1
|
Ver Loren van Themaat AH, Uddin MJ, Christiani CJ, Hemager N, Ellersgaard D, Klee Burton B, Spang KS, Greve A, Gantriis D, Mors O, Elgaard Thorup AA, Plessen KJ, Nordentoft M, Møllegaard Jepsen JR. Odor identification in 7-year-old children at familial high risk of schizophrenia or bipolar disorder - the Danish high risk and resilience study VIA 7. Schizophr Res 2020; 216:77-84. [PMID: 31924376 DOI: 10.1016/j.schres.2019.12.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Odor identification deficits occur in individuals with schizophrenia and their unaffected first-degree relatives, while deficits are less pronounced in individuals with bipolar disorder. We hypothesized that children at familial high-risk for schizophrenia (FHR-SZ) show odor identification deficits compared to population-based controls and that children at familial high-risk for bipolar disorder (FHR-BP) perform intermediate. METHODS Odor identification was assessed at age 7 in 184 children with FHR-SZ, 106 children with FHR-BP, and 186 population-based controls with the Brief Smell Identification Test. Dimensional and predefined categorical outcomes were used in the analyses. Potential relationships with psychopathological, cognitive, and home environmental variables were conducted using hierarchical and logistic multiple regression analyses. RESULTS ANOVA revealed no between-group differences in odor identification. Using the recommended cut-off (below 5), we found a significantly greater proportion of boys at FHR-SZ than population-based boys with an abnormal odor identification (p = .013). However, a supplementary analysis using a Danish-based cut-off (below 4) did not support this. All children showed significant, positive associations of odor identification with female gender, social responsiveness, and verbal working memory. Lower social responsiveness predicted abnormal odor identification in boys at FHR-SZ, only using the recommended cut-off. CONCLUSIONS Odor identification efficacy and risk status appear independent in this early developmental phase. Using the recommended threshold, abnormal odor identification is more frequent in young boys at FHR-SZ than in population-based boys and is linked to lower social responsiveness. The validity of these results is questioned by non-significant differences in the rates when using an exploratory Danish-based threshold.
Collapse
Affiliation(s)
- Anna Hester Ver Loren van Themaat
- Child and Adolescent Mental Health Centre, Mental Health Services, Gentofte Hospitalsvej, Entrance 15, 4th Floor, DK-2900, Hellerup, Copenhagen, Capital Region of Denmark, Denmark.
| | - Md Jamal Uddin
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Copenhagen Gentofte Hospitalsvej 15, 4th Floor, Hellerup, DK-2900 Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark; Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-10104 Copenhagen, Denmark
| | - Camilla Jerlang Christiani
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Copenhagen Gentofte Hospitalsvej 15, 4th Floor, Hellerup, DK-2900 Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark
| | - Nicoline Hemager
- Child and Adolescent Mental Health Centre, Mental Health Services, Gentofte Hospitalsvej, Entrance 15, 4th Floor, DK-2900, Hellerup, Copenhagen, Capital Region of Denmark, Denmark; Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Copenhagen Gentofte Hospitalsvej 15, 4th Floor, Hellerup, DK-2900 Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark
| | - Ditte Ellersgaard
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Copenhagen Gentofte Hospitalsvej 15, 4th Floor, Hellerup, DK-2900 Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Centre, Mental Health Services, Gentofte Hospitalsvej, Entrance 15, 4th Floor, DK-2900, Hellerup, Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark
| | - Katrine Søborg Spang
- Child and Adolescent Mental Health Centre, Mental Health Services, Gentofte Hospitalsvej, Entrance 15, 4th Floor, DK-2900, Hellerup, Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, DK-8200 Aarhus, Denmark
| | - Ditte Gantriis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, DK-8200 Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, DK-8200 Aarhus, Denmark
| | - Anne Amalie Elgaard Thorup
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Copenhagen Gentofte Hospitalsvej 15, 4th Floor, Hellerup, DK-2900 Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark
| | - Kerstin Jessica Plessen
- Child and Adolescent Mental Health Centre, Mental Health Services, Gentofte Hospitalsvej, Entrance 15, 4th Floor, DK-2900, Hellerup, Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark; Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Avenue d'Echallens 9, CH-1004 Lausanne, Switzerland
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Copenhagen Gentofte Hospitalsvej 15, 4th Floor, Hellerup, DK-2900 Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Child and Adolescent Mental Health Centre, Mental Health Services, Gentofte Hospitalsvej, Entrance 15, 4th Floor, DK-2900, Hellerup, Copenhagen, Capital Region of Denmark, Denmark; Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Mental Health Services, Copenhagen Gentofte Hospitalsvej 15, 4th Floor, Hellerup, DK-2900 Copenhagen, Capital Region of Denmark, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark; Center for Neuropsychiatric Schizophrenia Research, Mental Health Services, Glostrup, Ndr. Ringvej 29-67, Copenhagen DK-2600, Capital Region of Denmark, Denmark; Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services, Nordstjernevej 41, Glostrup, Copenhagen DK-2600, Capital Region of Denmark, Denmark
| |
Collapse
|
2
|
Lin A, Brewer WJ, Yung AR, Nelson B, Pantelis C, Wood SJ. Olfactory identification deficits at identification as ultra-high risk for psychosis are associated with poor functional outcome. Schizophr Res 2015; 161:156-62. [PMID: 25476117 DOI: 10.1016/j.schres.2014.10.051] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 10/27/2014] [Accepted: 10/27/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND We have previously reported that olfactory identification (OI) deficits are a promising premorbid marker of transition from ultra-high risk (UHR) to schizophrenia, but not to psychotic illness more generally. Whether this remains the case at longer follow-up, and whether there is decline in OI ability are unclear. METHOD The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 81 participants at baseline (identification of risk for psychosis) and 254 individuals at follow-up. Forty-nine participants underwent UPSIT assessment at both time points. UPSIT scores were investigated at an average of 7.08years after identification of risk in relation to transition to psychosis, a diagnosis of schizophrenia, and psychosocial/functional outcome. RESULTS UPSIT scores at baseline and follow-up did not differ between participants who transitioned to psychosis and those who did not. Similarly, there were no significant differences on UPSIT scores at baseline or follow-up between individuals with a diagnosis of schizophrenia and transitioned individuals without schizophrenia. Those with a poor functional outcome showed significantly lower baseline UPSIT scores than participants with good outcome. There was no significant association between functional outcome and follow-up UPSIT scores. There were no significant changes in UPSIT over time for any group. CONCLUSIONS These results suggest that impaired OI is not a good marker of the onset of psychosis and schizophrenia, but may differentiate UHR individuals who experience a poor functional outcome, regardless of transition status.
Collapse
Affiliation(s)
- A Lin
- Telethon Kids Institute, The University of Western Australia, Australia.
| | - W J Brewer
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - A R Yung
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia; Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - B Nelson
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia
| | - S J Wood
- Telethon Kids Institute, The University of Western Australia, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia
| |
Collapse
|
3
|
Kamath V, Turetsky BI, Calkins ME, Kohler CG, Conroy CG, Borgmann-Winter K, Gatto DE, Gur RE, Moberg PJ. Olfactory processing in schizophrenia, non-ill first-degree family members, and young people at-risk for psychosis. World J Biol Psychiatry 2014; 15:209-18. [PMID: 22070564 PMCID: PMC3922881 DOI: 10.3109/15622975.2011.615862] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES While deficits in odor identification and discrimination have been reported in schizophrenia, few studies have examined the relative specificity of these deficits in patients and at-risk youth. METHOD Sniffin' Sticks odor identification and discrimination were assessed in schizophrenia outpatients and non-ill first-degree relatives (Study One), as well as youth at clinical (CR) or genetic (GR) risk for schizophrenia (Study Two). Scores were z-transformed, using the performance of a demographically-matched adult or adolescent comparison group. RESULTS Patients and relatives were impaired on odor identification, but odor discrimination impairment was limited to the patient group. A similar pattern of impairment emerged in at-risk youth. GR youth were impaired on odor identification but not discrimination, while CR youth were impaired on both tasks. In patients, olfactory impairment was correlated with negative symptomatology. CONCLUSIONS To our knowledge, this is the first study to show that CR youth are impaired on both olfactory tasks, as observed in adult schizophrenia patients. GR youth were impaired only on odor identification like their adult counterparts. These data suggest that odor identification impairment, in isolation, may represent a genetic marker of vulnerability for schizophrenia, while odor discrimination deficits may be a biomarker associated with the development of psychosis.
Collapse
Affiliation(s)
- Vidyulata Kamath
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA,Correspondence to: Vidya Kamath, Ph.D., Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Medical Center, 3400 Spruce Street, 10 Floor – Gates Building, Philadelphia, PA 19104. Telephone: 215.839.9193 Fax: 215.662.7903
| | - Bruce I. Turetsky
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA USA
| | - Monica E. Calkins
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA
| | - Christian G. Kohler
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA
| | - Catherine G. Conroy
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA
| | - Karin Borgmann-Winter
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA,Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Dana E. Gatto
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA
| | - Raquel E. Gur
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA,Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA USA
| | - Paul J. Moberg
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA USA,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA USA
| |
Collapse
|
4
|
Lee MR, Wehring HJ, McMahon RP, Linthicum J, Cascella N, Liu F, Bellack A, Buchanan RW, Strauss GP, Contoreggi C, Kelly DL. Effects of adjunctive intranasal oxytocin on olfactory identification and clinical symptoms in schizophrenia: results from a randomized double blind placebo controlled pilot study. Schizophr Res 2013; 145:110-5. [PMID: 23415472 PMCID: PMC4125132 DOI: 10.1016/j.schres.2013.01.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 12/21/2012] [Accepted: 01/03/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND Deficits in olfactory identification have been widely reported in patients with schizophrenia (SZ) and are associated with negative symptomatology. Adjunctive oxytocin delivered intranasally has been shown to improve some aspects of social cognition as well as positive and negative symptoms in patients with schizophrenia. Given the intranasal delivery route of oxytocin to olfactory pathways and that olfactory abnormalities are a potential endophenotype in SZ, we investigated the effect of intranasal oxytocin on olfactory identification as well as positive and negative symptoms in people with schizophrenia. METHODS Individuals with schizophrenia or schizoaffective disorder (n=28; 16 outpatients, 12 inpatients) were randomized to receive adjunctive intranasal oxytocin 20 IU BID or placebo for 3 weeks. RESULTS All 28 participants completed the clinical trial. Odor identification performance significantly improved on the University of Pennsylvania Smell Identification Test (UPSIT) total score and subscore for pleasant smells. UPSIT score (F=5.20, df=1,23, p=0.032) and subscore for pleasant smells (F=4.56, df=1,23, p=0.044), in patients treated with oxytocin were compared to placebo from baseline to endpoint. Global symptomatology as well as positive and negative symptoms were not improved by intranasal oxytocin. In fact, global symptoms, not positive or negative symptoms, improved in the placebo group. Secondary analysis shows that intranasal oxytocin improved negative symptoms in the small group of inpatients. Intranasal oxytocin was well tolerated during the three week trial. CONCLUSION Adjunctive intranasal oxytocin may improve olfactory identification, particularly in items of positive valence. Larger studies are needed to determine the effects of oxytocin on negative symptoms in SZ. (NCT00884897; http://www.clinicaltrials.gov).
Collapse
Affiliation(s)
- Mary R Lee
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD 21224, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Fusar-Poli P, Borgwardt S, Bechdolf A, Addington J, Riecher-Rössler A, Schultze-Lutter F, Keshavan M, Wood S, Ruhrmann S, Seidman LJ, Valmaggia L, Cannon T, Velthorst E, De Haan L, Cornblatt B, Bonoldi I, Birchwood M, McGlashan T, Carpenter W, McGorry P, Klosterkötter J, McGuire P, Yung A. The psychosis high-risk state: a comprehensive state-of-the-art review. JAMA Psychiatry 2013; 70:107-20. [PMID: 23165428 PMCID: PMC4356506 DOI: 10.1001/jamapsychiatry.2013.269] [Citation(s) in RCA: 985] [Impact Index Per Article: 89.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. OBJECTIVE To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. DATA SOURCES Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. STUDY SELECTION AND DATA EXTRACTION Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. DATA SYNTHESIS Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. CONCLUSIONS The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.
Collapse
Affiliation(s)
- Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK.
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | | | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
| | - Matcheri Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Stephen Wood
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia; School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Larry J. Seidman
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston
| | - Lucia Valmaggia
- Departments of Psychosis Studies and Psychology, King's College London, London, United Kingdom; OASIS team for prodromal psychosis, NHSSLAM Foundation Trust, London
| | - Tyrone Cannon
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Eva Velthorst
- Department of Early Psychosis, Academic Medical Center, Amsterdam, the Netherlands
| | - Lieuwe De Haan
- Department of Early Psychosis, Academic Medical Center, Amsterdam, the Netherlands
| | - Barbara Cornblatt
- Department of Psychiatry Research, The Zucker Hillside Hospital, New York, New York
| | - Ilaria Bonoldi
- OASIS team for prodromal psychosis, NHSSLAM Foundation Trust, London; Department of Psychosis Studies King's College London, London, United Kingdom
| | - Max Birchwood
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | | | - William Carpenter
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore
| | - Patrick McGorry
- Orygen Youth Health Research Centre, University of Melbourne, Melbourne
| | | | - Philip McGuire
- Department of Psychosis Studies King's College London, London, United Kingdom; OASIS team for prodromal psychosis, NHSSLAM Foundation Trust, London
| | - Alison Yung
- Orygen Youth Health Research Centre, University of Melbourne, Melbourne
| |
Collapse
|
6
|
Kamath V, Moberg PJ, Calkins ME, Borgmann-Winter K, Conroy CG, Gur RE, Kohler CG, Turetsky BI. An odor-specific threshold deficit implicates abnormal cAMP signaling in youths at clinical risk for psychosis. Schizophr Res 2012; 138:280-4. [PMID: 22537567 PMCID: PMC3372687 DOI: 10.1016/j.schres.2012.03.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 03/23/2012] [Accepted: 03/26/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND While olfactory deficits have been reported in schizophrenia and youths at-risk for psychosis, few studies have linked these deficits to current pathophysiological models of the illness. There is evidence that disrupted cyclic adenosine 3',5'-monophosphate (cAMP) signaling may contribute to schizophrenia pathology. As cAMP mediates olfactory signal transduction, the degree to which this disruption could manifest in olfactory impairment was ascertained. Odor-detection thresholds to two odorants that differ in the degree to which they activate intracellular cAMP were assessed in clinical risk and low-risk participants. METHOD Birhinal assessments of odor-detection threshold sensitivity to lyral and citralva were acquired in youths experiencing prodromal symptoms (n=17) and controls at low risk for developing psychosis (n=15). Citralva and lyral are odorants that differ in cAMP activation; citralva is a strong cAMP activator and lyral is a weak cAMP activator. RESULTS The overall group-by-odor interaction was statistically significant. At-risk youths showed significantly reduced odor detection thresholds for lyral, but showed intact detection thresholds for citralva. This odor-specific threshold deficit was uncorrelated with deficits in odor identification or discrimination, which were also present. ROC curve analysis revealed that olfactory performance correctly classified at-risk and low-risk youths with greater than 97% accuracy. CONCLUSIONS This study extends prior findings of an odor-specific hyposmia implicating cAMP-mediated signal transduction in schizophrenia and unaffected first-degree relatives to include youths at clinical risk for developing the disorder. These results suggest that dysregulation of cAMP signaling may be present during the psychosis prodrome.
Collapse
Affiliation(s)
- Vidyulata Kamath
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Paul J. Moberg
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Monica E. Calkins
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Karin Borgmann-Winter
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA,Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Catherine G. Conroy
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Raquel E. Gur
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA,Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Christian G. Kohler
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Bruce I. Turetsky
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| |
Collapse
|
7
|
Cohen AS, Brown LA, Auster TL. Olfaction, "olfiction," and the schizophrenia-spectrum: an updated meta-analysis on identification and acuity. Schizophr Res 2012; 135:152-7. [PMID: 22244185 DOI: 10.1016/j.schres.2011.12.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 12/08/2011] [Accepted: 12/12/2011] [Indexed: 11/15/2022]
Abstract
Olfaction deficits in individuals with schizophrenia are well documented. A meta-analysis conducted nearly a dozen years ago on the topic revealed a deficit of a full standard deviation in magnitude compared to nonpatient controls. Recent efforts have been attempted to determine whether deficits in olfactory identification and acuity reflect a vulnerability marker of schizophrenia-spectrum pathology. To address this issue, the present study conducted a meta-analysis of 16 studies of individuals with schizotypy, defined in terms of a) "ultra-high risk" status, b) having an affected biological family member, or c) having extreme scores on a schizotypy questionnaire. We also conducted an updated meta-analysis of 40 studies of olfactory functioning in schizophrenia. Consistent with the prior meta-analysis, patients with schizophrenia showed impairments in olfaction identification on a full standard deviation in magnitude (d = -.99). Individuals with schizotypy showed much more subtle (d = -.24) differences in olfaction, though the effect sizes were higher for studies examining individuals at "ultra-high risk" (d = -.67) versus studies examining individuals with psychometrically-defined (d = -.14) schizotypy. Differences in olfactory acuity, relative to their respective control groups, were small for both the schizophrenia (d = -.45) and schizotypy (d = -.38) studies but were similar in magnitude. The present findings argue against the notion that deficits in olfaction identification are a vulnerability marker of schizophrenia. Suggestions for future research are recommended.
Collapse
Affiliation(s)
- Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA 708080, United States.
| | | | | |
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW Olfaction is a field of growing interest in schizophrenia research. This article reviews recent studies on olfactory functions in schizophrenia. RECENT FINDINGS The current literature provides additional insights into olfactory deficits, abnormalities, and olfactory hedonic dysfunction in schizophrenia. Recent findings reinforce particular associations with negative symptoms and deficit syndrome schizophrenia. Studies indicate that abnormalities in patients with schizophrenia extend to more peripheral olfactory structures and functions, including olfactory receptor neuron dysfunction. Olfactory identification ability was found to relate to prodromal disorganization symptoms in young high-risk patients. Further support for the notion of a genetic contribution to olfactory dysfunction in schizophrenia derives from studies reporting physiological olfactory dysfunction (olfactory event-related potentials) in unaffected relatives, and an odor-specific hyposmia, present in both patients with schizophrenia and family members. SUMMARY Further research is needed to improve our understanding of olfactory dysfunction in schizophrenia. Recent encouraging findings underscore that the olfactory system is a field of research that holds promise for advancing our understanding of the pathophysiology of schizophrenia and possibly as a useful endophenotypic marker of neurodevelopmental vulnerability.
Collapse
|
9
|
Malhi GS. Recommendations. Acta Neuropsychiatr 2009; 21:105. [PMID: 26953747 DOI: 10.1111/j.1601-5215.2009.00393.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Gin S Malhi
- 1Discipline of Psychological Medicine, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|