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Liu L, Ren D, Li K, Ji L, Feng M, Li Z, Meng L, He G, Shi Y. Unraveling schizophrenia's genetic complexity through advanced causal inference and chromatin 3D conformation. Schizophr Res 2024; 270:476-485. [PMID: 38996525 DOI: 10.1016/j.schres.2024.07.005] [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: 01/18/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024]
Abstract
Schizophrenia is a polygenic complex disease with a heritability as high as 80 %, yet the mechanism of polygenic interaction in its pathogenesis remains unclear. Studying the interaction and regulation of schizophrenia susceptibility genes is crucial for unraveling the pathogenesis of schizophrenia and developing antipsychotic drugs. Therefore, we developed a bioinformatics method named GRACI (Gene Regulation Analysis based on Causal Inference) based on the principles of information theory, a causal inference model, and high order chromatin 3D conformation. GRACI captures the interaction and regulatory relationships between schizophrenia susceptibility genes by analyzing genotyping data. Two datasets, comprising 1459 and 2065 samples respectively, were analyzed, and the gene networks from both datasets were constructed. GRACI showcased superior accuracy when compared to widely adopted methods for detecting gene-gene interactions and intergenic regulation. This alignment was further substantiated by its correlation with chromatin high-order conformation patterns. Using GRACI, we identified three potential genes-KCNN3, KCNH1, and KCND3-that are directly associated with schizophrenia pathogenesis. Furthermore, the results of GRACI on the standalone dataset illustrated the method's applicability to other complex diseases. GRACI download: https://github.com/liuliangjie19/GRACI.
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Affiliation(s)
- Liangjie Liu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China
| | - Decheng Ren
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China
| | - Keyi Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China
| | - Lei Ji
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China
| | - Mofan Feng
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China
| | - Zhuoheng Li
- Department of Electrical Engineering and Computer Science, University of Michigan, 1301 Beal Avenue, Ann Arbor, MI 48109, USA
| | - Luming Meng
- Key Laboratory for Biobased Materials and Energy of Ministry of Education, College of Materials and Energy, South China Agricultural University, Guangzhou 510630, China
| | - Guang He
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China
| | - Yi Shi
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, 1954 Huashan Road, Shanghai 200030, China; Research Institute for Doping Control, Shanghai University of Sport, Shanghai 200438, China.
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Remmers MCC, Reijs RP, Hoebe CJPA. Defining and distinguishing early life stress, trauma, adversity, toxic and chronic stress and allostatic load: a descriptive review. Scand J Public Health 2024:14034948241260105. [PMID: 39087715 DOI: 10.1177/14034948241260105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
AIMS Various concepts are used to study the impact of stress on childhood development. These concepts are often used inconsistently or interchangeably. Our main objectives were to determine how selected stress concepts (chronic stress, toxic stress, allostatic load, early life stress, childhood adversity, childhood trauma and adverse childhood experiences; ACEs) are defined, operationalized and described, and to provide a theoretical context to aid the choice for a preferred concept in public health research. METHODS For this descriptive review, we systematically searched for literature published before 4 August 2021, on PubMed, Embase and PsycInfo. Two independent reviewers included studies. Exclusion criteria were: no systematic review, not peer reviewed, not published in English, selected stress concepts were no predetermined variable or a substantial topic in the discussion, full text was unobtainable or study described non-human or non-childhood populations. Data extraction forms were used. Descriptives were gathered, publication fields were identified through Journal Citation Reports categories, and verbatim descriptions were ordered in text and Venn diagrams. RESULTS Of 264 screened studies, 124 were included. ACEs, childhood adversity and childhood trauma were used most. ACEs were the main concept used most frequently (47.6%). A total of 11 of 14 public and environmental health journals used ACEs. All concepts refer to prolonged, repeated, interpersonal stress from 0 to 18 years, that can alter physiological systems. Four concepts were stressor oriented, two concepts focused on stress response and effect and one on the state of challenged homeostasis. CONCLUSIONS ACEs seem most fitting for public health setting, due to their operationalizability, large set of core experiences and widespread use.
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Affiliation(s)
- Maarten C C Remmers
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Youth Health Care, Public Health Service Limburg-North, Venlo, Netherlands
| | - Rianne P Reijs
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Youth Health Care, Living Lab Public Health Mosa, Public Health Service South Limburg, Heerlen, Netherlands
| | - Christian J P A Hoebe
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, Public Health Service South Limburg, Heerlen, Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, Netherlands
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Wambua GN, Kilian S, Chiliza B. A qualitative study of coping strategies and resilience in the aftermath of childhood adversity in first-episode psychosis. Early Interv Psychiatry 2024. [PMID: 38764159 DOI: 10.1111/eip.13551] [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: 06/14/2023] [Revised: 01/24/2024] [Accepted: 05/09/2024] [Indexed: 05/21/2024]
Abstract
AIM Exposure to adversity during childhood is associated with elevated risk for commonly occurring forms of psychopathology, especially psychotic disorders. Despite the noteworthy consequences associated with adverse childhood experiences, an inconsistent and unpredictable number of at-risk populations present with remarkably good physical and mental health outcomes that can be attributed to resilience. This study aimed to qualitatively explore the experience of childhood adverse events and coping strategies employed by individuals that promote resilience and better mental health outcomes. METHODS Fourteen individuals with a history of childhood adversity were recruited to participate using a case-study approach. A semi-structured interview guide was developed based on empirical evidence and theoretical background, and the interviews were analysed using a reflexive thematic approach. RESULTS Our findings showed that the type of adversity impacted the experience of trauma, for example, the death of a caregiver versus emotional abuse or witnessing violence at home. Five coping strategies were identified (social support, religious coping, problem or emotion-focused coping, and meaning-making), with healthy controls found to identify and use these resources more than the psychosis group to promote individual well-being and better mental health outcomes. CONCLUSIONS Our findings provide insights into experiences in the aftermath of childhood adversity, emphasising the need to assess the history of trauma systematically. They further underscore the importance of mental health prevention programmes bolstering individual-level coping strategies and the resources available within our environments to help them manage adversity, improve overall outcomes, and promote resilience.
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Affiliation(s)
- G N Wambua
- Department of Psychiatry, University of Kwa-Zulu Natal, Durban, South Africa
| | - S Kilian
- Department of Psychiatry, Stellenbosch University, Cape town, South Africa
| | - B Chiliza
- Department of Psychiatry, University of Kwa-Zulu Natal, Durban, South Africa
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Strelchuk D, Wiles N, Turner K, Derrick C, Martin D, Davies J, Zammit S. Eye-movement desensitisation and reprocessing therapy (EMDR) to prevent transition to psychosis in people with an at-risk mental state (ARMS): mixed method feasibility study. BJPsych Open 2024; 10:e105. [PMID: 38721786 PMCID: PMC11094432 DOI: 10.1192/bjo.2024.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/28/2024] [Accepted: 02/18/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Trauma plays an important role in the development of psychosis, but no studies have investigated whether a trauma-focused therapy could prevent psychosis. AIMS This study aimed to establish whether it would be feasible to conduct a multicentre randomised controlled trial (RCT) to prevent psychosis in people with an at-risk mental state (ARMS), using eye-movement desensitisation and reprocessing therapy (EMDR). METHOD This started as a mixed-method randomised study comparing EMDR to treatment as usual but, as a result of low participant recruitment, was changed to a single-arm feasibility study. The proposed primary outcome for an RCT was transition to psychosis at 12-month follow-up. Data on secondary outcomes were also collected. Qualitative interviews were conducted with patients and therapists. RESULTS Fourteen participants were recruited from the Early Intervention teams. Most people who expressed an interest in taking part attended an assessment to determine eligibility. All those eligible consented to take part. A total of 64% (7 of 11) of participants who were offered EMDR were followed up at 12 months. Of the 11 participants offered EMDR, one (11%, 95% CI: 0.2%, 48%) transitioned to psychosis. Nine patients and three therapists were interviewed. Participants who completed therapy (n = 4; mean 10.5 sessions) found EMDR helpful, but those who discontinued (n = 6; mean 5.2 sessions) said it had not benefitted them overall. Therapists said EMDR could be effective, although not for all patients. CONCLUSIONS Future studies recruiting people with an ARMS to an RCT may need to extend recruitment beyond Early Intervention teams. Although some individuals found EMDR helpful, reasons for discontinuing need to be addressed in future studies.
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Affiliation(s)
- Daniela Strelchuk
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, UK
| | - Nicola Wiles
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, UK
| | - Katrina Turner
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, UK; and Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Catherine Derrick
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - David Martin
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK; and Medical Education, Avon Wiltshire Partnership NHS Mental Health Trust, Bath NHS House Combe Park, Bath, UK
| | - Jonathan Davies
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Stan Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, UK; and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, UK
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Zhang Y, Lin C, Li H, Li L, Zhou X, Xiong Y, Yan J, Xie M, Zhang X, Zhou C, Yang L. The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping. BMC Psychiatry 2024; 24:346. [PMID: 38720293 PMCID: PMC11077779 DOI: 10.1186/s12888-024-05792-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Studies have revealed the effects of childhood adversity, anxiety, and negative coping on sleep quality in older adults, but few studies have focused on the association between childhood adversity and sleep quality in rural older adults and the potential mechanisms of this influence. In this study, we aim to evaluate sleep quality in rural older adults, analyze the impact of adverse early experiences on their sleep quality, and explore whether anxiety and negative coping mediate this relationship. METHODS Data were derived from a large cross-sectional study conducted in Deyang City, China, which recruited 6,318 people aged 65 years and older. After excluding non-agricultural household registration and lack of key information, a total of 3,873 rural older adults were included in the analysis. Structural equation modelling (SEM) was used to analyze the relationship between childhood adversity and sleep quality, and the mediating role of anxiety and negative coping. RESULTS Approximately 48.15% of rural older adults had poor sleep quality, and older adults who were women, less educated, widowed, or living alone or had chronic illnesses had poorer sleep quality. Through structural equation model fitting, the total effect value of childhood adversity on sleep quality was 0.208 (95% CI: 0.146, 0.270), with a direct effect value of 0.066 (95% CI: 0.006, 0.130), accounting for 31.73% of the total effect; the total indirect effect value was 0.142 (95% CI: 0.119, 0.170), accounting for 68.27% of the total effect. The mediating effects of childhood adversity on sleep quality through anxiety and negative coping were significant, with effect values of 0.096 (95% CI: 0.078, 0.119) and 0.024 (95% CI: 0.014, 0.037), respectively. The chain mediating effect of anxiety and negative coping between childhood adversity and sleep quality was also significant, with an effect value of 0.022 (95% CI: 0.017, 0.028). CONCLUSIONS Anxiety and negative coping were important mediating factors for rural older adult's childhood adversity and sleep quality. This suggests that managing anxiety and negative coping in older adults may mitigate the negative effects of childhood adversity on sleep quality.
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Affiliation(s)
- Yuqin Zhang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Chengwei Lin
- Sichuan Provincial Center for Disease Control and Prevention, No.6, Zhongxue Road, Wuhou District, Chengdu, 610041, China
| | - Hongwei Li
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Lei Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Deyang Integrated Traditional Chinese and Western Medicine Hospital, Deyang, 618000, China
| | - Xueyan Zhou
- Centre for Aging Health Service of Deyang City, Deyang, 618000, China
| | - Ying Xiong
- Health Commission of Deyang City, Deyang, 618000, China
| | - Jin Yan
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Mengxue Xie
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China
| | - Xueli Zhang
- Sichuan Provincial Health Information Center, Chengdu, 610015, Sichuan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research,School of Public Health, Cheeloo College of Medicine,Shandong University, NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Lian Yang
- School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan, China.
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Khosroshahi PA, Ashayeri H, Ghanbari M, Malek A, Farhang S, Haghi M. Downregulation of miR-29a as a possible diagnostic biomarker for schizophrenia. Mol Biol Rep 2024; 51:617. [PMID: 38705955 PMCID: PMC11070389 DOI: 10.1007/s11033-024-09428-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/08/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND MicroRNAs (miRNAs) are epigenetic factors regulating many genes involved in brain development. Dysregulation of miRNA could result in dysregulation of genes which may contribute to diseases affecting the brain and behavior (e.g., schizophrenia). miR-29 family is a miRNA family contributing to brain maturation. miR-29 knockout in animal studies is reported to correlate with psychiatric disorders very similar to those seen in schizophrenia. In this study, we aimed to evaluate the miR-29a level in patients with schizophrenia and its potential value in the diagnosis of schizophrenia. MATERIALS AND METHODS The serum sample of 42 patients with schizophrenia and 40 healthy subjects were obtained from the Azeri Recent onset/Acute phase psychosis Survey (ARAS) Cohort study. After preparations, the expression level of miR-29a was investigated by real-time PCR. The SPSS and GraphPad prism software were used to analyze the relation between miR-29a level and clinical parameters and its potential as a biomarker for the diagnosis of schizophrenia. RESULTS Our study showed a significantly lower miR-29a level in patients compared to healthy controls (p = 0.0012). Furthermore, miR-29a level was significantly lower in some types of schizophrenia (p = 0.024). miR-29a level was not related to sex, age, or heredity (p > 0.05). miR-29a also showed 80% specificity and 71.43% sensitivity in the diagnosis of schizophrenia. CONCLUSION Downregulation of miR-29a in schizophrenia is significantly related to the development of this illness. It might have the potential as a biomarker for schizophrenia.
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Affiliation(s)
| | - Hamidreza Ashayeri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Ghanbari
- Clinical Research Development Center, Mohammad Kermanshahi and Farabi Hospitals, Imam Khomeini, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ayyoub Malek
- University Medical Center Groningen, University of Groningen, University Center for Psychiatry, Groningen, The Netherlands
| | - Sara Farhang
- University Medical Center Groningen, University of Groningen, University Center for Psychiatry, Groningen, The Netherlands.
- Research center of psychiatry and behavioral sciences, Tabriz university of medical sciences, Tabriz, Iran.
| | - Mehdi Haghi
- Department of Animal Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran.
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Kisely S, Arnautovska U, Siskind D, Warren N, Najman JM. Admissions for psychosis following agency-notified child maltreatment at 40-year-follow-up: Results from the Childhood Adversity and Lifetime Morbidity (CALM) cohort. Schizophr Res 2024; 267:247-253. [PMID: 38581827 DOI: 10.1016/j.schres.2024.03.040] [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: 06/16/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
There is substantial evidence of an association between self-reported child maltreatment (CM) and subsequent psychosis in retrospective data. Such findings may be affected by recall bias. Prospective studies of notifications to statutory agencies address recall bias but are less common and subject to attrition bias. These studies may therefore be underpowered to detect significant associations for some CM types such as sexual abuse. This study therefore linked administrative health data to a large birth cohort that included notifications to child protection agencies. We assessed psychiatric outcomes of CM as measured by inpatient admissions for non-affective psychoses (ICD10 codes F20-F29) to both public and private hospitals in Brisbane, Australia. Follow-up was up to 40 years old. There were 6087 cohort participants whose data could be linked to the administrative health data. Of these, 10.1 % had been the subject of a CM notification. Seventy-two participants (1.2 %) had been admitted for non-affective psychosis by 40-year follow-up. On adjusted analysis, all notified and substantiated types of CM were associated with admissions for non-affective psychosis. This included neglect, physical, sexual or emotional abuse, as well as notifications for multiple CM types. For instance, there was a 2.72-fold increase in admissions following any agency notification (95 % CI = 1.53-4.85). All maltreatment types therefore show a significant association with subsequent admissions for psychosis up to the age of 40. Screening for CM in individuals who present with psychosis is, therefore, indicated, as well as greater awareness that survivors of CM may be at higher risk of developing psychotic symptoms.
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Affiliation(s)
- Steve Kisely
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada; Metro South Addiction and Mental Health Service, Brisbane, Australia.
| | - Urska Arnautovska
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Dan Siskind
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Nicola Warren
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Medical School, The University of Queensland, Woolloongabba 4102, Queensland, Australia; Metro South Addiction and Mental Health Service, Brisbane, Australia
| | - Jake Moses Najman
- School of Public Health, The University of Queensland, Public Health Building, Herston 4006, Queensland, Australia; School of Social Sciences, The University of Queensland, St Lucia 4072, Queensland, Australia
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Seguí-Grivé M, Jurado N, Navarrete A, Morelló C, Ortega E, Boluda M, Muntané G, Llaurador-Coll M, Vilella E, Gutiérrez-Zotes A. Influence of the typology and timing of childhood trauma in psychoticism. Arch Womens Ment Health 2024:10.1007/s00737-024-01459-9. [PMID: 38656388 DOI: 10.1007/s00737-024-01459-9] [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: 11/08/2023] [Accepted: 03/14/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Child maltreatment (CM) is associated with psychosis; however little is known about the frequency, type, and timing of abuse in the personality pathology domain of psychoticism (PSY) in the DSM-5. The purpose of this study was to analyze childhood trauma typology and frequency according to gender and to identify sensitive periods of susceptibility to CM in women with high PSY. METHODS The Maltreatment and Abuse Chronology Exposure (MACE) scale was used to evaluate the frequency, severity and timing of each type of maltreatment. The full sample consisted of 83 participants with different psychiatric diagnoses. Psychoticism was assessed with the DSM-5 Personality Inventory (PID-5). To identify the differences in CM exposure between the PSY+ (high psychoticism) and PSY- (low psychoticism) groups, the Mann-Whitney U test, the chi square test and random forest (RF) test were used. RESULTS Comparing PSY + and PSY-, revealed gender differences in the impact of abuse, with highly frequent and severe types of abuse, in women. In women, PSY + and PSY-, were differentiated especially in non-verbal emotional abuse, peer physical bullying and parental verbal abuse. Several periods with a major peak at age seven followed by peaks at age 17 and 12 years old were identified. CONCLUSION Increased exposure to CM occurs in women with PSY+. A sensitivity to CM exposure during early childhood and late adolescence could be a risk factor for psychoticism in women.
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Affiliation(s)
- M Seguí-Grivé
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - N Jurado
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - A Navarrete
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - C Morelló
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - E Ortega
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - M Boluda
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - G Muntané
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - M Llaurador-Coll
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
| | - E Vilella
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - A Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain.
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain.
- Universitat Rovira i Virgili, Reus, Spain.
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.
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Goh KK, Kanahara N, Chiu YH, Lu ML. The impact of childhood trauma exposure on social functioning in schizophrenia: the moderated mediation role of oxytocin and oxytocin receptor gene polymorphisms. Psychol Med 2024; 54:980-992. [PMID: 37721215 DOI: 10.1017/s003329172300274x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Childhood trauma has been linked to increased risk of schizophrenia and social dysfunction, and oxytocin and its receptor gene have been implicated in regulating social behavior. This study investigated the potential role of oxytocin and oxytocin receptor gene (OXTR) in mediating the effects of childhood trauma on social functioning in schizophrenia. METHODS The study consisted of 382 patients with schizophrenia and 178 healthy controls who were assessed using the Taiwanese version of the Childhood Trauma Questionnaire (CTQ-SF), the Social Functioning Scale (SFS), and plasma oxytocin levels. DNA was extracted to genotype the OXTR and ten single-nucleotide polymorphisms (SNPs; rs2254298, rs237885, rs237887, rs237899, rs53576, rs9840864, rs13316193, rs7632287, rs1042778, and rs237895) were selected. RESULTS Patients with schizophrenia showed higher CTQ-SF scores (t = 12.549, p < 0.001), lower SFS scores (t = -46.951, p < 0.001), and lower plasma oxytocin levels (t = -5.448, p < 0.001) compared to healthy controls. The study also found significant differences in OXTR SNPs between both groups, with risk alleles being more prevalent in patients with schizophrenia (t = 2.734, p = 0.006). Results indicated a significant moderated mediation effect, with oxytocin and the OXTR SNPs partially mediating the relationship between childhood trauma exposure and social functioning in patients with schizophrenia (index of mediation = 0.038, 95% CI [0.033-0.044]). CONCLUSIONS The findings suggest that oxytocin and its receptor gene may be promising targets for interventions aimed at improving social functioning in patients with a history of childhood trauma and schizophrenia. However, further research is needed to fully understand these effects and the potential of oxytocin-based interventions in this population.
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Affiliation(s)
- Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- The Innovative and Translational Research Center of Brain Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Nobuhisa Kanahara
- Division of Medical Treatment and Rehabilitation, Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Yi-Hang Chiu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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10
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Vai B, Calesella F, Pelucchi A, Riberto M, Poletti S, Bechi M, Cavallaro R, Francesco B. Adverse childhood experiences differently affect Theory of Mind brain networks in schizophrenia and healthy controls. J Psychiatr Res 2024; 172:81-89. [PMID: 38367321 DOI: 10.1016/j.jpsychires.2024.02.034] [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: 07/28/2023] [Revised: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024]
Abstract
Patients with schizophrenia (SZ) show impairments in both affective and cognitive dimensions of theory of mind (ToM). SZ are also particularly vulnerable to detrimental effect of adverse childhood experiences (ACE), influencing the overall course of the disorder and fostering poor social functioning. ACE associate with long-lasting detrimental effects on brain structure, function, and connectivity in regions involved in ToM. Here, we investigated whether ToM networks are differentially affected by ACEs in healthy controls (HC) and SZ, and if these effects can predict the disorder clinical outcome. 26 HC and 33 SZ performed a ToM task during an fMRI session. Whole-brain functional response and connectivity (FC) were extracted, investigating the interaction between ACEs and diagnosis. FC values significantly affected by ACEs were entered in a cross-validated LASSO regression predicting Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), and task performance. ACEs and diagnosis showed a widespread interaction at both affective and cognitive tasks, including connectivity between vmPFC, ACC, precentral and postcentral gyri, insula, PCC, precuneus, parahippocampal gyrus, temporal pole, thalamus, and cerebellum, and functional response in the ACC, thalamus, parahippocampal gyrus and putamen. FC predicted the PANSS score, the fantasy dimension of IRI, and the AToM response latency. Our results highlight the crucial role of early stress in differentially shaping ToM related brain networks in HC and SZ. These effects can also partially explain the clinical and behavioral outcomes of the disorder, extending our knowledge of the effects of ACEs.
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Affiliation(s)
- Benedetta Vai
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Federico Calesella
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Alice Pelucchi
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Martina Riberto
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Roberto Cavallaro
- Vita-Salute San Raffaele University, Milano, Italy; Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Benedetti Francesco
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy
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11
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Jonas KG, Cannon TD, Docherty AR, Dwyer D, Gur RC, Gur RE, Nelson B, Reininghaus U, Kotov R. Psychosis superspectrum I: Nosology, etiology, and lifespan development. Mol Psychiatry 2024; 29:1005-1019. [PMID: 38200290 DOI: 10.1038/s41380-023-02388-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024]
Abstract
This review describes the Hierarchical Taxonomy of Psychopathology (HiTOP) model of psychosis-related psychopathology, the psychosis superspectrum. The HiTOP psychosis superspectrum was developed to address shortcomings of traditional diagnoses for psychotic disorders and related conditions including low reliability, arbitrary boundaries between psychopathology and normality, high symptom co-occurrence, and heterogeneity within diagnostic categories. The psychosis superspectrum is a transdiagnostic dimensional model comprising two spectra-psychoticism and detachment-which are in turn broken down into fourteen narrow components, and two auxiliary domains-cognition and functional impairment. The structure of the spectra and their components are shown to parallel the genetic structure of psychosis and related traits. Psychoticism and detachment have distinct patterns of association with urbanicity, migrant and ethnic minority status, childhood adversity, and cannabis use. The superspectrum also provides a useful model for describing the emergence and course of psychosis, as components of the superspectrum are relatively stable over time. Changes in psychoticism predict the onset of psychosis-related psychopathology, whereas changes in detachment and cognition define later course. Implications of the superspectrum for genetic, socio-environmental, and longitudinal research are discussed. A companion review focuses on neurobiology, treatment response, and clinical utility of the superspectrum, and future research directions.
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Affiliation(s)
- Katherine G Jonas
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA.
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Anna R Docherty
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ruben C Gur
- Brain Behavior Laboratory, Department of Psychiatry and the Penn-CHOP Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Raquel E Gur
- Brain Behavior Laboratory, Department of Psychiatry and the Penn-CHOP Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
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12
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Robinson N, Ploner A, Leone M, Lichtenstein P, Kendler KS, Bergen SE. Environmental risk factors for schizophrenia and bipolar disorder from childhood to diagnosis: a Swedish nested case-control study. Psychol Med 2024:1-10. [PMID: 38425272 DOI: 10.1017/s0033291724000266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Shared genetic risk between schizophrenia (SCZ) and bipolar disorder (BD) is well-established, yet the extent to which they share environmental risk factors remains unclear. We compare the associations between environmental exposures during childhood/prior to disorder onset with the risk of developing SCZ and BD. METHODS We conducted a Swedish register-based nested case-control study using 4184 SCZ cases and 18 681 BD cases diagnosed 1988-2013. Cases were matched to five controls by birth year, birth region, and sex. Conditional logistic regression was used to estimate incidence rate ratios (IRR) for SCZ and BD for each exposure (severe childhood infections, adverse childhood experiences (ACEs), substance use disorders (SUDs), urban birth/longest residence). RESULTS All SUD types were associated with very high risk (IRR 4.9-25.5), and all forms of ACEs with higher risk (IRR 1.5-4.3) for both disorders. In the mutually adjusted models, ACEs demonstrated slightly higher risk for BD (SCZ IRR 1.30, 1.19-1.42; BD IRR 1.49, 1.44-1.55), while for SUD, risk was higher for SCZ (SCZ IRR 9.43, 8.15-10.92; BD IRR 5.50, 5.15-5.88). Infections were associated with increased risk of BD (IRR 1.21, 1.17-1.26) but not SCZ. Urban birth and urban longest residence were associated with higher risk of SCZ (IRR 1.19, 1.03-1.37), while only the combination of urban birth and rural longest residence showed higher risk for BD (IRR 1.24, 1.13-1.35). CONCLUSIONS There were both shared and unique environmental risk factors: SUDs and ACEs were risk factors for both disorders, while infections were more strongly associated with BD and urbanicity with SCZ.
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Affiliation(s)
- Natassia Robinson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Marica Leone
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Janssen Pharmaceutical Companies of Johnson & Johnson, Solna, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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13
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Reininghaus U, Daemen M, Postma MR, Schick A, Hoes-van der Meulen I, Volbragt N, Nieman D, Delespaul P, de Haan L, van der Pluijm M, Breedvelt JJF, van der Gaag M, Lindauer R, Boehnke JR, Viechtbauer W, van den Berg D, Bockting C, van Amelsvoort T. Transdiagnostic Ecological Momentary Intervention for Improving Self-Esteem in Youth Exposed to Childhood Adversity: The SELFIE Randomized Clinical Trial. JAMA Psychiatry 2024; 81:227-239. [PMID: 38019495 PMCID: PMC10687716 DOI: 10.1001/jamapsychiatry.2023.4590] [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] [Received: 05/12/2023] [Accepted: 10/06/2023] [Indexed: 11/30/2023]
Abstract
Importance Targeting low self-esteem in youth exposed to childhood adversity is a promising strategy for preventing adult mental disorders. Ecological momentary interventions (EMIs) allow for the delivery of youth-friendly, adaptive interventions for improving self-esteem, but robust trial-based evidence is pending. Objective To examine the efficacy of SELFIE, a novel transdiagnostic, blended EMI for improving self-esteem plus care as usual (CAU) compared with CAU only. Design, Setting, and Participants This was a 2-arm, parallel-group, assessor-blinded, randomized clinical trial conducted from December 2018 to December 2022. The study took place at Dutch secondary mental health services and within the general population and included youth (aged 12-26 years) with low self-esteem (Rosenberg Self-Esteem Scale [RSES] <26) exposed to childhood adversity. Interventions A novel blended EMI (3 face-to-face sessions, email contacts, app-based, adaptive EMI) plus CAU or CAU only. Main Outcomes and Measures The primary outcome was RSES self-esteem at postintervention and 6-month follow-up. Secondary outcomes included positive and negative self-esteem, schematic self-beliefs, momentary self-esteem and affect, general psychopathology, quality of life, observer-rated symptoms, and functioning. Results A total of 174 participants (mean [SD] age, 20.7 [3.1] years; 154 female [89%]) were included in the intention-to-treat sample, who were primarily exposed to childhood emotional abuse or neglect, verbal or indirect bullying, and/or parental conflict. At postintervention, 153 participants (87.9%) and, at follow-up, 140 participants (80.5%), provided primary outcome data. RSES self-esteem was, on average, higher in the experimental condition (blended EMI + CAU) than in the control condition (CAU) across both postintervention and follow-up as a primary outcome (B = 2.32; 95% CI, 1.14-3.50; P < .001; Cohen d-type effect size [hereafter, Cohen d] = 0.54). Small to moderate effect sizes were observed suggestive of beneficial effects on positive (B = 3.85; 95% CI, 1.83-5.88; P < .001; Cohen d = 0.53) and negative (B = -3.78; 95% CI, -6.59 to -0.98; P = .008; Cohen d = -0.38) self-esteem, positive (B = 1.58; 95% CI, 0.41-2.75; P = .008; Cohen d = 0.38) and negative (B = -1.71; 95% CI, -2.93 to -0.48; P = .006; Cohen d = -0.39) schematic self-beliefs, momentary self-esteem (B = 0.29; 95% CI, 0.01-0.57; P = .04; Cohen d = 0.24), momentary positive affect (B = 0.23; 95% CI, 0.01-0.45; P = .04; Cohen d = 0.20), momentary negative affect (B = -0.33; 95% CI, -0.59 to -0.03, P = .01, Cohen d = -0.27), general psychopathology (B = -17.62; 95% CI, -33.03 to -2.21; P = .03; Cohen d = -0.34), and quality of life (B = 1.16; 95% CI, 0.18-2.13; P = .02; Cohen d = 0.33) across postintervention and follow-up. No beneficial effects on symptoms and functioning were observed. Conclusions and Relevance A transdiagnostic, blended EMI demonstrated efficacy on the primary outcome of self-esteem and signaled beneficial effects on several secondary outcomes. Further work should focus on implementing this novel EMI in routine public mental health provision. Trial Registration Dutch Trial Register Identifier:NL7129(NTR7475).
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Affiliation(s)
- Ulrich Reininghaus
- Central Institute of Mental Health, Department of Public Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, Health Service and Population Research Department, King’s College London, London, United Kingdom
| | - Maud Daemen
- Central Institute of Mental Health, Department of Public Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Mary Rose Postma
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Mondriaan Mental Health Centre, Maastricht, the Netherlands
| | - Anita Schick
- Central Institute of Mental Health, Department of Public Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Nele Volbragt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Dorien Nieman
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam Public Health, Amsterdam, the Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam Public Health, Amsterdam, the Netherlands
| | - Marieke van der Pluijm
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam Public Health, Amsterdam, the Netherlands
| | - Josefien Johanna Froukje Breedvelt
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University, Amsterdam, the Netherlands
| | - Ramon Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, location Academic Medical Center, Amsterdam, the Netherlands
- Levvel, Academic Centre for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Jan R. Boehnke
- Central Institute of Mental Health, Department of Public Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- School of Health Sciences, University of Dundee, Dundee, United Kingdom
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - David van den Berg
- Department of Clinical Psychology, VU University, Amsterdam, the Netherlands
- Department of Psychosis research, Parnassia Psychiatric Institute, The Hague, the Netherlands
| | - Claudi Bockting
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam Public Health, Amsterdam, the Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Mondriaan Mental Health Centre, Maastricht, the Netherlands
- Koraal, YiP, Urmond, the Netherlands
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14
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Chen YJ, Lu ML, Chiu YH, Chen C, Santos VHJ, Goh KK. Linking childhood trauma to the psychopathology of schizophrenia: the role of oxytocin. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:24. [PMID: 38388569 PMCID: PMC10883944 DOI: 10.1038/s41537-024-00433-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/31/2023] [Indexed: 02/24/2024]
Abstract
Childhood trauma has been linked to schizophrenia, but underlying biological mechanisms remain elusive. This study explored the potential role of plasma oxytocin as a mediator in the relationship between childhood trauma and the psychopathology of schizophrenia. 160 patients with schizophrenia and 80 age- and sex-matched healthy controls were assessed for childhood trauma experiences using the Childhood Trauma Questionnaire and structured interviews. Psychopathology was evaluated using the Positive and Negative Syndrome Scale and plasma oxytocin levels were measured. Results showed that patients with schizophrenia had lower oxytocin levels and higher childhood trauma scores than healthy controls. There was a significant correlation between childhood trauma scores and psychopathology, with plasma oxytocin levels being inversely associated with psychopathology, except for positive symptoms. Hierarchical regression analysis indicated that both childhood trauma scores and plasma oxytocin levels significantly predicted psychopathology. Plasma oxytocin levels partially mediated the relationship between childhood trauma and schizophrenia psychopathology. This study underscores the potential role of oxytocin in bridging the gap between childhood trauma and schizophrenia.
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Affiliation(s)
- Yuan-Jung Chen
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hang Chiu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chenyi Chen
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- The Innovative and Translational Research Center of Brain Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Vitor Hugo Jesus Santos
- Department of Psychiatry and Mental Health, Faculty of Health Sciences (FCS-UBI), Cova da Beira University Hospital Center, Covilhã, Portugal
| | - Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.
- The Innovative and Translational Research Center of Brain Consciousness, Taipei Medical University, Taipei, Taiwan.
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15
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Gildawie KR, Wang K, Budge KE, Byrnes EM. Effects of Maternal Separation on Effort-based Responding for Sucrose Are Associated with c-Fos Expression in the Nucleus Accumbens Core. Neuroscience 2024; 537:174-188. [PMID: 38036058 PMCID: PMC10872495 DOI: 10.1016/j.neuroscience.2023.11.030] [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: 08/04/2023] [Revised: 11/06/2023] [Accepted: 11/26/2023] [Indexed: 12/02/2023]
Abstract
In both people and animals, exposure to adverse experiences early in life can alter neurodevelopment and lead to long-term behavioral effects, including effects on reward processing. In the current study, we use a well-validated rodent model of maternal neglect, maternal separation (MS), to investigate the impact of early life adversity on reward learning and motivation and identify associated modifications in cellular activation in reward-relevant areas. Litters of Long-Evans rats were separated from the dam for either 15 min (brief) or 180 min (prolonged)/day from postnatal day (PND)2 to PND14. As adults, offspring were trained to lever press for a sucrose pellet using fixed ratio (FR) schedules and motivation was tested using a progressive ratio (PR) schedule over 10 daily sessions to assess sustained effects on effort-based responding. Immunohistochemical staining for c-Fos was conducted in a subset of animals that underwent an additional PR session. While there were no effects on reward learning, both MS180 males and females demonstrated increased effort-based responding on the first day of PR testing, while only MS180 males demonstrated a sustained increase in effort across all 10 days. MS180-induced changes in c-Fos expression in the dorsal and ventral striatum were observed, with subregion-specific effects along the rostrocaudal axis. Moreover, regression analyses suggest that motivated responding for a sucrose food reward in MS180-exposed, but not MS15-exposed animals, was associated with increased c-Fos expression in the rostral nucleus accumbens core. These findings implicate specific striatal regions in sex-specific modulation of sustained effort-based reward behavior following early life adversity.
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Affiliation(s)
- Kelsea R Gildawie
- Department of Comparative Pathobiology, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA
| | - Katherine Wang
- Department of Comparative Pathobiology, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA
| | - Kerri E Budge
- Department of Comparative Pathobiology, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA
| | - Elizabeth M Byrnes
- Department of Comparative Pathobiology, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA 01536, USA.
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16
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Marlow S, Laugharne R, Allard J, Bassett P, Priebe S, Ledger J, Kerr J, Priest D, Vanhoorn A, Boland C, Shankar R. A pragmatic randomized controlled exploratory trial of the effectiveness of Eye Movement Desensitization and Reprocessing therapy for psychotic disorder. J Psychiatr Res 2024; 169:257-263. [PMID: 38056231 DOI: 10.1016/j.jpsychires.2023.11.024] [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: 03/11/2023] [Revised: 11/04/2023] [Accepted: 11/15/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND People with severe mental illness are often excluded from trials related to Eye Movement Desensitization and Reprocessing (EMDR) therapy. Principal concerns are that they may not tolerate treatment, might risk relapse or that psychotic symptoms may worsen. There is however building evidence of a traumatogenic etiology of psychotic disorder that may benefit therapeutically from EMDR. However, EMDR in this role is done mainly in specialist tertiary settings. AIM To conduct a randomized exploratory trial of prospective treatment of EMDR for people with psychotic disorder and a history of trauma in an adult community mental health service. METHODS A randomized exploratory trial with a controlled pilot design was employed to conduct a prospective treatment and six-month follow-up study with an interim 10-week analysis in a rural county in the UK (population 538,000). We recruited participants with psychotic disorder who had a reported history of trauma and were interested in receiving trauma therapy. They were then randomized to either receive EMDR or treatment as usual (TAU). The primary instrument used was the Impact of Events Scale (IES) with secondary instruments of Positive and Negative Symptoms of Psychotic Disorder (PANSS), PTSD Checklist (PCL-C), and subjective Quality of Life (MANSA). RESULTS IES scores showed significant improvements in the EMDR group (n = 24, age 42.0 SD (14.5), 42% male) compared to the TAU group (n = 12, age 34.4 SD (11.3), 50% male) at 10 weeks and at six months (p < 0.05). There were significant improvements in PCL-C and PANSS negative symptoms scores associated with treatment (p < 0.05). All other scales showed positive trends. CONCLUSIONS This study demonstrates that EMDR can reduce the impact of traumatic events for patients with a psychotic disorder in a clinical setting in the UK. The improvements in psychotic disorder persisted for six months after treatment. TRIAL REGISTRATION ISRCTN43816889.
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Affiliation(s)
- Simon Marlow
- Cornwall Partnership NHS Foundation Trust, Truro, UK
| | - Richard Laugharne
- Cornwall Partnership NHS Foundation Trust, Truro, UK; Cornwall Intellectual Disability Equitable Research (CIDER) University of Plymouth Peninsula School of Medicine, Truro, UK
| | - Jon Allard
- Cornwall Partnership NHS Foundation Trust, Truro, UK
| | | | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary's, University of London, UK
| | - Joanne Ledger
- Cornwall Partnership NHS Foundation Trust, Truro, UK
| | | | | | - Alje Vanhoorn
- Cornwall Partnership NHS Foundation Trust, Truro, UK
| | - Cailin Boland
- Cornwall Partnership NHS Foundation Trust, Truro, UK
| | - Rohit Shankar
- Cornwall Partnership NHS Foundation Trust, Truro, UK; Cornwall Intellectual Disability Equitable Research (CIDER) University of Plymouth Peninsula School of Medicine, Truro, UK.
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17
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Arcego DM, Buschdorf JP, O'Toole N, Wang Z, Barth B, Pokhvisneva I, Rayan NA, Patel S, de Mendonça Filho EJ, Lee P, Tan J, Koh MX, Sim CM, Parent C, de Lima RMS, Clappison A, O'Donnell KJ, Dalmaz C, Arloth J, Provençal N, Binder EB, Diorio J, Silveira PP, Meaney MJ. A Glucocorticoid-Sensitive Hippocampal Gene Network Moderates the Impact of Early-Life Adversity on Mental Health Outcomes. Biol Psychiatry 2024; 95:48-61. [PMID: 37406925 DOI: 10.1016/j.biopsych.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/15/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Early stress increases the risk for psychiatric disorders. Glucocorticoids are stress mediators that regulate transcriptional activity and morphology in the hippocampus, which is implicated in the pathophysiology of multiple psychiatric conditions. We aimed to establish the relevance of hippocampal glucocorticoid-induced transcriptional activity as a mediator of the effects of early life on later psychopathology in humans. METHODS RNA sequencing was performed with anterior and posterior hippocampal dentate gyrus from adult female macaques (n = 12/group) that were chronically treated with betamethasone (glucocorticoid receptor agonist) or vehicle. Coexpression network analysis identified a preserved gene network in the posterior hippocampal dentate gyrus that was strongly associated with glucocorticoid exposure. The single nucleotide polymorphisms in the genes in this network were used to create an expression-based polygenic score in humans. RESULTS The expression-based polygenic score significantly moderated the association between early adversity and psychotic disorders in adulthood (UK Biobank, women, n = 44,519) and on child peer relations (ALSPAC [Avon Longitudinal Study of Parents and Children], girls, n = 1666 for 9-year-olds and n = 1594 for 11-year-olds), an endophenotype for later psychosis. Analyses revealed that this network was enriched for glucocorticoid-induced epigenetic remodeling in human hippocampal cells. We also found a significant association between single nucleotide polymorphisms from the expression-based polygenic score and adult brain gray matter density. CONCLUSIONS We provide an approach for the use of transcriptomic data from animal models together with human data to study the impact of environmental influences on mental health. The results are consistent with the hypothesis that hippocampal glucocorticoid-related transcriptional activity mediates the effects of early adversity on neural mechanisms implicated in psychiatric disorders.
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Affiliation(s)
- Danusa Mar Arcego
- Douglas Research Centre, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada.
| | - Jan-Paul Buschdorf
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Nicholas O'Toole
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Zihan Wang
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Barbara Barth
- Douglas Research Centre, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | | | - Sachin Patel
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | | | - Patrick Lee
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Jennifer Tan
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Ming Xuan Koh
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Chu Ming Sim
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Carine Parent
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | | | - Andrew Clappison
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Kieran J O'Donnell
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada; Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Carla Dalmaz
- Department of Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Janine Arloth
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany; Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Nadine Provençal
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Elisabeth B Binder
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
| | - Josie Diorio
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Patrícia Pelufo Silveira
- Douglas Research Centre, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
| | - Michael J Meaney
- Douglas Research Centre, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore; Brain Body Initiative, Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
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18
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De Prisco M, Oliva V, Fico G, Montejo L, Possidente C, Bracco L, Fortea L, Anmella G, Hidalgo-Mazzei D, Fornaro M, de Bartolomeis A, Serretti A, Murru A, Vieta E, Radua J. Differences in facial emotion recognition between bipolar disorder and other clinical populations: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110847. [PMID: 37625644 DOI: 10.1016/j.pnpbp.2023.110847] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/01/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023]
Abstract
Facial emotion (or expression) recognition (FER) is a domain of affective cognition impaired across various psychiatric conditions, including bipolar disorder (BD). We conducted a systematic review and meta-analysis searching for eligible articles published from inception to April 26, 2023, in PubMed/MEDLINE, Scopus, EMBASE, and PsycINFO to examine whether and to what extent FER would differ between people with BD and those with other mental disorders. Thirty-three studies comparing 1506 BD patients with 1973 clinical controls were included in the present systematic review, and twenty-six of them were analyzed in random-effects meta-analyses exploring the discrepancies in discriminating or identifying emotional stimuli at a general and specific level. Individuals with BD were more accurate in identifying each type of emotion during a FER task compared to individuals diagnosed with schizophrenia (SCZ) (SMD = 0.27; p-value = 0.006), with specific differences in the perception of anger (SMD = 0.46; p-value = 1.19e-06), fear (SMD = 0.38; p-value = 8.2e-04), and sadness (SMD = 0.33; p-value = 0.026). In contrast, BD patients were less accurate than individuals with major depressive disorder (MDD) in identifying each type of emotion (SMD = -0.24; p-value = 0.014), but these differences were more specific for sad emotional stimuli (SMD = -0.31; p-value = 0.009). No significant differences were observed when BD was compared with children and adolescents diagnosed with attention-deficit/hyperactivity disorder. FER emerges as a potential integrative instrument for guiding diagnosis by enabling discrimination between BD and SCZ or MDD. Enhancing the standardization of adopted tasks could further enhance the accuracy of this tool, leveraging FER potential as a therapeutic target.
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Affiliation(s)
- Michele De Prisco
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Vincenzo Oliva
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Giovanna Fico
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain.
| | - Laura Montejo
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Chiara Possidente
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Lorenzo Bracco
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy.
| | - Lydia Fortea
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, IDIBAPS, Barcelona, Spain.
| | - Gerard Anmella
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain.
| | - Diego Hidalgo-Mazzei
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain.
| | - Michele Fornaro
- Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy.
| | - Andrea de Bartolomeis
- Section of Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy.
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Andrea Murru
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain.
| | - Eduard Vieta
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Joaquim Radua
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, IDIBAPS, Barcelona, Spain; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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19
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Schaug JP, Storebø OJ, Pedersen MB, Haahr UH, Simonsen E. How first-episode psychosis patients' subjective beliefs about their childhood trauma's causal effect provide support for potential schizophrenia subtypes. Schizophr Res 2023; 262:175-183. [PMID: 37992561 DOI: 10.1016/j.schres.2023.11.005] [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: 06/03/2022] [Revised: 10/04/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Childhood and adolescent trauma is a risk factor for developing psychosis-spectrum disorders. The current study aimed to assess how childhood trauma might predict psychosis symptomatology, and how patients' beliefs of whether trauma is the cause of psychosis might affect this association. METHODS Ninety-six first-episode psychosis patients were assessed for childhood traumatic experiences with the Brief Betrayal Trauma Survey, and for psychosis symptoms with the Positive and Negative Syndrome Scale. RESULTS Non-interpersonal trauma predicted higher positive symptoms, whereas more trauma domains experienced predicted lower negative symptoms. Almost half of the participants believed trauma to be related to psychosis, were 12 times more likely to reexperience trauma through psychosis, and had higher excitative and emotional symptoms. Non-interpersonal trauma also predicted higher positive symptoms in this group. Those who did not believe trauma to be the cause of psychosis had higher negative symptoms, and a negative dose-response was found for negative and disorganised symptoms, in which more trauma domains experienced predicted lower scores. CONCLUSIONS Results imply two traumagenic pathways to psychosis, one characterised by positive, excitative, and emotional symptoms, and one negative subtype, characterised by negative and disorganised symptoms. Clinical implications for how findings might contribute to better treatments are discussed.
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Affiliation(s)
- Julie Perrine Schaug
- Centre for Evidence-Based Psychiatry, Psychiatric Research Unit, Psychiatric Services Region Zealand, 4200 Slagelse, Denmark
| | - Ole Jakob Storebø
- Centre for Evidence-Based Psychiatry, Psychiatric Research Unit, Psychiatric Services Region Zealand, 4200 Slagelse, Denmark; Department of Psychology, University of Southern Denmark, Faculty of Health Sciences, 5230 Odense M, Denmark; Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, 4000 Roskilde, Denmark.
| | - Marlene Buch Pedersen
- Early Psychosis Intervention Centre, Psychiatric Services Region Zealand East, 4000 Roskilde, Denmark
| | - Ulrik Helt Haahr
- Psychiatric Research Unit, Psychiatric Services Region Zealand, 4200 Slagelse, Denmark
| | - Erik Simonsen
- Early Psychosis Intervention Centre, Psychiatric Services Region Zealand East, 4000 Roskilde, Denmark; Department of Clinical Medicine, University of Copenhagen, Denmark
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20
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Hood BJ, Komoski MC. Treating Trauma in Criminal Justice-Involved with SMI: "Trauma Is a Huge Part of It". Community Ment Health J 2023; 59:1537-1548. [PMID: 37268846 DOI: 10.1007/s10597-023-01141-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 05/17/2023] [Indexed: 06/04/2023]
Abstract
Individuals with serious mental illness are both disproportionately represented in the criminal justice system and more likely to experience correlates with offending (e.g., trauma, substance abuse, and homelessness). Moreover, research using the Adverse Childhood Experiences has found strong correlation between childhood trauma and later negative outcomes, including criminal justice involvement. Despite this, research has yet to examine how trauma can influence treatment decisions for criminal justice-involved individuals with SMI. Using a qualitative approach and in-depth semi-structured interviews with 61 community mental health service providers, the current study addresses this gap in the literature. Findings confirm the high prevalence of trauma in this population as well as suggests a number of key findings for this population including (1) how trauma affects treatment decisions, (2) the existing barriers related to the treatment of trauma, and (3) what service providers need to effectively treat trauma. Implications for policy and practice are extensive.
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Affiliation(s)
- Brittany J Hood
- Texas A&M International University, 5201 University Boulevard, Academic Innovation Center (AIC) 314, Laredo, TX, 78041, USA.
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21
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White R, Haddock G, Haarmans M, Varese F. Being more satisfied with romantic relationship status is associated with increased mental wellbeing in people with experience of psychosis. Front Psychiatry 2023; 14:1232973. [PMID: 37840795 PMCID: PMC10569177 DOI: 10.3389/fpsyt.2023.1232973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Aims Romantic relationships represent one of the most salient sources of social support. In general population studies, they are associated with both physical and psychological benefits. Research suggests that for people with psychosis, romantic relationships may also have a positive impact on a range of outcomes, but the reasons for these associations are still unclear. This study aims to investigate whether satisfaction with romantic relationships status is associated with better wellbeing outcomes in people with experience of psychosis and explore three possible psychological mediators of this relationship. Methods Participants who had previously sought support for psychosis (n = 190) completed an online survey including measures of relationship status satisfaction (the Satisfaction with Relationship Scale) as well as measures of psychotic symptoms (the CAPE-42), general well-being (Short Warwick-Edinburgh Mental Wellbeing Scale) and several psychological variables relevant to the pathway between romantic relationships and well-being outcomes, namely loneliness, internalised stigma, self-esteem and attachment. Results Fearful attachment and partner criticism were negatively associated with relationship status satisfaction. Having a partner was positively associated with relationship status satisfaction. Higher levels of relationship status satisfaction were associated with lower psychotic symptoms and higher mental wellbeing. This relationship was mediated by loneliness, internalised stigma, and self-esteem. Conclusion Mental health services should be mindful of the associations between romantic relationship satisfaction and wellbeing. Service users with a fearful attachment style may particularly benefit from support in this area.
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Affiliation(s)
- Rebecca White
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Maria Haarmans
- Department of Sociology, School of Social Sciences, Faculty of Humanities, The University of Manchester, Manchester, United Kingdom
- School of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Filippo Varese
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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22
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Saunders KRK, McGuinness E, Barnett P, Foye U, Sears J, Carlisle S, Allman F, Tzouvara V, Schlief M, Vera San Juan N, Stuart R, Griffiths J, Appleton R, McCrone P, Rowan Olive R, Nyikavaranda P, Jeynes T, K T, Mitchell L, Simpson A, Johnson S, Trevillion K. A scoping review of trauma informed approaches in acute, crisis, emergency, and residential mental health care. BMC Psychiatry 2023; 23:567. [PMID: 37550650 PMCID: PMC10405430 DOI: 10.1186/s12888-023-05016-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/10/2023] [Indexed: 08/09/2023] Open
Abstract
Experiences of trauma in childhood and adulthood are highly prevalent among service users accessing acute, crisis, emergency, and residential mental health services. These settings, and restraint and seclusion practices used, can be extremely traumatic, leading to a growing awareness for the need for trauma informed care (TIC). The aim of TIC is to acknowledge the prevalence and impact of trauma and create a safe environment to prevent re-traumatisation. This scoping review maps the TIC approaches delivered in these settings and reports related service user and staff experiences and attitudes, staff wellbeing, and service use outcomes.We searched seven databases (EMBASE; PsycINFO; MEDLINE; Web of Science; Social Policy and Practice; Maternity and Infant Care Database; Cochrane Library Trials Register) between 24/02/2022-10/03/2022, used backwards and forwards citation tracking, and consulted academic and lived experience experts, identifying 4244 potentially relevant studies. Thirty-one studies were included.Most studies (n = 23) were conducted in the USA and were based in acute mental health services (n = 16). We identified few trials, limiting inferences that can be drawn from the findings. The Six Core Strategies (n = 7) and the Sanctuary Model (n = 6) were the most commonly reported approaches. Rates of restraint and seclusion reportedly decreased. Some service users reported feeling trusted and cared for, while staff reported feeling empathy for service users and having a greater understanding of trauma. Staff reported needing training to deliver TIC effectively.TIC principles should be at the core of all mental health service delivery. Implementing TIC approaches may integrate best practice into mental health care, although significant time and financial resources are required to implement organisational change at scale. Most evidence is preliminary in nature, and confined to acute and residential services, with little evidence on community crisis or emergency services. Clinical and research developments should prioritise lived experience expertise in addressing these gaps.
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Affiliation(s)
- Katherine R K Saunders
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK.
| | - Elizabeth McGuinness
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Phoebe Barnett
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
- Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, & Health Psychology, University College London, London, UK
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
| | - Una Foye
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Jessica Sears
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sophie Carlisle
- Section of Women's Mental Health, King's College London, London, UK
| | - Felicity Allman
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Vasiliki Tzouvara
- Care for Long Term Conditions Research Division, King's College London, London, UK
| | - Merle Schlief
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - Norha Vera San Juan
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Ruth Stuart
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Jessica Griffiths
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
| | - Rebecca Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - Paul McCrone
- Institute for Lifecourse Development, University of Greenwich, London, UK
- School of Health Sciences, University of Greenwich, London, UK
| | - Rachel Rowan Olive
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Patrick Nyikavaranda
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - Tamar Jeynes
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
| | - T K
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
| | - Lizzie Mitchell
- NIHR Mental Health Policy Research Unit Lived Experience Working Group, Division of Psychiatry, University College London, London, UK
| | - Alan Simpson
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Sonia Johnson
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - Kylee Trevillion
- NIHR Mental Health Policy Research Unit, Institute of Psychiatry, Psychology and Neuroscience, King's College London, David Goldberg Building, De Crespigny Park, SE5 8AF, London, UK
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23
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Grundy A, Ng E, Rank C, Quinlan J, Giovinazzo G, Viau R, Ponka D, Garner R. Mental health and neurocognitive disorder-related hospitalization rates in immigrants and Canadian-born population: a linkage study. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:692-704. [PMID: 36809592 PMCID: PMC10348999 DOI: 10.17269/s41997-023-00740-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 01/05/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVES Mental health and neurocognitive conditions are important causes of hospitalization among immigrants, though patterns may vary by immigrant category, world region of origin, and time since arrival in Canada. This study uses linked administrative data to explore differences in mental health hospitalization rates between immigrants and individuals born in Canada. METHODS Hospital records from the Discharge Abstract Database and the Ontario Mental Health Reporting System for 2011 to 2017 were linked to the 2016 Longitudinal Immigrant Database and to Statistics Canada's 2011 Canadian Census Health and Environment Cohort. Age-standardized hospitalization rates for mental health-related conditions (ASHR-MHs) were derived for immigrants and the Canadian-born population. ASHR-MHs overall and for leading mental health conditions were compared between immigrants and the Canadian-born population, stratified by sex and selected immigration characteristics. Quebec hospitalization data were not available. RESULTS Overall, immigrants had lower ASHR-MHs compared to the Canadian-born population. Mood disorders were leading causes of mental health hospitalization for both cohorts. Psychotic, substance-related, and neurocognitive disorders were also leading causes of mental health hospitalization, although there was variation in their relative importance between subgroups. Among immigrants, ASHR-MHs were higher among refugees and lower among economic immigrants, those from East Asia, and those who arrived in Canada most recently. CONCLUSION Differences in hospitalization rates among immigrants from various immigration streams and world regions, particularly for specific types of mental health conditions, highlight the importance of future research that incorporates both inpatient and outpatient mental health services to further understand these relationships.
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Affiliation(s)
- Anne Grundy
- Migration Health Branch, Immigration, Refugees and Citizenship Canada, 250 Tremblay Rd, Ottawa, ON, K1G 5P4, Canada.
| | - Edward Ng
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
| | - Claudia Rank
- Migration Health Branch, Immigration, Refugees and Citizenship Canada, 250 Tremblay Rd, Ottawa, ON, K1G 5P4, Canada
| | - Jacklyn Quinlan
- Migration Health Branch, Immigration, Refugees and Citizenship Canada, 250 Tremblay Rd, Ottawa, ON, K1G 5P4, Canada
| | - George Giovinazzo
- Migration Health Branch, Immigration, Refugees and Citizenship Canada, 250 Tremblay Rd, Ottawa, ON, K1G 5P4, Canada
| | - Rachel Viau
- Migration Health Branch, Immigration, Refugees and Citizenship Canada, 250 Tremblay Rd, Ottawa, ON, K1G 5P4, Canada
| | - David Ponka
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Rochelle Garner
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
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24
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Jeste DV, Malaspina D, Bagot K, Barch DM, Cole S, Dickerson F, Dilmore A, Ford CL, Karcher NR, Luby J, Rajji T, Pinto-Tomas AA, Young LJ. Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: III. Biology. Schizophr Bull 2023; 49:867-880. [PMID: 37023360 PMCID: PMC10318888 DOI: 10.1093/schbul/sbad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
BACKGROUND Social determinants of health (SDoHs) are nonmedical factors that significantly impact health and longevity. We found no published reviews on the biology of SDoHs in schizophrenia-spectrum psychotic disorders (SSPD). STUDY DESIGN We present an overview of pathophysiological mechanisms and neurobiological processes plausibly involved in the effects of major SDoHs on clinical outcomes in SSPD. STUDY RESULTS This review of the biology of SDoHs focuses on early-life adversities, poverty, social disconnection, discrimination including racism, migration, disadvantaged neighborhoods, and food insecurity. These factors interact with psychological and biological factors to increase the risk and worsen the course and prognosis of schizophrenia. Published studies on the topic are limited by cross-sectional design, variable clinical and biomarker assessments, heterogeneous methods, and a lack of control for confounding variables. Drawing on preclinical and clinical studies, we propose a biological framework to consider the likely pathogenesis. Putative systemic pathophysiological processes include epigenetics, allostatic load, accelerated aging with inflammation (inflammaging), and the microbiome. These processes affect neural structures, brain function, neurochemistry, and neuroplasticity, impacting the development of psychosis, quality of life, cognitive impairment, physical comorbidities, and premature mortality. Our model provides a framework for research that could lead to developing specific strategies for prevention and treatment of the risk factors and biological processes, thereby improving the quality of life and increasing the longevity of people with SSPD. CONCLUSIONS Biology of SDoHs in SSPD is an exciting area of research that points to innovative multidisciplinary team science for improving the course and prognosis of these serious psychiatric disorders.
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Affiliation(s)
- Dilip V Jeste
- Department of Psychiatry, University of California, San Diego (Retired), CA, USA
| | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience and Genetics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kara Bagot
- Department of Psychiatry, Addiction Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deanna M Barch
- Departments of Psychological and Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Steve Cole
- Departments of Psychiatry and Biobehavioral Sciences, and Medicine, University of California, Los Angeles, CA, USA
| | - Faith Dickerson
- Department of Psychology, Sheppard Pratt, Baltimore, MD, USA
| | - Amanda Dilmore
- Department of Pediatrics, University of California, San Diego, CA, USA
| | - Charles L Ford
- Center for Translational Social Neuroscience, Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Joan Luby
- Department of Psychiatry (Child), Washington University in St. Louis, St. Louis, MO, USA
| | - Tarek Rajji
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adrián A Pinto-Tomas
- Biochemistry Department, School of Medicine, Universidad de Costa Rica, San José, Costa Rica
| | - Larry J Young
- Center for Translational Social Neuroscience, Department of Psychiatry, Emory University, Atlanta, GA, USA
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25
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Bartolomé-Valenzuela M, Pereda N, Guilera G. [Prevalence of adverse and victimization experiences in adult people with severe mental illness in Barcelona]. GACETA SANITARIA 2023; 37:102314. [PMID: 37348295 DOI: 10.1016/j.gaceta.2023.102314] [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: 10/08/2022] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To describe the extension of the adverse experiences, including victimization, lived in childhood and adulthood in a sample of people with severe mental illness residing in Barcelona, Spain. METHOD Descriptive, quantitative and cross-sectional study. Adverse and victimization experiences were assessed using 26 items from the Adverse Childhood Experiences Questionnaire (ACE-IQ). Items were included obtain information regarding victimization during adulthood. Seventy-four people with severe mental illness were interviewed (median age: 42.03 years; standard deviation: 9.60). RESULTS All participants reported at least two victimization experiences throughout their lifetime. The most frequent experiences were conventional crimes (87.8%) and victimization by caregivers (86.5%). Before age 18, half of the participants reported having experienced physical violence by their caregivers (52.7%) and almost one out of three reported to have been victim of sexual abuse (32.4%). Women were almost 13 times more likely to experience sexual victimization than men throughout their lifetime (odds ratio: 12.75; 95% confidence interval: 4.19-38.71). CONCLUSIONS Victimization experienced by people with severe mental illness is a widespread problem that has received little attention. The results of this study are consistent with those obtained in previous investigations and underscore the need to translate this knowledge into medical practice into medical practice, considering them in order to develop treatments with a comprehensive approach to mental health.
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Affiliation(s)
- Marina Bartolomé-Valenzuela
- Grupo de Investigación en Victimización Infantil y Adolescente (GReVIA), Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Barcelona, Barcelona, España
| | - Noemí Pereda
- Grupo de Investigación en Victimización Infantil y Adolescente (GReVIA), Departamento de Psicología Clínica y Psicobiología, Facultad de Psicología, Universidad de Barcelona, Barcelona, España.
| | - Georgina Guilera
- Grupo de Investigación en Victimización Infantil y Adolescente (GReVIA), Departamento de Psicología Social y Psicología Cuantitativa, Facultad de Psicología, Universidad de Barcelona, Barcelona, España
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26
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Christy A, Cavero D, Navajeeva S, Murray-O’Shea R, Rodriguez V, Aas M, Trotta G, Moudiab S, Garrido N, Zamora B, Sideli L, Wrobel AL, Salazar de Pablo G, Alameda L. Association Between Childhood Adversity and Functional Outcomes in People With Psychosis: A Meta-analysis. Schizophr Bull 2023; 49:285-296. [PMID: 36107860 PMCID: PMC10016406 DOI: 10.1093/schbul/sbac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Despite the accepted link between childhood adversity (CA) and psychotic disorders, evidence on the relationship between CA and poor functional outcome remains less consistent and has never been reviewed quantitatively. The aim of this meta-analysis was to systematically examine the association between CA and functional outcomes in people with psychotic disorders. STUDY DESIGN The study protocol was registered on the International Prospective Register of Systematic Reviews (CRD42021254201). A search was conducted across EMBASE, MEDLINE, PsycINFO, and Cochrane Libraries (CENTRAL) using search terms related to psychosis; CA (general, sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect); and functional outcomes (social, occupational, and general functioning [GF]). We conducted random-effects models, sensitivity and heterogeneity analyses, meta-regressions, and we assessed quality. STUDY RESULTS Our meta-analysis comprised 35 studies, including 10 568 cases with psychosis. General CA was negatively associated with GF (28 studies; r = -0.109, 95%CI = -0.161 to -0.05, P < .001), with greater effects in prospective data (10 studies; r = -0.151, 95% CI = -0.236 to -0.063, P = .001). General CA was also associated with social functioning (r = -0.062, 95% CI = -0.120 to -0.004, P = .018) but not occupational outcomes. All CA subtypes except sexual abuse were significantly associated with GF, with emotional and physical neglect showing the largest magnitudes of effect (ranging from r = -0.199 to r = -0.250). CONCLUSIONS This meta-analysis provides evidence for a negative association between general CA, specific subtypes, and general and social functional outcomes in people with psychosis.
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Affiliation(s)
- Angeline Christy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Daniela Cavero
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sujeena Navajeeva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Rachel Murray-O’Shea
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
- NORMENT, Centre for Research on Mental Disorders, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Socayna Moudiab
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nathalia Garrido
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
| | - Blanca Zamora
- Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| | - Lucia Sideli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Human Science, LUMSA University, Rome, Italy
| | - Anna L Wrobel
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Gonzalo Salazar de Pablo
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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27
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Lemvigh C, Brouwer R, Hilker R, Anhøj S, Baandrup L, Pantelis C, Glenthøj B, Fagerlund B. The relative and interactive impact of multiple risk factors in schizophrenia spectrum disorders: a combined register-based and clinical twin study. Psychol Med 2023; 53:1266-1276. [PMID: 35822354 DOI: 10.1017/s0033291721002749] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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 Research has yielded evidence for genetic and environmental factors influencing the risk of schizophrenia. Numerous environmental factors have been identified; however, the individual effects are small. The additive and interactive effects of multiple risk factors are not well elucidated. Twin pairs discordant for schizophrenia offer a unique opportunity to identify factors that differ between patients and unaffected co-twins, who are perfectly matched for age, sex and genetic background. METHODS Register data were combined with clinical data for 216 twins including monozygotic (MZ) and dizygotic (DZ) proband pairs (one or both twins having a schizophrenia spectrum diagnosis) and MZ/DZ healthy control (HC) pairs. Logistic regression models were applied to predict (1) illness vulnerability (being a proband v. HC pair) and (2) illness status (being the patient v. unaffected co-twin). Risk factors included: A polygenic risk score (PRS) for schizophrenia, birth complications, birth weight, Apgar scores, paternal age, maternal smoking, season of birth, parental socioeconomic status, urbanicity, childhood trauma, estimated premorbid intelligence and cannabis. RESULTS The PRS [odds ratio (OR) 1.6 (1.1-2.3)], childhood trauma [OR 4.5 (2.3-8.8)], and regular cannabis use [OR 8.3 (2.1-32.7)] independently predicted illness vulnerability as did an interaction between childhood trauma and cannabis use [OR 0.17 (0.03-0.9)]. Only regular cannabis use predicted having a schizophrenia spectrum diagnosis between patients and unaffected co-twins [OR 3.3 (1.1-10.4)]. CONCLUSION The findings suggest that several risk factors contribute to increasing schizophrenia spectrum vulnerability. Moreover, cannabis, a potentially completely avoidable environmental risk factor, seems to play a substantial role in schizophrenia pathology.
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Affiliation(s)
- C Lemvigh
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - R Brouwer
- Department of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - R Hilker
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Anhøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark
| | - L Baandrup
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Mental Health Center Copenhagen, Copenhagen NV, Denmark
| | - C Pantelis
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - B Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - B Fagerlund
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
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28
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Butjosa A, Usall J, Vila-Badia R, Mezquida G, Cuesta MJ, Rodríguez-Toscano E, Amoretti S, Lobo A, González-Pinto A, Espliego A, Corripio I, Vieta E, Baeza I, Bergé D, Bernardo M, García-Rizo C, Mayoral M, Merchan J, Alonso-Solís A, Rabella M, López P, Zorrilla I, De-la-Cámara C, Barcones F, Sanjuan J, Dolores Moltó M, Morro L, Monserrat C, Verdolini N, Salagre E, la Serna ED, Castro-Fornieles J, Contreras Fernández F, Saiz Masvidal C, Paz Garcia-Portilla M, Bousoño M, Gutiérrez Fraile M, Zabala Rabadán A, Dompablo M, Rodriguez-Jimenez R, Rubio-Abadal E, Pardo M, Sarró S, Pomarol-Clotet E, Ibanez A, Sánchez-Torres AM, Selva-Vera G. Impact of traumatic life events on clinical variables of individuals with first-episode psychosis and healthy controls. Int J Soc Psychiatry 2023; 69:134-145. [PMID: 35068217 DOI: 10.1177/00207640211070398] [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: 11/17/2022]
Abstract
BACKGROUND Traumatic life events (TLEs) are one of the most robust environmental risk factors for the onset of first-episode psychosis (FEP). AIMS To explore TLEs in FEP patients and healthy controls (HC), to analyze gender differences and to examine whether TLEs were associated with sociodemographic, clinical and psychofunctional variables in all FEP sample and split by age. METHODS Descriptive and cross-sectional study. Three hundred and thirty-five FEP and 253 HC were recruited at 16 Spanish mental health research centers. The Traumatic Experiences in Psychiatric Outpatients Questionnaire was administered. RESULTS We found a higher number of TLEs in FEP than in HC, and the proportion of individuals with three or more TLEs was significantly higher in the FEP group. No differences were found in terms of gender and age. There was no relationship between total number of TLEs and psychotic symptomatology and functional outcomes. CONCLUSIONS The number and cumulative TLEs should be taken into account in the detection, epidemiology and process of recovery in FEP.
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Affiliation(s)
- Anna Butjosa
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain
| | - Judith Usall
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Regina Vila-Badia
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Gisela Mezquida
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Elisa Rodríguez-Toscano
- Instituto de Psiquiatría y Salud Mental del Hospital Gregorio Marañón, Servicio de Psiquiatría del Niño y del Adolescente, Madrid, Spain.,Departamento de Psicología experimental, Procesos psicológicos y logopedia, Universidad Complutense de Madrid, Spain
| | - Silvia Amoretti
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Medicine and Psychiatry, University of Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, UPV/EHU, Vitoria, Spain
| | - Ana Espliego
- Departamento de Psicología experimental, Procesos psicológicos y logopedia, Universidad Complutense de Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Psychiatry, Hospital de Sant Pau, Barcelona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Catalonia, Spain
| | - Inmaculada Baeza
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Child and Adolescent Psychiatry and Psychology Department, SGR489, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, Spain
| | - Dani Bergé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
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29
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Kaki S, DeRosa H, Timmerman B, Brummelte S, Hunter RG, Kentner AC. Developmental Manipulation-Induced Changes in Cognitive Functioning. Curr Top Behav Neurosci 2023; 63:241-289. [PMID: 36029460 PMCID: PMC9971379 DOI: 10.1007/7854_2022_389] [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] [Indexed: 10/15/2022]
Abstract
Schizophrenia is a complex neurodevelopmental disorder with as-yet no identified cause. The use of animals has been critical to teasing apart the potential individual and intersecting roles of genetic and environmental risk factors in the development of schizophrenia. One way to recreate in animals the cognitive impairments seen in people with schizophrenia is to disrupt the prenatal or neonatal environment of laboratory rodent offspring. This approach can result in congruent perturbations in brain physiology, learning, memory, attention, and sensorimotor domains. Experimental designs utilizing such animal models have led to a greatly improved understanding of the biological mechanisms that could underlie the etiology and symptomology of schizophrenia, although there is still more to be discovered. The implementation of the Research and Domain Criterion (RDoC) has been critical in taking a more comprehensive approach to determining neural mechanisms underlying abnormal behavior in people with schizophrenia through its transdiagnostic approach toward targeting mechanisms rather than focusing on symptoms. Here, we describe several neurodevelopmental animal models of schizophrenia using an RDoC perspective approach. The implementation of animal models, combined with an RDoC framework, will bolster schizophrenia research leading to more targeted and likely effective therapeutic interventions resulting in better patient outcomes.
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Affiliation(s)
- Sahith Kaki
- School of Arts and Sciences, Health Psychology Program, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
| | - Holly DeRosa
- School of Arts and Sciences, Health Psychology Program, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
- University of Massachusetts Boston, Boston, MA, USA
| | - Brian Timmerman
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Susanne Brummelte
- Department of Psychology, Wayne State University, Detroit, MI, USA
- Translational Neuroscience Program, Wayne State University, Detroit, MI, USA
| | | | - Amanda C Kentner
- School of Arts and Sciences, Health Psychology Program, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA.
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30
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Hosak L, Hosakova K, Malekirad M, Kamaradova Koncelikova D, Zapletalova J, Latalova K. Environmental Factors in the Etiology of Mental Disorders in the Czech Republic. Neuropsychiatr Dis Treat 2023; 19:349-359. [PMID: 36785848 PMCID: PMC9922064 DOI: 10.2147/ndt.s379811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/24/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Both genetic and environmental factors are important in etiology of mental disorders. Calculating polyenviromic risk/protective scores provides an updated perspective in research on the environmental causes of psychiatric disorders. We aimed to compare environmental risk and protective factors in patients with psychosis or a mood disorder (PSYCH+MOOD) and those with an anxiety disorder (ANX). METHODS We administered the internationally accepted questionnaire from the EUropean Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study, enriched with mood and anxiety disorder-relevant measures, to patients at two large university hospitals in the Czech Republic. RESULTS Ninety-four PSYCH+MOOD patients (average age 42.5 years; 46 males) and 52 ANX patients (average age 47.2 years; 17 males) participated. Neither polyenviromic risk score nor polyenviromic protective score differed significantly between PSYCH+MOOD and ANX groups (p = 0.149; p = 0.466, respectively). CONCLUSION Scientific validity of the polyenviromic risk/protective score construct must still be demonstrated in large psychiatric samples, ideally in prospective studies. Nevertheless, researchers have already started to investigate environmental factors in the etiology of mental disorders in their complexity, similarly to polygenic risk scores.
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Affiliation(s)
- Ladislav Hosak
- Department of Psychiatry, Charles University, School of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Kristyna Hosakova
- Department of Psychiatry, Charles University, School of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Mohammad Malekirad
- Department of Psychiatry, Charles University, School of Medicine in Hradec Kralove and University Hospital, Hradec Kralove, Czech Republic
| | - Dana Kamaradova Koncelikova
- Department of Psychiatry, Palacky University Olomouc, Faculty of Medicine and Dentistry and University Hospital, Olomouc, Czech Republic
| | - Jana Zapletalova
- Department of Medical Biophysics, Palacky University Olomouc, Faculty of Medicine and Dentistry, Olomouc, Czech Republic
| | - Klara Latalova
- Department of Psychiatry, Palacky University Olomouc, Faculty of Medicine and Dentistry and University Hospital, Olomouc, Czech Republic
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31
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O'Hare K, Hussain A, Laurens KR, Hindmarsh G, Carr VJ, Tzoumakis S, Harris F, Green MJ. Self-reported mental health of children known to child protection services: an Australian population-based record linkage study. Eur Child Adolesc Psychiatry 2023; 32:101-112. [PMID: 34247296 DOI: 10.1007/s00787-021-01841-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
Maltreated children are vulnerable to adverse mental health outcomes. Information about how children's mental health needs vary according to different levels of child protection contact (potentially culminating in out-of-home care [OOHC]) is valuable for the effective provision of services. This study aimed to examine associations between different levels of contact with child protection services before the age of 10 years and self-reported mental health difficulties at age 11 years. Participants (n = 26,960) were drawn from the New South Wales Child Development Study, a multiagency, multigenerational, longitudinal record linkage study that combines administrative records with cross-sectional survey data. We examined associations between four levels of child protection response (non-threshold reports, unsubstantiated reports, substantiated reports, OOHC; each relative to no report) and six domains of self-reported mental health difficulties (including internalising and externalising symptoms, and psychotic-like experiences). All levels of contact with child protection services were associated with increased odds of mental health difficulties in all domains. Children who had been placed in OOHC and children with substantiated reports had the highest odds of reporting clinical levels of mental health difficulties; 48.1% of children with an OOHC placement and 45.6% of those with substantiated child protection reports showed clinical levels of mental health difficulties in at least one domain. Children with child protection reports that were unsubstantiated, or determined not to meet the threshold for risk-of-significant harm, were also at increased risk of mental health difficulties in middle childhood. These findings underscore the importance of early detection and intervention for all children at risk of maltreatment.
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Affiliation(s)
- Kirstie O'Hare
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Aniqa Hussain
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Kristin R Laurens
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.,School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Gabrielle Hindmarsh
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.,Neuroscience Research Australia, Sydney, Australia.,Department of Psychiatry, Monash University, Melbourne, Australia
| | - Stacy Tzoumakis
- School of Criminology and Criminal Justice, Griffith University, Southport, Australia
| | - Felicity Harris
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia. .,Neuroscience Research Australia, Sydney, Australia.
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32
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Barnes GL, Emsley R, Garety P, Hardy A. Investigating Specific Associations Between Childhood Victimization Profiles and Positive Psychosis Symptoms: The Mediating Roles of Anxiety, Depression, and Schema. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgad017. [PMID: 37398699 PMCID: PMC10313155 DOI: 10.1093/schizbullopen/sgad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background Childhood trauma is a risk factor for psychosis. It is proposed this is due to traumatic events giving rise to psychological mechanisms that are implicated in the development and maintenance of symptoms. Investigation of the psychological mechanisms accounting for relationships between trauma and psychosis will be assisted by focusing on specific trauma profiles, hallucination modalities, and delusion subtypes. Study Design In 171 adults with schizophrenia-spectrum diagnoses and high-conviction delusions, associations between childhood trauma classes, and hallucination and delusion factors, were tested using structural equation models (SEMs). Anxiety, depression, and negative schema were examined as potential mediators of trauma class-psychosis symptom factor links. Study Results Significant associations were found between the emotional abuse/neglect and poly-victimization classes with persecutory delusions and delusions of influence, that were all mediated through anxiety (β = 1.24-0.23, P = < .05). There was an association between the physical abuse class and grandiose/religious delusions that was not explained by the mediators (β = 1.86, P = < .05). Trauma class was not significantly associated with any hallucination modality (β = 0.004-1.46, P = > .05). Conclusions In a sample of people with strongly held delusions, this study demonstrates that childhood victimization is associated with delusions of influence and grandiose beliefs, as well as with persecutory delusions in psychosis. Consistent with previous findings, the potent, mediating role of anxiety supports affective pathway theories and the utility of targeting threat-related processes when treating trauma effects in psychosis.
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Affiliation(s)
- Georgina L Barnes
- To whom correspondence should be addressed; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; e-mail:
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK
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33
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Miljevic C, Munjiza-Jovanovic A, Jovanovic T. Impact of Childhood Adversity, as Early Life Distress, on Cytokine Alterations in Schizophrenia. Neuropsychiatr Dis Treat 2023; 19:579-586. [PMID: 36938321 PMCID: PMC10015972 DOI: 10.2147/ndt.s396168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/23/2023] [Indexed: 03/21/2023] Open
Abstract
Even though inflammation theory has been introduced in the pathophysiology of psychosis almost a century ago, many of its aspects have remained unelucidated. Numerous studies have shown cytokine dysregulation in schizophrenia and a predominance of pro-inflammatory cytokines, but on another side, various cytokines in a pro-inflammatory group have different trends in all subtypes of schizophrenia. Alterations are also present in anti-inflammatory and regulatory cytokines, but findings are still not consistent. On the other hand, it is well known that abuse and neglect in childhood may be predictors of psychotic disorders, and childhood adversity is also associated with alterations of the immune and inflammatory response (through various mechanisms including HPA dysregulation as well). This review aims to analyze conducted studies and elucidate the link between childhood abuse, schizophrenia, and cytokine alterations. Putting together this complex psycho-immunological puzzle for the subgroup of schizophrenia-diagnosed patients with distinct immunological abnormalities and a history of childhood abuse can help us to answer the question about the future treatment of these patients.
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Affiliation(s)
- Cedo Miljevic
- Department of Psychiatry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinical Trial Unit, Institute of Mental Health, Belgrade, Serbia
- Correspondence: Cedo Miljevic, Department of Psychiatry, Faculty of Medicine, University of Belgrade, Milana Kasanina 3, Belgrade, 11 000, Serbia, Tel +381 11 3307500, Fax +381 33 40 629, Email
| | - Ana Munjiza-Jovanovic
- Department of Psychiatry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Day Hospital for Adolescents, Institute of Mental Health, Belgrade, Serbia
| | - Teodora Jovanovic
- Department for Psychotic Disorders, Institute of Mental Health, Belgrade, Serbia
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34
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Dryden‐Mead T, Nelson B, Bendall S. "They may be confronting but they are good questions to be asking" young people's experiences of completing a trauma and PTSD screening tool in an early psychosis program. Psychol Psychother 2022; 95:1090-1107. [PMID: 35942544 PMCID: PMC9804455 DOI: 10.1111/papt.12420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 07/26/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is a history of inadequate enquiry about, and assessment of, trauma in young people within Early Psychosis services and even when screening does occur there is little known about how young people experience this process. AIMS This study aimed to explore young people's experiences of completing a trauma and PTSD screening tool when receiving a service in an Early Psychosis Program. METHOD Semi-structured interviews were conducted with 10 young people, aged 18-24 years, to explore their subjective experience of this process. Transcripts were analysed via interpretative phenomenological analysis. RESULTS Four super-ordinate themes were identified: (i) an emotional experience, (ii) the importance of the relationship with the clinician, (iii) an opportunity to reflect on past experiences, and (iv) the ability to be able to provide honest responses. Results from this study indicated that young people expected to be asked about their trauma experiences, acknowledged that this was challenging for them but found that this was made easier due to the relationship they had built with the clinician, the timing of the screening and also, possibly, by the written style format of the questionnaires. CONCLUSIONS Young people in this study accepted the need for screening for traumatic histories, and expected to be asked about their traumatic experiences, despite the possibility of a short-term increase in distress. The support offered by a trusted clinician, whom the young person had built a relationship with, appeared to be an important component to the willingness and the ability of the young person to complete the questionnaires. This reinforces the fact that screening for trauma in an early psychosis service can be conducted in a way that is safe and acceptable to young people.
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Affiliation(s)
- Tracey Dryden‐Mead
- Centre for Youth Mental HealthThe University of MelbourneMelbourneVic.Australia
| | - Barnaby Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health and Centre for Youth Mental HealthThe University of MelbourneMelbourneVic.Australia
| | - Sarah Bendall
- Orygen, the National Centre of Excellence in Youth Mental Health and Centre for Youth Mental HealthThe University of MelbourneMelbourneVic.Australia
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35
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Setién-Suero E, Ayesa-Arriola R, Peña J, Crespo-Facorro B, Ojeda N. Trauma and psychosis: The mediating role of premorbid adjustment and recent stressful events in a 3-year longitudinal study. J Psychiatr Res 2022; 155:279-285. [PMID: 36166937 DOI: 10.1016/j.jpsychires.2022.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/30/2022] [Accepted: 09/16/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Some of the most-studied environmental factors that can contribute to the development of psychosis are the adversities experienced at an early age. Among these, childhood interpersonal trauma (CIT) has been considered especially influential in the onset of the disease. The aim of the study was to explore the relationship between CIT and the first episode of psychosis (FEP), as well as the relationship between CIT and clinical and functional outcomes 3 years after illness onset. METHODS A total of 278 patients with a FEP and 52 healthy controls were studied. Logistic regression analysis was carried out to examine the explained variation by CIT at the beginning of psychosis. Recent stressful events and premorbid adjustment related to CIT, were introduced in path analyses to determine their mediating effects between CIT and the disease and its clinical and functional results. RESULTS Mediation analyses showed that CIT was indirectly associated with belonging to the FEP group through recent stressful events (Effect = 0.981; SE = 0.323; CI = 0.485 to 1.761). Premorbid academic adjustment in late adolescence mediated the relationship between CIT and clinical and functional outcomes, specifically in the measurements of the Scales for Assessment of Positive and Negative Symptoms, in the Brief Psychiatric Rating Scale, and in the Disability Assessment Scale. CONCLUSIONS These findings suggest that early traumatic experiences play an important role in the FEP. Early intervention that promotes good academic adjustment during adolescence and/or avoids retraumatisation could positively impact both the onset and the course of psychotic illness.
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Affiliation(s)
- Esther Setién-Suero
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Rosa Ayesa-Arriola
- University Hospital Marqués de Valdecilla. Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.
| | - Javier Peña
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria de Sevilla, IBiS, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - Natalia Ojeda
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
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36
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Xie M, Zhao Z, Dai M, Wu Y, Huang Y, Liu Y, Tang Y, Xiao L, Wei W, Zhang G, Du X, Li C, Guo W, Ma X, Deng W, Wang Q, Li T. Associations between urban birth or childhood trauma and first-episode schizophrenia mediated by low IQ. SCHIZOPHRENIA 2022; 8:89. [PMID: 36309513 PMCID: PMC9617944 DOI: 10.1038/s41537-022-00289-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/17/2022] [Indexed: 11/09/2022]
Abstract
Exposure to urban birth, childhood trauma, and lower Intelligence Quotient (IQ) were the most well-established risk factors for schizophrenia in developed countries. In developing countries, whether urban birth is a risk factor for schizophrenia and how these factors are related to one another remain unclear. This study aimed to investigate whether IQ mediates the relationship between urban birth or childhood trauma and first-episode schizophrenia (FES) in China. Birthplace, childhood trauma questionnaire (CTQ), and IQ were collected from 144 patients with FES and 256 healthy controls (HCs). Hierarchical logistic regression analysis was conducted to investigate the associations between birthplace, childhood trauma, IQ, and FES. Furthermore, mediation analysis was used to explore the mediation of IQ in the relationship between birthplace or childhood trauma and FES. After adjusting for age, sex and educational attainment, the final model identified urban birth (odds ratio (OR) = 3.15, 95% CI = 1.54, 6.44) and childhood trauma (OR = 2.79, 95% CI = 1.92, 4.06) were associated an elevated risk for FES. The 52.94% total effect of birthplace on the risk of FES could be offset by IQ (indirect effect/direct effect). The association between childhood trauma and FES could be partly explained by IQ (22.5%). In total, the mediation model explained 70.5% of the total variance in FES. Our study provides evidence that urban birth and childhood trauma are associated with an increased risk of FES. Furthermore, IQ mediates the relationship between urban birth or childhood trauma and FES.
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Affiliation(s)
- Min Xie
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Zhengyang Zhao
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Minhan Dai
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Yulu Wu
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Yunqi Huang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Yunjia Liu
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Yiguo Tang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Liling Xiao
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Wei Wei
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Guangya Zhang
- grid.263761.70000 0001 0198 0694Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangdong Du
- grid.263761.70000 0001 0198 0694Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Chuanwei Li
- grid.263761.70000 0001 0198 0694Department of Psychiatry, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Wanjun Guo
- grid.13402.340000 0004 1759 700XAffiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, 310013 Hangzhou, Zhejiang China
| | - Xiaohong Ma
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Wei Deng
- grid.13402.340000 0004 1759 700XAffiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, 310013 Hangzhou, Zhejiang China
| | - Qiang Wang
- grid.412901.f0000 0004 1770 1022Mental Health Center, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan China
| | - Tao Li
- grid.13402.340000 0004 1759 700XAffiliated Mental Health Centre & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, 310013 Hangzhou, Zhejiang China
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Burger SR, van der Linden T, Hardy A, de Bont P, van der Vleugel B, Staring ABP, de Roos C, van Zelst C, Gottlieb JD, Mueser KT, van Minnen A, de Jongh A, Marcelis M, van der Gaag M, van den Berg D. Trauma-focused therapies for post-traumatic stress in psychosis: study protocol for the RE.PROCESS randomized controlled trial. Trials 2022; 23:851. [PMID: 36199107 PMCID: PMC9532824 DOI: 10.1186/s13063-022-06808-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/30/2022] [Indexed: 08/29/2023] Open
Abstract
INTRODUCTION Many people with psychotic disorders experience symptoms of post-traumatic stress disorder (PTSD). In recent years, several trauma-focused therapies (TFTs), including cognitive restructuring (CR), prolonged exposure (PE), and eye movement desensitization and reprocessing (EMDR) have been studied and found to be safe and effective in reducing PTSD symptoms in individuals with psychosis. However, studies were conducted in different countries, with varying inclusion criteria, therapy duration, control groups, and trial outcomes. RE.PROCESS will be the first study to compare the impact of CR, PE, and EMDR with a waiting list control condition within the same context. METHODS AND ANALYSIS This is the protocol of a pragmatic, single-blind, multicentre, superiority randomized controlled trial, in which CR, PE, and EMDR are compared to a waiting list control condition for TFT (WL) in a naturalistic treatment setting. Inclusion criteria are as follows: age ≥ 16 years; meeting full DSM-5 diagnostic criteria for PTSD on the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), with a total CAPS score ≥ 23; and a psychotic disorder in the schizophrenia spectrum confirmed by the Structured Clinical Interview for DSM-5 (SCID-5). Participants (N=200) will be randomly allocated to 16 sessions of one of the TFTs or WL, in addition to receiving treatment as usual (TAU) for psychosis. The primary objective is to compare the effects of CR, PE, and EMDR to WL on researcher-rated severity of PTSD symptoms over time from baseline to 6-month follow-up. Secondary objectives are to examine these effects at the separate time-points (i.e., mid-treatment, post-treatment, and at 6-month follow-up) and to test the effects for clinician-rated presence of PTSD diagnosis, and self-rated severity of (complex) PTSD symptoms. DISCUSSION This is the first RCT to directly compare the effects of CR, PE, and EMDR within the same context to TAU on PTSD symptoms in individuals with psychosis and PTSD. Secondary effects on clinical and functional outcomes will be investigated both directly after therapy and long term. TRIAL REGISTRATION ISRCTN ISRCTN56150327 . Registered 18 June 2019.
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Affiliation(s)
- Simone R Burger
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Room MF-B543, Van der Boechorstraat 7, Amsterdam, 1081 BT, the Netherlands. .,Department of Psychosis Research and Innovation, Parnassia Psychiatric Institute, The Hague, the Netherlands.
| | - Tineke van der Linden
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Room MF-B543, Van der Boechorstraat 7, Amsterdam, 1081 BT, the Netherlands.,Department of Research and Innovation, GGzE Mental Health Institute, Eindhoven, the Netherlands
| | - Amy Hardy
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Paul de Bont
- GGZ Oost-Brabant Mental Health Institute, Boekel, the Netherlands
| | | | | | - Carlijn de Roos
- Academic Centre for Child and Adolescent Psychiatry Level, Amsterdam University Medical Centre (location AMC), Amsterdam, The Netherlands
| | - Catherine van Zelst
- Department of Psychosis Research and Innovation, Parnassia Psychiatric Institute, The Hague, the Netherlands
| | - Jennifer D Gottlieb
- Cambridge Health Alliance & Harvard Medical School Department of Psychiatry, Cambridge, MA, USA
| | | | - Agnes van Minnen
- Behavourial Science Institute, Radboud Universiteit Nijmegen, Nijmegen, the Netherlands.,PSYTREC Mental Health Institute, Bilthoven, the Netherlands
| | - Ad de Jongh
- PSYTREC Mental Health Institute, Bilthoven, the Netherlands.,Department of Behavioral Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands.,Institute of Health and Society, University of Worcester, Worcester, UK.,School of Psychology, Queen's University, Belfast, Northern Ireland
| | - Machteld Marcelis
- Department of Research and Innovation, GGzE Mental Health Institute, Eindhoven, the Netherlands.,Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Room MF-B543, Van der Boechorstraat 7, Amsterdam, 1081 BT, the Netherlands.,Department of Psychosis Research and Innovation, Parnassia Psychiatric Institute, The Hague, the Netherlands
| | - David van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Room MF-B543, Van der Boechorstraat 7, Amsterdam, 1081 BT, the Netherlands.,Department of Psychosis Research and Innovation, Parnassia Psychiatric Institute, The Hague, the Netherlands
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Strelchuk D, Hammerton G, Wiles N, Croft J, Turner K, Heron J, Zammit S. PTSD as a mediator of the relationship between trauma and psychotic experiences. Psychol Med 2022; 52:2722-2730. [PMID: 33315002 PMCID: PMC9647519 DOI: 10.1017/s0033291720004821] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/29/2020] [Accepted: 11/16/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Traumatic experiences are associated with a higher risk of psychotic illnesses, but little is known about potentially modifiable mechanisms underlying this relationship. This study aims to examine whether post-traumatic stress disorder (PTSD) symptoms mediate the relationship between trauma and psychotic experiences (PEs). METHODS We used data from the Avon Longitudinal Study of Parents and Children to examine whether: PTSD symptoms mediate the relationships between (a) childhood trauma and adolescent PEs (study of adolescent PEs; n = 2952), and (b) childhood/adolescent trauma and PEs in early adulthood (study of adult PEs; n = 2492). We examined associations between variables using logistic regression, and mediation using the parametric g-computation formula. RESULTS Exposure to trauma was associated with increased odds of PEs (adolescent PEs: ORadjusted 1.48, 95% CI 1.23-1.78; adult PEs: ORadjusted 1.57, 95% CI 1.25-1.98) and PTSD symptoms (adolescent PTSD: ORadjusted 1.59, 95% CI 1.31-1.93; adult PTSD: ORadjusted 1.50, 95% CI 1.36-1.65). The association between PTSD symptoms and PE was stronger in adolescence (ORadjusted 4.63, 95% CI 2.34-9.17) than in adulthood (ORadjusted 1.62, 95% CI 0.80-3.25). There was some evidence that PTSD symptoms mediated the relationship between childhood trauma and adolescent PEs (proportion mediated 14%), though evidence of mediation was weaker for adult PEs (proportion mediated 8%). CONCLUSIONS These findings are consistent with the hypothesis that PTSD symptoms partly mediate the association between trauma exposure and PEs. Targeting PTSD symptoms might help prevent the onset of psychotic outcomes.
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Affiliation(s)
- Daniela Strelchuk
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Gemma Hammerton
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Nicola Wiles
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Jazz Croft
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katrina Turner
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stanley Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
- Division of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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Rosenfield PJ, Jiang D, Pauselli L. Childhood adversity and psychotic disorders: Epidemiological evidence, theoretical models and clinical considerations. Schizophr Res 2022; 247:55-66. [PMID: 34210561 DOI: 10.1016/j.schres.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 02/08/2023]
Abstract
While genetic factors play a critical role in the risk for schizophrenia and other psychotic disorders, increasing evidence points to the role of childhood adversity as one of several environmental factors that can significantly impact the development, manifestations and outcome of these disorders. This paper reviews the epidemiological evidence linking childhood adversity and psychotic disorders and explores various theoretical models that seek to explain the connection. We discuss neurobiological parallels between the impact of childhood trauma and psychosis on the brain and then explore the impact of childhood adversity on different domains of clinical presentation. Finally, implications for prevention and treatment are considered, both on individual and structural levels.
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Affiliation(s)
- Paul J Rosenfield
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - David Jiang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
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40
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Grindey A, Bradshaw T. Do different adverse childhood experiences lead to specific symptoms of psychosis in adulthood? A systematic review of the current literature. Int J Ment Health Nurs 2022; 31:868-887. [PMID: 35306711 DOI: 10.1111/inm.12992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/18/2022] [Accepted: 03/05/2022] [Indexed: 11/28/2022]
Abstract
Previous research has demonstrated significant associations between adverse childhood experiences (ACEs) and risks of psychosis. Further research has examined underlying mechanisms to understand the relationship between these variables. This review aimed to explore the associations between various ACEs and the development of different psychotic symptoms in adulthood. The Cochrane Library, Cinahl, PsychINFO, Medline, Embase, and Web of Science were searched from January 1980 to November 2021 to ensure a systematic review of relevant literature. Poverty, fostering, adoption, childhood emotional and physical neglect, and childhood physical (CPA), sexual (CSA), and emotional abuse (CEA) significantly correlated with delusions. Significant relationships were found between hallucinations and CSA and CPA. Paranoia correlated with violent adversities including CPA, assault, and witnessing killing. Limited associations were identified for thought disorder and negative symptoms. The findings of this review indicate that there may be a degree of specificity between various ACEs and psychotic symptoms, but these findings are subject to some limitations. The findings also demonstrate the importance of inquiring about and addressing ACE in clinical practice to develop formulations and treatment plans for individuals with psychosis.
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Affiliation(s)
- Ashleigh Grindey
- Home Based Treatment Team, Salford, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Tim Bradshaw
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
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41
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Lucero MM, Satz S, Miceli R, Swartz HA, Manelis A. The effects of mood disorders and childhood trauma on fear of positive and negative evaluation. Acta Psychol (Amst) 2022; 227:103603. [PMID: 35523082 PMCID: PMC9189689 DOI: 10.1016/j.actpsy.2022.103603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 04/18/2022] [Accepted: 04/26/2022] [Indexed: 11/28/2022] Open
Abstract
Fear of positive and negative evaluation is maladaptive and may result in psychosocial dysfunction. Although being diagnosed with mood disorders or experiencing childhood trauma may potentially affect fear of evaluation, previous studies examined this phenomenon mostly in social anxiety disorders. To fill this gap, we investigated the relationship between childhood trauma and fear of positive and negative evaluation in individuals with bipolar disorder (BD), depressive disorders (DD), and healthy controls (HC). 43 individuals with BD, 89 with DD, and 65 HC completed clinical interviews and self-report assessments. The relationship between participants’ diagnoses and presence of trauma on fear of positive and negative evaluation was examined using ANCOVA. Independently of experiencing childhood trauma, fear of positive evaluation was significantly higher in individuals with mood disorders vs. HC. Fear of negative evaluation was significantly associated with diagnosis-by-trauma interaction. Significantly lower scores were observed in individuals with BD without childhood trauma compared to those with childhood trauma and individuals with DD. Compared to HC, more individuals with mood disorders experienced childhood trauma. While experiencing childhood trauma may increase vulnerability to mood disorders in general, it is especially detrimental for individuals with BD by increasing the risk for developing a fear of negative evaluation.
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42
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Tendolkar I, Polat T, Peters H, Akkermans R, van de Laar F. Commonly occurring adversities in families as risk factors for developing psychosocial and psychiatric morbidities: evidence from general practice. BJPsych Open 2022; 8:e123. [PMID: 35770375 PMCID: PMC9301779 DOI: 10.1192/bjo.2022.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Childhood adversity may lead to mental and somatic complications throughout life. General practitioners are equipped to identify and manage adverse events in households. The relationship between adversities and psychiatric symptoms has not been studied in primary care. AIMS We investigated the relationship of common adversities in families with respect to subsequent development of psychosocial and psychiatric problems in young children. METHOD We analysed data from seven general practices, including participants between 0 and 9 years of age. Adversity was defined as having a household member who was diagnosed with cancer, psychiatric disease or social problems. We compared these patients with controls matched for gender, age and general practice. The primary outcome was any new episode defined with a psychological and psychiatric label. Secondarily, the encounter rates at the general practices after adversity were analysed. RESULTS Participants in both groups were followed for an average of 12 years, whereby patients with an adversity were more likely to develop psychiatric morbidities compared with matched references (odds ratio 1.38, 95% CI 1.12-1.68, P = 0.002), also revealing higher encounter rates at general practices. We found no statistically significant association between adversities in the family and increased psychosocial symptoms. CONCLUSIONS The short- and long-term consequences of exposure to negative events in childhood are of great public health importance. Our data suggest screening more proactively for consequences of commonly occurring adversities in families, as they are a risk factor for subsequent psychiatric symptoms. Enhanced consultation frequency at general practitioners following adversities should be differentiated in more detail.
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Affiliation(s)
- Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Centre for Medical Neuroscience, Department of Psychiatry, Radboud University Nijmegen Medical Center, The Netherlands
| | - Talip Polat
- Department of General Psychiatry, Institute for Mental Health Care Eindhoven (GGzE), The Netherlands
| | - Hans Peters
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, The Netherlands
| | - Reinier Akkermans
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, The Netherlands
| | - Floris van de Laar
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, The Netherlands
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43
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DeRosa H, Richter T, Wilkinson C, Hunter RG. Bridging the Gap Between Environmental Adversity and Neuropsychiatric Disorders: The Role of Transposable Elements. Front Genet 2022; 13:813510. [PMID: 35711940 PMCID: PMC9196244 DOI: 10.3389/fgene.2022.813510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/13/2022] [Indexed: 12/21/2022] Open
Abstract
Long regarded as “junk DNA,” transposable elements (TEs) have recently garnered much attention for their role in promoting genetic diversity and plasticity. While many processes involved in mammalian development require TE activity, deleterious TE insertions are a hallmark of several psychiatric disorders. Moreover, stressful events including exposure to gestational infection and trauma, are major risk factors for developing psychiatric illnesses. Here, we will provide evidence demonstrating the intersection of stressful events, atypical TE expression, and their epigenetic regulation, which may explain how neuropsychiatric phenotypes manifest. In this way, TEs may be the “bridge” between environmental perturbations and psychopathology.
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Affiliation(s)
- Holly DeRosa
- Psychology Department, Developmental Brain Sciences Program, College of Liberal Arts, University of Massachusetts Boston, Boston, MA, United States
| | - Troy Richter
- Psychology Department, Developmental Brain Sciences Program, College of Liberal Arts, University of Massachusetts Boston, Boston, MA, United States
| | - Cooper Wilkinson
- Psychology Department, Developmental Brain Sciences Program, College of Liberal Arts, University of Massachusetts Boston, Boston, MA, United States
| | - Richard G Hunter
- Psychology Department, Developmental Brain Sciences Program, College of Liberal Arts, University of Massachusetts Boston, Boston, MA, United States
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44
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The effects of developmental trauma on theory of mind and its relationship to psychotic experiences: A behavioural study. Psychiatry Res 2022; 312:114544. [PMID: 35417825 DOI: 10.1016/j.psychres.2022.114544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/30/2022] [Accepted: 04/03/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Developmental psychological trauma induces vulnerability to psychosis. However, the mechanisms underlying this association are poorly understood. Impairments in Theory of Mind (ToM) have been observed in adult survivors of developmental trauma and individuals with psychosis. ToM is therefore a candidate mechanism underlying the association between developmental trauma and psychosis. METHODS We used a computerised version of the Director task - where a participant is instructed by a confederate to move an object around a 4 × 4 grid, whilst taking account of whether these objects are visible to a confederate who instructs the participant - to investigate impairments in ToM in 209 participants (age: M = 37.8, SD=13.6; 56% female). Participants were divided into a) developmental trauma-positive (DT+) and control groups (DT-) based on their history of developmental trauma and b) then further into subclinical (S) and healthy groups (H) as based on psychotic experiences indexed by the CAPE-P15. After exclusion, the numbers in each group were: DT+H (47), DT+S (84), DT-H (54), DT-S (12). (Total: 197). RESULTS Developmental trauma exposure was associated with psychotic experiences (OR: 7.89, p < .001), which remained significant after controlling for demographic and clinical confounds (adjusted R2 = 0.452, R2 change = 0.0184, p = .009). Participants with developmental trauma (F1, 194) = 5.46, p = .020, ηp2 = 0.027) and participants more prone to psychotic experiences (F1, 194) = 4.71, p = .031, ηp2 = 0.024) demonstrated significantly lower accuracy on the Director task relative to their respective control, after controlling for the effects of age. CONCLUSIONS ToM deficits are associated with self-reported developmental trauma and psychotic experiences. Further work is needed to explore these relationships further and whether they represent generalised or specific effect effects on developmental trauma and psychopathological domains.
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45
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Strachan LP, Paulik G, McEvoy PM. A narrative review of psychological theories of post-traumatic stress disorder, voice hearing, and other psychotic symptoms. Clin Psychol Psychother 2022; 29:1791-1811. [PMID: 35578567 PMCID: PMC10084244 DOI: 10.1002/cpp.2754] [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: 10/27/2021] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Most voice hearers report childhood trauma. Many voice hearers report comorbid post-traumatic stress symptoms and that the content of their voices (auditory verbal hallucinations) is directly (voices repeat phrases spoken by perpetrators) or indirectly (voice content and trauma is thematically similar) related to their trauma. The factors that maintain trauma-related voices are unknown, and there is limited research in this area. This study aimed to identify potential maintaining factors of trauma-related voices by reviewing models of post-traumatic stress disorder (PTSD) and positive symptoms of psychosis. METHOD Models of PTSD and positive symptoms were reviewed to identify potential factors that are unique and common to both sets of symptoms. RESULTS We reviewed 10 models of PTSD, 4 models of positive symptoms, and 2 trauma-informed models of voice hearing. One model provided a theoretical explanation of different types of trauma-related voices. Twenty-one factors were extracted from 16 theoretical models. No existing model incorporated all these factors. DISCUSSION Existing PTSD and positive symptom models present a range of common and unique factors. There may be value in extending existing integrative models to include a broader range of potential factors that could explain different pathways to, and expressions of, trauma-related voices. A future research agenda is presented to investigate how such an extension could lead to more complete individualized case formulations and targeted treatments.
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Affiliation(s)
- Laura P Strachan
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Georgie Paulik
- School of Psychology, Murdoch University, Perth, Western Australia, Australia.,Perth Voices Clinic, Murdoch, Western Australia, Australia.,School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Peter M McEvoy
- School of Population Health, Curtin University, Perth, Western Australia, Australia.,enAble Institute, Curtin University, Perth, Western Australia, Australia.,Centre for Clinical Interventions, Perth, Western Australia, Australia
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46
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Abram SV, Weittenhiller LP, Bertrand CE, McQuaid JR, Mathalon DH, Ford JM, Fryer SL. Psychological Dimensions Relevant to Motivation and Pleasure in Schizophrenia. Front Behav Neurosci 2022; 16:827260. [PMID: 35401135 PMCID: PMC8985863 DOI: 10.3389/fnbeh.2022.827260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Motivation and pleasure deficits are common in schizophrenia, strongly linked with poorer functioning, and may reflect underlying alterations in brain functions governing reward processing and goal pursuit. While there is extensive research examining cognitive and reward mechanisms related to these deficits in schizophrenia, less attention has been paid to psychological characteristics that contribute to resilience against, or risk for, motivation and pleasure impairment. For example, psychological tendencies involving positive future expectancies (e.g., optimism) and effective affect management (e.g., reappraisal, mindfulness) are associated with aspects of reward anticipation and evaluation that optimally guide goal-directed behavior. Conversely, maladaptive thinking patterns (e.g., defeatist performance beliefs, asocial beliefs) and tendencies that amplify negative cognitions (e.g., rumination), may divert cognitive resources away from goal pursuit or reduce willingness to exert effort. Additionally, aspects of sociality, including the propensity to experience social connection as positive reinforcement may be particularly relevant for pursuing social goals. In the current review, we discuss the roles of several psychological characteristics with respect to motivation and pleasure in schizophrenia. We argue that individual variation in these psychological dimensions is relevant to the study of motivation and reward processing in schizophrenia, including interactions between these psychological dimensions and more well-characterized cognitive and reward processing contributors to motivation. We close by emphasizing the value of considering a broad set of modulating factors when studying motivation and pleasure functions in schizophrenia.
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Affiliation(s)
- Samantha V Abram
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Lauren P Weittenhiller
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Claire E Bertrand
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
| | - John R McQuaid
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Daniel H Mathalon
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Judith M Ford
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Susanna L Fryer
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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47
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Steenkamp L, Weijers J, Gerrmann J, Eurelings-Bontekoe E, Selten JP. The relationship between childhood abuse and severity of psychosis is mediated by loneliness: an experience sampling study. Schizophr Res 2022; 241:306-311. [PMID: 30940399 DOI: 10.1016/j.schres.2019.03.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 03/18/2019] [Accepted: 03/24/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND This study tested the hypotheses that (i) the relationship between a history of childhood abuse and severity of psychosis is mediated by loneliness; (ii) the relationship between loneliness and psychosis is mediated by within-person fluctuations in depressive and anxious feelings. METHODS Fifty-nine individuals with non-affective psychotic disorder rated the intensity of loneliness, positive symptoms, and depressive and anxious feelings during repeated moments in daily life (Experience Sampling Method). Childhood abuse was assessed retrospectively using the 'Childhood Experience of Care and Abuse' interview. To test the mediation hypotheses, a multilevel structural equation modeling paradigm was used. RESULTS As predicted, the relationship between severity of childhood abuse and positive symptoms was mediated by loneliness (b=0.08, 95% CI [0.02, 0.13], p=0.005). In turn, the relationship between loneliness and positive symptoms was mediated by within-person fluctuations in both depressive (b=0.04, 95% CI [0.02, 0.06], p<0.001) and anxious (b=0.02, 95% CI [0.01, 0.03], p=0.002) symptomatology. Depression was a stronger mediator than anxiety (b=0.02, 95% CI [0.00, 0.04], p=0.027). CONCLUSIONS Our findings highlight the role of childhood abuse and loneliness in the severity of psychosis in daily life.
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Affiliation(s)
- Lisa Steenkamp
- Rivierduinen Psychiatric Institute, Sandifortdreef 19, 2333 ZZ Leiden, the Netherlands; Unit Clinical Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Wytemaweg 8, 3015 CN Rotterdam, the Netherlands; Generation R Study group, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
| | - Jonas Weijers
- Rivierduinen Psychiatric Institute, Sandifortdreef 19, 2333 ZZ Leiden, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands
| | - Jorinde Gerrmann
- Rivierduinen Psychiatric Institute, Sandifortdreef 19, 2333 ZZ Leiden, the Netherlands; Unit Clinical Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands; Foundation Centrum'45, Arq Psychotrauma Expert Groep, Nienoord 5, 1112 XE Diemen, the Netherlands; Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Elisabeth Eurelings-Bontekoe
- Unit Clinical Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, the Netherlands
| | - Jean-Paul Selten
- Rivierduinen Psychiatric Institute, Sandifortdreef 19, 2333 ZZ Leiden, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, Universiteitssingel 50, 6229 ER, Maastricht, the Netherlands
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48
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Sun S, Sheridan M, Tyrka A, Donofry SD, Erickson K, Loucks E. Addressing the biological embedding of early life adversities (ELA) among adults through mindfulness: Proposed mechanisms and review of converging evidence. Neurosci Biobehav Rev 2022; 134:104526. [PMID: 34998833 PMCID: PMC8844271 DOI: 10.1016/j.neubiorev.2022.104526] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 12/18/2022]
Abstract
Early life adversities (ELA) are prevalent and have a profound and adverse impact across the lifespan, including on age-related health outcomes, yet interventions to remediate its adverse impact are scarce. This paper presents evidence for mindfulness training to reduce the elevated mental and physical health risks linked to ELA among adults by targeting biological mechanisms of ELA leading to these adverse health outcomes. We first provide a brief overview of ELA, its adverse health impacts, and mechanisms that might be responsible. Next, we review converging evidence that demonstrates that mindfulness training influences key biological pathways involved in ELA-linked negative health consequences, including (a) brain networks involved in self-regulation, (b) immunity and inflammation, (c) telomere biology, and (d) epigenetic modifications. Further, we review preliminary evidence from mindfulness-based trials that focused on populations impacted by ELA. We discuss limitations of this review and provide recommendations for future research. If effective, a mindfulness-based approach could be an important public health strategy for remediating the adverse mental and physical health consequences of ELA.
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Affiliation(s)
- Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, United States; Mindfulness Center at Brown University, United States.
| | - Margaret Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Audrey Tyrka
- Initiative on Stress, Trauma, and Resilience, Department of Psychiatry and Human Behavior, Brown University Alpert Medical School
| | | | - Kirk Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA,Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA,Center for the Neural Basis of Cognition, Pittsburgh, PA
| | - Eric Loucks
- Department of Behavioral and Social Sciences, Brown University School of Public Health,Mindfulness Center at Brown University
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Kovacs TZ, Hill RW, Watson S, Turkington D. Clusters, lines and webs-so does my patient have psychosis? reflections on the use of psychiatric conceptual frameworks from a clinical vantage point. Philos Ethics Humanit Med 2022; 17:6. [PMID: 35152913 PMCID: PMC8842805 DOI: 10.1186/s13010-022-00118-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/22/2022] [Indexed: 06/14/2023] Open
Abstract
Mental health professionals working in hospitals or community clinics inevitably face the realisation that we possess imperfect conceptual means to understand mental disorders. In this paper the authors bring together ideas from the fields of Philosophy, Psychiatry, Cognitive Psychology and Linguistics to reflect on the ways we represent phenomena of high practical importance that we often take for granted, but are nevertheless difficult to define in ontological terms. The paper follows through the development of the concept of psychosis over the last two centuries in the interplay of three different conceptual orientations: the categorical, dimensional and network approaches. Each of these represent the available knowledge and dominant thinking styles of the era in which they emerged and take markedly different stances regarding the nature of mental phenomena. Without particular commitment to any ontological positions or models described, the authors invite the reader into a thinking process about the strengths and weaknesses of these models, and how they can be reconciled in multidisciplinary settings to benefit the process of patient care.
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Affiliation(s)
- Tibor Zoltan Kovacs
- Early Intervention in Psychosis Service, Newcastle upon Tyne, Cumbria, UK.
- Northumberland Tyne and Wear NHS Foundation Trust, 1 Benton View, Forest Hall, Newcastle upon Tyne, NE12 7JJ, UK.
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
| | - Reece William Hill
- School of Medical Education, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Stuart Watson
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - Douglas Turkington
- Cumbria, Northumberland, Tyne and Wear NHS Trust, Monkwearmouth Hospital, Newcastle Road, Sunderland, SR5 1NB, UK
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50
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Nagtegaal MH, Boonmann C. Child Sexual Abuse and Problems Reported by Survivors of CSA: A Meta-Review. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:147-176. [PMID: 34633279 DOI: 10.1080/10538712.2021.1985673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
A systematic meta-review of reviews and meta-analyses on problems reported by survivors of Child Sexual Abuse (CSA) was conducted. The aim was to comprise a comprehensive overview of 1) problems reported by survivors of CSA, and 2) variables moderating these relations. Two raters independently conducted a search through PubMed, PsychINFO, Campbell Library, Cochrane Library and Web of Science. Twenty-five reviews and meta-analyses reporting on 53 problems related to CSA were analyzed. All fell into five domains: medical, psychological, sexual, repeated (self-)harm, and a final category of other problems. Thirty-six of all problems (68%) were consistently and significantly more commonly reported by CSA survivors as compared to individuals without a history of CSA. Most moderator analyses did not significantly influence these relationships. In conclusion, CSA is associated with various problems across different domains and overall, these problems are prevalent independent of specific characteristics of and circumstances surrounding the abuse.
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Affiliation(s)
| | - Cyril Boonmann
- Psychiatric University Hospitals (UPK), Basel, Switzerland
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