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Sapienza J, Martini F, Comai S, Cavallaro R, Spangaro M, De Gregorio D, Bosia M. Psychedelics and schizophrenia: a double-edged sword. Mol Psychiatry 2024:10.1038/s41380-024-02743-x. [PMID: 39294303 DOI: 10.1038/s41380-024-02743-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 08/29/2024] [Accepted: 09/02/2024] [Indexed: 09/20/2024]
Abstract
Psychedelics have shown promising effects in several psychiatric diseases as demonstrated by multiple clinical trials. However, no clinical experiments on patients with schizophrenia have been conducted up to date, except for some old semi-anecdotal studies mainly performed in the time-span '50s-'60s. Notably, these studies reported interesting findings, particularly on the improvement of negative symptoms and social cognition. With no doubts the lack of modern clinical studies is due to the psychomimetic properties of psychedelics, a noteworthy downside that could worsen positive symptoms. However, a rapidly increasing body of evidence has suggested that the mechanisms of action of such compounds partially overlaps with the pathogenic underpinnings of schizophrenia but in an opposite way. These findings suggest that, despite being a controversial issue, the use of psychedelics in the treatment of schizophrenia would be based on a strong biological rationale. Therefore, the aim of our perspective paper is to provide a background on the old experiments with psychedelics performed on patients with schizophrenia, interpreting them in the light of recent molecular findings on their ability to induce neuroplasticity and modulate connectivity, the immune and TAARs systems, neurotransmitters, and neurotropic factors. No systematic approach was adopted in reviewing the evidence given the difficulty to retrieve and interpret old findings. Interestingly, we identified a therapeutic potential of psychedelics in schizophrenia adopting a critical point of view, particularly on negative symptoms and social cognition, and we summarized all the relevant findings. We also identified an eligible subpopulation of chronic patients predominantly burdened by negative symptoms, outlining possible therapeutic strategies which encompass very low doses of psychedelics (microdosing), carefully considering safety and feasibility, to pave the way to future clinical trials.
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Affiliation(s)
- Jacopo Sapienza
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Humanities and Life Sciences, University School for Advanced Studies IUSS, Pavia, Italy
| | | | - Stefano Comai
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Roberto Cavallaro
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of medicine, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Danilo De Gregorio
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Bosia
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- School of medicine, Vita-Salute San Raffaele University, Milan, Italy
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Lucarini V, Grice M, Wehrle S, Cangemi F, Giustozzi F, Amorosi S, Rasmi F, Fascendini N, Magnani F, Marchesi C, Scoriels L, Vogeley K, Krebs MO, Tonna M. Language in interaction: turn-taking patterns in conversations involving individuals with schizophrenia. Psychiatry Res 2024; 339:116102. [PMID: 39089189 DOI: 10.1016/j.psychres.2024.116102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 05/15/2024] [Accepted: 07/23/2024] [Indexed: 08/03/2024]
Abstract
Individuals with schizophrenia generally show difficulties in interpersonal communication. Linguistic analyses shed new light on speech atypicalities in schizophrenia. However, very little is known about conversational interaction management by these individuals. Moreover, the relationship between linguistic features, psychopathology, and patients' subjectivity has received limited attention to date. We used a novel methodology to explore dyadic conversations involving 58 participants (29 individuals with schizophrenia and 29 control persons) and medical doctors. High-quality stereo recordings were obtained and used to quantify turn-taking patterns. We investigated psychopathological dimensions and subjective experiences using the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), the Examination of Anomalous Self Experience scale (EASE), the Autism Rating Scale (ARS) and the Abnormal Bodily Phenomena questionnaire (ABPq). Different turn-taking patterns of both patients and interviewers characterised conversations involving individuals with schizophrenia. We observed higher levels of overlap and mutual silence in dialogues with the patients compared to dialogues with control persons. Mutual silence was associated with negative symptom severity; no dialogical feature was correlated with anomalous subjective experiences. Our findings suggest that individuals with schizophrenia display peculiar turn-taking behaviour, thereby enhancing our understanding of interactional coordination in schizophrenia.
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Affiliation(s)
- Valeria Lucarini
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team: Pathophysiology of psychiatric disorders: development and vulnerability, Paris 75014, France; GHU Paris Psychiatrie et Neurosciences, CJAAD, Evaluation, Prevention and Therapeutic Innovation Department, Hôpital Sainte Anne, Paris 75014, France; CNRS GDR 3557-Institut de Psychiatrie, France.
| | - Martine Grice
- IfL-Phonetics, University of Cologne, Cologne, Germany
| | - Simon Wehrle
- IfL-Phonetics, University of Cologne, Cologne, Germany
| | | | - Francesca Giustozzi
- Psychiatric Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Stefano Amorosi
- Psychiatric Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesco Rasmi
- Psychiatric Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nikolas Fascendini
- Psychiatric Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Magnani
- Psychiatric Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Carlo Marchesi
- Psychiatric Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Mental Health, Local Health Service, Parma, Italy
| | - Linda Scoriels
- GHU Paris Psychiatrie et Neurosciences, CJAAD, Evaluation, Prevention and Therapeutic Innovation Department, Hôpital Sainte Anne, Paris 75014, France
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany; Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Marie-Odile Krebs
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team: Pathophysiology of psychiatric disorders: development and vulnerability, Paris 75014, France; GHU Paris Psychiatrie et Neurosciences, CJAAD, Evaluation, Prevention and Therapeutic Innovation Department, Hôpital Sainte Anne, Paris 75014, France; CNRS GDR 3557-Institut de Psychiatrie, France
| | - Matteo Tonna
- Psychiatric Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Mental Health, Local Health Service, Parma, Italy
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Tonna M. The Evolution of Symbolic Thought: At the Intersection of Schizophrenia Psychopathology, Ethnoarchaeology, and Neuroscience. Cult Med Psychiatry 2024:10.1007/s11013-024-09873-5. [PMID: 38995487 DOI: 10.1007/s11013-024-09873-5] [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] [Accepted: 06/29/2024] [Indexed: 07/13/2024]
Abstract
The human capacity for symbolic representation arises, evolutionarily and developmentally, from the exploitation of a widespread sensorimotor network, along a fundamental continuity between embodied and symbolic modes of experience. In this regard, the fine balancing between constrained sensorimotor connections (responsible for self-embodiment processing) and more untethered neural associations (responsible for abstract and symbolic processing) is context dependent and plastically neuromodulated, thus intersubjectively constructed within a specific socio-cultural milieu. Instead, in the schizophrenia spectrum this system falls off catastrophically, due to an unbalance toward too unconstrained sensorimotor connectivity, leading to a profound distortion of self/world relation with a symbolic activity detached from its embodied ground. For this very reason, however, schizophrenia psychopathology may contribute to unveil, in a distorted or magnified way, ubiquitous structural features of human symbolic activity, beneath the various, historically determined cultural systems. In this respect, a comparative approach, linking psychopathology and ethnoarchaeology, allows highlight the following invariant formal characteristics of symbolic processing: (1) Emergence of salient perceptive fragments, which stand out from the perceptual field. (2) Spreading of a multiplicity of new significances with suspension of common-sense meaning. (3) Dynamic and passive character through which meaning proliferation is experienced. This study emphasizes the importance of fine-grained psychopathology to elucidate, within a cross-disciplinary framework, the evolutionarily and developmental pathways that shape the basic structures of human symbolization.
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Affiliation(s)
- Matteo Tonna
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Ospedale Maggiore, Padiglione Braga, Viale A. Gramsci 14, 43126, Parma, Italy.
- Department of Mental Health, Local Health Service, Parma, Italy.
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Ballerini M, Magnani F, Amorosi S, Dell'Anna C, Borrelli DF, Marchesi C, Lucarini V, Castellini G, Tonna M. Anomalous Self-Experiences are predictive of social dysfunction in people with schizophrenia. Schizophr Res 2024; 266:116-117. [PMID: 38401409 DOI: 10.1016/j.schres.2024.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/21/2023] [Accepted: 02/17/2024] [Indexed: 02/26/2024]
Affiliation(s)
| | - Francesca Magnani
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
| | - Stefano Amorosi
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
| | - Caterina Dell'Anna
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
| | | | - Carlo Marchesi
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy; Department of Mental Health, Local Health Service, Parma, Italy
| | - Valeria Lucarini
- Institute of Psychiatry and Neuroscience of Paris (IPNP), Université Paris Cité, Paris, France
| | | | - Matteo Tonna
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy; Department of Mental Health, Local Health Service, Parma, Italy.
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