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Remmers MCC, Reijs RP, Hoebe CJPA. Defining and distinguishing early life stress, trauma, adversity, toxic and chronic stress and allostatic load: a descriptive review. Scand J Public Health 2024:14034948241260105. [PMID: 39087715 DOI: 10.1177/14034948241260105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
AIMS Various concepts are used to study the impact of stress on childhood development. These concepts are often used inconsistently or interchangeably. Our main objectives were to determine how selected stress concepts (chronic stress, toxic stress, allostatic load, early life stress, childhood adversity, childhood trauma and adverse childhood experiences; ACEs) are defined, operationalized and described, and to provide a theoretical context to aid the choice for a preferred concept in public health research. METHODS For this descriptive review, we systematically searched for literature published before 4 August 2021, on PubMed, Embase and PsycInfo. Two independent reviewers included studies. Exclusion criteria were: no systematic review, not peer reviewed, not published in English, selected stress concepts were no predetermined variable or a substantial topic in the discussion, full text was unobtainable or study described non-human or non-childhood populations. Data extraction forms were used. Descriptives were gathered, publication fields were identified through Journal Citation Reports categories, and verbatim descriptions were ordered in text and Venn diagrams. RESULTS Of 264 screened studies, 124 were included. ACEs, childhood adversity and childhood trauma were used most. ACEs were the main concept used most frequently (47.6%). A total of 11 of 14 public and environmental health journals used ACEs. All concepts refer to prolonged, repeated, interpersonal stress from 0 to 18 years, that can alter physiological systems. Four concepts were stressor oriented, two concepts focused on stress response and effect and one on the state of challenged homeostasis. CONCLUSIONS ACEs seem most fitting for public health setting, due to their operationalizability, large set of core experiences and widespread use.
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Affiliation(s)
- Maarten C C Remmers
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Youth Health Care, Public Health Service Limburg-North, Venlo, Netherlands
| | - Rianne P Reijs
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Youth Health Care, Living Lab Public Health Mosa, Public Health Service South Limburg, Heerlen, Netherlands
| | - Christian J P A Hoebe
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, Public Health Service South Limburg, Heerlen, Netherlands
- Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, Netherlands
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Gkintoni E, Skokou M, Gourzis P. Integrating Clinical Neuropsychology and Psychotic Spectrum Disorders: A Systematic Analysis of Cognitive Dynamics, Interventions, and Underlying Mechanisms. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:645. [PMID: 38674291 PMCID: PMC11051923 DOI: 10.3390/medicina60040645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: The study aims to provide a comprehensive neuropsychological analysis of psychotic spectrum disorders, including schizophrenia, bipolar disorder, and depression. It focuses on the critical aspects of cognitive impairments, diagnostic tools, intervention efficacy, and the roles of genetic and environmental factors in these disorders. The paper emphasizes the diagnostic significance of neuropsychological tests in identifying cognitive deficiencies and their predictive value in the early management of psychosis. Materials and Methods: The study involved a systematic literature review following the PRISMA guidelines. The search was conducted in significant databases like Scopus, PsycINFO, PubMed, and Web of Science using keywords relevant to clinical neuropsychology and psychotic spectrum disorders. The inclusion criteria required articles to be in English, published between 2018 and 2023, and pertinent to clinical neuropsychology's application in these disorders. A total of 153 articles were identified, with 44 ultimately included for detailed analysis based on relevance and publication status after screening. Results: The review highlights several key findings, including the diagnostic and prognostic significance of mismatch negativity, neuroprogressive trajectories, cortical thinning in familial high-risk individuals, and distinct illness trajectories within psychosis subgroups. The studies evaluated underline the role of neuropsychological tests in diagnosing psychiatric disorders and emphasize early detection and the effectiveness of intervention strategies based on cognitive and neurobiological markers. Conclusions: The systematic review underscores the importance of investigating the neuropsychological components of psychotic spectrum disorders. It identifies significant cognitive impairments in attention, memory, and executive function, correlating with structural and functional brain abnormalities. The paper stresses the need for precise diagnoses and personalized treatment modalities, highlighting the complex interplay between genetic, environmental, and psychosocial factors. It calls for a deeper understanding of these neuropsychological processes to enhance diagnostic accuracy and therapeutic outcomes.
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Affiliation(s)
- Evgenia Gkintoni
- Department of Psychiatry, University General Hospital of Patras, 26504 Patras, Greece; (M.S.); (P.G.)
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Andreo-Jover J, Wootton O, Fernández-Jiménez E, Muñoz-Sanjosé A, Mediavilla R, Bravo-Ortiz MF, Susser E, Gur RC, Stein DJ. Adverse childhood experiences and cognition: A cross-sectional study in Xhosa people living with schizophrenia and matched medical controls. Compr Psychiatry 2024; 130:152459. [PMID: 38330854 DOI: 10.1016/j.comppsych.2024.152459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with impaired cognitive function in adult life in the general population as well as in people living with schizophrenia (PLS). Research on cognitive function in PLS in low- and middle-income countries (LMIC) is, however, limited. The objectives of this study were to investigate the association between ACE types and various cognitive domains in a sample of PLS and matched medical controls, and to determine the moderating effect of group membership (PLS vs. medical controls) on these associations, in the South African setting. METHODS Participants (n PLS = 520; n medical controls = 832) completed the Childhood Trauma Questionnaire-Short Form, the Structured Clinical Interview for DSM-IV (SCID-I), and the University of Pennsylvania Computerized Neurocognitive Battery (PennCNB). An efficiency or speed score was used to assess performance across 9 cognitive domains. The association between exposure to different ACE types and 9 cognitive domains was examined using partial correlations and multiple linear regression models, adjusting for sex, age and education years. Finally, potential moderating effects of group membership (PLS vs. medical controls) on the association between ACEs and cognitive domains were tested. RESULTS In the entire sample, emotional and physical abuse predicted worse performance on sensorimotor and emotion identification domains. Also, emotional abuse was negatively associated with motor function, physical abuse was negatively associated with spatial processing, and physical neglect was negatively associated with face memory and emotion identification. In contrast, emotional neglect was related to better performance on abstraction and mental flexibility. No moderating effect of group membership was found on any of these associations. CONCLUSION Exposure to ACEs was associated with social and non-social cognition in adulthood, although the magnitude of these relationships was small and similar between PLS and matched medical controls. The nature of these associations differed across ACE subtype, suggesting the need for a nuanced approach to studying a range of mechanisms that may underlie different associations. However, a number of ACE subtypes were associated with worse performance on emotional identification, indicating that some underlying mechanisms may have more transversal impact. These findings contribute to the sparse body of literature on ACEs and cognition in PLS in LMIC.
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Affiliation(s)
- Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Olivia Wootton
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Eduardo Fernández-Jiménez
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Universidad Europea de Madrid, Faculty of Social Sciences and Communication, Madrid, Spain.
| | - Ainoa Muñoz-Sanjosé
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Roberto Mediavilla
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
| | - María Fe Bravo-Ortiz
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, United States; Department of Psychiatry, New York State Psychiatric Institute, New York, United States
| | - Ruben C Gur
- Brain Behavior Laboratories, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States
| | - Dan J Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Rowe AL, Perich T, Meade T. Bipolar disorder and cumulative trauma: A systematic review of prevalence and illness outcomes. J Clin Psychol 2024; 80:692-713. [PMID: 38277425 DOI: 10.1002/jclp.23650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/24/2023] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND The experience of cumulative trauma may be common in bipolar disorder (BD). However, it is not frequently reported as most studies focus on childhood trauma without examining differences in the amount of trauma experienced. This systematic review aimed to determine the prevalence of lifetime cumulative trauma in BD as well as explore associated illness outcomes. METHODS A systematic review was completed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Both the prevalence and outcomes of cumulative trauma in BD were assessed. Five electronic databases were searched (Embase, MEDLINE, PsycINFO, Web of Science, and PTSD Pubs) for records from January 2010 until December 2022. RESULTS A total of 20 studies, with 9304 participants were included in the narrative synthesis. At least one-third of BD participants had experienced cumulative trauma, with a prevalence range from 29% to 82%. The main outcomes associated with a history of cumulative trauma were earlier age of onset, longer episode duration, more lifetime mood episodes, greater likelihood of experiencing psychotic features, and higher likelihood of past suicide attempts. LIMITATIONS This review has been limited by the lack of studies directly assessing cumulative trauma in BD. CONCLUSIONS Cumulative trauma is prevalent in BD. Preliminary evidence indicates an association with a range of adverse outcomes, emphasizing the need for clinicians to obtain a detailed trauma history and to consider these risks in the management of the disorder. Future studies should report on the prevalence of cumulative trauma, particularly in adulthood as this area remains unexplored.
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Affiliation(s)
- Amy-Leigh Rowe
- School of Psychology, Western Sydney University, Penrith, Australia
| | - Tania Perich
- School of Psychology, Western Sydney University, Penrith, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Tanya Meade
- School of Psychology, Western Sydney University, Penrith, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
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Karamaouna P, Zouraraki C, Economou E, Kafetsios K, Bitsios P, Giakoumaki SG. Cold executive function processes and their hot analogs in schizotypy. J Int Neuropsychol Soc 2024; 30:285-294. [PMID: 37750805 DOI: 10.1017/s1355617723000590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
OBJECTIVE To examine cold (based on logical reasoning) versus hot (having emotional components) executive function processes in groups with high individual schizotypal traits. METHOD Two-hundred and forty-seven participants were administered the Schizotypal Personality Questionnaire and were allocated into schizotypal (cognitive-perceptual, paranoid, negative, disorganized) or control groups according to pre-specified criteria. Participants were also administered a battery of tasks examining working memory, complex selective attention, response inhibition, decision-making and fluid intelligence and their affective counterparts. The outcome measures of each task were reduced to one composite variable thus formulating five cold and five hot cognitive domains. Between-group differences in the cognitive domains were examined with repeated measures analyses of covariance. RESULTS For working memory, the control and the cognitive-perceptual groups outperformed negative schizotypes, while for affective working memory controls outperformed the disorganized group. Controls also scored higher compared with the disorganized group in complex selective attention, while both the control and the cognitive-perceptual groups outperformed negative schizotypes in complex affective selective attention. Negative schizotypes also had striking difficulties in response inhibition, as they scored lower compared with all other groups. Despite the lack of differences in fluid intelligence, controls scored higher compared with all schizotypal groups (except from cognitive-perceptual schizotypes) in emotional intelligence; the latter group reported higher emotional intelligence compared with negative schizotypes. CONCLUSION Results indicate that there is no categorical association between the different schizotypal dimensions with solely cold or hot executive function processes and support impoverished emotional intelligence as a core feature of schizotypy.
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Affiliation(s)
- Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
| | - Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
| | - Elias Economou
- Laboratory of Experimental Psychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
| | | | - Panos Bitsios
- Department of Psychiatry and Behavioural Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
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Vaskinn A, Ueland T, Melle I, Sundet K. Sex differences in social cognition among individuals with schizophrenia and in healthy control participants: a secondary analysis of published data. Arch Womens Ment Health 2024:10.1007/s00737-024-01422-8. [PMID: 38244033 DOI: 10.1007/s00737-024-01422-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE Sex differences are present among individuals experiencing schizophrenia. Whether these differences extend to social cognition is unclear. In this study, we investigated sex differences in emotion perception, social perception and theory of mind (ToM). METHODS We examined sex differences between males and females with schizophrenia on five social cognitive tests. Healthy male and female control participants were included to examine if any sex difference was illness-specific. Emotion perception was measured with Pictures of Facial Affect (PFA) and Emotion in Biological Motion (EmoBio); social perception with the Relationships Across Domains Test (RAD); and ToM with the Movie for the Assessment of Social Cognition (MASC) and Hinting Task. RESULTS Two-way analyses of variance revealed overall group differences for all tests, with healthy controls outperforming individuals with schizophrenia. Significant sex effects were present for PFA and Hinting Task. There were no significant interaction effects. Within-group independent samples t-tests yielded one significant sex difference, i.e., among healthy controls for PFA. CONCLUSIONS Females had better facial emotion perception than males. This sex difference was statistically significant among healthy controls and medium-large among individuals experiencing schizophrenia. There were no significant sex differences for other social cognitive domains. The study did not find evidence for a general female advantage in social cognition.
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Affiliation(s)
- Anja Vaskinn
- Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, PO Box 4956, Nydalen, 0424, Oslo, Norway.
- Institute of Clinical Medicine, Norwegian Centre for Mental Disorders Research, University of Oslo, Oslo, Norway.
| | - Torill Ueland
- Department of Psychology, University of Oslo, Oslo, Norway
- Psychosis Research Section, Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- Institute of Clinical Medicine, Norwegian Centre for Mental Disorders Research, University of Oslo, Oslo, Norway
- Psychosis Research Section, Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Kjetil Sundet
- Department of Psychology, University of Oslo, Oslo, Norway
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Corley E, Patlola SR, Laighneach A, Corvin A, McManus R, Kenyon M, Kelly JP, Mckernan DP, King S, Hallahan B, Mcdonald C, Morris DW, Donohoe G. Genetic and inflammatory effects on childhood trauma and cognitive functioning in patients with schizophrenia and healthy participants. Brain Behav Immun 2024; 115:26-37. [PMID: 37748567 DOI: 10.1016/j.bbi.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023] Open
Abstract
Recent studies have reported a negative association between exposure to childhood trauma, including physical neglect, and cognitive functioning in patients with schizophrenia. Childhood trauma has been found to influence immune functioning, which may contribute to the risk of schizophrenia and cognitive symptoms of the disorder. In this study, we aimed to test the hypothesis that physical neglect is associated with cognitive ability, and that this association is mediated by a combined latent measure of inflammatory response, and moderated by higher genetic risk for schizophrenia. The study included 279 Irish participants, comprising 102 patients and 177 healthy participants. Structural equation modelling was used to perform mediation and moderation analyses. Inflammatory response was measured via basal plasma levels of IL-6, TNF-α, and CRP, and cognitive performance was assessed across three domains: full-scale IQ, logical memory, and the emotion recognition task. Genetic variation for schizophrenia was estimated using a genome-wide polygenic score based on genome-wide association study summary statistics. The results showed that inflammatory response mediated the association between physical neglect and all measures of cognitive functioning, and explained considerably more variance than any of the inflammatory markers alone. Furthermore, genetic risk for schizophrenia was observed to moderate the direct pathway between physical neglect and measures of non-social cognitive functioning in both patient and healthy participants. However, genetic risk did not moderate the mediated pathway associated with inflammatory response. Therefore, we conclude that the mediating role of inflammatory response and the moderating role of higher genetic risk may independently influence the association between adverse early life experiences and cognitive function in patients and healthy participants.
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Affiliation(s)
- Emma Corley
- School of Psychology, University of Galway, Ireland; Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland
| | - Saahithh Redddi Patlola
- Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland; Pharmacology & Therapeutics and Galway Neuroscience Centre, University of Galway, Ireland
| | - Aodán Laighneach
- Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland; School of Biological and Chemical Sciences, University of Galway, Ireland
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, Ireland
| | - Ross McManus
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, Ireland
| | - Marcus Kenyon
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, Ireland
| | - John P Kelly
- Pharmacology & Therapeutics and Galway Neuroscience Centre, University of Galway, Ireland
| | - Declan P Mckernan
- Pharmacology & Therapeutics and Galway Neuroscience Centre, University of Galway, Ireland
| | - Sinead King
- School of Psychology, University of Galway, Ireland; Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland
| | - Brian Hallahan
- Department of Psychiatry, Clinical Science Institute, University of Galway, Ireland
| | - Colm Mcdonald
- Department of Psychiatry, Clinical Science Institute, University of Galway, Ireland
| | - Derek W Morris
- Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland; School of Biological and Chemical Sciences, University of Galway, Ireland
| | - Gary Donohoe
- School of Psychology, University of Galway, Ireland; Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland.
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Lovric S, Klaric M, Lovric I, Camber R, Kresic Coric M, Kvesic J, Kajic-Selak A. Clinical characteristics of psychotic disorders in patients with childhood trauma. Medicine (Baltimore) 2023; 102:e36733. [PMID: 38134067 PMCID: PMC10735130 DOI: 10.1097/md.0000000000036733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
Childhood trauma is an important predictor of psychotic disorders, with special emphasis on physical and sexual abuse. It influences the clinical picture and course of psychotic disorders. This study was conducted in the Department of Psychiatry of the University Clinical Hospital Mostar. The sample consisted of 135 participants, aged 18 to 65 years. The screening instrument to examine cognitive status was the short version of MMSE-2. Patients' background information was collected using a sociodemographic questionnaire constructed for this study. To determine childhood trauma, the Child Abuse Experience Inventory was used to examine physical, sexual, and emotional abuse, neglect and domestic violence. The positive and negative syndrome scale scale was used to evaluate the clinical profile of psychoticism, the SSI questionnaire was used to evaluate the severity of suicidality, and the functionality of the participants was evaluated using the WHODAS 2.0. Results indicate that a significant number of participants with psychotic disorders experienced childhood trauma, an important determinant of their illness. Participants who had witnessed abuse had more severe clinical presentations (earlier onset and longer duration of illness) and more pronounced psychotic symptomatology and a lower degree of functionality. Decreased functionality is associated with witnessing abuse and physical abuse. During the civil war, a significant percentage of the participants were in childhood and adolescent development (26.7%) and exposed to frequent emotional abuse and domestic violence. As 1 traumatic event in childhood makes a person more susceptible to more traumatic experiences during life. Childhood trauma is a serious and pervasive problem that has a significant impact on the development, course, and severity of the clinical presentation of psychotic disorders. Accordingly, it is necessary to provide continuous education to mental health workers, primarily psychiatrists, regarding childhood trauma so that treatment may be approached more systematically and a plan of therapeutic interventions may be more adequately designed, which would necessarily include psychosocial support in addition to pharmacotherapy.
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Affiliation(s)
- Sanjin Lovric
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Miro Klaric
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Ivona Lovric
- Department of Dermatology of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Renata Camber
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Martina Kresic Coric
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Josip Kvesic
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Anita Kajic-Selak
- Department of Psychiatry of the University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
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Enthoven ASD, Gangadin SS, de Haan L, Veling W, de Vries EFJ, Doorduin J, Begemann MJH, Sommer IEC. The association of childhood trauma with depressive and negative symptoms in recent onset psychosis: a sex-specific analysis. Psychol Med 2023; 53:7795-7804. [PMID: 37435649 PMCID: PMC10755234 DOI: 10.1017/s0033291723001824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Childhood trauma may impact the course of schizophrenia spectrum disorders (SSD), specifically in relation to the increased severity of depressive or negative symptoms. The type and impact of trauma may differ between sexes. In a large sample of recent-onset patients, we investigated the associations of depressive and negative symptoms with childhood trauma and whether these are sex-specific. METHODS A total of 187 first-episode psychosis patients in remission (Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment study) and 115 recent-onset SSD patients (Simvastatin study) were included in this cross-sectional study (men: n = 218; women: n = 84). Total trauma score and trauma subtypes were assessed using the Childhood Trauma Questionnaire Short Form; depressive and negative symptoms were rated using the Positive And Negative Symptoms Scale. Sex-specific regression analyses were performed. RESULTS Women reported higher rates of sexual abuse than men (23.5% v. 7.8%). Depressive symptoms were associated with total trauma scores and emotional abuse ratings in men (β: 0.219-0.295; p ≤ 0.001). In women, depressive symptoms were associated with sexual abuse ratings (β: 0.271; p = 0.011). Negative symptoms were associated with total trauma score and emotional neglect ratings in men (β: 0.166-0.232; p ≤ 0.001). Negative symptoms in women were not linked to childhood trauma, potentially due to lack of statistical power. CONCLUSIONS Depressive symptom severity was associated with different types of trauma in men and women with recent-onset SSD. Specifically, in women, depressive symptom severity was associated with childhood sexual abuse, which was reported three times as often as in men. Our results emphasize the importance of sex-specific analyses in SSD research.
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Affiliation(s)
- Anne-Sophie D. Enthoven
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Shiral S. Gangadin
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lieuwe de Haan
- Department of Early Psychosis, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Wim Veling
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Erik F. J. de Vries
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Janine Doorduin
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - HAMLETT and OPHELIA Consortium
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke J. H. Begemann
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Iris E. C. Sommer
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Keřková B, Knížková K, Večeřová M, Šustová P, Fürstová P, Hrubý A, Španiel F, Rodriguez M. Inflammation and cognitive performance in first-episode schizophrenia spectrum disorders: The moderating effects of childhood trauma. Schizophr Res 2023; 261:185-193. [PMID: 37783016 DOI: 10.1016/j.schres.2023.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 07/28/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023]
Abstract
In this study, we aimed to determine whether childhood trauma moderated the relationship between inflammation and cognitive functioning in persons with first-episode schizophrenia spectrum disorders (SSDs). We included data from 92 individuals who participated in the nationwide Early-Stage Schizophrenia Outcome study. These individuals completed the Childhood Trauma Questionnaire, provided a fasting blood sample for high-sensitivity C-reactive protein analysis, and underwent extensive neuropsychological testing. The intervening effects of age, sex, education, smoking status, and body mass index were controlled. Results indicated that childhood trauma levels significantly moderated the relationship between inflammation and four cognitive domains: speed of processing, working memory, visual memory, and verbal memory. Inflammation also predicted verbal memory scores irrespective of childhood trauma levels or the covariates. Upon further exploration, the significant moderation effects appeared to be primarily driven by males. In conclusion, a history of childhood trauma may be an important determinant in evaluating how inflammation relates to the cognitive performance of people with first-episode SSDs, particularly in speed of processing, working memory, visual memory, and verbal memory. We recommend that future researchers examining the effect of inflammation on cognitive functioning in SSDs include trauma as a moderating variable in their models and further examine additional moderating effects of sex.
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Affiliation(s)
- Barbora Keřková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Karolína Knížková
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Monika Večeřová
- National Institute of Mental Health, Klecany, Czech Republic
| | - Petra Šustová
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Arts, Charles University in Prague, Czech Republic
| | - Petra Fürstová
- National Institute of Mental Health, Klecany, Czech Republic
| | - Aleš Hrubý
- National Institute of Mental Health, Klecany, Czech Republic
| | - Filip Španiel
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University in Prague, Czech Republic
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Arts, Charles University in Prague, Czech Republic
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11
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Golay P, Abrahamyan Empson L, Mebdouhi N, Conus P, Alameda L. A better understanding of the impact of childhood trauma on depression in early psychosis: A differential item functioning approach. Schizophr Res 2023; 261:18-23. [PMID: 37688909 DOI: 10.1016/j.schres.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/01/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Childhood trauma (CT) has been shown to impact depressive symptoms measured broadly in early psychosis patients. Beyond the broad intensity of such impact, less is known about which depressive features are more impacted. METHODS Patients of a specialized early intervention programme were evaluated after the first two and six months of treatment with the Montgomery-Asberg Depression Rating Scale (MADRS). We used the first assessment available. We estimated an Item-response model to reveal potential differential item functioning (DIF) in order to highlight depressive features that could be impacted differently than others by experiences of abuse (sexual physical and emotional) and neglect (physical and emotional). RESULTS Two hundred and sixty-two recent onset patients with psychosis were assessed. Results at the beginning of the Treatment and Early Intervention in Psychosis Program (TIPP) showed that abuse but not neglect was associated with more severe depression levels, measured at a global MADRS score. Concerning specific depressive symptoms, concentration difficulties were left largely unaffected by abuse in contrast with other aspects of depression. CONCLUSIONS The cognitive item of the depressive dimension assessed by the MADRS was not impacted by experiences of abuse, while the remaining subdomains involving anxiety, suicidality, somatic symptoms, and anhedonia were. Trials focusing on improving the impact of depression in traumatised individuals should account for the possible diluting effect of concentration when measuring the depression broadly. DIF is a promising method to better understand the impact many variables may have on various psychological dimensions at the item level.
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Affiliation(s)
- Philippe Golay
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Psychology, Faculty of Social and Political Science, University of Lausanne, Switzerland.
| | - Lilith Abrahamyan Empson
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nadir Mebdouhi
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Philippe Conus
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Luis Alameda
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK; Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
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12
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Trotta G, Rodriguez V, Quattrone D, Spinazzola E, Tripoli G, Gayer-Anderson C, Freeman TP, Jongsma HE, Sideli L, Aas M, Stilo SA, La Cascia C, Ferraro L, La Barbera D, Lasalvia A, Tosato S, Tarricone I, D'Andrea G, Tortelli A, Schürhoff F, Szöke A, Pignon B, Selten JP, Velthorst E, de Haan L, Llorca PM, Rossi Menezes P, Del Ben CM, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, Richards A, Rutten BP, Van Os J, Austin-Zimmerman I, Li Z, Morgan C, Sham PC, Vassos E, Wong C, Bentall R, Fisher HL, Murray RM, Alameda L, Di Forti M. Cannabis use as a potential mediator between childhood adversity and first-episode psychosis: results from the EU-GEI case-control study. Psychol Med 2023; 53:7375-7384. [PMID: 38078747 PMCID: PMC10719680 DOI: 10.1017/s0033291723000995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/21/2023] [Accepted: 03/27/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Childhood adversity and cannabis use are considered independent risk factors for psychosis, but whether different patterns of cannabis use may be acting as mediator between adversity and psychotic disorders has not yet been explored. The aim of this study is to examine whether cannabis use mediates the relationship between childhood adversity and psychosis. METHODS Data were utilised on 881 first-episode psychosis patients and 1231 controls from the European network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Detailed history of cannabis use was collected with the Cannabis Experience Questionnaire. The Childhood Experience of Care and Abuse Questionnaire was used to assess exposure to household discord, sexual, physical or emotional abuse and bullying in two periods: early (0-11 years), and late (12-17 years). A path decomposition method was used to analyse whether the association between childhood adversity and psychosis was mediated by (1) lifetime cannabis use, (2) cannabis potency and (3) frequency of use. RESULTS The association between household discord and psychosis was partially mediated by lifetime use of cannabis (indirect effect coef. 0.078, s.e. 0.022, 17%), its potency (indirect effect coef. 0.059, s.e. 0.018, 14%) and by frequency (indirect effect coef. 0.117, s.e. 0.038, 29%). Similar findings were obtained when analyses were restricted to early exposure to household discord. CONCLUSIONS Harmful patterns of cannabis use mediated the association between specific childhood adversities, like household discord, with later psychosis. Children exposed to particularly challenging environments in their household could benefit from psychosocial interventions aimed at preventing cannabis misuse.
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Affiliation(s)
- Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Tom P Freeman
- University of Bath Department of Pharmacy and Pharmacology: University of Bath Department of Life Sciences, Bath, UK
| | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, UK
| | - Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy
| | - Monica Aas
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simona A Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Caterina La Cascia
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Laura Ferraro
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Daniele La Barbera
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- University of Bologna Department of Medical and Surgical Sciences: Universita degli Studi di Bologna Dipartimento di Scienze Mediche e Chirurgiche, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Franck Schürhoff
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Andrei Szöke
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Baptiste Pignon
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands
| | - Eva Velthorst
- Mount Sinai School of Medicine Department of Psychiatry: Icahn School of Medicine, New York, NY, USA
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Cristina M Del Ben
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Jose Luis Santos
- Department of Psychiatry, Hospital ‘Virgen de la Luz’, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigation Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Centro de Investigation Biomedica en Red de Salud Mental, School of Medicine, Universidad de Valencia, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Department of Medicine, Neuroscience Institute, University of Barcelona, Institute d'investigations Biomediques, August Pi I Sunyer, Centro de Investigation Biomedica en Red de Salud Mental, Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Maranon, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | - Alexander Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Isabelle Austin-Zimmerman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Zhikun Li
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Pak C Sham
- Hong Kong University: University of Hong Kong, Hong Kong
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Chloe Wong
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard Bentall
- The University of Sheffield Department of Psychology, Sheffield, UK
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - EU-GEI WP2 Group
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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13
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Sideli L, Aas M, Quattrone D, La Barbera D, La Cascia C, Ferraro L, Alameda L, Velthorst E, Trotta G, Tripoli G, Schimmenti A, Fontana A, Gayer-Anderson C, Stilo S, Seminerio F, Sartorio C, Marrazzo G, Lasalvia A, Tosato S, Tarricone I, Berardi D, D'Andrea G, Arango C, Arrojo M, Bernardo M, Bobes J, Sanjuán J, Santos JL, Menezes PR, Del-Ben CM, Jongsma HE, Jones PB, Kirkbride JB, Llorca PM, Tortelli A, Pignon B, de Haan L, Selten JP, Van Os J, Rutten BP, Bentall R, Di Forti M, Murray RM, Morgan C, Fisher HL. The relationship between genetic liability, childhood maltreatment, and IQ: findings from the EU-GEI multicentric case-control study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1573-1580. [PMID: 37335320 PMCID: PMC10460355 DOI: 10.1007/s00127-023-02513-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/04/2023] [Indexed: 06/21/2023]
Abstract
This study investigated if the association between childhood maltreatment and cognition among psychosis patients and community controls was partially accounted for by genetic liability for psychosis. Patients with first-episode psychosis (N = 755) and unaffected controls (N = 1219) from the EU-GEI study were assessed for childhood maltreatment, intelligence quotient (IQ), family history of psychosis (FH), and polygenic risk score for schizophrenia (SZ-PRS). Controlling for FH and SZ-PRS did not attenuate the association between childhood maltreatment and IQ in cases or controls. Findings suggest that these expressions of genetic liability cannot account for the lower levels of cognition found among adults maltreated in childhood.
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Affiliation(s)
- Lucia Sideli
- Department of Human Science, LUMSA University, Piazza delle Vaschette, 101, 00193, Rome, Italy.
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England.
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy.
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- Department of Behavioural Sciences, OsloMet, Oslo Metropolitan University, Oslo, Norway
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Seville, Spain
- Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Seville, Spain
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Eva Velthorst
- Department of Research, Mental Health Service Organization 'GGZ Noord-Holland-Noord', Hoorn, The Netherlands
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Andrea Fontana
- Department of Human Science, LUMSA University, Piazza delle Vaschette, 101, 00193, Rome, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Simona Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Giovanna Marrazzo
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Hospital "Virgen de La Luz", Cuenca, Spain
| | | | | | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, England
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
- EA 7280 Npsydo, Université Clermont Auvergne, Clermont-Ferrand, France
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, England
| | | | - Andrea Tortelli
- Establissement Public de Santé, Maison Blanche, Paris, France
| | - Baptiste Pignon
- AP-HP, Groupe Hospitalier "Mondor", Pôle de Psychiatrie, Créteil, France
- Institut National de la Santé et de la Recherche Médicale, U955, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Richard Bentall
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
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14
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Mohamed Saini S, Bousman CA, Mancuso SG, Cropley V, Van Rheenen TE, Lenroot RK, Bruggemann J, Weickert CS, Weickert TW, Sundram S, Everall IP, Pantelis C. Genetic variation in glutamatergic genes moderates the effects of childhood adversity on brain volume and IQ in treatment-resistant schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:59. [PMID: 37709784 PMCID: PMC10502098 DOI: 10.1038/s41537-023-00381-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/20/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Suriati Mohamed Saini
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
- Department of Psychiatry, Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Cheras, Kuala Lumpur, Malaysia.
| | - Chad A Bousman
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Medical Genetics, Psychiatry, and Physiology and Pharmacology, The University of Calgary, Calgary, AB, Canada
| | - Serafino G Mancuso
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University, Melbourne, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University, Melbourne, VIC, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Psychiatry and Behavioural Science, University of New Mexico, Albuquerque, NM, USA
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Cynthia S Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Neuroscience & Physiology, SUNY Upstate Medical University, NY, USA
- Schizophrenia Research Laboratory, Neuroscience Research Australia, NSW, Australia
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
- Department of Neuroscience & Physiology, SUNY Upstate Medical University, NY, USA
| | - Suresh Sundram
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Monash Medical Centre, Monash Health, Clayton, VIC, Australia
| | - Ian P Everall
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Western Centre for Health Research & Education, Sunshine Hospital, Western Health, St Albans, VIC, 3021, Australia
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15
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Ered A, Chun CA, O’Brien KJ, Creatura GM, Ellman LM. Working memory performance is related to childhood trauma but not psychotic-like experiences in a nonpsychiatric sample. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023:2023-98264-001. [PMID: 37561443 PMCID: PMC10858292 DOI: 10.1037/tra0001568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
OBJECTIVE This project seeks to clarify the impact of childhood trauma and psychotic-like experiences (PLEs) on working memory (WM) and explore gender differences in these relationships. The effect of childhood trauma on WM performance has yet to be explored in individuals with PLEs, despite consistent associations between trauma, psychosis spectrum symptoms, and WM performance. METHOD In 466 undergraduates, positive PLEs (Prodromal Questionnaire) and trauma (Childhood Trauma Questionnaire) were examined to determine contributions to WM performance on a spatial n-back task. We conducted hierarchical linear regressions on the total sample and stratified by gender to examine the effects of childhood trauma, positive PLEs, and their interaction on WM performance. Supplemental analyses explored attenuated negative and disorganized symptoms. RESULTS Controlling for age, there were no significant main effects of positive PLEs, childhood trauma, their interaction, or three-way interaction including gender in predicting WM. After stratifying by gender, childhood trauma was significantly associated with poorer WM in females only. Post hoc analyses revealed that in the full sample, physical neglect predicted WM performance and was a trend for females, while sexual abuse trended toward predicting WM in males. Supplemental analyses of attenuated negative and disorganized symptoms revealed childhood trauma significantly predicted WM in the full sample and females only for negative symptoms. CONCLUSIONS Females who have experienced childhood trauma may be at greater risk for WM problems, irrespective of co-occurring PLEs, suggesting that cognitive difficulties may be partially attributable to history of trauma. These findings have potential implications for intervention strategies in trauma-exposed individuals. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Arielle Ered
- Department of Psychology and Neuroscience, Temple University
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
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16
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Rosa M, Scassellati C, Cattaneo A. Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review. Front Psychol 2023; 14:1156415. [PMID: 37425159 PMCID: PMC10327487 DOI: 10.3389/fpsyg.2023.1156415] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/01/2023] [Indexed: 07/11/2023] Open
Abstract
Although the association between cognitive performances and the onset of psychiatric disorders has been widely investigated, limited research on the role of childhood trauma or early life stress (CT/ELS), and whether this role differs between clinical and non-clinical cohorts is available. This systematic review aims at filling this gap, testing whether the occurrence of CT/ELS and its subtypes are associated with cognitive domains (general cognitive ability, executive functions, working memory, attention, processing speed, verbal/visual memory) in patients with psychiatric disorders and in non-clinical populations. This study followed the PRISMA 2020 guidelines and the Newcastle-Ottawa scale for quality assessment. The search was performed until May 2022. Seventy-four studies were classified as eligible. The graphical representations of the results reported an association between exposure to CT/ELS and worse general cognitive ability, verbal/visual memory, processing speed and attention in patients affected by anxiety, mood and psychotic disorders, and that specific CT/ELS subtypes (physical neglect, physical/sexual abuse) can differentially influence specific cognitive abilities (executive functions, attention, working memory, verbal/visual memory). In non-clinical cohorts we found associations between CT/ELS exposure and impairments in executive functions, processing speed and working memory, while physical neglect was related to general cognitive ability and working memory. Concerning the emotional abuse/neglect subtypes in both populations, the results indicated their involvement in cognitive functioning; however, the few studies conducted are not enough to reach definitive conclusions. These findings suggest an association of CT/ELS with specific cognitive deficits and psychopathology.
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Affiliation(s)
- Melissa Rosa
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Catia Scassellati
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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17
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Barczyk ZA, Foulds JA, Porter RJ, Douglas KM. Childhood trauma and cognitive functioning in mood disorders: A systematic review. Bipolar Disord 2023; 25:263-277. [PMID: 36949602 DOI: 10.1111/bdi.13321] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Cognitive impairment is a core feature of mood disorders and has been identified as an important treatment target. A better understanding of the factors contributing to cognitive impairment in mood disorders would be beneficial in developing interventions to address cognitive impairment. One key factor is childhood trauma. The aim of this review was to systematically synthesise and review research examining associations between reported childhood trauma and cognitive functioning in mood disorders. METHODS Studies in adult samples examining the relationship between objective cognitive function and reported childhood trauma in major depressive disorder and/or bipolar disorder (in-episode or euthymia) were identified. Searches were conducted on PubMed, Embase and PsycINFO until January 2022. A narrative review technique was used due to the heterogeneity of group comparisons, cognitive tests and data analysis across studies. RESULTS Seventeen studies met the criteria for inclusion (mood disorders N = 1723, healthy controls N = 797). Evidence for childhood trauma being related to poorer cognitive functioning was consistent across global cognitive functioning and executive function domains for euthymic patients and psychomotor speed for in-episode patients. There was mixed evidence for verbal learning and memory and executive function for in-episode patients. Identification of patterns within other domains was difficult due to limited number of studies. CONCLUSION Findings from this review suggest childhood trauma is associated with poorer cognitive functioning in people with mood disorders. Targeted interventions to improve cognition may be warranted for this group.
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Affiliation(s)
- Zoe A Barczyk
- Department of Psychological Medicine, University of Otago, Christchurch, 8011, New Zealand
| | - James A Foulds
- Department of Psychological Medicine, University of Otago, Christchurch, 8011, New Zealand
| | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, 8011, New Zealand
- Specialist Mental Health Services, Canterbury District Health Board, Christchurch, 8024, New Zealand
| | - Katie M Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, 8011, New Zealand
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18
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Faustino B, Fonseca IB. Exploring relationships between executive functions and maladaptive cyclical patterns in a transdiagnostic sample. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-9. [PMID: 37184438 DOI: 10.1080/23279095.2023.2204526] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Executive functions are described as a set of neurocognitive processes underlying human mental processing, while maladaptive cyclical patterns are the dysfunctional psychological elements associated with psychological distress and symptomatology that tend to be recurrent. Both psychological constructs tend to be studied by different scientific fields and with different methods which limits a coherent theoretical integration. Therefore, the present study aims to explore the relationships between executive functions and maladaptive cyclical patterns. A sample was gathered (N = 96, Mage = 20.78, SD = 4.63), and completed several self-report questionnaires along with several neuropsychological tests for the assessment of executive functions. Results showed that behavioral inhibition correlated negatively with maladaptive cyclical patterns while cognitive inflexibility correlated positively. Regression analysis showed that behavioral inhibition, psychological inflexibility, and recurring states of mind predicted emotional processing difficulties. These results emphasize previous assumptions that a difference between self-report questionnaires and behavioral tasks may limit the integrated study of psychological and neurocognitive processes.
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Affiliation(s)
- Bruno Faustino
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
- Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Lisbon, Portugal
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19
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Fusar-Poli L, Prachason T, Erzin G, Pries LK, Brondino N, Politi P, Delespaul P, Kenis G, Luykx JJ, Lin BD, Richards AL, Akdede B, Binbay T, Altınyazar V, Yalınçetin B, Gümüş-Akay G, Cihan B, Soygür H, Ulaş H, Cankurtaran EŞ, Kaymak SU, Mihaljevic MM, Andric-Petrovic S, Mirjanic T, Bernardo M, Mezquida G, Amoretti S, Bobes J, Saiz PA, García-Portilla MP, Sanjuan J, Escarti MJ, Santos JL, Jiménez-López E, Arrojo M, Carracedo A, López G, González-Peñas J, Parellada M, Maric NP, Atbaşoğlu C, Üçok A, Alptekin K, Saka MC, Arango C, O'Donovan M, van Os J, Rutten BP, Guloksuz S. Examining the association between exposome score for schizophrenia and cognition in schizophrenia, siblings, and healthy controls: Results from the EUGEI study. Psychiatry Res 2023; 323:115184. [PMID: 37015164 DOI: 10.1016/j.psychres.2023.115184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND People with schizophrenia spectrum disorders (SSD) frequently present cognitive impairments. Here, we investigated whether the exposome score for schizophrenia (ES-SCZ) - a cumulative environmental exposure score - was associated with impairments of neurocognition, social cognition, and perception in patients with SSD, their unaffected siblings, and healthy controls. METHODS This cross-sectional sample consisted of 1200 patients, 1371 siblings, and 1564 healthy controls. Neurocognition, social cognition, and perception were assesed using a short version of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), the Degraded Facial Affect Recognition Task (DFAR), and the Benton Facial Recognition Test (BFR), respectively. Regression models were used to analyze the association between ES-SCZ and cognitive domains in each group. RESULTS There were no statistically significant associations between ES-SCZ and cognitive domains in SSD. ES-SCZ was negatively associated with T-score of cognition in siblings (B=-0.40, 95% CI -0.76 to -0.03) and healthy controls (B=-0.63, 95% CI -1.06 to -0.21). Additionally, ES-SCZ was positively associated with DFAR-total in siblings (B=0.83, 95% CI 0.26 to 1.40). Sensitivity analyses excluding cannabis use history from ES-SCZ largely confirmed the main findings. CONCLUSIONS Longitudinal cohorts may elucidate how environmental exposures influence the onset and course of cognitive impairments in trans-syndromic psychosis spectrum.
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Affiliation(s)
- Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Thanavadee Prachason
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Gamze Erzin
- Department of Psychiatry, Health Science University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Natascia Brondino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands; Mondriaan Mental Health Centre, Maastricht/Heerlen, The Netherlands
| | - Gunter Kenis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jurjen J Luykx
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands; Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; GGNet Mental Health, Apeldoorn, The Netherlands
| | - Bochao D Lin
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alexander L Richards
- Cardiff University Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Berna Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tolga Binbay
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Vesile Altınyazar
- Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Berna Yalınçetin
- Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Güvem Gümüş-Akay
- Department of Physiology, School of Medicine, Ankara University, Ankara, Turkey; Brain Research Center, Ankara University, Ankara, Turkey; Neuroscience and Neurotechnology Center of Excellence (NÖROM), Ankara, Turkey
| | - Burçin Cihan
- Department of Psychology, Middle East Technical University, Ankara, Turkey
| | - Haldun Soygür
- Turkish Federation of Schizophrenia Associations, Ankara, Turkey
| | - Halis Ulaş
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | | | | | - Marina M Mihaljevic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Clinic for Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia
| | - Sanja Andric-Petrovic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Institute of Mental Health, Belgrade, Serbia
| | - Tijana Mirjanic
- Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain
| | - Julio Bobes
- Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - Pilar A Saiz
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - Maria Paz García-Portilla
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain; Mental Health Services of Principado de Asturias, Oviedo, Spain
| | - Julio Sanjuan
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Maria Jose Escarti
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - José Luis Santos
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
| | - Estela Jiménez-López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Angel Carracedo
- Grupo de Medicina Genómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidad de Santiago de Compostela, Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica (SERGAS), IDIS, Santiago de Compostela, Spain
| | - Gonzalo López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Javier González-Peñas
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Nadja P Maric
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Institute of Mental Health, Belgrade, Serbia
| | - Cem Atbaşoğlu
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alp Üçok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Meram Can Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Celso Arango
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Michael O'Donovan
- Cardiff University Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Bart Pf Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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Cumulative trauma in bipolar disorder: An examination of prevalence and outcomes across the lifespan. J Affect Disord 2023; 327:254-261. [PMID: 36566941 DOI: 10.1016/j.jad.2022.12.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/08/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Trauma is highly prevalent in bipolar disorder, and while considerable research has been undertaken in relation to childhood trauma, little is known about the experience and the impact of exposure to multiple trauma types across the lifespan, otherwise known as cumulative trauma. This study aimed to examine the prevalence of cumulative trauma in bipolar disorder and explore its association with illness and other outcomes. METHODS Participants were recruited online globally and comprised 114 adults aged 23 to 73 years with BD-I (41.2 %) or BD-II (58.8 %). Participants completed an online questionnaire containing items regarding symptoms and trauma history followed by a diagnostic interview to confirm their BD diagnosis and assess BD symptoms. RESULTS Cumulative trauma accounted for most of the trauma exposure across both childhood (n = 89; 78.1 %) and adulthood (n = 72; 63.2 %). Those with lifetime cumulative trauma (n = 64; 56 %) were more likely to experience at least one other co-morbid mental health condition in addition to their BD diagnosis (88 %) and report significantly lower ratings of perceived social support compared to those who did not experience any cumulative trauma (N = 15; 13 %). LIMITATIONS This study has been limited by the cross-sectional retrospective design as well as the use of self-selection to participate. CONCLUSIONS Cumulative trauma is highly prevalent in bipolar disorder and is associated with greater likelihood of experiencing a psychiatric comorbidity and decreased levels of social support. More research is needed to explore the nature of this relationship and determine whether increasing social support may be of benefit.
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Christy A, Cavero D, Navajeeva S, Murray-O’Shea R, Rodriguez V, Aas M, Trotta G, Moudiab S, Garrido N, Zamora B, Sideli L, Wrobel AL, Salazar de Pablo G, Alameda L. Association Between Childhood Adversity and Functional Outcomes in People With Psychosis: A Meta-analysis. Schizophr Bull 2023; 49:285-296. [PMID: 36107860 PMCID: PMC10016406 DOI: 10.1093/schbul/sbac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Despite the accepted link between childhood adversity (CA) and psychotic disorders, evidence on the relationship between CA and poor functional outcome remains less consistent and has never been reviewed quantitatively. The aim of this meta-analysis was to systematically examine the association between CA and functional outcomes in people with psychotic disorders. STUDY DESIGN The study protocol was registered on the International Prospective Register of Systematic Reviews (CRD42021254201). A search was conducted across EMBASE, MEDLINE, PsycINFO, and Cochrane Libraries (CENTRAL) using search terms related to psychosis; CA (general, sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect); and functional outcomes (social, occupational, and general functioning [GF]). We conducted random-effects models, sensitivity and heterogeneity analyses, meta-regressions, and we assessed quality. STUDY RESULTS Our meta-analysis comprised 35 studies, including 10 568 cases with psychosis. General CA was negatively associated with GF (28 studies; r = -0.109, 95%CI = -0.161 to -0.05, P < .001), with greater effects in prospective data (10 studies; r = -0.151, 95% CI = -0.236 to -0.063, P = .001). General CA was also associated with social functioning (r = -0.062, 95% CI = -0.120 to -0.004, P = .018) but not occupational outcomes. All CA subtypes except sexual abuse were significantly associated with GF, with emotional and physical neglect showing the largest magnitudes of effect (ranging from r = -0.199 to r = -0.250). CONCLUSIONS This meta-analysis provides evidence for a negative association between general CA, specific subtypes, and general and social functional outcomes in people with psychosis.
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Affiliation(s)
- Angeline Christy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Daniela Cavero
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sujeena Navajeeva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Rachel Murray-O’Shea
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
- NORMENT, Centre for Research on Mental Disorders, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Socayna Moudiab
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nathalia Garrido
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
| | - Blanca Zamora
- Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| | - Lucia Sideli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Human Science, LUMSA University, Rome, Italy
| | - Anna L Wrobel
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Gonzalo Salazar de Pablo
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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Novaes de Oliveira Roldan AC, Fernandes Júnior LCC, de Oliveira CEC, Nunes SOV. Impact of ZNF804A rs1344706 or CACNA1C rs1006737 polymorphisms on cognition in patients with severe mental disorders: A systematic review and meta-analysis. World J Biol Psychiatry 2023; 24:195-208. [PMID: 35786202 DOI: 10.1080/15622975.2022.2097308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis focussed on insights into the relationship between CACNA1C-rs1006737 and ZNF804A-rs1344706 polymorphisms and cognitive performance in schizophrenia (SCZ) spectrum and bipolar disorder (BD) and provide some contributions for clinical practice. METHODS We searched the websites databases (PubMED, PsycINFO, Web of Science, EMBASE and Cochrane Library) using eligibility and exclusion criteria to capture all potential studies, based on PICO model and according to the PRISMA. RESULTS Eight articles were included in this systematic review (five referring to CACNA1C-rs1006737 and three related to ZNF804A-rs1344706 polymorphisms), with a total of 5759 participants (1751 SCZ patients, 348 BD patients, 3626 controls and 34 first-degree relatives). The results demonstrated that the pooled effect of CACNA1C-rs1006737 (risk difference RD = 0.08; 95% CI 0.02-0.15) was associated with altered cognitive function in patients with severe mental disorders, but not ZNF804A-rs1344706 polymorphism (RD = 0.19; 95% CI 0.09-0.48. CONCLUSION The present meta-analysis provides evidence regarding slight association between CACNA1C-rs1006737 polymorphisms and cognitive performance in severe mental disorders, indicating that cognitive impairment in severe mental disorders associated with the CACNA1C rs1006737 risk variants could only be expressed when interacting with environmental exposures. This study is registered with PROSPERO, number CRD42021246726.
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23
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Zouraraki C, Kyriklaki A, Economou E, Giakoumaki SG. The moderating role of early traumatic experiences on the association of schizotypal traits with visual perception. Scand J Psychol 2023; 64:10-20. [PMID: 35833570 DOI: 10.1111/sjop.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/11/2022] [Accepted: 06/24/2022] [Indexed: 01/11/2023]
Abstract
The findings on the association of schizotypal traits with the perception of visual illusions are scarce and inconsistent and have not taken into consideration potential effects of childhood traumatic experiences, a risk factor for schizophrenia-spectrum conditions. Thus, the present study addressed the question of potential moderating effects of early traumatic experiences on the association between different aspects of schizotypal traits with the perception of the Müller-Lyer and Navon's Hierarchical Letters (NHL) illusions. The study revealed that (a) increased suspiciousness was associated with increased liability to the Müller-Lyer illusion, when the exposure to traumatic events was high, whereas the opposite pattern was true when the exposure to traumatic events was low; (b) negative schizotypy was associated with more accurate global perception, and high disorganized schizotypy was associated with superior accuracy when target letters were present during the NHL illusion, when early traumatic experiences were at lower levels; and (c) high negative, disorganized, and total schizotypy were associated with lower accuracy when target letters were present in the NHL paradigm, when early traumatic experiences were at higher levels. The findings of the study suggest that early traumatic events differentially moderate the relationship between various aspects of schizotypal traits and visual perceptual processing.
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Affiliation(s)
- Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, University of Crete, Rethymno, Crete, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
| | - Andriani Kyriklaki
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Elias Economou
- Laboratory of Experimental Psychology, Department of Psychology, University of Crete, Rethymno, Crete, Greece
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, University of Crete, Rethymno, Crete, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
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24
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Ristanovic I, Vargas TG, Damme KSF, Mittal VA. Hippocampal subfields, daily stressors, and resting cortisol in individuals at clinical high-risk for psychosis. Psychoneuroendocrinology 2023; 148:105996. [PMID: 36495626 PMCID: PMC9898196 DOI: 10.1016/j.psyneuen.2022.105996] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/17/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION The hippocampus, comprised of functionally distinct subfields, both regulates stress and is affected by it during psychosis pathogenesis. Hippocampal abnormalities are evident across psychosis spectrum and are associated with aberrant cortisol levels and greater environmental stressors exposure. These associations, particularly at the subfield-level, are poorly understood in individuals at clinical high-risk (CHR) for psychosis. This represents a significant literature gap given this critical pathogenetic period is characterized by an interplay between environmental stressors and biological susceptibility. METHODS A total of 121 participants including 51 CHR (mean age=18.61) and 70 healthy controls (HC; mean age=18.3) were enrolled in the study. Participants completed a structural scan, salivary cortisol assays, and a self-report measure assessing distress from daily stressors exposure (DSI). Hippocampal subfield segmentation was conducted using Freesurfer. RESULTS Smaller hippocampal subfields were associated with greater stress levels. Greater DSI was associated with lower volumes in CA1 (r = -0.38) and CA2/3 (r = -0.29), but not in CA4/DG (r = -0.28), presubiculum (r = -0.09), or subiculum (r = -0.17). Higher resting cortisol was associated with lower volumes in presubiculum (r = -0.4) but not subiculum (r = -0.22), CA1 (r = 0.08), CA2/3 (r = 0.1), or CA4/DG (r = -0.005). Regressions indicated effects for CA1 and DSI (β = 0.57, p = .03) and presubiculum and cortisol (β = 0.61, p = .02) are specific to CHR participants relative to HCs. CONCLUSIONS The findings provided insights into links between stress and brain vulnerability during psychosis-risk period. Regional differences highlighted potentially different mechanisms by which stress impacts specific subfields. Presubiculum may be more susceptible to the impact of early stress on HPA-axis and cornu amonis to acute stressors.
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Affiliation(s)
- Ivanka Ristanovic
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA.
| | - Teresa G Vargas
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA
| | - Katherine S F Damme
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA
| | - Vijay Anand Mittal
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA; Northwestern University, Department of Psychiatry, Chicago, IL 60611, USA; Northwestern University, Medical Social Sciences, Chicago IL 60611, USA; Norhtwestern University, Institute for Policy Research, Evanston, IL 60208, USA
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25
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Zarubin VC, Gupta T, Mittal VA. History of trauma is a critical treatment target for individuals at clinical high-risk for psychosis. Front Psychiatry 2023; 13:1102464. [PMID: 36683986 PMCID: PMC9846262 DOI: 10.3389/fpsyt.2022.1102464] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
People meeting criteria for a clinical high-risk (CHR) for psychosis syndrome frequently represent a heterogeneous, help-seeking, and dynamic population. Among the numerous symptoms and risk factors for psychosis, exposure to trauma stands out as both highly prevalent and poorly understood. Indeed, while up to 80% of individuals meeting criteria for a CHR syndrome report trauma histories, there is currently limited research dedicated to this specific area. This is particularly problematic as trauma is tied to risk for conversion, leads to a range of clinical issues, and contributes to disability and poor quality of life. Fortunately, recent research in the general population has led to a significant evolution in the way trauma is assessed and understood, and further, some studies have indicated that targeted trauma interventions in formal psychotic disorders are highly effective. However, direct adoption is challenging as the CHR syndrome holds a number of unique concerns (e.g., clinical heterogeneity, developmental trauma), and characteristically, involves a developing pediatric or young adult population that also comes with specific considerations (e.g., living with caregivers, transitionary period in roles). In this "perspective" we frame the issues around understanding trauma in CHR individuals, discuss viable treatments and unique considerations, and provide suggestions for future steps in developing and incorporating trauma-focused interventions in this population.
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Affiliation(s)
- Vanessa C. Zarubin
- Department of Psychology, Northwestern University, Evanston, IL, United States
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Chicago, IL, United States
| | - Tina Gupta
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Evanston, IL, United States
- Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Chicago, IL, United States
- Department of Psychiatry, Northwestern University, Chicago, IL, United States
- Medical Social Sciences, Northwestern University, Chicago, IL, United States
- Institute for Policy Research (IPR), Northwestern University, Chicago, IL, United States
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26
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Dudley R, Turkington D, Coulthard N, Pyle M, Gumley A, Schwannauer M, Kingdon D, Morrison AP. Childhood Trauma in Clozapine-Resistant Schizophrenia: Prevalence, and Relationship With Symptoms. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgad030. [PMID: 39145330 PMCID: PMC11207680 DOI: 10.1093/schizbullopen/sgad030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis The role of early adversity and trauma is increasingly recognized in psychosis but treatments for trauma and its consequences are lacking. Psychological treatments need to understand the prevalence of these experiences, the relationship with specific symptoms and identify potentially tractable processes that may be targeted in therapy. It was hypothesized that greater adversity, and specifically abuse rather than neglect, would be associated with positive symptoms and specifically hallucinations. In addition, negative beliefs would mediate the relationship with positive symptoms. Study Design 292 Patients with treatment resistant psychosis completed measures of early adversity as well as current symptoms of psychosis. Study Results Early adversity in the form of abuse and neglect were common in one-third of the sample. Adversity was associated with higher levels of psychotic symptoms generally, and more so with positive rather than negative symptoms. Abuse rather than neglect was associated with positive but not with negative symptoms. Abuse rather than neglect was associated with hallucinations but not delusions. Abuse and neglect were related to negative beliefs about the self and negative beliefs about others. Mediation demonstrated a general relationship with adversity, negative-self, and other views and overall psychotic symptoms but not in relation to the specific experience of abuse and hallucinations. Females were more likely to be abused, but not neglected, than males. Conclusions Whilst most relationships were modest, they supported previous work indicating that adversity contributes to people with psychosis experiencing distressing symptoms especially hallucinations. Treatments need to address and target adversity.
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Affiliation(s)
- Robert Dudley
- Early Intervention in Psychosis Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
- Department of Psychology, University of York, York, YO10 5DDUK
| | - Douglas Turkington
- Early Intervention in Psychosis Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - Naomi Coulthard
- Early Intervention in Psychosis Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle Upon Tyne, NE3 3XT, UK
| | - Melissa Pyle
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK
| | - Andrew Gumley
- School of Health & Wellbeing, University of, Glasgow Clarice Pears Building, 90 Byres Road, Glasgow G12 8TBUK
| | - Matthias Schwannauer
- Department of Clinical Psychology, School of Health in Social Science, The University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - David Kingdon
- University Department of Psychiatry, University of Southampton, Academic Centre, CollegeKeep 4-12 Terminus Terrace Southampton SO14 3DT, UK
| | - Anthony P Morrison
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Prestwich, M25 3BL, UK
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27
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Environmental Risk Factors and Cognitive Outcomes in Psychosis: Pre-, Perinatal, and Early Life Adversity. Curr Top Behav Neurosci 2023; 63:205-240. [PMID: 35915384 PMCID: PMC9892366 DOI: 10.1007/7854_2022_378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Risk for psychosis begins to accumulate as early as the fetal period through exposure to obstetric complications like fetal hypoxia, maternal stress, and prenatal infection. Stressors in the postnatal period, such as childhood trauma, peer victimization, and neighborhood-level adversity, further increase susceptibility for psychosis. Cognitive difficulties are among the first symptoms to emerge in individuals who go on to develop a psychotic disorder. We review the relationship between pre-, perinatal, and early childhood adversities and cognitive outcomes in individuals with psychosis. Current evidence shows that the aforementioned environmental risk factors may be linked to lower overall intelligence and executive dysfunction, beginning in the premorbid period and persisting into adulthood in individuals with psychosis. It is likely that early life stress contributes to cognitive difficulties in psychosis through dysregulation of the body's response to stress, causing changes such as increased cortisol levels and chronic immune activation, which can negatively impact neurodevelopment. Intersectional aspects of identity (e.g., sex/gender, race/ethnicity), as well as gene-environment interactions, likely inform the developmental cascade to cognitive difficulties throughout the course of psychotic disorders and are reviewed below. Prospective studies of birth cohorts will serve to further clarify the relationship between early-life environmental risk factors and cognitive outcomes in the developmental course of psychotic disorders. Specific methodological recommendations are provided for future research.
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28
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Lakkireddy SP, Balachander S, Dayalamurthy P, Bhattacharya M, Joseph MS, Kumar P, Kannampuzha AJ, Mallappagari S, Narayana S, Alexander AC, Muthukumaran M, Sheth S, Puzhakkal JC, Ramesh V, Thatikonda NS, Selvaraj S, Ithal D, Sreeraj VS, Mahadevan J, Holla B, Venkatasubramanian G, John JP, Murthy P, Benegal V, Reddy YCJ, Jain S, Viswanath B. Neurocognition and its association with adverse childhood experiences and familial risk of mental illness. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110620. [PMID: 35995305 PMCID: PMC7615105 DOI: 10.1016/j.pnpbp.2022.110620] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022]
Abstract
Environmental factors such as adverse childhood experiences (ACEs) may affect neurocognition, an endophenotype for several mental illnesses. This study examines the effect of ACEs on neurocognitive performance in first-degree relatives (FDRs) of patients with severe mental illness to determine whether familial risk has a moderating effect on the relationship between ACEs and neurocognition. Unaffected FDRs from multiplex families with severe mental illnesses (schizophrenia, bipolar disorder, obsessive-compulsive disorder, or alcohol use disorder) (n = 324) and healthy controls (with no familial risk) (n = 188) underwent neurocognitive tests for processing speed, new learning, working memory and Theory of Mind. ACEs were measured using the WHO ACE-International Questionnaire (ACE-IQ). Regression models were done to predict each neurocognitive domain by the effect of familial risk, ACE-IQ Score and their interaction (familial risk*ACE-IQ score). The main effect of familial risk predicted poor performance in all domains of neurocognition (p < 0.01), and the interaction had a negative association with global neurocognition (β = -0.093, p = 0.009), processing speed (β = -0.109, p = 0.003) and working memory (β = -0.092, p = 0.01). Among the ACEs sub-domains, only maltreatment (specifically the main effect of physical neglect and the interaction effect of sexual abuse with familial risk) predicted poorer neurocognition. In FDRs of schizophrenia and bipolar disorder, only the main effects of familial risk were significantly associated with poorer neurocognition. We conclude that there is a relationship between ACEs (especially maltreatment) and neurocognitive functioning, which is moderated by the familial risk of mental illnesses. Genetic/familial vulnerability may have a stronger association with neurocognition in schizophrenia and bipolar disorder.
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Affiliation(s)
- Sai Priya Lakkireddy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Srinivas Balachander
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
| | - Pavithra Dayalamurthy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Mahashweta Bhattacharya
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Mino Susan Joseph
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pramod Kumar
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Anand Jose Kannampuzha
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sreenivasulu Mallappagari
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Shruthi Narayana
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Alen Chandy Alexander
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Moorthy Muthukumaran
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sweta Sheth
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Joan C Puzhakkal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vinutha Ramesh
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Navya Spurthi Thatikonda
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sowmya Selvaraj
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Dhruva Ithal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vanteemar S Sreeraj
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Jayant Mahadevan
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Bharath Holla
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - John P John
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Pratima Murthy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Vivek Benegal
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Y C Janardhan Reddy
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sanjeev Jain
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Biju Viswanath
- Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India.
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29
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Zhao Y, Wu C. Childhood maltreatment experiences and emotion perception in young Chinese adults: Sex as a moderator. Stress Health 2022; 38:666-678. [PMID: 34921491 DOI: 10.1002/smi.3122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 12/14/2022]
Abstract
Men and women seem to perceive and react differently to emotional stimuli and have different susceptibilities to childhood trauma. With a cross-sectional design, this study aimed to investigate whether specific patterns of childhood-maltreatment experiences are associated with specific patterns of emotion perception and the sex differences in this relationship. A total of 173 adults rated valence, arousal, and dominance for 60 pictures (varying in pleasantness, unpleasantness, and neutral emotion) from the International Affective Picture System and completed the Childhood Trauma Questionnaire-Short Form. Using a partial least squares (PLS) regression analysis, after controlling for depressive and anxious states, recent stressful life events, personality, and cognitive reappraisal strategy, we identified a profile (linear combination) of childhood-maltreatment experiences (emotional neglect, physical neglect, and physical abuse) that was associated with a profile of emotion-perception dimensions (perceiving negative visual stimuli as more unpleasant and subservient, positive stimuli as more pleasant and dominant, and neutral stimuli as more arousing). This association pattern was significant only for the male participants. Hence, our findings suggest that childhood maltreatment might make men more "emotional" in their adulthood. The impact of this childhood-maltreatment-associated alteration in emotion perception on male mental health needs further investigation.
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Affiliation(s)
- Yiran Zhao
- School of Nursing, Peking University Health Science Center, Beijing, China
| | - Chao Wu
- School of Nursing, Peking University Health Science Center, Beijing, China
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30
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Rosenfield PJ, Jiang D, Pauselli L. Childhood adversity and psychotic disorders: Epidemiological evidence, theoretical models and clinical considerations. Schizophr Res 2022; 247:55-66. [PMID: 34210561 DOI: 10.1016/j.schres.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 02/08/2023]
Abstract
While genetic factors play a critical role in the risk for schizophrenia and other psychotic disorders, increasing evidence points to the role of childhood adversity as one of several environmental factors that can significantly impact the development, manifestations and outcome of these disorders. This paper reviews the epidemiological evidence linking childhood adversity and psychotic disorders and explores various theoretical models that seek to explain the connection. We discuss neurobiological parallels between the impact of childhood trauma and psychosis on the brain and then explore the impact of childhood adversity on different domains of clinical presentation. Finally, implications for prevention and treatment are considered, both on individual and structural levels.
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Affiliation(s)
- Paul J Rosenfield
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - David Jiang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
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31
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Cruz D, Lichten M, Berg K, George P. Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Front Psychiatry 2022; 13:800687. [PMID: 35935425 PMCID: PMC9352895 DOI: 10.3389/fpsyt.2022.800687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.
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Affiliation(s)
- Daniel Cruz
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | | | - Kevin Berg
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | - Preethi George
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
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32
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Adverse Childhood Experiences and Neurocognition in Borderline Personality Disorder: A Call-to-Action Perspective Review. Harv Rev Psychiatry 2022; 30:248-260. [PMID: 35849742 DOI: 10.1097/hrp.0000000000000344] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Adverse childhood experiences (ACEs) contribute to the development of personality traits leading to adult borderline personality disorder (BPD). Neurocognitive changes could partly mediate the association between ACEs and BPD. We discuss how exposure to ACEs could induce alterations in neurocognition, which, in turn, would contribute to the development of BPD. We conducted a review of MEDLINE articles through 2021, documenting a link between ACEs, neurocognitive impairments, and BPD, and also focusing on the pairwise associations. ACEs appear to have a strong impact on neurocognition and are a predictive factor for BPD. Maltreated, abused, and emotionally invalidated children are more likely to present BPD traits. Neurocognitive impairments in adults exposed to ACEs and in patients with BPD arise from similar brain alterations in the amygdala, hippocampus, and prefrontal cortex. These impairments seem to be linked with clinical dimensions of BPD: increased impulsivity to altered inhibitory control; dissociative experiences to nonspecific autobiographical memory; and emotionally biased facial recognition to unstable interpersonal relationships. This perspective review highlights the contributory role of neurocognition in the association between ACEs and BPD. Additional research is needed, however, on the interconnections among ACEs, neurocognition, and BPD. Future studies could also focus on developing tools to assess early adversity in BPD specifically and on psychotherapeutic approaches to promptly remedy neurocognitive impairments.
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Panayi P, Berry K, Sellwood W, Campodonico C, Bentall RP, Varese F. The Role and Clinical Correlates of Complex Post-traumatic Stress Disorder in People With Psychosis. Front Psychol 2022; 13:791996. [PMID: 35369153 PMCID: PMC8967251 DOI: 10.3389/fpsyg.2022.791996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Traumatic experiences and post-traumatic stress are highly prevalent in people with psychosis, increasing symptom burden, decreasing quality of life and moderating treatment response. A range of post-traumatic sequelae have been found to mediate the relationship between trauma and psychotic experiences, including the "traditional" symptoms of post-traumatic stress disorder (PTSD). The International Classification of Diseases-11th Edition recognizes a more complex post-traumatic presentation, complex PTSD (cPTSD), which captures both the characteristic symptoms of PTSD alongside more pervasive post-traumatic sequelae known as 'disturbances in self-organization' (DSOs). The prevalence and impact of cPTSD and DSOs in psychosis remains to be explored. In the first study of this kind, 144 participants with psychosis recruited from North West United Kingdom mental health services completed measures assessing trauma, PTSD and cPTSD symptoms and symptoms of psychosis. Forty-percent of the sample met criteria for cPTSD, compared to 10% who met diagnostic criteria for PTSD. PTSD and DSOs mediated the relationship between trauma and positive symptoms, controlling for dataset membership. Both PTSD and DSOs mediated the relationship between trauma and affective symptoms but did not explain a significant proportion of variance in negative symptoms. Cognitive and excitative symptoms of psychosis did not correlate with trauma, PTSD or DSO scores. These findings indicate the possible value of adjunct therapies to manage cPTSD symptoms in people with psychosis, pending replication in larger epidemiological samples and longitudinal studies.
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Affiliation(s)
- Peter Panayi
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Katherine Berry
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - William Sellwood
- Faculty of Health & Medicine, Division of Health Research, University of Lancaster, Lancaster, United Kingdom
| | - Carolina Campodonico
- School of Psychology and Computer Science, University of Central Lancashire, Lancashire, United Kingdom
| | - Richard P. Bentall
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Filippo Varese
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Sideli L, Schimmenti A, La Barbera D, La Cascia C, Ferraro L, Aas M, Alameda L, Velthorst E, Fisher HL, Caretti V, Trotta G, Tripoli G, Quattrone D, Gayer-Anderson C, Seminerio F, Sartorio C, Marrazzo G, Lasalvia A, Tosato S, Tarricone I, Berardi D, D’Andrea G, Arango C, Arrojo M, Bernardo M, Bobes J, Sanjuán J, Santos JL, Menezes PR, Del-Ben CM, Jongsma HE, Jones PB, Kirkbride JB, Llorca PM, Tortelli A, Pignon B, de Haan L, Selten JP, Van Os J, Rutten BP, Di Forti M, Morgan C, Murray RM. Childhood Maltreatment, Educational Attainment, and IQ: Findings From a Multicentric Case-control Study of First-episode Psychosis (EU-GEI). Schizophr Bull 2022; 48:575-589. [PMID: 35137235 PMCID: PMC9077421 DOI: 10.1093/schbul/sbac004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND HYPOTHESIS Evidence suggests that childhood maltreatment (ie, childhood abuse and childhood neglect) affects educational attainment and cognition. However, the association between childhood maltreatment and Intelligence Quotient (IQ) seems stronger among controls compared to people with psychosis. We hypothesised that: the association between childhood maltreatment and poor cognition would be stronger among community controls than among people with first-episode of psychosis (FEP); compared to abuse, neglect would show stronger associations with educational attainment and cognition; the association between childhood maltreatment and IQ would be partially accounted for by other risk factors; and the association between childhood maltreatment, educational attainment, and IQ would be stronger among patients with affective psychoses compared to those with nonaffective psychoses. STUDY DESIGN 829 patients with FEP and 1283 community controls from 16 EU-GEI sites were assessed for child maltreatment, education attainment, and IQ. STUDY RESULTS In both the FEP and control group, childhood maltreatment was associated with lower educational attainment. The association between childhood maltreatment and lower IQ was robust to adjustment for confounders only among controls. Whereas childhood neglect was consistently associated with lower attainment and IQ in both groups, childhood abuse was associated with IQ only in controls. Among both patients with affective and nonaffective psychoses, negative associations between childhood maltreatment and educational attainment were observed, but the crude association with IQ was only evident in affective psychoses. CONCLUSIONS Our findings underscore the role of childhood maltreatment in shaping academic outcomes and cognition of people with FEP as well as controls.
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Affiliation(s)
- Lucia Sideli
- To whom correspondence should be addressed; Department of Human Science, LUMSA University, Piazza delle Vaschette, 101 – 00193 Rome, Italy; tel: +39 06 684 221, e-mail:
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,NORMENT, Centre for Research On Mental Disorders, Oslo University Hospital and University of Oslo, Norway,Department of Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Norway
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Departamento de Psiquiatria, Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA,Early Psychosis Section, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Helen L Fisher
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England,ESRC Centre for Society and Mental Health, King’s College London, London, UK
| | | | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Diego Quattrone
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England
| | - Charlotte Gayer-Anderson
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England,Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Giovanna Marrazzo
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Italy
| | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Giuseppe D’Andrea
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de
Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Department of Medicine, Neuroscience Institute, University of Barcelona, Institut d’Investigacions Biomèdiques, August Pi I Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Hospital “Virgen de la Luz”, Cuenca, Spain
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, Universidade de São Paulo, São Paulo, Brazil
| | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, England,Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England,EA 7280 Npsydo, Université Clermont Auvergne, Clermont-Ferrand, France
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, England
| | | | - Andrea Tortelli
- Establissement Public de Santé, Maison Blanche, Paris, France
| | - Baptiste Pignon
- AP-HP, Groupe Hospitalier “Mondor,” Pôle de Psychiatrie, Créteil, France,Institut National de la Santé et de la Recherche Médicale, U955, Créteil, France,Fondation Fondamental, Créteil, France
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands,Department Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marta Di Forti
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King’s College London, London, UK,Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
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Gebreegziabhere Y, Habatmu K, Mihretu A, Cella M, Alem A. Cognitive impairment in people with schizophrenia: an umbrella review. Eur Arch Psychiatry Clin Neurosci 2022; 272:1139-1155. [PMID: 35633394 PMCID: PMC9508017 DOI: 10.1007/s00406-022-01416-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/11/2022] [Indexed: 01/08/2023]
Abstract
Cognitive impairment is one of the core symptoms of schizophrenia. Quite a number of systematic reviews were published related to cognitive impairment in people with schizophrenia (PWS). This umbrella review, therefore, aimed at reviewing and synthesizing the findings of systematic reviews related to domains of cognition impaired and associated factors in PWS. We searched four electronic databases. Data related to domains, occurrence, and associated factors of cognitive impairment in PWS were extracted. The quality of all eligible systematic reviews was assessed using A MeaSurement Tool to Assess methodological quality of systematic Review (AMSTAR) tool. Results are summarized and presented in a narrative form. We identified 63 systematic reviews fulfilling the eligibility criteria. The included reviews showed that PWS had lower cognitive functioning compared to both healthy controls and people with affective disorders. Similar findings were reported among psychotropic free cases and people with first episode psychosis. Greater impairment of cognition was reported in processing speed, verbal memory, and working memory domains. Greater cognitive impairment was reported to be associated with worse functionality and poor insight. Cognitive impairment was also reported to be associated with childhood trauma and aggressive behaviour. According to our quality assessment, the majority of the reviews had moderate quality. We were able to find a good number of systematic reviews on cognitive impairment in PWS. The reviews showed that PWS had higher impairment in different cognitive domains compared to healthy controls and people with affective disorders. Impairment in domains of memory and processing speed were reported frequently.
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Affiliation(s)
- Yohannes Gebreegziabhere
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia. .,Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Kassahun Habatmu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Awoke Mihretu
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England UK
| | - Atalay Alem
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Kasznia J, Pytel A, Stańczykiewicz B, Samochowiec J, Waszczuk K, Kulik M, Cyran A, Misiak B. The Impact of Adverse Childhood Experiences on Coping Strategies in Schizophrenia Spectrum Disorders: A Case-Control Study. Psychol Res Behav Manag 2021; 14:1315-1323. [PMID: 34466040 PMCID: PMC8403075 DOI: 10.2147/prbm.s324152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/18/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose Several studies have shown that individuals with schizophrenia-spectrum disorders (SSD) employ ineffective coping styles. However, it remains unknown whether a history of adverse childhood experiences (AC Es), associated with a risk of SSD, contributes to these observations. Therefore, in this study, we aimed to investigate whether exposure to ACEs is associated with coping styles in subjects with SSD. Patients and Methods We recruited 127 inpatients with SSD and 56 healthy controls. Coping styles and ACEs were recorded using self-reports. Results Individuals with SSD had significantly higher use of using avoidance coping. A history of parental antipathy, physical and sexual abuse was significantly more frequent in subjects with SSD compared to controls. Subjects with SSD had significantly higher multiplicity and severity of ACEs. Individuals with SSD and a history of parental loss had significantly higher use of avoidance coping compared to controls with and without a history of parental loss. Other characteristics of ACEs (age at first exposure, severity and multiplicity) were not associated with using specific coping strategies. Conclusion These findings imply that higher use of using avoidance coping by individuals with SSD might be related to a history of parental loss.
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Affiliation(s)
- Justyna Kasznia
- Inpatient Psychiatric Unit, Municipal General Hospital, Ostrów Wielkopolski, Poland
| | - Aleksandra Pytel
- Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland
| | | | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna Waszczuk
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Małgorzata Kulik
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Agnieszka Cyran
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland
| | - Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland
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Vaskinn A, Engelstad KN, Torgalsbøen AK, Rund BR. Childhood trauma, social cognition and schizophrenia: Specific association between physical neglect and cognitive theory of mind in homicide offenders. Psychiatry Res 2021; 303:114093. [PMID: 34247060 DOI: 10.1016/j.psychres.2021.114093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/19/2022]
Abstract
Schizophrenia is associated with a small, but increased risk of violent behavior, including homicide. Violent individuals with schizophrenia have elevated rates of childhood trauma and substantial social cognitive impairments. The aim of this study was to examine if childhood trauma is related to social cognition in homicide offenders with schizophrenia. We recruited 26 individuals with schizophrenia sentenced to compulsory mental care for homicide/attempted homicide and 28 non-violent schizophrenia controls. They filled out the Childhood Trauma Questionnaire (CTQ), providing scores for physical abuse, sexual abuse, emotional abuse, physical neglect and emotional neglect. Social cognition was assessed with two measures of emotion processing (Emotion in Biological Motion, Pictures of Facial Affect) and two theory of mind (ToM) tests (Hinting Task, Movie for the Assessment of Social Cognition: MASC). Spearman's rho correlation coefficients were computed, and significant results followed up with partial correlation analyses controlling for IQ. Three associations were statistically significant, all in the homicide group; between CTQ physical neglect and cognitive ToM assessed with Hinting Task and with MASC, and between CTQ emotional neglect and Hinting Task. Only the first remained significant after controlling for IQ, indicating a specific association between physical neglect and cognitive ToM in homicide offenders with schizophrenia.
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Affiliation(s)
- Anja Vaskinn
- Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | | | | | - Bjørn Rishovd Rund
- Research Department, Vestre Viken Hospital Trust, Drammen, Norway; Department of Psychology, University of Oslo, Oslo, Norway
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Lebovitz JG, Millett CE, Shanahan M, Levy-Carrick NC, Burdick KE. The impact of lifetime interpersonal and intentional trauma on cognition and vulnerability to psychosis in bipolar disorder. BJPsych Open 2021. [PMCID: PMC8444053 DOI: 10.1192/bjo.2021.991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background
Studies have shown that over half of individuals with bipolar disorder experience early-life trauma, which may influence clinical outcomes, including suicidality and presence of psychotic features. However, studies report inconsistent findings regarding the effect of trauma on cognitive outcomes in bipolar disorder.
Aims
Our study explores the effect of lifetime trauma on the level of vulnerability to psychosis and cognitive performance in participants with bipolar disorder.
Method
We evaluated lifetime trauma history in 236 participants with a diagnosis of bipolar disorder type 1 or 2, using the Structured Clinical Interview for DSM-IV and the Childhood Trauma Questionnaire. We classified trauma types based on the Substance Abuse and Mental Health Services Administration's concept of trauma, which characterises the type of experienced trauma (e.g. interpersonal and intentional, accidental or naturally occurring). Our primary outcome measures of interest were vulnerability to psychosis (Schizotypal Personality Questionnaire), cognitive performance (MATRICS Consensus Cognitive Battery) and social functioning (Social Adjustment Scale Self-Report).
Results
Multivariate analysis of covariance showed a significant effect of trauma type on the Schizotypal Personality Questionnaire cognitive–perceptual domain (F(3) = 6.7, P < 0.001). The no-trauma group had lower cognitive–perceptual schizotypal features compared with the accidental and intentional trauma (P < 0.001) and interpersonal and intentional trauma (P = 0.01) groups.
Conclusions
Our results highlight the need for careful trauma inquiry in patients with bipolar disorder, and consideration of how trauma-focused or -informed treatments may be an integral part of treatment planning to improve outcomes in bipolar disorder.
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Kasznia J, Pytel A, Stańczykiewicz B, Samochowiec J, Preś J, Rachubińska K, Misiak B. Adverse Childhood Experiences and Neurocognition in Schizophrenia Spectrum Disorders: Age at First Exposure and Multiplicity Matter. Front Psychiatry 2021; 12:684099. [PMID: 34305680 PMCID: PMC8295342 DOI: 10.3389/fpsyt.2021.684099] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/08/2021] [Indexed: 12/14/2022] Open
Abstract
Adverse childhood experiences (ACEs) might be related to cognitive impairments observed in schizophrenia spectrum disorders (SSD). However, it remains unknown what aspects of ACEs are associated with cognitive impairments in SSD. Therefore, we aimed to investigate the association between various characteristics of ACEs (age at first exposure, severity, and multiplicity) and cognition in SSD and healthy controls (HCs). We enrolled 127 individuals with SSD and 56 HCs. Cognitive performance was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The Childhood Experience of Care and Abuse Questionnaire was administered to record a history of ACEs. The following characteristics of ACEs were analyzed: multiplicity, severity, and age at first exposure. Individuals with SSD had significantly lower scores on all RBANS domains. Multiplicity and severity of ACEs were significantly higher in patients with SSD compared to HCs. In both groups, greater multiplicity of ACEs was associated with lower scores of global cognition and delayed memory. Additionally, in subjects with SSD, greater multiplicity and younger age at first exposure were associated with lower scores of attention. The present findings indicate that greater multiplicity and younger age at first exposure are the most important aspects of ACEs contributing to cognitive impairments observed in SSD. Moreover, ACEs might exert differential impact on cognition in SSD and HCs.
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Affiliation(s)
- Justyna Kasznia
- Inpatient Psychiatric Unit, Municipal General Hospital, Ostrów Wielkopolski, Poland
| | - Aleksandra Pytel
- Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland
| | | | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Joanna Preś
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | | | - Błażej Misiak
- Division of Consultation Psychiatry and Neuroscience, Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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Rodriguez V, Aas M, Vorontsova N, Trotta G, Gadelrab R, Rooprai NK, Alameda L. Exploring the Interplay Between Adversity, Neurocognition, Social Cognition, and Functional Outcome in People With Psychosis: A Narrative Review. Front Psychiatry 2021; 12:596949. [PMID: 33762975 PMCID: PMC7982734 DOI: 10.3389/fpsyt.2021.596949] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/10/2021] [Indexed: 12/14/2022] Open
Abstract
History of adversity is associated with subsequent psychosis, and with a spectrum of cognitive alterations in individuals with psychosis. These cognitive features go from neurocognitive aspects as working memory and attention, to complex social cognitive processes as theory of mind and emotional perception. Difficulties in these domains impact patients' social and occupational functioning, which has been shown to be more impaired in those previously exposed to childhood trauma. However, the interplay between adversity, neurocognition, and functioning is yet poorly understood. This narrative review aims to explore the evidence on whether deficits in neurocognitive and social cognitive domains may act as possible putative mechanism linking adversity with functioning in people with psychosis. We show available evidence supporting the link between adversity and poorer functioning in psychosis, especially in chronic stages; and replicated evidence suggesting associations of social cognition and, to a lesser extent, neurocognition with impairment in functioning in patients; although there is still an important gap in the literature testing particularly deficits in social cognition as mediator of the link between adversity and functional decline in psychosis. Targeting interventions focusing on neurocognition and social cognition in individuals with adversity and psychosis seems important, given the severe deterioration of these patients in these domains, although more research is needed to test whether such treatments can specifically improve functioning in individuals with psychosis and adversity. Literature aiming to understand the determinants of functional outcome should consider the pervasive impact of childhood adversity, and its related effects on cognition.
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Affiliation(s)
- Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NORMENT Centre for Psychosis Research, Oslo University Hospital, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | - Natasha Vorontsova
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Romayne Gadelrab
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Navneet Kaur Rooprai
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
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Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR. The Impact of Childhood Trauma on Developing Bipolar Disorder: Current Understanding and Ensuring Continued Progress. Neuropsychiatr Dis Treat 2020; 16:3095-3115. [PMID: 33364762 PMCID: PMC7751794 DOI: 10.2147/ndt.s285540] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022] Open
Abstract
Childhood trauma (CT) has been repeatedly linked to earlier onset and greater severity of bipolar disorder (BD) in adulthood. However, such knowledge is mostly based on retrospective and cross-sectional studies in adults with BD. The first objective of this selective review is to characterize the short-term effects of CT in the development of BD by focusing on studies in young people. The second objective is to describe the longer-term consequences of CT by considering studies with adult participants. This review first outlines the most prominent hypotheses linking CT exposure and the onset of BD. Then, it summarizes the psychological and biological risk factors implicated in the development of BD, followed by a discussion of original studies that investigated the role of CT in young people with early-onset BD, youths at increased risk of developing BD, or young people with BD with a focus on subclinical and clinical outcome measures. The review considers additional biological and psychological factors associated with a negative impact of CT on the long-term course of BD in later adulthood. Finally, we discuss how the integration of information of CT can improve ongoing early identification of BD and mitigate severe clinical expression in later adulthood.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Mark Corcoran
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Maria R Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
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Misiak B, Karpiński P, Szmida E, Grąźlewski T, Jabłoński M, Cyranka K, Rymaszewska J, Piotrowski P, Kotowicz K, Frydecka D. Adverse Childhood Experiences and Methylation of the FKBP5 Gene in Patients with Psychotic Disorders. J Clin Med 2020; 9:jcm9123792. [PMID: 33255215 PMCID: PMC7759816 DOI: 10.3390/jcm9123792] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/15/2020] [Accepted: 11/19/2020] [Indexed: 01/07/2023] Open
Abstract
Altered methylation of the FKBP5 gene has been observed in various mental disorders and attributed to the effects of adverse childhood experiences (ACEs). However, the level of FKBP5 methylation has not been investigated in patients with psychotic disorders. Therefore, in this study we aimed to determine the FKBP5 methylation in patients with psychosis and controls, taking into account the effects of ACEs. Participants were 85 patients with psychotic disorders, including first-episode psychosis (FEP) patients and acutely relapsed schizophrenia (SCZ-AR) patients, as well as 56 controls. The level of four CpG sites at the FKBP5 gene was determined in the peripheral blood leukocytes using pyrosequencing. After controlling for potential confounding factors, the level of FKBP5 methylation at one out of four tested CpG sites was significantly lower in FEP patients compared to other groups of participants. Significant main effects of parental antipathy and sexual abuse on the level of FKBP5 methylation were observed at the differentially methylated CpG site. Participants reporting this category of ACEs had significantly lower levels of FKBP5 methylation at this CpG site. Lower levels of FKBP5 methylation were associated with better cognitive performance and higher functional capacity in patients with psychosis. In controls, lower methylation of FKBP5 was related to worse performance of immediate memory and language skills. Our findings suggest that hypomethylation of the FKBP5 appears at early stages of psychosis and might be associated with a history of ACEs as well as less severe clinical manifestation.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
- Correspondence:
| | - Paweł Karpiński
- Department of Genetics, Wroclaw Medical University, Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland; (P.K.); (E.S.)
- Laboratory of Genomics & Bioinformatics, Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12 Street, 53-114 Wroclaw, Poland
| | - Elżbieta Szmida
- Department of Genetics, Wroclaw Medical University, Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland; (P.K.); (E.S.)
| | - Tomasz Grąźlewski
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland; (T.G.); (M.J.)
| | - Marcin Jabłoński
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland; (T.G.); (M.J.)
| | - Katarzyna Cyranka
- Department of Psychiatry, Jagiellonian University, Kopernika 21a Street, 31-501 Cracow, Poland;
| | - Joanna Rymaszewska
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
| | - Patryk Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
| | - Kamila Kotowicz
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland; (J.R.); (P.P.); (K.K.); (D.F.)
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43
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Vaskinn A, Melle I, Aas M, Berg AO. Sexual abuse and physical neglect in childhood are associated with affective theory of mind in adults with schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2020; 23:100189. [PMID: 33134093 PMCID: PMC7586237 DOI: 10.1016/j.scog.2020.100189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/09/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Abstract
Whereas childhood trauma is associated with reduced nonsocial cognition in schizophrenia, research on the relationship between childhood trauma and social cognition is limited and mixed. The aim of this study was to examine the association between childhood trauma and theory of mind (ToM) in persons with schizophrenia (n = 68) compared to healthy control participants (n = 70). Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ), providing information on physical abuse, emotional abuse, sexual abuse, physical neglect and emotional neglect. ToM was indexed by the Movie for the Assessment of Social Cognition (MASC), which yields scores for total, cognitive and affective ToM, and for three error types (overmentalizing, undermentalizing, no mentalizing). Persons with schizophrenia had elevated rates of childhood trauma and lower ToM scores than healthy controls. In the schizophrenia group, associations between sexual abuse and affective ToM was statistically significant. In regression analyses, physical neglect was found to be the strongest predictor of affective ToM. In healthy controls, childhood trauma was not associated with ToM. Follow-up analyses comparing individuals with/without clinically significant childhood trauma, confirmed the findings for the schizophrenia group. No causal inferences can be made in this cross-sectional study, but the results suggest an illness-specific association between both sexual abuse and physical neglect in childhood, and adult affective ToM in individuals with 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
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Monica Aas
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Akiah Ottesen Berg
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
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Gawęda Ł, Pionke R, Hartmann J, Nelson B, Cechnicki A, Frydecka D. Toward a Complex Network of Risks for Psychosis: Combining Trauma, Cognitive Biases, Depression, and Psychotic-like Experiences on a Large Sample of Young Adults. Schizophr Bull 2020; 47:395-404. [PMID: 33728467 PMCID: PMC7965064 DOI: 10.1093/schbul/sbaa125] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although the linkage between traumatic life events and psychotic-like experiences (PLEs) is well established, the knowledge of potential mechanisms of this relationship is scarce. The aim of the present study was to better understand the structure of connections between traumatic life events and PLEs by considering at the same time the role of cognitive biases and depressive symptoms in the population of young adults (18-35 years of age, M = 26.52, SD = 4.74, n = 6772). Our study was conducted within a framework of network analysis. PLEs were measured with the Prodromal Questionnaire (PQ-16), cognitive biases were measured with nine items from the Davos Assessment of Cognitive Biases Scale-18 (DACOBS-18), depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression Scale (CESD-R) and exposure to traumatic life events was measured with a combination of Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and Traumatic Experience Checklist (TEC). The results present a network of all nodes being interconnected within and between domains, with no isolated factors. Exposures to sexual trauma were the most central node in the network. Pathways were identified from trauma to PLEs via cognitive biases and depressive symptoms. However, the shortest pathway between the most central traumatic life event and PLEs was through other traumatic life events, without cognitive biases or depressive symptoms along the way. Our findings suggest the importance of environmental adversities as well as dysfunctional information processing and depression in the network of psychosis risks.
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Affiliation(s)
- Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,To whom correspondence should be addressed; Institute of Psychology, Polish Academy of Sciences, Jaracza 1, 00-378 Warsaw, Poland; tel: +48 (22) 583-13-80, fax: +48 (22) 583-13-81, e-mail:
| | - Renata Pionke
- Psychopathology and Early Interventions Lab, II Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Jessica Hartmann
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrzej Cechnicki
- Department of Community Psychiatry, Chair of Psychiatry, Medical College Jagiellonian University, Krakow, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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45
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Corcoran M, Hawkins EL, O'Hora D, Whalley HC, Hall J, Lawrie SM, Dauvermann MR. Are working memory and glutamate concentrations involved in early-life stress and severity of psychosis? Brain Behav 2020; 10:e01616. [PMID: 32385970 PMCID: PMC7303391 DOI: 10.1002/brb3.1616] [Citation(s) in RCA: 6] [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: 09/02/2019] [Revised: 02/18/2020] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Occurrences of early-life stress (ELS) are associated with the severity of psychotic symptoms and working memory (WM) deficits in patients with psychosis (PSY). This study investigated potential mediation roles of WM behavioral performance and glutamate concentrations in prefrontal brain regions on the association between ELS and psychotic symptom severity in PSY. METHOD Forty-seven patients with PSY (established schizophrenia, n = 30; bipolar disorder, n = 17) completed measures of psychotic symptom severity. In addition, data on ELS and WM performance were collected in both patients with PSY and healthy controls (HC; n = 41). Resting-state glutamate concentrations in the bilateral dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) were also assessed with proton magnetic resonance spectroscopy for both PSY and HC groups. t tests, analyses of variance, and regression analyses were utilized. RESULTS Participants with PSY reported significantly more ELS occurrences and showed poorer WM performance than HC. Furthermore, individuals with PSY displayed lower glutamate concentrations in the left DLPFC than HC. Neither ELS nor WM performance were predictive of severity of psychotic symptoms in participants with PSY. However, we found a significant negative correlation between glutamate concentrations in the left DLPFC and ELS occurrence in HC only. CONCLUSION In individuals with PSY, the current study found no evidence that the association between ELS and psychotic symptoms is mediated by WM performance or prefrontal glutamate concentrations. In HC, the association between ELS experience and glutamate concentrations may indicate a neurometabolite effect of ELS that is independent of an illness effect in psychosis.
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Affiliation(s)
- Mark Corcoran
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Emma L Hawkins
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Denis O'Hora
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | | | - Jeremy Hall
- Neuroscience and Mental Health Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | | | - Maria R Dauvermann
- School of Psychology, National University of Ireland Galway, Galway, Ireland.,McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Psychiatry, University of Cambridge, Cambridge, UK
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Chen J, Zang Z, Braun U, Schwarz K, Harneit A, Kremer T, Ma R, Schweiger J, Moessnang C, Geiger L, Cao H, Degenhardt F, Nöthen MM, Tost H, Meyer-Lindenberg A, Schwarz E. Association of a Reproducible Epigenetic Risk Profile for Schizophrenia With Brain Methylation and Function. JAMA Psychiatry 2020; 77:628-636. [PMID: 32049268 PMCID: PMC7042900 DOI: 10.1001/jamapsychiatry.2019.4792] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
IMPORTANCE Schizophrenia is a severe mental disorder in which epigenetic mechanisms may contribute to illness risk. Epigenetic profiles can be derived from blood cells, but to our knowledge, it is unknown whether these predict established brain alterations associated with schizophrenia. OBJECTIVE To identify an epigenetic signature (quantified as polymethylation score [PMS]) of schizophrenia using machine learning applied to genome-wide blood DNA-methylation data; evaluate whether differences in blood-derived PMS are mirrored in data from postmortem brain samples; test whether the PMS is associated with alterations of dorsolateral prefrontal cortex hippocampal (DLPFC-HC) connectivity during working memory in healthy controls (HC); explore the association between interactions between polygenic and epigenetic risk with DLPFC-HC connectivity; and test the specificity of the signature compared with other serious psychiatric disorders. DESIGN, SETTING, AND PARTICIPANTS In this case-control study conducted from 2008 to 2018 in sites in Germany, the United Kingdom, the United States, and Australia, blood DNA-methylation data from 2230 whole-blood samples from 6 independent cohorts comprising HC (1238 [55.5%]) and participants with schizophrenia (803 [36.0%]), bipolar disorder (39 [1.7%]), major depressive disorder 35 [1.6%]), and autism (27 [1.2%]), and first-degree relatives of all patient groups (88 [3.9%]) were analyzed. DNA-methylation data were further explored from 244 postmortem DLPFC samples from 136 HC and 108 patients with schizophrenia. Neuroimaging and genome-wide association data were available for 393 HC. The latter data was used to calculate a polygenic risk score (PRS) for schizophrenia. The data were analyzed in 2019. MAIN OUTCOMES AND MEASURES The accuracy of schizophrenia control classification based on machine learning using epigenetic data; association of schizophrenia PMS scores with DLPFC-HC connectivity; and association of the interaction between PRS and PMS with DLPFC-HC connectivity. RESULTS This study included 7488 participants (4395 men [58.7%]), of whom 3158 (2230 men [70.6%]) received a diagnosis of schizophrenia. The PMS signature was associated with schizophrenia across 3 independent data sets (area under the curve [AUC] from 0.69 to 0.78; P value from 0.049 to 1.24 × 10-7) and data from postmortem DLPFC samples (AUC = 0.63; P = 1.42 × 10-4), but not with major depressive disorder (AUC = 0.51; P = .16), autism (AUC = 0.53; P = .66), or bipolar disorder (AUC = 0.58; P = .21). Pathways contributing most to the classification included synaptic processes. Healthy controls with schizophrenia-like PMS showed significantly altered DLPFC-HC connectivity (validation methylation/magnetic resonance imaging, t < -3.81; P for familywise error, <.04; validation magnetic resonance imaging, t < -3.54; P for familywise error, <.02), mirroring the lack of functional decoupling in schizophrenia. There was no significant association of the interaction between PMS and PRS with DLPFC-HC connectivity (P > .19). CONCLUSIONS AND RELEVANCE We identified a reproducible blood DNA-methylation signature specific for schizophrenia that was correlated with altered functional DLPFC-HC coupling during working memory and mapped to methylation differences found in DLPFC postmortem samples. This indicates a possible epigenetic contribution to a schizophrenia intermediate phenotype and suggests that PMS could be of interest to be studied in the context of multimodal biomarkers for disease stratification and treatment personalization.
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Affiliation(s)
- Junfang Chen
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Zhenxiang Zang
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Urs Braun
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Kristina Schwarz
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anais Harneit
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Thomas Kremer
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ren Ma
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Janina Schweiger
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Carolin Moessnang
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lena Geiger
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Han Cao
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Franziska Degenhardt
- School of Medicine & University Hospital Bonn, Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Markus M. Nöthen
- School of Medicine & University Hospital Bonn, Institute of Human Genetics, University of Bonn, Bonn, Germany,Life & Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - Heike Tost
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Emanuel Schwarz
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Childhood trauma and cognitive functioning in individuals at clinical high risk (CHR) for psychosis. Dev Psychopathol 2020; 33:53-64. [PMID: 31959269 DOI: 10.1017/s095457941900155x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Evidence suggests that early trauma may have a negative effect on cognitive functioning in individuals with psychosis, yet the relationship between childhood trauma and cognition among those at clinical high risk (CHR) for psychosis remains unexplored. Our sample consisted of 626 CHR children and 279 healthy controls who were recruited as part of the North American Prodrome Longitudinal Study 2. Childhood trauma up to the age of 16 (psychological, physical, and sexual abuse, emotional neglect, and bullying) was assessed by using the Childhood Trauma and Abuse Scale. Multiple domains of cognition were measured at baseline and at the time of psychosis conversion, using standardized assessments. In the CHR group, there was a trend for better performance in individuals who reported a history of multiple types of childhood trauma compared with those with no/one type of trauma (Cohen d = 0.16). A history of multiple trauma types was not associated with greater cognitive change in CHR converters over time. Our findings tentatively suggest there may be different mechanisms that lead to CHR states. Individuals who are at clinical high risk who have experienced multiple types of childhood trauma may have more typically developing premorbid cognitive functioning than those who reported minimal trauma do. Further research is needed to unravel the complexity of factors underlying the development of at-risk states.
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Abstract
The development of effective intervention and prevention strategies among individuals with psychosis risk syndromes may help to reduce symptomatology and conversion to a psychotic disorder. Although strides have been made in this area, more work is needed, particularly given the setbacks that remain (such as heterogeneity among this group). There has been a shift with the introduction of clinical staging models toward expanding current intervention and prevention efforts to a more developmental and transdiagnostic approach. With this, this article seeks to review treatments both recently and currently discussed in the staging literature, introduce advances in psychosis risk syndrome treatments that may be beneficial to consider in clinical staging heuristics, and pinpoint other promising options.
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Affiliation(s)
- Tina Gupta
- Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Vijay A Mittal
- Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA.,Department of Psychiatry, Northwestern University, 420 E. Superior Street, Chicago, IL, 60611, USA.,Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL, 60208, USA.,Department of Medical Social Sciences, Northwestern University, 420 E. Superior Street, Chicago, IL, 60611, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, 633 N. St. Claire Street, Chicago, IL, 60611, USA
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49
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Green MF, Horan WP, Lee J. Nonsocial and social cognition in schizophrenia: current evidence and future directions. World Psychiatry 2019; 18:146-161. [PMID: 31059632 PMCID: PMC6502429 DOI: 10.1002/wps.20624] [Citation(s) in RCA: 330] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cognitive impairment in schizophrenia involves a broad array of nonsocial and social cognitive domains. It is a core feature of the illness, and one with substantial implications for treatment and prognosis. Our understanding of the causes, consequences and interventions for cognitive impairment in schizophrenia has grown substantially in recent years. Here we review a range of topics, including: a) the types of nonsocial cognitive, social cognitive, and perceptual deficits in schizophrenia; b) how deficits in schizophrenia are similar or different from those in other disorders; c) cognitive impairments in the prodromal period and over the lifespan in schizophrenia; d) neuroimaging of the neural substrates of nonsocial and social cognition, and e) relationships of nonsocial and social cognition to functional outcome. The paper also reviews the considerable efforts that have been directed to improve cognitive impairments in schizophrenia through novel psychopharmacology, cognitive remediation, social cognitive training, and alternative approaches. In the final section, we consider areas that are emerging and have the potential to provide future insights, including the interface of motivation and cognition, the influence of childhood adversity, metacognition, the role of neuroinflammation, computational modelling, the application of remote digital technology, and novel methods to evaluate brain network organization. The study of cognitive impairment has provided a way to approach, examine and comprehend a wide range of features of schizophrenia, and it may ultimately affect how we define and diagnose this complex disorder.
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Affiliation(s)
- Michael F. Green
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral SciencesUniversity of California, Los Angeles (UCLA)Los AngelesCAUSA,Desert Pacific Mental Illness Research, Education and Clinical CenterVeterans Affairs Greater Los Angeles Healthcare SystemLos AngelesCAUSA,Veterans Affairs Program for Enhancing Community Integration for Homeless VeteransLos AngelesCAUSA
| | - William P. Horan
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral SciencesUniversity of California, Los Angeles (UCLA)Los AngelesCAUSA,Desert Pacific Mental Illness Research, Education and Clinical CenterVeterans Affairs Greater Los Angeles Healthcare SystemLos AngelesCAUSA,Veterans Affairs Program for Enhancing Community Integration for Homeless VeteransLos AngelesCAUSA
| | - Junghee Lee
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral SciencesUniversity of California, Los Angeles (UCLA)Los AngelesCAUSA,Desert Pacific Mental Illness Research, Education and Clinical CenterVeterans Affairs Greater Los Angeles Healthcare SystemLos AngelesCAUSA,Veterans Affairs Program for Enhancing Community Integration for Homeless VeteransLos AngelesCAUSA
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