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Poulou A, Anagnostopoulos F, Vatakis A, Mellon RC, Mueller DR. The implementation and effectiveness of Integrated Psychological Therapy (IPT) in chronic middle-aged inpatients with schizophrenia. Schizophr Res Cogn 2025; 39:100330. [PMID: 39355202 PMCID: PMC11439836 DOI: 10.1016/j.scog.2024.100330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 09/09/2024] [Indexed: 10/03/2024]
Abstract
Introduction Cognitive rehabilitation is essential for schizophrenia treatment since it improves function. Moreover, the relationship between cognitive rehabilitation and functioning is significantly affected by negative symptoms and social cognition. Integrated Psychological Therapy (IPT) is a promising approach that integrates interventions in neurocognition, social cognition, and functional level. This study examines IPT's efficacy in chronic middle-aged inpatients. Methods A randomized controlled study involved 44 individuals with schizophrenia. Twenty-one IPT participants received 50 biweekly sessions and medication, while twenty-three control participants received treatment as usual/supportive therapy and pharmacotherapy. Pre- and post-intervention and six- and twelve-month follow-ups were arranged to assess neurocognition, social perception, psychopathology, and functioning using the Matrics Consensus Cognitive Battery, Social Perception Scale, Positive and Negative Syndrome Scale, and Global Assessment of Functioning. Results Speed of processing, attention/vigilance, overall composite, and neurocognitive composite scores improved significantly in the IPT group. Social Perception Scale performance improved in all areas after the intervention and persisted for 6 months. Positive, negative, and total psychopathology symptoms decreased significantly post-intervention and at the 12-month follow-up, whereas participants' functioning improved significantly. Conclusions Middle-aged chronic inpatients with schizophrenia may benefit from IPT in neurocognition, social perception, psychopathology, and functioning. This field of study may provide insight into schizophrenia treatment, hence further research is encouraged.
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Affiliation(s)
- Aikaterini Poulou
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Fotios Anagnostopoulos
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Argiro Vatakis
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Robert C Mellon
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Daniel R Mueller
- University Clinic of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychology, Faculty of Humanities, University of Fribourg, Fribourg, Switzerland
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Zhang T, Wei Y, Tang X, Cui H, Hu Y, Xu L, Liu H, Wang Z, Chen T, Hu Q, Li C, Wang J. Cognitive Impairments in Drug-Naive Patients With First-Episode Negative Symptom-Dominant Psychosis. JAMA Netw Open 2024; 7:e2415110. [PMID: 38842809 PMCID: PMC11157355 DOI: 10.1001/jamanetworkopen.2024.15110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 04/04/2024] [Indexed: 06/07/2024] Open
Abstract
Importance Available antipsychotic medications are predominantly used to treat positive symptoms, such as hallucinations and delusions, in patients with first-episode psychosis (FEP). However, treating negative and cognitive symptoms, which are closely related to functional outcomes, remains a challenge. Objective To explore the cognitive characteristics of patients with negative symptom-dominant (NSD) psychosis. Design, Setting, and Participants This large-scale cross-sectional study of patients with FEP was led by the Shanghai Mental Health Center in China from 2016 to 2021, with participants recruited from 10 psychiatric tertiary hospitals. A comprehensive cognitive assessment was performed among 788 patients with FEP who were drug-naive. Symptom profiles were determined using the Positive and Negative Symptoms Scale (PANSS), and NSD was defined as a PANSS score for negative symptoms higher than that for positive and general symptoms. Positive symptom-dominant (PSD) and general symptom-dominant (GSD) psychosis were defined similarly. Data were analyzed in 2023. Exposure Psychotic symptoms were categorized into 3 groups: NSD, PSD, and GSD. Main Outcomes and Measures Neurocognitive performance, assessed using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. Results This study included 788 individuals with FEP (median age, 22 [IQR, 17-28] years; 399 men [50.6%]). Patients with NSD exhibited more-pronounced cognitive impairment than did those with PSD or GSD. Specifically, cognitive differences between the NSD and PSD group, as well as between the NSD and GSD group, were most notable in the processing speed and attention domains (Trail Making [F = 4.410; P = .01], Symbol Coding [F = 4.957; P = .007], Verbal Learning [F = 3.198; P = .04], and Continuous Performance [F = 3.057; P = .05]). Patients with PSD and GSD showed no significant cognitive differences. Cognitive impairment was positively associated with the severity of negative symptoms. Most of the cognitive function tests used were able to differentiate patients with NSD from those with PSD and GSD, with significant differences observed across a range of tests, from Brief Visuospatial Memory Test-Revised (χ2 = 3.968; P = .05) to Brief Assessment of Cognition in Schizophrenia symbol coding (χ2 = 9.765; P = .002). Conclusions and Relevance The findings of this cross-sectional study of patients with FEP suggest the presence of a clinical subtype characterized by a predominance of negative symptoms and cognitive impairment.
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Affiliation(s)
- TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - YanYan Wei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - XiaoChen Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - HuiRu Cui
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - YeGang Hu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - LiHua Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, PR China
| | - ZiXuan Wang
- Shanghai Xinlianxin Psychological Counseling Center, Shanghai, PR China
| | - Tao Chen
- Big Data Research Lab, University of Waterloo, Waterloo, Ontario, Canada
- Labor and Worklife Program, Harvard University, Cambridge, Massachusetts
| | - Qiang Hu
- Department of Psychiatry, ZhenJiang Mental Health Center, Zhenjiang, PR China
| | - ChunBo Li
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China
- Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, PR China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China
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Thibaudeau E, Rae J, Raucher-Chéné D, Bougeard A, Lepage M. Disentangling the Relationships Between the Clinical Symptoms of Schizophrenia Spectrum Disorders and Theory of Mind: A Meta-analysis. Schizophr Bull 2023; 49:255-274. [PMID: 36244001 PMCID: PMC10016420 DOI: 10.1093/schbul/sbac150] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND HYPOTHESIS Previous studies have suggested links between clinical symptoms and theory of mind (ToM) impairments in schizophrenia spectrum disorders (SSD), but it remains unclear whether some symptoms are more strongly linked to ToM than others. STUDY DESIGN A meta-analysis (Prospero; CRD42021259723) was conducted to quantify and compare the strength of the associations between ToM and the clinical symptoms of SSD (Positive, Negative, Cognitive/Disorganization, Depression/Anxiety, Excitability/Hostility). Studies (N = 130, 137 samples) including people with SSD and reporting a correlation between clinical symptoms and ToM were retrieved from Pubmed, PsycNet, Embase, Cochrane Library, Science Direct, Proquest, WorldCat, and Open Gray. Correlations for each dimension and each symptom were entered into a random-effect model using a Fisher's r-to-z transformation and were compared using focused-tests. Publication bias was assessed with the Rosenthal failsafe and by inspecting the funnel plot and the standardized residual histogram. STUDY RESULTS The Cognitive/Disorganization (Zr = 0.28) and Negative (Zr = 0.24) dimensions revealed a small to moderate association with ToM, which was significantly stronger than the other dimensions. Within the Cognitive/Disorganization dimension, Difficulty in abstract thinking (Zr = 0.36) and Conceptual disorganization (Zr = 0.39) showed the strongest associations with ToM. The association with the Positive dimension (Zr = 0.16) was small and significantly stronger than the relationship with Depression/Anxiety (Zr = 0.09). Stronger associations were observed between ToM and clinical symptoms in younger patients, those with an earlier age at onset of illness and for tasks assessing a combination of different mental states. CONCLUSIONS The relationships between Cognitive/Disorganization, Negative symptoms, and ToM should be considered in treating individuals with SSD.
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Affiliation(s)
- Elisabeth Thibaudeau
- McGill University, Department of Psychiatry, Montreal, Canada
- Douglas Research Centre, Montreal, Canada
| | - Jesse Rae
- Douglas Research Centre, Montreal, Canada
- McGill University, Department of Psychology, Montreal, Canada
| | - Delphine Raucher-Chéné
- McGill University, Department of Psychiatry, Montreal, Canada
- Douglas Research Centre, Montreal, Canada
- Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France
- Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
| | | | - Martin Lepage
- McGill University, Department of Psychiatry, Montreal, Canada
- Douglas Research Centre, Montreal, Canada
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Sahl AC, Rognlien HF, Andreassen OA, Melle I, Ueland T, Vaskinn A. Theory of mind in schizophrenia: a comparison of subgroups with low and high IQ. Nord J Psychiatry 2022; 77:329-335. [PMID: 35916656 DOI: 10.1080/08039488.2022.2106512] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND Social cognitive impairment is common in schizophrenia, but it is unclear if it is present in individuals with high IQ. This study compared theory of mind (ToM) in schizophrenia participants with low or high IQ to healthy controls. METHODS One hundred and nineteen participants (71 healthy controls, 17 high IQ (IQ ≥115), and 31 low IQ (IQ ≤95) schizophrenia participants) were assessed with the Movie for the Assessment of Social Cognition, providing scores for total, cognitive, and affective ToM, along with overmentalizing, undermentalizing, and no-mentalizing errors. IQ was measured with Wechsler Abbreviated Scale of Intelligence; clinical symptoms with the Positive and Negative Syndrome Scale. RESULTS Healthy controls performed better than the low IQ schizophrenia group for all ToM scores, and better than the high IQ schizophrenia group for the total score and under- and no-mentalizing errors. The high IQ group made fewer overmentalizing errors and had better total and cognitive ToM than the low IQ group. Their number of overmentalizing errors was indistinguishable from healthy controls. CONCLUSION Global ToM impairment was present in the low IQ schizophrenia group. Overmentalizing was not present in the high IQ group and appears related to lower IQ. Intact higher-level reasoning may prevent the high IQ group from making overmentalizing errors, through self-monitoring or inhibition. We propose that high IQ patients are chiefly impaired in lower-level ToM, whereas low IQ patients also have impaired higher-level ToM. Conceivably, this specific impairment could help explain the lower functioning reported in persons with intact IQ.
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Affiliation(s)
- André C Sahl
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Henning F Rognlien
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torill Ueland
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
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5
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Zierhut M, Böge K, Bergmann N, Hahne I, Braun A, Kraft J, Ta TMT, Ripke S, Bajbouj M, Hahn E. The Relationship Between the Recognition of Basic Emotions and Negative Symptoms in Individuals With Schizophrenia Spectrum Disorders - An Exploratory Study. Front Psychiatry 2022; 13:865226. [PMID: 35573376 PMCID: PMC9091587 DOI: 10.3389/fpsyt.2022.865226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Current research suggests that emotion recognition is impaired in individuals affected by schizophrenia spectrum disorders (SSD). However, the specific impact of negative symptoms on the ability to recognize single basic emotions has not yet been explored sufficiently and is the aim of the present study. A sample of N = 66 individuals diagnosed with SSD was recruited at the Charité - Universitätsmedizin Berlin. In a first step, correlation analyses were conducted between seven different negative symptom subdomains of the Positive and Negative Syndrome Scale (PANSS) and the accuracy and latency in recognizing the six basic emotions (anger, disgust, fear, happiness, sadness, surprise) using the Emotion Recognition Task (ERT) of the Cambridge Neuropsychological Test Automated Battery (CANTAB). The significant correlations were subjected to linear regression models that controlled for the significant covariates diagnoses, age, sex, and education. Results revealed that in individuals with SSD the negative symptom domain of blunted affect significantly predicted the accuracy of emotion recognition performance (p < 0.05), particularly, when recognizing happiness (p < 0.05). Additionally, we found that stereotyped thinking also predicted the performance of emotion recognition, especially the response latency (p < 0.05) and difficulty in abstract thinking predicted the recognition of fear (p < 0.05). However, the nominal significances did not withstand correction for multiple tests and therefore need to be followed up in further studies with a larger sample.
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Affiliation(s)
- Marco Zierhut
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,BIH Charitè Junior Clinician Scientist Program, BIH Biomedical Innovation Academy, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Alice Braun
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Julia Kraft
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
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6
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Raucher-Chéné D, Thibaudeau E, Sauvé G, Lavigne KM, Lepage M. Understanding others as a mediator between verbal memory and negative symptoms in schizophrenia-spectrum disorder. J Psychiatr Res 2021; 143:429-435. [PMID: 34656875 DOI: 10.1016/j.jpsychires.2021.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/05/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022]
Abstract
From the onset of schizophrenia, verbal memory (VM) deficits and negative symptoms are strongly associated, and both additively predict functional outcomes. Emotion recognition (ER) and theory of mind (ToM; the ability to infer others' mental states), two components of social cognition, are also particularly affected in schizophrenia. Explanatory models of negative symptoms have integrated these cognitive impairments as potential precursors and previous studies revealed relationships between ER and/or ToM and VM, as well as with negative symptoms, but the organization of these associations remains unclear. We aimed to determine whether impairments in VM and social cognition sequentially pave the way for negative symptoms in schizophrenia. To this end, we used mediation analyses. One hundred and forty participants with a diagnosis of schizophrenia or schizoaffective disorder were recruited. First, correlational analyses were conducted between our variables of interest. The mediating effect of social cognition between VM and negative symptoms was then examined using the PROCESS macro. Variables of interest were significantly correlated (r = |0.166| to |0.391|), except for ER and negative symptoms. Only the serial multiple mediation model with 2 mediators (ER followed by ToM) revealed a significant indirect effect of VM on negative symptoms (β = - 0.160, 95% CI = -.370 to -.004). This relationship was selective for expressive negative symptoms (e.g., blunted affect and alogia). This study illustrates the richness of the relationship between cognitive deficits and negative symptoms and provides additional information for the involvement of social cognition in negative symptoms' etiology.
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Affiliation(s)
- Delphine Raucher-Chéné
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
| | - Elisabeth Thibaudeau
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada
| | - Geneviève Sauvé
- Douglas Mental Health University Institute, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada
| | - Katie M Lavigne
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
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7
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Pelin H, Ising M, Stein F, Meinert S, Meller T, Brosch K, Winter NR, Krug A, Leenings R, Lemke H, Nenadić I, Heilmann-Heimbach S, Forstner AJ, Nöthen MM, Opel N, Repple J, Pfarr J, Ringwald K, Schmitt S, Thiel K, Waltemate L, Winter A, Streit F, Witt S, Rietschel M, Dannlowski U, Kircher T, Hahn T, Müller-Myhsok B, Andlauer TFM. Identification of transdiagnostic psychiatric disorder subtypes using unsupervised learning. Neuropsychopharmacology 2021; 46:1895-1905. [PMID: 34127797 PMCID: PMC8429672 DOI: 10.1038/s41386-021-01051-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 02/07/2023]
Abstract
Psychiatric disorders show heterogeneous symptoms and trajectories, with current nosology not accurately reflecting their molecular etiology and the variability and symptomatic overlap within and between diagnostic classes. This heterogeneity impedes timely and targeted treatment. Our study aimed to identify psychiatric patient clusters that share clinical and genetic features and may profit from similar therapies. We used high-dimensional data clustering on deep clinical data to identify transdiagnostic groups in a discovery sample (N = 1250) of healthy controls and patients diagnosed with depression, bipolar disorder, schizophrenia, schizoaffective disorder, and other psychiatric disorders. We observed five diagnostically mixed clusters and ordered them based on severity. The least impaired cluster 0, containing most healthy controls, showed general well-being. Clusters 1-3 differed predominantly regarding levels of maltreatment, depression, daily functioning, and parental bonding. Cluster 4 contained most patients diagnosed with psychotic disorders and exhibited the highest severity in many dimensions, including medication load. Depressed patients were present in all clusters, indicating that we captured different disease stages or subtypes. We replicated all but the smallest cluster 1 in an independent sample (N = 622). Next, we analyzed genetic differences between clusters using polygenic scores (PGS) and the psychiatric family history. These genetic variables differed mainly between clusters 0 and 4 (prediction area under the receiver operating characteristic curve (AUC) = 81%; significant PGS: cross-disorder psychiatric risk, schizophrenia, and educational attainment). Our results confirm that psychiatric disorders consist of heterogeneous subtypes sharing molecular factors and symptoms. The identification of transdiagnostic clusters advances our understanding of the heterogeneity of psychiatric disorders and may support the development of personalized treatments.
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Affiliation(s)
- Helena Pelin
- Max Planck Institute of Psychiatry, Munich, Germany.
- International Max Planck Research School for Translational Psychiatry, Munich, Germany.
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Nils R Winter
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Ramona Leenings
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Hannah Lemke
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Julia Pfarr
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
| | - Kai Ringwald
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Lena Waltemate
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Alexandra Winter
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Fabian Streit
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephanie Witt
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marcella Rietschel
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Marburg, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Bertram Müller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Till F M Andlauer
- Max Planck Institute of Psychiatry, Munich, Germany.
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Global Computational Biology and Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Germany.
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8
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The Relationship between Negative Symptoms and Both Emotion Management and Non-social Cognition in Schizophrenia Spectrum Disorders. J Int Neuropsychol Soc 2021; 27:916-928. [PMID: 33342446 DOI: 10.1017/s1355617720001290] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE There is ongoing debate regarding the relationship between clinical symptoms and cognition in schizophrenia spectrum disorders (SSD). The present study aimed to explore the potential relationships between symptoms, with an emphasis on negative symptoms, and social and non-social cognition. METHOD Hierarchical cluster analysis with k-means optimisation was conducted to characterise clinical subgroups using the Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms in n = 130 SSD participants. Emergent clusters were compared on the MATRICS Consensus Cognitive Battery, which measures non-social cognition and emotion management as well as demographic and clinical variables. Spearman's correlations were then used to investigate potential relationships between specific negative symptoms and emotion management and non-social cognition. RESULTS Four distinct clinical subgroups were identified: 1. high hallucinations, 2. mixed symptoms, 3. high negative symptoms, and 4. relatively asymptomatic. The high negative symptom subgroup was found to have significantly poorer emotion management than the high hallucination and relatively asymptomatic subgroups. No further differences between subgroups were observed. Correlation analyses revealed avolition-apathy and anhedonia-asociality were negatively correlated with emotion management, but not non-social cognition. Affective flattening and alogia were not associated with either emotion management or non-social cognition. CONCLUSIONS The present study identified associations between negative symptoms and emotion management within social cognition, but no domains of non-social cognition. This relationship may be specific to motivation, anhedonia and apathy, but not expressive deficits. This suggests that targeted interventions for social cognition may also result in parallel improvement in some specific negative symptoms.
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Wójciak P, Domowicz K, Andrzejewska M, Rybakowski JK. Negative symptoms in schizophrenia, assessed by the brief negative symptom scale, self-evaluation of negative symptom scale, and social cognition: a gender effect. Int J Psychiatry Clin Pract 2021; 25:252-257. [PMID: 32862741 DOI: 10.1080/13651501.2020.1810278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Negative symptoms of schizophrenia can be related to social cognition. The aim was to measure a relationship between the results on the new scales for the assessment of negative symptoms such as the Brief Negative Symptom Scale (BNSS) and Self-evaluation of Negative Symptoms (SNS), and the measures of social cognition. METHODS The study included 80 patients (40 men, 40 women) with schizophrenia, aged 19-63 (mean 38 years), during the improvement period. They were assessed using the BNSS, SNS, Personal and Social Performance (PSP) scales, and the tests for social cognition such as the Facial Emotion Identification Test, Reading the Mind in Eyes Test, Strange Stories and Faux Pas Test. RESULTS Male patients obtained higher scores than females when assessed by the BNSS. No gender differences were observed for the SNS scale. Female patients scored better in the PSP and both parts of the Faux Pas test and obtained a significant correlation between the results of the SNS scale, BNSS, PSP, and the affective part of the Faux-Pas test what was not the case in males. CONCLUSIONS Gender differences were found in the assessment of negative symptoms by a clinical scale and the relationship between negative symptoms and social cognition.KEY POINTSFemale patients scored better in the BNSS, PSP and both parts of the Faux-Pas testGender differences were present in the assessment of negative symptoms by clinical (BNSS) but not the self-assessment (SNS) scale.Female patients obtained a significant correlation between the results of the SNS scale, BNSS, PSP, and the affective part of the Faux-Pas test what was not the case in male subjects.
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Affiliation(s)
- Paweł Wójciak
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Klaudia Domowicz
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Marta Andrzejewska
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.,Department of Psychiatric Nursing, Poznan University of Medical Sciences, Poznan, Poland
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10
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Jeganathan J, Breakspear M. An active inference perspective on the negative symptoms of schizophrenia. Lancet Psychiatry 2021; 8:732-738. [PMID: 33865502 DOI: 10.1016/s2215-0366(20)30527-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/03/2020] [Accepted: 11/23/2020] [Indexed: 10/21/2022]
Abstract
Predictive coding has played a transformative role in the study of psychosis, casting delusions and hallucinations as statistical inference in a system with abnormal precision. However, the negative symptoms of schizophrenia, such as affective blunting, avolition, and asociality, remain poorly understood. We propose a computational framework for emotional expression based on active inference-namely that affective behaviours such as smiling are driven by predictions about the social consequences of smiling. Similarly to how delusions and hallucinations can be explained by predictive uncertainty in sensory circuits, negative symptoms naturally arise from uncertainty in social prediction circuits. This perspective draws on computational principles to explain blunted facial expressiveness and apathy-anhedonia in schizophrenia. Its phenomenological consequences also shed light on the content of paranoid delusions and indistinctness of self-other boundaries. Close links are highlighted between social prediction, facial affect mirroring, and the fledgling study of interoception. Advances in automated analysis of facial expressions and acoustic speech patterns will allow empirical testing of these computational models of the negative symptoms of schizophrenia.
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Affiliation(s)
- Jayson Jeganathan
- School of Psychology, College of Engineering, Science, and the Environment, The University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia.
| | - Michael Breakspear
- School of Psychology, College of Engineering, Science, and the Environment, The University of Newcastle, Newcastle, NSW, Australia; School of Medicine and Public Health, College of Health and Medicine, The University of Newcastle, Newcastle, NSW, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
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11
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Have We Been Comparing Theory of Mind in High-Functioning Autism to Patients with Chronic Schizophrenia: a Systematic Review and Meta-Analysis. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00265-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Deng F, Phillips MR, Cai B, Yu G, Qian M, Grivel MM, Chen H, Ouyang X, Xue F, Zhao M, Kegeles LS, Susser ES, Keshavan MS, Stone WS, Yang LH. Comparison of social cognition using an adapted Chinese version of the Reading the Mind in the Eyes Test in drug-naive and regularly medicated individuals with chronic schizophrenia and healthy controls in rural China. Psychol Med 2021; 52:1-13. [PMID: 33722309 PMCID: PMC10352022 DOI: 10.1017/s003329172100043x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Social cognition has not previously been assessed in treatment-naive patients with chronic schizophrenia, in patients over 60 years of age, or in patients with less than 5 years of schooling. METHODS We revised a commonly used measure of social cognition, the Reading the Mind in the Eyes Test (RMET), by expanding the instructions, using both self-completion and interviewer-completion versions (for illiterate respondents), and classifying each test administration as 'successfully completed' or 'incomplete'. The revised instrument (RMET-CV-R) was administered to 233 treatment-naive patients with chronic schizophrenia (UT), 154 treated controls with chronic schizophrenia (TC), and 259 healthy controls (HC) from rural communities in China. RESULTS In bivariate and multivariate analyses, successful completion rates and RMET-CV-R scores (percent correct judgments about emotion exhibited in 70 presented slides) were highest in HC, intermediate in TC, and lowest in UT (adjusted completion rates, 97.0, 72.4, and 49.9%, respectively; adjusted RMET-CV-R scores, 45.4, 38.5, and 34.6%, respectively; all p < 0.02). Stratified analyses by the method of administration (self-completed v. interviewer-completed) and by education and age ('educated-younger' v. 'undereducated-older') show the same relationship between groups (i.e. NC>TC>UT), though not all differences remain statistically significant. CONCLUSIONS We find poorer social cognition in treatment-naive than in treated patients with chronic schizophrenia. The discriminant validity of RMET-CV-R in undereducated, older patients demonstrates the feasibility of administering revised versions of RMET to patients who may otherwise be considered ineligible due to education or age by changing the method of test administration and carefully assessing respondents' ability to complete the task successfully.
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Affiliation(s)
- Fei Deng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- University of Nottingham School of Economics (Ningbo, China), Zhejiang, China
| | - Michael R. Phillips
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
- New York State Psychiatric Institute, New York, New York
| | - Bing Cai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gary Yu
- New York University Rory Meyers College of Nursing, New York, New York
| | - Min Qian
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, New York
| | | | - Hanhui Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinyi Ouyang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Xue
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingru Zhao
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Lawrence S. Kegeles
- Department of Psychiatry, Columbia University, New York, New York
- New York State Psychiatric Institute, New York, New York
| | - Ezra S. Susser
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
- New York State Psychiatric Institute, New York, New York
| | - Matcheri S. Keshavan
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - William S. Stone
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Lawrence H. Yang
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
- New York University School of Global Public Health, New York, New York
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13
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Habtewold TD, Liemburg EJ, Islam MA, de Zwarte SMC, Boezen HM, Bruggeman R, Alizadeh BZ. Association of schizophrenia polygenic risk score with data-driven cognitive subtypes: A six-year longitudinal study in patients, siblings and controls. Schizophr Res 2020; 223:135-147. [PMID: 32631699 DOI: 10.1016/j.schres.2020.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/23/2020] [Accepted: 05/06/2020] [Indexed: 12/12/2022]
Abstract
Cross-sectional studies have shown that the polygenic risk score for schizophrenia (PRSSCZ) may influence heterogeneity in cognitive performance although evidence from family-based longitudinal study is limited. This study aimed to identify trajectories of cognitive function and assess whether the PRSSCZ is associated with baseline cognitive performance and predicted six-year trajectories. We included 1119 patients with a schizophrenia spectrum disorder, and 1059 unaffected siblings and 586 unrelated controls who are eligible at baseline. Genotype data were collected at baseline, whereas clinical and sociodemographic data were collected at baseline, three and six years. Group-based trajectory modeling was applied on a weighted standardized composite score of general cognition to unravel cognitive subtypes and explore trajectories over time. We followed a standard procedure to calculate the polygenic risk score. A random-effects ordinal regression model was used to investigate the association between PRSSCZ and cognitive subtypes. Five cognitive subtypes with variable trajectories were found in patients, four in siblings and controls, and six in all combined samples. PRSSCZ significantly predicted poor cognitive trajectories in patients, siblings and all samples. After Bonferroni correction and adjustment for non-genetic factors, only the results in all combined sample remained significant. Cognitive impairment in schizophrenia is heterogeneous and may be linked with high PRSSCZ. Our finding confirmed at least in all combined samples the presence of genetic overlap between schizophrenia and cognitive function and can give insight into the mechanisms of cognitive deficits.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands.
| | - Edith J Liemburg
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Md Atiqul Islam
- Shahjalal University of Science and Technology, Department of Statistics, Sylhet 3114, Bangladesh
| | - Sonja M C de Zwarte
- Utrecht University, University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Utrecht, Netherlands
| | - H Marike Boezen
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | | | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical and Developmental Neuropsychology, Groningen, the Netherlands.
| | - Behrooz Z Alizadeh
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
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14
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Nunes A, Trappenberg T, Alda M. The definition and measurement of heterogeneity. Transl Psychiatry 2020; 10:299. [PMID: 32839448 PMCID: PMC7445182 DOI: 10.1038/s41398-020-00986-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 07/21/2020] [Accepted: 08/10/2020] [Indexed: 12/31/2022] Open
Abstract
Heterogeneity is an important concept in psychiatric research and science more broadly. It negatively impacts effect size estimates under case-control paradigms, and it exposes important flaws in our existing categorical nosology. Yet, our field has no precise definition of heterogeneity proper. We tend to quantify heterogeneity by measuring associated correlates such as entropy or variance: practices which are akin to accepting the radius of a sphere as a measure of its volume. Under a definition of heterogeneity as the degree to which a system deviates from perfect conformity, this paper argues that its proper measure roughly corresponds to the size of a system's event/sample space, and has units known as numbers equivalent. We arrive at this conclusion through focused review of more than 100 years of (re)discoveries of indices by ecologists, economists, statistical physicists, and others. In parallel, we review psychiatric approaches for quantifying heterogeneity, including but not limited to studies of symptom heterogeneity, microbiome biodiversity, cluster-counting, and time-series analyses. We argue that using numbers equivalent heterogeneity measures could improve the interpretability and synthesis of psychiatric research on heterogeneity. However, significant limitations must be overcome for these measures-largely developed for economic and ecological research-to be useful in modern translational psychiatric science.
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Affiliation(s)
- Abraham Nunes
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Thomas Trappenberg
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
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15
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Rashid B, Calhoun V. Towards a brain-based predictome of mental illness. Hum Brain Mapp 2020; 41:3468-3535. [PMID: 32374075 PMCID: PMC7375108 DOI: 10.1002/hbm.25013] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 01/10/2023] Open
Abstract
Neuroimaging-based approaches have been extensively applied to study mental illness in recent years and have deepened our understanding of both cognitively healthy and disordered brain structure and function. Recent advancements in machine learning techniques have shown promising outcomes for individualized prediction and characterization of patients with psychiatric disorders. Studies have utilized features from a variety of neuroimaging modalities, including structural, functional, and diffusion magnetic resonance imaging data, as well as jointly estimated features from multiple modalities, to assess patients with heterogeneous mental disorders, such as schizophrenia and autism. We use the term "predictome" to describe the use of multivariate brain network features from one or more neuroimaging modalities to predict mental illness. In the predictome, multiple brain network-based features (either from the same modality or multiple modalities) are incorporated into a predictive model to jointly estimate features that are unique to a disorder and predict subjects accordingly. To date, more than 650 studies have been published on subject-level prediction focusing on psychiatric disorders. We have surveyed about 250 studies including schizophrenia, major depression, bipolar disorder, autism spectrum disorder, attention-deficit hyperactivity disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, and substance dependence. In this review, we present a comprehensive review of recent neuroimaging-based predictomic approaches, current trends, and common shortcomings and share our vision for future directions.
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Affiliation(s)
- Barnaly Rashid
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
| | - Vince Calhoun
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS)Georgia State University, Georgia Institute of Technology, and Emory UniversityAtlantaGeorgiaUSA
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16
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A systematic review and narrative synthesis of data-driven studies in schizophrenia symptoms and cognitive deficits. Transl Psychiatry 2020; 10:244. [PMID: 32694510 PMCID: PMC7374614 DOI: 10.1038/s41398-020-00919-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/24/2020] [Accepted: 07/03/2020] [Indexed: 12/30/2022] Open
Abstract
To tackle the phenotypic heterogeneity of schizophrenia, data-driven methods are often applied to identify subtypes of its symptoms and cognitive deficits. However, a systematic review on this topic is lacking. The objective of this review was to summarize the evidence obtained from longitudinal and cross-sectional data-driven studies in positive and negative symptoms and cognitive deficits in patients with schizophrenia spectrum disorders, their unaffected siblings and healthy controls or individuals from general population. Additionally, we aimed to highlight methodological gaps across studies and point out future directions to optimize the translatability of evidence from data-driven studies. A systematic review was performed through searching PsycINFO, PubMed, PsycTESTS, PsycARTICLES, SCOPUS, EMBASE and Web of Science electronic databases. Both longitudinal and cross-sectional studies published from 2008 to 2019, which reported at least two statistically derived clusters or trajectories were included. Two reviewers independently screened and extracted the data. In this review, 53 studies (19 longitudinal and 34 cross-sectional) that conducted among 17,822 patients, 8729 unaffected siblings and 5520 controls or general population were included. Most longitudinal studies found four trajectories that characterized by stability, progressive deterioration, relapsing and progressive amelioration of symptoms and cognitive function. Cross-sectional studies commonly identified three clusters with low, intermediate (mixed) and high psychotic symptoms and cognitive profiles. Moreover, identified subgroups were predicted by numerous genetic, sociodemographic and clinical factors. Our findings indicate that schizophrenia symptoms and cognitive deficits are heterogeneous, although methodological limitations across studies are observed. Identified clusters and trajectories along with their predictors may be used to base the implementation of personalized treatment and develop a risk prediction model for high-risk individuals with prodromal symptoms.
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17
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Shou X, Mavroudeas G, Magdon-Ismail M, Figueroa J, Kuruzovich JN, Bennett KP. Supervised mixture of experts models for population health. Methods 2020; 179:101-110. [PMID: 32446958 DOI: 10.1016/j.ymeth.2020.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/01/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022] Open
Abstract
We propose a machine learning driven approach to derive insights from observational healthcare data to improve public health outcomes. Our goal is to simultaneously identify patient subpopulations with differing health risks and to find those risk factors within each subpopulation. We develop two supervised mixture of experts models: a Supervised Gaussian Mixture model (SGMM) for general features and a Supervised Bernoulli Mixture model (SBMM) tailored to binary features. We demonstrate the two approaches on an analysis of high cost drivers of Medicaid expenditures for inpatient stays. We focus on the three diagnostic categories that accounted for the highest percentage of inpatient expenditures in New York State (NYS) in 2016. When compared with state-of-the-art learning methods (random forests, boosting, neural networks), our approaches provide comparable prediction performance while also extracting insightful subpopulation structure and risk factors. For problems with binary features the proposed SBMM provides as good or better performance than alternative methods while offering insightful explanations. Our results indicate the promise of such approaches for extracting population health insights from electronic health care records.
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Affiliation(s)
- Xiao Shou
- Institute for Data Exploration and Applications, Rensselaer Polytechnic Institute, Troy, USA; Mathematics Department, Rensselaer Polytechnic Institute, Troy, USA
| | | | | | - Jose Figueroa
- Computer Science Department, Rensselaer Polytechnic Institute, Troy, USA
| | | | - Kristin P Bennett
- Institute for Data Exploration and Applications, Rensselaer Polytechnic Institute, Troy, USA; Mathematics Department, Rensselaer Polytechnic Institute, Troy, USA; Computer Science Department, Rensselaer Polytechnic Institute, Troy, USA
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18
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Kaczkurkin AN, Moore TM, Sotiras A, Xia CH, Shinohara RT, Satterthwaite TD. Approaches to Defining Common and Dissociable Neurobiological Deficits Associated With Psychopathology in Youth. Biol Psychiatry 2020; 88:51-62. [PMID: 32087950 PMCID: PMC7305976 DOI: 10.1016/j.biopsych.2019.12.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/07/2019] [Accepted: 12/11/2019] [Indexed: 01/31/2023]
Abstract
Psychiatric disorders show high rates of comorbidity and nonspecificity of presenting clinical symptoms, while demonstrating substantial heterogeneity within diagnostic categories. Notably, many of these psychiatric disorders first manifest in youth. We review progress and next steps in efforts to parse heterogeneity in psychiatric symptoms in youths by identifying abnormalities within neural circuits. To address this fundamental challenge in psychiatry, a number of methods have been proposed. We provide an overview of these methods, broadly organized into dimensional versus categorical approaches and single-view versus multiview approaches. Dimensional approaches including factor analysis and canonical correlation analysis aim to capture dimensional associations between psychopathology and brain measures across a continuous spectrum from health to disease. In contrast, categorical approaches, such as clustering and community detection, aim to identify subtypes of individuals within a class of symptoms or brain features. We highlight several studies that apply these methods to samples of youths and discuss issues to consider when using these approaches. Finally, we end by highlighting avenues for future research.
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Affiliation(s)
| | - Tyler M Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Aristeidis Sotiras
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri; Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Cedric Huchuan Xia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Russell T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Theodore D Satterthwaite
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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19
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Ergül C, Üçok A. Negative symptom subgroups have different effects on the clinical course of schizophrenia after the first episode: A 24-month follow up study. Eur Psychiatry 2020; 30:14-9. [PMID: 25174272 DOI: 10.1016/j.eurpsy.2014.07.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/26/2014] [Accepted: 07/27/2014] [Indexed: 11/25/2022] Open
Abstract
AbstractObjective:The aim of this study was to assess the factor structure of negative symptoms in first-episode schizophrenia (FES), and to examine the relationship of these factors with clinical course and functioning of patients during the two-year follow up.Method:We assessed 174 drug-naïve patients with FES using Brief Psychiatric Rating Scale-Expanded (BPRS), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), and Global Assessment of Functioning (GAF) and a cognitive battery at admission. The scales were repeated monthly during follow up. We recorded the patients’ functioning levels, remission, and work status after 12 and 24 months.Results:A two-factor structure was found at the baseline, whereas one factor was found after 12 and 24 months. Expressive deficit (ED) factor consisted of alogia and blunted affect, and motivation-pleasure deficit (MPD) factor consisted of avolition and anhedonia. ED factor was related to earlier onset and remission, and it was negatively correlated with duration of education and cognitive test scores. MPD factor was related to duration of untreated psychosis, family history of schizophrenia, and work status, and it appeared as the only independent variable that contributed to the baseline GAF score in linear regression analysis.Conclusion:Our findings suggest that the factors have different aetiologies and impacts on the clinical course of schizophrenia and functioning after FES.
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Affiliation(s)
- C Ergül
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Millet Street, Çapa, Fatih, Istanbul, Turkey
| | - A Üçok
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Millet Street, Çapa, Fatih, Istanbul, Turkey.
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20
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Vaskinn A, Horan WP. Social Cognition and Schizophrenia: Unresolved Issues and New Challenges in a Maturing Field of Research. Schizophr Bull 2020; 46:464-470. [PMID: 32133507 PMCID: PMC7147571 DOI: 10.1093/schbul/sbaa034] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Social cognition has become a topic of widespread interest in experimental and treatment research in schizophrenia over the past 15 years. This explosion of interest largely reflects the robust evidence that social cognition is among the strongest known correlates of poor community functioning throughout the course of schizophrenia. While progress has been impressive, we consider several fundamental questions about the scope, structure, and optimal measurement of social cognition that remain unanswered and point to the need for continued method development. We also consider more recently emerging questions about individual differences, ecological and cross-cultural validity, and intervention approaches, as well as broader technological changes that impact how we understand and use social cognition at a societal level. Continued efforts to creatively grapple with the complexities and challenges the field now faces hold great promise for helping us understand and more effectively treat a major source of functional disability in schizophrenia.
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Affiliation(s)
- Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway,To whom correspondence should be addressed; tel: + 47 23 02 73 31, fax: + 47 23 02 73 33,
| | - William P Horan
- VeraSci Inc, Durham, NC,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
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21
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Kaczkurkin AN, Sotiras A, Baller EB, Barzilay R, Calkins ME, Chand GB, Cui Z, Erus G, Fan Y, Gur RE, Gur RC, Moore TM, Roalf DR, Rosen AF, Ruparel K, Shinohara RT, Varol E, Wolf DH, Davatzikos C, Satterthwaite TD. Neurostructural Heterogeneity in Youths With Internalizing Symptoms. Biol Psychiatry 2020; 87:473-482. [PMID: 31690494 PMCID: PMC7007843 DOI: 10.1016/j.biopsych.2019.09.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 09/01/2019] [Accepted: 09/03/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Internalizing disorders such as anxiety and depression are common psychiatric disorders that frequently begin in youth and exhibit marked heterogeneity in treatment response and clinical course. Given that symptom-based classification approaches do not align with underlying neurobiology, an alternative approach is to identify neurobiologically informed subtypes based on brain imaging data. METHODS We used a recently developed semisupervised machine learning method (HYDRA [heterogeneity through discriminative analysis]) to delineate patterns of neurobiological heterogeneity within youths with internalizing symptoms using structural data collected at 3T from a sample of 1141 youths. RESULTS Using volume and cortical thickness, cross-validation methods indicated 2 highly stable subtypes of internalizing youths (adjusted Rand index = 0.66; permutation-based false discovery rate p < .001). Subtype 1, defined by smaller brain volumes and reduced cortical thickness, was marked by impaired cognitive performance and higher levels of psychopathology than both subtype 2 and typically developing youths. Using resting-state functional magnetic resonance imaging and diffusion images not considered during clustering, we found that subtype 1 also showed reduced amplitudes of low-frequency fluctuations in frontolimbic regions at rest and reduced fractional anisotropy in several white matter tracts. In contrast, subtype 2 showed intact cognitive performance and greater volume, cortical thickness, and amplitudes during rest compared with subtype 1 and typically developing youths, despite still showing clinically significant levels of psychopathology. CONCLUSIONS We identified 2 subtypes of internalizing youths differentiated by abnormalities in brain structure, function, and white matter integrity, with one of the subtypes showing poorer functioning across multiple domains. Identification of biologically grounded internalizing subtypes may assist in targeting early interventions and assessing longitudinal prognosis.
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Affiliation(s)
- Antonia N. Kaczkurkin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Aristeidis Sotiras
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Department of Radiology, Washington University, St. Louis, MO, 63110, USA,Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Erica B. Baller
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ran Barzilay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Monica E. Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ganesh B. Chand
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zaixu Cui
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Guray Erus
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yong Fan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Philadelphia Veterans Administration Medical Center, Philadelphia, PA 19104
| | - Tyler M. Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David R. Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Adon F.G. Rosen
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Russell T. Shinohara
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA,Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Erdem Varol
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA,Department of Statistics, Center for Theoretical Neuroscience, Grossman Center for the Statistics of Mind, Columbia University, New York, NY 10027
| | - Daniel H. Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christos Davatzikos
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Theodore D. Satterthwaite
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA
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22
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Halverson TF, Hajdúk M, Pinkham AE, Harvey PD, Jarskog LF, Nye L, Penn DL. Psychometric properties of the Observable Social Cognition Rating Scale (OSCARS): Self-report and informant-rated social cognitive abilities in schizophrenia. Psychiatry Res 2020; 286:112891. [PMID: 32145477 PMCID: PMC7483899 DOI: 10.1016/j.psychres.2020.112891] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 02/07/2023]
Abstract
Individuals with schizophrenia spectrum disorders (SSD) consistently show deficits in social cognition (SC) which is associated with real world outcomes. Psychosocial treatments have demonstrated reliable improvements in SC abilities, highlighting the need for accurate identification of SC deficits for efficient and individualized treatment planning. To this end, the Observable Social Cognition Rating Scale (OSCARS) is an 8-item scale with both self and informant versions. This study investigated psychometric properties of the OSCARS as both a self and informant-reported scale in a large sample of SSD (n = 382) and individuals without a psychiatric diagnosis (n = 289). A two-factor structure (Social Cognitive Bias and Social Cognitive Ability) of the OSCARS demonstrated acceptable model fit with good internal consistency for both self- and informant-report. The OSCARS had adequate convergent, external, and predictive validity. Area Under the Curve (AUC) values suggest the OSCARS has some value in identifying individuals with impaired SC and social competence, although stronger AUC values were demonstrated when identifying individuals with impaired real-world functioning. Overall, psychometric properties indicate the OSCARS may be a useful first-step tool for clinicians to detect functioning deficits in SSD and efficiently identify individuals in need of additional assessment or psychosocial interventions.
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Affiliation(s)
- Tate F Halverson
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC, United States.
| | - Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia; Clinic of Psychiatry, Faculty of Medicine, Comenius University, Bratislava, Slovakia; Center for Psychiatric Disorders Research - UK, Science Park, Comenius University in Bratislava, Slovakia
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX; Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL; Research Service, Miami VA Healthcare System, Miami, FL
| | - L Fredrik Jarskog
- University of North Carolina at Chapel Hill, North Carolina Psychiatric Research Center, Raleigh, NC, United States
| | - Lana Nye
- College of Social Work, The University of Utah, Salt Lake City, UT
| | - David L Penn
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC, United States; Australian Catholic University, School of Behavioural and Health Sciences, Melbourne, VIC, Australia
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23
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Pelletier-Baldelli A, Holt DJ. Are Negative Symptoms Merely the "Real World" Consequences of Deficits in Social Cognition? Schizophr Bull 2020; 46:236-241. [PMID: 31598707 PMCID: PMC7043060 DOI: 10.1093/schbul/sbz095] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Many investigations have demonstrated that negative symptoms and social cognitive deficits in schizophrenia play a large role in determining functional outcomes and ultimately long-term prognosis. Given this, there is increasing interest in understanding the relationship between these two symptom domains, particularly since studies have consistently found moderate to large associations between them. This shared variance raises a key question: to what degree do these two categories of symptoms arise from overlapping or identical changes in brain function? In other words, do some or all negative symptoms represent merely the downstream effects of social cognition deficits on daily functioning? In this commentary, the evidence for and against this possibility, limitations of currently validated empirical measurements of these symptoms, and directions for further investigation of this hypothesis are discussed. Understanding the shared and distinct mechanisms of these disabling deficits will have important implications for the design of novel, personalized treatments for psychotic illness.
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Affiliation(s)
- Andrea Pelletier-Baldelli
- Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC,Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA,To whom correspondence should be addressed; Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27513; tel: 919-966-1648, e-mail:
| | - Daphne J Holt
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA,The Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
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24
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Peveretou F, Radke S, Derntl B, Habel U. A Short Empathy Paradigm to Assess Empathic Deficits in Schizophrenia. Behav Sci (Basel) 2020; 10:bs10020041. [PMID: 31991547 PMCID: PMC7071360 DOI: 10.3390/bs10020041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/30/2022] Open
Abstract
Empathy is important for successful social interaction and maintaining relationships. Several studies detected impairments in empathic abilities in schizophrenia, with some even indicating a broader deficit in several components, including emotion recognition, perspective taking, and affective responsiveness. The aim of our study was to validate a short version of the previous empathy paradigm as a reliable and easily applicable method to assess empathic deficits in patients with schizophrenia potentially within clinical routine. To do so, we applied the short version to 30 patients (14 females) diagnosed with schizophrenia meeting the DSM-5 criteria and 30 well-matched healthy controls (14 females). The data analysis indicates a significant empathic deficit in patients due to worse performance in all three domains. We managed to replicate most of the findings of our previous study. In contrary to the previous study, significant correlations between performance in the empathy tasks and psychopathology occurred: the severity of negative symptoms was negatively associated with performance in the emotion recognition task and the affective responsiveness task. Gender did not significantly affect performance in the empathy tasks. Regarding the results, our short empathy paradigm appears to be a valid method in assessing empathic impairments in schizophrenia that may be useful in clinical routine.
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Affiliation(s)
- Foteini Peveretou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (S.R.); (U.H.)
- Correspondence: ; Tel.: +49-241-80-80368; Fax: +49-241-80-82401
| | - Sina Radke
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (S.R.); (U.H.)
- Jülich Aachen Research Alliance—BRAIN Institute I: Brain Structure–Function Relationships: Decoding the Human Brain at Systemic Levels, Research Center Jülich GmbH and RWTH Aachen University, Wilhelm-Johnen-Strasse, 52425 Jülich, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Medical School, University of Tübingen, Calwerstrasse 14, 72076 Tübingen, Germany;
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (S.R.); (U.H.)
- Jülich Aachen Research Alliance—BRAIN Institute I: Brain Structure–Function Relationships: Decoding the Human Brain at Systemic Levels, Research Center Jülich GmbH and RWTH Aachen University, Wilhelm-Johnen-Strasse, 52425 Jülich, Germany
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25
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Fekete J, Pótó Z, Varga E, Csulak T, Zsélyi O, Tényi T, Herold R. Persons With Schizophrenia Misread Hemingway: A New Approach to Study Theory of Mind in Schizophrenia. Front Psychiatry 2020; 11:396. [PMID: 32457668 PMCID: PMC7224255 DOI: 10.3389/fpsyt.2020.00396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/17/2020] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Theory of Mind (ToM) is a key component of social cognition. Recently the Short Story Task (SST) was developed as a new measurement of ToM. SST uses a short story of Ernest Hemingway to assess ToM skills. SST proved to be a suitable tool, and sensitive to individual differences among healthy subjects. Our aim was to test SST to evaluate the ToM skills of persons with schizophrenia. MATERIALS AND METHODS SST was used to assess ToM skills. After reading the short story "The End of Something" a structured interview was done with 14 questions. Spontaneous mental state reasoning, explicit mental state inference and comprehension of nonmental aspects of the story were evaluated. 47 persons with schizophrenia in remission and 48 healthy controls were assessed and compared. RESULTS Persons with schizophrenia performed significantly more poorly in the explicit mental state inference questions. Ceiling effect was not detectable in explicit ToM scores. Patients made less spontaneous mental state references as well, although the occurrence of spontaneous mental state terms was infrequent in both groups. Patients were also less accurate in answering comprehension questions, but the difference was not significant after Bonferroni correction. DISCUSSION Our results lined up with the original findings and we found SST to be a sensitive tool to explore the individual differences in ToM performance, not only among healthy subjects, but also among persons with schizophrenia especially in explicit mental state inferences without observing the ceiling effect. We found, however, SST to be less sensitive to measure spontaneous mental state reasoning and also the lack of the use of another ToM test to assess convergent validity of SST for indicating ToM deficits in schizophrenia stands as a limitation of current study.
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Affiliation(s)
- Judit Fekete
- Doctoral School of Clinical Neurosciences, Medical School, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Pótó
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Eszter Varga
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Tímea Csulak
- Doctoral School of Clinical Neurosciences, Medical School, University of Pécs, Pécs, Hungary
| | - Orsolya Zsélyi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
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26
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Zabihi M, Oldehinkel M, Wolfers T, Frouin V, Goyard D, Loth E, Charman T, Tillmann J, Banaschewski T, Dumas G, Holt R, Baron-Cohen S, Durston S, Bölte S, Murphy D, Ecker C, Buitelaar JK, Beckmann CF, Marquand AF. Dissecting the Heterogeneous Cortical Anatomy of Autism Spectrum Disorder Using Normative Models. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:567-578. [PMID: 30799285 PMCID: PMC6551348 DOI: 10.1016/j.bpsc.2018.11.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/30/2018] [Accepted: 11/30/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The neuroanatomical basis of autism spectrum disorder (ASD) has remained elusive, mostly owing to high biological and clinical heterogeneity among diagnosed individuals. Despite considerable effort toward understanding ASD using neuroimaging biomarkers, heterogeneity remains a barrier, partly because studies mostly employ case-control approaches, which assume that the clinical group is homogeneous. METHODS Here, we used an innovative normative modeling approach to parse biological heterogeneity in ASD. We aimed to dissect the neuroanatomy of ASD by mapping the deviations from a typical pattern of neuroanatomical development at the level of the individual and to show the necessity to look beyond the case-control paradigm to understand the neurobiology of ASD. We first estimated a vertexwise normative model of cortical thickness development using Gaussian process regression, then mapped the deviation of each participant from the typical pattern. For this, we employed a heterogeneous cross-sectional sample of 206 typically developing individuals (127 males) and 321 individuals with ASD (232 males) (6-31 years of age). RESULTS We found few case-control differences, but the ASD cohort showed highly individualized patterns of deviations in cortical thickness that were widespread across the brain. These deviations correlated with severity of repetitive behaviors and social communicative symptoms, although only repetitive behaviors survived corrections for multiple testing. CONCLUSIONS Our results 1) reinforce the notion that individuals with ASD show distinct, highly individualized trajectories of brain development and 2) show that by focusing on common effects (i.e., the "average ASD participant"), the case-control approach disguises considerable interindividual variation crucial for precision medicine.
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Affiliation(s)
- Mariam Zabihi
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
| | - Marianne Oldehinkel
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Thomas Wolfers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Vincent Frouin
- Neurospin, Institut des sciences du vivant Frédéric Joliot, CEA-Université Paris-Saclay, Gif-sur-Yvette, France
| | - David Goyard
- Neurospin, Institut des sciences du vivant Frédéric Joliot, CEA-Université Paris-Saclay, Gif-sur-Yvette, France
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Julian Tillmann
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom; Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna, Vienna, Austria
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Mannheim, Germany
| | - Guillaume Dumas
- Human Genetics and Cognitive Functions Unit, Institut Pasteur, Paris, France
| | - Rosemary Holt
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Durston
- Department of Psychiatry, University Medical Centre, Utrecht, the Netherlands
| | - Sven Bölte
- Center for Neurodevelopmental Disorders, Division of Neuropsychiatry, Department of Women's and Children's Health, Stockholm, Sweden; Child and Adolescent Psychiatry, Centre of Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom; Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
| | - Christine Ecker
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt am Main, Goethe University Frankfurt, Frankfurt, Germany
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
| | - Christian F Beckmann
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Centre for Functional MRI of the Brain, University of Oxford, Oxford, United Kingdom
| | - Andre F Marquand
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, United Kingdom
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27
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Oliver LD, Haltigan JD, Gold JM, Foussias G, DeRosse P, Buchanan RW, Malhotra AK, Voineskos AN. Lower- and Higher-Level Social Cognitive Factors Across Individuals With Schizophrenia Spectrum Disorders and Healthy Controls: Relationship With Neurocognition and Functional Outcome. Schizophr Bull 2019; 45:629-638. [PMID: 30107517 PMCID: PMC6483578 DOI: 10.1093/schbul/sby114] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Schizophrenia spectrum disorders (SSDs) often feature social cognitive deficits. However, little work has focused on the factor structure of social cognition, and results have been inconsistent in schizophrenia. This study aimed to elucidate the factor structure of social cognition across people with SSDs and healthy controls. It was hypothesized that a 2-factor model, including lower-level "simulation" and higher-level "mentalizing" factors, would demonstrate the best fit across participants. METHODS Participants with SSDs (N = 164) and healthy controls (N = 102) completed social cognitive tasks ranging from emotion recognition to complex mental state inference, as well as clinical and functional outcome, and neurocognitive measures. Structural equation modeling was used to test social cognitive models, models of social cognition and neurocognition, measurement invariance between cases and controls, and relationships with outcome measures. RESULTS A 2-factor (simulation and mentalizing) model fit the social cognitive data best across participants and showed adequate measurement invariance in both SSD and control groups. Patients showed lower simulation and mentalizing scores than controls, but only mentalizing was significantly associated with negative symptoms and functional outcome. Social cognition also mediated the relationship between neurocognition and both negative symptoms and functional outcome. CONCLUSIONS These results uniquely indicate that distinct lower- and higher-level aspects of social cognition exist across SSDs and healthy controls. Further, mentalizing may be particularly linked to negative symptoms and functional outcome. This informs future studies of the neural circuitry underlying social cognition and the development of targeted treatment options for improving functional outcome.
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Affiliation(s)
- Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - John D Haltigan
- Clinical Research Division, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Clinical Research Division, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Pamela DeRosse
- Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Anil K Malhotra
- Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hofstra University, Hempstead, NY,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Clinical Research Division, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,To whom correspondence should be addressed; Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; tel: 416-535-8501 (ext. 33977), fax: 416-260-4162, e-mail:
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28
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Bliksted V, Frith C, Videbech P, Fagerlund B, Emborg C, Simonsen A, Roepstorff A, Campbell-Meiklejohn D. Hyper- and Hypomentalizing in Patients with First-Episode Schizophrenia: fMRI and Behavioral Studies. Schizophr Bull 2019; 45:377-385. [PMID: 29534245 PMCID: PMC6403062 DOI: 10.1093/schbul/sby027] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Historically, research investigating neural correlates of mentalizing deficits in schizophrenia has focused on patients who have been ill for several years with lengthy exposure to medication. Little is known about the neural and behavioral presentations of theory-of-mind deficits in schizophrenia, shortly after the first episode of psychosis. METHODS We investigated social cognition in 17 recently diagnosed first-episode schizophrenia (FES) patients with little or no exposure to antipsychotic medication and 1:1 matched healthy controls. We recorded behavioral and neural responses to the Animated Triangles Task (ATT), which is a nonverbal validated mentalizing task that measures the ascription of intentionality to the movements of objects. RESULTS FES patients under-interpreted social cues and over-interpreted nonsocial cues. These effects were influenced by current intelligence (IQ). Control group and FES neural responses replicated earlier findings in healthy adults. However, a region of anterior medial prefrontal cortex (amPFC) of FES patients showed a different response pattern to that of controls. Unlike healthy controls, patients increased activity in this social cognition region while studying "random" movements of shapes, as compared to the study of movements normally interpreted as "intentional". CONCLUSIONS Mentalizing deficits in FES consists of hypo- and hypermentalizing. The neural pattern of FES patients is consistent with deficits in the ability to switch off mentalizing processes in potentially social contexts, instead increasing them when intentionality is not forthcoming. Overall, results demonstrate complexities of theory of mind deficits in schizophrenia that should be considered when offering social cognitive training programs.
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Affiliation(s)
- Vibeke Bliksted
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Risskov, Denmark
- Interacting Minds Centre, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Chris Frith
- Leopold Müller Functional Imaging Laboratory, Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | | | - Birgitte Fagerlund
- Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, Glostrup, Denmark
- Lundbeck Foundation Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, Glostrup, Denmark
| | - Charlotte Emborg
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Risskov, Denmark
| | - Arndis Simonsen
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Risskov, Denmark
- Interacting Minds Centre, Aarhus University, Aarhus, Denmark
| | - Andreas Roepstorff
- Interacting Minds Centre, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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29
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Etchepare A, Roux S, Destaillats JM, Cady F, Fontanier D, Couhet G, Prouteau A. What are the specificities of social cognition in schizophrenia? A cluster-analytic study comparing schizophrenia with the general population. Psychiatry Res 2019; 272:369-379. [PMID: 30599441 DOI: 10.1016/j.psychres.2018.12.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 12/03/2018] [Accepted: 12/06/2018] [Indexed: 12/28/2022]
Abstract
While social cognition (SC) is widely recognized as being impaired in schizophrenia, little is known about the potential heterogeneity in individuals' functioning. Using a wide range of SC measures and a cluster-analytic approach, we compared SC profiles in the general population and in people with schizophrenia. A total of 131 healthy controls and 101 participants with schizophrenia were included. Groups were compared on sociodemographic, neurocognition, anxiety and depressive mood variables. Three profiles were identified in healthy controls: one with good SC abilities (Homogeneous SC group) and two with specific weaknesses in complex Facial Emotion Recognition (Low FER group) or Affective Theory of Mind (Low AToM group). However, these patterns were not found in participants with schizophrenia, who were characterized rather by levels of SC functioning (i.e., Low, Medium and High SC groups). Importantly, while the High SC group (47.9% of the sample) exhibited normal performances, the two others were underpinned by different pathological processes (i.e., alexithymia for Medium SC group or neurocognition dysfunctioning for Low SC group). These results have important implications for future research as well as for clinical practice regarding assessment methodology and therapeutic interventions.
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Affiliation(s)
- Aurore Etchepare
- Laboratoire de Psychologie EA 4139, Université de Bordeaux, 3ter Place de la Victoire, 33 000 Bordeaux, France; Pôle de Soins de Réhabilitation de la Dordogne (PSRD), Centre Hospitalier Vauclaire, Lieu-dit Vauclaire, 24 700 Montpon-Ménestérol, France.
| | - Solenne Roux
- Laboratoire de Psychologie EA 4139, Université de Bordeaux, 3ter Place de la Victoire, 33 000 Bordeaux, France
| | - Jean-Marc Destaillats
- Département de Psychiatrie Adulte, Hôpital de Jonzac, Domaine des Fossés, 17 500 St Martial de Vitaterne, France
| | - Florian Cady
- Centre d'Evaluation et de Réhabilitation (CER), Centre Hospitalier Esquirol, 39 rue Jean-Baptiste Ruchaud, 87 000 Limoges, France
| | - David Fontanier
- Centre d'Evaluation et de Réhabilitation (CER), Centre Hospitalier Esquirol, 39 rue Jean-Baptiste Ruchaud, 87 000 Limoges, France
| | - Geoffroy Couhet
- Centre de Réhabilitation Psycho-Sociale (CRPS), Tour de Gassies, rue de la Tour-de-Gassies, 33 500 Bruges, France
| | - Antoinette Prouteau
- Laboratoire de Psychologie EA 4139, Université de Bordeaux, 3ter Place de la Victoire, 33 000 Bordeaux, France; Département de Psychiatrie Adulte, Hôpital de Jonzac, Domaine des Fossés, 17 500 St Martial de Vitaterne, France
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de Sousa P, Sellwood W, Griffiths M, Bentall RP. Disorganisation, thought disorder and socio-cognitive functioning in schizophrenia spectrum disorders. Br J Psychiatry 2019; 214:103-112. [PMID: 30139394 DOI: 10.1192/bjp.2018.160] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Poor social cognition is prevalent in schizophrenia spectrum disorders. Some authors argue that these effects are symptom-specific and that socio-cognitive difficulties (e.g. theory of mind) are strongly associated with thought disorder and symptoms of disorganisation.AimsThe current review tests the strength of this association. METHOD We meta-analysed studies published between 1980 and 2016 that tested the association between social cognition and these symptoms in schizophrenia spectrum disorders. RESULTS Our search (PsycINFO, MEDLINE and Web of Science) identified 123 studies (N = 9107). Overall effect size as r = -0.313, indicating a moderate association between symptoms and social cognition. Subanalyses yielded a moderate association between symptoms and theory of mind (r = -0.349) and emotion recognition (r = -0.334), but smaller effect sizes for social perception (r = -0.188), emotion regulation (r = -0.169) and attributional biases (r = -0.143). CONCLUSIONS The association is interpreted within models of communication that highlight the importance of mentalisation and processing of partner-specific cues in conversational alignment and grounding.Declaration of interestsNone.
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Affiliation(s)
- Paulo de Sousa
- Department of Clinical Psychology,University of Liverpool,UK
| | - William Sellwood
- Division of Health Research,Faculty of Health and Medicine,Lancaster University,UK
| | | | - Richard P Bentall
- Clinical Psychology Unit,Department of Psychology,University of Sheffield,UK
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Stratification and prediction of remission in first-episode psychosis patients: the OPTiMiSE cohort study. Transl Psychiatry 2019; 9:20. [PMID: 30655509 PMCID: PMC6336802 DOI: 10.1038/s41398-018-0366-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 12/10/2018] [Indexed: 11/09/2022] Open
Abstract
Early response to first-line antipsychotic treatments is strongly associated with positive long-term symptomatic and functional outcome in psychosis. Unfortunately, attempts to identify reliable predictors of treatment response in first-episode psychosis (FEP) patients have not yet been successful. One reason for this could be that FEP patients are highly heterogeneous in terms of symptom expression and underlying disease biological mechanisms, thereby impeding the identification of one-size-fits-all predictors of treatment response. We have used a clustering approach to stratify 325 FEP patients into four clinical subtypes, termed C1A, C1B, C2A and C2B, based on their symptoms assessed using the Positive and Negative Syndrome Scale (PANSS) scale. Compared to C1B, C2A and C2B patients, those from the C1A subtype exhibited the most severe symptoms and were the most at risk of being non-remitters when treated with the second-generation antipsychotic drug amisulpride. Before treatment, C1A patients exhibited higher serum levels of several pro-inflammatory cytokines and inflammation-associated biomarkers therefore validating our stratification approach on external biological measures. Most importantly, in the C1A subtype, but not others, lower serum levels of interleukin (IL)-15, higher serum levels of C-X-C motif chemokine 12 (CXCL12), previous exposure to cytomegalovirus (CMV), use of recreational drugs and being younger were all associated with higher odds of being non-remitters 4 weeks after treatment. The predictive value of this model was good (mean area under the curve (AUC) = 0.73 ± 0.10), and its specificity and sensitivity were 45 ± 0.09% and 83 ± 0.03%, respectively. Further validation and replication of these results in clinical trials would pave the way for the development of a blood-based assisted clinical decision support system in psychosis.
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Rakitzi S, Georgila P. Integrated Psychological Therapy and Treatment-Resistant Schizophrenia: Initial Findings. Psychiatry 2019; 82:354-367. [PMID: 31385737 DOI: 10.1080/00332747.2019.1616658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The aim of this Randomized Controlled Trial (RCT) is to present the initial findings of a larger RCT study conducted internationally for the first time, regarding the hypothesis, when the Integrated Psychological Therapy (IPT) for individuals with schizophrenia is more and when it is less effective, regarding Treatment-Resistant Schizophrenia (TRS) and nontreatment resistant schizophrenia (NTRS).Methods: Forty-eight outpatients with schizophrenia of an adult psychiatric department participated in this RCT study. Eleven outpatients of IPT and 11 of the Treatment as Usual (TAU) belong to TRS. Thirteen patients of IPT and 13 of TAU belong to NTRS. A test battery was given at baseline after therapy (10 weeks) and at 3 months' follow-up. Neurocognition, social cognition, psychopathology, and functional outcome were assessed. The General Linear Model (GLM) for repeated measurements was used. Effect sizes, z-scores, and the sign test were calculated.Results: There was a statistical significance for verbal memory; positive, negative symptoms and general psychopathology; Global Assessment and Functioning scale (GAF) and quality of life favoring NTRS. Effect sizes showed superiority of NTRS in comparison to TRS. The sign test showed a significant improvement in Integrated Psychological Therapy treatment-resistant schizophrenia (IPTTRS) that was maintained in the follow-up, in Integrated Psychological Therapy nontreatment resistant schizophrenia (IPTNTRS) and in Treatment as Usual nontreatment resistant schizophrenia (TAUNTRS).Conclusion: The IPT is more effective in NTRS in comparison to TRS, although IPTTRS showed some improvements, maintained at follow-up. Further RCT studies with larger samples are needed.
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Abstract
Social cognition (SC) appears to contribute to long-term outcomes in schizophrenia; however, little is known about whether different forms of SC are supported by the same cognitive processes. Accordingly, we examined the relationship of two domains of SC: emotion recognition (ER), using the Bell-Lysaker Emotion Recognition Test, and social inference (SI), using the Social Attribution Task-Multiple Choice, to measures of neurocognition, metacognition, theory of mind (ToM), and symptoms. Participants were 72 adults with schizophrenia in a nonacute phase. Multivariate analysis of variance and univariate analysis of variance revealed participants with intact ER had better neurocognition (MATRICS Consensus Cognitive Battery [MCCB]), metacognition (Metacognition Assessment Scale-Abbreviated), ToM (The Hinting Task), and higher emotional discomfort symptoms than participants with impaired scores. Participants with intact SI had higher MCCB visual and verbal learning and SC scores. Stepwise regressions revealed neurocognition and metacognition uniquely contribute to ER performance. Results suggest ER and SI are differentially related to cognitive processes.
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Cho JM, Lee K. Effects of motivation interviewing using a group art therapy program on negative symptoms of schizophrenia. Arch Psychiatr Nurs 2018; 32:878-884. [PMID: 30454632 DOI: 10.1016/j.apnu.2018.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/24/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND We investigated the effect of motivation interviewing using group art therapy on the negative symptoms of schizophrenia. METHODS Participants were patients with chronic schizophrenia admitted to the D psychiatric wards in D city, Korea. There were 17 and 18 patients in the experimental and control groups, respectively. The data collection period was from November 28, 2016 to January 28, 2017. Motivation interviewing using group art therapy was conducted twice per week over 6 weeks (12 sessions in total). RESULTS The significance of the intervention effects were confirmed via measures of negative symptoms, motivation and pleasure, interpersonal relationships, personal hygiene, and hospital program attendance. The experimental group exhibited significantly greater improvements in negative symptoms, motivation and pleasure, interpersonal relationships, personal hygiene, and hospital program attendance than did the control group. CONCLUSIONS The results showed that the motivation interviewing using group art therapy was an effective nursing intervention for the negative symptoms of schizophrenia.
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Hajdúk M, Harvey PD, Penn DL, Pinkham AE. Social cognitive impairments in individuals with schizophrenia vary in severity. J Psychiatr Res 2018; 104:65-71. [PMID: 29982084 DOI: 10.1016/j.jpsychires.2018.06.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/05/2018] [Accepted: 06/28/2018] [Indexed: 01/02/2023]
Abstract
Social cognitive deficits are a hallmark feature of schizophrenia and have been confirmed by several meta-analyses; however, the uniformity of these impairments across individuals remains unknown. The present study evaluated the heterogeneity of social cognitive impairment. A secondary aim was to identify a subset of measures to quickly identify those individuals who are most in need of remediation. Two independent samples of people with schizophrenia (n = 176; n = 178) and their respective healthy control groups (n = 104; n = 154) were selected from two phases of the Social Cognition Psychometric Evaluation (SCOPE) project, which assessed multiple domains of social cognition. Latent profile analysis was utilized to identify sub-clusters of performance within each patient sample. Receiver operator curve and discriminant analysis were implemented to identify tasks suitable as screening tools. Three clusters were identified in each sample that differed primarily in severity of impairment. The first showed no social cognitive impairment (∼25% of patients). The second consisted of patients with mild impairment (∼40% of each sample), and the third showed severe SC impairment (∼32%). Patients in the severe cluster were older, less educated, more neurocognitively impaired, and lower functioning. Using the Bell Lysaker Emotion Recognition Task (BLERT) for screening provided sensitivity of 80.15% and specificity 89.13%. Combining BLERT with the Reading the Mind in the Eyes task yielded sensitivity of 91.60% and specificity 75.00% for identifying impaired individuals. These results illustrate the existence of distinct degrees of social cognitive impairment in schizophrenia and indicate that remediation efforts may not be necessary for all individuals.
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Affiliation(s)
- Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovak Republic; Department of Psychiatry, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Research Service, Miami VA Healthcare System, USA
| | - David L Penn
- Department of Psychology, University of North Carolina, Chapel Hill, NC, USA; School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA; Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, USA.
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Stiekema APM, Islam MA, Liemburg EJ, Castelein S, van den Heuvel ER, van Weeghel J, Aleman A, Bruggeman R, van der Meer L. Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder. Schizophr Res 2018. [PMID: 28648915 DOI: 10.1016/j.schres.2017.06.024] [Citation(s) in RCA: 15] [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: 11/19/2022]
Abstract
BACKGROUND The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores could be identified, iii) whether baseline SA and ED subdomain scores were related to functioning and quality of life six years later and iv) the longitudinal relationship between subgroups and outcomes. METHODS Measurements at baseline, three and six years from 1067 patients participating in the Genetic Risk and Outcome of Psychosis (GROUP) project were used. We applied mixed models analysis, regression analysis and trajectory analyses. RESULTS SA and ED subdomain scores decreased over time. Within both subdomains, four subgroups were identified: for both SA and ED a steady low course (±60%), increased (±15%) and decreased course (±15%). Within SA only, a higher level decreased course (±6%) and within ED only, a course with relatively stable high ED scores (±6%) was found. Lower symptom levels at baseline were related to better functioning (SA & ED) and quality of life (SA) at six years. Overall, low SA and low ED subgroups showed better outcomes than the other subgroups. CONCLUSION In many patients the course of negative symptoms is unstable and related to the course of outcome. Patients who do show steady low negative symptom levels (60%) may complicate the interpretation of treatment evaluation studies, as they may average out possible effects in subgroups with fluctuating symptom levels.
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Affiliation(s)
- Annemarie P M Stiekema
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands; School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Md Atiqul Islam
- University of Groningen, University Center for Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; University of Groningen, Rob Giel Research Center, University Medical Center Groningen, Groningen, The Netherlands; Department of Statistics, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh
| | - Edith J Liemburg
- University of Groningen, University Center for Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; University of Groningen, Rob Giel Research Center, University Medical Center Groningen, Groningen, The Netherlands; University of Groningen, Department of Neuroscience, Groningen, University Medical Center Groningen, The Netherlands; Research Department, Lentis Psychiatric Institute, Groningen, The Netherlands
| | - Stynke Castelein
- University of Groningen, University Center for Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; Research Department, Lentis Psychiatric Institute, Groningen, The Netherlands
| | - Edwin R van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Jaap van Weeghel
- Parnassia Group, Dijk en Duin Mental Health Center, Castricum, The Netherlands; Department of TRANZO, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
| | - André Aleman
- University of Groningen, Department of Neuroscience, Groningen, University Medical Center Groningen, The Netherlands; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- University of Groningen, University Center for Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; University of Groningen, Rob Giel Research Center, University Medical Center Groningen, Groningen, The Netherlands
| | - Lisette van der Meer
- Department of Rehabilitation, Lentis Psychiatric Institute, Zuidlaren, The Netherlands; University of Groningen, University Center for Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
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Meng Q, Li R, Hou F, Zhang Q. Effects of chlorpromazine on sleep quality, clinical and emotional measures among patients with schizophrenia. Clin Neurol Neurosurg 2018; 165:134-138. [DOI: 10.1016/j.clineuro.2018.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 12/14/2017] [Accepted: 01/09/2018] [Indexed: 10/18/2022]
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Mosheva M, Eyal S, Weisman O, Gilad R, Fishman Y, Weinberger R, Weizman A, Gothelf D. Higher adaptive functioning and lower rate of psychotic comorbidity in married versus unmarried individuals with 22q11.2 deletion syndrome. Am J Med Genet A 2017; 176:2365-2374. [DOI: 10.1002/ajmg.a.38555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/28/2017] [Accepted: 11/03/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Mariela Mosheva
- The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital; Sheba Medical Center; Tel Hashomer Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Stav Eyal
- The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital; Sheba Medical Center; Tel Hashomer Israel
| | - Omri Weisman
- The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital; Sheba Medical Center; Tel Hashomer Israel
- Sagol School of Neuroscience; Tel Aviv University; Tel Aviv Israel
| | - Reut Gilad
- Jerusalem Mental Health Center; Eitanim Psychiatric Hospital; Jerusalem Israel
| | - Yael Fishman
- The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital; Sheba Medical Center; Tel Hashomer Israel
| | - Ronnie Weinberger
- The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital; Sheba Medical Center; Tel Hashomer Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
- Geha Mental Health Center and Felsenstein Medical Research Center; Petah Tikva Israel
| | - Doron Gothelf
- The Child Psychiatry Division, Edmond and Lily Safra Children's Hospital; Sheba Medical Center; Tel Hashomer Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
- Sagol School of Neuroscience; Tel Aviv University; Tel Aviv Israel
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Cicero DC, Klaunig MJ, Trask CL, Neis AM. Anomalous Self-Experiences and positive symptoms are independently associated with emotion processing deficits in schizophrenia. Schizophr Res 2016; 176:456-461. [PMID: 27562615 DOI: 10.1016/j.schres.2016.08.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 08/15/2016] [Accepted: 08/18/2016] [Indexed: 11/16/2022]
Abstract
Social-cognitive models posit a role of Anomalous Self-Experiences (ASEs), disturbances in the subjective experience of the self, in the development and maintenance of psychosis. Theorists have suggested that ASEs may underlie the social-cognitive deficits that are common in people with schizophrenia. Positive symptoms, negative symptoms, and ASEs may interfere with the ability to perceive, use, understand, and manage emotions. In the current study, 45 people with schizophrenia and 28 healthy controls completed the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE), the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), and were rated on the Positive and Negative Syndrome Scale (PANSS). Participants with schizophrenia had higher IPASE scores and lower MSCEIT scores than the comparison group. In a series of simultaneous regressions, ASEs, but not positive or negative symptoms, were associated with Total MSCEIT scores and the Using Emotions branch score. In contrast, positive symptoms, but not ASEs or negative symptoms were associated with Perceiving and Managing Emotions branches. Both ASEs and positive symptoms independently contributed to Emotional Experiencing scores. The severity of negative symptoms was not associated with deficits in any MSCEIT scores. These results suggest unique roles for ASEs and positive symptoms in emotion processing deficits in people with schizophrenia.
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Marquand AF, Rezek I, Buitelaar J, Beckmann CF. Understanding Heterogeneity in Clinical Cohorts Using Normative Models: Beyond Case-Control Studies. Biol Psychiatry 2016; 80:552-61. [PMID: 26927419 PMCID: PMC5023321 DOI: 10.1016/j.biopsych.2015.12.023] [Citation(s) in RCA: 275] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/20/2015] [Accepted: 12/15/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite many successes, the case-control approach is problematic in biomedical science. It introduces an artificial symmetry whereby all clinical groups (e.g., patients and control subjects) are assumed to be well defined, when biologically they are often highly heterogeneous. By definition, it also precludes inference over the validity of the diagnostic labels. In response, the National Institute of Mental Health Research Domain Criteria proposes to map relationships between symptom dimensions and broad behavioral and biological domains, cutting across diagnostic categories. However, to date, Research Domain Criteria have prompted few methods to meaningfully stratify clinical cohorts. METHODS We introduce normative modeling for parsing heterogeneity in clinical cohorts, while allowing predictions at an individual subject level. This approach aims to map variation within the cohort and is distinct from, and complementary to, existing approaches that address heterogeneity by employing clustering techniques to fractionate cohorts. To demonstrate this approach, we mapped the relationship between trait impulsivity and reward-related brain activity in a large healthy cohort (N = 491). RESULTS We identify participants who are outliers within this distribution and show that the degree of deviation (outlier magnitude) relates to specific attention-deficit/hyperactivity disorder symptoms (hyperactivity, but not inattention) on the basis of individualized patterns of abnormality. CONCLUSIONS Normative modeling provides a natural framework to study disorders at the individual participant level without dichotomizing the cohort. Instead, disease can be considered as an extreme of the normal range or as-possibly idiosyncratic-deviation from normal functioning. It also enables inferences over the degree to which behavioral variables, including diagnostic labels, map onto biology.
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Affiliation(s)
- Andre F. Marquand
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands,Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands,Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, King’s College London, London, United Kingdom,Address correspondence to Andre F. Marquand, Ph.D., Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Kapittelweg 29, Nijmegen 6525 EN, The Netherlands.
| | - Iead Rezek
- Schlumberger Gould Research Center, Cambridge, United Kingdom
| | - Jan Buitelaar
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands,Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatric University Centre, Nijmegen, The Netherlands
| | - Christian F. Beckmann
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands,Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands,Oxford Centre for Functional Magnetic Resonance Imaging of the Brain, University of Oxford, OxfordUnited Kingdom
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Rocca P, Galderisi S, Rossi A, Bertolino A, Rucci P, Gibertoni D, Montemagni C, Sigaudo M, Mucci A, Bucci P, Acciavatti T, Aguglia E, Amore M, Bellomo A, De Ronchi D, Dell'Osso L, Di Fabio F, Girardi P, Goracci A, Marchesi C, Monteleone P, Niolu C, Pinna F, Roncone R, Sacchetti E, Santonastaso P, Zeppegno P, Maj M. Social cognition in people with schizophrenia: a cluster-analytic approach. Psychol Med 2016; 46:2717-2729. [PMID: 27649341 DOI: 10.1017/s0033291716001100] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. METHOD A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. RESULTS We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (⩾14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI <10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. CONCLUSIONS If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person.
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Affiliation(s)
- P Rocca
- Department of Neuroscience, Section of Psychiatry,University of Turin,Turin,Italy
| | - S Galderisi
- Department of Psychiatry,University of Naples SUN,Naples,Italy
| | - A Rossi
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - A Bertolino
- Department of Neurological and Psychiatric Sciences,University of Bari,Bari,Italy
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - D Gibertoni
- Department of Biomedical and Neuromotor Sciences,University of Bologna,Bologna,Italy
| | - C Montemagni
- Department of Neuroscience, Section of Psychiatry,University of Turin,Turin,Italy
| | - M Sigaudo
- Department of Neuroscience, Section of Psychiatry,University of Turin,Turin,Italy
| | - A Mucci
- Department of Psychiatry,University of Naples SUN,Naples,Italy
| | - P Bucci
- Department of Psychiatry,University of Naples SUN,Naples,Italy
| | - T Acciavatti
- Department of Neuroscience and Imaging, Chair of Psychiatry,G. d'Annunzio University,Chieti,Italy
| | - E Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit,University of Catania,Catania,Italy
| | - M Amore
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry,University of Genoa,Genoa,Italy
| | - A Bellomo
- Department of Medical Sciences, Psychiatry Unit,University of Foggia,Foggia,Italy
| | - D De Ronchi
- Department of Biomedical and Neuromotor Sciences, Section of Psychiatry,University of Bologna,Bologna,Italy
| | - L Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry,University of Pisa,Pisa,Italy
| | - F Di Fabio
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - P Girardi
- Department of Neurosciences, Mental Health and Sensory Organs,S. Andrea Hospital, Sapienza University of Rome,Rome,Italy
| | - A Goracci
- Department of Molecular Medicine and Clinical Department of Mental Health,University of Siena,Siena,Italy
| | - C Marchesi
- Department of Neuroscience, Psychiatry Unit,University of Parma,Parma,Italy
| | - P Monteleone
- Department of Medicine and Surgery, Chair of Psychiatry,University of Salerno,Salerno,Italy
| | - C Niolu
- Department of Systems Medicine, Chair of Psychiatry,Tor Vergata University of Rome,Rome,Italy
| | - F Pinna
- Department of Public Health, Clinical and Molecular Medicine, Section of Psychiatry,University of Cagliari,Cagliari,Italy
| | - R Roncone
- Department of Life, Health and Environmental Sciences, Unit of Psychiatry,University of L'Aquila,L'Aquila,Italy
| | - E Sacchetti
- Psychiatric Unit,School of Medicine, University of Brescia,Brescia,Italy
| | - P Santonastaso
- Psychiatric Clinic, Department of Neurosciences,University of Padua,Padua,Italy
| | - P Zeppegno
- Department of Translational Medicine, Psychiatric Unit,University of Eastern Piedmont,Novara,Italy
| | - M Maj
- Department of Psychiatry,University of Naples SUN,Naples,Italy
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Traditional Chinese version of the Mayer Salovey Caruso Emotional Intelligence Test (MSCEIT-TC): Its validation and application to schizophrenic individuals. Psychiatry Res 2016; 243:61-70. [PMID: 27367492 DOI: 10.1016/j.psychres.2016.04.107] [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: 04/15/2015] [Revised: 03/04/2016] [Accepted: 04/29/2016] [Indexed: 11/23/2022]
Abstract
Schizophrenia is an illness that impairs a person's social cognition. The Mayer Salovey Caruso Emotional Intelligence Test (MSCEIT) is the most well-known test used to measure emotional intelligence (EI), which is a major component of social cognition. Given the absence of EI ability-based scales adapted to Chinese speakers, we translated the MSCEIT into a Traditional Chinese version (MSCEIT-TC) and validated this scale for use in schizophrenia studies. The specific aims were to validate the MSCEIT-TC, to develop a norm for the MSCEIT-TC, and use this norm to explore the EI performance of schizophrenic individuals. We included in our study seven hundred twenty-eight healthy controls and seventy-six individuals with schizophrenia. The results suggest that the MSCEIT-TC is reliable and valid when assessing EI. The results showed good discrimination and validity when comparing the two study groups. Impairment was the greatest for two branches Understanding and Managing Emotions, which implies that the deficits of schizophrenia individuals involve ToM (theory of mind) tasks. Deficits involving the negative scale of schizophrenia was related to impaired performance when the MSCEIT-TC was used (in branch 2, 3, 4, and the area Strategic). Our findings suggest that the MSCEIT-TC can be used for emotional studies in healthy Chinese and in clinical setting for investigating schizophrenic individuals.
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Marquand AF, Wolfers T, Mennes M, Buitelaar J, Beckmann CF. Beyond Lumping and Splitting: A Review of Computational Approaches for Stratifying Psychiatric Disorders. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 1:433-447. [PMID: 27642641 PMCID: PMC5013873 DOI: 10.1016/j.bpsc.2016.04.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/06/2016] [Accepted: 04/06/2016] [Indexed: 01/03/2023]
Abstract
Heterogeneity is a key feature of all psychiatric disorders that manifests on many levels, including symptoms, disease course, and biological underpinnings. These form a substantial barrier to understanding disease mechanisms and developing effective, personalized treatments. In response, many studies have aimed to stratify psychiatric disorders, aiming to find more consistent subgroups on the basis of many types of data. Such approaches have received renewed interest after recent research initiatives, such as the National Institute of Mental Health Research Domain Criteria and the European Roadmap for Mental Health Research, both of which emphasize finding stratifications that are based on biological systems and that cut across current classifications. We first introduce the basic concepts for stratifying psychiatric disorders and then provide a methodologically oriented and critical review of the existing literature. This shows that the predominant clustering approach that aims to subdivide clinical populations into more coherent subgroups has made a useful contribution but is heavily dependent on the type of data used; it has produced many different ways to subgroup the disorders we review, but for most disorders it has not converged on a consistent set of subgroups. We highlight problems with current approaches that are not widely recognized and discuss the importance of validation to ensure that the derived subgroups index clinically relevant variation. Finally, we review emerging techniques-such as those that estimate normative models for mappings between biology and behavior-that provide new ways to parse the heterogeneity underlying psychiatric disorders and evaluate all methods to meeting the objectives of such as the National Institute of Mental Health Research Domain Criteria and Roadmap for Mental Health Research.
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Affiliation(s)
- Andre F. Marquand
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen
- Department of Cognitive Neuroscience , Radboud University Medical Centre, Nijmegen
- Department of Neuroimaging (AFM), Centre for Neuroimaging Sciences, Institute of Psychiatry, King’s College London, London
| | - Thomas Wolfers
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen
| | - Maarten Mennes
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen
| | - Jan Buitelaar
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen
- Department of Cognitive Neuroscience , Radboud University Medical Centre, Nijmegen
- Karakter Child and Adolescent Psychiatric University Centre, Nijmegen, The Netherlands
| | - Christian F. Beckmann
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen
- Department of Cognitive Neuroscience , Radboud University Medical Centre, Nijmegen
- Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (CFB), University of Oxford, London, United Kingdom
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Rakitzi S, Georgila P, Efthimiou K, Mueller DR. Efficacy and feasibility of the Integrated Psychological Therapy for outpatients with schizophrenia in Greece: Final results of a RCT. Psychiatry Res 2016; 242:137-143. [PMID: 27280523 DOI: 10.1016/j.psychres.2016.05.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 05/03/2016] [Accepted: 05/30/2016] [Indexed: 11/29/2022]
Abstract
The goal of this study was to evaluate the efficacy and the feasibility of cognitive remediation group therapy in patients with schizophrenia in Greece. For this purpose, the cognitive part of the Integrated Psychological Therapy (IPT), focusing on neuro- and social cognition, was compared in a randomized controlled trial (RCT) with treatment as usual (TAU). 48 outpatients took part in the study. IPT groups received 20 biweekly 1-h-therapy sessions. A test-battery was assessed at baseline, after therapy, and at a 3-month follow-up. Regarding cognitive functioning, significant effects favouring IPT were found in working memory and social perception during therapy and at follow-up. No effects could be found in verbal memory and vigilance. Significant effects favoring IPT were found in negative symptoms, in insight and in general symptoms during therapy and at follow-up using the Positive and Negative Syndrome Scale (PANSS). No effects were evident in positive symptoms and in psychosocial functioning. Significant effects favoring TAU were found in the quality of life assessment at follow-up. The study supports evidence for the feasibility and efficacy of IPT in psychiatric care in Greece and it hopefully will initiate the broader use of evidenced-based treatments like IPT in Greek Psychiatry.
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Affiliation(s)
| | - Polyxeni Georgila
- Psychiatric Department for Adults at the General Hospital "G. Gennimatas", Mesogion 154, 11527 Athens, Greece.
| | | | - Daniel R Mueller
- University Hospital of Psychiatry and Psychotherapy Bern, Bolligenstrasse 111, CH 3000 Bern 60, Switzerland.
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Zhao Y, Li J, Liu X, Song Y, Wang R, Yang Z, Liu J. Altered spontaneous neural activity in the occipital face area reflects behavioral deficits in developmental prosopagnosia. Neuropsychologia 2016; 89:344-355. [PMID: 27475965 DOI: 10.1016/j.neuropsychologia.2016.05.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 05/04/2016] [Accepted: 05/24/2016] [Indexed: 11/27/2022]
Abstract
Individuals with developmental prosopagnosia (DP) exhibit severe difficulties in recognizing faces and to a lesser extent, also exhibit difficulties in recognizing non-face objects. We used fMRI to investigate whether these behavioral deficits could be accounted for by altered spontaneous neural activity. Two aspects of spontaneous neural activity were measured: the intensity of neural activity in a voxel indexed by the fractional amplitude of spontaneous low-frequency fluctuations (fALFF), and the connectivity of a voxel to neighboring voxels indexed by regional homogeneity (ReHo). Compared with normal adults, both the fALFF and ReHo values within the right occipital face area (rOFA) were significantly reduced in DP subjects. Follow-up studies on the normal adults revealed that these two measures indicated further functional division of labor within the rOFA. The fALFF in the rOFA was positively correlated with behavioral performance in recognition of non-face objects, whereas ReHo in the rOFA was positively correlated with processing of faces. When considered together, the altered fALFF and ReHo within the same region (rOFA) may account for the comorbid deficits in both face and object recognition in DPs, whereas the functional division of labor in these two measures helps to explain the relative independency of deficits in face recognition and object recognition in DP.
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Affiliation(s)
- Yuanfang Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, China
| | - Jingguang Li
- College of Education, Dali University, Dali 671003, China
| | - Xiqin Liu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, China
| | - Yiying Song
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, China
| | - Ruosi Wang
- Psychology Department, Harvard University, 02138 USA
| | - Zetian Yang
- The Rockefeller University, New York, NY 10065, USA
| | - Jia Liu
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, China; School of Psychology, Beijing Normal University, Beijing 100875, China.
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Stiekema APM, Liemburg EJ, van der Meer L, Castelein S, Stewart R, van Weeghel J, Aleman A, Bruggeman R. Confirmatory Factor Analysis and Differential Relationships of the Two Subdomains of Negative Symptoms in Chronically Ill Psychotic Patients. PLoS One 2016; 11:e0149785. [PMID: 26895203 PMCID: PMC4760738 DOI: 10.1371/journal.pone.0149785] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 02/04/2016] [Indexed: 01/30/2023] Open
Abstract
Research suggests a two factor structure for negative symptoms in patients with psychotic disorders: social amotivation (SA) and expressive deficits (ED). Applying this two-factor structure in clinical settings may provide valuable information with regard to outcomes and to target treatments. We aimed to investigate 1) whether the factor structure is also supported in chronically ill patients with a psychotic disorder and 2) what the relationship is between these factors and functioning (overall functioning and living situation), depressive symptoms and quality of life. 1157 Patients with a psychotic disorder and a duration of illness of 5 years or more were included in the analysis (data selected from the Pharmacotherapy Monitoring Outcome Survey; PHAMOUS). A confirmatory factor analysis was performed using items of the Positive and Negative Syndrome Scale that were previously identified to reflect negative symptoms (N1-4, N6, G5, G7, G13, G16). Subsequently, regression analysis was performed on outcomes. The results confirmed the distinction between SA (N2, N4, G16) and ED (N1, N3, N6, G5, G7, G13) in chronically ill patients. Both factors were related to worse overall functioning as measured with the Health of the Nation Outcome Scales, ED was uniquely associated with residential living status. Higher scores for SA were associated with more depressive symptoms and worse quality of life. Thus, SA is most strongly related to level of social-emotional functioning, while ED are more related to living situation and thereby are indicative of level of everyday functioning. This subdivision may be useful for research purposes and be a valuable additional tool in clinical practice and treatment development.
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Affiliation(s)
- Annemarie P. M. Stiekema
- Department of Rehabilitation, Lentis Center for Mental Health Care, Zuidlaren, the Netherlands
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- * E-mail:
| | - Edith J. Liemburg
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Research Department, Lentis Center for Mental Health Care, Groningen, the Netherlands
| | - Lisette van der Meer
- Department of Rehabilitation, Lentis Center for Mental Health Care, Zuidlaren, the Netherlands
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Stynke Castelein
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Research Department, Lentis Center for Mental Health Care, Groningen, the Netherlands
| | - Roy Stewart
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jaap van Weeghel
- Parnassia Group, Dijk en Duin Mental Health Center, Castricum, the Netherlands
- Tilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific center for Care and Welfare, Tilburg, the Netherlands
- Phrenos, Center of Expertise on severe mental illness, Utrecht, the Netherlands
| | - André Aleman
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Richard Bruggeman
- Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- University Center of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Lam M, Abdul Rashid NA, Lee SA, Lim J, Foussias G, Fervaha G, Ruhrman S, Remington G, Lee J. Baseline social amotivation predicts 1-year functioning in UHR subjects: A validation and prospective investigation. Eur Neuropsychopharmacol 2015; 25:2187-96. [PMID: 26553972 DOI: 10.1016/j.euroneuro.2015.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/17/2015] [Accepted: 10/22/2015] [Indexed: 12/15/2022]
Abstract
Social amotivation and diminished expression have been reported to underlie negative symptomatology in schizophrenia. In the current study we sought to establish and validate these negative symptom domains in a large cohort of schizophrenia subjects (n=887) and individuals who are deemed to be Ultra-High Risk (UHR) for psychosis. Confirmatory factor analysis conducted on PANSS item domains demonstrate that the dual negative symptom domains exist in schizophrenia and UHR subjects. We further sought to examine if these negative symptom domains were associated with functioning in UHR subjects. Linear regression analyses confirmed that social amotivation predicted functioning in UHR subjects prospectively at 1 year follow up. Results suggest that the association between social amotivation and functioning is generalisable beyond schizophrenia populations to those who are at-risk of developing psychosis. Social amotivation may be an important dimensional clinical construct to be studied across a range of psychiatric conditions.
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Affiliation(s)
- Max Lam
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Sara-Ann Lee
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Jeanette Lim
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - George Foussias
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Gagan Fervaha
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Stephan Ruhrman
- Department of Psychiatry and Psychotherapy, University of Cologne, Germany
| | - Gary Remington
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore; Department of General Psychiatry 1, Institute of Mental Health, Singapore, Singapore; Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore, Singapore.
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Kalin M, Kaplan S, Gould F, Pinkham A, Penn D, Harvey PD. Social cognition, social competence, negative symptoms and social outcomes: Inter-relationships in people with schizophrenia. J Psychiatr Res 2015; 68:254-60. [PMID: 26228427 PMCID: PMC4524806 DOI: 10.1016/j.jpsychires.2015.07.008] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/18/2015] [Accepted: 07/09/2015] [Indexed: 11/30/2022]
Abstract
Social deficits are common in people with schizophrenia and the treatment of deficits in social competence has been a long-time treatment strategy. However, negative symptoms and social cognitive deficits also contribute to social dysfunction. In this study, we examined the correlations between everyday social outcomes, a performance based measure of social competence, and performance on 8 different social cognition tests in 179 patients with schizophrenia. Social cognition, social competence, and motivation-related negative symptoms accounted for 32% of the variance in real-world social outcomes. In addition, two different social cognition tests, along with expression-related negative symptoms accounted for 32% of the variance in performance-based assessments of social competence. These data suggest that negative symptoms exert an important influence on social outcomes and social competence, but not social cognition, and that social cognition and social competence exert separable influences on real-world social outcomes. Improving social outcomes seems to require a multi-faceted approach which considers social cognition, social competence, and negative symptoms.
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Affiliation(s)
- Marc Kalin
- University of Miami Miller School of Medicine
| | - Sara Kaplan
- University of Miami Miller School of Medicine
| | | | - Amy Pinkham
- The University of Texas at Dallas,The University of Texas Southwestern Medical School
| | - David Penn
- University of North Carolina,Australian Catholic University
| | - Philip D. Harvey
- University of Miami Miller School of Medicine,Research Service, Bruce W. Carter VA Medical Center, Miami, FL
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Abstract
Endophenotypes are disease-associated phenotypes that are thought to reflect the neurobiological or other mechanisms that underlie the more overt symptoms of a psychiatric illness. Endophenotypes have been critical in understanding the genetics, neurobiology, and treatment of schizophrenia. Because psychiatric illnesses have multiple causes, including both genetic and nongenetic risk factors, an endophenotype linked to one of the mechanisms may be expressed more frequently than the disease itself. However, in schizophrenia research, endophenotypes have almost exclusively been studied in older adolescents or adults who have entered or passed through the age of risk for the disorder. Yet, schizophrenia is a neurodevelopmental disorder where prenatal development starts a cascade of brain changes across the lifespan. Endophenotypes have only minimally been utilized to explore the perinatal development of vulnerability. One major impediment to the development of perinatally-useful endophenotypes has been the established validity criteria. For example, the criterion that the endophenotype be more frequently present in those with disease than those without is difficult to demonstrate when there can be a decades-long period between endophenotype measurement and the age of greatest risk for onset of the disorder. This article proposes changes to the endophenotype validity criteria appropriate to perinatal research and reviews how application of these modified criteria helped identify a perinatally-usable phenotype of risk for schizophrenia, P50 sensory gating, which was then used to propose a novel perinatal primary prevention intervention.
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Affiliation(s)
- Randal G. Ross
- Department of Psychiatry, University of Colorado Denver, Aurora, CO,*To whom correspondence should be addressed; Department of Psychiatry, School of Medicine, University of Colorado Denver, 13001 E. 17th Place, Campus Box F546, Aurora, CO 80045, US; tel: 303-724-6203, fax: 303-724-6207, e-mail:
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver, Aurora, CO
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Bahk YC, Jang SK, Lee JY, Choi KH. Korean facial emotion recognition tasks for schizophrenia research. Psychiatry Investig 2015; 12:235-41. [PMID: 25866525 PMCID: PMC4390595 DOI: 10.4306/pi.2015.12.2.235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 04/01/2014] [Accepted: 04/11/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Despite the fact that facial emotion recognition (FER) tasks using Western faces should be applied with caution to non-Western participants or patients, there are few psychometrically sound and validated FER tasks featuring Easterners' facial expressions for emotions. Thus, we aimed to develop and establish the psychometric properties of the Korean Facial Emotion Identification Task (K-FEIT) and the Korean Facial Emotion Discrimination Task (K-FEDT) for individuals with schizophrenia. METHODS The K-FEIT and K-FEDT were administered to 42 Korean individuals with schizophrenia to evaluate their psychometric properties. To test the convergent and divergent validities, the Social Behavior Sequencing Task (SBST) and hinting task were administered as social-cognitive measures, and the Trail Making Test (TMT)-A and -B were administered as neurocognitive measures. RESULTS Average accuracy on the K-FEIT and K-FEDT were 63% and 74%, respectively, and internal consistencies of the K-FEIT and K-FEDT were 0.82 and 0.95, respectively. The K-FEIT and K-FEDT were significantly correlated with SBST and Hinting Task, but not with TMT-A and B. CONCLUSION Following replication studies in a larger sample, the K-FEIT and K-FEDT are expected to facilitate future studies targeting facial emotion recognition in schizophrenia in Korea. Limitations and directions for future research are discussed.
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Affiliation(s)
- Yong-Chun Bahk
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Seon-Keong Jang
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Jee Ye Lee
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea University, Seoul, Republic of Korea
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