1
|
Aversa S, Ghanem J, Grunfeld G, Lemonde AC, Malla A, Iyer S, Joober R, Lepage M, Shah J. Sociodemographic and clinical correlates of hallucinations in patients entering an early intervention program for first episode psychosis. Schizophr Res 2024; 269:86-92. [PMID: 38754313 DOI: 10.1016/j.schres.2024.04.026] [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: 11/18/2023] [Revised: 03/28/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
Hallucinations are a core feature of psychosis, and their severity during the acute phase of illness is associated with a range of poor outcomes. Various clinical and sociodemographic factors may predict hallucinations and other positive psychotic symptoms in first episode psychosis (FEP). Despite this, the precise factors associated with hallucinations at first presentation to an early intervention service have not been extensively researched. Through detailed interviews and chart reviews, we investigated sociodemographic and clinical predictors in 636 minimally-medicated patients who entered PEPP-Montréal, an early intervention service for FEP, between 2003 and 2018. Hallucinations were measured using the Scale for the Assessment of Positive Symptoms (SAPS), while negative symptoms were assessed using the Scale for the Assessment of Negative symptoms (SANS). Depressive symptoms were evaluated through the Calgary Depression Scale for Schizophrenia (CDSS), and anxiety symptoms via the Hamilton Rating Scale for Anxiety (HAS). A majority (n = 381, 59.9 %) of the sample presented with clinically significant hallucinations (SAPS global hallucinations score ≥ 3) at program entry. These patients had an earlier age at onset, fewer years of education, and a higher severity of delusions, depression and negative symptoms than those without clinical-level hallucinations. These results suggest that individuals with clinically significant hallucinations at admission tend to be younger and have a greater overall symptom burden. This makes it especially important to monitor hallucinations alongside delusions, depression and negative symptoms in order to identify who might benefit from targeted interventions. The implications of these findings for early intervention and person-centered care are discussed.
Collapse
Affiliation(s)
- Samantha Aversa
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, 7070 Champlain Blvd, Verdun, Montreal, Quebec H4H 1A8, Canada.
| | - Joseph Ghanem
- Douglas Mental Health University Institute, 6875 Bd LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Department of Psychology, Faculty of Science, McGill University, 2001 Av. McGill College, Montréal, QC H3A 1G1, Canada.
| | - Gili Grunfeld
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, 7070 Champlain Blvd, Verdun, Montreal, Quebec H4H 1A8, Canada; Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 1033 Pine Ave W, Montreal, Quebec H3A 1A1, Canada.
| | - Ann-Catherine Lemonde
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, 7070 Champlain Blvd, Verdun, Montreal, Quebec H4H 1A8, Canada; Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 1033 Pine Ave W, Montreal, Quebec H3A 1A1, Canada.
| | - Ashok Malla
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, 7070 Champlain Blvd, Verdun, Montreal, Quebec H4H 1A8, Canada; Douglas Mental Health University Institute, 6875 Bd LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 1033 Pine Ave W, Montreal, Quebec H3A 1A1, Canada.
| | - Srividya Iyer
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, 7070 Champlain Blvd, Verdun, Montreal, Quebec H4H 1A8, Canada; Douglas Mental Health University Institute, 6875 Bd LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 1033 Pine Ave W, Montreal, Quebec H3A 1A1, Canada.
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, 7070 Champlain Blvd, Verdun, Montreal, Quebec H4H 1A8, Canada; Douglas Mental Health University Institute, 6875 Bd LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 1033 Pine Ave W, Montreal, Quebec H3A 1A1, Canada.
| | - Martin Lepage
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, 7070 Champlain Blvd, Verdun, Montreal, Quebec H4H 1A8, Canada; Douglas Mental Health University Institute, 6875 Bd LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Department of Psychology, Faculty of Science, McGill University, 2001 Av. McGill College, Montréal, QC H3A 1G1, Canada; Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 1033 Pine Ave W, Montreal, Quebec H3A 1A1, Canada.
| | - Jai Shah
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, 7070 Champlain Blvd, Verdun, Montreal, Quebec H4H 1A8, Canada; Douglas Mental Health University Institute, 6875 Bd LaSalle, Verdun, Montreal, QC H4H 1R3, Canada; Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 1033 Pine Ave W, Montreal, Quebec H3A 1A1, Canada.
| |
Collapse
|
2
|
Jongeneel A, Delespaul P, Tromp N, Scheffers D, van der Vleugel B, de Bont P, Kikkert M, Croes CF, Staring AB, Riper H, van der Gaag M, van den Berg D. Effects on voice hearing distress and social functioning of unguided application of a smartphone app - A randomized controlled trial. Internet Interv 2024; 35:100717. [PMID: 38328276 PMCID: PMC10847757 DOI: 10.1016/j.invent.2024.100717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/27/2023] [Accepted: 01/23/2024] [Indexed: 02/09/2024] Open
Abstract
Background Temstem is a smartphone app developed with and for clinical voice hearing individuals with the aim to reduce their voice hearing distress and improve social functioning. Methods A randomized controlled trial with adult outpatients suffering from distressing and frequent auditory verbal hallucinations (AVH) was conducted. Participants were randomized to unguided 'Temstem+AVH monitoring' or unguided 'AVH monitoring only' (control condition). Assessments were performed at baseline, post-intervention (week 5-6), and follow-up (week 9-10). Primary outcomes were voice hearing distress and social functioning, as measured with Experience Sampling Method (ESM), consisting of multiple daily questionnaires during six days. In addition, voices and mood were self-monitored with help of a daily reflective questionnaire. Analyses were linear regression models (intention-to-treat). Results 44 Participants were allocated to Temstem and 45 to the control condition. No significant differences between the groups were found on both primary outcomes. Conclusion Our results do not support the effectiveness of stand-alone use of Temstem versus symptom monitoring on voice hearing distress or social functioning in voice hearing individuals. In order to potentially improve effectiveness of an mHealth tool in a population of people with frequent and distressing voices, we recommend to involve persons with lived experience in all stages of development and research; to thoroughly test the (technological) usability before performing an RCT; to test whether guidance of a therapist is needed to optimize effectiveness; and to provide prompts to remind the user to actually use the tool.
Collapse
Affiliation(s)
- Alyssa Jongeneel
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands
- Research Centre, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN Den Haag, Netherlands
| | - Philippe Delespaul
- School of MentalHealth and NeuroSciences, Maastricht University, Maastricht, Netherlands
- Mondriaan Mental Health Centre, Maastricht, Heerlen, Netherlands
| | - Nynke Tromp
- Department of Industrial Design, Delft University of Technology, Landbergstraat 15, 2628 CE Delft, Netherlands
| | - Dorien Scheffers
- Research Centre, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN Den Haag, Netherlands
| | - Berber van der Vleugel
- Community Mental Health Service, GGZ Noord-Holland Noord, Alkmaar, Netherlands
- Viersprong Institute for Personality Disorders, Amsterdam, Netherlands
| | - Paul de Bont
- Department of Early Intervention Psychosis, Mental Health Organisation GGZ Oost Brabant, Land van Cuijck en Noord Limburg, Boxmeer, Netherlands
| | | | - Carlos F. Croes
- GGz Centraal Mental Health Institution, Amersfoort, Netherlands
| | | | - Heleen Riper
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands
- Department of Research and Innovation, GGZ InGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | - Mark van der Gaag
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands
| | - David van den Berg
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands
- Research Centre, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN Den Haag, Netherlands
| |
Collapse
|
3
|
Smith L, Rossell SL, Thomas N, Toh WL. Intersections of phenomenology, voice beliefs and distress in bipolar disorder: a comparison with schizophrenia. Behav Cogn Psychother 2024; 52:78-92. [PMID: 37749628 DOI: 10.1017/s1352465823000395] [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] [Indexed: 09/27/2023]
Abstract
BACKGROUND Auditory verbal hallucinations (AVH), or voice-hearing, can be a prominent symptom during fluctuating mood states in bipolar disorder (BD). AIMS The current study aimed to: (i) compare AVH-related distress in BD relative to schizophrenia (SCZ), (ii) examine correlations between phenomenology and voice beliefs across each group, and (iii) explore how voice beliefs may uniquely contribute to distress in BD and SCZ. METHOD Participants were recruited from two international sites in Australia (BD=31; SCZ=50) and the UK (BD=17). Basic demographic-clinical information was collected, and mood symptoms were assessed. To document AVH characteristics, a 4-factor model of the Psychotic Symptoms Rating Scale and the Beliefs about Voices Questionnaire-Revised were used. Statistical analyses consisted of group-wise comparisons, Pearson's correlations and multiple hierarchical regressions. RESULTS It was found that AVH-related distress was not significantly higher in BD than SCZ, but those with BD made significantly more internal attributions for their voices. In the BD group, AVH-related distress was significantly positively correlated with malevolence, omnipotence and resistance, However, only resistance, alongside mania and depressive symptoms, significantly contributed to AVH-related distress in BD. DISCUSSION Our findings have several clinical implications, including identification of voice resistance as a potential therapeutic target to prioritise in BD. Factoring in the influence of mood symptoms on AVH-related distress as well as adopting more acceptance-oriented therapies may also be of benefit.
Collapse
Affiliation(s)
- Lindsay Smith
- National and Specialist CAMHS, At-Risk and Forensic Service, South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, Maudsley Hospital, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Susan L Rossell
- Centre for Mental Health & Brain Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Psychiatry, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Neil Thomas
- Centre for Mental Health & Brain Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Psychology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Wei Lin Toh
- Centre for Mental Health & Brain Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
- Department of Psychiatry, St Vincent's Hospital, Melbourne, Victoria, Australia
- Department of Psychology, Alfred Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
4
|
Cao P, Chen C, Si Q, Li Y, Ren F, Han C, Zhao J, Wang X, Xu G, Sui Y. Volumes of hippocampal subfields suggest a continuum between schizophrenia, major depressive disorder and bipolar disorder. Front Psychiatry 2023; 14:1191170. [PMID: 37547217 PMCID: PMC10400724 DOI: 10.3389/fpsyt.2023.1191170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Objective There is considerable debate as to whether the continuum of major psychiatric disorders exists and to what extent the boundaries extend. Converging evidence suggests that alterations in hippocampal volume are a common sign in psychiatric disorders; however, there is still no consensus on the nature and extent of hippocampal atrophy in schizophrenia (SZ), major depressive disorder (MDD) and bipolar disorder (BD). The aim of this study was to verify the continuum of SZ - BD - MDD at the level of hippocampal subfield volume and to compare the volume differences in hippocampal subfields in the continuum. Methods A total of 412 participants (204 SZ, 98 MDD, and 110 BD) underwent 3 T MRI scans, structured clinical interviews, and clinical scales. We segmented the hippocampal subfields with FreeSurfer 7.1.1 and compared subfields volumes across the three diagnostic groups by controlling for age, gender, education, and intracranial volumes. Results The results showed a gradual increase in hippocampal subfield volumes from SZ to MDD to BD. Significant volume differences in the total hippocampus and 13 of 26 hippocampal subfields, including CA1, CA3, CA4, GC-ML-DG, molecular layer and the whole hippocampus, bilaterally, and parasubiculum in the right hemisphere, were observed among diagnostic groups. Medication treatment had the most effect on subfields of MDD compared to SZ and BD. Subfield volumes were negatively correlated with illness duration of MDD. Positive correlations were found between subfield volumes and drug dose in SZ and MDD. There was no significant difference in laterality between diagnostic groups. Conclusion The pattern of hippocampal volume reduction in SZ, MDD and BD suggests that there may be a continuum of the three disorders at the hippocampal level. The hippocampus represents a phenotype that is distinct from traditional diagnostic strategies. Combined with illness duration and drug intervention, it may better reflect shared pathophysiology and mechanisms across psychiatric disorders.
Collapse
Affiliation(s)
- Peiyu Cao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Congxin Chen
- Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Qi Si
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
- Huai’an No. 3 People’s Hospital, Huai’an, China
| | - Yuting Li
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Fangfang Ren
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Chongyang Han
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Jingjing Zhao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Xiying Wang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Guoxin Xu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| | - Yuxiu Sui
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain Hospital, Nanjing, China
| |
Collapse
|
5
|
Mak O, Couth S, Plack CJ, Kotz SA, Yao B. Investigating the lateralisation of experimentally induced auditory verbal hallucinations. Front Neurosci 2023; 17:1193402. [PMID: 37483346 PMCID: PMC10359906 DOI: 10.3389/fnins.2023.1193402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/16/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Auditory verbal hallucinations (AVHs), or hearing non-existent voices, are a common symptom in psychosis. Recent research suggests that AVHs are also experienced by neurotypical individuals. Individuals with schizophrenia experiencing AVHs and neurotypicals who are highly prone to hallucinate both produce false positive responses in auditory signal detection. These findings suggest that voice-hearing may lie on a continuum with similar mechanisms underlying AVHs in both populations. Methods The current study used a monaural auditory stimulus in a signal detection task to test to what extent experimentally induced verbal hallucinations are (1) left-lateralised (i.e., more likely to occur when presented to the right ear compared to the left ear due to the left-hemisphere dominance for language processing), and (2) predicted by self-reported hallucination proneness and auditory imagery tendencies. In a conditioning task, fifty neurotypical participants associated a negative word on-screen with the same word being played via headphones through successive simultaneous audio-visual presentations. A signal detection task followed where participants were presented with a target word on-screen and indicated whether they heard the word being played concurrently amongst white noise. Results Results showed that Pavlovian audio-visual conditioning reliably elicited a significant number of false positives (FPs). However, FP rates, perceptual sensitivities, and response biases did not differ between either ear. They were neither predicted by hallucination proneness nor auditory imagery. Discussion The results show that experimentally induced FPs in neurotypicals are not left-lateralised, adding further weight to the argument that lateralisation may not be a defining feature of hallucinations in clinical or non-clinical populations. The findings also support the idea that AVHs may be a continuous phenomenon that varies in severity and frequency across the population. Studying induced AVHs in neurotypicals may help identify the underlying cognitive and neural mechanisms contributing to AVHs in individuals with psychotic disorders.
Collapse
Affiliation(s)
- Olivia Mak
- Division of Human Communication, Development & Hearing, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Samuel Couth
- Division of Human Communication, Development & Hearing, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Christopher J. Plack
- Division of Human Communication, Development & Hearing, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| | - Sonja A. Kotz
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Bo Yao
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| |
Collapse
|
6
|
Hirai S, Sakuma A, Kunii Y, Shimbo H, Hino M, Izumi R, Nagaoka A, Yabe H, Kojima R, Seki E, Arai N, Komori T, Okado H. Disease specific brain capillary angiopathy in schizophrenia, bipolar disorder, and Alzheimer's disease. J Psychiatr Res 2023; 163:74-79. [PMID: 37207434 DOI: 10.1016/j.jpsychires.2023.04.011] [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: 01/20/2023] [Revised: 03/26/2023] [Accepted: 04/08/2023] [Indexed: 05/21/2023]
Abstract
Schizophrenia (SZ) and bipolar disorder (BD), which are both psychiatric disorders, share some common clinical evidence. We recently discovered that brain capillary angiopathy is another common feature of these psychiatric disorders using fibrin accumulation in vascular endothelial cells as an indicator. This study aimed to characterize the similarities and differences in cerebral capillary injuries in various brain diseases to provide new diagnostic methods for SZ and BD and to develop new therapeutic strategies. We evaluated whether discrepancies exist in the degree of vascular damage among SZ and BD and other brain disorders (amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), and Alzheimer's disease (AD)) using postmortem brains. Our results demonstrate that fibrin was strongly accumulated in the capillaries of the grey matter (GM) of brains of patients with SZ and AD and in the capillaries of the white matter (WM) in those of patients with SZ, BD, and AD when compared with control subjects without any psychiatric or neurological disease history. However, ALS and PD brains did not present a significant increase in the amount of accumulated fibrin, either in the capillaries of WM or GM. Furthermore, significant leakage of fibrin into the brain parenchyma, indicating a vascular physical disruption, was observed in the brains of patients with AD but not in the brains of other patients compared with control subjects. In conclusion, our work reveals that Fibrin-accumulation in the brain capillaries are observed in psychiatric disorders, such as SZ, BD, and AD. Furthermore, fibrin-accumulating, nonbreaking type angiopathy is characteristic of SZ and BD, even though there are regional differences between these diseases.
Collapse
Affiliation(s)
- Shinobu Hirai
- Brain Metabolic Regulation Group, Frontier Laboratory, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan.
| | - Atsuhiro Sakuma
- Brain Metabolic Regulation Group, Frontier Laboratory, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan
| | - Yasuto Kunii
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan; Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Miyagi, 980-8573, Japan
| | - Hiroko Shimbo
- Brain Metabolic Regulation Group, Frontier Laboratory, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan; Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan
| | - Mizuki Hino
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan; Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Miyagi, 980-8573, Japan
| | - Ryuta Izumi
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Atsuko Nagaoka
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Rika Kojima
- Laboratory of Neuropathology, Tokyo Metropolitan Institute of Medical Sciences, Tokyo, 156-8506, Japan
| | - Erika Seki
- Laboratory of Neuropathology, Tokyo Metropolitan Institute of Medical Sciences, Tokyo, 156-8506, Japan
| | - Nobutaka Arai
- Laboratory of Neuropathology, Tokyo Metropolitan Institute of Medical Sciences, Tokyo, 156-8506, Japan
| | - Takashi Komori
- Department of Pathology and Laboratory Medicine, Tokyo Metropolitan Neurological Hospital, Tokyo, 183-0042, Japan
| | - Haruo Okado
- Sleep Disorders Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan.
| |
Collapse
|
7
|
Yang J, Tao H, Sun F, Fan Z, Yang J, Liu Z, Xue Z, Chen X. The anatomical networks based on probabilistic structurally connectivity in bipolar disorder across mania, depression, and euthymic states. J Affect Disord 2023; 329:42-49. [PMID: 36842653 DOI: 10.1016/j.jad.2023.02.109] [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: 04/10/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUNDS There have pieces of evidence of the distinct aberrant functional network topology profile in bipolar disorder (BD) across mania, depression, and euthymic episodes. However, the underlying anatomical network topology pattern in BD across different episodes is unclear. METHODS We calculated the whole-brain probabilistic structurally connectivity across 143 subjects (72 with BD [34 depression; 13 mania; 25 euthymic] and 53 healthy controls), and used graph theory to examine the trait- and state-related topology alterations of the structural connectome in BD. The correlation analysis was further conducted to explore the relationship between detected network measures and clinical symptoms. RESULTS There no omnibus alteration of any global network metrics were observed across all diagnostic groups. In the regional network metrics level, bipolar depression showed increased clustering coefficient in the right lingual gyrus compared with all other groups, and the increased clustering coefficient in the right lingual gyrus positively correlated with depression, anxiety, and illness burden symptoms but negatively correlated with mania symptoms; manic and euthymic patients showed decreased clustering coefficient in the left inferior occipital gyrus compared with HCs. LIMITATIONS The moderate sample size of all patient groups (especially for subjects with mania) might have contributed to the negative findings of the trait feature in this study. CONCLUSIONS We demonstrated the altered regional connectivity pattern in the occipital lobe of the bipolar depression and mania episode, especially the lingual gyrus. The association of the clustering coefficient in the lingual gyrus with clinical symptoms helps monitor the state of BD.
Collapse
Affiliation(s)
- Jie Yang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haojuan Tao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Fuping Sun
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zebin Fan
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jun Yang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zhening Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Zhimin Xue
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xudong Chen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| |
Collapse
|
8
|
Abalo-Rodríguez I, Santos-Mayo A, Moratti S. Pavlovian conditioning-induced hallucinations reduce MMN amplitudes for duration but not frequency deviants. Schizophr Res 2023; 256:63-71. [PMID: 37156071 DOI: 10.1016/j.schres.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/12/2023] [Accepted: 04/30/2023] [Indexed: 05/10/2023]
Abstract
The mismatch negativity (MMN) is an evoked potential that indexes auditory regularity violations. Since the 90's, a reduced amplitude of this brain activity in patients with schizophrenia has been consistently reported. Recently, this alteration has been related to the presence of auditory hallucinations (AHs) rather than the schizophrenia diagnostic per se. However, making this attribution is rather problematic due to the high heterogeneity of symptoms in schizophrenia. In an attempt to isolate the AHs influence on the MMN amplitude from other cofounding variables, we artificially induced AHs in a non-clinical population by Pavlovian conditioning. Before and after conditioning, volunteers (N = 31) participated in an oddball paradigm that elicited an MMN. Two different types of deviants were presented: a frequency and a duration deviant, as the MMN alteration seems to be especially present in schizophrenia with the latter type of deviant. Hence, this pre-post design allowed us to compare whether experiencing conditioning-induced AHs exert any influence on MMN amplitudes. Our results show that duration-deviant related MMN reductions significantly correlate with the number of AHs experienced. Moreover, we found a significant correlation between AHs proneness (measured with the Launay-Slade Hallucination Extended Scale) and the number of AHs experienced during the paradigm. In sum, our study shows that AHs can be conditioned and exert similar effects on MMN modulation in healthy participants as has been reported for patients with schizophrenia. Thus, conditioning paradigms offer the possibility to study the association between hallucinations and MMN reductions without the confounding variables present in schizophrenia patients.
Collapse
Affiliation(s)
- Inés Abalo-Rodríguez
- Department of Experimental Psychology, Complutense University of Madrid, Spain; Center of Cognitive and Computational Neuroscience, Complutense University of Madrid, Spain
| | - Alejandro Santos-Mayo
- Department of Experimental Psychology, Complutense University of Madrid, Spain; Center of Cognitive and Computational Neuroscience, Complutense University of Madrid, Spain
| | - Stephan Moratti
- Department of Experimental Psychology, Complutense University of Madrid, Spain; Center of Cognitive and Computational Neuroscience, Complutense University of Madrid, Spain.
| |
Collapse
|
9
|
Chang X, Zhao W, Kang J, Xiang S, Xie C, Corona-Hernández H, Palaniyappan L, Feng J. Language abnormalities in schizophrenia: binding core symptoms through contemporary empirical evidence. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:95. [PMID: 36371445 PMCID: PMC9653408 DOI: 10.1038/s41537-022-00308-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Both the ability to speak and to infer complex linguistic messages from sounds have been claimed as uniquely human phenomena. In schizophrenia, formal thought disorder (FTD) and auditory verbal hallucinations (AVHs) are manifestations respectively relating to concrete disruptions of those abilities. From an evolutionary perspective, Crow (1997) proposed that "schizophrenia is the price that Homo sapiens pays for the faculty of language". Epidemiological and experimental evidence points to an overlap between FTD and AVHs, yet a thorough investigation examining their shared neural mechanism in schizophrenia is lacking. In this review, we synthesize observations from three key domains. First, neuroanatomical evidence indicates substantial shared abnormalities in language-processing regions between FTD and AVHs, even in the early phases of schizophrenia. Second, neurochemical studies point to a glutamate-related dysfunction in these language-processing brain regions, contributing to verbal production deficits. Third, genetic findings further show how genes that overlap between schizophrenia and language disorders influence neurodevelopment and neurotransmission. We argue that these observations converge into the possibility that a glutamatergic dysfunction in language-processing brain regions might be a shared neural basis of both FTD and AVHs. Investigations of language pathology in schizophrenia could facilitate the development of diagnostic tools and treatments, so we call for multilevel confirmatory analyses focused on modulations of the language network as a therapeutic goal in schizophrenia.
Collapse
Affiliation(s)
- Xiao Chang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Wei Zhao
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, PR China
| | - Jujiao Kang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- Shanghai Center for Mathematical Sciences, Shanghai, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Chao Xie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Hugo Corona-Hernández
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada.
- Lawson Health Research Institute, London, Ontario, Canada.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Zhangjiang Fudan International Innovation Center, Shanghai, China.
- Shanghai Center for Mathematical Sciences, Shanghai, China.
- Department of Computer Science, University of Warwick, Coventry, UK.
| |
Collapse
|
10
|
Chakrabarti S, Singh N. Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review. World J Psychiatry 2022; 12:1204-1232. [PMID: 36186500 PMCID: PMC9521535 DOI: 10.5498/wjp.v12.i9.1204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/02/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder (BD) and can have an adverse effect on its course, outcome, and treatment. However, despite a considerable amount of research, the impact of psychotic symptoms on BD remains unclear, and there are very few systematic reviews on the subject.
AIM To examine the extent of psychotic symptoms in BD and their impact on several aspects of the illness.
METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. An electronic literature search of six English-language databases and a manual search was undertaken to identify published articles on psychotic symptoms in BD from January 1940 to December 2021. Combinations of the relevant Medical Subject Headings terms were used to search for these studies. Articles were selected after a screening phase, followed by a review of the full texts of the articles. Assessment of the methodological quality of the studies and the risk of bias was conducted using standard tools.
RESULTS This systematic review included 339 studies of patients with BD. Lifetime psychosis was found in more than a half to two-thirds of the patients, while current psychosis was found in a little less than half of them. Delusions were more common than hallucinations in all phases of BD. About a third of the patients reported first-rank symptoms or mood-incongruent psychotic symptoms, particularly during manic episodes. Psychotic symptoms were more frequent in bipolar type I compared to bipolar type II disorder and in mania or mixed episodes compared to bipolar depression. Although psychotic symptoms were not more severe in BD, the severity of the illness in psychotic BD was consistently greater. Psychosis was usually associated with poor insight and a higher frequency of agitation, anxiety, and hostility but not with psychiatric comorbidity. Psychosis was consistently linked with increased rates and the duration of hospitalizations, switching among patients with depression, and poorer outcomes with mood-incongruent symptoms. In contrast, psychosis was less likely to be accompanied by a rapid-cycling course, longer illness duration, and heightened suicidal risk. There was no significant impact of psychosis on the other parameters of course and outcome.
CONCLUSION Though psychotic symptoms are very common in BD, they are not always associated with an adverse impact on BD and its course and outcome.
Collapse
Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
| | - Navdeep Singh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
| |
Collapse
|
11
|
Toh WL, Bere M, Rossell SL. Distinguishing multimodal versus multisensory hallucinations in psychosis: Key definitions and a way forward. Aust N Z J Psychiatry 2022; 56:445-450. [PMID: 34256623 DOI: 10.1177/00048674211031455] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The study of hallucinations across multiple senses in psychosis has garnered renewed interest. Recent studies have adopted the term multimodal hallucinations to describe these experiences, yet some appear to be investigating a different, but related, phenomenon. In the current paper, we suggest use of the terms multimodal hallucinations and multisensory hallucinations to categorise distinct events that involve unusual sensory experiences across multiple domains. We propose that the constructs of temporality and relatedness are critical to delineating these experiences, where multimodal hallucinations refer to hallucinations in two or more sensory modes occurring concurrently in time and/or with significant thematic overlaps. Multisensory hallucinations conversely denote similar multisensory experiences, but with no temporal or relatedness constraints. This is accompanied by a decision-making framework for identifying whether a set of unusual perceptual experiences constitutes multimodal hallucinations or otherwise. We conclude by suggesting several priorities for future research, including empirical validation of our proposed model, further investigation of phenomenology, developing appropriate assessment tools and investigating underlying cognitive and other aetiological mechanisms.
Collapse
Affiliation(s)
- Wei Lin Toh
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.,Department of Psychology, Alfred Health, Melbourne, VIC, Australia
| | - Mikaela Bere
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.,Department of Psychiatry, St. Vincent's Mental Health, Fitzroy, VIC, Australia
| |
Collapse
|
12
|
de Boer JN, Corona Hernández H, Gerritse F, Brederoo SG, Wijnen FNK, Sommer IE. Negative content in auditory verbal hallucinations: a natural language processing approach. Cogn Neuropsychiatry 2022; 27:139-149. [PMID: 34154512 DOI: 10.1080/13546805.2021.1941831] [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] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Negative content of auditory verbal hallucinations (AVH) is a strong predictor of distress and impairment. This paper quantifies emotional voice-content in order to explore both subjective (i.e. perceived) and objectively (i.e. linguistic sentiment) measured negativity and investigates associations with distress. METHODS Clinical and non-clinical participants with frequent AVH (n = 40) repeated and recorded their AVH verbatim directly upon hearing. The AVH were analyzed for emotional valence using Pattern, a rule-based sentiment analyzer for Dutch. The AVH of the clinical individuals were compared to those of non-clinical voice-hearers on emotional valence and associated with experienced distress. RESULTS The mean objective valence of AVH in patients was significantly more negative than those of non-clinical voice-hearers. In the clinical individuals a larger proportion of the voice-utterances was negative (34.7% versus 18.4%) in objective valence. The linguistic valence of the AVH showed a significant, strong association with the perceived negativity, amount of distress and disruption of life, but not with the intensity of distress. CONCLUSIONS Our results indicate that AVH of patients have a more negative linguistic content than those of non-clinical voice-hearers, which is associated with the experienced distress. Thus, patients not only perceive their voices as more negative, objective analyses confirm this.
Collapse
Affiliation(s)
- J N de Boer
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - H Corona Hernández
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - F Gerritse
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - S G Brederoo
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
| | - F N K Wijnen
- Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, the Netherlands
| | - I E Sommer
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
13
|
Schutte MJL, Voppel A, Collin G, Abramovic L, Boks MPM, Cahn W, van Haren NEM, Hugdahl K, Koops S, Mandl RCW, Sommer IEC. Modular-Level Functional Connectome Alterations in Individuals With Hallucinations Across the Psychosis Continuum. Schizophr Bull 2022; 48:684-694. [PMID: 35179210 PMCID: PMC9077417 DOI: 10.1093/schbul/sbac007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Functional connectome alterations, including modular network organization, have been related to the experience of hallucinations. It remains to be determined whether individuals with hallucinations across the psychosis continuum exhibit similar alterations in modular brain network organization. This study assessed functional connectivity matrices of 465 individuals with and without hallucinations, including patients with schizophrenia and bipolar disorder, nonclinical individuals with hallucinations, and healthy controls. Modular brain network organization was examined at different scales of network resolution, including (1) global modularity measured as Qmax and Normalised Mutual Information (NMI) scores, and (2) within- and between-module connectivity. Global modular organization was not significantly altered across groups. However, alterations in within- and between-module connectivity were observed for higher-order cognitive (e.g., central-executive salience, memory, default mode), and sensory modules in patients with schizophrenia and nonclinical individuals with hallucinations relative to controls. Dissimilar patterns of altered within- and between-module connectivity were found bipolar disorder patients with hallucinations relative to controls, including the visual, default mode, and memory network, while connectivity patterns between visual, salience, and cognitive control modules were unaltered. Bipolar disorder patients without hallucinations did not show significant alterations relative to controls. This study provides evidence for alterations in the modular organization of the functional connectome in individuals prone to hallucinations, with schizophrenia patients and nonclinical individuals showing similar alterations in sensory and higher-order cognitive modules. Other higher-order cognitive modules were found to relate to hallucinations in bipolar disorder patients, suggesting differential neural mechanisms may underlie hallucinations across the psychosis continuum.
Collapse
Affiliation(s)
- Maya J L Schutte
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Alban Voppel
- To whom correspondence should be addressed; Neuroimaging Center, PO Box 196, 9700 AD, Groningen, The Netherlands; tel: +31 88 75 58672, fax: +31887555487, e-mail:
| | - Guusje Collin
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands,Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA,McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Lucija Abramovic
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Marco P M Boks
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands,Department of Child and adolescent psychiatry/psychology, Erasmus University Medical Center, Sophia’s Children’s Hospital, Rotterdam, Netherlands
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway,Department of Psychiatry, Haukeland University Hospital, Bergen, Norway,Department of Radiology, Haukeland University Hospital, Bergen, Norway,NORMENT Norwegian Center for the Study of Mental Disorders, Haukeland University hospital, Bergen, Norway
| | - Sanne Koops
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - René C W Mandl
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Iris E C Sommer
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| |
Collapse
|
14
|
Jiang X, Yuan Y, Li Z, Ou Y, Li Z. First-episode olfactory hallucination in a patient with anxiety disorder: A case report. Front Psychiatry 2022; 13:990341. [PMID: 36203838 PMCID: PMC9530368 DOI: 10.3389/fpsyt.2022.990341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Olfactory hallucination refers to olfactory perception in the absence of chemical stimuli. Although it has been associated with many neurological and psychotic disorders, it has rarely been reported as the first and only symptom in patients with anxiety disorder, and its treatment remains inadequate. CASE SUMMARY A 66-year-old woman who had been experiencing gradually worsening olfactory hallucinations for almost 4 years was diagnosed with generalized anxiety disorder. Olfactory hallucination disappeared after treatment with anti-anxiety drugs. CONCLUSION Olfactory hallucination can be the first and only symptom in patients with anxiety disorder and may be effectively treated with anti-anxiety medication. In fact, it can precede the diagnosis of anxiety disorder by several years.
Collapse
Affiliation(s)
- Xingmei Jiang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yiwen Yuan
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Zhixiong Li
- The Third Department of Clinical Psychology, Karamay Municipal People's Hospital, Karamay, China
| | - Ying Ou
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Zhe Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.,Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| |
Collapse
|
15
|
Caruana N, Seymour K. Objects that induce face pareidolia are prioritized by the visual system. Br J Psychol 2021; 113:496-507. [PMID: 34923634 DOI: 10.1111/bjop.12546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 12/03/2021] [Indexed: 11/25/2022]
Abstract
The human visual system has evolved specialized neural mechanisms to rapidly detect faces. Its broad tuning for facial features is thought to underlie the illusory perception of faces in inanimate objects, a phenomenon called face pareidolia. Recent studies on face pareidolia suggest that the mechanisms underlying face processing, at least at the early stages of visual encoding, may treat objects that resemble faces as real faces; prioritizing their detection. In our study, we used breaking continuous flash suppression (b-CFS) to examine whether the human visual system prioritizes the detection of objects that induce face pareidolia over stimuli matched for object content. Similar to previous b-CFS results using real face stimuli, we found that participants detected the objects with pareidolia faces faster than object-matched control stimuli. Given that face pareidolia has been more frequently reported amongst individuals prone to hallucinations, we also explored whether this rapid prioritization is intact in individuals with schizophrenia, and found evidence suggesting that it was. Our findings suggest that face pareidolia engages a broadly tuned mechanism that facilitates rapid face detection. This may involve the proposed fast subcortical pathway that operates outside of visual awareness.
Collapse
Affiliation(s)
- Nathan Caruana
- Department of Cognitive Science, Macquarie University, Sydney, New South Wales, Australia.,Perception in Action Research Centre, Macquarie University, Sydney, New South Wales, Australia
| | - Kiley Seymour
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia.,The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, New South Wales, Australia.,Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| |
Collapse
|
16
|
Julayanont P, Suryadevara U. Psychosis. Continuum (Minneap Minn) 2021; 27:1682-1711. [PMID: 34881732 DOI: 10.1212/con.0000000000001013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW Psychosis can manifest in primary psychotic disorders, neurologic diseases, and medical conditions. This article reviews the definition of psychotic symptoms and the evaluation and management of psychosis in primary psychiatric and neurologic disorders frequently seen in neurologic practice. RECENT FINDINGS Emerging evidence supports significant connections between psychosis and structural and functional brain changes in both primary psychotic and neurologic disorders. In addition to antidopaminergic activity, the mechanism of new-generation antipsychotics shifts to act on serotonin receptors, which potentially contributes to their benefits in the treatment of negative symptoms of psychosis and a lesser frequency of extrapyramidal side effects compared with typical antipsychotics. This is also helpful in the treatment of psychosis in patients who have neurodegenerative diseases and are vulnerable to developing extrapyramidal side effects from typical antipsychotics. SUMMARY Even with significant overlap, management of psychosis in primary psychotic disorders differs from the approach of psychosis in neurologic diseases. This article helps clinicians learn how to practically evaluate psychosis from both psychiatric and neurologic perspectives.
Collapse
|
17
|
Hwang M, Roh YS, Talero J, Cohen BM, Baker JT, Brady RO, Öngür D, Shinn AK. Auditory hallucinations across the psychosis spectrum: Evidence of dysconnectivity involving cerebellar and temporal lobe regions. Neuroimage Clin 2021; 32:102893. [PMID: 34911197 PMCID: PMC8636859 DOI: 10.1016/j.nicl.2021.102893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/29/2021] [Accepted: 11/19/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Auditory hallucinations (AH) are typically associated with schizophrenia (SZ), but they are also prevalent in bipolar disorder (BD). Despite the large body of research on the neural correlates of AH in SZ, the pathophysiology underlying AH remains unclear. Few studies have examined the neural substrates associated with propensity for AH in BD. Investigating AH across the psychosis spectrum has the potential to inform about the neural signature associated with the trait of AH, irrespective of psychiatric diagnosis. METHODS We compared resting state functional magnetic resonance imaging data in psychosis patients with (n = 90 AH; 68 SZ, 22 BD) and without (n = 55 NAH; 16 SZ, 39 BD) lifetime AH. We performed region of interest (ROI)-to-ROI functional connectivity (FC) analysis using 91 cortical, 15 subcortical, and 26 cerebellar atlas-defined regions. The primary aim was to identify FC differences between patients with and without lifetime AH. We secondarily examined differences between AH and NAH within each diagnosis. RESULTS Compared to the NAH group, patients with AH showed higher FC between cerebellum and frontal (left precentral gyrus), temporal [right middle temporal gyrus (MTG), left inferior temporal gyrus (ITG), left temporal fusiform gyrus)], parietal (bilateral superior parietal lobules), and subcortical (left accumbens, left palldium) brain areas. AH also showed lower FC between temporal lobe regions (between right ITG and right MTG and bilateral superior temporal gyri) relative to NAH. CONCLUSIONS Our findings suggest that dysconnectivity involving the cerebellum and temporal lobe regions may be common neurofunctional elements associated with AH propensity across the psychosis spectrum. We also found dysconnectivity patterns that were unique to lifetime AH within SZ or bipolar psychosis, suggesting both common and distinct mechanisms underlying AH pathophysiology in these disorders.
Collapse
Affiliation(s)
- Melissa Hwang
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Youkyung S Roh
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Jessica Talero
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA
| | - Bruce M Cohen
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Program for Neuropsychiatric Research, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Justin T Baker
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Roscoe O Brady
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Ann K Shinn
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, 115 Mill St, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
| |
Collapse
|
18
|
Dubovsky SL, Ghosh BM, Serotte JC, Cranwell V. Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:160-177. [PMID: 33166960 DOI: 10.1159/000511348] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/30/2020] [Indexed: 11/19/2022]
Abstract
Psychotic depression was initially considered to be at one end of a continuum of severity of major depression. Subsequent experience demonstrated that psychosis is an independent trait that may accompany mood disorders of varying severity. While much has been learned about the impact of severe mood congruent delusions and hallucinations on the course and treatment response of depression, less is known about fleeting or mild psychosis, mood incongruent features, or psychotic symptoms that reflect traumatic experiences. Acute treatment of psychotic unipolar depression generally involves the combination of an antidepressant and an antipsychotic drug or electroconvulsive therapy. There is inadequate information about maintenance treatment of unipolar psychotic depression and acute and chronic treatment of psychotic bipolar disorder. Decision-making therefore still must rely in part on clinical experience.
Collapse
Affiliation(s)
- Steven L Dubovsky
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA, .,Departments of Psychiatry and Medicine, University of Colorado School of Medicine, Denver, Colorado, USA,
| | - Biswarup M Ghosh
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Jordan C Serotte
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Victoria Cranwell
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| |
Collapse
|
19
|
Olfactory hallucinations in a population-based sample. Psychiatry Res 2021; 304:114117. [PMID: 34391204 DOI: 10.1016/j.psychres.2021.114117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 11/21/2022]
Abstract
Olfactory hallucinations referring to olfactory perceptions in the absence of chemical stimuli, occur in non-clinical and clinical populations. Few studies have investigated their prevalence in the general population and little is known about factors triggering and maintaining them such as substance use, severe life events, and mood. We analyzed self-report data from 2500 community dwelling Norwegians, aged 18-96 years, for occurrence of olfactory hallucinations and co-occurring hallucinations in other modalities (auditory, visual, tactile). Analyses included age, sex, self-reported symptoms of depression and anxiety, mental health status, and experience of severe life-events. The results show that 4.2% (95% CI 3.5-5.1%) reported having experienced olfactory hallucinations, and 56% of individuals experiencing olfactory hallucinations also reported these in combination with hallucinations in other modalities. Prevalence varied significantly in terms of age and sex, in that olfactory hallucinations were most frequently reported by young individuals and females. Self-reported symptoms of anxiety and experience of stressful life events were significantly associated with olfactory hallucinations, suggesting that experiencing olfactory hallucinations may negatively affect functioning and may increase the likelihood of developing psychopathology. Findings underline the need to continue to examine olfactory hallucinations albeit with a more comprehensive assessment in order to increase knowledge on this experience.
Collapse
|
20
|
Moriyama TS, Drukker M, Guloksuz S, Ten Have M, de Graaf R, van Dorsselaer S, Gunther N, Bak M, van Os J. Evidence for an interrelated cluster of Hallucinatory experiences in the general population: an incidence study. Psychol Med 2021; 51:2034-2043. [PMID: 32317030 DOI: 10.1017/s0033291720000793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although hallucinations have been studied in terms of prevalence and its associations with psychopathology and functional impairment, very little is known about sensory modalities other than auditory (i.e. haptic, visual and olfactory), as well the incidence of hallucinations, factors predicting incidence and subsequent course. METHODS We examined the incidence, course and risk factors of hallucinatory experiences across different modalities in two unique prospective general population cohorts in the same country using similar methodology and with three interview waves, one over the period 1996-1999 (NEMESIS) and one over the period 2007-2015 (NEMESIS-2). RESULTS In NEMESIS-2, the yearly incidence of self-reported visual hallucinations was highest (0.33%), followed by haptic hallucinations (0.31%), auditory hallucinations (0.26%) and olfactory hallucinations (0.23%). Rates in NEMESIS-1 were similar (respectively: 0.35%, 0.26%, 0.23%, 0.22%). The incidence of clinician-confirmed hallucinations was approximately 60% of the self-reported rate. The persistence rate of incident hallucinations was around 20-30%, increasing to 40-50% for prevalent hallucinations. Incident hallucinations in one modality were very strongly associated with occurrence in another modality (median OR = 59) and all modalities were strongly associated with delusional ideation (median OR = 21). Modalities were approximately equally strongly associated with the presence of any mental disorder (median OR = 4), functioning, indicators of help-seeking and established environmental risk factors for psychotic disorder. CONCLUSIONS Hallucinations across different modalities are a clinically relevant feature of non-psychotic disorders and need to be studied in relation to each other and in relation to delusional ideation, as all appear to have a common underlying mechanism.
Collapse
Affiliation(s)
- Tais S Moriyama
- Instituto Bairral, Itapira, Brazil
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marjan Drukker
- 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
| | - Magreet Ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Nicole Gunther
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Psychology, Open University, Heerlen, The Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
| |
Collapse
|
21
|
Common and distinct global functional connectivity density alterations in patients with bipolar disorder with and without auditory verbal hallucination during major depressive episodes. Brain Imaging Behav 2021; 14:2724-2730. [PMID: 31900890 DOI: 10.1007/s11682-019-00222-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Although an increasing number of studies has explored the neural mechanisms of auditory verbal hallucination (AVH) using many modalities, including neuroimaging, neurotransmitters, and electroencephalography, the etiology of AVH remains unclear. In this study, we investigated the neuroimaging characteristics of AVH in patients with bipolar disorder (BD) experiencing depressive episodes with and without AVH. For this study, we recruited 80 patients with BD and depressive status (40 with and 40 without AVH), and 40 healthy individuals. Their global functional connectivity density (gFCD) was screened by functional magnetic resonance imaging. Differences in gFCD among the three groups were tested using voxel-wise one-way analysis of covariance. Patients in both BD groups demonstrated increased gFCD in the central parietal lobe, insular lobe, and middle cingulate cortex, and decreased gFCD in the posterior parietal cortex, lateral prefrontal cortex, and occipital lobe (all bilateral). We defined these alterations as the common aberrant gFCD pattern for BD with and without AVH. Compared with the other two groups, patients in the BD with AVH group demonstrated increased gFCD in the Broca and Wernicke regions, and decreased gFCD in the hippocampus (all bilateral). We defined these alterations as the distinct aberrant gFCD pattern for BD with AVH. To our knowledge, this report is the first to date to describe gFCD alterations in patients with BD with and without AVH. Our findings suggest that disturbances in brain activity and information communication capacity in patients with BD and AVH are located mainly in the left frontoparietal network, control network, and memory circuit. However, these observations were made only in patients with BD during depressive episodes, and without consideration of many factors, such as the treatment mode, symptom relapse, and BD subtype. Hence, the conclusions of this study merely provide clues for further study, and do not fully represent brain alterations in patients with BD and AVH. Further large-sample cohort studies are needed to clarify and expand on these findings.
Collapse
|
22
|
Zorzi G, Thiebaut de Schotten M, Manara R, Bussè C, Corbetta M, Cagnin A. White matter abnormalities of right hemisphere attention networks contribute to visual hallucinations in dementia with Lewy bodies. Cortex 2021; 139:86-98. [PMID: 33848693 DOI: 10.1016/j.cortex.2021.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/16/2021] [Accepted: 03/04/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Functional alterations of the visual attention networks in a setting of impaired visual information processing have a role in the genesis of visual hallucinations (VH) in dementia with Lewy bodies (DLB). This multimodal MRI study aims at exploring structural and functional basis of VH. METHODS 23 DLB patients (10 with and 13 without VH) and 13 healthy controls were studied. They underwent MRI with T1-w sequences to measure cortical thickness, DTI for whole-brain and single tract microstructural properties and rs-fMRI of the default mode, dorsal and ventral attention, and visual networks. RESULTS In DLB with VH, whole-brain DTI revealed a lower fractional anisotropy and a greater mean diffusivity in the right frontal and temporo-parietal white matter tracts. Tracts dissection showed lower fractional anisotropy in the right inferior and superior (ventral part) longitudinal fasciculi (ILF and SLF) (p < .05, corrected), and greater mean diffusivity (p < .05). The extent of white matter microstructural alterations involving the right ILF and SLF correlated with the severity of VH (r = .55, p < .01; r = .42, p < .05, respectively), and with performance in the visual attention task (r = -.56 and r = -.61; p < .01, respectively). Cortical thickness in the projection areas of the right SLF was significantly reduced (p < .05). Patients with VH also showed an altered functional connectivity in the ventral attention network, connected by the ventral portion of the SLF (p < .05). CONCLUSIONS Our findings suggest that a combination of microstructural and functional alterations involving the attention networks in the right hemisphere may be important in the genesis of VH.
Collapse
Affiliation(s)
- Giovanni Zorzi
- Department of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy.
| | - Michel Thiebaut de Schotten
- Padova Neuroscience Center, University of Padova, Padova, Italy; Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France; Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
| | - Renzo Manara
- Department of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Cinzia Bussè
- Department of Neuroscience, University of Padova, Padova, Italy
| | - Maurizio Corbetta
- Department of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy; Department of Neurology, Radiology, Neuroscience, Washington University School of Medicine, St.Louis, MO, USA
| | - Annachiara Cagnin
- Department of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy
| |
Collapse
|
23
|
Silverstein SM, Lai A. The Phenomenology and Neurobiology of Visual Distortions and Hallucinations in Schizophrenia: An Update. Front Psychiatry 2021; 12:684720. [PMID: 34177665 PMCID: PMC8226016 DOI: 10.3389/fpsyt.2021.684720] [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: 03/23/2021] [Accepted: 05/14/2021] [Indexed: 12/15/2022] Open
Abstract
Schizophrenia is characterized by visual distortions in ~60% of cases, and visual hallucinations (VH) in ~25-50% of cases, depending on the sample. These symptoms have received relatively little attention in the literature, perhaps due to the higher rate of auditory vs. visual hallucinations in psychotic disorders, which is the reverse of what is found in other neuropsychiatric conditions. Given the clinical significance of these perceptual disturbances, our aim is to help address this gap by updating and expanding upon prior reviews. Specifically, we: (1) present findings on the nature and frequency of VH and distortions in schizophrenia; (2) review proposed syndromes of VH in neuro-ophthalmology and neuropsychiatry, and discuss the extent to which these characterize VH in schizophrenia; (3) review potential cortical mechanisms of VH in schizophrenia; (4) review retinal changes that could contribute to VH in schizophrenia; (5) discuss relationships between findings from laboratory measures of visual processing and VH in schizophrenia; and (6) integrate findings across biological and psychological levels to propose an updated model of VH mechanisms, including how their content is determined, and how they may reflect vulnerabilities in the maintenance of a sense of self. In particular, we emphasize the potential role of alterations at multiple points in the visual pathway, including the retina, the roles of multiple neurotransmitters, and the role of a combination of disinhibited default mode network activity and enhanced state-related apical/contextual drive in determining the onset and content of VH. In short, our goal is to cast a fresh light on the under-studied symptoms of VH and visual distortions in schizophrenia for the purposes of informing future work on mechanisms and the development of targeted therapeutic interventions.
Collapse
Affiliation(s)
- Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States.,Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, United States.,Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, United States.,Center for Visual Science, University of Rochester Medical Center, Rochester, NY, United States
| | - Adriann Lai
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, United States
| |
Collapse
|
24
|
Tang Y, Gui H, Tarbox-Berry S, Hu S, Ma X, Wang Q. Editorial: Genetic Mechanisms of Biomarkers in Schizophrenia, Bipolar Disorder and Depression. Front Psychiatry 2021; 12:736055. [PMID: 34475833 PMCID: PMC8406636 DOI: 10.3389/fpsyt.2021.736055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 07/20/2021] [Indexed: 02/05/2023] Open
Affiliation(s)
- Yiguo Tang
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Hongsheng Gui
- Behavioral Health and Psychiatry Research, Henry Ford Health System, Detroit, MI, United States
| | - Sarah Tarbox-Berry
- Department of Neurology, School of Medicine, Wayne State University, Detroit, MI, United States.,Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States
| | - Shaohua Hu
- Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Clinical Research Center for Psychiatric Medicine of Shaanxi, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| |
Collapse
|
25
|
Abo Hamza EG, Kéri S, Csigó K, Bedewy D, Moustafa AA. Pareidolia in Schizophrenia and Bipolar Disorder. Front Psychiatry 2021; 12:746734. [PMID: 34955913 PMCID: PMC8702957 DOI: 10.3389/fpsyt.2021.746734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
While there are many studies on pareidolia in healthy individuals and patients with schizophrenia, to our knowledge, there are no prior studies on pareidolia in patients with bipolar disorder. Accordingly, in this study, we, for the first time, measured pareidolia in patients with bipolar disorder (N = 50), and compared that to patients with schizophrenia (N = 50) and healthy controls (N = 50). We have used (a) the scene test, which consists of 10 blurred images of natural scenes that was previously found to produce illusory face responses and (b) the noise test which had 32 black and white images consisting of visual noise and 8 images depicting human faces; participants indicated whether a face was present on these images and to point to the location where they saw the face. Illusory responses were defined as answers when observers falsely identified objects that were not on the images in the scene task (maximum illusory score: 10), and the number of noise images in which they reported the presence of a face (maximum illusory score: 32). Further, we also calculated the total pareidolia score for each task (the sum number of images with illusory responses in the scene and noise tests). The responses were scored by two independent raters with an excellent congruence (kappa > 0.9). Our results show that schizophrenia patients scored higher on pareidolia measures than both healthy controls and patients with bipolar disorder. Our findings are agreement with prior findings on more impaired cognitive processes in schizophrenia than in bipolar patients.
Collapse
Affiliation(s)
- Eid G Abo Hamza
- Psychology Department, College of Humanities and Sciences, Ajman University, Ajman, United Arab Emirates.,College of Education, Tanta University, Tanta, Egypt
| | - Szabolcs Kéri
- National Institute of Psychiatry and Addictions, Budapest, Hungary.,Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary.,Department of Physiology, University of Szeged, Szeged, Hungary
| | - Katalin Csigó
- National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Dalia Bedewy
- Psychology Department, College of Humanities and Sciences, Ajman University, Ajman, United Arab Emirates.,College of Education, Tanta University, Tanta, Egypt
| | - Ahmed A Moustafa
- Department of Human Anatomy and Physiology, the Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.,School of Psychology & Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, NSW, Australia
| |
Collapse
|
26
|
Tu PC, Chen MH, Chang WC, Kao ZK, Hsu JW, Lin WC, Li CT, Su TP, Bai YM. Identification of common neural substrates with connectomic abnormalities in four major psychiatric disorders: A connectome-wide association study. Eur Psychiatry 2020; 64:e8. [PMID: 33267917 PMCID: PMC8057470 DOI: 10.1192/j.eurpsy.2020.106] [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] [Indexed: 11/23/2022] Open
Abstract
Background Recent imaging studies of large datasets suggested that psychiatric disorders have common biological substrates. This study aimed to identify all the common neural substrates with connectomic abnormalities across four major psychiatric disorders by using the data-driven connectome-wide association method of multivariate distance matrix regression (MDMR). Methods This study analyzed a resting functional magnetic resonance imaging dataset of 100 patients with schizophrenia, 100 patients with bipolar I disorder, 100 patients with bipolar II disorder, 100 patients with major depressive disorder, and 100 healthy controls (HCs). We calculated a voxel-wise 4,330 × 4,330 matrix of whole-brain functional connectivity (FC) with 8-mm isotropic resolution for each participant and then performed MDMR to identify structures where the overall multivariate pattern of FC was significantly different between each patient group and the HC group. A conjunction analysis was performed to identify common neural regions with FC abnormalities across these four psychiatric disorders. Results The conjunction of the MDMR maps revealed that the four groups of patients shared connectomic abnormalities in distributed cortical and subcortical structures, which included bilateral thalamus, cerebellum, frontal pole, supramarginal gyrus, postcentral gyrus, lingual gyrus, lateral occipital cortex, and parahippocampus. The follow-up analysis based on pair-wise FC of these regions demonstrated that these psychiatric disorders also shared similar patterns of FC abnormalities characterized by sensory/subcortical hyperconnectivity, association/subcortical hypoconnectivity, and sensory/association hyperconnectivity. Conclusions These findings suggest that major psychiatric disorders share common connectomic abnormalities in distributed cortical and subcortical regions and provide crucial support for the common network hypothesis of major psychiatric disorders.
Collapse
Affiliation(s)
- Pei-Chi Tu
- Department of Medical Research, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Wan-Chen Chang
- Department of Medical Research, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Zih-Kai Kao
- Department of Medical Research, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei112, Taiwan.,Department of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
27
|
Roes MM, Yin J, Taylor L, Metzak PD, Lavigne KM, Chinchani A, Tipper CM, Woodward TS. Hallucination-Specific structure-function associations in schizophrenia. Psychiatry Res Neuroimaging 2020; 305:111171. [PMID: 32916453 DOI: 10.1016/j.pscychresns.2020.111171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 08/15/2020] [Accepted: 08/19/2020] [Indexed: 01/13/2023]
Abstract
Combining structural (sMRI) and functional magnetic resonance imaging (fMRI) data in schizophrenia patients with and without auditory hallucinations (9 SZ_AVH, 12 SZ_nAVH), 18 patients with bipolar disorder, and 22 healthy controls, we examined whether cortical thinning was associated with abnormal activity in functional brain networks associated with auditory hallucinations. Language-task fMRI data were combined with mean cortical thickness values from 148 brain regions in a constrained principal component analysis (CPCA) to identify brain structure-function associations predictable from group differences. Two components emerged from the multimodal analysis. The "AVH component" highlighted an association of frontotemporal and cingulate thinning with altered brain activity characteristic of hallucinations among patients with AVH. In contrast, the "Bipolar component" distinguished bipolar patients from healthy controls and linked increased activity in the language network with cortical thinning in the left occipital-temporal lobe. Our findings add to a body of evidence of the biological underpinnings of hallucinations and illustrate a method for multimodal data analysis of structure-function associations in psychiatric illness.
Collapse
Affiliation(s)
- Meighen M Roes
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada; BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada
| | - John Yin
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Laura Taylor
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Paul D Metzak
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Katie M Lavigne
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Abhijit Chinchani
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Christine M Tipper
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Todd S Woodward
- BC Mental Health and Substance Use Services Research Institute, Provincial Health Services Authority, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
28
|
Coerver KA, Subramanian PS. Visual hallucinations in psychiatric, neurologic, and ophthalmologic disease. Curr Opin Ophthalmol 2020; 31:475-482. [PMID: 33009079 DOI: 10.1097/icu.0000000000000701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Recent studies have increased our understanding of the biochemical and structural bases of visual hallucinations in patients with a variety of underlying causes. RECENT FINDINGS Visual hallucinations may be related to disruption of functional connectivity networks, with underlying biochemical dysfunction such as decreased in cholinergic activity. Structural abnormalities in primary and higher order visual processing areas also have been found in patients with visual hallucinations. The occurrence of visual hallucinations after vision loss, the Charles Bonnet syndrome, may have more functional similarity to psychiatric and neurodegenerative causes than previously suspected despite retained insight into the unreal nature of the phenomena. SUMMARY Visual hallucinations are common, and patients may not report them if specific inquiries are not made. Presence or absence of hallucinations may be of diagnostic and therapeutic importance, especially in patients with neurodegenerative conditions that have overlapping features. Treatment of visual hallucinations remains challenging and must be tailored to each patient based on the underlying cause and comorbid conditions.
Collapse
Affiliation(s)
| | - Prem S Subramanian
- Department of Ophthalmology
- Department of Neurology
- Department of Neurosurgery, University of Colorado School of Medicine
- Sue Anschutz-Rodgers UCHealth Eye Center, Aurora, Colorado, USA
| |
Collapse
|
29
|
Toh WL, Thomas N, Hollander Y, Rossell SL. On the phenomenology of auditory verbal hallucinations in affective and non-affective psychosis. Psychiatry Res 2020; 290:113147. [PMID: 32569924 DOI: 10.1016/j.psychres.2020.113147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/02/2020] [Accepted: 05/25/2020] [Indexed: 12/16/2022]
Abstract
Phenomenological comparisons of auditory verbal hallucinations (AVHs) in affective versus non-affective psychosis have not been adequately documented. The current study aimed to: a) comprehensively describe AVH phenomenology by diagnosis and mood state, b) investigate significant predictors of voice-related distress and functional impairment, and c) conduct qualitative thematic analysis of participants' experiences. Participants were diagnosed with: a) bipolar disorder (n = 31), b) major depressive disorder (n = 34), c) schizophrenia (n = 50), or d) schizoaffective disorder (n = 26). Current voice-hearers were also subdivided into prevailing mood states: a) euthymic (n = 23), b) depressed (n = 51), or c) mania-mixed (n = 12). An in-depth, semi-structured interview was conducted, accompanied by mixed-methods analyses. Of the 34 AVH characteristics, significant group differences across diagnoses were identified only for frequency, number of voices, form of address, perceived location, level of conviction, beliefs regarding origin, and functional interference. Random forests modelling (RFM) showed experienced distress and functional interference were best predicted by discrete AVH variables. Qualitative thematic analysis revealed first-order themes: a) content, b) form, c) function, and d) non-voice. There were more similarities than differences in the phenomenology of AVHs across diagnoses, yet significant predictors of voice-related distress and functional impairment differed across affective and non-affective psychosis. This has important nosological and therapeutic applications.
Collapse
Affiliation(s)
- Wei Lin Toh
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Melbourne, Australia.
| | - Neil Thomas
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Melbourne, Australia
| | - Yitzchak Hollander
- Psychiatric Intensive Care Service, Alfred Hospital, Melbourne Australia
| | - Susan Lee Rossell
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Melbourne, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| |
Collapse
|
30
|
Okuneye VT, Meda S, Pearlson GD, Clementz BA, Keshavan MS, Tamminga CA, Ivleva E, Sweeney JA, Gershon ES, Keedy SK. Resting state auditory-language cortex connectivity is associated with hallucinations in clinical and biological subtypes of psychotic disorders. NEUROIMAGE-CLINICAL 2020; 27:102358. [PMID: 32745995 PMCID: PMC7398970 DOI: 10.1016/j.nicl.2020.102358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 01/16/2023]
Abstract
Transdiagnostic evidence for neural disruption in psychotic hallucinations. Hallucinations associated increased connectivity in auditory association cortex. Brain regions for auditory-verbal language comprehension linked to hallucinations. Interhemispheric connectivity alterations related to subgroup-specific findings. Hallucinations link to auditory rs-connectivity tested in 243 psychosis patients.
Background Auditory hallucinations are prevalent across the major psychotic disorders, but their underlying mechanism is poorly understood. Limited prior work supports a hypothesis of altered auditory/language brain systems. To more definitively assess this, we examined whether alterations in resting state connectivity of auditory and language cortices are associated with hallucination severity in a large sample of individuals in the schizo-bipolar spectrum. Methods Whole brain resting state connectivity of auditory and language cortex (primary auditory cortex, unimodal auditory association cortex, Wernicke’s area [speech and heteromodal association cortex] and Broca’s area [speech production motor]) was evaluated for 243 subjects with schizophrenia, schizoaffective, or bipolar disorder with psychosis and 186 healthy controls from the Bipolar Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. Regression analyses were conducted to evaluate whether resting state connectivity of auditory and language cortex was a significant predictor of current overall hallucination severity (information about specific modality of hallucinations experienced was not available). Results Increased connectivity between lower and higher order regions of left temporal-parietal auditory/language processing cortex was associated with worse hallucination severity for all psychosis patients. Additionally, within bipolar subjects, increased interhemispheric connectivity between higher order temporal-parietal auditory/language regions was related to greater hallucination severity. When patients were categorized by B-SNIP biomarker-based Biotype groups, interhemispheric connectivity between left auditory association cortex and right core auditory cortex was related to greater hallucination severity for Biotype 1 patients. Exploratory analyses resulted in different patterns of connectivity of auditory/language cortex in patients and controls, unrelated to current hallucination severity. Conclusions Although the findings cannot be precisely attributed to auditory hallucination severity or possible differences in such experiences between groups, increased connectivity among the left hemisphere auditory and receptive language cortex may represent a significant factor contributing to hallucination severity across psychotic disorders, and additional subgroup specific connectivity alterations may also be present.
Collapse
Affiliation(s)
- Victoria T Okuneye
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, IL, USA
| | | | | | | | | | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, TX, USA
| | - Elena Ivleva
- Department of Psychiatry, University of Texas Southwestern Medical Center, TX, USA
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, OH, USA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, IL, USA
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, IL, USA.
| |
Collapse
|
31
|
Zhuo C, Ji F, Lin X, Tian H, Wang L, Xu Y, Wang W, Jiang D. Global functional connectivity density alterations in patients with bipolar disorder with auditory verbal hallucinations and modest short-term effects of transcranial direct current stimulation augmentation treatment-Baseline and follow-up study. Brain Behav 2020; 10:e01637. [PMID: 32304288 PMCID: PMC7303392 DOI: 10.1002/brb3.1637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/18/2020] [Accepted: 03/26/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To investigate the neuroimaging characteristics of auditory verbal hallucinations (AVHs) in patients with bipolar disorder (BP) experiencing depressive episodes with and without AVHs, and alterations in those characteristics after transcranial direct current stimulation (tDCS). METHODS For a baseline pilot study, we recruited 80 patients with BP and depressive status (40 with and 40 without AVHs), and 40 healthy controls (HCs). Their global functional connectivity density (gFCD) was screened by functional magnetic resonance imaging (fMRI). Voxel-wise one-way analysis of covariance (ANCOVA) was conducted to detect intergroup differences in gFCD. In a follow-up study, the effects of 5 weeks of tDCS augmentation treatment on clinical symptoms and gFCD were assessed in the 40 BP patients with AVHs. RESULTS Compared to HCs, BP patients with and without AVHs exhibited increased gFCD in the central parietal lobe, insular lobe, and middle cingulate cortex, with decreased gFCD in the posterior parietal cortex, lateral prefrontal cortex, and occipital lobe (all bilateral). Only patients with AVHs showed increased gFCD in the Broca and Wernicke regions, and decreased gFCD in the hippocampus (all bilateral). After 5 weeks of tDCS, AVHs were slightly alleviated and gFCD abnormalities in the hippocampus were mildly attenuated. CONCLUSIONS Patients with BP and AVHs showed disturbances in the brain's communication capacity mainly in the left frontoparietal network, control network, and memory circuitry. Five weeks of tDCS alleviated AVHs slightly, without improving depressive symptoms, and attenuated hippocampal gFCD alterations in these patients.
Collapse
Affiliation(s)
- Chuanjun Zhuo
- School of Mental Health, Jining Medical University, Jining, China.,Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China.,Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China.,Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital and University of Alberta, Xiamen, China
| | - Feng Ji
- School of Mental Health, Jining Medical University, Jining, China
| | - Xiaodong Lin
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, China
| | - Lina Wang
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Wenqiang Wang
- Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital and University of Alberta, Xiamen, China
| | - Deguo Jiang
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
| |
Collapse
|
32
|
Pamphlett R, Kum Jew S, Doble PA, Bishop DP. Elemental imaging shows mercury in cells of the human lateral and medial geniculate nuclei. PLoS One 2020; 15:e0231870. [PMID: 32320439 PMCID: PMC7176133 DOI: 10.1371/journal.pone.0231870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/26/2020] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Interference with the transmission of sensory signals along visual and auditory pathways has been implicated in the pathogenesis of hallucinations. The relay centres for vision (the lateral geniculate nucleus) and hearing (the medial geniculate nucleus) appear to be susceptible to the uptake of circulating mercury. We therefore investigated the distribution of mercury in cells of both these geniculate nuclei. MATERIALS AND METHODS Paraffin-embedded tissue sections containing the lateral geniculate nucleus were obtained from 50 adults (age range 20-104 years) who at autopsy had a variety of clinicopathological conditions, including neurological and psychiatric disorders. The medial geniculate nucleus was present in seven sections. Sections were stained for mercury using autometallography. Laser ablation-inductively coupled plasma-mass spectrometry was used to confirm the presence of mercury. RESULTS Ten people had mercury in cells of the lateral geniculate nucleus, and in the medial geniculate nucleus of three of these. Medical diagnoses in these individuals were: none (3), Parkinson disease (3), and one each of depression, bipolar disorder, multiple sclerosis, and mercury self-injection. Mercury was distributed in different groups of geniculate capillary endothelial cells, neurons, oligodendrocytes, and astrocytes. Mass spectrometry confirmed the presence of mercury. CONCLUSION Mercury is present in different combinations of cell types in the lateral and medial geniculate nuclei in a proportion of people from varied backgrounds. This raises the possibility that mercury-induced impairment of the function of the geniculate nuclei could play a part in the genesis of visual and auditory hallucinations. Although these findings do not provide a direct link between mercury in geniculate cells and hallucinations, they suggest that further investigations into the possibility of toxicant-induced hallucinations are warranted.
Collapse
Affiliation(s)
- Roger Pamphlett
- Discipline of Pathology, Brain and Mind Centre, Sydney Medical School, The University of Sydney, Sydney, Australia
- Department of Neuropathology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Stephen Kum Jew
- Discipline of Pathology, Brain and Mind Centre, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Philip A. Doble
- Elemental Bio-Imaging Facility, School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
| | - David P. Bishop
- Elemental Bio-Imaging Facility, School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
33
|
Shinn AK, Wolff JD, Hwang M, Lebois LAM, Robinson MA, Winternitz SR, Öngür D, Ressler KJ, Kaufman ML. Assessing Voice Hearing in Trauma Spectrum Disorders: A Comparison of Two Measures and a Review of the Literature. Front Psychiatry 2020; 10:1011. [PMID: 32153431 PMCID: PMC7050446 DOI: 10.3389/fpsyt.2019.01011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 12/20/2019] [Indexed: 11/13/2022] Open
Abstract
Voice hearing (VH) can occur in trauma spectrum disorders (TSD) such as posttraumatic stress disorder (PTSD) and dissociative disorders. However, previous estimates of VH among individuals with TSD vary widely. In this study, we sought to better characterize the rate and phenomenology of VH in a sample of 70 women with TSD related to childhood abuse who were receiving care in a specialized trauma program. We compared the rate of VH within our sample using two different measures: 1) the auditory hallucination (AH) item in the Structured Clinical Interview for DSM-IV-TR (SCID), and 2) the thirteen questions involving VH in the Multidimensional Inventory of Dissociation (MID), a self-report questionnaire that comprehensively assesses pathological dissociation. We found that 45.7% of our sample met threshold for SCID AH, while 91.4% met criteria for MID VH. Receiver operating characteristics (ROC) analyses showed that while SCID AH and MID VH items have greater than chance agreement, the strength of agreement is only moderate, suggesting that SCID and MID VH items measure related but not identical constructs. Thirty-two patients met criteria for both SCID AH and at least one MID VH item ("unequivocal VH"), 32 for at least one MID VH item but not SCID AH ("ambiguous VH"), and 6 met criteria for neither ("unequivocal non-VH"). Relative to the ambiguous VH group, the unequivocal VH group had higher dissociation scores for child voices, and higher mean frequencies for child voices and Schneiderian voices. Our findings suggest that VH in women with TSD related to childhood abuse is common, but that the rate of VH depends on how the question is asked. We review prior studies examining AH and/or VH in TSD, focusing on the measures used to ascertain these experiences, and conclude that our two estimates are consistent with previous studies that used comparable instruments and patient samples. Our results add to growing evidence that VH-an experience typically considered psychotic or psychotic-like-is not equivalent to having a psychotic disorder. Instruments that assess VH apart from psychotic disorders and that capture their multidimensional nature may improve identification of VH, especially among patients with non-psychotic disorders.
Collapse
Affiliation(s)
- Ann K. Shinn
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Jonathan D. Wolff
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
| | - Melissa Hwang
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States
| | - Lauren A. M. Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
- Neurobiology of Fear Laboratory, McLean Hospital, Belmont, MA, United States
| | - Mathew A. Robinson
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
| | - Sherry R. Winternitz
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Neurobiology of Fear Laboratory, McLean Hospital, Belmont, MA, United States
| | - Milissa L. Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
| |
Collapse
|
34
|
Jongeneel A, van Veen SC, Scheffers D, Riper H, van den Hout MA, van der Gaag M, van den Berg D. Linguistic dual tasking reduces emotionality, vividness and credibility of voice memories in voice-hearing individuals: Results from a controlled trial. Schizophr Res 2020; 216:249-254. [PMID: 31883929 DOI: 10.1016/j.schres.2019.11.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 09/20/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
Dual taxation of the working memory during recall is an effective strategy to reduce the emotionality and vividness of visual intrusive memories and potentially changes dysfunctional beliefs associated with the memories. This study tested the hypothesis that dual tasking decreases emotionality, vividness and credibility of auditory intrusive images (i.e., memories of auditory hallucinations) with a two-level (time: pre and post; condition: dual tasking and recall only) within-subjects design. Thirty-seven voice-hearing participants selected two negative voice-hearing experiences. They recalled one of these experiences while performing a lingual dual task (i.e., language game on smartphone app) and recalled one memory without a dual task (in counterbalanced order). During the pre-test and post-test, emotionality and vividness of the voice-hearing memories were rated, as well as the credibility of the voice statements. There was a significantly greater decrease in emotionality, vividness and credibility during dual tasking than during recall only. This study provides proof of principle that the salience and credibility of the content of auditory hallucinations can be reduced by dual tasking; the clinical implications are also discussed.
Collapse
Affiliation(s)
- Alyssa Jongeneel
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Van der Boechorstraat 7, 1081, BT, Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512, HN, Den Haag, the Netherlands.
| | - Suzanne C van Veen
- Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands
| | | | - Heleen Riper
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Van der Boechorstraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Marcel A van den Hout
- Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Van der Boechorstraat 7, 1081, BT, Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512, HN, Den Haag, the Netherlands
| | - David van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Van der Boechorstraat 7, 1081, BT, Amsterdam, the Netherlands; Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512, HN, Den Haag, the Netherlands
| |
Collapse
|
35
|
van Bergen AH, Verkooijen S, Vreeker A, Abramovic L, Hillegers MH, Spijker AT, Hoencamp E, Regeer EJ, Knapen SE, Riemersma-van der Lek RF, Schoevers R, Stevens AW, Schulte PFJ, Vonk R, Hoekstra R, van Beveren NJ, Kupka RW, Sommer IEC, Ophoff RA, Kahn RS, Boks MPM. The characteristics of psychotic features in bipolar disorder. Psychol Med 2019; 49:2036-2048. [PMID: 30303059 DOI: 10.1017/s0033291718002854] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND In a large and comprehensively assessed sample of patients with bipolar disorder type I (BDI), we investigated the prevalence of psychotic features and their relationship with life course, demographic, clinical, and cognitive characteristics. We hypothesized that groups of psychotic symptoms (Schneiderian, mood incongruent, thought disorder, delusions, and hallucinations) have distinct relations to risk factors. METHODS In a cross-sectional study of 1342 BDI patients, comprehensive demographical and clinical characteristics were assessed using the Structured Clinical Interview for DSM-IV (SCID-I) interview. In addition, levels of childhood maltreatment and intelligence quotient (IQ) were assessed. The relationships between these characteristics and psychotic symptoms were analyzed using multiple general linear models. RESULTS A lifetime history of psychotic symptoms was present in 73.8% of BDI patients and included delusions in 68.9% of patients and hallucinations in 42.6%. Patients with psychotic symptoms showed a significant younger age of disease onset (β = -0.09, t = -3.38, p = 0.001) and a higher number of hospitalizations for manic episodes (F11 338 = 56.53, p < 0.001). Total IQ was comparable between groups. Patients with hallucinations had significant higher levels of childhood maltreatment (β = 0.09, t = 3.04, p = 0.002). CONCLUSIONS In this large cohort of BDI patients, the vast majority of patients had experienced psychotic symptoms. Psychotic symptoms in BDI were associated with an earlier disease onset and more frequent hospitalizations particularly for manic episodes. The study emphasizes the strength of the relation between childhood maltreatment and hallucinations but did not identify distinct subgroups based on psychotic features and instead reported of a large heterogeneity of psychotic symptoms in BD.
Collapse
Affiliation(s)
- Annet H van Bergen
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Department of Psychiatry, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands
| | - Sanne Verkooijen
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Annabel Vreeker
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Manon H Hillegers
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annet T Spijker
- Department of Mood Disorders, PsyQ, The Hague and Rotterdam, The Netherlands
| | - Erik Hoencamp
- Parnassie Group, The Hague, The Netherlands
- Insitute of Psychology Leiden University, Leiden, The Netherlands
| | - Eline J Regeer
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
| | - Stefan E Knapen
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rixt F Riemersma-van der Lek
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Robert Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anja W Stevens
- Dimence Center for Bipolar Disorders, Almelo, The Netherlands
| | - Peter F J Schulte
- Mental Health Service, Noord Holland Noord, Alkmaar, The Netherlands
| | - Ronald Vonk
- Reinier van Arkel, 's-Hertogenbosch, The Netherlands
| | - Rocco Hoekstra
- Antes, Delta Center for Mental Health Care, Rotterdam, The Netherlands
| | | | - Ralph W Kupka
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Iris E C Sommer
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Roel A Ophoff
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Semel Institute For Neuroscience and Human Behavior, University of California, Los Angeles, USA
| | - René S Kahn
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Department of Psychiatry, Mount Sinai School of Medicine, New York, USA
| | - Marco P M Boks
- Department of Psychiatry, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| |
Collapse
|
36
|
Chawla N, Deep R, Khandelwal SK, Garg A. Reduced integrity of superior longitudinal fasciculus and arcuate fasciculus as a marker for auditory hallucinations in schizophrenia: A DTI tractography study. Asian J Psychiatr 2019; 44:179-186. [PMID: 31398683 DOI: 10.1016/j.ajp.2019.07.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/05/2019] [Accepted: 07/23/2019] [Indexed: 12/15/2022]
Abstract
AIMS AND OBJECTIVES The study aimed to assess and compare fractional anisotropy (FA) in bilateral superior longitudinal fasciculi (SLF) and arcuate fasciculi (AF) across schizophrenia with auditory hallucinations(AH), without AH, and healthy controls using diffusion tensor imaging (DTI) tractography. METHODOLOGY Right-handed adult (18-50 years) individuals with DSM-5 diagnosis of schizophrenia with AH (group-I; n=30) were compared to those without lifetime AH (group-II; n=32) and healthy controls (group-III; n=30). Severity of psychosis in groups-I and II was assessed using SAPS, SANS, and CGI-SCH, and psychopathology was assessed using PSYRATS. The FA was calculated for all images on DTI studio-version 3.0 using tractography technique. RESULTS All three groups were comparable for age, gender, education and illness-severity. Schizophrenia subjects with AH had significantly lower FA values in bilateral SLF and AF compared to those without AH and healthy controls. No difference was observed in corresponding FA values between schizophrenia without AH and healthy controls. CONCLUSION White matter disruptions in bilateral SLF and AF appear to be specific to schizophrenia with AH and must be explored further as potential marker of AH, pending replication in other studies.
Collapse
Affiliation(s)
- Nishtha Chawla
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi 110029, India
| | - Raman Deep
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi 110029, India.
| | - Sudhir K Khandelwal
- Dept of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi 110029, India
| | - Ajay Garg
- Department of Neuroimaging and Interventional Neuroradiology, AIIMS, New Delhi, Delhi 110029, India
| |
Collapse
|
37
|
Karrer TM, Bassett DS, Derntl B, Gruber O, Aleman A, Jardri R, Laird AR, Fox PT, Eickhoff SB, Grisel O, Varoquaux G, Thirion B, Bzdok D. Brain-based ranking of cognitive domains to predict schizophrenia. Hum Brain Mapp 2019; 40:4487-4507. [PMID: 31313451 DOI: 10.1002/hbm.24716] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/10/2019] [Accepted: 06/26/2019] [Indexed: 12/22/2022] Open
Abstract
Schizophrenia is a devastating brain disorder that disturbs sensory perception, motor action, and abstract thought. Its clinical phenotype implies dysfunction of various mental domains, which has motivated a series of theories regarding the underlying pathophysiology. Aiming at a predictive benchmark of a catalog of cognitive functions, we developed a data-driven machine-learning strategy and provide a proof of principle in a multisite clinical dataset (n = 324). Existing neuroscientific knowledge on diverse cognitive domains was first condensed into neurotopographical maps. We then examined how the ensuing meta-analytic cognitive priors can distinguish patients and controls using brain morphology and intrinsic functional connectivity. Some affected cognitive domains supported well-studied directions of research on auditory evaluation and social cognition. However, rarely suspected cognitive domains also emerged as disease relevant, including self-oriented processing of bodily sensations in gustation and pain. Such algorithmic charting of the cognitive landscape can be used to make targeted recommendations for future mental health research.
Collapse
Affiliation(s)
- Teresa M Karrer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Birgit Derntl
- Translational Brain Medicine, Jülich Aachen Research Alliance (JARA), Aachen, Germany.,Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Oliver Gruber
- Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - André Aleman
- BCN Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Renaud Jardri
- Division of Psychiatry, University of Lille, CNRS UMR 9193, SCALab and CHU Lille, Fontan Hospital, Lille, France
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, Florida
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas.,South Texas Veterans Health Care System, San Antonio, Texas.,State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Heinrich-Heine University, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-7), Research Centre Jülich, Jülich, Germany
| | - Olivier Grisel
- Parietal Team, INRIA Saclay/NeuroSpin, Palaiseau, France
| | - Gaël Varoquaux
- Parietal Team, INRIA Saclay/NeuroSpin, Palaiseau, France
| | | | - Danilo Bzdok
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.,Translational Brain Medicine, Jülich Aachen Research Alliance (JARA), Aachen, Germany.,Parietal Team, INRIA Saclay/NeuroSpin, Palaiseau, France
| |
Collapse
|
38
|
Visual hallucinations associated with multimodal hallucinations, suicide attempts and morbidity of illness in psychotic disorders. Schizophr Res 2019; 208:196-201. [PMID: 30842029 PMCID: PMC6664439 DOI: 10.1016/j.schres.2019.02.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 02/02/2019] [Accepted: 02/25/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Visual hallucinations (VH) are a common, but understudied symptom of psychosis, experienced by individuals across diagnostic categories of psychotic and neuropsychiatric conditions. There are limited data on VH and associated clinical phenotypes in adult idiopathic psychotic disorders, which are needed to elucidate their relevance to psychotic illness paradigms. METHOD In this cross-sectional study, we examined clinical risk factors for VH in a well-characterized sample of 766 patients with adult psychotic disorders across diagnostic categories of schizophrenia (n = 227), schizoaffective disorder (n = 210), and bipolar I disorder (n = 329). The Structured Clinical Interview for DSM-IV-TR was used for diagnosis and symptom measurements. RESULTS The prevalence of VH was 26.1% (200/766). Multivariate logistic regression showed that VH were independently associated with the presence of hallucinations in other modalities, including auditory, tactile, olfactory, and gustatory hallucinations. History of a suicide attempt and catatonic behavior were also associated with VH. In addition, specific delusions were associated with VH, in particular, delusions of control, and religious, erotomanic and jealousy delusions. Diagnosis, negative symptoms, and family history of psychosis were not independent predictors of VH. CONCLUSIONS Results showed the clinical and disease relevance of VH as they were associated with severe morbidity of illness, including suicide attempts and catatonic behavior. Findings also suggest a phenotype associated with hallucinations in other modalities and specific types of delusions. Based on our findings, VH may be a significant factor in assessing for suicidality and illness severity, warranting clinical attention and further study of underlying mechanisms.
Collapse
|
39
|
Zhuo C, Jiang D, Liu C, Lin X, Li J, Chen G, Xie Z, Xu Z, Zhou C, Zhu J. Understanding auditory verbal hallucinations in healthy individuals and individuals with psychiatric disorders. Psychiatry Res 2019; 274:213-219. [PMID: 30807972 DOI: 10.1016/j.psychres.2019.02.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/17/2019] [Accepted: 02/17/2019] [Indexed: 01/09/2023]
Abstract
Auditory verbal hallucinations(AVHs) are psychiatric manifestations that are common in patients with psychiatric disorders and can occur in healthy individuals. This review summarizes the existing literature on the phenomenological features of auditory verbal hallucinations, imaging findings, and interventions, focusing on patients with schizophrenia who experience auditory verbal hallucinations, in addition to patients with borderline personality disorder, bipolar disorder, major depressive disorder, and posttraumatic stress disorder, as well as healthy individuals. The phenomenological features of AVHs vary in different psychiatric disorders, and the symptoms are associated with changes in specific brain structures and disturbances in brain function, blood flow, and metabolism. Interventions for auditory verbal hallucinations include antipsychotic drugs, neurostimulation, and cognitive behavioral therapy.
Collapse
Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China; Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China; Department of Psychiatric-Neuroimaging-Genetics and comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, 300222, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Chuanxin Liu
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Jie Li
- Department of Psychiatric-Neuroimaging-Genetics and comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, 300222, China
| | - Guangdong Chen
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| | - Zuoliang Xie
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| | - ZhangJi Xu
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Jingjing Zhu
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| |
Collapse
|
40
|
Rollins CP, Garrison JR, Simons JS, Rowe JB, O'Callaghan C, Murray GK, Suckling J. Meta-analytic Evidence for the Plurality of Mechanisms in Transdiagnostic Structural MRI Studies of Hallucination Status. EClinicalMedicine 2019; 8:57-71. [PMID: 31193632 PMCID: PMC6537703 DOI: 10.1016/j.eclinm.2019.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/15/2019] [Accepted: 01/27/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hallucinations are transmodal and transdiagnostic phenomena, occurring across sensory modalities and presenting in psychiatric, neurodegenerative, neurological, and non-clinical populations. Despite their cross-category occurrence, little empirical work has directly compared between-group neural correlates of hallucinations. METHODS We performed whole-brain voxelwise meta-analyses of hallucination status across diagnoses using anisotropic effect-size seed-based d mapping (AES-SDM), and conducted a comprehensive systematic review in PubMed and Web of Science until May 2018 on other structural correlates of hallucinations, including cortical thickness and gyrification. FINDINGS 3214 abstracts were identified. Patients with psychiatric disorders and hallucinations (eight studies) exhibited reduced gray matter (GM) in the left insula, right inferior frontal gyrus, left anterior cingulate/paracingulate gyrus, left middle temporal gyrus, and increased in the bilateral fusiform gyrus, while patients with neurodegenerative disorders with hallucinations (eight studies) showed GM decreases in the left lingual gyrus, right supramarginal gyrus/parietal operculum, left parahippocampal gyrus, left fusiform gyrus, right thalamus, and right lateral occipital gyrus. Group differences between psychiatric and neurodegenerative hallucination meta-analyses were formally confirmed using Monte Carlo randomizations to determine statistical significance, and a jackknife sensitivity analysis established the reproducibility of results across nearly all study combinations. For other structural measures (28 studies), the most consistent findings associated with hallucination status were reduced cortical thickness in temporal gyri in schizophrenia and altered hippocampal volume in Parkinson's disease and dementia. Additionally, increased severity of hallucinations in schizophrenia correlated with GM reductions within the left superior temporal gyrus, right middle temporal gyrus, bilateral supramarginal and angular gyri. INTERPRETATION Distinct patterns of neuroanatomical alteration characterize hallucination status in patients with psychiatric and neurodegenerative diseases, suggesting a plurality of anatomical signatures. This approach has implications for treatment, theoretical frameworks, and generates refutable predictions for hallucinations in other diseases and their occurrence within the general population. FUNDING None.
Collapse
Affiliation(s)
- Colleen P.E. Rollins
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Corresponding author at: Department of Psychiatry, University of Cambridge, Cambridge CB2 0SP, UK
| | - Jane R. Garrison
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Jon S. Simons
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - James B. Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| |
Collapse
|
41
|
Moernaut N, Vanheule S, Feyaerts J. Content Matters, a Qualitative Analysis of Verbal Hallucinations. Front Psychol 2018; 9:1958. [PMID: 30416463 PMCID: PMC6212510 DOI: 10.3389/fpsyg.2018.01958] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/21/2018] [Indexed: 11/16/2022] Open
Abstract
Auditory verbal hallucinations have traditionally especially been researched from a form-based approach, with content getting much less attention. In this article, we argue for the importance of looking at content to get a fuller understanding of the hallucinatory experience. Guided by Lacanian psychoanalysis, we conducted a thematic and a narrative analysis on interviews with 10 schizophrenic patients about their hallucinations. We discerned five themes in the data, which were based on Lacanian theory and had to do with existential questions: parenthood and authority, sexuality and relationships, gender identity, life in the light of death, and what does the other want? Furthermore, we added a theme for unclassified content. Narratively, we found that participants constructed a story of four steps about their hallucinatory experiences. These steps were disturbing events in the past posing an existential question, triggering event, period of confusion, and hearing voices that allude to existential themes. Participants succeed in different degrees in integrating their hallucinatory experiences in their own life history. These stories can be situated on a continuum by making use of three prototypical narrating styles: the meta-delusional, delusional, and chaotic narrative type. Overall, our analysis shows that hallucinations can both be thematically and narratively organized, by making use of a theoretical framework like Lacanian psychoanalysis. Our research demonstrates that hallucinatory contents are not random but are about existential issues imbedded in a life narrative. Future research would benefit of integrating content and form-based approaches.
Collapse
Affiliation(s)
- Nienke Moernaut
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Ghent, Belgium
| | - Stijn Vanheule
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Ghent, Belgium
| | - Jasper Feyaerts
- Department of Psychoanalysis and Clinical Consulting, Ghent University, Ghent, Belgium
| |
Collapse
|
42
|
Kamp KS, O'Connor M, Spindler H, Moskowitz A. Bereavement hallucinations after the loss of a spouse: Associations with psychopathological measures, personality and coping style. DEATH STUDIES 2018; 43:260-269. [PMID: 29757086 DOI: 10.1080/07481187.2018.1458759] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 12/14/2017] [Accepted: 02/08/2018] [Indexed: 06/08/2023]
Abstract
Bereavement hallucinations (BHs) were assessed in 175 conjugally bereaved participants 4 years post loss, to explore whether BHs were: (a) associated with psychological distress and (b) predicted by sociodemographic variables, personality and/or coping style. Participants with BHs scored significantly higher than those without BHs on prolonged grief, post-traumatic stress, depression symptoms, and emotional loneliness. Hierarchical logistic regression analysis showed avoidant coping, openness to experience, and length of marriage to significantly predict BHs, while detached coping was negatively associated with BHs. This study suggests that BHs may be an indicator of psychological distress in bereavement.
Collapse
Affiliation(s)
- Karina Stengaard Kamp
- a Department of Psychology and Behavioral Sciences , Aarhus University , Bartholins Allé 11 , Aarhus C , DK , 8000 , Denmark
| | - Maja O'Connor
- a Department of Psychology and Behavioral Sciences , Aarhus University , Bartholins Allé 11 , Aarhus C , DK , 8000 , Denmark
| | - Helle Spindler
- a Department of Psychology and Behavioral Sciences , Aarhus University , Bartholins Allé 11 , Aarhus C , DK , 8000 , Denmark
| | - Andrew Moskowitz
- b Touro College Berlin, Campus Am Rupenhorn , Am Rupenhorn 5 , Berlin , 14055 , Germany
| |
Collapse
|
43
|
Birnie KI, Stewart R, Kolliakou A. Recorded atypical hallucinations in psychotic and affective disorders and associations with non-benzodiazepine hypnotic use: the South London and Maudsley Case Register. BMJ Open 2018; 8:e025216. [PMID: 30269078 PMCID: PMC6169776 DOI: 10.1136/bmjopen-2018-025216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Hallucinations are present in many conditions, notably psychosis. Although under-researched, atypical hallucinations, such as tactile, olfactory and gustatory (TOGHs), may arise secondary to hypnotic drug use, particularly non-benzodiazepine hypnotics ('Z drugs'). This retrospective case-control study investigated the frequency of TOGHs and their associations with prior Z drug use in a large mental healthcare database. METHODS TOGHs were ascertained in 2014 using a bespoke natural language processing algorithm and were analysed against covariates (including use of Z drugs, demographic factors, diagnosis, disorder severity and other psychotropic medications) ascertained prior to 2014. RESULTS In 43 339 patients with International Classification of Diseases, Tenth Edition schizophreniform or affective disorder diagnoses, 324 (0.75%) had any TOGH recorded (0.54% tactile, 0.24% olfactory, 0.06% gustatory hallucinations). TOGHs were associated with male gender, black ethnicity, schizophreniform diagnosis and higher disorder severity on Health of the National Outcome Scales. In fully adjusted models, tactile and olfactory hallucinations remained independently associated with prior mention of Z drugs (ORs 1.86 and 1.60, respectively). CONCLUSIONS We successfully developed a natural language processing algorithm to identify instances of TOGHs in the clinical record. TOGHs overall, tactile and olfactory hallucinations were shown to be associated with prior mention of Z drugs. This may have implications for the diagnosis and treatment of patients with comorbid sleep and psychiatric conditions.
Collapse
Affiliation(s)
| | - Robert Stewart
- Department of Psychological Medicine, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Anna Kolliakou
- Department of Psychological Medicine, King's College London, London, UK
| |
Collapse
|
44
|
Stern S, Santos R, Marchetto MC, Mendes APD, Rouleau GA, Biesmans S, Wang QW, Yao J, Charnay P, Bang AG, Alda M, Gage FH. Neurons derived from patients with bipolar disorder divide into intrinsically different sub-populations of neurons, predicting the patients' responsiveness to lithium. Mol Psychiatry 2018; 23:1453-1465. [PMID: 28242870 PMCID: PMC5573640 DOI: 10.1038/mp.2016.260] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/04/2016] [Accepted: 12/06/2016] [Indexed: 11/09/2022]
Abstract
Bipolar disorder (BD) is a progressive psychiatric disorder with more than 3% prevalence worldwide. Affected individuals experience recurrent episodes of depression and mania, disrupting normal life and increasing the risk of suicide greatly. The complexity and genetic heterogeneity of psychiatric disorders have challenged the development of animal and cellular models. We recently reported that hippocampal dentate gyrus (DG) neurons differentiated from induced pluripotent stem cell (iPSC)-derived fibroblasts of BD patients are electrophysiologically hyperexcitable. Here we used iPSCs derived from Epstein-Barr virus-immortalized B-lymphocytes to verify that the hyperexcitability of DG-like neurons is reproduced in this different cohort of patients and cells. Lymphocytes are readily available for research with a large number of banked lines with associated patient clinical description. We used whole-cell patch-clamp recordings of over 460 neurons to characterize neurons derived from control individuals and BD patients. Extensive functional analysis showed that intrinsic cell parameters are very different between the two groups of BD neurons, those derived from lithium (Li)-responsive (LR) patients and those derived from Li-non-responsive (NR) patients, which led us to partition our BD neurons into two sub-populations of cells and suggested two different subdisorders. Training a Naïve Bayes classifier with the electrophysiological features of patients whose responses to Li are known allows for accurate classification with more than 92% success rate for a new patient whose response to Li is unknown. Despite their very different functional profiles, both populations of neurons share a large, fast after-hyperpolarization (AHP). We therefore suggest that the large, fast AHP is a key feature of BD and a main contributor to the fast, sustained spiking abilities of BD neurons. Confirming our previous report with fibroblast-derived DG neurons, chronic Li treatment reduced the hyperexcitability in the lymphoblast-derived LR group but not in the NR group, strengthening the validity and utility of this new human cellular model of BD.
Collapse
Affiliation(s)
- S Stern
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | - R Santos
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, CA, USA,Ecole Normale Supérieure, PSL Research University, CNRS, Inserm, Institut de Biologie de l’Ecole Normale Supérieure (IBENS), Paris, France
| | - MC Marchetto
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | - APD Mendes
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | - GA Rouleau
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - S Biesmans
- Conrad Prebys Center for Chemical Genomics, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Q-W Wang
- State Key Laboratory of Membrane Biology, Tsinghua-Peking Joint Center for Life Sciences, School of Life Sciences, IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, China
| | - J Yao
- State Key Laboratory of Membrane Biology, Tsinghua-Peking Joint Center for Life Sciences, School of Life Sciences, IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, China
| | - P Charnay
- Ecole Normale Supérieure, PSL Research University, CNRS, Inserm, Institut de Biologie de l’Ecole Normale Supérieure (IBENS), Paris, France
| | - AG Bang
- Conrad Prebys Center for Chemical Genomics, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada. Correspondence: Professor FH Gage, Laboratory of Genetics, The Salk Institute for Biological Studies, The Salk Institute, 10010 North Torrey Pines Road, La Jolla, CA 92037, USA
| | - FH Gage
- Laboratory of Genetics, The Salk Institute for Biological Studies, La Jolla, CA, USA
| |
Collapse
|
45
|
Influence of comorbid alcohol use disorders on the clinical patterns of major depressive disorder: A general population-based study. Drug Alcohol Depend 2018; 187:40-47. [PMID: 29626745 DOI: 10.1016/j.drugalcdep.2018.02.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/30/2018] [Accepted: 02/01/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND To compare the symptom patterns of major depressive disorder (MDD) among subjects with MDD and 1) no alcohol use disorder (AUD), 2) alcohol abuse and 3) alcohol dependence, respectively. METHODS In a general population survey of 38,694 French individuals, MDD and AUDs were assessed using the Mini International Neuropsychiatric Interview 5.0.0 (MINI). A total of 4339 subjects (11.2%) in the sample met the criteria for MDD. Among them, 413 (9.5%) AUD subjects were identified: 138 (3.2%) for alcohol abuse and 275 (6.3%) for alcohol dependence. The associations of each of the ten MDD criteria of the MINI and psychiatric clinical features were compared among the three groups. The relative profiles of 'MDD + AUD' vs. 'MDD alone' were determined using a multivariable stepwise regression model. RESULTS With the noAUD group as the reference, sadness (OR = 0.46; 95%CI, 0.29-0.74) and anhedonia (OR = 1.66; 95%CI, 1.06-2.73) were only associated with alcohol abuse. Sleep disorders (OR = 2.07; 95%CI, 1.51-2.88), feelings of guilt (OR = 1.41; 95%CI, 1.05-1.90), diminished concentration/indecisiveness (OR = 1.52; 95%CI, 1.12-2.07) and thoughts of death (OR = 1.95; 95%CI 1.49-2.55) were only associated with alcohol dependence. Weight or appetite variations were both associated with alcohol abuse (OR = 1.7; 95%CI, 1.15-2.53) and dependence (OR = 1.41; 95%CI, 1.06-1.88). Bipolar disorder and PTSD were only associated with alcohol dependence. Psychotic features, previous suicide attempts, and panic disorder were more frequent in the MDD-AUD group. CONCLUSION MDD-AUD subjects displayed a more severe profile with specific symptomatology and comorbidity profiles compared to MDD-only subjects.
Collapse
|
46
|
Jongeneel A, Scheffers D, Tromp N, Nuij C, Delespaul P, Riper H, van der Gaag M, van den Berg D. Reducing distress and improving social functioning in daily life in people with auditory verbal hallucinations: study protocol for the 'Temstem' randomised controlled trial. BMJ Open 2018; 8:e020537. [PMID: 29511020 PMCID: PMC5879499 DOI: 10.1136/bmjopen-2017-020537] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Auditory verbal hallucinations (AVH) are prevalent experiences that can induce distress and impede social functioning. While most voice hearers benefit from antipsychotic medication or cognitive-behavioural therapy, additional effective interventions are needed to reduce the burden of experiencing AVH. 'Temstem' is an easily accessible and useable smartphone application that was developed by designers in close cooperation with voice hearers and experts. By using language games, Temstem aims to reduce distress and improve social functioning. METHODS This is a single-blind multicentre randomised controlled trial with two arms: 'Temstem+AVH monitoring' versus 'AVH monitoring' (total n=100). Participants are adult patients who suffer daily from AVH and will be recruited in outpatient units. Primary assessment in daily life is made by the Experience Sampling Method (ESM) and daily monitoring with the PsyMate app. During an ESM period of 6 days, participants assess their mental state (including AVH and context) several times a day by filling in short questionnaires. There are three 6-day ESM periods: at baseline (week 0-1), post-treatment (weeks 5-6) and follow-up (weeks 9-10). In addition, during the entire 10-week study period, all participants monitor their AVH two times a day with a short assessment via the PsyMate app. Participants in the Temstem+AVH monitoring condition are provided with the Temstem app from week 1 to 6. Other assessments made at baseline, post-treatment and follow-up are based on questionnaires and a clinical interview. ETHICS AND DISSEMINATION The results from this study will provide an evaluation of the effectiveness of Temstem, a non-invasive and easily accessible app for voice hearers, and insight into the determinants of optimal use. Results will be disseminated unreservedly, irrespective of the magnitude or direction of the effects. This study protocol was approved by the Medical Ethics Committee of the VU University Medical Centre (METC number: 2015.435/NL53684.029.15). TRIAL REGISTRATION NUMBER ISRCTN75717636; Pre-results.
Collapse
Affiliation(s)
- Alyssa Jongeneel
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Research and Innovation, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | | | - Nynke Tromp
- Department of Industrial Design, Delft University of Technology, Delft, The Netherlands
| | - Chani Nuij
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
- Mondriaan, Heerlen, The Netherlands
| | - Heleen Riper
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Research and Innovation, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - David van den Berg
- Research and Innovation, Parnassia Psychiatric Institute, The Hague, The Netherlands
| |
Collapse
|
47
|
Hallucinations as a presenting complaint in emergency departments: Prevalence, diagnosis, and costs. Psychiatry Res 2018; 261:220-224. [PMID: 29329038 DOI: 10.1016/j.psychres.2017.12.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/22/2017] [Accepted: 12/31/2017] [Indexed: 11/21/2022]
Abstract
Hallucinations occur in the context of many disorders. When experienced as distressing, they are a likely cause of presentation to emergency departments. Knowledge about the rates, diagnoses, and associated costs of hallucinations in emergency departments however is currently lacking. In this study, we analysed patients' presenting complaints in Western Australia's Emergency Department Data Collection dataset during a two year period (n = 1,798,754). Visits to emergency departments because of distressing hallucinations were more common than previously assumed. Hallucinations (auditory, visual, undifferentiated modality) accounted for 1.8% of all mental health-related presentations and 0.09% of all general health presentations (84.7 per 100,000 persons). Psychotic disorders accounted for a third of all presentations, and hallucinations without a clear medical or psychiatric cause represented 17% of the sample. Hallucination presentations had significantly prolonged lengths of stay compared to other mental health presentations (15 vs 7.5h, p < 0.001) and were linked to frequent re-admissions (average of 7.4 visits per year). Cost estimates revealed that hallucinations were in the top-10 most costly mental health complaint, and twice as costly to treat as delusions. Altogether, the service utilisation and care needs of people with distressing hallucinations outside of mental health services appear much larger than usually estimated.
Collapse
|
48
|
Fernandes TMP, Andrade SM, de Andrade MJO, Nogueira RMTBL, Santos NA. Colour discrimination thresholds in type 1 Bipolar Disorder: a pilot study. Sci Rep 2017; 7:16405. [PMID: 29180712 PMCID: PMC5703961 DOI: 10.1038/s41598-017-16752-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/16/2017] [Indexed: 11/09/2022] Open
Abstract
Although some studies have reported perceptual changes in psychosis, no definitive conclusions have been drawn about visual disturbances that are related to bipolar disorder (BPD). The purpose of the present study was to evaluate colour vision in BPD patients. Data were recorded from 24 participants: healthy control group (n = 12) and type 1 BPD group (n = 12). The participants were 20-45 years old and they were free from neurological disorders and identifiable ocular disease and had normal or corrected-to-normal visual acuity. Colour discrimination was evaluated using the Lanthony D-15d, Trivector and Ellipse tests, using a psychophysical forced-choice method. The relationship of visual measures to mood state and cognitive function was also investigated. The results showed that BPD patients had higher colour discrimination thresholds in the D15d (p < 0.001), Trivector (p < 0.001) and Ellipse (p < 0.01) tests compared with healthy controls. Linear regression analysis showed that mood state was related to colour discrimination. BPD individuals were not impaired in cognitive tasks. The present study provided new evidence of potential links between type 1 BPD and visual processing impairments. This research suggests a new direction for studies and the need for research in this field of study.
Collapse
Affiliation(s)
- Thiago Monteiro Paiva Fernandes
- Cognitive Neuroscience and Behaviour Program, Federal University of Paraiba, Joao Pessoa, Brazil.
- Perception, Neuroscience and Behaviour Laboratory, Federal University of Paraiba, Joao Pessoa, Brazil.
| | - Suellen Marinho Andrade
- Cognitive Neuroscience and Behaviour Program, Federal University of Paraiba, Joao Pessoa, Brazil
| | | | | | - Natanael Antonio Santos
- Cognitive Neuroscience and Behaviour Program, Federal University of Paraiba, Joao Pessoa, Brazil
- Perception, Neuroscience and Behaviour Laboratory, Federal University of Paraiba, Joao Pessoa, Brazil
| |
Collapse
|
49
|
Kazour F, Richa S, Desmidt T, Lemaire M, Atanasova B, El Hage W. Olfactory and gustatory functions in bipolar disorders: A systematic review. Neurosci Biobehav Rev 2017; 80:69-79. [DOI: 10.1016/j.neubiorev.2017.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 05/09/2017] [Indexed: 01/01/2023]
|
50
|
Kamperman AM, Veldman-Hoek MJ, Wesseloo R, Robertson Blackmore E, Bergink V. Phenotypical characteristics of postpartum psychosis: A clinical cohort study. Bipolar Disord 2017; 19:450-457. [PMID: 28699248 DOI: 10.1111/bdi.12523] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 06/12/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Postpartum psychosis (PP) is known for its clear onset but its phenotype has never been clearly described in a cohort. The aim of this study was to describe PP symptomatology, and to identify subgroups of patients based on symptom profiles. METHODS We prospectively assessed a wide range of symptoms in cases of PP in a cohort of women (N=130) admitted to the Mother-Baby inpatient unit. Using a person-centered analytic approach, we distinguished mutually exclusive subgroups of women. Subgroups were related to demographic and clinical characteristics. RESULTS The most prevalent symptoms of PP were irritability (73%), abnormal thought content (72%), and anxiety (71%). Suicidal and infanticidal ideation was present in 19% and 8% of patients, respectively. Delusions and hallucinations often had a negative content. Latent class analysis revealed three symptom profiles, a manic (34%), depressive (41%) and atypical (25%) profile, respectively. The manic profile is characterized by manic symptoms and agitation, the depressive profile by depressive and anxiety symptoms, and the atypical profile by disturbance of consciousness and disorientation. In women with a depressive profile, treatment was started 2 weeks later (P=.049), and more often voluntarily, than in manic and atypical women (P=.037). CONCLUSIONS We distinguished subgroups of PP patients with a manic, depressive, and atypical profile. Disturbance of consciousness, disorientation, and depersonalization/derealization were less prevalent than previously suggested in the literature. Instead, the depressive profile was the most prevalent, but the depressive profile can easily remain undetected, which could lead to treatment delay and risk of suicide/infanticide. Within the manic profile, irritability was highly prevalent and occurred more often than elevated mood.
Collapse
Affiliation(s)
- Astrid M Kamperman
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marian J Veldman-Hoek
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.,Antes Center for Mental Health Care, Rotterdam, The Netherlands
| | - Richard Wesseloo
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Veerle Bergink
- Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|