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Toimela J, Halt A, Kerkelä M, Kampman O, Suvisaari J, Kieseppä T, Lähteenvuo M, Tiihonen J, Ahola-Olli A, Veijola J, Holm M. Association of obesity to reaction time and visual memory in schizophrenia. Schizophr Res Cogn 2024; 37:100316. [PMID: 38764744 PMCID: PMC11101897 DOI: 10.1016/j.scog.2024.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 05/05/2024] [Indexed: 05/21/2024]
Abstract
Background Both overweight and cognitive deficits are common among people with schizophrenia (SZ) and schizoaffective disorder. The results in earlier studies have been inconsistent on whether overweight is associated with cognitive deficits in psychotic disorders. Aims Our aim in this study was to detect possible associations between obesity and cognitive deficits among study participants with SZ and schizoaffective disorder. Methods The study sample included 5382 participants with a clinical diagnosis of SZ or schizoaffective disorder selected from the Finnish SUPER study. Obesity was measured both with body-mass index and waist circumference. The cognitive performance was evaluated with two tests from the Cambridge automated neuropsychological test battery: Reaction time was evaluated with the 5-choice serial reaction time task. Visual memory was evaluated with the paired associative learning test. The final analysis included a total sample of 4498 participants applicable for the analysis of the reaction time and 3967 participants for the analysis of the visual memory. Results Obesity measured with body-mass index was associated with better performance in reaction time task among both female and male participants. Among male participants, overweight was associated with better performance in the visual memory test. The waist circumference was not associated with cognitive measures. Conclusions The results suggest that obesity in people with SZ or schizoaffective disorder might not be associated with cognitive deficits but instead with better cognitive performance. The results were opposite from earlier literature on the general population. More research is required to better understand whether the results might be partly caused by the differences in the etiology of obesity between the general population and people with SZ.
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Affiliation(s)
- J.S. Toimela
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - A.H. Halt
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, FI-90220 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M. Kerkelä
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - O. Kampman
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå SE-90187, Sweden
- University of Turku, Faculty of Medicine, Department of Clinical Medicine (Psychiatry), Turku, Finland
- The Wellbeing Services Country of Ostrobothnia, Department of Psychiatry, Vaasa, Finland
- The Pirkanmaa Wellbeing Services Country, Department of Psychiatry, Tampere, Finland
| | - J. Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), FI-00271 Helsinki, Finland
| | - T. Kieseppä
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), FI-00271 Helsinki, Finland
- University of Helsinki, Helsinki University Hospital, Psychiatry, FI-00029 Helsinki, Finland
| | - M. Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, FI-70240 Kuopio, Finland
| | - J. Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, FI-70240 Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, SE-11364 Stockholm, Sweden
| | - A. Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, FI-00014 Helsinki, Finland
- Department of Internal Medicine, Satasairaala Hospital, Pori, Finland
| | - J. Veijola
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, FI-90220 Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M. Holm
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), FI-00271 Helsinki, Finland
| | - The SUPER researchers listed in the Acknowledgements
- Research Unit of Clinical Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, FI-90220 Oulu, Finland
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), FI-00271 Helsinki, Finland
- University of Helsinki, Helsinki University Hospital, Psychiatry, FI-00029 Helsinki, Finland
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, FI-70240 Kuopio, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, SE-11364 Stockholm, Sweden
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, FI-00014 Helsinki, Finland
- Department of Internal Medicine, Satasairaala Hospital, Pori, Finland
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå SE-90187, Sweden
- University of Turku, Faculty of Medicine, Department of Clinical Medicine (Psychiatry), Turku, Finland
- The Wellbeing Services Country of Ostrobothnia, Department of Psychiatry, Vaasa, Finland
- The Pirkanmaa Wellbeing Services Country, Department of Psychiatry, Tampere, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Chen X, Wang T, Tian Y, Ma Y, Liu Y, Chen H, Hou H, Hu Q, Chu M. Smoking-diseases correlation database: comprehensive analysis of the correlation between smoking and 422 diseases based on NHANES 2013-2018. Front Public Health 2024; 12:1325856. [PMID: 38912260 PMCID: PMC11190184 DOI: 10.3389/fpubh.2024.1325856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 05/24/2024] [Indexed: 06/25/2024] Open
Abstract
Background Smoking is a risk factor for a wide range of diseases. Previous research has confirmed over 30 Smoking-Associated Diseases in diverse systems. There is limited research exploring the correlation among multiple diseases, with an absence of comprehensive investigations. Few studies concentrate on diseases exhibiting a negative correlation with smoking, wherein smokers demonstrate a lower prevalence. Objective This study aimed to detect the correlation between smoking and other diseases using data from National Health and Nutrition Examination Surveys (NHANES) and construct a Smoking-Diseases Correlation Database (SDCD). The second aim is to obtain an extensive screening test for diseases that may be linked to smoking. Methods 39,126 subjects' data from the NHANES 2013-2018 dataset were extracted. The baseline information, difference in blood routine and blood chemistry indicators between smokers and non-smokers, and diseases' correlation with smoking in four different models were analyzed by R. The data and statistics were aggregated into an online SDCD. Results Our study reported 46 Smoking-Associated Diseases (SAD), including 29 Smoking Positively Associated Diseases (SPAD) and 17 Smoking Negatively Associated Diseases (SNAD). The SDCD of 422 diseases was constructed and can be accessed at https://chatgptmodel.shinyapps.io/sdcd/. Conclusion Our findings revealed 46 SADs including 29 SPADs and 17 SNADs. We aggregated the statistics and developed online SDCD, advancing our understanding of the correlation between smoking and diseases.
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Affiliation(s)
- Xi Chen
- NHC Key Laboratory of Medical Immunology (Peking University), Department of Immunology, School of Basic Medical Sciences, Peking University, Beijing, China
- Department of Adult Joint Reconstructive Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Tengkun Wang
- NHC Key Laboratory of Medical Immunology (Peking University), Department of Immunology, School of Basic Medical Sciences, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Yushan Tian
- Beijing Life Science Academy, Beijing, China
| | - Yinchao Ma
- NHC Key Laboratory of Medical Immunology (Peking University), Department of Immunology, School of Basic Medical Sciences, Peking University, Beijing, China
- Beijing Life Science Academy, Beijing, China
| | - Yuan Liu
- NHC Key Laboratory of Medical Immunology (Peking University), Department of Immunology, School of Basic Medical Sciences, Peking University, Beijing, China
| | - Huan Chen
- Beijing Life Science Academy, Beijing, China
| | - Hongwei Hou
- Beijing Life Science Academy, Beijing, China
| | - Qingyuan Hu
- Beijing Life Science Academy, Beijing, China
| | - Ming Chu
- NHC Key Laboratory of Medical Immunology (Peking University), Department of Immunology, School of Basic Medical Sciences, Peking University, Beijing, China
- Beijing Life Science Academy, Beijing, China
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Koster M, Mannsdörfer L, van der Pluijm M, de Haan L, Ziermans T, van Wingen G, Vermeulen J. The Association Between Chronic Tobacco Smoking and Brain Alterations in Schizophrenia: A Systematic Review of Magnetic Resonance Imaging Studies. Schizophr Bull 2024:sbae088. [PMID: 38824451 DOI: 10.1093/schbul/sbae088] [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] [Indexed: 06/03/2024]
Abstract
BACKGROUND AND HYPOTHESIS The high co-occurrence of tobacco smoking in patients with schizophrenia spectrum disorders (SSD) poses a serious health concern, linked to increased mortality and worse clinical outcomes. The mechanisms underlying this co-occurrence are not fully understood. STUDY DESIGN Addressing the need for a comprehensive overview of the impact of tobacco use on SSD neurobiology, we conducted a systematic review of neuroimaging studies (including structural, functional, and neurochemical magnetic resonance imaging studies) that investigate the association between chronic tobacco smoking and brain alterations in patients with SSD. STUDY RESULTS Eight structural and fourteen functional studies were included. Structural studies show widespread independent and additive reductions in gray matter in relation to smoking and SSD. The majority of functional studies suggest that smoking might be associated with improvements in connectivity deficits linked to SSD. However, the limited number of and high amount of cross-sectional studies, and high between-studies sample overlap prevent a conclusive determination of the nature and extent of the impact of smoking on brain functioning in patients with SSD. Overall, functional results imply a distinct neurobiological mechanism for tobacco addiction in patients with SSD, possibly attributed to differences at the nicotinic acetylcholine receptor level. CONCLUSIONS Our findings highlight the need for more longitudinal and exposure-dependent studies to differentiate between inherent neurobiological differences and the (long-term) effects of smoking in SSD, and to unravel the complex interaction between smoking and schizophrenia at various disease stages. This could inform more effective strategies addressing smoking susceptibility in SSD, potentially improving clinical outcomes.
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Affiliation(s)
- Merel Koster
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lilli Mannsdörfer
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke van der Pluijm
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Tim Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Guido van Wingen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jentien Vermeulen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Li W, Yue L, Xiao S. Demographic, biochemical, clinical, and cognitive symptom differences between smokers and non-smokers in Chinese older male patients with chronic schizophrenia. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01762-7. [PMID: 38462585 DOI: 10.1007/s00406-024-01762-7] [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: 01/31/2023] [Accepted: 01/13/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Several studies have suggested that smoking may impair cognitive function and worsen psychiatric symptoms in people with schizophrenia, but the results have not been consistent. There have been few studies to date that have examined the effects of smoking in older men with chronic schizophrenia. METHODS The participants in our study consisted of 167 order Chinese males with chronic schizophrenia and 359 normal control subjects. We split them into smoking and non-smoking groups based on whether or not they smoked. Second, we compared their differences in terms of general demographic characteristics (such as age, education, body mass index, age of illness onset, and course of disease), disease information (such as hypertension, diabetes, and hyperlipidemia), lifestyle factors (such as physical exercise and lunch break), blood biochemical indicators (such as albumin, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein and fasting blood glucose), and medication usage (such as clozapine, olanzapine, risperidone, and chlorpromazine). Lastly, a neuropsychological test battery was used to assess their psychiatric and cognitive symptoms, for example, the Montreal Cognitive Assessment (MoCA) was used to assess their overall cognitive functioning. Their depressive symptoms were assessed by the geriatric depression scale (GDS). Activities of daily living (ADL) were used to assess their ability to lead a daily life, while the positive and negative syndrome scales (PANSS) were used to assess their psychiatric symptoms. RESULTS Smokers who develop schizophrenia at older ages had a higher body mass index than non-smokers. We also found that plasma albumin, triglycerides, low-density lipoprotein, and fasting blood glucose concentrations were significantly higher in smokers. In contrast, smokers with schizophrenia also had lower PANSS total scores, negative symptom scores, and general psychopathology scores. A forward stepwise binary logistics regression analysis demonstrated a significant association between negative symptom scores and smoking status (B = 0.112, p < 0.001, OR = 1.119, 95% confidence interval: 1.059-1.181). Correlation analysis was carried out and it was found that the amount of cigarette consumption per day had a negative correlation with plasma albumin level(r = - 0.290, p = 0.004). However, no such association was found in normal controls. CONCLUSIONS Elderly Chinese men with schizophrenia have a higher percentage of smokers, and although smoking can reduce their plasma albumin levels, it does contribute to the prevention of negative symptoms.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
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5
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Sprenger S, Anderson JS. Dying to Quit: Understanding the Burden of Tobacco in Psychiatric Patients-A Clinical Review. J Psychiatr Pract 2024; 30:23-31. [PMID: 38227724 DOI: 10.1097/pra.0000000000000764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Smoking is the leading cause of preventable death worldwide and remains a critical public health challenge. The burden of disease caused by smoking is disproportionately borne by persons living with mental illness. Public health efforts to address smoking have not historically translated to a significant reduction in smoking prevalence among patients with mental illness. Smoking is a substantial cause of morbidity and mortality among psychiatric patients who smoke at 1.7 to 3.3 times the rate of the general population. Among those with serious mental illness, tobacco-related illness accounts for half of all deaths. Nicotine dependence also interferes with treatment and worsens many psychiatric symptoms. Interventions are underutilized due to persistent misunderstandings regarding tobacco cessation for patients who are mentally ill. Addressing these misunderstandings is crucial in targeting the disparate rates of smoking in this population. Therefore, it is incumbent on psychiatrists to address the outsized effect that smoking has on patients with mental illness.
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Affiliation(s)
- Steven Sprenger
- SPRENGER, ANDERSON: Deparment of Psychiatry, Tristar Centennial Medical Center, Nashville, TN
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6
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Sandhu AK, Naderi E, Wijninga MJ, Liemburg EJ, Cath D, Bruggeman R, Alizadeh BZ. Pharmacogenetics of Long-Term Outcomes of Schizophrenia Spectrum Disorders: The Functional Role of CYP2D6 and CYP2C19. J Pers Med 2023; 13:1354. [PMID: 37763122 PMCID: PMC10532576 DOI: 10.3390/jpm13091354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/25/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
Schizophrenia spectrum disorders (SSD) are complex mental disorders, and while treatment with antipsychotics is important, many patients do not respond or develop serious side effects. Genetic variation has been shown to play a considerable role in determining an individual's response to antipsychotic medication. However, previous pharmacogenetic (PGx) studies have been limited by small sample sizes, lack of consensus regarding relevant genetic variants, and cross-sectional designs. The current study aimed to investigate the association between PGx variants and long-term clinical outcomes in 691 patients of European ancestry with SSD. Using evidence from the literature on candidate genes involved in antipsychotic pharmacodynamics, we created a polygenic risk score (PRS) to investigate its association with clinical outcomes. We also created PRS using core variants of psychotropic drug metabolism enzymes CYP2D6 and CYP2C19. Furthermore, the CYP2D6 and CYP2C19 functional activity scores were calculated to determine the relationship between metabolism and clinical outcomes. We found no association for PGx PRSs and clinical outcomes; however, an association was found with CYP2D6 activity scores by the traditional method. Higher CYP2D6 metabolism was associated with high positive and high cognitive impairment groups relative to low symptom severity groups. These findings highlight the need to test PGx efficacy with different symptom domains. More evidence is needed before pharmacogenetic variation can contribute to personalized treatment plans.
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Affiliation(s)
- Amrit K. Sandhu
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Elnaz Naderi
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Centre for Statistical Genetics, Gertude H. Sergiesky Centre, Department of Neurology, Columbia University Medical Centre, New York, NY 10032, USA
| | - Morenika J. Wijninga
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Edith J. Liemburg
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | | | - Danielle Cath
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- GGZ Drenthe, Department of Specialist Trainings, 9704 LA Assen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Behrooz Z. Alizadeh
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
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Falkai P, Schwaiger R, Schmitt A, Röll L, Maurus I. Sports Therapy for Schizophrenia Psychoses: from the Idea to the Guideline. DAS GESUNDHEITSWESEN 2023; 85:S212-S217. [PMID: 37751760 DOI: 10.1055/a-2129-7421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Schizophrenia psychoses can be treated much better today due to the introduction of antipsychotics about 70 years ago in conjunction with the implementation of specific psychotherapies. However, current treatment options are still limited in the area of negative symptoms and disease-associated cognitive deficits. In the last 15 years, randomised controlled trials (RCTs) have been able to show that physical training and especially endurance training could represent a comprehensive complementary treatment approach and could lead to a significant improvement in positive, but especially also in negative symptoms and cognitive deficits. As a result, sports therapy for schizophrenia psychoses has found its way not only into the national treatment guidelines of the German Society for Psychiatry, Psychotherapy, Psychosomatics and Neurology (DGPPN), but also into European recommendations such as those of the European Psychiatric Association (EPA). With the introduction of the "Living guideline" format (here an update takes place at least once a year), a broader implementation in health care will be easier in the future. Based on a narrative review, this paper describes the process of implementing sports therapy for schizophrenia psychoses from its beginnings to its incorporation into guidelines and can be applied analogously to other forms of therapy.
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Affiliation(s)
- Peter Falkai
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Rebecca Schwaiger
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, University of São Paulo (USP), São Paulo, Brazil
| | - Lukas Röll
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
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Cattarinussi G, Gugliotta AA, Sambataro F. The Risk for Schizophrenia-Bipolar Spectrum: Does the Apple Fall Close to the Tree? A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6540. [PMID: 37569080 PMCID: PMC10418911 DOI: 10.3390/ijerph20156540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/24/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
Schizophrenia (SCZ) and bipolar disorder (BD) are severe psychiatric disorders that share clinical features and several risk genes. Important information about their genetic underpinnings arises from intermediate phenotypes (IPs), quantifiable biological traits that are more prevalent in unaffected relatives (RELs) of patients compared to the general population and co-segregate with the disorders. Within IPs, neuropsychological functions and neuroimaging measures have the potential to provide useful insight into the pathophysiology of SCZ and BD. In this context, the present narrative review provides a comprehensive overview of the available evidence on deficits in neuropsychological functions and neuroimaging alterations in unaffected relatives of SCZ (SCZ-RELs) and BD (BD-RELs). Overall, deficits in cognitive functions including intelligence, memory, attention, executive functions, and social cognition could be considered IPs for SCZ. Although the picture for cognitive alterations in BD-RELs is less defined, BD-RELs seem to present worse performances compared to controls in executive functioning, including adaptable thinking, planning, self-monitoring, self-control, and working memory. Among neuroimaging markers, SCZ-RELs appear to be characterized by structural and functional alterations in the cortico-striatal-thalamic network, while BD risk seems to be associated with abnormalities in the prefrontal, temporal, thalamic, and limbic regions. In conclusion, SCZ-RELs and BD-RELs present a pattern of cognitive and neuroimaging alterations that lie between patients and healthy individuals. Similar abnormalities in SCZ-RELs and BD-RELs may be the phenotypic expression of the shared genetic mechanisms underlying both disorders, while the specificities in neuropsychological and neuroimaging profiles may be associated with the differential symptom expression in the two disorders.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
| | - Alessio A. Gugliotta
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, 35131 Padova, Italy; (G.C.); (A.A.G.)
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
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Castaldelli-Maia JM, Camargos de Oliveira V, Irber FM, Blaas IK, Angerville B, Sousa Martins-da-Silva A, Koch Gimenes G, Waisman Campos M, Torales J, Ventriglio A, Guillois C, El Ouazzani H, Gazaix L, Favré P, Dervaux A, Apter G. Psychopharmacology of smoking cessation medications: focus on patients with mental health disorders. Int Rev Psychiatry 2023; 35:397-417. [PMID: 38299651 DOI: 10.1080/09540261.2023.2249084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/14/2023] [Indexed: 02/02/2024]
Abstract
The adverse effects of smoking cessation in individuals with mental health disorders have been a point of concern, and progress in the development of treatment has been slow. The primary first-line treatments for smoking cessation are Nicotine Replacement Therapy, Bupropion, Varenicline, and behavioural support. Nortriptyline and Clonidine are second-line treatments used when the first-line treatments are not effective or are contraindicated. Smoking cessation medications have been shown to be effective in reducing nicotine cravings and withdrawal symptoms and promoting smoking cessation among patients living with mental disorders. However, these medications may have implications for patients' mental health and need to be monitored closely. The efficacy and side effects of these medications may vary depending on the patient's psychiatric condition, medication regimen, substance use, or medical comorbidities. The purpose of this review is to synthesise the pharmacokinetics, pharmacodynamics, therapeutic effects, adverse effects, and pharmacological interactions of first- and second-line smoking cessation drugs, with an emphasis on patients suffering from mental illnesses. Careful consideration of the risks and benefits of using smoking cessation medications is necessary, and treatment plans must be tailored to individual patients' needs. Monitoring symptoms and medication regimens is essential to ensure optimal treatment outcomes.
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Affiliation(s)
- João Mauricio Castaldelli-Maia
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | - Israel K Blaas
- Perdizes Institute (IPer), Clinics Hospital (HCFMUSP), Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | - Gislaine Koch Gimenes
- Perdizes Institute (IPer), Clinics Hospital (HCFMUSP), Medical School, University of São Paulo, São Paulo, Brazil
| | - Marcela Waisman Campos
- Department of Cognitive Neurology, Neuropsychiatry, and Neuropsychology, FLENI, Buenos Aires, Argentina
| | - Julio Torales
- Department of Psychiatry, National University of Asuncion, San Lorenzo, Paraguay
- Regional Institute of Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
- School of Health Sciences, Universidad Sudamericana, Pedro Juan Caballero, Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Carine Guillois
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Houria El Ouazzani
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Léna Gazaix
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Pascal Favré
- Établissement Public de Santé Mentale, Neuilly sur Marne, France
| | - Alain Dervaux
- Établissement Public de Santé Barthélémy Durand, Étampes, France
- Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Gisèle Apter
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Établissement Public de Santé Mentale, Neuilly sur Marne, France
- Societé de l'Information Psychiatrique, Bron, France
- University of Rouen Normandy, Rouen, France
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10
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Mallet J, Godin O, Dansou Y, Mazer N, Scognamiglio C, Berna F, Boyer L, Capdevielle D, Chéreau I, D'Amato T, Dubreucq J, Fond G, Leigner S, Llorca PM, Misdrahi D, Passerieux C, Rey R, Pignon B, Urbach M, Schorr B, Schürhoff F, Yann LS, Dubertret C. Current (but not ex) cigarette smoking is associated with worse cognitive performances in schizophrenia: results from the FACE-SZ cohort. Psychol Med 2023; 53:5279-5290. [PMID: 36073848 DOI: 10.1017/s0033291722002574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Tobacco use is common in subjects with schizophrenia (SZ) and has sometimes been associated with better functioning in short-term studies. Only few studies embrace an extensive examination of tobacco influence on clinical, cognitive and therapeutic characteristics in stabilized SZ outpatients. The objective of the present study was to assess the association between cognitive performances and smoking status in SZ subjects. METHODS In total, 1233 SZ participants (73.9% men, mean age 31.5) were included and tested with a comprehensive battery. Tobacco status was self-declared (never-, ex-, or current smokers). Multivariable analyses including principal component analyses (PCA) were used. RESULTS In total, 53.7% were smokers with 33.7% of them nicotine-dependent. Multiple factor analysis revealed that current tobacco smoking was associated with impaired general intellectual ability and abstract reasoning (aOR 0.60, 95% IC 0.41-0.88, p = 0.01) and with a lifetime alcohol use disorder (p = 0.026) and a lifetime cannabis use disorder (p < 0.001). Ex- and never-smokers differed for age, mean outcome, cannabis history and medication [ex-smokers being older (p = 0.047), likely to have higher income (p = 0.026), a lifetime cannabis use disorder (p < 0.001) and higher CPZeq doses (p = 0.005)]. Premorbid IQ in the three groups significantly differed with, from higher to lower: ex-smokers, never-smoker, current smokers (all p < 0.001). CONCLUSIONS This study is the largest to date providing strong evidence that chronic smoking is associated with cognitive impairment in SZ, arguing against the self-medication hypothesis as a contributor to the high prevalence of smoking in SZ. Ex-smokers may also represent a specific subgroup. Longitudinal studies are warranted to determine the developmental impact of tobacco on neurocognition.
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Affiliation(s)
- Jasmina Mallet
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
| | - Ophélia Godin
- Fondation Fondamental, Créteil, France
- Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, France
| | | | - Nicolas Mazer
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
| | - Claire Scognamiglio
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
| | - Fabrice Berna
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Laurent Boyer
- AP-HM, Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Delphine Capdevielle
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chéreau
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Thierry D'Amato
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Julien Dubreucq
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Guillaume Fond
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HM, Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Sylvain Leigner
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Pierre-Michel Llorca
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - David Misdrahi
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), Bordeaux, France
| | - Christine Passerieux
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France
- DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines 94807, Villejuif, France
| | - Romain Rey
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Baptiste Pignon
- Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, France
| | - Mathieu Urbach
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France
- DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines 94807, Villejuif, France
| | - Benoit Schorr
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Franck Schürhoff
- Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, France
| | - Le Strat Yann
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
| | - Caroline Dubertret
- University of Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
- Fondation Fondamental, Créteil, France
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11
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Pross B, Münz S, Nitsche MA, Padberg F, Strube W, Papazova I, Falkai P, Hasan A. Smoking status ameliorates cholinergic impairments in cortical inhibition in patients with schizophrenia. Brain Res 2023; 1812:148380. [PMID: 37121425 DOI: 10.1016/j.brainres.2023.148380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 05/02/2023]
Abstract
Rationale Modulation of cortical excitability, in particular inhibition, is impaired in patients with schizophrenia. Chronic nicotine consumption, which is prevalent in this group, has been shown to alter cortical excitability in healthy individuals and to increase inhibitory activity. Thus, beneficial effects of smoking on impaired cortical excitability in patients with schizophrenia have been proposed, though direct experimental evidence is still lacking. OBJECTIVES We aimed to explore the effect of chronic smoking on cortical excitability by comparing smoking and non-smoking patients with schizophrenia. METHOD Twenty-six smoking and 19 non-smoking patients diagnosed with schizophrenia were included. Transcranial magnetic stimulation (TMS) applied to the primary motor cortex served as experimental paradigm for measuring corticospinal and intracortical excitability as follows: Resting motor threshold (RMT) and the input/output curve (I/O curve) were obtained to assess corticospinal excitability. Intracortical excitability was explored using paired-pulse TMS techniques (intracortical facilitation (ICF), short-latency intracortical inhibition (SICI) and short-latency afferent inhibition (SAI)). RESULTS A significantly stronger inhibition in the cholinergically driven SAI protocol was observed in smokers compared to non-smokers. All other measures did not show significant differences between groups. CONCLUSION Our results suggest an increased inhibition within cholinergic circuits due to chronic nicotine consumption in schizophrenia. This increase may compensate impaired cholinergic neurotransmission and could explain the high rate of smokers in schizophrenia.
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Affiliation(s)
- Benjamin Pross
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany.
| | - Susanne Münz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund, Dept. Psychology and Neurosciences, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Strube
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
| | - Irina Papazova
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Faculty of Medicine, University of Augsburg, Bezirkskrankenhaus Augsburg, Geschwister-Schönert-Str. 1, 86156 Augsburg, Germany
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12
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Lan X, Wu F, Wang C, Wu K, Fang Z, Lao G, Zhang B, Ning Y, Zhou Y. Sex differences in the association of plasma cytokines and neurocognition in first-episode major depressive disorder. J Affect Disord 2023; 322:258-266. [PMID: 36370912 DOI: 10.1016/j.jad.2022.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Peripheral cytokines were found to be involved in the pathophysiology of neurocognition in individuals with major depressive disorder (MDD). However, whether there are sex differences in this association between cytokines and cognition in MDD remains unknown. Our aim is to examine sex differences in the relationship between plasma cytokines and cognition in MDD. METHOD One hundred and twenty-seven first episode drug naïve patients with MDD and sixty healthy controls (HCs) were recruited for present study. The MATRICS Consensus Cognitive Battery was administered to measure the cognition. Plasma concentrations of nineteen cytokines were measured using high sensitivity multiplex bead-based assays. RESULTS Both female and male patients with MDD had significant cognitive impairment in verbal learning and visual learning and had higher levels of a range of cytokines than HCs (all p < 0.05). Female patients performed worse in trail making (F = 4.442, p = 0.018) and had higher concentration of interleukin (IL)-4 (F = 7.775, p = 0.006) than males. In female MDD, a significant positive association between category frequency and level of IL-4 was observed (B = 8.040, p = 0.031). However, this association was not present in male MDD or HCs (p > 0.05). LIMITATION Present study used a cross-sectional design. CONCLUSION Female MDD patients had worse trail making performance and higher level of IL-4 than males. The elevated IL-4 in female MDD was positively associated with category fluency, suggesting that IL-4 may be involved in the pathophysiology related to specific cognitive domain in female MDD patients.
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Affiliation(s)
- Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Fengchun Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Kai Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
| | - Ziyan Fang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Guohui Lao
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
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13
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Rault O, Romeo B, Butlen-Ducuing F, Rari E, Benyamina A, Martelli C. Impact of cannabis use and its cessation on the dosage and the efficacy of antipsychotic drugs in in- and outpatients with schizophrenia taking medication: A systematic review and meta-analysis. J Psychiatr Res 2022; 156:713-721. [PMID: 36410310 DOI: 10.1016/j.jpsychires.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022]
Abstract
Compared with the general population, there are more cannabis users among patients suffering from schizophrenia and this consumption seems to impact the course and the treatment of their pathology. The aim of this meta-analysis and systematic review was to assess the impact of cannabis use on the efficacy of treatments, more particularly regarding the antipsychotic dosage, symptoms evolution, therapeutic resistance and the risk of relapse in patients with schizophrenia taking medication. We performed a systematic search of keywords on multiple databases up to August 2020 to identify all studies meeting the following criteria: comparison between cannabis smokers and non-cannabis users in patients with schizophrenia, assessment of antipsychotics doses, information about their efficacy or resistance to treatment and control of the compliance. Standardized mean differences were calculated for antipsychotic dosage and symptoms evolution at discharge, and a systematic review was performed for other outcomes. Twelve studies were included. Cannabis use did not seem to be associated with higher doses of antipsychotics at seven days and at the end of the studies, nor with poorer symptoms evolution, and nor with higher rate of antipsychotic resistance. However, cannabis use seems to be associated with a higher risk of relapse. This meta-analysis provides evidence that previous cannabis use, or occasional use, in patients with schizophrenia taking medication does not impact antipsychotic efficacy as described by antipsychotic dosage or PANSS score.
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Affiliation(s)
- Ophélie Rault
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche PSYCOMADD 4872, Université Paris Sud - AP-HP, Université Paris Saclay, France.
| | - Bruno Romeo
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche PSYCOMADD 4872, Université Paris Sud - AP-HP, Université Paris Saclay, France
| | - Florence Butlen-Ducuing
- Office of Therapies for Neurological and Psychiatric Disorders, European Medicines Agency, Amsterdam, the Netherlands
| | - Eirini Rari
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche PSYCOMADD 4872, Université Paris Sud - AP-HP, Université Paris Saclay, France
| | - Amine Benyamina
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche PSYCOMADD 4872, Université Paris Sud - AP-HP, Université Paris Saclay, France
| | - Catherine Martelli
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800, Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions-Unité de Recherche PSYCOMADD 4872, Université Paris Sud - AP-HP, Université Paris Saclay, France; INSERM U A1299 "Trajectoires développementales en Psychiatrie", Université Paris-Saclay, Ecole Normale Supérieure Paris-Saclay, CNRS 9010, Centre Borelli, Digiteo-Labs, Bâtiment 660 Claude Shannon, Avenue des Sciences, 91190, Gif-sur-Yvette, France
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14
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Ringin E, Cropley V, Zalesky A, Bruggemann J, Sundram S, Weickert CS, Weickert TW, Bousman CA, Pantelis C, Van Rheenen TE. The impact of smoking status on cognition and brain morphology in schizophrenia spectrum disorders. Psychol Med 2022; 52:3097-3115. [PMID: 33443010 DOI: 10.1017/s0033291720005152] [Citation(s) in RCA: 4] [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: 01/09/2023]
Abstract
BACKGROUND Cigarette smoking is associated with worse cognition and decreased cortical volume and thickness in healthy cohorts. Chronic cigarette smoking is prevalent in schizophrenia spectrum disorders (SSD), but the effects of smoking status on the brain and cognition in SSD are not clear. This study aimed to understand whether cognitive performance and brain morphology differed between smoking and non-smoking individuals with SSD compared to healthy controls. METHODS Data were obtained from the Australian Schizophrenia Research Bank. Cognitive functioning was measured in 299 controls and 455 SSD patients. Cortical volume, thickness and surface area data were analysed from T1-weighted structural scans obtained in a subset of the sample (n = 82 controls, n = 201 SSD). Associations between smoking status (cigarette smoker/non-smoker), cognition and brain morphology were tested using analyses of covariance, including diagnosis as a moderator. RESULTS No smoking by diagnosis interactions were evident, and no significant differences were revealed between smokers and non-smokers across any of the variables measured, with the exception of a significantly thinner left posterior cingulate in smokers compared to non-smokers. Several main effects of smoking in the cognitive, volume and thickness analyses were initially significant but did not survive false discovery rate (FDR) correction. CONCLUSIONS Despite the general absence of significant FDR-corrected findings, trend-level effects suggest the possibility that subtle smoking-related effects exist but were not uncovered due to low statistical power. An investigation of this topic is encouraged to confirm and expand on our findings.
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Affiliation(s)
- Elysha Ringin
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Department of Electrical and Electronic Engineering, University of Melbourne, Melbourne, VIC, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
| | - Suresh Sundram
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
- Mental Health Program, Monash Health, Clayton, Victoria, Australia
| | - Cynthia Shannon Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York 13210, USA
| | - Thomas W Weickert
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- School of Psychiatry, University of New South Wales, New South Wales, Australia
- Neuroscience Research Australia, New South Wales, Australia
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York 13210, USA
| | - Chad A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Departments of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Calgary, AB, Canada
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
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15
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Harvey PD, Bosia M, Cavallaro R, Howes OD, Kahn RS, Leucht S, Müller DR, Penadés R, Vita A. Cognitive dysfunction in schizophrenia: An expert group paper on the current state of the art. Schizophr Res Cogn 2022; 29:100249. [PMID: 35345598 PMCID: PMC8956816 DOI: 10.1016/j.scog.2022.100249] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/12/2022]
Abstract
Cognitive impairment in schizophrenia represents one of the main obstacles to clinical and functional recovery. This expert group paper brings together experts in schizophrenia treatment to discuss scientific progress in the domain of cognitive impairment to address cognitive impairments and their consequences in the most effective way. We report on the onset and course of cognitive deficits, linking them to the alterations in brain function and structure in schizophrenia and discussing their role in predicting the transition to psychosis in people at risk. We then address the assessment tools with reference to functioning and social cognition, examining the role of subjective measures and addressing new methods for measuring functional outcomes including technology based approaches. Finally, we briefly review treatment options for cognitive deficits, focusing on cognitive remediation programs, highlighting their effects on brain activity and conclude with the potential benefit of individualized integrated interventions combing cognitive remediation with other approaches.
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Affiliation(s)
- Philip D Harvey
- Division of Psychology, Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Marta Bosia
- Vita-Salute San Raffaele University School of Medicine, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - Roberto Cavallaro
- Vita-Salute San Raffaele University School of Medicine, Milan, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - Oliver D Howes
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK.,MRC London Institute of Medical Sciences, Imperial College London, London, UK
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stefan Leucht
- Section Evidence-Based Medicine in Psychiatry and Psychotherapy, Department of Psychiatry and Psychotherapy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Daniel R Müller
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Rafael Penadés
- Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel Street, 08036 Barcelona, Spain
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Department of Mental Health and Addiction Services, Spedali Civili Hospital, Brescia, Italy
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16
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Garrido-Torres N, Ruiz-Veguilla M, Alameda L, Canal-Rivero M, Ruiz MJ, Gómez-Revuelta M, Ayesa-Arriola R, Rubio-García A, Crespo-Facorro B, Vázquez-Bourgon J. Prevalence of metabolic syndrome and related factors in a large sample of antipsychotic naïve patients with first-episode psychosis: Baseline results from the PAFIP cohort. Schizophr Res 2022; 246:277-285. [PMID: 35878542 DOI: 10.1016/j.schres.2022.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 06/03/2022] [Accepted: 07/10/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Few investigations have been carried out on metabolic syndrome in antipsychotic- naïve patients with schizophrenia. METHODS Our primary objective was to compare the prevalence of Metabolic Syndrome (MetS), as defined by the National Cholesterol Education Program, Adult Treatment Panel III in 2001 (NCEP-ATP III), between a Spanish cohort of 303 drug-naïve patients with a first episode of psychosis (FEP) without any previous cardiovascular condition, and 153 healthy individuals. RESULTS Participants included 303 patients with FEP (M:F 53:46) and 153 control subjects (M:F 56:43). The mean and standard deviation ages were 31(9.38) and 29 (7.57) years in the study and control groups respectively (F = 4.09; p = 0.93). We found that the prevalence of MetS in drug-naïve patients with FEP (5.6 %) was similar to the prevalence of MetS in age-sex matched controls (5.12 %). However, 60.7 % of patients with FEP met at least one of the five MetS components, while among the control subjects only 36.5 % met at least one component. Additionally, we found that other factors not included among the operational definition of MetS, but still important in cardiovascular risk, were also altered. CONCLUSION FEP patients have a greater risk of presenting at least one altered MetS component than healthy controls which could indicate the need of development of screening methods detecting cardiovascular risk. Likewise, gender differences in metabolic components such as waist circumference, which is a predictor of cardiovascular events have been found. Similarly, research should focus on metabolic risk predictors that include not only MetS, but also specific parameters for the early psychosis population.
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Affiliation(s)
- Nathalia Garrido-Torres
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain
| | - Miguel Ruiz-Veguilla
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain
| | - Luis Alameda
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain; Service of General Psychiatry, Lausanne University Hospital (CHUV), Lausanne 1008, Switzerland; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Manuel Canal-Rivero
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain
| | - María Juncal Ruiz
- Department of Psychiatry, Sierrallana Hospital-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Torrelavega, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
| | - Marcos Gómez-Revuelta
- Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Rosa Ayesa-Arriola
- Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Ana Rubio-García
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain
| | - Benedicto Crespo-Facorro
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain.
| | - Javier Vázquez-Bourgon
- Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
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McGrath T, Baskerville R, Rogero M, Castell L. Emerging Evidence for the Widespread Role of Glutamatergic Dysfunction in Neuropsychiatric Diseases. Nutrients 2022; 14:nu14050917. [PMID: 35267893 PMCID: PMC8912368 DOI: 10.3390/nu14050917] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/06/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
The monoamine model of depression has long formed the basis of drug development but fails to explain treatment resistance or associations with stress or inflammation. Recent animal research, clinical trials of ketamine (a glutamate receptor antagonist), neuroimaging research, and microbiome studies provide increasing evidence of glutamatergic dysfunction in depression and other disorders. Glutamatergic involvement across diverse neuropathologies including psychoses, neurodevelopmental, neurodegenerative conditions, and brain injury forms the rationale for this review. Glutamate is the brain's principal excitatory neurotransmitter (NT), a metabolic and synthesis substrate, and an immune mediator. These overlapping roles and multiple glutamate NT receptor types complicate research into glutamate neurotransmission. The glutamate microcircuit comprises excitatory glutamatergic neurons, astrocytes controlling synaptic space levels, through glutamate reuptake, and inhibitory GABA interneurons. Astroglia generate and respond to inflammatory mediators. Glutamatergic microcircuits also act at the brain/body interface via the microbiome, kynurenine pathway, and hypothalamus-pituitary-adrenal axis. Disruption of excitatory/inhibitory homeostasis causing neuro-excitotoxicity, with neuronal impairment, causes depression and cognition symptoms via limbic and prefrontal regions, respectively. Persistent dysfunction reduces neuronal plasticity and growth causing neuronal death and tissue atrophy in neurodegenerative diseases. A conceptual overview of brain glutamatergic activity and peripheral interfacing is presented, including the common mechanisms that diverse diseases share when glutamate homeostasis is disrupted.
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Affiliation(s)
- Thomas McGrath
- Green Templeton College, University of Oxford, Oxford OX2 6HG, UK; (T.M.); (L.C.)
| | - Richard Baskerville
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0BP, UK
- Correspondence:
| | - Marcelo Rogero
- School of Public Health, University of Sao Paulo, Sao Paulo 01246-904, Brazil;
| | - Linda Castell
- Green Templeton College, University of Oxford, Oxford OX2 6HG, UK; (T.M.); (L.C.)
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18
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van der Heijden HS, Schirmbeck F, Kempton MJ, van der Gaag M, Allot K, Nelson B, Ruhrmann S, de Haan L, Vermeulen JM. Impact of smoking Behavior on cognitive functioning in persons at risk for psychosis and healthy controls: A longitudinal study. Eur Psychiatry 2021; 64:e60. [PMID: 34544507 PMCID: PMC8516743 DOI: 10.1192/j.eurpsy.2021.2233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background The high prevalence of smoking in individuals who are at ultra-high risk (UHR) for psychosis is well known and moderate cognitive deficits have also been found in UHR. However, the association between smoking and cognition in UHR is unknown and longitudinal studies are lacking. Method A cohort study with 330 UHR individuals and 66 controls was conducted, as part of the European network of national schizophrenia networks studying gene–environment interactions (EU-GEI). At baseline and after 6, 12, and 24 months, smoking behavior was assessed with the Composite International Diagnostic Interview and cognitive functioning with a comprehensive test battery. Linear mixed-effects analyses were used to examine the multicross-sectional and prospective associations between (change in) smoking behavior and cognitive functioning, accounting for confounding variables. Results At baseline, 53% of UHR and 27% of controls smoked tobacco. Smoking UHR and controls did not significantly differ from nonsmoking counterparts on the tested cognitive domains (speed of processing, attention/vigilance, working memory, verbal learning, or reasoning/problem solving) across different assessment times. Neither smoking cessation nor initiation was associated with a significant change in cognitive functioning in UHR. Conclusions No associations were found between smoking and cognitive impairment in UHR nor in controls. However, the fact that one in every two UHR individuals report daily use of tobacco is alarming. Our data suggest that UHR have fewer cognitive impairments and higher smoking cessation rates compared to patients with first-episode psychosis found in literature. Implications to promote smoking cessation in the UHR stage need further investigation.
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Affiliation(s)
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands.,Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Mark van der Gaag
- Psychosis Research Institute, Parnassia Group, Hague, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Kelly Allot
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands.,Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Jentien M Vermeulen
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands
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An Open Trial of Metacognitive Remediation Therapy and Pharmacotherapy to Promote Smoking Cessation among Individuals with Psychotic-Spectrum Disorders. J Smok Cessat 2021; 2021:6617716. [PMID: 34429783 PMCID: PMC8337155 DOI: 10.1155/2021/6617716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 05/22/2021] [Accepted: 07/07/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Individuals with psychotic-spectrum disorders may smoke due to the ameliorating effect of nicotine on the cognitive deficits that accompany these illnesses. Metacognitive remediation therapy (MCR) has been shown to produce improvements in cognitive functioning among individuals with psychotic-spectrum disorders and provides a foundation for a novel smoking cessation intervention for this population. Aims To complete an open investigation of pharmacotherapy and a modified version of MCR [MCR to Quit (MCR-Q)] in promoting smoking cessation among individuals with psychotic-spectrum disorders. Methods Forty-nine individuals with a psychotic-spectrum disorder and who currently smoke cigarettes participated in MCR-Q while also receiving evidence-based smoking cessation pharmacotherapy. Tobacco use was assessed as follows: (i) prior to MCR-Q, (ii) immediately after completing MCR-Q, and (iii) six weeks after completion of MCR-Q. Results /Findings. During participation in MCR-Q, nearly 80% of participants made a 24-hour quit attempt. Following the completion of MCR-Q, participants experienced reductions in level of nicotine dependency and exhaled carbon monoxide, with reductions in nicotine dependency sustained six weeks after completion of MCR-Q. Over the course of their participation in MCR-Q, participants reported strong therapeutic alliance with their MCR-Q therapist and high levels of intrinsic motivation with regard to completing MCR-Q exercises. Conclusions The results from the current study suggest cautious optimism with regard to the use of MCR-Q in combination with medication for individuals with psychotic-spectrum disorders who want to quit smoking.
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20
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Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications. SCHIZOPHRENIA RESEARCH AND TREATMENT 2021; 2021:7698030. [PMID: 34938579 PMCID: PMC8687814 DOI: 10.1155/2021/7698030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022]
Abstract
Recent data suggests that the prevalence of smoking in schizophrenia remains high. While reports suggest that smoking increases the risk of developing schizophrenia, the potential causative role of smoking in this relationship needs further investigation. Smokers with schizophrenia are more likely to have more intense positive symptoms and lower cognitive function, but diminished intensity of extrapyramidal side effects than nonsmoking patients with schizophrenia. They were also more likely to exhibit aggressive behaviour compared to nonsmokers, which could suggest higher levels of baseline aggression. The significant cost associated with regular tobacco expenditure can detract from investment in key domains. Large-scale trials have shown that pharmacotherapy for smoking cessation is effective and does not worsen the risk of developing neuropsychiatric symptoms compared to placebo. Electronic cigarette use among schizophrenia patients is high, and there is emerging evidence supportive of its efficacy. Future improvements include large-scale trials assessing the utility, efficacy, and safety of electronic cigarettes in schizophrenia patients.
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