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Dondé C, Dubertret C, Fond G, Andre M, Berna F, Boyer L, Capdevielle D, Chereau I, Coulon N, Dorey JM, Leignier S, Llorca PM, Misdrahi D, Passerieux C, Pignon B, Rey R, Schorr B, Schürhoff F, Urbach M, Polosan M, Mallet J. History of learning disorders is associated with worse cognitive and functional outcomes in schizophrenia: results from the multicentric FACE-SZ cross-sectional dataset. Eur Arch Psychiatry Clin Neurosci 2023; 273:1773-1783. [PMID: 36583738 DOI: 10.1007/s00406-022-01544-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
Schizophrenia is associated with early neurodevelopmental disorders, including most frequently learning disorders (LD), among them dyslexia and dyspraxia. Despite the demonstrated links between schizophrenia and LD, specific clinical patterns of the schizophrenia with a history of LD subgroup remain unknown. The aim of the present study was to investigate cognitive impairment, symptoms and functional outcome associated with a history of LD in a large cross-sectional, multicentric, sample of schizophrenia subjects. 492 community-dwelling subjects with schizophrenia (75.6% male, mean age 30.8 years) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia in France and received a thorough clinical assessment. The 51 (10.4%) subjects identified with a history of LD had significantly impaired general cognitive ability (Wechsler Adult Intelligence Scale Full Scale Total IQ: Cohen's d = 0.50, p = 0.001), processing speed (d = 0.19), verbal comprehension (d = 0.29), working memory (d = 0.31), cognitive inhibition and flexibility (d = 0.26), central executive functioning (d = 0.26), phonemic verbal fluency (d = 0.22) and premorbid intellectual ability (d = 0.48), as well as with a worse functional outcome (Global Assessment of Functioning, d = 0.21), independently of age, sex, education level, symptoms, treatments, and addiction comorbidities. These results indicate that a history of LD is associated with later cognitive impairment and functional outcome in schizophrenia. This suggests that history of LD is a relevant clinical marker to discriminate subgroups of patients with schizophrenia with different profiles in a precision psychiatry framework.
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Affiliation(s)
- Clément Dondé
- Fondation Fondamental, Créteil, France.
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France.
- Psychiatry Department, CH Alpes-Isère, 38000, Saint-Egrève, France.
| | - Caroline Dubertret
- Fondation Fondamental, Créteil, France
- Institute of Psychiatry and Neuroscience of Paris, Université de Paris, INSERM UMR1266, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Guillaume Fond
- Fondation Fondamental, Créteil, France
- School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, AP-HM, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Myrtille Andre
- Fondation Fondamental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Fabrice Berna
- Fondation Fondamental, Créteil, France
- Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Strasbourg, France
| | - Laurent Boyer
- Fondation Fondamental, Créteil, France
- School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, AP-HM, Aix-Marseille Univ., 27 Boulevard Jean Moulin, 13005, Marseille, France
| | - Delphine Capdevielle
- Fondation Fondamental, Créteil, France
- Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation Fondamental, Créteil, France
- University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, 63000, Clermont-Ferrand, France
| | - Nathalie Coulon
- Fondation Fondamental, Créteil, France
- Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - Jean-Michel Dorey
- Fondation Fondamental, Créteil, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - Sylvain Leignier
- Fondation Fondamental, Créteil, France
- Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, Saint-Egrève, France
| | - Pierre-Michel Llorca
- Fondation Fondamental, Créteil, France
- University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, 63000, Clermont-Ferrand, France
| | - David Misdrahi
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
- Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France
- Aquitaine Institute for Cognitive and Integrative Neuroscience, UMR 5287-INCIA, University of Bordeaux, CNRS, Bordeaux, France
| | - Christine Passerieux
- Fondation Fondamental, Créteil, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 Rue de Versailles, 78157, Le Chesnay, France
- DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines 94807, Villejuif, France
| | - Baptiste Pignon
- Fondation Fondamental, Créteil, France
- UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie Génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de Psychiatrie, Créteil, France Fondation FondaMental, Fondation de Cooperation Scientifique, Université Paris-Est, Créteil, France
| | - Romain Rey
- Fondation Fondamental, Créteil, France
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 Bd Pinel, BP 30039, 69678, Bron Cedex, France
| | - Benoît Schorr
- Fondation Fondamental, Créteil, France
- Fédération de Médecine Translationnelle de Strasbourg, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Strasbourg, France
| | - Franck Schürhoff
- Fondation Fondamental, Créteil, France
- UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie Génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de Psychiatrie, Créteil, France Fondation FondaMental, Fondation de Cooperation Scientifique, Université Paris-Est, Créteil, France
| | - Mathieu Urbach
- Fondation Fondamental, Créteil, France
- Department of Adult Psychiatry and Addictology, Versailles Hospital, Centre Hospitalier de Versailles, 177 Rue de Versailles, 78157, Le Chesnay, France
| | - Mircea Polosan
- Fondation Fondamental, Créteil, France
- Univ. Grenoble Alpes, Inserm, U1216, Adult Psychiatry Department CHU Grenoble Alpes, Grenoble Institut Neurosciences, 38000, Grenoble, France
- Psychiatry Department, CH Alpes-Isère, 38000, Saint-Egrève, France
| | - Jasmina Mallet
- Fondation Fondamental, Créteil, France
- Institute of Psychiatry and Neuroscience of Paris, Université de Paris, INSERM UMR1266, Paris, France
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
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Gelner H, Karska J, Gawęda Ł, Samochowiec J, Misiak B. Effects of the interaction between PTSD and ADHD symptoms on the level of reporting psychotic-like experiences: findings from a non-clinical population. Front Psychiatry 2023; 14:1232606. [PMID: 37867761 PMCID: PMC10587572 DOI: 10.3389/fpsyt.2023.1232606] [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: 05/31/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Psychotic-like experiences (PLEs) are increasingly being recognized as subclinical phenomena that might predict the development of various mental disorders that are not limited to the psychosis spectrum. Accumulating evidence suggests that attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are highly comorbid mental disorders. However, their interactive effect on the occurrence of PLEs has not been investigated so far. Therefore, in the present study we aimed to investigate the effect of interaction between ADHD and PTSD symptoms on the level of psychotic-like experiences (PLEs) in the non-clinical sample. Methods The study included 3,000 individuals aged 18-35 years with a negative history of psychiatric treatment. The symptoms of ADHD and PTSD were assessed using self-reports. Results There was a significant association of the interaction between ADHD and PTSD with the level of reporting PLEs. This association remained significant after adjustment for age, gender, the level of education, the current vocational situation, lifetime history of problematic substance use, and depressive symptoms. Post-hoc tests demonstrated significantly higher levels of reporting PLEs in participants with positive screening for both ADHD and PTSD compared to other subgroups of participants. Also, individuals with positive screening for one vulnerability (either ADHD or PTSD) reported significantly higher levels of reporting PLEs compared to those with a negative screening for ADHD and PTSD. In turn, no significant differences between individuals reporting one vulnerability, i.e., between those with positive screening for ADHD and those with positive screening for PTSD, were observed. Conclusion Findings from the present study imply that both PTSD and ADHD symptoms the interaction effect on the level of reporting PLEs that might be of importance for early intervention strategies. However, observed associations require replication in clinical samples.
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Affiliation(s)
- Hanna Gelner
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Julia Karska
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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Seitz-Holland J, Nägele FL, Kubicki M, Pasternak O, Cho KIK, Hough M, Mulert C, Shenton ME, Crow TJ, James ACD, Lyall AE. Shared and distinct white matter abnormalities in adolescent-onset schizophrenia and adolescent-onset psychotic bipolar disorder. Psychol Med 2023; 53:4707-4719. [PMID: 35796024 PMCID: PMC11119277 DOI: 10.1017/s003329172200160x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND While adolescent-onset schizophrenia (ADO-SCZ) and adolescent-onset bipolar disorder with psychosis (psychotic ADO-BPD) present a more severe clinical course than their adult forms, their pathophysiology is poorly understood. Here, we study potentially state- and trait-related white matter diffusion-weighted magnetic resonance imaging (dMRI) abnormalities along the adolescent-onset psychosis continuum to address this need. METHODS Forty-eight individuals with ADO-SCZ (20 female/28 male), 15 individuals with psychotic ADO-BPD (7 female/8 male), and 35 healthy controls (HCs, 18 female/17 male) underwent dMRI and clinical assessments. Maps of extracellular free-water (FW) and fractional anisotropy of cellular tissue (FAT) were compared between individuals with psychosis and HCs using tract-based spatial statistics and FSL's Randomise. FAT and FW values were extracted, averaged across all voxels that demonstrated group differences, and then utilized to test for the influence of age, medication, age of onset, duration of illness, symptom severity, and intelligence. RESULTS Individuals with adolescent-onset psychosis exhibited pronounced FW and FAT abnormalities compared to HCs. FAT reductions were spatially more widespread in ADO-SCZ. FW increases, however, were only present in psychotic ADO-BPD. In HCs, but not in individuals with adolescent-onset psychosis, FAT was positively related to age. CONCLUSIONS We observe evidence for cellular (FAT) and extracellular (FW) white matter abnormalities in adolescent-onset psychosis. Although cellular white matter abnormalities were more prominent in ADO-SCZ, such alterations may reflect a shared trait, i.e. neurodevelopmental pathology, present across the psychosis spectrum. Extracellular abnormalities were evident in psychotic ADO-BPD, potentially indicating a more dynamic, state-dependent brain reaction to psychosis.
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Affiliation(s)
- Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Felix L. Nägele
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Kang Ik K. Cho
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Morgan Hough
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, UK
- Highfield Unit, University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
- Centre for Psychiatry and Psychotherapy, Justus-Liebig-University, Giessen, Germany
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Timothy J. Crow
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Anthony C. D. James
- SANE POWIC, University Department of Psychiatry, Warneford Hospital, Oxford, UK
- Highfield Unit, University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Amanda E. Lyall
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Associations of neurodevelopmental risk factors with psychosis proneness: Findings from a non-clinical sample of young adults. Compr Psychiatry 2023; 123:152385. [PMID: 36931184 DOI: 10.1016/j.comppsych.2023.152385] [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: 11/22/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
Psychotic disorders often develop as the continuum of subclinical symptoms that include hallucination-like and delusion-like experiences, and are commonly referred to as psychotic-like experiences (PLEs). To date, a number of neurodevelopmental risk factors of psychosis have been detected, yet their mutual interplay remains unknown. Therefore, we aimed to investigate the additive association of childhood trauma history, reading disabilities and symptoms of attention-deficit/hyperactivity disorder (ADHD) with psychosis proneness. A total of 3000 young adults (58.3% females, aged 18-35 years) with a negative history of psychiatric treatment were recruited to the cross-sectional study through computer-assisted web interview. Self-reports were administered to measure childhood trauma history, ADHD symptoms and reading disabilities. Linear regression analyses revealed significant main associations of childhood trauma history and reading disabilities with higher levels of PLEs. There were no significant main associations of ADHD with the level of PLEs. However, the associations of all possible interactions between neurodevelopmental risk factors with the level of PLEs were significant. Our findings suggest that childhood trauma history and reading disabilities may additively increase a risk of psychosis. The present findings bring new implications for early intervention strategies in psychosis and posit the rationale of recording the accumulation of neurodevelopmental vulnerabilities in clinical practice.
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Fiksinski AM, Hoftman GD, Vorstman JAS, Bearden CE. A genetics-first approach to understanding autism and schizophrenia spectrum disorders: the 22q11.2 deletion syndrome. Mol Psychiatry 2023; 28:341-353. [PMID: 36192458 PMCID: PMC9812786 DOI: 10.1038/s41380-022-01783-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 02/03/2023]
Abstract
Recently, increasing numbers of rare pathogenic genetic variants have been identified that are associated with variably elevated risks of a range of neurodevelopmental outcomes, notably including Autism Spectrum Disorders (ASD), Schizophrenia Spectrum Disorders (SSD), and Intellectual Disability (ID). This review is organized along three main questions: First, how can we unify the exclusively descriptive basis of our current psychiatric diagnostic classification system with the recognition of an identifiable, highly penetrant genetic risk factor in an increasing proportion of patients with ASD or SSD? Second, what can be learned from studies of individuals with ASD or SSD who share a common genetic basis? And third, what accounts for the observed variable penetrance and pleiotropy of neuropsychiatric phenotypes in individuals with the same pathogenic variant? In this review, we focus on findings of clinical and preclinical studies of the 22q11.2 deletion syndrome (22q11DS). This particular variant is not only one of the most common among the increasing list of known rare pathogenic variants, but also one that benefits from a relatively long research history. Consequently, 22q11DS is an appealing model as it allows us to: (1) elucidate specific genotype-phenotype associations, (2) prospectively study behaviorally defined classifications, such as ASD or SSD, in the context of a known, well-characterized genetic basis, and (3) elucidate mechanisms underpinning variable penetrance and pleiotropy, phenomena with far-reaching ramifications for research and clinical practice. We discuss how findings from animal and in vitro studies relate to observations in human studies and can help elucidate factors, including genetic, environmental, and stochastic, that impact the expression of neuropsychiatric phenotypes in 22q11DS, and how this may inform mechanisms underlying neurodevelopmental expression in the general population. We conclude with research priorities for the field, which may pave the way for novel therapeutics.
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Affiliation(s)
- Ania M Fiksinski
- Department of Psychology and Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, Division of Mental Health, MHeNS, Maastricht University, Maastricht, The Netherlands
| | - Gil D Hoftman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Jacob A S Vorstman
- Program in Genetics and Genome Biology, Research Institute, and Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
- Department of Psychology, University of California, Los Angeles, CA, USA.
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Carpenter JS, Scott J, Iorfino F, Crouse JJ, Ho N, Hermens DF, Cross SPM, Naismith SL, Guastella AJ, Scott EM, Hickie IB. Predicting the emergence of full-threshold bipolar I, bipolar II and psychotic disorders in young people presenting to early intervention mental health services. Psychol Med 2022; 52:1990-2000. [PMID: 33121545 DOI: 10.1017/s0033291720003840] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Predictors of new-onset bipolar disorder (BD) or psychotic disorder (PD) have been proposed on the basis of retrospective or prospective studies of 'at-risk' cohorts. Few studies have compared concurrently or longitudinally factors associated with the onset of BD or PDs in youth presenting to early intervention services. We aimed to identify clinical predictors of the onset of full-threshold (FT) BD or PD in this population. METHOD Multi-state Markov modelling was used to assess the relationships between baseline characteristics and the likelihood of the onset of FT BD or PD in youth (aged 12-30) presenting to mental health services. RESULTS Of 2330 individuals assessed longitudinally, 4.3% (n = 100) met criteria for new-onset FT BD and 2.2% (n = 51) met criteria for a new-onset FT PD. The emergence of FT BD was associated with older age, lower social and occupational functioning, mania-like experiences (MLE), suicide attempts, reduced incidence of physical illness, childhood-onset depression, and childhood-onset anxiety. The emergence of a PD was associated with older age, male sex, psychosis-like experiences (PLE), suicide attempts, stimulant use, and childhood-onset depression. CONCLUSIONS Identifying risk factors for the onset of either BD or PDs in young people presenting to early intervention services is assisted not only by the increased focus on MLE and PLE, but also by recognising the predictive significance of poorer social function, childhood-onset anxiety and mood disorders, and suicide attempts prior to the time of entry to services. Secondary prevention may be enhanced by greater attention to those risk factors that are modifiable or shared by both illness trajectories.
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Affiliation(s)
- Joanne S Carpenter
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
| | - Jan Scott
- Department of Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, England
- Diderot University, Sorbonne City, Paris, France
| | - Frank Iorfino
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
| | - Jacob J Crouse
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
| | - Nicholas Ho
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
| | - Daniel F Hermens
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
- Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Shane P M Cross
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
- School of Psychology, The University of Sydney, Camperdown, New South Wales, Australia
| | - Sharon L Naismith
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
- School of Psychology, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Adam J Guastella
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
| | - Elizabeth M Scott
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
- School of Medicine, University of Notre Dame, Sydney, Australia
| | - Ian B Hickie
- Youth Mental Health Team, Brain & Mind Centre, The University of Sydney, Camperdown, Australia
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Carey E, Gillan D, Burke T, Burns A, Murphy TM, Kelleher I, Cannon M. Social cognition and self-reported ASD traits in young adults who have reported psychotic experiences: A population-based, longitudinal study. Schizophr Res 2021; 237:54-61. [PMID: 34500376 DOI: 10.1016/j.schres.2021.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 07/14/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Social cognition is considered a trait marker of psychosis, and has rarely been investigated in young adults who have reported psychotic experiences (PE). The aim of the present study was to explore whether social cognition, self-reported Autism Spectrum Disorder (ASD) traits and functioning were associated with PE. METHODS Participants were invited to take part in a 10-year follow-up study (mean age 20.9 years), of whom 103 participants returned, including 41 who had reported PE either past or current. Social cognition (theory of mind, social perception and locus of control) was assessed and a self-report measure of ASD traits was administered. Psychopathology and global functioning were assessed using the SCID-5. Analyses investigated group differences between PE and controls, and the association between social cognition and functioning in the PE group. A mediation analysis investigated if the association between PE and social cognition was explained by ASD traits. RESULTS The PE group had poorer theory of mind scores (F = 4.22, p = .043), specifically for neutral and negative stimuli, and an external locus of control (F = 5.73, p = .019) in young adulthood. The PE group had a significantly greater number of self-reported ASD traits than the controls (χ2(2) = 10.65). External locus of control had a significant negative correlation with current role functioning in the PE group. The association between PE and social cognition abilities was not mediated by ASD traits. CONCLUSION Psychotic experiences are associated with poorer theory of mind and an external locus of control, as well as proportionally more self-reported ASD traits, in young adulthood.
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Affiliation(s)
- Eleanor Carey
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity College Institute of Neuroscience, Dublin, Ireland.
| | - Diane Gillan
- Dept. of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Tom Burke
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Annette Burns
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tanya M Murphy
- Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Ian Kelleher
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Dept. of Psychiatry, Beaumont Hospital, Dublin, Ireland
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Developmental Psychotic Risk: Toward a Neurodevelopmentally Informed Staging of Vulnerability to Psychosis. Harv Rev Psychiatry 2021; 28:271-278. [PMID: 32692090 DOI: 10.1097/hrp.0000000000000266] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Koike S, Uematsu A, Sasabayashi D, Maikusa N, Takahashi T, Ohi K, Nakajima S, Noda Y, Hirano Y. Recent Advances and Future Directions in Brain MR Imaging Studies in Schizophrenia: Toward Elucidating Brain Pathology and Developing Clinical Tools. Magn Reson Med Sci 2021; 21:539-552. [PMID: 34408115 DOI: 10.2463/mrms.rev.2021-0050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Schizophrenia is a common severe psychiatric disorder that affects approximately 1% of general population through the life course. Historically, in Kraepelin's time, schizophrenia was a disease unit conceptualized as dementia praecox; however, since then, the disease concept has changed. Recent MRI studies had shown that the neuropathology of the brain in this disorder was characterized by mild progression before and after the onset of the disease, and that the brain alterations were relatively smaller than assumed. Although genetic factors contribute to the brain alterations in schizophrenia, which are thought to be trait differences, other changes include factors that are common in psychiatric diseases. Furthermore, it has been shown that the brain differences specific to schizophrenia were relatively small compared to other changes, such as those caused by brain development, aging, and gender. In addition, compared to the disease and participant factors, machine and imaging protocol differences could affect MRI signals, which should be addressed in multi-site studies. Recent advances in MRI modalities, such as multi-shell diffusion-weighted imaging, magnetic resonance spectroscopy, and multimodal brain imaging analysis, may be candidates to sharpen the characterization of schizophrenia-specific factors and provide new insights. The Brain/MINDS Beyond Human Brain MRI (BMB-HBM) project has been launched considering the differences and noises irrespective of the disease pathologies and includes the future perspectives of MRI studies for various psychiatric and neurological disorders. The sites use restricted MRI machines and harmonized multi-modal protocols, standardized image preprocessing, and traveling subject harmonization. Data sharing to the public will be planned in FY 2024. In the future, we believe that combining a high-quality human MRI dataset with genetic data, randomized controlled trials, and MRI for non-human primates and animal models will enable us to understand schizophrenia, elucidate its neural bases and therapeutic targets, and provide tools for clinical application at bedside.
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Affiliation(s)
- Shinsuke Koike
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM).,University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB).,The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), The University of Tokyo
| | - Akiko Uematsu
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences.,Research Center for Idling Brain Science (RCIBS), University of Toyama
| | - Norihide Maikusa
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences.,Research Center for Idling Brain Science (RCIBS), University of Toyama
| | - Kazutaka Ohi
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine
| | | | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine
| | - Yoji Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University.,Institute of Industrial Science, The University of Tokyo
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Poletti M, Gebhardt E, Raballo A. Developmental dynamic interplay between executive functions and psychotic risk. APPLIED NEUROPSYCHOLOGY. CHILD 2021; 10:194-197. [PMID: 31318294 DOI: 10.1080/21622965.2019.1641096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
According to the neurodevelopmental hypothesis of schizophrenia, the premorbid stages of nonaffective psychosis are characterized by early phenotypic manifestations of neurobiological vulnerability, whose developmental trends are accurately characterized for IQ, language, and motor abilities. More elusive is the developmental relationship between psychotic risk and executive functions. Few longitudinal studies are available on this relationship, suggesting a developmental lag for executive functions in subjects that will develop psychosis in young adulthood. In this brief commentary we underline specific developmental characteristics of psychotic manifestations that should be considered by further studies, which are aimed at grasping the developmental relationship between psychotic risk and neurocognitive features. Psychosis is an end-stage phenomenon that represents the long-term outcome of a prolonged psychopathological construction. By designing studies addressing developmentally-sensitive risk phenotypes for psychosis, it will be possible to understand how executive functions (among other neurocognitive features) might impact the risk of developing psychosis.
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Affiliation(s)
- Michele Poletti
- Department of Mental Health, Azienda Unità Sanitaria Locale-IRCSS, Reggio Emilia, Italy
| | - Eva Gebhardt
- Melograno Medical Psychotherapy Centre, Rome, Italy
| | - Andrea Raballo
- Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy
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11
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Chen PH, Tsai SY, Pan CH, Chen YL, Chang HM, Su SS, Chen CC, Kuo CJ. High Risk and Trajectories of Physical Illnesses before the Diagnosis of Bipolar Disorder. J Affect Disord 2021; 281:99-108. [PMID: 33310452 DOI: 10.1016/j.jad.2020.11.127] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The authors investigated the distributions and trajectories of physical illnesses preceding the diagnosis of bipolar disorder with comparison to schizophrenia and general populations. METHODS Using data from the Taiwan National Health Insurance Research Database entered from 1996 to end of 2012, we identified 13,079 patients newly diagnosed as having bipolar disorder between the age of 13 and 40 years (ie, cases). For each case with bipolar disorder, two age- and sex- and diagnosis year- schizophrenia comparisons (n=26,158)(n=26,158) and four age- and sex-matched comparisons representing the general population (n=52,316)(n=52,316) were randomly selected from the cohort. Multivariate conditional logistic regression analyses were conducted to estimate the risk of physical illness before the diagnosis (index date). Variables exhibiting a powerful association (p<0·001) were retained in the final model. RESULTS During the year before diagnosis, patients with newly diagnosed bipolar disorder had a higher risk of numerous physical illnesses across the cardiovascular, respiratory, gastrointestinal, endocrine/metabolic, and musculoskeletal/integument systems compared with those with schizophrenia and the general population. Trends in the risk of specific physical illnesses, mainly hypertension, heart disease, asthma, ulcer disease, hyperlipidemia, and connective tissue disease, were increased across the 3-year prodromal phase of bipolar disorder relative to schizophrenia. CONCLUSIONS Intriguingly, physical illnesses before the diagnosis of bipolar disorder are pervasive with higher risk. Moreover, the trajectories of physical illnesses markedly differ from those of schizophrenia before full manifestation.
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Affiliation(s)
- Pao-Huan Chen
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shang-Ying Tsai
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Yi-Lung Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Hu-Ming Chang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Sheng-Siang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Department of Psychiatry, Mackay Medical College, Taipei, Taiwan
| | - Chian-Jue Kuo
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
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12
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Maj M, van Os J, De Hert M, Gaebel W, Galderisi S, Green MF, Guloksuz S, Harvey PD, Jones PB, Malaspina D, McGorry P, Miettunen J, Murray RM, Nuechterlein KH, Peralta V, Thornicroft G, van Winkel R, Ventura J. The clinical characterization of the patient with primary psychosis aimed at personalization of management. World Psychiatry 2021; 20:4-33. [PMID: 33432763 PMCID: PMC7801854 DOI: 10.1002/wps.20809] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medica-tion is prescribed, with second-generation antipsychotics usually preferred to first-generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is evidence to support its efficacy. Psychosocial interventions are often provided, especially in chronic cases, but those applied are frequently not validated by research. Evidence-based family interventions and supported employment programs are seldom implemented in ordinary practice. Although the notion that patients with primary psychosis are at increased risk for cardiovascular diseases and diabetes mellitus is widely shared, it is not frequent that appropriate measures be implemented to address this problem. The view that the management of the patient with primary psychosis should be personalized is endorsed by the vast majority of clinicians, but this personalization is lacking or inadequate in most clinical contexts. Although many mental health services would declare themselves "recovery-oriented", it is not common that a focus on empowerment, identity, meaning and resilience is ensured in ordinary practice. The present paper aims to address this situation. It describes systematically the salient domains that should be considered in the characterization of the individual patient with primary psychosis aimed at personalization of management. These include positive and negative symptom dimensions, other psychopathological components, onset and course, neurocognition and social cognition, neurodevelopmental indicators; social functioning, quality of life and unmet needs; clinical staging, antecedent and concomitant psychiatric conditions, physical comorbidities, family history, history of obstetric complications, early and recent environmental exposures, protective factors and resilience, and internalized stigma. For each domain, simple assessment instruments are identified that could be considered for use in clinical practice and included in standardized decision tools. A management of primary psychosis is encouraged which takes into account all the available treatment modalities whose efficacy is supported by research evidence, selects and modulates them in the individual patient on the basis of the clinical characterization, addresses the patient's needs in terms of employment, housing, self-care, social relationships and education, and offers a focus on identity, meaning and resilience.
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Affiliation(s)
- Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Jim van Os
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marc De Hert
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium
- Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, LVR-Klinikum Düsseldorf, and WHO Collaborating Center on Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Philip D Harvey
- Division of Psychology, Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge and Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Dolores Malaspina
- Department of Psychiatry and Neuroscience, Ichan Medical School at Mount Sinai, New York, NY, USA
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Jouko Miettunen
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Robin M Murray
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Keith H Nuechterlein
- Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine, and Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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13
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Allott K, Van‐der‐el K, Bryce S, Hamilton M, Adams S, Burgat L, Killackey E, Rickwood D. Need for clinical neuropsychological assessment in headspace youth mental health services: A national survey of providers. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Kelly Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,
| | - Kristi Van‐der‐el
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,
| | - Shayden Bryce
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,
| | - Matthew Hamilton
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,
| | - Sophie Adams
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,
- Orygen Youth Health, Parkville, Victoria, Australia,
| | - Liz Burgat
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,
| | - Eoin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia,
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia,
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia,
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14
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Fisher CA, Hetrick SE, Merrett Z, Parrish EM, Allott K. Neuropsychology and Youth Mental Health in Victoria: The Results of a Clinical Service Audit. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Caroline A. Fisher
- Child and Youth Mental Health Service, Eastern Health,
- Living Well Program, The Melbourne Clinic,
- Department of Psychology, Royal Melbourne Hospital, Melbourne Health,
| | - Sarah E. Hetrick
- Orygen, The National Centre for Excellence in Youth Mental Health,
- Centre for Youth Mental Health, The University of Melbourne,
| | - Zalie Merrett
- Child and Youth Mental Health Service, Eastern Health,
- Department of Psychological Sciences, Swinburne University,
| | - Emma M. Parrish
- Orygen, The National Centre for Excellence in Youth Mental Health,
- Department of Psychology, Northeastern University,
| | - Kelly Allott
- Orygen, The National Centre for Excellence in Youth Mental Health,
- Centre for Youth Mental Health, The University of Melbourne,
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15
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Holland JF, Khandaker GM, Dauvermann MR, Morris D, Zammit S, Donohoe G. Effects of early life adversity on immune function and cognitive performance: results from the ALSPAC cohort. Soc Psychiatry Psychiatr Epidemiol 2020; 55:723-733. [PMID: 31897578 DOI: 10.1007/s00127-019-01813-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 11/28/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Early life adversity (ELA) is a significant risk factor for mental health disorders. One hypothesised mechanism by which this occurs is via an effect on immune response. In this analysis of epidemiological data, we tested whether ELA was associated with cognitive performance, and if so, whether these effects were influenced by immune function. METHODS We investigated the longitudinal relationship between ELA, inflammatory markers, and cognition in data from Avon Longitudinal Study of Parents And Children (ALSPAC; n ~ 5000). ELA was defined in terms of physical/emotional abuse, harsh parenting, or domestic violence before 5 years. Social cognition was measured in terms of theory of mind, and general cognitive ability was measured using IQ. Inflammatory markers included serum C-reactive protein and interleukin-6 levels. RESULTS A significant association was observed between IQ and harsh parenting, whereby children who were physically disciplined had lower IQ scores (accounting for relevant social factors). Both immune markers were associated with variation in cognition, however, neither accounted for the effects of ELA on cognition. DISCUSSION This study highlights the impact of ELA on cognition. In the absence of evidence that these effects are explained by inflammation, other mechanisms by which the effects of ELA are mediated are discussed.
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Affiliation(s)
- Jessica F Holland
- Cognitive Genetics and Cognitive Therapy Group, The Centre for Neuroimaging, Cognition and Genomics (NICOG), School of Psychology and Discipline of Biochemistry, National University of Ireland Galway, Galway, Ireland
| | - Golam M Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Herschel Smith Building for Brain & Mind Sciences, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Maria R Dauvermann
- Cognitive Genetics and Cognitive Therapy Group, The Centre for Neuroimaging, Cognition and Genomics (NICOG), School of Psychology and Discipline of Biochemistry, National University of Ireland Galway, Galway, Ireland
| | - Derek Morris
- Cognitive Genetics and Cognitive Therapy Group, The Centre for Neuroimaging, Cognition and Genomics (NICOG), School of Psychology and Discipline of Biochemistry, National University of Ireland Galway, Galway, Ireland
| | - Stanley Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre, University of Bristol, Bristol, UK
| | - Gary Donohoe
- Cognitive Genetics and Cognitive Therapy Group, The Centre for Neuroimaging, Cognition and Genomics (NICOG), School of Psychology and Discipline of Biochemistry, National University of Ireland Galway, Galway, Ireland.
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16
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Delagneau G, Bowden SC, Bryce S, van-der-El K, Hamilton M, Adams S, Burgat L, Killackey E, Rickwood D, Allott K. Thematic analysis of youth mental health providers' perceptions of neuropsychological assessment services. Early Interv Psychiatry 2020; 14:220-227. [PMID: 31512388 DOI: 10.1111/eip.12876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 08/09/2019] [Accepted: 08/25/2019] [Indexed: 01/18/2023]
Abstract
AIM A growing number of quantitative studies have investigated the utility of neuropsychological assessment in mental health settings. However, to the best of our knowledge, no previous study has qualitatively explored youth mental health providers' perceptions of neuropsychological assessment services. A more in-depth understanding of the perceived advantages and barriers associated with neuropsychological assessment in youth mental health settings is critical to better inform policy, practice and service uptake. Thus, the aim of this study was to qualitatively explore clinicians' views about neuropsychological assessments for youth with mental health concerns. METHODS A single open-ended qualitative question, included as part of an anonymous cross-sectional online survey, was completed by clinicians (N = 206) treating or assessing adolescents and young adults within Australian primary care mental health centres (headspace). Responses were analysed using an inductive approach to thematic analysis. RESULTS Five main themes were identified. Clinicians (a) identified barriers to accessing neuropsychological assessments (53%), (b) indicated a range of mixed outcomes following neuropsychological assessment (39%), (c) highlighted a need for neuropsychological assessments (22%), (d) reported a lack of awareness about this resource (10%) and (e) described practice issues associated with neuropsychological services (4%). CONCLUSION This study uncovered perceived factors contributing to reduced access to neuropsychological assessment in Australian youth mental health settings. Given potential adverse outcomes resulting from this clinical service gap, efforts should be made to address factors contributing to poorer access, thereby mitigating the impact of poor access on the management of mental illness in youth. Several strategies, including funding neuropsychological assessments, are discussed.
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Affiliation(s)
- Garance Delagneau
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Stephen C Bowden
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Shayden Bryce
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Kristi van-der-El
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Matthew Hamilton
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Sophie Adams
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen Youth Health, Parkville, Victoria, Australia
| | - Liz Burgat
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Eoin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia & headspace The National Youth Mental Health Foundation, Melbourne, Australia
| | - Kelly Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
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Paula-Pérez I. Convergencias y divergencias genéticas, neurobiológicas y ambientales entre el autismo y el espectro de la esquizofrenia. ANUARIO DE PSICOLOGÍA 2018. [DOI: 10.1016/j.anpsic.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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18
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Khandaker GM, Stochl J, Zammit S, Goodyer I, Lewis G, Jones PB. Childhood inflammatory markers and intelligence as predictors of subsequent persistent depressive symptoms: a longitudinal cohort study. Psychol Med 2018; 48:1514-1522. [PMID: 29140226 PMCID: PMC6088526 DOI: 10.1017/s0033291717003038] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND To identify developmental sub-groups of depressive symptoms during the second decade of life, a critical period of brain development, using data from a prospective birth cohort. To test whether childhood intelligence and inflammatory markers are associated with subsequent persistent depressive symptoms. METHODS IQ, a proxy for neurodevelopment, was measured at age 8 years. Interleukin 6 (IL-6) and C-reactive protein, typical inflammatory markers, were measured at age 9 years. Depressive symptoms were measured six times between 10 and 19 years using the short mood and feelings questionnaire (SMFQ), which were coded as binary variable and then used in latent class analysis to identify developmental sub-groups of depressive symptoms. RESULTS Longitudinal SMFQ data from 9156 participants yielded three distinct population sub-groups of depressive symptoms: no symptoms (81.2%); adolescent-onset symptoms (13.2%); persistent symptoms (5.6%). Lower IQ and higher IL-6 levels in childhood were independently associated with subsequent persistent depressive symptoms in a linear, dose-response fashion, but not with adolescent-onset symptoms. Compared with the group with no symptoms the adjusted odds ratio for persistent depressive symptoms per s.d. increase in IQ was 0.80 (95% CI, 0.68-0.95); that for IL-6 was 1.20 (95% CI, 1.03-1.39). Evidence for an association with IL-6 remained after controlling for initial severity of depressive symptoms at 10 years. There was no evidence that IL-6 moderated or mediated the IQ-persistent depressive symptom relationship. CONCLUSIONS The results indicate potentially important roles for two distinct biological processes, neurodevelopment and inflammation, in the aetiology of persistent depressive symptoms in young people.
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Affiliation(s)
- G. M. Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - J. Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Kinanthropology, Charles University, Prague, Czech Republic
| | - S. Zammit
- Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, Bristol, UK
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - I. Goodyer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - G. Lewis
- Division of Psychiatry, University College London, London, UK
| | - P. B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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19
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Koike S, Barnett J, Jones PB, Richards M. Cognitive profiles in childhood and adolescence differ between adult psychotic and affective symptoms: a prospective birth cohort study. Psychol Med 2018; 48:11-22. [PMID: 28988550 PMCID: PMC5729848 DOI: 10.1017/s0033291717000393] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 01/25/2017] [Accepted: 01/26/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Differences between verbal and non-verbal cognitive development from childhood to adulthood may differentiate between those with and without psychotic symptoms and affective symptoms in later life. However, there has been no study exploring this in a population-based cohort. METHOD The sample was drawn from the MRC National Survey of Health and Development, and consisted of 2384 study members with self-reported psychotic experiences and affective symptoms at the age of 53 years, and with complete cognitive data at the ages of 8 and 15 years. The association between verbal and non-verbal cognition at age 8 years and relative developmental lag from age 8 to 15 years, and both adult outcomes were tested with the covariates adjusted, and mutually adjusted for verbal and non-verbal cognition. RESULTS Those with psychotic experiences [thought interference (n = 433), strange experience (n = 296), hallucination (n = 88)] had lower cognition at both the ages of 8 and 15 years in both verbal and non-verbal domains. After mutual adjustment, lower verbal cognition at age 8 years and greater verbal developmental lag were associated with higher likelihood of psychotic experiences within individuals, whereas there was no association between non-verbal cognition and any psychotic experience. In contrast, those with case-level affective symptoms (n = 453) had lower non-verbal cognition at age 15 years, and greater developmental lag in the non-verbal domain. After adjustment, lower non-verbal cognition at age 8 years and greater non-verbal developmental lag were associated with higher risk of case-level affective symptoms within individuals. CONCLUSIONS These results suggest that cognitive profiles in childhood and adolescence differentiate psychiatric disease spectra.
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Affiliation(s)
- S. Koike
- MRC Unit for Lifelong Health and Ageing at
UCL, 33 Bedford Place, London WC1B 5JU,
UK
- University of Tokyo Institute for Diversity
& Adaptation of Human Mind (UTIDAHM), 3-8-1 Komaba,
Meguro-ku, Tokyo 153-8902, Japan
- Center for Evolutionary Cognitive
Sciences, Graduate School of Arts and Sciences, The University of
Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo 153-8902,
Japan
| | - J. Barnett
- Department of Psychiatry,
University of Cambridge, Cambridge CB2
0SZ, UK
- Cambridge Cognition Ltd,
Cambridge CB25 9TU, UK
| | - P. B. Jones
- Department of Psychiatry,
University of Cambridge, Cambridge CB2
0SZ, UK
- CAMEO, Cambridgeshire & Peterborough NHS
Foundation Trust, Cambridge CB21 5EF,
UK
| | - M. Richards
- MRC Unit for Lifelong Health and Ageing at
UCL, 33 Bedford Place, London WC1B 5JU,
UK
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20
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Association between childhood infection, serum inflammatory markers and intelligence: findings from a population-based prospective birth cohort study. Epidemiol Infect 2017; 146:256-264. [PMID: 29198208 PMCID: PMC5851035 DOI: 10.1017/s0950268817002710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
A link between infection, inflammation, neurodevelopment and adult illnesses has been proposed. The objective of this study was to examine the association between infection burden during childhood - a critical period of development for the immune and nervous systems - and subsequent systemic inflammatory markers and general intelligence. In the Avon Longitudinal Study of Parents and Children, a prospective birth cohort in England, we examined the association of exposure to infections during childhood, assessed at seven follow-ups between age 1·5 and 7·5 years, with subsequent: (1) serum interleukin 6 and C-reactive protein (CRP) levels at age 9; (2) intelligence quotient (IQ) at age 8. We also examined the relationship between inflammatory markers and IQ. Very high infection burden (90+ percentile) was associated with higher CRP levels, but this relationship was explained by body mass index (adjusted odds ratio (OR) 1·19; 95% confidence interval (CI) 0·95-1·50), maternal occupation (adjusted OR 1·23; 95% CI 0·98-1·55) and atopic disorders (adjusted OR 1·24; 95% CI 0·98-1·55). Higher CRP levels were associated with lower IQ; adjusted β = -0·79 (95% CI -1·31 to -0·27); P = 0·003. There was no strong evidence for an association between infection and IQ. The findings indicate that childhood infections do not have an independent, lasting effect on circulating inflammatory marker levels subsequently in childhood; however, elevated inflammatory markers may be harmful for intellectual development/function.
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van Harten PN, Walther S, Kent JS, Sponheim SR, Mittal VA. The clinical and prognostic value of motor abnormalities in psychosis, and the importance of instrumental assessment. Neurosci Biobehav Rev 2017; 80:476-487. [PMID: 28711662 DOI: 10.1016/j.neubiorev.2017.06.007] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 06/06/2017] [Accepted: 06/13/2017] [Indexed: 01/15/2023]
Abstract
Motor abnormalities comprise several clinical signs intrinsic to psychosis. Critically, these features are of prognostic value in individuals at-risk for psychosis, and for those in early stages of psychotic disorders. Motor abnormalities such as tremor, rigidity, and neurological soft signs often go unrecognized. Currently, advances in this area are limited by a paucity of theoretical conceptions categorizing or linking these behaviours to underlying neurobiology affected in psychosis. However, emerging technological advances have significantly improved the ability to detect and assess motor abnormalities with objective instruments in a timely and reliable manner. Further, converging evidence has laid the groundwork for theoretically and empirically derived categorization and conceptualization. This review summarizes these advances, stressing the importance of motor abnormalities for understanding vulnerability across different stages of psychosis and introducing these innovative instrumental approaches. Patients, researchers and clinicians will benefit from these new developments, as better assessment aids the development of targeted interventions to ultimately improve the care for individuals experiencing psychosis.
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Affiliation(s)
- Peter N van Harten
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands; Psychiatric Centre GGz Central, Amersfoort, The Netherlands.
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Switzerland
| | | | | | - Vijay A Mittal
- Northwestern University, Department of Psychology, Department of Psychiatry, Institute for Policy Research, Department of Medical Social Sciences, Evanston/Chicago, USA
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22
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Navarro-Mateu F, Alonso J, Lim CCW, Saha S, Aguilar-Gaxiola S, Al-Hamzawi A, Andrade LH, Bromet EJ, Bruffaerts R, Chatterji S, Degenhardt L, de Girolamo G, de Jonge P, Fayyad J, Florescu S, Gureje O, Haro JM, Hu C, Karam EG, Kovess-Masfety V, Lee S, Medina-Mora ME, Ojagbemi A, Pennell BE, Posada-Villa J, Scott KM, Stagnaro JC, Kendler KS, Kessler RC, McGrath JJ, Kessler RC, McGrath JJ. The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys. Acta Psychiatr Scand 2017; 136:74-84. [PMID: 28542726 PMCID: PMC5664954 DOI: 10.1111/acps.12749] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE While psychotic experiences (PEs) are known to be associated with a range of mental and general medical disorders, little is known about the association between PEs and measures of disability. We aimed to investigate this question using the World Mental Health surveys. METHOD Lifetime occurrences of six types of PEs were assessed along with 21 mental disorders and 14 general medical conditions. Disability was assessed with a modified version of the WHO Disability Assessment Schedule. Descriptive statistics and logistic regression models were used to investigate the association between PEs and high disability scores (top quartile) with various adjustments. RESULTS Respondents with PEs were more likely to have top quartile scores on global disability than respondents without PEs (19.1% vs. 7.5%; χ2 = 190.1, P < 0.001) as well as greater likelihood of cognitive, social, and role impairment. Relationships persisted in each adjusted model. A significant dose-response relationship was also found for the PE type measures with most of these outcomes. CONCLUSIONS Psychotic experiences are associated with disability measures with a dose-response relationship. These results are consistent with the view that PEs are associated with disability regardless of the presence of comorbid mental or general medical disorders.
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Affiliation(s)
- Fernando Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud. IMIB-Arrixaca. CIBERESP-Murcia, Murcia, Spain
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Carmen C. W. Lim
- Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia
| | - Sukanta Saha
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia
| | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq
| | - Laura H. Andrade
- Section of Psychiatric Epidemiology - LIM 23, Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Somnath Chatterji
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre, Via Pilastroni 4, Brescia, Italy
| | - Peter de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, NL; Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical
| | - John Fayyad
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - Chiyi Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University,Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | | | - Akin Ojagbemi
- College of Medicine, University of Ibadan; University College Hospital, Ibadan, Nigeria
| | - Beth-Ellen Pennell
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jose Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Kate M. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Juan Carlos Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina
| | | | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - John J. McGrath
- Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland, St. Lucia, Queensland, Australia; and National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - R. C. Kessler
- Department of Health Care Policy; Harvard Medical School; Boston MA USA
| | - J. J. McGrath
- Queensland Centre for Mental Health Research; University of Queensland; St. Lucia QLD Australia
- Queensland Brain Institute; University of Queensland; St. Lucia QLD Australia
- National Centre for Register-based Research; Aarhus BSS; Aarhus University; Aarhus Denmark
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23
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Larson FV, Wagner AP, Jones PB, Tantam D, Lai MC, Baron-Cohen S, Holland AJ. Psychosis in autism: comparison of the features of both conditions in a dually affected cohort. Br J Psychiatry 2017; 210:269-275. [PMID: 27979819 PMCID: PMC5376719 DOI: 10.1192/bjp.bp.116.187682] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 07/25/2016] [Accepted: 08/04/2016] [Indexed: 01/20/2023]
Abstract
BackgroundThere is limited information on the presentation and characteristics of psychotic illness experienced by people with autism spectrum disorder (ASD).AimsTo describe autistic and psychotic phenomenology in a group of individuals with comorbid ASD and psychosis (ASD-P) and compare this group with populations affected by either, alone.MethodWe studied 116 individuals with ASD-P. We compared features of their ASD with people with ASD and no comorbid psychosis (ASD-NP), and clinical characteristics of psychosis in ASD-P with people with psychosis only.ResultsIndividuals with ASD-P had more diagnoses of atypical psychosis and fewer of schizophrenia compared with individuals with psychosis only. People with ASD-P had fewer stereotyped interests/behaviours compared with those with ASD-NP.ConclusionsOur data show there may be a specific subtype of ASD linked to comorbid psychosis. The results support findings that psychosis in people with ASD is often atypical, particularly regarding affective disturbance.
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Affiliation(s)
- Felicity V. Larson
- Correspondence: Felicity Larson, PhD, Department of Psychology (Clinical Psychology Section), Frankland Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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24
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Downs JM, Lechler S, Dean H, Sears N, Patel R, Shetty H, Simonoff E, Hotopf M, Ford TJ, Diaz-Caneja CM, Arango C, MacCabe JH, Hayes RD, Pina-Camacho L. The Association Between Comorbid Autism Spectrum Disorders and Antipsychotic Treatment Failure in Early-Onset Psychosis: A Historical Cohort Study Using Electronic Health Records. J Clin Psychiatry 2017; 78:e1233-e1241. [PMID: 29125721 PMCID: PMC6037287 DOI: 10.4088/jcp.16m11422] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 04/12/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE In a sample of children and adolescents with first-episode psychosis, we investigated whether multiple treatment failure (MTF, defined as the initiation of a third trial of novel antipsychotic due to nonadherence, adverse effects, or insufficient response) was associated with comorbid autism spectrum disorders. METHODS Data were from the electronic health records of 638 children (51% male) aged from 10 to 17 years with first-episode psychosis (per ICD-10 criteria) from January 1, 2008, to November 1, 2014, referred to mental health services in South London, United Kingdom; data were extracted using the Clinical Record Interactive Search (CRIS) system. The effect of autism spectrum disorder comorbidity on the development of MTF during a 5-year period was modeled using Cox regression. RESULTS There were 124 cases of MTF prior to the age of 18 (19.4% of the sample). Comorbid autism spectrum disorders were significantly associated with MTF (adjusted hazard ratio = 1.99; 95% CI, 1.19-3.31; P = .008) after controlling for a range of potential confounders. Other factors significantly associated with MTF included higher age at first presentation (P = .001), black ethnicity (P = .03), and frequency of clinical contact (P < .001). No significant association between other comorbid neurodevelopmental disorders (hyperkinetic disorder or intellectual disability) and MTF was found. CONCLUSIONS Children with first-episode psychosis and comorbid autism spectrum disorders at first presentation are less likely to have a beneficial response to antipsychotics.
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Affiliation(s)
- Johnny M. Downs
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Suzannah Lechler
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Harry Dean
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Nicola Sears
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Rashmi Patel
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Hitesh Shetty
- NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Emily Simonoff
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | | | - Covadonga M. Diaz-Caneja
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - James H. MacCabe
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Richard D. Hayes
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK
| | - Laura Pina-Camacho
- Institute of Psychiatry, Psychology Neuroscience, King’s College London, UK,NIHR South London and Maudsley NHS Foundation Trust Biomedical Research Centre, UK,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
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Peripheral Inflammatory Markers Contributing to Comorbidities in Autism. Behav Sci (Basel) 2016; 6:bs6040029. [PMID: 27983615 PMCID: PMC5197942 DOI: 10.3390/bs6040029] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 12/08/2016] [Accepted: 12/09/2016] [Indexed: 11/17/2022] Open
Abstract
This study evaluates the contribution of peripheral biomarkers to comorbidities and clinical findings in autism. Seventeen autistic children and age-matched typically developing (AMTD), between three to nine years old were evaluated. The diagnostic followed the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DMS-IV) and the Childhood Autism Rating Scale (CARS) was applied to classify the severity. Cytokine profile was evaluated in plasma using a sandwich type ELISA. Paraclinical events included electroencephalography (EEG) record. Statistical analysis was done to explore significant differences in cytokine profile between autism and AMTD groups and respect clinical and paraclinical parameters. Significant differences were found to IL-1β, IL-6, IL-17, IL-12p40, and IL-12p70 cytokines in individuals with autism compared with AMTD (p < 0.05). All autistic patients showed interictalepileptiform activity at EEG, however, only 37.5% suffered epilepsy. There was not a regional focalization of the abnormalities that were detectable with EEG in autistic patients with history of epilepsy. A higher IL-6 level was observed in patients without history of epilepsy with interictalepileptiform activity in the frontal brain region, p < 0.05. In conclusion, peripheral inflammatory markers might be useful as potential biomarkers to predict comorbidities in autism as well as reinforce and aid informed decision-making related to EEG findings in children with Autism spectrum disorders (ASD).
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26
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Siebald C, Khandaker GM, Zammit S, Lewis G, Jones PB. Association between childhood psychiatric disorders and psychotic experiences in adolescence: A population-based longitudinal study. Compr Psychiatry 2016; 69:45-52. [PMID: 27423344 PMCID: PMC4959416 DOI: 10.1016/j.comppsych.2016.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 05/04/2016] [Accepted: 05/05/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adolescent psychotic experiences (PEs) are common, and are associated with both psychotic and non-psychotic illnesses. In order to examine psychopathological and cognitive antecedents of adolescent PEs, we have conducted a longitudinal study of common childhood psychiatric disorders and subsequent adolescent PEs in the population-based prospective ALSPAC birth cohort. METHOD Depression, anxiety, attention deficit hyperactivity disorder, oppositional defiant or conduct disorder, and pervasive developmental disorder were diagnosed according to DSM-IV criteria in 8253 participants at age 8years. IQ was assessed by WISC-III also at 8years. PEs, depressive and anxiety symptoms were assessed at 13years. Logistic regression calculated odds ratio (OR) for PEs at 13years associated with psychiatric disorders at 8years. Linear regression calculated mean difference in IQ between groups with and without psychiatric disorder. Mediating effects of IQ, mood and anxiety symptoms on the psychiatric disorder-PEs relationship were examined. RESULTS In total, 599 children were assessed to have a DSM-IV psychiatric disorder at 8years (7.2%). These children compared with those without any psychiatric disorder performed worse on all measures of IQ; adjusted mean difference in total IQ -6.17 (95% CI, -7.86, -4.48). Childhood psychiatric disorders were associated with PEs subsequently in adolescence; adjusted OR 1.96 (95% CI, 1.47-2.68). The association between psychiatric disorder and subsequent PEs was partly mediated by, independently, IQ deficit at 8years and depressive and anxiety symptoms at 13years. CONCLUSIONS The findings indicate that adolescent PEs are associated with general cognitive ability and past and present psychopathological factors.
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Affiliation(s)
| | - Golam M. Khandaker
- Department of Psychiatry, University of Cambridge, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK,Corresponding author at: Department of Psychiatry, Box 189, Cambridge Biomedical Campus, Cambridge CB2 2QQ, UK.Department of PsychiatryCambridge Biomedical CampusBox 189CambridgeCB2 2QQUK
| | - Stanley Zammit
- Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, UK,Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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27
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McGrath JJ, Saha S, Al-Hamzawi AO, Alonso J, Andrade L, Borges G, Bromet EJ, Oakley Browne M, Bruffaerts R, Caldas de Almeida JM, Fayyad J, Florescu S, de Girolamo G, Gureje O, Hu C, de Jonge P, Kovess-Masfety V, Lepine JP, Lim CCW, Navarro-Mateu F, Piazza M, Sampson N, Posada-Villa J, Kendler KS, Kessler RC. Age of Onset and Lifetime Projected Risk of Psychotic Experiences: Cross-National Data From the World Mental Health Survey. Schizophr Bull 2016; 42:933-41. [PMID: 27038468 PMCID: PMC4903064 DOI: 10.1093/schbul/sbw011] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Given the early age of onset (AOO) of psychotic disorders, it has been assumed that psychotic experiences (PEs) would have a similar early AOO. The aims of this study were to describe (a) the AOO distribution of PEs, (b) the projected lifetime risk of PEs, and (c) the associations of PE AOO with selected PE features. METHODS Data came from the WHO World Mental Health (WMH) surveys. A total of 31 261 adult respondents across 18 countries were assessed for lifetime prevalence of PE. Projected lifetime risk (at age 75 years) was estimated using a 2-part actuarial method. AOO distributions were described for the observed and projected estimates. We examined associations of AOO with PE type metric and annualized PE frequency. RESULTS Projected lifetime risk for PEs was 7.8% (SE = 0.3), slightly higher than lifetime prevalence (5.8%, SE = 0.2). The median (interquartile range; IQR) AOO based on projected lifetime estimates was 26 (17-41) years, indicating that PEs commence across a wide age range. The AOO distributions for PEs did not differ by sex. Early AOO was positively associated with number of PE types (F = 14.1, P < .001) but negatively associated with annualized PE frequency rates (F = 8.0, P < .001). DISCUSSION While most people with lifetime PEs have first onsets in adolescence or young adulthood, projected estimates indicate that nearly a quarter of first onsets occur after age 40 years. The extent to which late onset PEs are associated with (a) late onset mental disorders or (b) declining cognitive and/or sensory function need further research.
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Affiliation(s)
- John J. McGrath
- *To whom correspondence should be addressed; Queensland Brain Institute, The University of Queensland, St Lucia, Queensland 4076, Australia; tel: 61-7-3271-8694, fax: 61-7-3271-8698, e-mail:
| | | | - Ali O. Al-Hamzawi
- Department of Psychiatry, College of Medicine, Qadisia University, Diwania Province, Iraq
| | - Jordi Alonso
- IMIM-Hospital del Mar Medical Research Institute, Parc de Salut Mar, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Laura Andrade
- Department/Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Guilherme Borges
- National Institute of Psychiatry, Mexico City, Mexico and Metropolitan Autonomous University, Mexico City, Mexico
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | | | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum—Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuvan, Belgium
| | - Jose M. Caldas de Almeida
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - John Fayyad
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Giovanni de Girolamo
- IRCCS St John of God Clinical Research Centre/IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Chiyi Hu
- Shenzhen Institute of Mental Health & Shenzhen Kanging Hospital, Shenzhen, China
| | - Peter de Jonge
- Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), Paris Descartes University, Paris, France
| | - Jean Pierre Lepine
- Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, University Paris Diderot and Paris Descartes Paris, Paris, France
| | - Carmen C. W. Lim
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Fernando Navarro-Mateu
- IMIB-Arrixaca, CIBERESP-Murcia, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar (Murcia), Murcia, Spain
| | - Maria Piazza
- National Institute of Health, Peru, Universidad Cayetano Hereidia, Lima, Peru
| | - Nancy Sampson
- Department of Health Care Policy, Harvard University, Boston, MA
| | | | - Kenneth S. Kendler
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
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Cederlöf M, Pettersson E, Sariaslan A, Larsson H, Östberg P, Kelleher I, Långström N, Gumpert CH, Lundström S, Lichtenstein P. The association between childhood autistic traits and adolescent psychotic experiences is explained by general neuropsychiatric problems. Am J Med Genet B Neuropsychiatr Genet 2016; 171B:153-9. [PMID: 26464122 DOI: 10.1002/ajmg.b.32386] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/25/2015] [Indexed: 11/10/2022]
Abstract
Studies suggest associations between childhood autistic traits and adolescent psychotic experiences. However, recent research suggests that a general neuropsychiatric problems factor predicts adverse outcomes better than specific diagnostic entities. To examine if the alleged association between autistic traits and psychotic experiences could rather be explained by a general neuropsychiatric problems factor comprising symptoms of ADHD, tic disorder, developmental coordination disorder, and learning disorder, we conducted a prospective cohort study based on the Child and Adolescent Twin Study in Sweden. In addition, we examined the genetic and environmental influences on the associations. A total of 9,282 twins with data on childhood autistic traits and other neuropsychiatric problems, and follow-up data on psychotic experiences at ages 15 and/or 18 years were included. First, psychotic experiences were regressed on autistic traits and second, the general neuropsychiatric problems factor was added to the model. Auditory hallucinations were analyzed separately from the other psychotic experiences. Finally, twin analyses were employed to disentangle genetic from environmental influences in the observed associations. Replicating prior research, significant associations were found between autistic traits in childhood and auditory hallucinations at ages 15 and 18. However, after controlling for the general neuropsychiatric problems factor, the associations between autistic traits and auditory hallucinations disappeared, whereas the association between the general neuropsychiatric problems factor and auditory hallucinations persisted after controlling for autistic traits. Twin analyses revealed that the association between the general neuropsychiatric problems factor and auditory hallucinations was driven by shared genetic influences. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Martin Cederlöf
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amir Sariaslan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Per Östberg
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Niklas Långström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Swedish Prison and Probation Service, R&D unit, Stockholm, Sweden
| | - Clara Hellner Gumpert
- Centre for Psychiatry Research & Education, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm County Council, Stockholm, Sweden
| | - Sebastian Lundström
- Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Stockholm, Sweden.,Gillberg Neuropsychiatry Centre, University of Gothenburg, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Clemmensen L, van Os J, Drukker M, Munkholm A, Rimvall MK, Væver M, Rask CU, Bartels-Velthuis AA, Skovgaard AM, Jeppesen P. Psychotic experiences and hyper-theory-of-mind in preadolescence--a birth cohort study. Psychol Med 2016; 46:87-101. [PMID: 26347066 DOI: 10.1017/s0033291715001567] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Knowledge on the risk mechanisms of psychotic experiences (PE) is still limited. The aim of this population-based study was to explore developmental markers of PE with a particular focus on the specificity of hyper-theory-of-mind (HyperToM) as correlate of PE as opposed to correlate of any mental disorder. METHOD We assessed 1630 children from the Copenhagen Child Cohort 2000 regarding PE and HyperToM at the follow-up at 11-12 years. Mental disorders were diagnosed by clinical ratings based on standardized parent-, teacher- and self-reported psychopathology. Logistic regression analyses were performed to test the correlates of PE and HyperToM, and the specificity of correlates of PE v. correlates of any Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) mental disorder. RESULTS Univariate analyses showed the following correlates of PE: familial psychiatric liability; parental mental illness during early child development; change in family composition; low family income; regulatory problems in infancy; onset of puberty; bullying; concurrent mental disorder; and HyperToM. When estimating the adjusted effects, only low family income, concurrent mental disorder, bullying and HyperToM remained significantly associated with PE. Further analyses of the specificity of these correlates with regard to outcome revealed that HyperToM was the only variable specifically associated with PE without concurrent mental disorder. Finally, HyperToM did not share any of the investigated precursors with PE. CONCLUSIONS HyperToM may have a specific role in the risk trajectories of PE, being specifically associated with PE in preadolescent children, independently of other family and child risk factors associated with PE and overall psychopathology at this age.
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Affiliation(s)
- L Clemmensen
- Child and Adolescent Mental Health Center,Mental Health Services,the Capital Region of Denmark,Denmark
| | - J van Os
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - M Drukker
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - A Munkholm
- Child and Adolescent Mental Health Center,Mental Health Services,the Capital Region of Denmark,Denmark
| | - M K Rimvall
- Child and Adolescent Mental Health Center,Mental Health Services,the Capital Region of Denmark,Denmark
| | - M Væver
- Department of Psychology,University of Copenhagen,Copenhagen,Denmark
| | - C U Rask
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital,Aarhus,Denmark
| | - A A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry,Groningen,The Netherlands
| | - A M Skovgaard
- Department of Public Health,University of Copenhagen,Copenhagen,Denmark
| | - P Jeppesen
- Child and Adolescent Mental Health Center,Mental Health Services,the Capital Region of Denmark,Denmark
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30
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Klaiman C, Fernandez-Carriba S, Hall C, Saulnier C. Assessment of Autism Across the Lifespan: A Way Forward. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2014. [DOI: 10.1007/s40474-014-0031-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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A critical review and meta-analysis of the perceptual pseudoneglect across psychiatric disorders: Is there a continuum? Cogn Process 2014; 16:17-25. [DOI: 10.1007/s10339-014-0640-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 10/27/2014] [Indexed: 12/11/2022]
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32
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Khandaker GM, Stochl J, Zammit S, Lewis G, Jones PB. Childhood Epstein-Barr Virus infection and subsequent risk of psychotic experiences in adolescence: a population-based prospective serological study. Schizophr Res 2014; 158:19-24. [PMID: 25048425 PMCID: PMC4561501 DOI: 10.1016/j.schres.2014.05.019] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/25/2014] [Accepted: 05/15/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Several studies suggest a link between early-life infection and adult schizophrenia. Cross-sectional studies have reported: (1) increased prevalence of Epstein-Barr Virus (EBV), a member of the Herpesviridae family in schizophrenia; (2) a possible role of Herpes simplex virus in cognitive dysfunction in schizophrenia and healthy controls. We report a longitudinal serological study of early-life EBV infection, childhood IQ, and subsequent risk of psychotic experiences (PE) in adolescence. METHODS Serum antibodies to EBV (anti-VCA IgG) were measured in 530 participants from the ALSPAC cohort at age 4 years. Assessments for IQ at age 9 and PE at age 13 were attended by 401 and 366 of these individuals, respectively. Logistic regression calculated odds ratio (OR) for PE in EBV-exposed, compared with unexposed group. Mean IQ scores were compared between these groups; effect of IQ on the EBV-PE association was examined. Potential confounders included age, gender, ethnicity, social class, household crowding, and concurrent depression and anxiety. RESULTS About 25% of the sample was exposed to EBV at age 4. EBV exposure was associated with subsequent risk of definite PE in adolescence; OR 5.37 (95% CI 1.71-16.87), which remained significant after confounding adjustment. EBV-exposed individuals compared with unexposed performed worse on all IQ measures; mean difference in full-scale IQ 4.15 (95% CI 0.44-7.87); however, this was explained by socio-demographic differences. The EBV-PE association was not explained by IQ. CONCLUSIONS Early-life exposure to EBV is associated with PE in adolescence, consistent with a role of infection/immune dysfunction in the aetiology of psychosis.
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Affiliation(s)
- Golam M Khandaker
- Department of Psychiatry, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, UK.
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Stanley Zammit
- Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, UK; Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK
| | - Glyn Lewis
- Centre for Mental Health, Addiction and Suicide Research, School of Social and Community Medicine, University of Bristol, UK; Division of Psychiatry, University College London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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