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Wahbeh MH, Boyd RJ, Yovo C, Rike B, McCallion AS, Avramopoulos D. A functional schizophrenia-associated genetic variant near the TSNARE1 and ADGRB1 genes. HGG ADVANCES 2024; 5:100303. [PMID: 38702885 PMCID: PMC11130735 DOI: 10.1016/j.xhgg.2024.100303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/01/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
Recent collaborative genome-wide association studies (GWAS) have identified >200 independent loci contributing to risk for schizophrenia (SCZ). The genes closest to these loci have diverse functions, supporting the potential involvement of multiple relevant biological processes, yet there is no direct evidence that individual variants are functional or directly linked to specific genes. Nevertheless, overlap with certain epigenetic marks suggest that most GWAS-implicated variants are regulatory. Based on the strength of association with SCZ and the presence of regulatory epigenetic marks, we chose one such variant near TSNARE1 and ADGRB1, rs4129585, to test for functional potential and assay differences that may drive the pathogenicity of the risk allele. We observed that the variant-containing sequence drives reporter expression in relevant neuronal populations in zebrafish. Next, we introduced each allele into human induced pluripotent cells and differentiated four isogenic clones homozygous for the risk allele and five clones homozygous for the non-risk allele into neural progenitor cells. Employing RNA sequencing, we found that the two alleles yield significant transcriptional differences in the expression of 109 genes at a false discovery rate (FDR) of <0.05 and 259 genes at a FDR of <0.1. We demonstrate that these genes are highly interconnected in pathways enriched for synaptic proteins, axon guidance, and regulation of synapse assembly. Exploration of genes near rs4129585 suggests that this variant does not regulate TSNARE1 transcripts, as previously thought, but may regulate the neighboring ADGRB1, a regulator of synaptogenesis. Our results suggest that rs4129585 is a functional common variant that functions in specific pathways likely involved in SCZ risk.
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Affiliation(s)
- Marah H Wahbeh
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Rachel J Boyd
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Christian Yovo
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Bailey Rike
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Andrew S McCallion
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Dimitrios Avramopoulos
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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Feola B, Flook EA, Seo DJ, Fox V, Oler J, Heckers S, Woodward ND, Blackford JU. Altered brain and physiological stress responses in early psychosis. Schizophr Res 2024; 271:112-119. [PMID: 39024959 DOI: 10.1016/j.schres.2024.07.018] [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: 11/28/2023] [Revised: 07/05/2024] [Accepted: 07/07/2024] [Indexed: 07/20/2024]
Abstract
Stress is proposed to be a crucial factor in the onset and presentation of psychosis. The early stage of psychosis provides a window into how stress interacts with the emergence of psychosis. Yet, how people with early psychosis respond to stress remains unclear. The current study examined how stress responses (brain, physiological, self-report) differ in early psychosis. Forty participants (20 early psychosis [EP], 20 healthy controls [HC]) completed a stress task in the scanner that involved viewing stressful and neutral-relaxing images. Physiological responses (cortisol, heart rate) and self-report of stress were also assessed. Region of Interest analyses were conducted with brain regions previously shown to be activated during the stress task (amygdala, hippocampus, striatum, hypothalamus, prefrontal cortex [dorsolateral, ventrolateral, medial orbital]). Linear mixed models were used to test for effects of group (EP, HC) and emotion (stress, neutral-relaxing). HC had higher hippocampus activation to stress versus neutral-relaxing conditions while EP did not show a difference (group x emotion interaction, p = 0.04). There were also significant main effects of group with EP having higher amygdala activation (p = 0.01), ventrolateral prefrontal cortex activation (vlPFC, p = 0.03), self-report of stress (p = 0.01), and heart rate (p < 0.001). Our study found preliminary evidence that people with early psychosis showed heightened response to stressful and non-threatening situations, across multiple levels of stress responses. Our findings suggest a novel perspective on stress alterations in early psychosis and highlight the importance of considering both stressful and non-stressful situations.
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Affiliation(s)
- Brandee Feola
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, United States of America.
| | | | - Dongju J Seo
- Yale School of Medicine, United States of America
| | - Victoria Fox
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, United States of America
| | - Jesse Oler
- University of Miami School of Medicine, United States of America
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, United States of America
| | - Neil D Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, United States of America
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Oliver D, Chesney E, Cullen AE, Davies C, Englund A, Gifford G, Kerins S, Lalousis PA, Logeswaran Y, Merritt K, Zahid U, Crossley NA, McCutcheon RA, McGuire P, Fusar-Poli P. Exploring causal mechanisms of psychosis risk. Neurosci Biobehav Rev 2024; 162:105699. [PMID: 38710421 PMCID: PMC11250118 DOI: 10.1016/j.neubiorev.2024.105699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/17/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
Robust epidemiological evidence of risk and protective factors for psychosis is essential to inform preventive interventions. Previous evidence syntheses have classified these risk and protective factors according to their strength of association with psychosis. In this critical review we appraise the distinct and overlapping mechanisms of 25 key environmental risk factors for psychosis, and link these to mechanistic pathways that may contribute to neurochemical alterations hypothesised to underlie psychotic symptoms. We then discuss the implications of our findings for future research, specifically considering interactions between factors, exploring universal and subgroup-specific factors, improving understanding of temporality and risk dynamics, standardising operationalisation and measurement of risk and protective factors, and developing preventive interventions targeting risk and protective factors.
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Affiliation(s)
- Dominic Oliver
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK; OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Edward Chesney
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, UK
| | - Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, UK
| | - George Gifford
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sarah Kerins
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paris Alexandros Lalousis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Yanakan Logeswaran
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - Kate Merritt
- Division of Psychiatry, Institute of Mental Health, UCL, London, UK
| | - Uzma Zahid
- Department of Psychology, King's College London, London, UK
| | - Nicolas A Crossley
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Robert A McCutcheon
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK; OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11 5DL, UK
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Petti E, Schiffman J, Oh H, Karcher NR. Evidence for Environmental Risk Factors and Cumulative Stress Linking Racial/Ethnic Identity and Psychotic-Like Experiences in ABCD Study Data. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00311-3. [PMID: 38852932 DOI: 10.1016/j.jaac.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 04/14/2024] [Accepted: 05/31/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVE Previous work has found increased endorsement of psychotic-like experiences (PLEs) among marginalized racial and ethnic groups. According to social determinants frameworks, marginalized groups are at increased risk for exposure to socio-environmental risk factors, including systemic factors (eg, poverty and poor housing conditions) and social stressors (eg, discrimination). We examine the extent to which environmental risk factors and stress account for associations between racial/ethnic groups with PLEs. METHOD Analyses included 11,876 young adolescents 9 to 10 years of age from the Adolescent Brain Cognitive Development (ABCD) study. Mediation models assessed whether stress at 1-year follow-up indirectly linked baseline environmental risk to later distressing PLEs at 2-year follow-up. Serial mediation models examined whether environmental risk and stress indirectly accounted for variation among racial/ethnic groups in self-reported distressing PLEs. RESULTS Through principal component and mediation analyses, we found evidence that the link between environmental risk (eg, poverty and exposure to crime) and distressing PLEs was mediated by stress. There was also evidence that higher endorsement of distressing PLEs within the Black and Hispanic groups was serially mediated by greater environmental risk and greater stress. CONCLUSION The analyses provide evidence that the associations between marginalized racial and ethnic identities with the endorsement of PLEs partially reflects the sequelae of systemic socio-environmental factors. Findings suggest the potential for intervening upon environmental risk factors to target the reduction of cumulative stress over time, which may in turn buffer against the development of PLEs. PLAIN LANGUAGE SUMMARY Using longitudinal data from 11,876 young adolescents aged 9-10 from the Adolescent Brain Cognitive Development (ABCD) study, this study examined environmental (e.g., poverty) and stress-related factors (e.g., experiences of discrimination, childhood adversity) that are associated with psychotic-like experiences, and whether these factors explain racial/ethnic differences in psychotic-like experiences. The authors found evidence that the association between these environmental risk factors and psychotic-like experiences is partially explained by cumulative stress, and that differences in psychotic-like experiences across racial/ethnic groups were accounted for by both environmental risk factors and stress. Results highlight that systemic factors may explain higher levels of psychotic-like experiences among historically marginalized racial/ethnic groups. Findings suggest the potential for intervening upon modifiable risk factors to buffer against stress, and in turn, the development of psychotic-like experiences over time. DIVERSITY INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way.
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Affiliation(s)
- Emily Petti
- University of California, Irvine, California.
| | | | - Hans Oh
- University of Southern California Suzanne Dworak-Peck School of Social Work, Los Angeles, California
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Guimond S, Alftieh A, Devenyi GA, Mike L, Chakravarty MM, Shah JL, Parker DA, Sweeney JA, Pearlson G, Clementz BA, Tamminga CA, Keshavan M. Enlarged pituitary gland volume: a possible state rather than trait marker of psychotic disorders. Psychol Med 2024; 54:1835-1843. [PMID: 38357733 PMCID: PMC11132920 DOI: 10.1017/s003329172300380x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND Enlarged pituitary gland volume could be a marker of psychotic disorders. However, previous studies report conflicting results. To better understand the role of the pituitary gland in psychosis, we examined a large transdiagnostic sample of individuals with psychotic disorders. METHODS The study included 751 participants (174 with schizophrenia, 114 with schizoaffective disorder, 167 with psychotic bipolar disorder, and 296 healthy controls) across six sites in the Bipolar-Schizophrenia Network on Intermediate Phenotypes consortium. Structural magnetic resonance images were obtained, and pituitary gland volumes were measured using the MAGeT brain algorithm. Linear mixed models examined between-group differences with controls and among patient subgroups based on diagnosis, as well as how pituitary volumes were associated with symptom severity, cognitive function, antipsychotic dose, and illness duration. RESULTS Mean pituitary gland volume did not significantly differ between patients and controls. No significant effect of diagnosis was observed. Larger pituitary gland volume was associated with greater symptom severity (F = 13.61, p = 0.0002), lower cognitive function (F = 4.76, p = 0.03), and higher antipsychotic dose (F = 5.20, p = 0.02). Illness duration was not significantly associated with pituitary gland volume. When all variables were considered, only symptom severity significantly predicted pituitary gland volume (F = 7.54, p = 0.006). CONCLUSIONS Although pituitary volumes were not increased in psychotic disorders, larger size may be a marker associated with more severe symptoms in the progression of psychosis. This finding helps clarify previous inconsistent reports and highlights the need for further research into pituitary gland-related factors in individuals with psychosis.
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Affiliation(s)
- Synthia Guimond
- Department of Psychiatry, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
- Department of Psychiatry, Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ahmad Alftieh
- Department of Psychiatry, The Royal’s Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Gabriel A. Devenyi
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Luke Mike
- Department of Psychiatry, Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - M. Mallar Chakravarty
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Douglas Mental Health University Institute, Verdun, QC, Canada
- Department of Biomedical Engineering, McGill University Montréal, QC, Canada
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, QC, Canada
| | - Jai L. Shah
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Douglas Mental Health University Institute, Verdun, QC, Canada
| | - David A. Parker
- Department of Psychology, BioImaging Research Center, University of Georgia, Athens, GA, USA
- Department of and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - John A. Sweeney
- Department of Psychiatry, University of Cincinnati, Cincinnati, OH, USA
| | - Godfrey Pearlson
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Brett A. Clementz
- Department of Psychology, BioImaging Research Center, University of Georgia, Athens, GA, USA
- Department of and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - Carol A. Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Massachusetts Mental Health Center and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Yan YJ, Hu HX, Zhang YJ, Wang LL, Pan YM, Lui SSY, Huang J, Chan RCK. Reward motivation adaptation in people with negative schizotypal features: development of a novel behavioural paradigm and identifying its neural correlates using resting-state functional connectivity analysis. Eur Arch Psychiatry Clin Neurosci 2024; 274:941-953. [PMID: 37395812 DOI: 10.1007/s00406-023-01640-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/13/2023] [Indexed: 07/04/2023]
Abstract
Reward motivation in individuals with high levels of negative schizotypal traits (NS) has been found to be lower than that in their counterparts. But it is unclear that whether their reward motivation adaptively changes with external effort-reward ratio, and what resting-state functional connectivity (rsFC) is associated with this change. Thirty-five individuals with high levels of NS and 44 individuals with low levels of NS were recruited. A 3T resting-state functional brain scan and a novel reward motivation adaptation behavioural task were administrated in all participants. The behavioural task was manipulated with three conditions (effort > reward condition vs. effort < reward condition vs. effort = reward condition). Under each condition were rated 'wanting' and 'liking' for rewards. The seed-based voxel-wise rsFC analysis was conducted to explore the rsFCs associated with the 'wanting' and 'liking' ratings in individuals with high levels of NS. 'Wanting' and 'liking' ratings of individuals with high levels of NS significantly declined in the effort > reward condition but did not rebound as high as their counterparts in the effort < reward condition. The rsFCs in NS group associated with these ratings were altered. The altered rsFCs in NS group involved regions in the prefrontal lobe, dopaminergic brain regions (ventral tegmental area, substantia nigra), hippocampus, thalamus and cerebellum. Individuals with high levels of NS manifested their reward motivation adaptation impairment as a failure of adjustment adaptively during effort-reward imbalance condition and altered rsFCs in prefrontal, dopaminergic and other brain regions.
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Affiliation(s)
- Yong-Jie Yan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Sino-Danish College of University of Chinese Academy of Sciences, Beijing, People's Republic of China
- Sino-Danish Centre for Education and Research, Beijing, People's Republic of China
| | - Hui-Xin Hu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Yi-Jing Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Yi-Ming Pan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region , People's Republic of China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China.
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China.
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, People's Republic of China.
- Sino-Danish College of University of Chinese Academy of Sciences, Beijing, People's Republic of China.
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, People's Republic of China.
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Shah JL, Paquin V, McIlwaine SV, Malla AK, Joober R, Pruessner M. Examining the psychobiological response to acute social stress across clinical stages and symptom trajectories in the early psychosis continuum. Dev Psychopathol 2024; 36:774-786. [PMID: 36852607 DOI: 10.1017/s0954579423000056] [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: 03/01/2023]
Abstract
The stress-vulnerability model has been repeatedly highlighted in relation to the risk, onset and course of psychosis, and has been independently studied in clinical high-risk (CHR) and first-episode psychosis (FEP) populations. Notable in this literature, however, is that there are few studies directly comparing markers of stress response across progressive stages of illness. Here we examined the psychobiological response to the Trier Social Stress Test in 28 CHR (mean age 19.1) and 61 FEP (age 23.0) patients, in order to understand the stage(s) or trajectories in which differences in subjective stress or physiological response occur. The overall clinical sample had greater perceived stress and blunted cortisol (FEP + CHR, n = 89, age 21.7) compared with healthy controls (n = 45, age 22.9). Additional analyses demonstrated elevated heart rate and systolic blood pressure in FEP compared with CHR, but there were no further differences in physiological parameters (cortisol, heart rate, or blood pressure) between stage- or trajectory-based groups. Together, this suggests that individual stress response markers may differentially emerge at particular stages en route to psychosis - and demonstrates how stage-based analyses can shed light on the emergence and evolution of neurobiological changes in mental illness.
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Affiliation(s)
- Jai L Shah
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Vincent Paquin
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Sarah V McIlwaine
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Ashok K Malla
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, Canada
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Kammerer MK, Nowak U, Lincoln TM, Krkovic K. Revisiting Cognitive Deficits in Outpatients with Psychotic Disorders: A Transdiagnostic Comparison of Cognitive Performance While Accounting for Putative Confounding Factors. Brain Sci 2024; 14:446. [PMID: 38790425 PMCID: PMC11119287 DOI: 10.3390/brainsci14050446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 05/26/2024] Open
Abstract
Recent research suggests that cognitive deficits in individuals with psychotic disorders could be overestimated because poor cognitive test performance is partly attributable to non-cognitive factors. To further test this, we included non-hospitalized individuals with psychotic disorders (PSY, n = 38), individuals with attenuated psychotic symptoms (n = 40), individuals with obsessive-compulsive disorders (n = 39), and healthy controls (n = 38). Relevant cognitive domains were assessed using the MATRICS Consensus Cognitive Battery. Putative confounding non-cognitive factors-heart rate, self-reported stress, negative affect, performance-related beliefs, and actigraphy-derived sleep-were assessed before cognitive testing. A multivariate analysis of covariance was calculated to examine group differences in cognitive performance while controlling for non-cognitive factors. PSY showed decreased test performance in graphomotor speed, attention, and verbal tasks compared to the other groups, whereas non-verbal/visual-spatial tasks were unimpaired. After accounting for non-cognitive factors, group differences diminished in verbal learning, whereas differences in the other domains remained significant. Against our hypotheses, the present findings indicate that some cognitive deficits in PSY cannot be attributed to momentary confounding factors.
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Affiliation(s)
- Mathias Konstantin Kammerer
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany; (M.K.K.); (U.N.); (T.M.L.)
| | - Ulrike Nowak
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany; (M.K.K.); (U.N.); (T.M.L.)
| | - Tania M. Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany; (M.K.K.); (U.N.); (T.M.L.)
| | - Katarina Krkovic
- Clinical Psychology and Psychotherapy for Children and Youth, Department of Psychology, Faculty of Human Sciences, University of Potsdam, 14476 Potsdam, Germany
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9
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Oh H, Banawa R, Zhou S, DeVylder J, Koyanagi A. The mental and physical health correlates of psychotic experiences among US college students: Findings from the Healthy Mind Study 2020. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:834-840. [PMID: 35427464 DOI: 10.1080/07448481.2022.2058879] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/15/2021] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Psychotic experiences have been framed as a marker of mental and physical health status; however, more research is needed to confirm these associations in university populations. METHODS We analyzed data from the Healthy Minds Survey (Fall Semester Cohort 2020), which is a non-probability sample of students attending one of 28 universities in the United States, who completed an online survey (September 2020-December 2020). We used multivariable logistic regression to examine the associations between several mental and physical health conditions and psychotic experiences, adjusting for age, gender, sexual orientation race/ethnicity, and international student status. RESULTS In terms of mental health, all conditions were associated with greater odds of having lifetime psychotic experiences. Having at least one mental health condition was associated with 2.18 times greater odds of having lifetime psychotic experiences (aOR: 2.18; 95% CI: 1.96-2.42). In terms of physical health, having at least one physical health condition was associated with 1.37 times greater odds of having lifetime psychotic experiences (aOR: 1.37; 95% CI: 1.22-1.53), but only four conditions were associated with greater odds of lifetime psychotic experiences, which were: asthma, gastrointestinal disease, HIV/AIDS, and other chronic disease. The counts of mental and physical health conditions were associated with greater odds of lifetime psychotic experiences in a dose-dependent fashion. CONCLUSION Psychotic experiences appear to be an indicator for mental health problems and some physical health problems. More research is needed to determine whether assessing for psychotic experiences broadly can help identify at-risk individuals in university settings who may benefit from targeted preventive interventions.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, CA, USA
| | - Rachel Banawa
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Sasha Zhou
- Department of Public Health, Wayne State University, Detroit, MI, USA
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, Bronx, NY, USA
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
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10
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Walker EF, Aberizk K, Yuan E, Bilgrami Z, Ku BS, Guest RM. Developmental perspectives on the origins of psychotic disorders: The need for a transdiagnostic approach. Dev Psychopathol 2024:1-11. [PMID: 38406831 DOI: 10.1017/s0954579424000397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Research on serious mental disorders, particularly psychosis, has revealed highly variable symptom profiles and developmental trajectories prior to illness-onset. As Dante Cicchetti pointed out decades before the term "transdiagnostic" was widely used, the pathways to psychopathology emerge in a system involving equifinality and multifinality. Like most other psychological disorders, psychosis is associated with multiple domains of risk factors, both genetic and environmental, and there are many transdiagnostic developmental pathways that can lead to psychotic syndromes. In this article, we discuss our current understanding of heterogeneity in the etiology of psychosis and its implications for approaches to conceptualizing etiology and research. We highlight the need for examining risk factors at multiple levels and to increase the emphasis on transdiagnostic developmental trajectories as a key variable associated with etiologic subtypes. This will be increasingly feasible now that large, longitudinal datasets are becoming available and researchers have access to more sophisticated analytic tools, such as machine learning, which can identify more homogenous subtypes with the ultimate goal of enhancing options for treatment and preventive intervention.
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Affiliation(s)
- Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Katrina Aberizk
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Emerald Yuan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Zarina Bilgrami
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Ryan M Guest
- Department of Psychology, Emory University, Atlanta, GA, USA
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11
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Bahlinger K, Lincoln TM, Clamor A. Do deficits in subjective stress recovery predict subsequent stress sensitivity and symptoms in schizophrenia spectrum disorders? Schizophr Res 2024; 264:170-177. [PMID: 38150849 DOI: 10.1016/j.schres.2023.12.021] [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: 03/15/2023] [Revised: 11/23/2023] [Accepted: 12/17/2023] [Indexed: 12/29/2023]
Abstract
High levels of stress play a crucial role in the development of psychotic symptoms, such as paranoia, and may stem in part from recovery deficits after stress exposure. However, it remains unclear whether deficient recovery causes a build-up of heightened stress levels that increases stress sensitivity and symptoms when exposed to another stressor. To test this, we investigated the effect of subjective stress recovery on the response to a subsequent stressor and paranoia. We applied two consecutive runs of the same combined physical and cognitive stressor separated by a recovery phase of 60 min in individuals with schizophrenia spectrum disorders (n = 49). We repeatedly assessed self-reported stress, negative affect, heart rate, heart rate variability, salivary cortisol, and paranoia. Recovery of self-reported stress was defined as the geometric mean of the percentage changes of self-reported stress during recovery after the first stressor, and was regressed on the response to the second stressor controlling for self-reported stress during the first stressor. Lower subjective stress recovery predicted higher levels of self-reported stress, negative affect, and paranoia in response to the second stressor. The subjective stress recovery was not predictive of the physiological stress response (heart rate, heart rate variability, or salivary cortisol). Taken together, the findings indicate that recovery deficits could contribute to high levels of self-reported stress, negative affect, and paranoia in schizophrenia spectrum disorders and that the improvement of stress recovery could be a promising approach for interventions.
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Affiliation(s)
- Katrin Bahlinger
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Germany.
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Germany
| | - Annika Clamor
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Sciences, Universität Hamburg, Germany
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12
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Cullen AE, Labad J, Oliver D, Al-Diwani A, Minichino A, Fusar-Poli P. The Translational Future of Stress Neurobiology and Psychosis Vulnerability: A Review of the Evidence. Curr Neuropharmacol 2024; 22:350-377. [PMID: 36946486 PMCID: PMC10845079 DOI: 10.2174/1570159x21666230322145049] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/17/2022] [Accepted: 12/27/2022] [Indexed: 03/23/2023] Open
Abstract
Psychosocial stress is a well-established risk factor for psychosis, yet the neurobiological mechanisms underlying this relationship have yet to be fully elucidated. Much of the research in this field has investigated hypothalamic-pituitary-adrenal (HPA) axis function and immuno-inflammatory processes among individuals with established psychotic disorders. However, as such studies are limited in their ability to provide knowledge that can be used to develop preventative interventions, it is important to shift the focus to individuals with increased vulnerability for psychosis (i.e., high-risk groups). In the present article, we provide an overview of the current methods for identifying individuals at high-risk for psychosis and review the psychosocial stressors that have been most consistently associated with psychosis risk. We then describe a network of interacting physiological systems that are hypothesised to mediate the relationship between psychosocial stress and the manifestation of psychotic illness and critically review evidence that abnormalities within these systems characterise highrisk populations. We found that studies of high-risk groups have yielded highly variable findings, likely due to (i) the heterogeneity both within and across high-risk samples, (ii) the diversity of psychosocial stressors implicated in psychosis, and (iii) that most studies examine single markers of isolated neurobiological systems. We propose that to move the field forward, we require well-designed, largescale translational studies that integrate multi-domain, putative stress-related biomarkers to determine their prognostic value in high-risk samples. We advocate that such investigations are highly warranted, given that psychosocial stress is undoubtedly a relevant risk factor for psychotic disorders.
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Affiliation(s)
- Alexis E. Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Solna, Sweden
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Javier Labad
- CIBERSAM, Sabadell, Barcelona, Spain
- Department of Mental Health and Addictions, Consorci Sanitari del Maresme, Mataró, Spain
| | - Dominic Oliver
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Adam Al-Diwani
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Amedeo Minichino
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- National Institute of Health Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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Oh H, Du J, Karcher NR, van der Ven E, DeVylder JE, Smith L, Koyanagi A. The separate and joint effects of recent interpersonal abuse and cannabis use on psychotic experiences: findings from students in higher education in the United States. Soc Psychiatry Psychiatr Epidemiol 2024; 59:77-85. [PMID: 37093229 PMCID: PMC10799783 DOI: 10.1007/s00127-023-02483-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Various forms of interpersonal abuse (e.g., physical, emotional, sexual) and cannabis use across the lifespan have both been known to increase odds of psychotic experiences; however, there have been few studies examining their separate and joint effects in the United States. METHODS We analyzed data from the Healthy Minds Study (2020-2021) and used multivariable logistic regression and interaction contrast ratios to assess separate and joint effects of interpersonal abuse (past 12 months) and cannabis use (past 30 days) on psychotic experiences (past 12 months). RESULTS Students who only used cannabis had significantly greater odds of psychotic experiences (aOR: 1.70; 95% CI 1.58-1.82), as well as those who only experienced interpersonal abuse (aOR: 2.40; 95% CI 2.25-2.56). However, those who reported both cannabis use and interpersonal abuse had the greatest odds, exceeding the sum of these individual effects (the combined effect aOR: 3.46; 95% CI 3.19-3.76). CONCLUSIONS Recent interpersonal abuse and recent cannabis use both separately and jointly increase odds of having recent psychotic experiences. Future research should continue to examine the potential interactive and additive impact of multiple known exposures to better inform primary and secondary prevention efforts.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, USA.
| | - Jinyu Du
- Southern Methodist University, Dallas, USA
| | - Nicole R Karcher
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, USA
| | - Els van der Ven
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain
- ICREA, Barcelona, Spain
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Wahbeh MH, Boyd RJ, Yovo C, Rike B, McCallion AS, Avramopoulos D. A Functional Schizophrenia-associated genetic variant near the TSNARE1 and ADGRB1 genes. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.18.570831. [PMID: 38187620 PMCID: PMC10769312 DOI: 10.1101/2023.12.18.570831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Recent collaborative genome wide association studies (GWAS) have identified >200 independent loci contributing to risk for schizophrenia (SCZ). The genes closest to these loci have diverse functions, supporting the potential involvement of multiple relevant biological processes; yet there is no direct evidence that individual variants are functional or directly linked to specific genes. Nevertheless, overlap with certain epigenetic marks suggest that most GWAS-implicated variants are regulatory. Based on the strength of association with SCZ and the presence of regulatory epigenetic marks, we chose one such variant near TSNARE1 and ADGRB1, rs4129585, to test for functional potential and assay differences that may drive the pathogenicity of the risk allele. We observed that the variant-containing sequence drives reporter expression in relevant neuronal populations in zebrafish. Next, we introduced each allele into human induced pluripotent cells and differentiated 4 isogenic clones homozygous for the risk allele and 5 clones homozygous for the non-risk allele into neural precursor cells. Employing RNA-seq, we found that the two alleles yield significant transcriptional differences in the expression of 109 genes at FDR <0.05 and 259 genes at FDR <0.1. We demonstrate that these genes are highly interconnected in pathways enriched for synaptic proteins, axon guidance, and regulation of synapse assembly. Exploration of genes near rs4129585 suggests that this variant does not regulate TSNARE1 transcripts, as previously thought, but may regulate the neighboring ADGRB1, a regulator of synaptogenesis. Our results suggest that rs4129585 is a functional common variant that functions in specific pathways likely involved in SCZ risk.
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Affiliation(s)
- Marah H Wahbeh
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Rachel J Boyd
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Christian Yovo
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Bailey Rike
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Andrew S McCallion
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Dimitrios Avramopoulos
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Cavaleri D, Capogrosso CA, Guzzi P, Bernasconi G, Re M, Misiak B, Crocamo C, Bartoli F, Carrà G. Blood concentrations of anterior pituitary hormones in drug-naïve people with first-episode psychosis: A systematic review and meta-analysis. Psychoneuroendocrinology 2023; 158:106392. [PMID: 37778198 DOI: 10.1016/j.psyneuen.2023.106392] [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: 06/11/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION The role of anterior pituitary hormones - i.e., adrenocorticotropic hormone (ACTH), luteinizing and follicle stimulating hormones (LH and FSH), growth hormone (GH), prolactin (PRL), and thyroid-stimulating hormone (TSH) - in early schizophrenia and psychoses unclear. We thus performed a systematic review and meta-analysis on the blood concentrations of ACTH, LH and FSH, GH, PRL, and TSH in drug-naïve people with first-episode psychosis (FEP) as compared with healthy controls. METHODS We searched Embase, MEDLINE, and PsycInfo for articles indexed until September 2022. Data quality was appraised. Random-effects meta-analyses were carried out, generating pooled standardized mean differences (SMDs). Between-study heterogeneity was estimated using the I2 statistic. Sensitivity and meta-regression analyses were performed. RESULTS Twenty-six studies were included. Drug-naïve people with FEP, compared to healthy subjects, had higher blood concentrations of ACTH (k = 7; N = 548; SMD = 0.62; 95%CI: 0.29 to 0.94; p < 0.001; I2 = 60.9%) and PRL (k = 17; N = 1757; SMD = 0.85; 95%CI: 0.56 to 1.14; p < 0.001; I2 = 85.5%) as well as lower levels of TSH (k = 6; N = 677; SMD = -0.34; 95%CI: -0.54 to -0.14; p = 0.001; I2 = 29.1%). Meta-regressions did not show any moderating effect of age (p = 0.78), sex (p = 0.21), or symptom severity (p = 0.87) on PRL concentrations in drug-naïve FEP. Available data were not sufficient to perform meta-analyses on FSH, LH, and GH. CONCLUSIONS Drug-naïve people with FEP have altered ACTH, PRL, and TSH blood concentrations, supporting the hypothesis that an abnormal anterior pituitary hormone secretion may be involved in the onset of schizophrenia and psychoses. Further research is needed to elucidate the role of pituitary hormones in FEP.
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Affiliation(s)
- Daniele Cavaleri
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy.
| | | | - Pierluca Guzzi
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Gianna Bernasconi
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Martina Re
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy; Division of Psychiatry, University College London, Maple House 149, London W1T 7BN, United Kingdom
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Dixon T, Cadenhead KS. Cannabidiol versus placebo as adjunctive treatment in early psychosis: study protocol for randomized controlled trial. Trials 2023; 24:775. [PMID: 38037108 PMCID: PMC10691114 DOI: 10.1186/s13063-023-07789-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Psychotic disorders are a leading cause of disability in young adults. Antipsychotics have been the primary intervention for psychosis for over 60 years, and yet, we have made little progress in treating negative symptoms, neurocognition, and functional disability. There is growing evidence that cannabidiol (CBD) is effective in treating positive psychotic symptoms, possibly also negative and neurocognitive symptoms, and moreover is well tolerated compared to other psychotropic medications. Anecdotally, patients participating in the Cognitive Assessment and Risk Evaluation (CARE) Early Psychosis Treatment Program at the University of California, San Diego, are self-administering CBD and report subjective improvement in stress, anxiety, and ability to cope with symptoms. The overarching aim of the trial is to explore the effectiveness of CBD augmentation on symptoms and neurocognition in early psychosis while also exploring the mechanism of action of CBD and predictors of response to treatment. The mechanism by which cannabidiol has a therapeutic effect on psychosis is poorly understood. Recent evidence has suggested that CBD may reduce stress and pro-inflammatory biomarker levels. Endocannabinoids also have powerful roles in eating behavior, reward, and mood, indicating these neurotransmitters may play a role in reducing hyperphagia and metabolic abnormalities that are present early in the course of psychotic illness and exacerbated by antipsychotic medication. The neurophysiological effects of CBD have been studied in animal models of psychosis that show improvements in information processing in response to CBD, but there are no studies in individuals with early psychosis. METHOD A total of 120 individuals in the early stages of psychosis will be randomized to 1000 mg of CBD versus placebo as an adjunct to existing treatment in a 8-week, double-blind superiority randomized control trial. The primary outcome measures are symptoms and neurocognition. DISCUSSION We hypothesized that CBD will improve symptoms and neurocognition as well as secondary outcome measures of neurohormones, inflammation, eating behaviors, and information processing. Importantly, predictors, moderators, and mediators of the CBD effects will be examined. A better understanding of which individuals are likely to respond to CBD can inform treatment planning and personalize treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT04411225. Registered on June 2, 2020.
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Affiliation(s)
- T Dixon
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0810, La Jolla, CA, 92093-0810, USA
| | - K S Cadenhead
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive 0810, La Jolla, CA, 92093-0810, USA.
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Giannopoulou I, Georgiades S, Stefanou MI, Spandidos DA, Rizos E. Links between trauma and psychosis (Review). Exp Ther Med 2023; 26:386. [PMID: 37456168 PMCID: PMC10347243 DOI: 10.3892/etm.2023.12085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/07/2023] [Indexed: 07/18/2023] Open
Abstract
The relationship between trauma and psychosis is complex and multifaceted, with evidence suggesting that trauma can be both a risk factor for the development of psychosis and a consequence of psychotic experiences. The present review aimed to provide an overview of the current state of knowledge on the relationship between trauma and psychosis, including historical and conceptual considerations, as well as epidemiological evidence. The potential explanation of the link between trauma and psychosis is provided through available models and similarities in their neurobiological associations. Overall, the research confirms the relationship between trauma and psychosis, and suggests that individuals with a co-occurring history of trauma and psychosis may have increased symptom severity and worse functional outcomes compared with individuals with psychosis alone. Future research should focus on elucidating the underlying causal pathways between trauma exposure and psychosis in order to inform effective treatment approaches aiming to prevent the intensification of psychotic symptoms and processes.
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Affiliation(s)
- Ioanna Giannopoulou
- Second Department of Psychiatry, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Stelios Georgiades
- Department of Basic Clinical Sciences, Medical School, University of Nicosia, 2415 Nicosia, Cyprus
| | - Maria-Ioanna Stefanou
- Second Department of Neurology, School of Medicine, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Emmanouil Rizos
- Second Department of Psychiatry, Attikon University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
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Datta A, Choudhary S, Soni S, Misra R, Singh K. Altered Heart Rate Variability During Rest in Schizophrenia: A State Marker. Cureus 2023; 15:e44145. [PMID: 37753044 PMCID: PMC10518643 DOI: 10.7759/cureus.44145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Autonomic nervous system (ANS) imbalance has been reported in a number of psychiatric disorders such as depression, schizophrenia, panic disorder, etc. Autonomic dysfunction in schizophrenia has been associated with the symptoms and manifestation of psychosis. Heart rate variability (HRV) as a tool has been widely used to assess ANS activity and the effect of disease on the sympathovagal balance. Therefore, in the present study, HRV derived from electrocardiogram (ECG) lead II at rest was investigated in order to understand the changes in frequency domain measures in patients with schizophrenia and their first-degree relatives compared to healthy controls. METHODS Twenty-five patients with schizophrenia, 24 first-degree relatives of patients, and 24 healthy controls (Diagnostic and Statistical Manual of Mental Disorders (DSM)-5; 18-45 years) were included in the study. HRV of the subjects was measured after five minutes of rest. ECG lead II was recorded for five minutes and HRV was analysed in the frequency domain: low frequency (LF), high frequency (HF), total power, and LF/HF ratio. HRV parameters and heart rate were statistically analysed for group comparisons using general linear model multivariate analysis. RESULTS Patients had significantly higher minimum heart rate and lower HF (normalized units (nu)) compared to their first-degree relatives. A trend was observed in HF (nu) with the lowest in patients followed by healthy controls and first-degree relatives and LF/HF ratio was the highest in patients followed by healthy controls and first-degree relatives, although not statistically significant. No significant difference was found between first-degree relatives and healthy controls. CONCLUSION The alteration of HRV in schizophrenia could be attributed to reduction in vagal tone and sympathetic dominance, which in turn could serve as state markers of schizophrenia.
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Affiliation(s)
- Anjum Datta
- Physiology, Subharti Medical College and Associated Chhatrapati Shivaji Subharti Hospital, Meerut, IND
| | - Sandeep Choudhary
- Psychiatry, Subharti Medical College and Associated Chhatrapati Shivaji Subharti Hospital, Meerut, IND
| | - Sunaina Soni
- Physiology, Subharti Medical College and Associated Chhatrapati Shivaji Subharti Hospital, Meerut, IND
| | - Rajesh Misra
- Physiology, Subharti Medical College and Associated Chhatrapati Shivaji Subharti Hospital, Meerut, IND
| | - Kiran Singh
- Physiology, Subharti Medical College and Associated Chhatrapati Shivaji Subharti Hospital, Meerut, IND
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Torrecilla P, Barrantes-Vidal N. The moderating role of hair cortisol in the association of early and recent stress with stress-related phenotypes. Front Psychol 2023; 14:1150142. [PMID: 37416538 PMCID: PMC10320289 DOI: 10.3389/fpsyg.2023.1150142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
BackgroundIncreased hair cortisol concentrations (HCC) have been found in clinical samples of schizophrenia, first episode psychosis and clinical risk for psychosis, but evidence of such is scarce in schizotypy. High HCC are supposed to reflect elevated chronic stress. However, HCC were not directly associated with adversity measures and stress-related phenotypes in previous research. This study tested whether HCC moderated the association between a comprehensive range of psychosocial stressors with several stress-related phenotypes in a sample of nonclinical young adults. It was expected that stressors, either distal (i.e., early-life) or recent, would be associated with subclinical features, particularly for those with elevated HCC, reflecting the effects of a potential biological sensitization to stress.MethodsThe sample comprised 132 nonclinical young adults belonging to the Barcelona Longitudinal Investigation of Schizotypy Study (BLISS). Participants completed a questionnaire of childhood adversity and two complementary measures of recent life events, tapping threatening vs. more general life events. Both the frequency and subjective impact (positive vs. negative) of general life events were also assessed. Psychotic (i.e., schizotypy, suspiciousness) and non-psychotic (i.e., depression, anxiety) subclinical features as well as appraisals of perceived stress were examined. Hierarchical linear regressions and simple slope analyses were computed.ResultsHCC moderated the effects of both early and recent stress on suspiciousness as well as the effects of recent life events on perceived stress, such that those with higher HCC presented increased suspiciousness and perceived stress at higher levels of stress exposure. Positive, but not negative, recent life events were associated with decreased perceived stress and depression, and these associations were moderated by low HCC, indicating a buffering effect for those with a non-impaired HPA axis.ConclusionIn line with the neural diathesis-stress model, results highlight the role of the interplay between the HPA axis and exposure to stressful experiences in exacerbating psychosis features and extend evidence to the nonclinical expression of the psychosis continuum. In addition, findings support the protective effect of positive experiences in decreasing stress appraisals and affective disturbances, which is consistent with emerging research about the relevance of positive factors in reducing the likelihood of psychopathological outcomes.
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Affiliation(s)
- Pilar Torrecilla
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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20
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Zwir I, Arnedo J, Mesa A, Del Val C, de Erausquin GA, Cloninger CR. Temperament & Character account for brain functional connectivity at rest: A diathesis-stress model of functional dysregulation in psychosis. Mol Psychiatry 2023; 28:2238-2253. [PMID: 37015979 PMCID: PMC10611583 DOI: 10.1038/s41380-023-02039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/06/2023]
Abstract
The human brain's resting-state functional connectivity (rsFC) provides stable trait-like measures of differences in the perceptual, cognitive, emotional, and social functioning of individuals. The rsFC of the prefrontal cortex is hypothesized to mediate a person's rational self-government, as is also measured by personality, so we tested whether its connectivity networks account for vulnerability to psychosis and related personality configurations. Young adults were recruited as outpatients or controls from the same communities around psychiatric clinics. Healthy controls (n = 30) and clinically stable outpatients with bipolar disorder (n = 35) or schizophrenia (n = 27) were diagnosed by structured interviews, and then were assessed with standardized protocols of the Human Connectome Project. Data-driven clustering identified five groups of patients with distinct patterns of rsFC regardless of diagnosis. These groups were distinguished by rsFC networks that regulate specific biopsychosocial aspects of psychosis: sensory hypersensitivity, negative emotional balance, impaired attentional control, avolition, and social mistrust. The rsFc group differences were validated by independent measures of white matter microstructure, personality, and clinical features not used to identify the subjects. We confirmed that each connectivity group was organized by differential collaborative interactions among six prefrontal and eight other automatically-coactivated networks. The temperament and character traits of the members of these groups strongly accounted for the differences in rsFC between groups, indicating that configurations of rsFC are internal representations of personality organization. These representations involve weakly self-regulated emotional drives of fear, irrational desire, and mistrust, which predispose to psychopathology. However, stable outpatients with different diagnoses (bipolar or schizophrenic psychoses) were highly similar in rsFC and personality. This supports a diathesis-stress model in which different complex adaptive systems regulate predisposition (which is similar in stable outpatients despite diagnosis) and stress-induced clinical dysfunction (which differs by diagnosis).
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Affiliation(s)
- Igor Zwir
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
- University of Granada, Department of Computer Science, Granada, Spain
- University of Texas, Rio Grande Valley School of Medicine, Institute of Neuroscience, Harlingen, TX, USA
| | - Javier Arnedo
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
- University of Granada, Department of Computer Science, Granada, Spain
| | - Alberto Mesa
- University of Granada, Department of Computer Science, Granada, Spain
| | - Coral Del Val
- University of Granada, Department of Computer Science, Granada, Spain
| | - Gabriel A de Erausquin
- University of Texas, Long School of Medicine, Department of Neurology, San Antonio, TX, USA
- Laboratory of Brain Development, Modulation and Repair, Glenn Biggs Institute of Alzheimer's & Neurodegenerative Disorders, San Antonio, TX, USA
| | - C Robert Cloninger
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA.
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Veremeyko T, Jiang R, He M, Ponomarev ED. Complement C4-deficient mice have a high mortality rate during PTZ-induced epileptic seizures, which correlates with cognitive problems and the deficiency in the expression of Egr1 and other immediate early genes. Front Cell Neurosci 2023; 17:1170031. [PMID: 37234916 PMCID: PMC10206007 DOI: 10.3389/fncel.2023.1170031] [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: 02/20/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Complement system plays an important role in the immune defense against pathogens; however, recent studies demonstrated an important role of complement subunits C1q, C4, and C3 in normal functions of the central nervous system (CNS) such as non-functional synapse elimination (synapse pruning), and during various neurologic pathologies. Humans have two forms of C4 protein encoded by C4A and C4B genes that share 99.5% homology, while mice have only one C4B gene that is functionally active in the complement cascade. Overexpression of the human C4A gene was shown to contribute to the development of schizophrenia by mediating extensive synapse pruning through the activation C1q-C4-C3 pathway, while C4B deficiency or low levels of C4B expression were shown to relate to the development of schizophrenia and autism spectrum disorders possibly via other mechanisms not related to synapse elimination. To investigate the potential role of C4B in neuronal functions not related to synapse pruning, we compared wildtype (WT) mice with C3- and C4B- deficient animals for their susceptibility to pentylenetetrazole (PTZ)- induced epileptic seizures. We found that C4B (but not C3)-deficient mice were highly susceptible to convulsant and subconvulsant doses of PTZ when compared to WT controls. Further gene expression analysis revealed that in contrast to WT or C3-deficient animals, C4B-deficient mice failed to upregulate expressions of multiple immediate early genes (IEGs) Egrs1-4, c-Fos, c-Jus, FosB, Npas4, and Nur77 during epileptic seizures. Moreover, C4B-deficient mice had low levels of baseline expression of Egr1 on mRNA and protein levels, which was correlated with the cognitive problems of these animals. C4-deficient animals also failed to upregulate several genes downstream of IEGs such as BDNF and pro-inflammatory cytokines IL-1β, IL-6, and TNF. Taken together, our study demonstrates a new role of C4B in the regulation of expression of IEGs and their downstream targets during CNS insults such as epileptic seizures.
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Affiliation(s)
- Tatyana Veremeyko
- Department of Biomedical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Biology, School of Sciences and Humanities, Nazarbayev University, Astana, Kazakhstan
- Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
| | - Rongcai Jiang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Mingliang He
- Department of Biomedical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Eugene D. Ponomarev
- Department of Biomedical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Biology, School of Sciences and Humanities, Nazarbayev University, Astana, Kazakhstan
- Chinese University of Hong Kong Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
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22
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Reich N, Delavari F, Schneider M, Thillainathan N, Eliez S, Sandini C. Multivariate patterns of disrupted sleep longitudinally predict affective vulnerability to psychosis in 22q11.2 Deletion Syndrome. Psychiatry Res 2023; 325:115230. [PMID: 37201254 DOI: 10.1016/j.psychres.2023.115230] [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: 01/04/2023] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/20/2023]
Abstract
22q11.2 deletion syndrome (22q11DS) contributes dramatically to increased genetic risk for psychopathology, and in particular schizophrenia. Sleep disorders, including obstructive sleep apnea (OSA), are also highly prevalent, making 22q11DS a unique model to explore their impact on psychosis vulnerability. Still, the contribution of sleep disturbances to psychosis vulnerability remains unclear. We characterized the sleep phenotype of 69 individuals with 22q11DS and 38 healthy controls with actigraphy and sleep questionnaires. Psychiatric symptoms were measured concomitantly with the baseline sleep assessment and at longitudinal follow-up, 3.58±0.85 years later. We used a novel multivariate partial-least-square-correlation (PLSC) approach to identify sleep patterns combining objective and subjective variables, which correlated with psychiatric symptoms. We dissected longitudinal pathways linking sleep disturbances to psychosis, using multi-layer-network-analysis. 22q11DS was characterized by a non-restorative sleep pattern, combining increased daytime fatigue despite longer sleep duration. Non-restorative sleep combined with OSA symptoms correlated with both emotional and psychotic symptoms. Moreover, a sleep pattern evocative of OSA predicted longitudinal worsening of positive and negative symptoms, by accentuating the effects of emotional dysregulation. These results suggest that sleep disturbances could significantly increase psychosis risk, along an affective pathway. If confirmed, this suggests that systematic screening of sleep quality could mitigate psychosis vulnerability in 22q11DS.
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Affiliation(s)
- Natacha Reich
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland
| | - Farnaz Delavari
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland; Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Niveettha Thillainathan
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland; Department of Genetic Medicine and Development, University of Geneva School of medicine, Geneva, Switzerland
| | - Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of medicine, Geneva, Switzerland.
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23
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Dauvermann MR, Costello L, Tronchin G, Holleran L, Mothersill D, Rokita KI, Kane R, Hallahan B, Corvin A, Morris D, McKernan DP, Kelly J, McDonald C, Donohoe G, Cannon DM. Childhood trauma is associated with altered white matter microstructural organization in schizophrenia. Psychiatry Res Neuroimaging 2023; 330:111616. [PMID: 36827958 DOI: 10.1016/j.pscychresns.2023.111616] [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: 12/09/2022] [Revised: 02/02/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
It has been reported that childhood trauma (CT) is associated with reductions in fractional anisotropy (FA) in individuals with schizophrenia (SZ). Here, we hypothesized that SZ with high levels of CT will show the greatest reductions in FA in frontolimbic and frontoparietal regions compared to healthy controls (HC) with high trauma levels and participants with no/low levels of CT. Thirty-seven SZ and 129 HC with CT experience were dichotomized into groups of 'none/low' or 'high' levels. Participants underwent diffusion-weighted MRI, and Tract-based spatial statistics were employed to assess the main effect of diagnosis, main effect of CT severity irrespective of diagnosis, and interaction between diagnosis and CT severity. SZ showed FA reductions in the corpus callosum and corona radiata compared to HC. Irrespective of a diagnosis, high CT levels (n = 48) were related to FA reductions in frontolimbic and frontoparietal regions compared to those with none/low levels of CT (n = 118). However, no significant interaction between diagnosis and high levels of CT was found (n = 13). Across all participants, we observed effects of CT on late developing frontolimbic and frontoparietal regions, suggesting that the effects of CT severity on white matter organization may be independent of schizophrenia.
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Affiliation(s)
- Maria R Dauvermann
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland; Institute for Mental Health, School of Psychology, University of Birmingham, B15 2TT, United Kingdom.
| | - Laura Costello
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Giulia Tronchin
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Laurena Holleran
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - David Mothersill
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland; Department of Psychology, School of Business, National College of Ireland, Dublin, Ireland; Department of Psychiatry, Trinity College Dublin, St. James's Hospital, Dublin, Ireland
| | - Karolina I Rokita
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Ruán Kane
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Brian Hallahan
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Aiden Corvin
- Department of Psychology, School of Business, National College of Ireland, Dublin, Ireland
| | - Derek Morris
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Declan P McKernan
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - John Kelly
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Colm McDonald
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Gary Donohoe
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
| | - Dara M Cannon
- Center for Neuroimaging, Cognition and Genomics (NICOG), Clinical Neuroimaging Laboratory, Galway Neuroscience Centre, University of Galway, Ireland, Galway, H91TK33, Ireland
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Nordholm D, Jensen MA, Kristiansen J, Glenthøj LB, Kristensen TD, Wenneberg C, Hjorthøj C, Garde AH, Nordentoft M. A longitudinal study on physiological stress in individuals at ultra high-risk of psychosis. Schizophr Res 2023; 254:218-226. [PMID: 36996675 DOI: 10.1016/j.schres.2023.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 01/19/2023] [Accepted: 03/03/2023] [Indexed: 04/01/2023]
Abstract
INTRODUCTION Individuals at ultra high-risk (UHR) of psychosis exhibit significantly higher stress levels than healthy controls (HC). This study investigates how physiological stress measures differ between HC and UHR individuals and how physiological stress is associated with attenuated psychotic symptoms and changes over time in UHR individuals. Additionally, it examines how the use of medication affects physiological levels of stress. METHOD The study included 72 UHR individuals and 36 HC. UHR were included according to the comprehensive assessment of at-risk mental state (CAARMS); a total-CAARMS score measured the attenuated psychotic symptoms and was calculated from the four psychosis subscales. HC and UHR were examined at baseline, and 47 UHR individuals were followed up after six months. Physiological stress measures were salivary cortisol, alpha-amylase (SAA) and heart-rate variability (HRV). Saliva was collected at four-time points during the day. RESULTS There was no significant difference regarding cortisol (awakening response) or SAA measures between HC and UHR individuals. The use of antipsychotics and antidepressants was associated with low HRV in UHR individuals. In an exploratory analysis of 19 UHR individuals, we found an association between the change in total-CAARMS (six months total-CAARMS minus baseline total CAARMS) and the change in HRV during sleep (six months HRV minus baseline HRV). CONCLUSION Our findings indicate that the use of antipsychotics and antidepressants could be associated with lower HRV in UHR individuals. There might be potential to investigate how HRV develops during the course of illness in UHR individuals.
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Affiliation(s)
- Dorte Nordholm
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark.
| | | | - Jesper Kristiansen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
| | - Tina Dam Kristensen
- Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Christina Wenneberg
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, and Center for Neuropsychiatric Schizophrenia Research, CNSR, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark; University of Copenhagen, Department of Public Health, Section of Epidemiology, Copenhagen, Denmark
| | - Anne Helene Garde
- The National Research Centre for the Working Environment, Copenhagen, Denmark; University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Denmark
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25
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Brandt JM, Hemager N, Ellersgaard D, Gregersen M, Søndergaard A, Ohland J, Søborg Spang K, Christiani C, Burton BK, Greve A, Hjorthøj C, Mors O, Plessen KJ, Møllegaard Jepsen JR, Nordentoft M, Elgaard Thorup AA. Hair cortisol concentrations and perceived stress in 7-year-old children at familial high-risk of schizophrenia or bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110750. [PMID: 36921662 DOI: 10.1016/j.pnpbp.2023.110750] [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: 05/28/2022] [Revised: 03/02/2023] [Accepted: 03/12/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Dysregulation of the HPA-axis, perceived stress and interpersonal trauma are associated with an elevated risk for schizophrenia and bipolar disorder. Being at familial high-risk of these two mental disorders also constitutes an increased risk. In this study, we aimed to investigate hair cortisol concentrations and perceived stress among 7-year-old children at familial high-risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP), and population-based controls (controls). METHODS A total of 515 children (mean age 7.8, SD 0.2) from baseline assessment of the Danish High Risk and Resilience Study - VIA 7 participated in this study. Hair cortisol concentrations were analyzed among 322 children (FHR-SZ; N = 111, FHR-BP; N = 82, controls; N = 129). Perceived stress was assessed with the Daily Life Stressor Scale including 512 children (FHR-SZ; N = 195, FHR-BP; N = 118, controls; N = 199). Interpersonal trauma was measured with face-to-face interviews. RESULTS Seven-year-old children at FHR-SZ or FHR-BP did not have a higher level of hair cortisol concentrations compared with controls (FHR-SZ: mean: 5.10, 95%CI 3.69-6.52; FHR-BP: mean: 5.01, 95%CI 3.27-6.72; controls: mean: 4.51, 95%CI 3.61-5.40; p = 0.77). Self-reported perceived stress was higher among children at FHR-SZ and FHR-BP compared with controls (FHR-SZ: mean: 12.09, 95%CI 10.99-13.19; FHR-BP: mean: 10.69, 95%CI 9.38-11.99; controls: mean: 8.90, 95%CI 8.13-9.68; p < 0.001). There was no significant association between hair cortisol concentrations and perceived stress (p = 0.84). Exploratory analyses revealed that interpersonal trauma exposure was neither associated with elevated hair cortisol nor perceived stress. CONCLUSIONS Children at FHR-SZ and FHR-BP did not exhibit higher levels of hair cortisol concentrations at age 7, while both FHR-groups had higher level of self-reported perceived stress compared with controls. Early attention to stress in children at FHR is crucial and these vulnerabilities should be targeted in future interventions studies.
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Affiliation(s)
- Julie Marie Brandt
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark.
| | - Nicoline Hemager
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark
| | - Ditte Ellersgaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark
| | - Maja Gregersen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark
| | - Anne Søndergaard
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark
| | - Jessica Ohland
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark
| | - Katrine Søborg Spang
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark
| | - Camilla Christiani
- Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Denmark
| | - Birgitte Klee Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Denmark; Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark
| | - Carsten Hjorthøj
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen, Department of Public Health, Section of Epidemiology, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Denmark
| | - Kerstin Jessica Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Division of Child and Adolescent Psychiatry, Department of Psychiatry, University Hospital Lausanne and University of Lausanne, Denmark
| | - Jens Richardt Møllegaard Jepsen
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Denmark; Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Denmark
| | - Merete Nordentoft
- CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Denmark; University of Copenhagen - Faculty of Health and Medical Sciences, Denmark; Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Denmark
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Gupta T, Antezana L, Porter C, Mayanil T, Bylsma LM, Maslar M, Horton LE. Skills program for awareness, connectedness, and empowerment: A conceptual framework of a skills group for individuals with a psychosis-risk syndrome. Front Psychiatry 2023; 14:1083368. [PMID: 37025348 PMCID: PMC10072161 DOI: 10.3389/fpsyt.2023.1083368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/10/2023] [Indexed: 03/08/2023] Open
Abstract
Intervention strategies for those diagnosed with psychotic disorders such as schizophrenia can be effective in reducing symptoms and improving quality of life. While strides have been made in developing prevention and intervention strategies earlier on in the disease progression, among those at clinical high-risk (CHR) for psychosis, challenges with heterogeneity can limit symptom and diagnosis specific treatment. Here, we discuss a newly developed therapy skills group called the Skills Program for Awareness, Connectedness, and Empowerment (SPACE) that integrates different types of behavioral skills - standard and radically open dialectical behavioral therapy as well as cognitive behavioral therapy - for CHR youth between the ages of 13-18 years. With the diathesis-stress framework serving as a foundation, the intervention is divided into three stages. These stages target specific signs and symptoms contributing to the progression of CHR symptoms. Stage 1 targets stress (with the goal of developing awareness and reducing distress), stage 2 targets self-disturbances (with a goal of increasing self-connectedness), and stage 3 targets social connectedness (with a goal of improving social domains of functioning). The focus of this article is to introduce the theoretical framework underlying the pilot skills group and discuss ongoing progress. Clinical Trial Registration NCT05398120; https://clinicaltrials.gov/ct2/show/NCT05398120.
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Affiliation(s)
- Tina Gupta
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Ligia Antezana
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Christian Porter
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Tushita Mayanil
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Lauren M. Bylsma
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Michael Maslar
- The Family Institute at Northwestern University, Evanston, IL, United States
| | - Leslie E. Horton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Yan YJ, Hu HX, Wang LL, Zhang YJ, Lui SSY, Huang J, Chan RCK. Negative schizotypal traits predict the reduction of reward motivation in effort-reward imbalance. Eur Arch Psychiatry Clin Neurosci 2023; 273:439-445. [PMID: 35637380 DOI: 10.1007/s00406-022-01419-3] [Citation(s) in RCA: 1] [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] [Received: 12/06/2021] [Accepted: 04/11/2022] [Indexed: 11/26/2022]
Abstract
The schizotypy construct is useful for studying the effects of environmental stress on development of subclinical negative symptoms. The relationship among self-report motivation, effort-reward imbalance (ERI), and schizotypal features has seldom been studied. We aimed to examine the possible moderation effect of schizotypal traits on ERI and reward motivation. Eight-hundred-and-forty-three college students were recruited online to complete a set of self-reported measures capturing schizotypal traits, effort-reward imbalance and reward motivation, namely the Schizotypal Personality Questionnaire (SPQ), the Effort-Reward Imbalance-School Version Questionnaire (C-ERI-S) and the Motivation and Pleasure Scale-Self Report (MAP-SR). We conducted multiple linear regression to construct models to investigate the moderating effects of schizotypal traits on the relationship between ERI and reward motivation. Stressful ERI situation predicted the reduction of reward motivation. Negative schizotypal traits showed a significant negative moderating effect on the relationship between ERI and reward motivation, while positive and disorganized schizotypal traits had significant positive moderating effects. Schizotypal traits subtypes differently moderate the relationship between ERI and reward motivation. Only negative schizotypal traits and stressful ERI situation together have negative impact on reward motivation.
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Affiliation(s)
- Yong-Jie Yan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Sino-Danish College of University of Chinese Academy of Sciences, Beijing, China
- Sino-Danish Centre for Education and Research, Beijing, China
| | - Hui-Xin Hu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, China
| | - Ling-Ling Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, China
| | - Yi-Jing Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, China
| | - Simon S Y Lui
- Department of Psychiatry, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, China.
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China.
- Sino-Danish College of University of Chinese Academy of Sciences, Beijing, China.
- Department of Psychology, The University of Chinese Academy of Sciences, Beijing, China.
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28
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Fekih-Romdhane F, Malaeb D, Loch AA, Farah N, Stambouli M, Cheour M, Obeid S, Hallit S. Problematic Smartphone Use Mediates the Pathway from Suicidal Ideation to Positive Psychotic Experiences: a Large Cross-Sectional, Population-Based Study. Int J Ment Health Addict 2023:1-18. [PMID: 36820017 PMCID: PMC9930705 DOI: 10.1007/s11469-023-01028-8] [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] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
The present study followed the newly hypothesized "suicidal drive for psychosis" suggesting that psychosis may be consequential to suicidal ideation (SI) and behavior and attempted to explain parts of the pathway between these variables. To this end, we aimed to test whether problematic smartphone use (PSU) has an indirect mediating effect in the cross-sectional relationship between SI and positive psychotic experiences (PEs). Lebanese community young adults (N=4158; 64.4% females; mean age 21.91±3.79) have been invited to participate to a cross-sectional, web-based study in the period from June to September 2022. After adjusting for potential confounders (i.e., the living situation, marital status, household crowding index, economic pressure, cannabis use, other drugs use, and past history of mental illness other than psychosis), we found that higher levels of suicidal ideation was significantly associated with greater PSU, which was also positively and significantly associated with more positive PEs. Finally, greater suicidal ideation was significantly and directly associated with more positive PEs. Our findings suggest that SPU may be regarded as a potential target for prevention and intervention in psychosis. Clinicians, educators, and school administrators ought to give greater attention to PSU among vulnerable young people who present with SI.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Nour Farah
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Manel Stambouli
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478 Saudi Arabia
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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29
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Ristanovic I, Vargas TG, Damme KSF, Mittal VA. Hippocampal subfields, daily stressors, and resting cortisol in individuals at clinical high-risk for psychosis. Psychoneuroendocrinology 2023; 148:105996. [PMID: 36495626 PMCID: PMC9898196 DOI: 10.1016/j.psyneuen.2022.105996] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/17/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION The hippocampus, comprised of functionally distinct subfields, both regulates stress and is affected by it during psychosis pathogenesis. Hippocampal abnormalities are evident across psychosis spectrum and are associated with aberrant cortisol levels and greater environmental stressors exposure. These associations, particularly at the subfield-level, are poorly understood in individuals at clinical high-risk (CHR) for psychosis. This represents a significant literature gap given this critical pathogenetic period is characterized by an interplay between environmental stressors and biological susceptibility. METHODS A total of 121 participants including 51 CHR (mean age=18.61) and 70 healthy controls (HC; mean age=18.3) were enrolled in the study. Participants completed a structural scan, salivary cortisol assays, and a self-report measure assessing distress from daily stressors exposure (DSI). Hippocampal subfield segmentation was conducted using Freesurfer. RESULTS Smaller hippocampal subfields were associated with greater stress levels. Greater DSI was associated with lower volumes in CA1 (r = -0.38) and CA2/3 (r = -0.29), but not in CA4/DG (r = -0.28), presubiculum (r = -0.09), or subiculum (r = -0.17). Higher resting cortisol was associated with lower volumes in presubiculum (r = -0.4) but not subiculum (r = -0.22), CA1 (r = 0.08), CA2/3 (r = 0.1), or CA4/DG (r = -0.005). Regressions indicated effects for CA1 and DSI (β = 0.57, p = .03) and presubiculum and cortisol (β = 0.61, p = .02) are specific to CHR participants relative to HCs. CONCLUSIONS The findings provided insights into links between stress and brain vulnerability during psychosis-risk period. Regional differences highlighted potentially different mechanisms by which stress impacts specific subfields. Presubiculum may be more susceptible to the impact of early stress on HPA-axis and cornu amonis to acute stressors.
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Affiliation(s)
- Ivanka Ristanovic
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA.
| | - Teresa G Vargas
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA
| | - Katherine S F Damme
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA
| | - Vijay Anand Mittal
- Northwestern University, Department of Psychology, Evanston, IL 60208, USA; Institute for Innovations in Developmental Sciences (DevSci), Northwestern University, Evanston, Chicago, IL, USA; Northwestern University, Department of Psychiatry, Chicago, IL 60611, USA; Northwestern University, Medical Social Sciences, Chicago IL 60611, USA; Norhtwestern University, Institute for Policy Research, Evanston, IL 60208, USA
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30
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Frau R, Melis M. Sex-specific susceptibility to psychotic-like states provoked by prenatal THC exposure: Reversal by pregnenolone. J Neuroendocrinol 2023; 35:e13240. [PMID: 36810840 DOI: 10.1111/jne.13240] [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: 08/01/2022] [Revised: 01/23/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023]
Abstract
Sociocultural attitudes towards cannabis legalization contribute to the common misconception that it is a relatively safe drug and its use during pregnancy poses no risk to the fetus. However, longitudinal studies demonstrate that maternal cannabis exposure results in adverse outcomes in the offspring, with a heightened risk for developing psychopathology. One of the most reported psychiatric outcomes is the proneness to psychotic-like experiences during childhood. How exposure to cannabis during gestation increases psychosis susceptibility in children and adolescents remains elusive. Preclinical research has indicated that in utero exposure to the major psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC), deranges brain developmental trajectories towards vulnerable psychotic-like endophenotypes later in life. Here, we present how prenatal THC exposure (PCE) deregulates mesolimbic dopamine development predisposing the offspring to schizophrenia-relevant phenotypes, exclusively when exposed to environmental challenges, such as stress or THC. Detrimental effects of PCE are sex-specific because female offspring do not display psychotic-like outcomes upon exposure to these challenges. Moreover, we present how pregnenolone, a neurosteroid that showed beneficial properties on the effects elicited by cannabis intoxication, normalizes mesolimbic dopamine function and rescues psychotic-like phenotypes. We, therefore, suggest this neurosteroid as a safe "disease-modifying" aid to prevent the onset of psychoses in vulnerable individuals. Our findings corroborate clinical evidence and highlight the relevance of early diagnostic screening and preventative strategies for young individuals at risk for mental diseases, such as male PCE offspring.
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Affiliation(s)
- Roberto Frau
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy
- The Guy Everett Laboratory for Neuroscience, University of Cagliari, Cagliari, Italy
| | - Miriam Melis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Italy
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31
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The relationship between technology addictions and schizotypal traits: mediating roles of depression, anxiety, and stress. BMC Psychiatry 2023; 23:67. [PMID: 36698079 PMCID: PMC9875437 DOI: 10.1186/s12888-023-04563-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The way how technology addiction relates to psychosis remains inconclusive and uncertain. The present study aimed to test the hypothesis of a mediating role of depression, anxiety and stress in the association between three technology (behavioral) addictions (i.e., Addiction to the Internet, smartphones and Facebook) and psychosis proneness as estimated through schizotypal traits in emerging adults. METHODS A cross-sectional study was performed among non-clinical Tunisian university students (67.6% females, mean age of 21.5 ± 2.5 years) using a paper-and-pencil self-administered questionnaire. RESULTS Results for the Pearson correlation revealed that higher smartphone, Internet, and Facebook addictions' scores were significantly and positively correlated with each of the depression, anxiety and stress subscores; whereas depression (r = 0.474), anxiety (r = 0.499) and stress (r = 0.461) scores were positively correlated with higher schizotypal traits. The results of the mediation analysis found a significant mediating effect for depressive, anxiety and stress symptoms on the cross-sectional relationship between each facet of the TA and schizotypal traits. CONCLUSION Our findings preliminarily suggest that an addictive use of smartphones, Internet and Facebook may act as a stressor that exacerbates psychosis proneness directly or indirectly through distress. Although future longitudinal research is needed to determine causality, we draw attention to the possibility that treating psychological distress may constitute an effective target of interventions to prevent psychosis in adolescents with technology addictions.
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32
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Environmental Risk Factors and Cognitive Outcomes in Psychosis: Pre-, Perinatal, and Early Life Adversity. Curr Top Behav Neurosci 2023; 63:205-240. [PMID: 35915384 PMCID: PMC9892366 DOI: 10.1007/7854_2022_378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Risk for psychosis begins to accumulate as early as the fetal period through exposure to obstetric complications like fetal hypoxia, maternal stress, and prenatal infection. Stressors in the postnatal period, such as childhood trauma, peer victimization, and neighborhood-level adversity, further increase susceptibility for psychosis. Cognitive difficulties are among the first symptoms to emerge in individuals who go on to develop a psychotic disorder. We review the relationship between pre-, perinatal, and early childhood adversities and cognitive outcomes in individuals with psychosis. Current evidence shows that the aforementioned environmental risk factors may be linked to lower overall intelligence and executive dysfunction, beginning in the premorbid period and persisting into adulthood in individuals with psychosis. It is likely that early life stress contributes to cognitive difficulties in psychosis through dysregulation of the body's response to stress, causing changes such as increased cortisol levels and chronic immune activation, which can negatively impact neurodevelopment. Intersectional aspects of identity (e.g., sex/gender, race/ethnicity), as well as gene-environment interactions, likely inform the developmental cascade to cognitive difficulties throughout the course of psychotic disorders and are reviewed below. Prospective studies of birth cohorts will serve to further clarify the relationship between early-life environmental risk factors and cognitive outcomes in the developmental course of psychotic disorders. Specific methodological recommendations are provided for future research.
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33
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Evolutionarily conserved gene expression patterns for affective disorders revealed using cross-species brain transcriptomic analyses in humans, rats and zebrafish. Sci Rep 2022; 12:20836. [PMID: 36460699 PMCID: PMC9718822 DOI: 10.1038/s41598-022-22688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/18/2022] [Indexed: 12/03/2022] Open
Abstract
Widespread, debilitating and often treatment-resistant, depression and other stress-related neuropsychiatric disorders represent an urgent unmet biomedical and societal problem. Although animal models of these disorders are commonly used to study stress pathogenesis, they are often difficult to translate across species into valuable and meaningful clinically relevant data. To address this problem, here we utilized several cross-species/cross-taxon approaches to identify potential evolutionarily conserved differentially expressed genes and their sets. We also assessed enrichment of these genes for transcription factors DNA-binding sites down- and up- stream from their genetic sequences. For this, we compared our own RNA-seq brain transcriptomic data obtained from chronically stressed rats and zebrafish with publicly available human transcriptomic data for patients with major depression and their respective healthy control groups. Utilizing these data from the three species, we next analyzed their differential gene expression, gene set enrichment and protein-protein interaction networks, combined with validated tools for data pooling. This approach allowed us to identify several key brain proteins (GRIA1, DLG1, CDH1, THRB, PLCG2, NGEF, IKZF1 and FEZF2) as promising, evolutionarily conserved and shared affective 'hub' protein targets, as well as to propose a novel gene set that may be used to further study affective pathogenesis. Overall, these approaches may advance cross-species brain transcriptomic analyses, and call for further cross-species studies into putative shared molecular mechanisms of affective pathogenesis.
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34
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Vargas TG, Mittal VA. The Critical Roles of Early Development, Stress, and Environment in the Course of Psychosis. ANNUAL REVIEW OF DEVELOPMENTAL PSYCHOLOGY 2022; 4:423-445. [PMID: 36712999 PMCID: PMC9879333 DOI: 10.1146/annurev-devpsych-121020-032354] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Psychotic disorders are highly debilitating with poor prognoses and courses of chronic illness. In recent decades, conceptual models have shaped understanding, informed treatment, and guided research questions. However, these models have classically focused on the adolescent and early adulthood stages immediately preceding onset while conceptualizing early infancy through all of childhood as a unitary premorbid period. In addition, models have paid limited attention to differential effects of types of stress; contextual factors such as local, regional, and country-level characteristics or sociocultural contexts; and the timing of the stressor or environmental risk. This review discusses emerging research suggesting that (a) considering effects specific to neurodevelopmental stages prior to adolescence is highly informative, (b) understanding specific stressors and levels of environmental exposures (i.e., systemic or contextual features) is necessary, and (c) exploring the dynamic interplay between development, levels and types of stressors, and environments can shed new light, informing a specified neurodevelopmental and multifaceted diathesis-stress model.
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Affiliation(s)
- T G Vargas
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
| | - V A Mittal
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
- Departments of Psychiatry and Medical Social Sciences, Institute for Innovations in Developmental Sciences, and Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
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35
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Caetano I, Ferreira S, Coelho A, Amorim L, Castanho TC, Portugal-Nunes C, Soares JM, Gonçalves N, Sousa R, Reis J, Lima C, Marques P, Moreira PS, Rodrigues AJ, Santos NC, Morgado P, Magalhães R, Picó-Pérez M, Cabral J, Sousa N. Perceived stress modulates the activity between the amygdala and the cortex. Mol Psychiatry 2022; 27:4939-4947. [PMID: 36117211 DOI: 10.1038/s41380-022-01780-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 01/14/2023]
Abstract
The significant link between stress and psychiatric disorders has prompted research on stress's impact on the brain. Interestingly, previous studies on healthy subjects have demonstrated an association between perceived stress and amygdala volume, although the mechanisms by which perceived stress can affect brain function remain unknown. To better understand what this association entails at a functional level, herein, we explore the association of perceived stress, measured by the PSS10 questionnaire, with disseminated functional connectivity between brain areas. Using resting-state fMRI from 252 healthy subjects spanning a broad age range, we performed both a seed-based amygdala connectivity analysis (static connectivity, with spatial resolution but no temporal definition) and a whole-brain data-driven approach to detect altered patterns of phase interactions between brain areas (dynamic connectivity with spatiotemporal information). Results show that increased perceived stress is directly associated with increased amygdala connectivity with frontal cortical regions, which is driven by a reduced occurrence of an activity pattern where the signals in the amygdala and the hippocampus evolve in opposite directions with respect to the rest of the brain. Overall, these results not only reinforce the pathological effect of in-phase synchronicity between subcortical and cortical brain areas but also demonstrate the protective effect of counterbalanced (i.e., phase-shifted) activity between brain subsystems, which are otherwise missed with correlation-based functional connectivity analysis.
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Affiliation(s)
- Inês Caetano
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Liliana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal.,Association P5 Digital Medical Center (ACMP5), 4710-057, Braga, Portugal
| | - Teresa Costa Castanho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal.,Association P5 Digital Medical Center (ACMP5), 4710-057, Braga, Portugal
| | - Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal.,CECAV-Veterinary and Animal Science Research Centre, Quinta de Prados, 5000-801, Vila Real, Portugal
| | - José Miguel Soares
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Nuno Gonçalves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Rui Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal.,Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu, 3500-228, Viseu, Portugal
| | - Joana Reis
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Catarina Lima
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Joana Cabral
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal. .,ICVS/3B's, PT Government Associate Laboratory, 4710-057, Braga/Guimarães, Portugal. .,Clinical Academic Center-Braga (2CA), 4710-243, Braga, Portugal. .,Association P5 Digital Medical Center (ACMP5), 4710-057, Braga, Portugal.
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36
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Zhu X, Zhu Y, Huang J, Zhou Y, Tong J, Zhang P, Luo X, Chen S, Tian B, Tan S, Wang Z, Han X, Tian L, Li CSR, Hong LE, Tan Y. Abnormal cortisol profile during psychosocial stress among patients with schizophrenia in a Chinese population. Sci Rep 2022; 12:18591. [PMID: 36329219 PMCID: PMC9633605 DOI: 10.1038/s41598-022-20808-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
Accumulating evidence suggests that hypothalamic-pituitary-adrenal axis dysfunction might play an important role in the pathophysiology of schizophrenia. The aim of this study was to explore the cortisol response to psychological stress in patients with schizophrenia. In this study, patients with schizophrenia (n = 104) and healthy volunteers (n = 59) were asked to complete psychological stress challenge tasks, which included the Paced Auditory Serial Addition Task and Mirror-Tracing Persistence Task, and pre- and post-task saliva samples were collected to measure cortisol levels. Emotions and psychopathology were assessed by the Positive and Negative Affect Schedule and Positive and Negative Syndrome Scale. The results showed (1) that the cortisol response and negative emotions in patients with schizophrenia differed significantly from those in healthy volunteers, (2) there were significant interactions between the sampling time and diagnosis for saliva cortisol levels, (3) there were significant interactions between the scoring time and diagnosis for the negative affect score of the PANAS, and (4) the changes in salivary cortisol levels and negative affect scores before and after the psychological stress challenge tasks were not correlated with clinical symptoms in patients with schizophrenia. These findings indicated an abnormal cortisol profile in patients with schizophrenia, which might be a biological characteristic of the disease.
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Affiliation(s)
- Xiaoyu Zhu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Yu Zhu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Junchao Huang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Yanfang Zhou
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Jinghui Tong
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Ping Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Song Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Baopeng Tian
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Zhiren Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Xiaole Han
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Li Tian
- Department of Physiology, Faculty of Medicine, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - L Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China.
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37
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Walker E. The permeable boundary between biological and psychological processes in the origins of psychosis. Psychiatry Res 2022; 317:114853. [PMID: 36152422 DOI: 10.1016/j.psychres.2022.114853] [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: 08/18/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 01/04/2023]
Abstract
In this commentary, I describe the factors that influenced my scientific perspective and methods. Initially, the impetus for my interest in psychosis was the life story of a schizophrenia patient who was a member of a discordant monozygotic twin-pair. This set the stage for viewing the etiology of schizophrenia and other psychoses as involving complex interactions between pre-existing vulnerabilities and exogenous factors. Over time, this crystalized in a neural diathesis-stress model that assumes neuromaturationally-moderated effects of adverse exposures on the expression of congenital vulnerabilities. Challenging issues for future research include identifying the genetic and environmental determinants of vulnerability and the neurobiological pathways mediating the effects of exposure to adversity.
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Affiliation(s)
- Elaine Walker
- Department of Psychology, Emory University, Atlanta, GA 30322, United States.
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38
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The impact of childhood trauma and daily life experiences on emotional and psychotic symptom intensity in psychosis: An experience sampling study. Psychiatry Res 2022; 317:114872. [PMID: 36265192 DOI: 10.1016/j.psychres.2022.114872] [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: 07/22/2022] [Revised: 09/14/2022] [Accepted: 09/29/2022] [Indexed: 01/05/2023]
Abstract
Adverse childhood experiences create vulnerability to psychosis through biological and cognitive changes, and that may be observed as an increased emotional and psychotic response to daily life experiences in adulthood. This study aims to examine the effects of childhood maltreatment on psychotic patients' daily stress and emotional and psychotic intensity related to various experiences throughout the day. Daily activities and events, and emotional and psychotic intensity of forty-one psychotic patients were assessed with the Experience Sampling Method. The Childhood Trauma Questionnaire (CTQ) was used to evaluate childhood adversities. Multilevel regression analyses showed that all trauma subtypes, except for sexual abuse, were associated with increased psychosis and event-stress. Emotional maltreatment was the most associated trauma type with high negative and low positive affect and increased daily stress. Patients reported the highest stress and negative affect related to internal experiences but the lowest stress related to recreational actions. Social activities were also associated with higher positive affect and lower stress and psychosis, with the high CTQ group having greater stress in those activities. Our study demonstrates the negative impact of childhood trauma, especially emotional maltreatment, on daily stress and emotional and psychotic intensity in psychotic patients via different daily experiences.
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39
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Karcher NR, Klaunig MJ, Elsayed NM, Taylor RL, Jay SY, Schiffman J. Understanding Associations Between Race/Ethnicity, Experiences of Discrimination, and Psychotic-like Experiences in Middle Childhood. J Am Acad Child Adolesc Psychiatry 2022; 61:1262-1272. [PMID: 35378237 PMCID: PMC9525459 DOI: 10.1016/j.jaac.2022.03.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 01/06/2022] [Accepted: 03/25/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The present study aimed to examine factors that may account for race/ethnicity differences in psychotic-like experiences (PLEs) in a middle childhood sample, including evidence for experiences of discrimination as a psychosocial mediator of these differences. METHOD In a sample of 9- to 10-year-olds (N = 10,839) from the Adolescent Brain Cognitive Development Study, we compared PLEs across racial/ethnic groups. We also examined whether experiences of discrimination indirectly linked racial/ethnic identity and PLEs and whether social support moderated this indirect association. RESULTS Differences between racial/ethnic groups were found in the endorsement of PLEs, such that Black and Hispanic participants endorsed higher levels of PLEs compared with Asian, multiracial/multiethnic, and White participants. These differences were accounted for in part by experiences of discrimination, an indirect effect that was in turn attenuated by increased social support. CONCLUSION This is the first study to suggest that the experience of discrimination may indirectly link the association between racial/ethnic differences and endorsement of PLEs using the Prodromal Questionnaire-Brief Child Version and additionally that social support may act as a moderator of this mediation. Results provide evidence that social inequities such as racial discrimination may contribute to increases in PLEs. These findings shed further light on the links between structural racism and mental health inequities for people in minoritized groups.
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Affiliation(s)
| | - Mallory J Klaunig
- University of Maryland, Baltimore County; University of California, Irvine
| | | | | | | | - Jason Schiffman
- University of Maryland, Baltimore County; University of California, Irvine
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40
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Caetano I, Amorim L, Castanho TC, Coelho A, Ferreira S, Portugal-Nunes C, Soares JM, Gonçalves N, Sousa R, Reis J, Lima C, Marques P, Moreira PS, Rodrigues AJ, Santos NC, Morgado P, Esteves M, Magalhães R, Picó-Pérez M, Sousa N. Association of amygdala size with stress perception: Findings of a transversal study across the lifespan. Eur J Neurosci 2022; 56:5287-5298. [PMID: 36017669 DOI: 10.1111/ejn.15809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 12/14/2022]
Abstract
Daily routines are getting increasingly stressful. Interestingly, associations between stress perception and amygdala volume, a brain region implicated in emotional behaviour, have been observed in both younger and older adults. Life stress, on the other hand, has become pervasive and is no longer restricted to a specific age group or life stage. As a result, it is vital to consider stress as a continuum across the lifespan. In this study, we investigated the relationship between perceived stress and amygdala size in 272 healthy participants with a broad age range. Participants were submitted to a structural magnetic resonance imaging (MRI) to extract amygdala volume, and the Perceived Stress Scale (PSS) scores were used as the independent variable in volumetric regressions. We found that perceived stress is positively associated with the right amygdala volume throughout life.
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Affiliation(s)
- Inês Caetano
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Liliana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal.,Association P5 Digital Medical Center (ACMP5), Braga, Portugal
| | - Teresa Costa Castanho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal.,Association P5 Digital Medical Center (ACMP5), Braga, Portugal
| | - Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal.,CECAV-Veterinary and Animal Science Research Centre, Vila Real, Portugal
| | - José Miguel Soares
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Nuno Gonçalves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Rui Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal.,Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Joana Reis
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Catarina Lima
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Ana João Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Madalena Esteves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal.,Association P5 Digital Medical Center (ACMP5), Braga, Portugal
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41
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Oh H, Susser E, Volpe VV, Lui F, Besecker M, Zhou S, Anglin DM. Psychotic experiences among Black college students in the United States: The role of socioeconomic factors and discrimination. Schizophr Res 2022; 248:198-205. [PMID: 36088750 PMCID: PMC10227771 DOI: 10.1016/j.schres.2022.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 07/27/2022] [Accepted: 09/04/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Psychosis is more prevalent among Black individuals compared with White individuals. However, it is unknown whether this disparity exists among college populations in the United States, and if so, what factors contribute to the disparity. METHODS We analyzed data from Black and White young adult students using the Health Minds Study (2020-2021), which is a survey administered at 140 colleges in the U.S. Using mediation analysis, we examined the extent to which the relation between race and psychotic experiences was mediated by socioeconomic factors (past and current financial distress, food insecurity, parental education) and discrimination. RESULTS Approximately 38 % of Black students and 30 % of White students reported lifetime psychotic experiences. Including all socioeconomic factors together in the same model accounted for just over half (50.2 %) the association between race and psychotic experiences. We then conducted additional analyses examining discrimination, all the socioeconomic factors plus discrimination accounted for 81.5 % of the association between race and psychotic experiences. When disentangling the mediators, food insecurity and discrimination accounted for the largest percentages of the association. The effects of past financial distress and parental education were modified by race. CONCLUSION Black college students were more likely to report lifetime psychotic experiences than their White counterparts. Moreover, socioeconomic factors and discrimination made significant contributions to this racial difference.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, 1149 Hill St Suite 1422, Los Angeles, CA 90015, United States of America.
| | - Ezra Susser
- Mailman School of Public Health, Columbia University, United States of America
| | - Vanessa V Volpe
- Department of Psychology, North Carolina State University, Campus Box 7650, Raleigh, NC 27695
| | - Florence Lui
- Memorial Sloan Kettering Cancer Center, United States of America
| | - Megan Besecker
- Suzanne Dworak Peck School of Social Work, University of Southern California, 1149 Hill St Suite 1422, Los Angeles, CA 90015, United States of America
| | - Sasha Zhou
- Department of Public Health, Wayne State University, United States of America
| | - Deidre M Anglin
- Department of Psychology, The City College of New York, City University of New York, 160 Convent Avenue, North Academic Center, New York, NY 10031, United States of America; The Graduate Center, City University of New York, 365 5th Avenue, New York, NY 10016, United States of America
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42
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Abstract
Despite strong evidence of the neurodevelopmental origins of psychosis, current pharmacological treatment is not usually initiated until after a clinical diagnosis is made, and is focussed on antagonising striatal dopamine receptors. These drugs are only partially effective, have serious side effects, fail to alleviate the negative and cognitive symptoms of the disorder, and are not useful as a preventive treatment. In recent years, attention has turned to upstream brain regions that regulate striatal dopamine function, such as the hippocampus. This review draws together these recent data to discuss why the hippocampus may be especially vulnerable in the pathophysiology of psychosis. First, we describe the neurodevelopmental trajectory of the hippocampus and its susceptibility to dysfunction, exploring this region's proneness to structural and functional imbalances, metabolic pressures, and oxidative stress. We then examine mechanisms of hippocampal dysfunction in psychosis and in individuals at high-risk for psychosis and discuss how and when hippocampal abnormalities may be targeted in these groups. We conclude with future directions for prospective studies to unlock the discovery of novel therapeutic strategies targeting hippocampal circuit imbalances to prevent or delay the onset of psychosis.
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43
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Mørkved N, Johnsen E, Kroken RA, Winje D, Larsen TK, Thimm JC, Rettenbacher MA, Johannesen CAB, Løberg EM. Impact of childhood trauma on antipsychotic effectiveness in schizophrenia spectrum disorders: A prospective, pragmatic, semi-randomized trial. Schizophr Res 2022; 246:49-59. [PMID: 35709647 DOI: 10.1016/j.schres.2022.05.022] [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: 09/16/2021] [Revised: 03/21/2022] [Accepted: 05/21/2022] [Indexed: 10/18/2022]
Abstract
Antipsychotic medications are generally effective in ameliorating psychotic symptoms in schizophrenia spectrum disorders (SSDs). Identifying predictors associated with poor treatment response is important for a personalized treatment approach. Childhood trauma (CT) may have a general and differential effect on the effectiveness of different types of antipsychotics in SSDs. The Bergen-Stavanger-Trondheim-Innsbruck (BeSt InTro) study is a pragmatic, researcher-initiated, semi-randomized trial. The present study aimed to investigate symptom change (the Positive and Negative Syndrome Scale) from baseline to 1, 3, 6, 12, 26, 39 and 52 weeks of antipsychotic treatment (amisulpride, aripiprazole and olanzapine) by group (CT/no CT). Participants (n = 98) with diagnoses within the schizophrenia spectrum (F20-29 in the International Classification of Diseases - 10th Revision) were randomized to receive amisulpride, aripiprazole or olanzapine, and for this study categorized into groups of none and low CT, and moderate to severe CT according to thresholds defined by the Childhood Trauma Questionnaire Short-Form manual. CT in SSDs predicted an overall slower treatment response and less antipsychotic effectiveness after 26 weeks of treatment, which was statistically nonsignificant at 52 weeks. Secondary analyses showed a differential effect of CT related to type of antipsychotic medication: patients with SSDs and CT who received olanzapine showed less antipsychotic effectiveness throughout 52 weeks of treatment. The intention-to-treat and per-protocol analyses were convergent. Our findings indicate that in patients with SSD and CT, delayed response to antipsychotics could be expected, and a longer evaluation period before considering change of medication may be recommended.
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Affiliation(s)
- N Mørkved
- Mosjøen District Psychiatric Centre, Helgeland Hospital, Skjervengan 17, 8657 Mosjøen, Norway; Department of Psychology, UiT The Arctic University of Norway, Pb 6050 Langnes, 9037 Tromsø, Norway.
| | - E Johnsen
- NORMENT Centre of Excellence and Division of Psychiatry, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Pb 7800, 5020 Bergen, Norway
| | - R A Kroken
- NORMENT Centre of Excellence and Division of Psychiatry, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Pb 7800, 5020 Bergen, Norway
| | - D Winje
- Faculty of Psychology, Department of Clinical Psychology, University of Bergen, Christies gate 13, 5015 Bergen, Norway
| | - T K Larsen
- Institute of Psychiatry, University of Bergen, Pb 7800, 5020 Bergen, Norway; TIPS Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Jan Johnsens gate12, 4011 Stavanger, Norway
| | - J C Thimm
- Department of Psychology, UiT The Arctic University of Norway, Pb 6050 Langnes, 9037 Tromsø, Norway; Center for Crisis Psychology, University of Bergen, 5009 Bergen, Norway
| | - M A Rettenbacher
- Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria
| | - C A Bartz Johannesen
- NORMENT Centre of Excellence and Division of Psychiatry, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Pb 7800, 5020 Bergen, Norway
| | - E-M Løberg
- NORMENT Centre of Excellence and Division of Psychiatry, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway; Faculty of Psychology, Department of Clinical Psychology, University of Bergen, Christies gate 13, 5015 Bergen, Norway; Department of Addiction Medicine, Haukeland University Hospital, Østre Murallmenningen 7, 5012 Bergen, Norway
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44
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Lavratti C, Iraci L, Ferreira A, Dorneles G, Pochmann D, da Rosa Boeira M, Peres A, Elsner V. Time course of epigenetic modulation in response to concurrent exercise training in patients with schizophrenia. COMPARATIVE EXERCISE PHYSIOLOGY 2022. [DOI: 10.3920/cep210013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study aimed to investigate the short and long-term effects of concurrent exercise training on anthropometric variables, HDCA2 activity and cortisol levels of individuals with schizophrenia (SZ). Therefore, 10 patients were submitted to the program (endurance and strength exercises in the same session, 60 min of duration, three times a week) and blood samples were collected before, 30 days and 180 days after the intervention started. Exercise training reduced the body mass index and body mass after 180 days of the intervention. A significant decrease on HDAC2 activity was found 180 days after intervention compared to before the intervention. The cortisol levels remained unchanged in any evaluated time-points. The concurrent exercise training was able to modulate HDAC2 activity in mononuclear cells and improve anthropometric variables in a time-dependent manner in patients with SZ.
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Affiliation(s)
- C. Lavratti
- Programa de Pós Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, CEP 90420-060 Porto Alegre, RS, Brazil
| | - L. Iraci
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - A. Ferreira
- Curso de Fisioterapia do Centro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - G. Dorneles
- Cellular and Molecular Immunology Lab., Department of Health Basic Sciences. Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - D. Pochmann
- Programa de Pós Graduação em Biociências e Reabilitação doCentro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
| | - M.C. da Rosa Boeira
- Programa de Pós Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Coronel Joaquim Pedro Salgado 80, Rio Branco, CEP 90420-060 Porto Alegre, RS, Brazil
| | - A. Peres
- Cellular and Molecular Immunology Lab., Department of Health Basic Sciences. Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - V.R. Elsner
- Cellular and Molecular Immunology Lab., Department of Health Basic Sciences. Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
- Programa de Pós Graduação em Biociências e Reabilitação doCentro Universitário Metodista-IPA, Porto Alegre, RS, Brazil
- Programa de Pós Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul, Brazil
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45
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Schonfeld L, Jaehne EJ, Ogden AR, Spiers JG, Hogarth S, van den Buuse M. Differential effects of chronic adolescent glucocorticoid or methamphetamine on drug-induced locomotor hyperactivity and disruption of prepulse inhibition in adulthood in mice. Prog Neuropsychopharmacol Biol Psychiatry 2022; 117:110552. [PMID: 35337859 DOI: 10.1016/j.pnpbp.2022.110552] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
Sensitization of dopaminergic activity has been suggested as an underlying mechanism in the psychotic symptoms of schizophrenia. Adolescent stress and chronic abuse of methamphetamine (Meth) are well-known risk factors for psychosis and schizophrenia; however it remains unknown how these factors compare in terms of dopaminergic behavioural sensitization in adulthood. In addition, while Brain-Derived Neurotrophic Factor (BDNF) has been implicated in dopaminergic activity and schizophrenia, its role in behavioural sensitization remains unclear. In this study we therefore compared the effect of chronic adolescent treatment with the stress hormone, corticosterone (Cort), or with Meth, on drug-induced locomotor hyperactivity and disruption of prepulse inhibition in adulthood in BDNF heterozygous mice and their wild-type controls, as well as on dopamine receptor gene expression. Between 6 and 9 weeks of age, the animals either received Cort in the drinking water or were treated with an escalating Meth dose protocol. In adulthood, Cort-pretreated mice showed significantly reduced Meth-induced locomotor hyperactivity compared to vehicle-pretreated mice. In contrast, Meth hyperlocomotion was significantly enhanced in animals pretreated with the drug in adolescence. There were no effects of either pretreatment on prepulse inhibition. BDNF Het mice showed greater Meth-induced hyperlocomotion and lower prepulse inhibition than WT mice. There were no effects of either pretreatment on D1 or D2 gene expression in either the dorsal or ventral striatum, while D3 mRNA was shown to be reduced in male mice only irrespective of genotype. These results suggest that in adolescence, chronically elevated glucocorticoid levels, a component of chronic stress, do not cause dopaminergic sensitization adulthood, in contrast to the effect of chronic Meth treatment in the same age period. BDNF does not appear to be involved in the effects of chronic Cort or chronic Meth.
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Affiliation(s)
- Lina Schonfeld
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Emily J Jaehne
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Alexandra R Ogden
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jereme G Spiers
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, Australia
| | - Samuel Hogarth
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Maarten van den Buuse
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Department of Pharmacology, University of Melbourne, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
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46
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Bridgwater M, Bachman P, Tervo-Clemmens B, Haas G, Hayes R, Luna B, Salisbury DF, Jalbrzikowski M. Developmental influences on symptom expression in antipsychotic-naïve first-episode psychosis. Psychol Med 2022; 52:1698-1709. [PMID: 33019960 PMCID: PMC8021611 DOI: 10.1017/s0033291720003463] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The neurodevelopmental model of psychosis was established over 30 years ago; however, the developmental influence on psychotic symptom expression - how age affects clinical presentation in first-episode psychosis - has not been thoroughly investigated. METHODS Using generalized additive modeling, which allows for linear and non-linear functional forms of age-related change, we leveraged symptom data from a large sample of antipsychotic-naïve individuals with first-episode psychosis (N = 340, 12-40 years, 1-12 visits), collected at the University of Pittsburgh from 1990 to 2017. We examined relationships between age and severity of perceptual and non-perceptual positive symptoms and negative symptoms. We tested for age-associated effects on change in positive or negative symptom severity following baseline assessment and explored the time-varying relationship between perceptual and non-perceptual positive symptoms across adolescent development. RESULTS Perceptual positive symptom severity significantly decreased with increasing age (F = 7.0, p = 0.0007; q = 0.003) while non-perceptual positive symptom severity increased with age (F = 4.1, p = 0.01, q = 0.02). Anhedonia severity increased with increasing age (F = 6.7, p = 0.00035; q = 0.0003), while flat affect decreased in severity with increased age (F = 9.8, p = 0.002; q = 0.006). Findings remained significant when parental SES, IQ, and illness duration were included as covariates. There were no developmental effects on change in positive or negative symptom severity (all p > 0.25). Beginning at age 18, there was a statistically significant association between severity of non-perceptual and perceptual symptoms. This relationship increased in strength throughout adulthood. CONCLUSIONS These findings suggest that as maturation proceeds, perceptual symptoms attenuate while non-perceptual symptoms are enhanced. Findings underscore how pathological brain-behavior relationships vary as a function of development.
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Affiliation(s)
- Miranda Bridgwater
- Department of Psychology, University of Maryland, Baltimore County, Maryland, USA
| | - Peter Bachman
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Gretchen Haas
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- VISN4 MIRECC at VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Rebecca Hayes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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47
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Ristanovic I, Haase CM, Lunsford-Avery JR, Mittal VA. The relationship between stress responding in family context and stress sensitivity with sleep dysfunction in individuals at clinical high-risk for psychosis. J Psychiatr Res 2022; 149:194-200. [PMID: 35287048 PMCID: PMC9176292 DOI: 10.1016/j.jpsychires.2022.02.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/02/2022] [Accepted: 02/28/2022] [Indexed: 12/13/2022]
Abstract
Stress and sleep have been implicated in the etiology of psychosis, and literature suggests they are closely related. Two distinct domains of stress associated with sleep dysfunction in the general population are responsivity to environmental stressors and stress sensitivity. However, to date, no research has examined relationships between these stress domains and sleep dysfunction in individuals at clinical high-risk (CHR) for psychosis. A total of 57 CHR (mean age = 18.89, SD = 1.82) and 61 healthy control (HC; mean age = 18.34, SD = 2.41) adolescents and young adults completed a measure of emerging stress intolerance. A subset of participants (CHR = 50, HC = 49) completed a measure indexing responsivity to family stressors - an integral context for this developmental stage overlapping with the psychosis-risk period. Sleep efficiency, continuity, and duration were objectively assessed by actigraphy (CHR = 38, HC = 36). Partial correlations with age and sex as covariates were conducted in both groups separately to examine relationships between stress and sleep. Results indicated that automatic maladaptive responsivity to family stressors was associated with disrupted sleep in the CHR but not HC group. Specifically, greater involuntary engagement was associated with poorer sleep efficiency (r = -.42) but not sleep continuity (r = 0.31) and duration (r = .-19). Interestingly, both adaptative and maladaptive voluntary responses to stressors (engagement and disengagement coping) were not associated with sleep. Finally, impaired stress tolerance was associated with sleep efficiency (r = -0.47), continuity (r = 0.37), and duration (r = -0.43). Taken together, findings provided important groundwork for understanding the role of the relationship between involuntary maladaptive responsivity to family stressors and stress sensitivity with sleep in psychosis etiology.
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Affiliation(s)
- Ivanka Ristanovic
- Northwestern University, Department of Psychology, Evanston, IL, USA.
| | - Claudia M. Haase
- Northwestern University, School of Education and Social Policy Evanston, IL
| | | | - Vijay A. Mittal
- Northwestern University, Department of Psychology, Evanston, IL,Northwestern University, Department of Psychiatry, Chicago, IL,Northwestern University, Medical Social Sciences, Chicago IL,Norhtwestern University, Institute for Policy Research, Evanston, IL
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48
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de Oliveira RP, de Andrade JS, Spina M, Chamon JV, Silva PHD, Werder AK, Ortolani D, Thomaz LDSC, Romariz S, Ribeiro DA, Longo BM, Spadari RC, Viana MDB, Melo-Thomas L, Céspedes IC, da Silva RCB. Clozapine prevented social interaction deficits and reduced c-Fos immunoreactivity expression in several brain areas of rats exposed to acute restraint stress. PLoS One 2022; 17:e0262728. [PMID: 35239670 PMCID: PMC8893644 DOI: 10.1371/journal.pone.0262728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/04/2022] [Indexed: 11/21/2022] Open
Abstract
In the present study, we evaluate the effect of acute restraint stress (15 min) of male Wistar rats on social interaction measurements and c-Fos immunoreactivity (c-Fos-ir) expression, a marker of neuronal activity, in areas involved with the modulation of acute physical restraint in rats, i.e., the paraventricular nucleus of the hypothalamus (PVN), median raphe nucleus (MnR), medial prefrontal cortex (mPFC), cingulate prefrontal cortex (cPFC), nucleus accumbens (NaC), hippocampus (CA3), lateral septum (LS) and medial amygdala (MeA). We considered the hypothesis that restraint stress exposure could promote social withdrawal induced by the activation of the hypothalamic-pituitary-adrenocortical (HPA) axis, and increase c-Fos expression in these limbic forebrain areas investigated. In addition, we investigated whether pretreatment with the atypical antipsychotic clozapine (5 mg/kg; I.P.) could attenuate or block the effects of restraint on these responses. We found that restraint stress induced social withdrawal, and increased c-Fos-ir in these areas, demonstrating that a single 15 min session of physical restraint of rats effectively activated the HPA axis, representing an effective tool for the investigation of neuronal activity in brain regions sensitive to stress. Conversely, pretreatment with clozapine, prevented social withdrawal and reduced c-Fos expression. We suggest that treatment with clozapine exerted a preventive effect in the social interaction deficit, at least in part, by blocking the effect of restraint stress in brain regions that are known to regulate the HPA-axis, including the cerebral cortex, hippocampus, hypothalamus, septum and amygdala. Further experiments will be done to confirm this hypothesis.
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Affiliation(s)
| | - José Simões de Andrade
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
| | - Marianna Spina
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
| | - João Vítor Chamon
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
| | | | - Ana Keyla Werder
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
| | - Daniela Ortolani
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
| | | | - Simone Romariz
- Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP/SP), São Paulo, Brazil
| | - Daniel Araki Ribeiro
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
| | - Beatriz Monteiro Longo
- Departamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP/SP), São Paulo, Brazil
| | - Regina Célia Spadari
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
| | - Milena de Barros Viana
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
| | - Liana Melo-Thomas
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps-Universityof Marburg, Marburg, Germany
- Marburg Center for Mind, Brain, and Behavior (MCMBB), Marburg, Marburg, Germany
| | - Isabel Cristina Céspedes
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Regina Cláudia Barbosa da Silva
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos (SP), Brazil
- Instituto de Neurociências e Comportamento (INeC), Ribeirão Preto, São Paulo, Brazil
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49
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Vargas T, Damme KSF, Osborne KJ, Mittal VA. Differentiating kinds of systemic stressors with relation to psychotic-like experiences in late childhood and early adolescence: the stimulation, discrepancy, and deprivation model of psychosis. Clin Psychol Sci 2022; 10:291-309. [PMID: 35402089 PMCID: PMC8993139 DOI: 10.1177/21677026211016415] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Conceptualizations that distinguish systems-level stress exposures are lacking; the Stimulation (lack of safety and high attentional demands), Discrepancy (social exclusion and lack of belonging), and Deprivation (lack of environmental enrichment) (SDD) theory of psychosis and stressors occurring at the systems-level has not been directly tested. METHODS Exploratory factor analysis was conducted on 3,207 youth, and associations with psychotic-like experiences (PLEs) were explored. RESULTS Though model fit was suboptimal, five factors were defined, and four were consistent with the SDD theory, and related to PLEs. Objective and subjective/self-report exposures for deprivation showed significantly stronger PLE associations compared to discrepancy and objective stimulation factors. Objective and subjective/self-report measures converged overall, though self-report stimulation exhibited a significantly stronger association with PLEs compared to objective stimulation. DISCUSSION Considering distinct system-level exposures could help clarify putative mechanisms and psychosis vulnerability. The preliminary approach potentially informs health policy efforts aimed at psychopathology prevention and intervention.
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Affiliation(s)
| | | | | | - Vijay A Mittal
- Northwestern University Department of Psychology, Northwestern University Department of Psychiatry, Northwestern University Department of Medical Social Sciences, Northwestern University Institute for Innovations in Developmental Sciences, Northwestern University Institute for Policy Research
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50
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Kiemes A, Gomes FV, Cash D, Uliana DL, Simmons C, Singh N, Vernon AC, Turkheimer F, Davies C, Stone JM, Grace AA, Modinos G. GABA A and NMDA receptor density alterations and their behavioral correlates in the gestational methylazoxymethanol acetate model for schizophrenia. Neuropsychopharmacology 2022; 47:687-695. [PMID: 34743200 PMCID: PMC8782908 DOI: 10.1038/s41386-021-01213-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/09/2021] [Accepted: 10/13/2021] [Indexed: 01/19/2023]
Abstract
Hippocampal hyperactivity driven by GABAergic interneuron deficits and NMDA receptor hypofunction is associated with the hyperdopaminergic state often observed in schizophrenia. Furthermore, previous research in the methylazoxymethanol acetate (MAM) rat model has demonstrated that repeated peripubertal diazepam administration can prevent the emergence of adult hippocampal hyperactivity, dopamine-system hyperactivity, and associated psychosis-relevant behaviors. Here, we sought to characterize hippocampal GABAA and NMDA receptors in MAM-treated rats and to elucidate the receptor mechanisms underlying the promising effects of peripubertal diazepam exposure. Quantitative receptor autoradiography was used to measure receptor density in the dorsal hippocampus CA1, ventral hippocampus CA1, and ventral subiculum. Specifically, [3H]-Ro15-4513 was used to quantify the density of α5GABAA receptors (α5GABAAR), [3H]-flumazenil to quantify α1-3;5GABAAR, and [3H]-MK801 to quantify NMDA receptors. MAM rats exhibited anxiety and schizophrenia-relevant behaviors as measured by elevated plus maze and amphetamine-induced hyperlocomotion (AIH), although diazepam only partially rescued these behaviors. α5GABAAR density was reduced in MAM-treated rats in all hippocampal sub-regions, and negatively correlated with AIH. Ventral hippocampus CA1 α5GABAAR density was positively correlated with anxiety-like behavior. Dorsal hippocampus CA1 NMDA receptor density was increased in MAM-treated rats, and positively correlated with AIH. [3H]-flumazenil revealed no significant effects. Finally, we found no significant effect of diazepam treatment on receptor densities, potentially related to the only partial rescue of schizophrenia-relevant phenotypes. Overall, our findings provide first evidence of α5GABAAR and NMDA receptor abnormalities in the MAM model, suggesting that more selective pharmacological agents may become a novel therapeutic mechanism in schizophrenia.
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Affiliation(s)
- Amanda Kiemes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Felipe V Gomes
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Diana Cash
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniela L Uliana
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Camilla Simmons
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nisha Singh
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Anthony C Vernon
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Federico Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James M Stone
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Anthony A Grace
- Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
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