive and attention dysfunctions might have a family aggregation and could be relevant cognitive endophenotypes for psychotic disorders. The study shows the potential of exploring intra-family neuropsychological performance supporting neurobiological and genetic research in SSD.
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Affiliation(s)
- Nancy Murillo-García
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain.,Department of Molecular Biology, Faculty of Medicine, University of Cantabria, Santander, Spain
| | - Alexandre Díaz-Pons
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain.,Faculty of Psychology, National University of Distance Education (UNED), Madrid, Spain
| | - Luis Manuel Fernández-Cacho
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain.,Department of Radiology, Marqués de Valdecilla University Hospital, Santander, Spain.,Faculty of Nursing, University of Cantabria, Santander, Spain
| | | | - Sara Martínez-Barrio
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain.,Faculty of Psychology, University Complutense of Madrid, Madrid, Spain
| | - Víctor Ortiz-García de la Foz
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain.,Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain
| | - Karl Neergaard
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain.,Department of Molecular Biology, Faculty of Medicine, University of Cantabria, Santander, Spain.,Faculty of Psychology, National University of Distance Education (UNED), Madrid, Spain.,Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain
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14
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Bornheimer LA, Cobia DJ, Li Verdugo J, Holzworth J, Smith MJ. Clinical insight and cognitive functioning as mediators in the relationships between symptoms of psychosis, depression, and suicide ideation in first-episode psychosis. J Psychiatr Res 2022; 147:85-93. [PMID: 35026597 PMCID: PMC10754229 DOI: 10.1016/j.jpsychires.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/22/2021] [Accepted: 01/03/2022] [Indexed: 11/21/2022]
Abstract
First-episode psychosis (FEP) is a particularly high-risk period for suicide. Literature suggests poor cognitive functioning may serve as a protective factor, while investigations of clinical insight reveal a complex relationship with suicide outcomes. This study examined the mediating role of cognition and clinical insight in the relationships between positive and negative symptoms, depression, and subsequent suicide ideation among individuals in FEP. Data were obtained from the Recovery After an Initial Schizophrenia Episode project. Participants (n = 404) included adolescents and adults in FEP between the ages of 15 and 40. Measurement utilized the Calgary Depression Rating Scale, Positive and Negative Syndrome Scale, and Brief Assessment of Cognition in Schizophrenia. Structural equation modeling was used to examine the mediation model. The likelihood of experiencing suicide ideation was significantly decreased when working memory was stronger (b = -0.034, SE = 0.02, OR = 0.967, p < .05), and significantly increased when clinical insight was stronger (b = 0.191, SE = 0.08, OR = 1.21, p < .01), positive symptoms were greater (b = 0.422, SE = 0.20, OR = 1.52, p < .05) and depressive symptoms were greater (b = 0.545, SE = 0.15, OR = 1.70, p < .001). Clinical insight and working memory functioned as mediators in the relationships between depression, positive symptoms, negative symptoms, and suicide ideation. Findings suggest it is essential that clinicians have awareness of insight being a risk factor for suicide ideation and balance therapeutic efforts to strengthen clinical insight and cognition in psychosocial treatments with suicide risk assessment and prevention methods.
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Affiliation(s)
- Lindsay A Bornheimer
- University of Michigan, School of Social Work, Ann Arbor, MI, USA; University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA.
| | - Derin J Cobia
- Brigham Young University, Department of Psychology and Neuroscience Center, Provo, UT, USA
| | | | - Joshua Holzworth
- University of Michigan, School of Social Work, Ann Arbor, MI, USA
| | - Matthew J Smith
- University of Michigan, School of Social Work, Ann Arbor, MI, USA
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15
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López-Díaz Á, Ayesa-Arriola R, Ortíz-García de la Foz V, Suárez-Pinilla P, Ramírez-Bonilla ML, Vázquez-Bourgon J, Ruiz-Veguilla M, Crespo-Facorro B. Predictors of diagnostic stability in brief psychotic disorders: Findings from a 3-year longitudinal study. Acta Psychiatr Scand 2021; 144:578-588. [PMID: 34431080 DOI: 10.1111/acps.13364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Brief psychotic disorder (BPD) is a relatively uncommon and underexplored psychotic condition. Even though BPD has been related to a more favorable outcome than other schizophrenia spectrum disorders (SSD), current knowledge of its predictive factors remains scant. This study aimed to examine its prevalence and find early predictors of BPD diagnostic stability. METHODS SSD diagnosis following Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria was explored in a large epidemiological cohort (n = 569) of non-affective first-episode psychosis (FEP) patients enrolled in a three-year longitudinal intervention program (PAFIP). Premorbid, sociodemographic, and clinical information was collected to characterize BPD patients and determine factors predictive of diagnostic stability. Multivariate analysis included predictors selected from clinical knowledge and also those that had achieved marginal significance (p ≤ 0.1) in univariate analysis. RESULTS A total of 59 patients enrolled in the PAFIP program (10.4% of the whole cohort) met DSM-IV criteria for BPD, of whom 40 completed the three-year follow-up. The temporal stability of BPD in our sample was as high as 40% (n = 16). Transition from BPD to schizophrenia occurred in 37% (n = 15) of patients. Fewer hallucinations at baseline and better insight independently significantly predicted BPD diagnostic stability over time. CONCLUSION Our findings confirm that BPD is a clinical condition with moderate-to-low temporal stability and demonstrate that approximately two-thirds of FEP individuals experiencing BPD will develop a long-lasting psychotic disorder during follow-up, mainly schizophrenia.
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Affiliation(s)
- Álvaro López-Díaz
- UGC Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain.,Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain.,Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain
| | - Rosa Ayesa-Arriola
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain.,Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.,Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Víctor Ortíz-García de la Foz
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain.,Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.,Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Paula Suárez-Pinilla
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain.,Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.,Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - María Luz Ramírez-Bonilla
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain.,Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.,Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Javier Vázquez-Bourgon
- Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain.,Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain.,Departamento de Psiquiatría, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Miguel Ruiz-Veguilla
- Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain.,Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain.,UGC Salud Mental, Hospital Universitario Virgen del Rocío, Seville, Spain.,Departamento de Psiquiatría, Universidad de Sevilla, Seville, Spain
| | - Benedicto Crespo-Facorro
- Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain.,Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Seville, Spain.,UGC Salud Mental, Hospital Universitario Virgen del Rocío, Seville, Spain.,Departamento de Psiquiatría, Universidad de Sevilla, Seville, Spain
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16
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Murillo-García N, Setién-Suero E, Pardo-de-Santayana G, Murillo-García M, Pelayo-Terán JM, Crespo-Facorro B, Ayesa-Arriola R. Entire duration of active psychosis and neurocognitive performance in first-episode non-affective psychosis. Early Interv Psychiatry 2021; 15:1266-1275. [PMID: 33244853 DOI: 10.1111/eip.13077] [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: 06/05/2020] [Revised: 08/27/2020] [Accepted: 11/15/2020] [Indexed: 11/28/2022]
Abstract
AIM To explore if the entire duration of active psychosis (DAP) is related to neurocognitive performance at baseline and at 3-year follow-up in patients with first episode psychosis (FEP). METHODS DAP was estimated for 481 FEP patients. A neuropsychological battery was administered to measure neurocognitive specific domains, and a global indicator of neurocognitive impairment (global deficits score, GDS) was calculated. According to the DAP quartiles, four subgroups were formed, and these were compared. In addition, a logistic regression analysis was carried out to predict neurocognitive impairment at 3-year follow-up. RESULTS FEP patients with the longest DAP (more than 18.36 months) presented a more severe global neurocognitive impairment evidenced in their GDS, both at baseline (F = 5.53; p˂ .01) and at 3-year follow-up (F = 4.16; p˂ .01). Moreover, a subgroup of participants with DAP between 7.40 and 18.36 months showed a specific attentional decline over the 3-year follow-up (F = 3.089; p˂ .05).The logistic regression model showed that sex (Wald = 7.29, p < .010), premorbid adjustment (Wald = 7.24, p < .010), attention (Wald = 12.10, p < .001), verbal memory (Wald = 16.29, p < .001) and visual memory (Wald = 9.41, p < .010) were significant predictors of neurocognitive impairment 3 years after the FEP. The variables composing the DAP were not significant predictors in this model. CONCLUSIONS DAP seems to be related to global neurocognitive impairment in FEP patients. These findings contribute in several ways to our understanding of the effects of active psychosis on the brain, and provide the basis for future research.
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Affiliation(s)
- Nancy Murillo-García
- IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.,Department of Molecular Biology, School of Medicine, University Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain
| | | | | | - Marisol Murillo-García
- International Education Program, Framingham State University, Framingham, Massachusetts, USA
| | - José María Pelayo-Terán
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.,Servicio de Salud de Castilla y León, Unidad de Calidad Asistencial y Seguridad del Paciente, Ponferrada, ES, Spain
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.,Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
| | - Rosa Ayesa-Arriola
- IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
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17
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Molina-García M, Fraguas D, del Rey-Mejías Á, Mezquida G, Sánchez-Torres AM, Amoretti S, Lobo A, González-Pinto A, Andreu-Bernabeu Á, Corripio I, Vieta E, Baeza I, Mané A, Cuesta M, de la Serna E, Payá B, Zorrilla I, Arango C, Bernardo M, Rapado-Castro M, Parellada M. The Role of Premorbid IQ and Age of Onset as Useful Predictors of Clinical, Functional Outcomes, and Recovery of Individuals with a First Episode of Psychosis. J Clin Med 2021; 10:2474. [PMID: 34199653 PMCID: PMC8199787 DOI: 10.3390/jcm10112474] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. METHODS we characterized 255 individuals who have experienced a first episode of psychosis in four a priori defined subgroups based on pIQ (low pIQ < 85; average pIQ ≥ 85) and age of onset (early onset < 18 years; adult onset ≥ 18 years). We conducted clinical and functional assessments at baseline and at two-year follow-up. We calculated symptom remission and recovery rates using the Positive and Negative Symptoms of Schizophrenia Schedule (PANSS) and the Global Assessment Functioning (GAF or Children-GAF). We examined clinical and functional changes with pair-wise comparisons and two-way mixed ANOVA. We built hierarchical lineal and logistic regression models to estimate the predictive value of the independent variables over functioning or recovery rates. RESULTS early-onset patients had more severe positive symptoms and poorer functioning than adult-onset patients. At two-year follow-up, only early-onset with low pIQ and adult-onset with average pIQ subgroups differed consistently, with the former having more negative symptoms (d = 0.59), poorer functioning (d = 0.82), lower remission (61% vs. 81.1%), and clinical recovery (34.1% vs. 62.2%). CONCLUSIONS early-onset individuals with low pIQ may present persistent negative symptoms, lower functioning, and less recovery likelihood at two-year follow-up. Intensive cognitive and functional programs for these individuals merit testing to improve long-term recovery rates in this subgroup.
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Affiliation(s)
- Mariola Molina-García
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - David Fraguas
- Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos (IdISSC), Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28040 Madrid, Spain;
| | - Ángel del Rey-Mejías
- Data Science Unit, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, School of Psychology, Complutense University of Madrid (UCM), 28223 Madrid, Spain;
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Ana M. Sánchez-Torres
- Department of Psychiatry, Navarra Institute for Health Research (IdiSNA), Complejo Hospitalario de Navarra, 31008 Pamplona, Spain; (A.M.S.-T.); (M.C.)
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain;
| | - Ana González-Pinto
- Department of Psychiatry, Bioaraba Health Research Institute, Hospital Universitario de Álava, Research Networking Center for Mental Health Network (CIBERSAM), University of the Basque Country (UPV/EHU), 01009 Vitoria, Spain; (A.G.-P.); (I.Z.)
| | - Álvaro Andreu-Bernabeu
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - Iluminada Corripio
- Department of Psychiatry, Institut d’Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Research Networking Center for Mental Health Network (CIBERSAM), Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain;
| | - Eduard Vieta
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Institute of Neurosciences, Hospital Clinic, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain;
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, SGR-881, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clínic de Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), Universitat de Barcelona, 08036 Barcelona, Spain;
| | - Anna Mané
- Hospital del Mar Medical Research Institute, Research Networking Center for Mental Health Network (CIBERSAM), Autonomous University of Barcelona, 08003 Barcelona, Spain;
| | - Manuel Cuesta
- Department of Psychiatry, Navarra Institute for Health Research (IdiSNA), Complejo Hospitalario de Navarra, 31008 Pamplona, Spain; (A.M.S.-T.); (M.C.)
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), 08036 Barcelona, Spain;
| | - Beatriz Payá
- IDIVAL, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
| | - Iñaki Zorrilla
- Department of Psychiatry, Bioaraba Health Research Institute, Hospital Universitario de Álava, Research Networking Center for Mental Health Network (CIBERSAM), University of the Basque Country (UPV/EHU), 01009 Vitoria, Spain; (A.G.-P.); (I.Z.)
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Marta Rapado-Castro
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC 3053, Australia
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
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18
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Abstract
Introduction: Most medical diagnoses present somewhat differently in men and women, more so at specific periods of life. Treatment effects may also differ. This is true for schizophrenia, where premorbid effects are experienced earlier in life in boys than in girls, and where symptoms and outcomes differ.Areas covered: This review does not cover all the differences that have been reported between men and women but, instead, focuses on the ones that carry important implications for clinical care: effective antipsychotic doses, medication side effects, symptom fluctuation due to hormonal levels, comorbidities, and women's requirements for prenatal, obstetric, postpartum, and parenting support.Expert opinion: Of consequence to schizophrenia, sex-biased genes, epigenetic modifications, and sex steroids all impact the structure and function of the brain. Furthermore, life experiences and social roles exert major sex-specific influences. The co-morbidities that accompany schizophrenia also affect men and women to different degrees. This review offers several examples of sex-specific intervention and concludes that gold standard treatment must look beyond symptoms and address all the physiologic, psychologic, and social role needs of men and women suffering from this psychiatric disorder.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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19
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Franceschini A, Fattore L. Gender-specific approach in psychiatric diseases: Because sex matters. Eur J Pharmacol 2021; 896:173895. [PMID: 33508283 DOI: 10.1016/j.ejphar.2021.173895] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/29/2020] [Accepted: 01/19/2021] [Indexed: 12/20/2022]
Abstract
In both animals and human beings, males and females differ in their genetic background and hormonally driven behaviour and show sex-related differences in brain activity and response to internal and external stimuli. Gender-specific medicine has been a neglected dimension of medicine for long time, and only in the last three decades it is receiving the due scientific and clinical attention. Research has recently begun to identify factors that could provide a neurobiological basis for gender-based differences in health and disease and to point to gonadal hormones as important determinants of male-female differences. Animal studies have been of great help in understanding factors contributing to sex-dependent differences and sex hormones action. Here we review and discuss evidence provided by clinical and animal studies in the last two decades showing gender (in humans) and sex (in animals) differences in selected psychiatric disorders, namely eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder), schizophrenia, mood disorders (anxiety, depression, obsessive-compulsive disorder) and neurodevelopmental disorders (autism spectrum disorders, attention-deficit/hyperactivity disorder).
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Affiliation(s)
- Anna Franceschini
- Addictive Behaviors Department, Local Health Authority, Trento, Italy
| | - Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council, Italy.
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20
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Giordano GM, Bucci P, Mucci A, Pezzella P, Galderisi S. Gender Differences in Clinical and Psychosocial Features Among Persons With Schizophrenia: A Mini Review. Front Psychiatry 2021; 12:789179. [PMID: 35002807 PMCID: PMC8727372 DOI: 10.3389/fpsyt.2021.789179] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/03/2021] [Indexed: 01/10/2023] Open
Abstract
An extensive literature regarding gender differences relevant to several aspects of schizophrenia is nowadays available. It includes some robust findings as well as some inconsistencies. In the present review, we summarize the literature on gender differences in schizophrenia relevant to clinical and social outcome as well as their determinants, focusing on clinical variables, while gender differences on biological factors which may have an impact on the outcome of the disorder were not included herewith. Consistent findings include, in male with respect to female patients, an earlier age of illness onset limited to early- and middle-onset schizophrenia, a worse premorbid functioning, a greater severity of negative symptoms, a lower severity of affective symptoms and a higher rate of comorbid alcohol/substance abuse. Discrepant findings have been reported on gender differences in positive symptoms and in social and non-social cognition, as well as in functional outcome and rates of recovery. In fact, despite the overall finding of a more severe clinical picture in males, this does not seem to translate into a worse outcome. From the recent literature emerges that, although some findings on gender differences in schizophrenia are consistent, there are still aspects of clinical and functional outcome which need clarification by means of further studies taking into account several methodological issues.
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Affiliation(s)
| | - Paola Bucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
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21
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Ayesa-Arriola R, de la Foz VOG, Setién-Suero E, Ramírez-Bonilla ML, Suárez-Pinilla P, Son JMV, Vázquez-Bourgon J, Juncal-Ruiz M, Gómez-Revuelta M, Tordesillas-Gutiérrez D, Crespo-Facorro B. Understanding sex differences in long-term outcomes after a first episode of psychosis. NPJ SCHIZOPHRENIA 2020; 6:33. [PMID: 33219222 PMCID: PMC7679369 DOI: 10.1038/s41537-020-00120-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 10/06/2020] [Indexed: 12/20/2022]
Abstract
While sex differences in schizophrenia have long been reported and discussed, long-term sex differences in outcomes among first episode of psychosis (FEP) patients in terms of the efficacy of Early Intervention Services (EIS) has been an under-explored area. A total of 209 FEP patients (95 females and 114 males) were reassessed after a time window ranging from 8 to 16 years after their first contact with an EIS program (PAFIP) that we will call the 10-year PAFIP cohort. Multiple clinical, cognitive, functioning, premorbid, and sociodemographic variables were explored at 1-year, 3-year and 10-year follow-ups. At first contact, females were older at illness onset, had higher premorbid adjustment and IQ, and were more frequently employed, living independently, and accompanied by a partner and/or children. Existence of a schizophrenia diagnosis, and cannabis and alcohol consumption were more probable among men. During the first 3 years, women showed a significantly better response to minimal antipsychotic dosages and higher rates of recovery than men (50% vs. 30.8%). Ten years later, more females continued living independently and had partners, while schizophrenia diagnoses and cannabis consumption continued to be more frequent among men. Females also presented a lower severity of negative symptoms; however, functionality and recovery differences did not show significant differences (46.7% vs. 34.4%). Between the 3- and 10-year follow-up sessions, an increase in dosage of antipsychotics was observed. These results suggest that the better outcomes seen among women during the first 3 years (while they were treated in an EIS) were in the presence of more favourable premorbid and baseline characteristics. After an average period of 10 years, with the only difference being in negative symptoms course, outcomes for women approximated those of men, drawing particular attention to the increase in dosage of antipsychotic medication once FEP patients were discharged from the EIS program towards community-based services. These findings help to pose the question of whether it is advisable to target sexes and lengthen EIS interventions.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain. .,CIBERSAM, Centro InvestigaciónBiomédicaen Red Salud Mental, Madrid, Spain.
| | - Víctor Ortíz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Centro InvestigaciónBiomédicaen Red Salud Mental, Madrid, Spain
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - María Luz Ramírez-Bonilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - Paula Suárez-Pinilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Centro InvestigaciónBiomédicaen Red Salud Mental, Madrid, Spain
| | - Jacqueline Mayoral-van Son
- CIBERSAM, Centro InvestigaciónBiomédicaen Red Salud Mental, Madrid, Spain.,Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain.,Instituto de Investigacion Sanitaria de Sevilla, IBiS, Sevilla, Spain
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Centro InvestigaciónBiomédicaen Red Salud Mental, Madrid, Spain
| | - María Juncal-Ruiz
- Sierrallana Hospital, Department of Psychiatry, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Marcos Gómez-Revuelta
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - Diana Tordesillas-Gutiérrez
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain.,CIBERSAM, Centro InvestigaciónBiomédicaen Red Salud Mental, Madrid, Spain
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro InvestigaciónBiomédicaen Red Salud Mental, Madrid, Spain.,Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain.,Instituto de Investigacion Sanitaria de Sevilla, IBiS, Sevilla, Spain
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22
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Qu M, Wang J, Chen DC, Chen S, Xiu MH, Zhang XY. Sex-specific association between peripheral superoxide dismutase, BDNF and cognitive impairment in drug-naive first episode patients with schizophrenia. Free Radic Biol Med 2020; 160:887-893. [PMID: 32949664 DOI: 10.1016/j.freeradbiomed.2020.09.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022]
Abstract
Patients with schizophrenia (SCZ) have cognitive impairments across several domains. Cognition decline is related to the complex interrelationship between brain-derived neurotrophic factor (BDNF) and redox system imbalance. However, the effect of sex on cognitive impairment and biomarkers has not been fully studied in patients with drug-naïve first episode (DNFE) SCZ. 327 DNFE SCZ patients and 391 healthy controls were recruited, and the levels of BDNF and malondialdehyde (MDA) and the activities of total SOD, Mn-SOD, CuZn-SOD enzymes were measured. Cognitive function was measured by using the Repeatable Battery for the Assessment of Neuropsychological status (RBANS) and clinical symptoms by the Positive and Negative Syndrome Scale (PANSS). Patients performed worse on most cognitive tasks than controls, but there was no significant sex difference in cognitive function between patients and controls. Further analysis showed that a sex difference in MDA was found in controls rather than patients, indicating that MDA levels in men were higher than those in women in controls. Moreover, the Mn-SOD was significantly correlated with attention, language and RBANS total scores only in male patients. Multiple linear regression analysis showed that the interaction between BDNF and Mn-SOD or SOD was associated with RBANS language index score in male patients. Our results suggest that the interrelationship of BDNF with antioxidant mechanisms may contribute to the pathological mechanisms underlying cognitive deficits only in male DNFE patients with SCZ, but not in female patients.
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Affiliation(s)
- Miao Qu
- Neurology Department, Xuan Wu Hospital of Capital Medical University, Beijing, China
| | - Jun Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, PR China
| | - Da Chun Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, PR China
| | - Song Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, PR China
| | - Mei Hong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, PR China.
| | - Xiang Yang 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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23
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Brain grey matter abnormalities in first episode non-affective psychosis patients with suicidal behaviours: The role of neurocognitive functioning. Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109948. [PMID: 32305356 DOI: 10.1016/j.pnpbp.2020.109948] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Suicide is one of the leading causes of premature death in first-episode psychosis (FEP) patients. The understanding of suicidal behaviour (SB) is limited, and new and integrative approaches focusing on the likely relationship of the biological and cognitive features of SB in the early phases of psychosis are warranted. We aimed to study the relationship of brain grey matter anomalies and cognitive functioning with SB or suicidal risk in a large sample of non-affective FEP patients. METHODS We used a voxel-based morphometry analysis in 145 FEP patients to investigate the pattern of structural brain abnormalities related to SB. In addition, bivariate and multivariate analyses were performed to explore the relationship between cognitive functioning and SB. RESULTS A reduction in grey matter volume in the frontal area, temporal gyrus, precuneus, uncus, amygdala, left cuneus and subcallosal gyrus as well as a marked regional volume reduction in the right hemisphere was linked with the presence of SB. Additionally, worse global cognitive functioning and living in urban areas were identified as suicide risk factors. CONCLUSIONS This study provides some insights about the brain abnormalities associated with SB in FEP patients. Specifically, the areas reported are involved in important functions related to SB, such as impulsivity, problem solving or responses to pain. Thus, the results confirm the relevant role of cognitive functioning on SB.
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24
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Carruthers SP, Van Rheenen TE, Gurvich C, Sumner PJ, Rossell SL. Characterising the structure of cognitive heterogeneity in schizophrenia spectrum disorders. A systematic review and narrative synthesis. Neurosci Biobehav Rev 2019; 107:252-278. [PMID: 31505202 DOI: 10.1016/j.neubiorev.2019.09.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/19/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022]
Abstract
The aim of the present review was to systematically summarise our current understanding of the structure of the cognitive heterogeneity that exists within schizophrenia spectrum disorder (SSD). Fifty-two relevant studies were identified from January 1980 to March 2019 that investigated cognitive subgroups within SSD. Twenty-five studies employed classification criteria based on current neuropsychological function, 14 studies employed various data-driven subgrouping methodologies and 13 studies investigated putative cognitive symptom trajectories. Despite considerable methodological variability, three distinct cognitive subgroups reliability emerged; a relatively intact cognitive subgroup characterised by high cognitive performance, an intermediate cognitive subgroup defined by mixed or moderate levels of cognitive function/dysfunction and a globally impaired subgroup characterised by severe cognitive deficits. Whilst preliminary evidence suggests that these subgroups may have further investigative relevance in and of themselves, additional research is required and discussed. A set of reporting guidelines are also presented to overcome the methodological inconsistencies identified in the reviewed literature.
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Affiliation(s)
- Sean P Carruthers
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia.
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred Hospital, Melbourne, 3004, Australia
| | - Philip J Sumner
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia; St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
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25
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Ayesa-Arriola R, Pelayo Terán JM, Setién-Suero E, Neergaard K, Ochoa S, Ramírez-Bonilla M, Pérez-Iglesias R, Crespo-Facorro B. Patterns of recovery course in early intervention for FIRST episode non-affective psychosis patients: The role of timing. Schizophr Res 2019; 209:245-254. [PMID: 30772066 DOI: 10.1016/j.schres.2019.01.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 01/07/2019] [Accepted: 01/19/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Prevention of symptom relapse and promotion of functional recovery are the two main goals of early intervention following a first episode of non-affective psychosis (FEP). The identification of patterns of recovery is important in developing and implementing recovery focused interventions at set time interval. METHOD Patterns of recovery course, in terms of symptomatic and functional remission, were explored at 1 and 3-year follow-up in a sample of 373 consecutive FEP patients. Relapses during this period were considered. RESULTS Four patterns of recovery course were defined: good stable (26%), good unstable (21%), poor unstable (10%), poor stable (43%). Those who met criteria for good stable recovery were more likely have less severe baseline negative symptoms (OR = 2.092; 95% CI = 0.99-4.419) and to not be diagnosed with schizophrenia (OR = 2.242; 95% CI = 1.015-4.954). Short DUP (OR = 2.152; 95% CI = 0.879-5.27) and low premorbid IQ (OR = 2.281; 95% CI = 0.954-5.457) increased the likelihood of good unstable recovery. Less severe baseline negative symptoms (OR = 3.851; 95% CI = 1.422-10.435) and single status (OR = 4.307; 95% CI = 1.014-18.293) increased the likelihood of a poor unstable recovery. Poor unstable pattern was significantly associated with a high relapse rate (73%). CONCLUSIONS Our results shed light on identifying different recovery patterns in FEP. Despite evidence for early intervention effectiveness, we should explore ways to prevent relapse and improve long-term recovery, particularly in reference to the role of timing in the design of interventions.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain.
| | - Jose María Pelayo Terán
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Unidad de Gestión Clínica de Psiquiatría y Salud Mental, Gerencia de Asistencia Sanitaria de El Bierzo, Servicio de Salud de Castilla y Leon (SACYL), Ponferrada, León, Spain
| | - Esther Setién-Suero
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
| | - Karl Neergaard
- Laboratoire Parole et Langage, Aix-Marseille University, Aix-en-Provence, France
| | - Susana Ochoa
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Mariluz Ramírez-Bonilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Rocío Pérez-Iglesias
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Department of Psychosis Studies, Institute of Psychiatry, King's College London, London
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
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