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Li Y, Jia H, Wei X, Zhen S, He SC, Zhang XY. Interaction of childhood trauma with BDNF and FKBP5 gene polymorphisms in predicting burnout in general occupational groups. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01825-9. [PMID: 38861240 DOI: 10.1007/s00406-024-01825-9] [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: 01/24/2024] [Accepted: 05/10/2024] [Indexed: 06/12/2024]
Abstract
Both the BDNF gene rs6265 and the FKBP5 gene rs1360780 polymorphisms are independently associated with adult psychotic-like experiences, when exposed to high childhood abuse; however, it remains unclear whether the relationship between childhood abuse and burnout is moderated by these two single nucleotide polymorphisms (SNPs). Furthermore, there is an interaction between glucocorticoid receptor transcriptional activity and BDNF signaling. Therefore, we investigated the interaction of these two SNPs with childhood trauma in predicting burnout. We recruited 990 participants (mean age 33.06 years, S.D. = 6.31) from general occupational groups and genotyped them for rs6265 and rs1360780. Burnout, childhood trauma, resilience, and job stress were measured through a series of rating scales. Gene-by-environment and gene-by-gene-by-environment interactions were examined using linear hierarchical regression and PROCESS macro in SPSS. Covariates included demographics and resilience. We found that rs6265 moderated the association between job stress and emotional exhaustion. Both rs6265 and rs1360780 moderated the association between childhood abuse and cynicism. There was significant interaction of childhood abuse × rs6265 × rs1360780 on emotional exhaustion and reduced personal accomplishment, so that rs6265 CC genotype and rs1360780 TT genotype together predicted higher levels of emotional exhaustion under high childhood abuse, while rs6265 TT genotype and rs1360780 CC genotype together exerted a resilient effect on reduced personal accomplishment in the face of childhood abuse. Our findings suggest that the rs6265 CC genotype and rs1360780 TT genotype may jointly contribute to increased risk of burnout under childhood trauma.
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Affiliation(s)
- Yuling Li
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education; Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 5 Yiheyuan Road, Haidian District, Beijing, 100871, China
| | - Haiying Jia
- Special Service Personnel Health Management Department, PLA Strategic Support Force Medical Center, Beijing, 100101, China
| | - Xueqian Wei
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 5 Yiheyuan Road, Haidian District, Beijing, 100871, China
| | - Shiqian Zhen
- Institute of Circulation and Consumption, Chinese Academy of International Trade and Economic Cooperation, 28 Donghou Lane, Andingmenwai, Dongcheng District, Beijing, 100710, China.
| | - Shu-Chang He
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, 5 Yiheyuan Road, Haidian District, Beijing, 100871, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Healthy, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China
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Thomas M, Rakesh D, Whittle S, Sheridan M, Upthegrove R, Cropley V. The neural, stress hormone and inflammatory correlates of childhood deprivation and threat in psychosis: A systematic review. Psychoneuroendocrinology 2023; 157:106371. [PMID: 37651860 DOI: 10.1016/j.psyneuen.2023.106371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/20/2023] [Accepted: 08/18/2023] [Indexed: 09/02/2023]
Abstract
Childhood adversity increases the risk of developing psychosis, but the biological mechanisms involved are unknown. Disaggregating early adverse experiences into core dimensions of deprivation and threat may help to elucidate these mechanisms. We therefore systematically searched the literature investigating associations between deprivation and threat, and neural, immune and stress hormone systems in individuals on the psychosis spectrum. Our search yielded 74 articles, from which we extracted and synthesized relevant findings. While study designs were heterogeneous and findings inconsistent, some trends emerged. In psychosis, deprivation tended to correlate with lower global cortical volume, and some evidence supported threat-related variation in prefrontal cortex morphology. Greater threat exposure was also associated with higher C-reactive protein, and higher and lower cortisol measures. When examined, associations in controls were less evident. Overall, findings indicate that deprivation and threat may associate with partially distinct biological mechanisms in the psychosis spectrum, and that associations may be stronger than in controls. Dimensional approaches may help disentangle the biological correlates of childhood adversity in psychosis, but more studies are needed.
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Affiliation(s)
- Megan Thomas
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia.
| | - Divyangana Rakesh
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia; Neuroimaging Department, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
| | - Margaret Sheridan
- Department of Psychology & Neuroscience, University of North Carolina, United States
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, United Kingdom; Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, United Kingdom
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Australia
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Thomas M, Whittle S, Tian YE, van Rheenen TE, Zalesky A, Cropley VL. Pathways from threat exposure to psychotic symptoms in youth: The role of emotion recognition bias and brain structure. Schizophr Res 2023; 261:304-313. [PMID: 37898031 DOI: 10.1016/j.schres.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/21/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Research supports an association between threatening experiences in childhood and psychosis. It is possible that early threat exposure disrupts the development of emotion recognition (specifically, producing a bias for facial expressions relating to threat) and the brain structures subserving it, contributing to psychosis development. METHODS Using data from the Philadelphia Neurodevelopmental Cohort, we examined associations between threat exposure and both the misattribution of facial expressions to fear/anger in an emotion recognition task, and gray matter volumes in key emotion processing regions. Our sample comprised youth with psychosis spectrum symptoms (N = 304), control youth (N = 787), and to evaluate specificity, youth with internalizing symptoms (N = 92). The moderating effects of group and sex were examined. RESULTS Both the psychosis spectrum and internalizing groups had higher levels of threat exposure than controls. In the total sample, threat exposure was associated with lower left medial prefrontal cortex (mPFC) volume but not misattributions to fear/anger. The effects of threat exposure did not significantly differ by group or sex. CONCLUSIONS The findings of this study provide evidence for an effect of threat exposure on mPFC morphology, but do not support an association between threat exposure and a recognition bias for threat-related expressions, that is particularly pronounced in psychosis. Future research should investigate factors linking transdiagnostic alterations related to threat exposure with psychotic symptoms, and attempt to clarify the mechanisms underpinning emotion recognition misattributions in threat-exposed youth.
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Affiliation(s)
- Megan Thomas
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia.
| | - Sarah Whittle
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Ye E Tian
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Tamsyn E van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia; Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
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Ma Y, Hendrickson T, Ramsay I, Shen A, Sponheim SR, MacDonald AW. Resting-State Functional Connectivity Explained Psychotic-like Experiences in the General Population and Partially Generalized to Patients and Relatives. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:1094-1103. [PMID: 37881569 PMCID: PMC10593874 DOI: 10.1016/j.bpsgos.2022.08.011] [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: 08/17/2021] [Revised: 08/11/2022] [Accepted: 08/31/2022] [Indexed: 11/15/2022] Open
Abstract
Background Psychotic-like experiences (PLEs) are considered the subclinical portion of the psychosis continuum. Research suggests that there are resting-state functional connectivity (rsFC) substrates of PLEs, yet it is unclear if the same substrates underlie more severe psychosis. Here, to our knowledge, we report the first study to build a cross-validated rsFC model of PLEs in a large community sample and directly test its ability to explain psychosis in an independent sample of patients with psychosis and their relatives. Methods Resting-state FC of 855 healthy young adults from the WU-Minn Human Connectome Project (HCP) was used to predict PLEs with elastic net. An rsFC composite score based on the resulting model was correlated with psychotic traits and symptoms in 118 patients with psychosis, 71 nonpsychotic first-degree relatives, and 45 healthy control subjects from the psychosis HCP. Results In the HCP, the cross-validated model explained 3.3% of variance in PLEs. Predictive connections spread primarily across the default, frontoparietal, cingulo-opercular, and dorsal attention networks. The model partially generalized to a younger, but not older, subsample in the psychosis HCP, explaining two measures of positive/disorganized psychotic traits (the Structured Interview for Schizotypy: β = 0.25, pone-tailed = .027; the Schizotypy Personality Questionnaire positive factor: β = 0.14, pone-tailed = .041). However, it did not differentiate patients from relatives and control subjects or explain psychotic symptoms in patients. Conclusions Some rsFC substrates of PLEs are shared across the psychosis continuum. However, explanatory power was modest, and generalization was partial. It is equally important to understand shared versus distinct rsFC variances across the psychosis continuum.
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Affiliation(s)
- Yizhou Ma
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Ian Ramsay
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Amanda Shen
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Scott R. Sponheim
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota
| | - Angus W. MacDonald
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
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Seah C, Huckins LM, Brennand KJ. Stem Cell Models for Context-Specific Modeling in Psychiatric Disorders. Biol Psychiatry 2023; 93:642-650. [PMID: 36658083 DOI: 10.1016/j.biopsych.2022.09.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 01/21/2023]
Abstract
Genome-wide association studies reveal the complex polygenic architecture underlying psychiatric disorder risk, but there is an unmet need to validate causal variants, resolve their target genes(s), and explore their functional impacts on disorder-related mechanisms. Disorder-associated loci regulate transcription of target genes in a cell type- and context-specific manner, which can be measured through expression quantitative trait loci. In this review, we discuss methods and insights from context-specific modeling of genetically and environmentally regulated expression. Human induced pluripotent stem cell-derived cell type and organoid models have uncovered context-specific psychiatric disorder associations by investigating tissue-, cell type-, sex-, age-, and stressor-specific genetic regulation of expression. Techniques such as massively parallel reporter assays and pooled CRISPR (clustered regularly interspaced short palindromic repeats) screens make it possible to functionally fine-map genome-wide association study loci and validate their target genes at scale. Integration of disorder-associated contexts with these patient-specific human induced pluripotent stem cell models makes it possible to uncover gene by environment interactions that mediate disorder risk, which will ultimately improve our ability to diagnose and treat psychiatric disorders.
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Affiliation(s)
- Carina Seah
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York; Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York
| | - Laura M Huckins
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York; Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| | - Kristen J Brennand
- Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York; Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
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Genetic and psychosocial stressors have independent effects on the level of subclinical psychosis: findings from the multinational EU-GEI study. Epidemiol Psychiatr Sci 2022; 31:e68. [PMID: 36165168 PMCID: PMC9533114 DOI: 10.1017/s2045796022000464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS Gene x environment (G×E) interactions, i.e. genetic modulation of the sensitivity to environmental factors and/or environmental control of the gene expression, have not been reliably established regarding aetiology of psychotic disorders. Moreover, recent studies have shown associations between the polygenic risk scores for schizophrenia (PRS-SZ) and some risk factors of psychotic disorders, challenging the traditional gene v. environment dichotomy. In the present article, we studied the role of GxE interaction between psychosocial stressors (childhood trauma, stressful life-events, self-reported discrimination experiences and low social capital) and the PRS-SZ on subclinical psychosis in a population-based sample. METHODS Data were drawn from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, in which subjects without psychotic disorders were included in six countries. The sample was restricted to European descendant subjects (n = 706). Subclinical dimensions of psychosis (positive, negative, and depressive) were measured by the Community Assessment of Psychic Experiences (CAPE) scale. Associations between the PRS-SZ and the psychosocial stressors were tested. For each dimension, the interactions between genes and environment were assessed using linear models and comparing explained variances of 'Genetic' models (solely fitted with PRS-SZ), 'Environmental' models (solely fitted with each environmental stressor), 'Independent' models (with PRS-SZ and each environmental factor), and 'Interaction' models (Independent models plus an interaction term between the PRS-SZ and each environmental factor). Likelihood ration tests (LRT) compared the fit of the different models. RESULTS There were no genes-environment associations. PRS-SZ was associated with positive dimensions (β = 0.092, R2 = 7.50%), and most psychosocial stressors were associated with all three subclinical psychotic dimensions (except social capital and positive dimension). Concerning the positive dimension, Independent models fitted better than Environmental and Genetic models. No significant GxE interaction was observed for any dimension. CONCLUSIONS This study in subjects without psychotic disorders suggests that (i) the aetiological continuum hypothesis could concern particularly the positive dimension of subclinical psychosis, (ii) genetic and environmental factors have independent effects on the level of this positive dimension, (iii) and that interactions between genetic and individual environmental factors could not be identified in this sample.
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Toutountzidis D, Gale TM, Irvine K, Sharma S, Laws KR. Childhood trauma and schizotypy in non-clinical samples: A systematic review and meta-analysis. PLoS One 2022; 17:e0270494. [PMID: 35767584 PMCID: PMC9242513 DOI: 10.1371/journal.pone.0270494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 06/10/2022] [Indexed: 01/14/2023] Open
Abstract
The association of early life adversities and psychosis symptoms is well documented in clinical populations; however, whether this relationship also extends into subclinical psychosis remains unclear. In particular, are early life adversities associated with increased levels of schizotypal personality traits in non-clinical samples? We conducted a systematic review and meta-analysis of associations between early life adversities and psychometrically defined schizotypal traits in non-clinical samples. The review followed PRISMA guidelines. The search using PubMed, Web of Science and EBSCO databases identified 1,609 articles in total. Twenty-five studies (N = 15,253 participants) met eligibility criteria for the review. An assessment of study quality showed that fewer than half of all studies were rated as methodologically robust. Meta-analyses showed that all forms of childhood abuse (emotional, physical and sexual) and neglect (emotional and physical) were significantly associated with psychometric schizotypy. The association of schizotypy traits with childhood emotional abuse (r = .33: 95%CI .30 to .37) was significantly larger than for all other form of abuse or neglect. Meta-regression analyses showed that the physical abuse-schizotypy relationship was stronger in samples with more women participants; and the sexual abuse-schizotypy relationship was stronger in younger samples. The current review identifies a dose-response relationship between all forms of abuse/neglect and schizotypy scores in non-clinical samples; however, a stronger association emerged for emotional abuse. More research is required to address the relationship of trauma types and specific symptom types. Future research should also address the under-representation of men.
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Affiliation(s)
- Diamantis Toutountzidis
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- * E-mail:
| | - Tim M. Gale
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Research and Development Department, Hertfordshire Partnership NHS Foundation Trust, Hatfield, United Kingdom
| | - Karen Irvine
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Shivani Sharma
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Keith R. Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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Wei Q, Pan Y, Zhang S, Yin W, Lin Q, Pan S, Dai C, Zhou L, Wu J. Epidemiology of childhood trauma and its association with insomnia and psychotic-like experiences in Chinese Zhuang adolescents. Front Psychiatry 2022; 13:974674. [PMID: 36072448 PMCID: PMC9441791 DOI: 10.3389/fpsyt.2022.974674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescents who have experienced childhood trauma are more likely to have insomnia and psychotic-like experiences (PLEs) than adolescents from other ethnic groups. However, little is known about the youth of ethnic minorities. This study aimed to investigate the epidemiology of childhood trauma and its relationship with insomnia and PLEs in Chinese Zhuang adolescents, focusing on the role of a specific type of trauma and accumulation. METHODS A questionnaire of Childhood Trauma Questionnaire-Short Form (CTQ-SF), Athens Insomnia Scale (AIS), and Chinese Version Community assessment psychic experiences-8 (CCAPE- 8) were all completed by 1,493 Chinese Zhuang adolescents. Chi-square and multivariate logistic regression analyses examined the association between childhood trauma and insomnia/PLEs. RESULTS The incidences of emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN) occurred at rates of 5.63, 5.02, 6.56, 23.98, and 33.15%, respectively. EA, SA, EN, and PN were all positively related to insomnia (OR: 1.314-7.720, all p < 0.05). EA and SA were positively associated with PLEs (OR: 2.131-3.202, all p < 0.001). Adolescents who had experienced three or more types of traumas were more likely to have insomnia (OR = 6.961, p < 0.001) and PLEs (OR = 3.558, p < 0.001). CONCLUSION The most common type of childhood trauma is PN. Childhood trauma has the primary effect on insomnia/PLE. A significant dose-response relationship was found between Childhood trauma and insomnia/ PLEs. This association varied depending on the type and accumulation of exposure.
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Affiliation(s)
- Qiaoyue Wei
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yuli Pan
- Department of Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, China
| | - Shengjie Zhang
- Department of Graduate Management, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Wenwen Yin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Qinghong Lin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Shuibo Pan
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Chenyangzi Dai
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Linhua Zhou
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China.,Department of Psychology, School of Medicine, Guangxi Medical College, Nanning, China
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Cokyaman T, Kasap T, Şehitoğlu H. Serum brain-derived neurotrophic factor in the diagnosis of febrile seizure. Pediatr Int 2021; 63:1082-1086. [PMID: 33289227 DOI: 10.1111/ped.14567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/06/2020] [Accepted: 11/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is a noncovalently linked homodimer protein from the neurotrophic growth factor family. Although it is expressed throughout the brain, it is produced more intensively in the entorhinal cortex and hippocampus and can cross the blood-brain barrier in two directions easily. The aim of this study is to understand, for the first time, whether there is a relationship between febrile seizure (FS) and BDNF. METHODS The study included cases diagnosed with FS and febrile illness, of similar age, weight, and height, between 6 months and 6 years. Samples for serum BDNF measurement were taken within the first 24-48 h of admission at the hospital and levels were measured using the commercial enzyme-linked immunosorbent assay kit and expressed in ng/mL. RESULTS Eighty cases (40 FS, 40 febrile illness) were included in the study. The mean serum BDNF was found to be 6.7 ± 2.4 ng/mL in the FS group and 4.5 ± 2.6 ng/mL in the febrile illness group (P = 0.001). No relation was found between gender, age, body weight, length, and platelet counts and serum BDNF levels. The optimal cut-off value for serum BDNF was found to be 5.2 ng/mL (75% sensitivity, 62.5% specificity, AUC: 0.723) to distinguish between FS and febrile illness. CONCLUSIONS Excluding demographic variables such as gender, age, weight, length, and platelet counts serum BDNF levels have increased in children with FS. Considering the hippocampal origin of FS, we can suggest that the pathophysiology of FS may be related to the BDNF.
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Affiliation(s)
- Turgay Cokyaman
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Tolga Kasap
- Faculty of Medicine, Department of Pediatrics, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Hilal Şehitoğlu
- Faculty of Medicine, Department of Medical Biochemistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Smit AM, Kilian S, Emsley RA, Luckhoff HK, Swartz L, Seedat S, Asmal L. Associations of premorbid adjustment with type and timing of childhood trauma in first-episode schizophrenia spectrum disorders. S Afr J Psychiatr 2021; 27:1639. [PMID: 34230867 PMCID: PMC8252179 DOI: 10.4102/sajpsychiatry.v27i0.1639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/16/2021] [Indexed: 11/01/2022] Open
Abstract
Background Childhood trauma may contribute to poorer premorbid social and academic adjustment which may be a risk factor for schizophrenia. Aim We explored the relationship between premorbid adjustment and childhood trauma, timing of childhood trauma's moderating role as well as the association of clinical and treatment-related confounders with premorbid adjustment. Setting We conducted a secondary analysis in 111 patients with first-episode schizophrenia (FES) disorders that formed part of two parent studies, EONKCS study (n =73) and the Shared Roots study (n =38). Methods Type of childhood trauma was assessed with the Childhood Trauma Questionnaire, short-form and premorbid adjustment using the Premorbid Adjustment Scale. Timing of childhood trauma was assessed using the Life Events Checklist and life events timeline. Linear regression analyses were used to assess the moderating effect of timing of childhood trauma. Clinical and treatment-related confounders were entered into sequential hierarchical regression models to identify independent predictors of premorbid adjustment across key life stages. Results Childhood physical neglect was associated with poorer premorbid academic functioning during childhood and early adolescence, and poorer premorbid social functioning during early and late adolescence. By hierarchical regression modelling (r 2 = 0.13), higher physical neglect subscale scores (p = 0.011) independently predicted poorer premorbid social adjustment during early adolescence. Timing of childhood trauma did not moderate the relationship between childhood trauma and premorbid functioning. Conclusion In patients with FES, childhood physical neglect may contribute to poorer premorbid social functioning during early adolescence. This may provide us with an opportunity to identify and treat at-risk individuals earlier.
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Affiliation(s)
- Anna M Smit
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sanja Kilian
- Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa
| | - Robin A Emsley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Hilmar K Luckhoff
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Leslie Swartz
- Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Tang W, Xu D, Yang Y, Xu J. Psychotic-like experiences in Chinese children and adolescents: The effect of earthquake exposure, maltreatment and negative life events. Early Interv Psychiatry 2021; 15:536-546. [PMID: 32500658 DOI: 10.1111/eip.12976] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/02/2020] [Accepted: 04/28/2020] [Indexed: 02/05/2023]
Abstract
AIM Psychotic-like experiences (PLEs) are common in adolescents who have experienced or are experiencing trauma. However, the potential relationships between exposure to a major earthquake, negative life events or maltreatment and PLEs in Chinese adolescents are poorly understood. Therefore, this study explored the prevalence of PLEs and the psychosocial correlates in adolescent earthquake survivors. METHODS A total of 6132 adolescents from 11 primary and high schools in the areas most severely affected by the Ya'an earthquake completed questionnaires on earthquake exposure, maltreatment, negative life events and PLEs, which included paranoid ideation and psychoticism. RESULTS It was found that earthquake exposure significantly contributed to the PLEs, child maltreatment explained a significant amount of the PLE variances, emotional abuse had the most important PLE role and negative life events also explained a large amount of the PLE variances, of which interpersonal difficulties and academic pressure had the greatest effects. CONCLUSIONS Interventions should seek to reduce parental emotional abuse, reduce academic performance pressure, improve interpersonal skills and resolve interpersonal difficulties, and specific interventions should target children and adolescents exposed to the earthquake to prevent PLEs, schizophrenia or other mental illnesses arising from multiple traumas.
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Affiliation(s)
- Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.,Institute of Emergency Management and Post-Disaster Reconstruction, Sichuan University, Chengdu, China
| | - Dun Xu
- Institute of Emergency Management and Post-Disaster Reconstruction, Sichuan University, Chengdu, China
| | - Yanchun Yang
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-Disaster Reconstruction, Sichuan University, Chengdu, China
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12
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The Impact of the FKBP5 Gene Polymorphisms on the Relationship between Traumatic Life Events and Psychotic-Like Experiences in Non-Clinical Adults. Brain Sci 2021; 11:brainsci11050561. [PMID: 33925151 PMCID: PMC8144983 DOI: 10.3390/brainsci11050561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/24/2021] [Indexed: 01/30/2023] Open
Abstract
Common variations of the FKBP5 gene are implicated in psychotic disorders, by modulating the hypothalamic–pituitary–adrenal axis reactivity to stress. It has been demonstrated that some of them might moderate the effects of childhood trauma on psychosis proneness. However, these associations have not been investigated with respect to traumatic life events (TLEs). Therefore, we aimed to explore whether the FKBP5 polymorphisms moderate the effects of TLEs on the level of psychotic-like experiences (PLEs). A total of 535 non-clinical adults were approached for participation, and genotyping of six FKBP5 polymorphisms (rs3800373, rs9470080, rs4713902, rs737054, rs1360780 and rs9296158) was performed. The Prodromal Questionnaire-16 (PQ-16) and the Traumatic Events Checklist (TEC) were administered to assess PLEs and TLEs, respectively. Among the rs1360780 CC homozygotes, a history of physical abuse was associated with significantly higher PQ-16 scores. This difference was not significant in the rs1360780 T allele carriers. Similarly, a history of physical abuse was associated with significantly higher PQ-16 scores in the rs9296158 GG homozygotes but not in the rs9296158 A allele carriers. Finally, emotional neglect was related to significantly higher PQ-16 scores in the rs737054 T allele carriers but not in the rs737054 CC homozygotes. The present study indicates that variation in the FKBP5 gene might moderate the effects of lifetime traumatic events on psychosis proneness.
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13
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Stickley A, Waldman K, Sumiyoshi T, Narita Z, Shirama A, Shin JI, Oh H. Childhood physical neglect and psychotic experiences: Findings from the National Comorbidity Survey Replication. Early Interv Psychiatry 2021; 15:256-262. [PMID: 32048480 DOI: 10.1111/eip.12932] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/17/2019] [Accepted: 01/27/2020] [Indexed: 11/30/2022]
Abstract
AIM Childhood adversities have been linked to an increased risk for psychosis. However, as yet, there has been comparatively little research on the effects of neglect. This study examined the association between childhood physical neglect and psychotic experiences (PEs) in a general population sample. METHODS Data were analysed from 2308 individuals collected during the National Comorbidity Survey Replication (NCS-R). Information on lifetime PEs was collected with the WHO-CIDI Psychosis Screen. Respondents also reported on five forms of childhood neglect (went hungry, went without necessities, went unsupervised, lacked medical care, chores too difficult/dangerous). Multivariable logistic regression analysis was used to examine associations. RESULTS In models adjusted for sociodemographic and psychiatric disorder variables, aggregated physical neglect scores (continuous/dichotomized) were associated with significantly increased odds for any lifetime PEs. All individual forms of neglect except went without necessities (odds ratio [OR]: 1.21, 95% confidence interval [CI]: 0.98-1.50) were significantly associated with PEs with ORs ranging from 1.28 (95% CI: 1.08-1.51, went unsupervised) to 1.53 (95% CI: 1.19-1.97, went without medical care). In models that were further adjusted for co-occurring forms of neglect and childhood physical abuse, doing chores that were too difficult/dangerous continued to be associated with significantly increased odds for PEs (OR: 1.29, 95% CI: 1.03-1.61). CONCLUSIONS Childhood physical neglect is associated with significantly increased odds for PEs in the general population. Screening for childhood adversities and PEs among potential patients may be important for the early detection of individuals at high risk for psychosis, as well as for formulating comprehensive and effective treatment plans.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Kyle Waldman
- Department of Sociology, Harvard University, Cambridge, Massachusetts
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Zui Narita
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Hans Oh
- University of Southern California, Suzanne Dworak Peck School of Social Work, Los Angeles, California
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14
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Raine A, Wong KKY, Liu J. The Schizotypal Personality Questionnaire for Children (SPQ-C): Factor Structure, Child Abuse, and Family History of Schizotypy. Schizophr Bull 2021; 47:323-331. [PMID: 32674122 PMCID: PMC8370046 DOI: 10.1093/schbul/sbaa100] [Citation(s) in RCA: 9] [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: 01/08/2023]
Abstract
There is a relative dearth of research on features of schizotypal personality in children, in part due to lack of instrumentation. This study tests 5 competing models of the factor structure of the self-report Schizotypal Personality Questionnaire for Children (SPQ-C) and examines its relationship with a family history of schizotypal personality disorder (SPD), child abuse, and stability over time. Hypotheses were tested on 454 11- to 12-year-old schoolchildren and their caregivers. Confirmatory factor analyses supported a 3-factor structure of the SPQ-C (cognitive-perceptual, interpersonal, and disorganized). Test-retest stability was relatively robust over 3 months (r = .67), 6 months (r = .64), and 12 months (r = .55), with acceptable internal reliabilities (r = .84 to .91). Regarding construct validity, children with a biological family history of SPD had higher scores on all 3 factors (d =.51). Abused children had higher schizotypy scores (d = .55). A genetic × environment interaction was observed, with schizotypy highest in those with both a family history of schizotypy and also child abuse. Findings are the first in the child schizotypy field to document a gene × environment interaction and the independence of child abuse from confounding genetic influences. Results support the utility of the SPQ-C in future family and clinical studies of schizotypal personality and provide an avenue for much-needed and neglected research into the early antecedents of child schizotypal personality.
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Affiliation(s)
- Adrian Raine
- Department of Criminology, Psychiatry, and Psychology, University of
Pennsylvania, Philadelphia, PA
| | - Keri Ka-Yee Wong
- Department of Psychology & Human Development, University College
London, London, UK
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia,
PA
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15
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Fares-Otero NE, Pfaltz MC, Rodriguez-Jimenez R, Schäfer I, Trautmann S. Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol. Eur J Psychotraumatol 2021; 12:1943872. [PMID: 36877473 PMCID: PMC10075514 DOI: 10.1080/20008198.2021.1943872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Background: Childhood maltreatment (CM) is thought to play a key role in the etiology and course of psychotic disorders (PD). In addition, CM is related to neurobiological and clinical characteristics that can lead to poor social functioning. However, the extent to which CM and social functioning are directly associated in individuals with PD, is unclear. Therefore, we aim to systematically review the literature to provide an estimate on the strength of the association between CM and different domains of social functioning in PD and to summarize potential moderators and mediators of this association.Methods and analysis: To identify relevant studies, we will systematically search the following databases: Pubmed (Medline), PsycInfo, Embase, Web of Science (Core Collection), and Pilots (trauma), manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between CM (exposure) and social functioning (outcome) in adults with PD. Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale.Analysis: Effect estimates will be pooled in a meta-analysis. Heterogeneity and publication bias will be assessed and the effects of potential moderators (genetic factors, type of diagnosis, duration of illness, type of CM and age at the time of CM exposure) will be analyzed using meta-regressions. Candidate moderators and mediators (neurocognition, cognitive schemas, comorbidities, stress sensitivity, attachment) will be also examined qualitatively.Ethics and dissemination: Because this review will make use of already published data, ethical approval will not be sought. This work has the potential to inform upcoming investigations on the association between the exposure to CM in PD and social functioning. PROSPERO registration number CRD42020175244.
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Key Words
- abuso infantil, negligencia, cognicivón social, relaciones interpersonales, funcionamiento en la comunidad, psicosis, revisión sistemática
- child abuse, neglect, social cognitive skills, interpersonal relationships, community functioning, psychosis, systematic review
- 人际关系
- 儿童虐待
- 忽视
- 社会功能
- 社会认知技能
- 精神病
- 系统综述
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Affiliation(s)
- Natalia E Fares-Otero
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 De Octubre (Imas12), Madrid, Spain.,Universidad Internacional de la Rioja, Spain
| | - Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Faculty of Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roberto Rodriguez-Jimenez
- Department of Psychiatry, Biomedical Research Institute, University Hospital 12 De Octubre (Imas12), Faculty of Medicine, University Complutense de Madrid (UCM), Madrid, Spain, CIBERSAM (Biomedical Research Networking Centre in Mental Health), Madrid, Spain
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sebastian Trautmann
- Department of Psychology, Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
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16
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Notaras M, van den Buuse M. Neurobiology of BDNF in fear memory, sensitivity to stress, and stress-related disorders. Mol Psychiatry 2020; 25:2251-2274. [PMID: 31900428 DOI: 10.1038/s41380-019-0639-2] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 12/01/2019] [Accepted: 12/12/2019] [Indexed: 01/17/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) is widely accepted for its involvement in resilience and antidepressant drug action, is a common genetic locus of risk for mental illnesses, and remains one of the most prominently studied molecules within psychiatry. Stress, which arguably remains the "lowest common denominator" risk factor for several mental illnesses, targets BDNF in disease-implicated brain regions and circuits. Altered stress-related responses have also been observed in animal models of BDNF deficiency in vivo, and BDNF is a common downstream intermediary for environmental factors that potentiate anxiety- and depressive-like behavior. However, BDNF's broad functionality has manifested a heterogeneous literature; likely reflecting that BDNF plays a hitherto under-recognized multifactorial role as both a regulator and target of stress hormone signaling within the brain. The role of BDNF in vulnerability to stress and stress-related disorders, such as posttraumatic stress disorder (PTSD), is a prominent example where inconsistent effects have emerged across numerous models, labs, and disciplines. In the current review we provide a contemporary update on the neurobiology of BDNF including new data from the behavioral neuroscience and neuropsychiatry literature on fear memory consolidation and extinction, stress, and PTSD. First we present an overview of recent advances in knowledge on the role of BDNF within the fear circuitry, as well as address mounting evidence whereby stress hormones interact with endogenous BDNF-TrkB signaling to alter brain homeostasis. Glucocorticoid signaling also acutely recruits BDNF to enhance the expression of fear memory. We then include observations that the functional common BDNF Val66Met polymorphism modulates stress susceptibility as well as stress-related and stress-inducible neuropsychiatric endophenotypes in both man and mouse. We conclude by proposing a BDNF stress-sensitivity hypothesis, which posits that disruption of endogenous BDNF activity by common factors (such as the BDNF Val66Met variant) potentiates sensitivity to stress and, by extension, vulnerability to stress-inducible illnesses. Thus, BDNF may induce plasticity to deleteriously promote the encoding of fear and trauma but, conversely, also enable adaptive plasticity during extinction learning to suppress PTSD-like fear responses. Ergo regulators of BDNF availability, such as the Val66Met polymorphism, may orchestrate sensitivity to stress, trauma, and risk of stress-induced disorders such as PTSD. Given an increasing interest in personalized psychiatry and clinically complex cases, this model provides a framework from which to experimentally disentangle the causal actions of BDNF in stress responses, which likely interact to potentiate, produce, and impair treatment of, stress-related psychiatric disorders.
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Affiliation(s)
- Michael Notaras
- Center for Neurogenetics, Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, Cornell University, New York, NY, USA.
| | - Maarten van den Buuse
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia. .,Department of Pharmacology, University of Melbourne, Melbourne, VIC, Australia.
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17
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Javed J, Karkal R, Nafisa D, Kakunje A. Folie a deux in monozygotic twins with childhood trauma: A case report. Asian J Psychiatr 2020; 53:102192. [PMID: 32534435 DOI: 10.1016/j.ajp.2020.102192] [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: 04/24/2020] [Revised: 05/12/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
Folie a deux is a rare syndrome characterized by induction of a delusion in a susceptible person in close proximity with an individual with known delusional disorder. We report a rare case of monozygotic twins with induced delusional disorder in one of the twins. The twins had experienced childhood trauma in the form of emotional neglect and physical abuse by the father. The primary case (Twin A) was diagnosed with delusional disorder and was treated with oral antipsychotic. The secondary case (Twin B) showed resolution of symptoms after separation from twin A. The case highlights the unique presentation of induced delusional symptoms in monozygotic twins and the close association between childhood trauma and psychosis.
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Affiliation(s)
- Janisar Javed
- Department of Psychiatry, Yenepoya Medical College, Mangaluru, 575018, India
| | - Ravichandra Karkal
- Department of Psychiatry, Yenepoya Medical College, Mangaluru, 575018, India.
| | - Dilshana Nafisa
- Department of Psychiatry, Yenepoya Medical College, Mangaluru, 575018, India
| | - Anil Kakunje
- Department of Psychiatry, Yenepoya Medical College, Mangaluru, 575018, India
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18
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Abstract
The brain-derived neurotrophic factor (BDNF) is a secretory growth factor that promotes neuronal proliferation and survival, synaptic plasticity and long-term potentiation in the central nervous system. Brain-derived neurotrophic factor biosynthesis and secretion are chrono-topically regulated processes at the cellular level, accounting for specific localizations and functions. Given its role in regulating brain development and activity, BDNF represents a potentially relevant gene for schizophrenia, and indeed BDNF and its non-synonymous functional variant, rs6265 (C → T, Val → Met) have been widely studied in psychiatric genetics. Human and animal studies have indicated that brain-derived neurotrophic factor is relevant for schizophrenia-related phenotypes, and that: (1) fine-tuned regulation of brain-derived neurotrophic factor secretion and activity is necessary to guarantee brain optimal development and functioning; (2) the Val → Met substitution is associated with impaired activity-dependent secretion of brain-derived neurotrophic factor; (3) disruption of brain-derived neurotrophic factor signaling is associated with altered synaptic plasticity and neurodevelopment. However, genome-wide association studies failed to associate the BDNF locus with schizophrenia, even though a sub-threshold association exists. Here, we will review studies focused on the relationship between the genetic variation of BDNF and schizophrenia, trying to fill the gap between genetic risk per se and insights from molecular biology. A deeper understanding of brain-derived neurotrophic factor biology and of the epigenetic regulation of brain-derived neurotrophic factor and its interactome during development may help clarifying the potential role of this gene in schizophrenia, thus informing development of brain-derived neurotrophic factor-based strategies of prevention and treatment of this disorder.
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19
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Stanton KJ, Denietolis B, Goodwin BJ, Dvir Y. Childhood Trauma and Psychosis: An Updated Review. Child Adolesc Psychiatr Clin N Am 2020; 29:115-129. [PMID: 31708041 DOI: 10.1016/j.chc.2019.08.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is growing evidence to support the link between childhood trauma and psychosis. Childhood trauma increases the risk for psychosis and affects severity and type of psychotic symptoms, and frequency of comorbid conditions, including depression and substance use. Childhood trauma is linked to more severe functional impairment in individuals with psychosis. There is evidence to support gender differences in the influence of childhood trauma on the course of psychotic illnesses, appearing to be more profound in girls and women. Other biological markers that may explain the link between childhood trauma and psychosis include brain-derived neurotrophic factor and other inflammatory markers.
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Affiliation(s)
- Kate J Stanton
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Brian Denietolis
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Brien J Goodwin
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way/Tobin Hall, Amherst, MA 01003, USA
| | - Yael Dvir
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
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20
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Evidence for interaction between genetic liability and childhood trauma in the development of psychotic symptoms. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1045-1054. [PMID: 31209522 DOI: 10.1007/s00127-019-01711-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 04/08/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Whilst childhood trauma (CT) is a known risk factor across the spectrum of psychosis expression, little is known about possible interplay with genetic liability. METHODS The TwinssCan Study collected data in general population twins, focussing on expression of psychosis at the level of subthreshold psychotic experiences. A multilevel mixed-effects linear regression analysis was performed including 745 subjects to assess the interaction between genetic liability and CT. The Symptom Checklist-90 (SCL-90-R) score of the co-twin was used as an indirect measure of genetic liability to psychopathology, while the Childhood Trauma Questionnaire Short-Form (CTQ-SF) was used to assess CT in the domains of physical, emotional and sexual abuse, as well as physical and emotional neglect. The Community Assessment of Psychic Experience (CAPE) questionnaire was used to phenotypically characterize psychosis expression. RESULTS In the model using the CAPE total score, the interaction between CT and genetic liability was close to statistical significance (χ2 = 5.6, df = 2, p = 0.06). Analyses of CAPE subscales revealed a significant interaction between CT and genetic liability (χ2 = 8.8, df = 2, p = 0.012) for the CAPE-negative symptoms subscale, but not for the other two subscales (i.e. positive and depressive). CONCLUSION The results suggest that the impact of CT on subthreshold expression of psychosis, particularly in the negative subdomain, may be larger in the co-presence of significant genetic liability for psychopathology.
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21
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Stevens LH, Turkington D, Drage L, Morrison T, Muncer S, Spencer HM, Dudley R. Investigation of a traumatic psychosis subgroup: a cluster analysis of an antipsychotic free cohort. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2019. [DOI: 10.1080/17522439.2019.1628290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Lucy H. Stevens
- Department of Clinical Psychology, Teesside University, Middlesbrough, UK
| | - Douglas Turkington
- Academic Psychiatry, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Laura Drage
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
| | - Tony Morrison
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, Manchester, UK
| | - Steven Muncer
- Department of Clinical Psychology, Teesside University, Middlesbrough, UK
| | - Helen M. Spencer
- Academic Psychiatry, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Robert Dudley
- Academic Psychiatry, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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22
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Childhood abuse and psychotic experiences - evidence for mediation by adulthood adverse life events. Epidemiol Psychiatr Sci 2019; 28:300-309. [PMID: 28988558 PMCID: PMC5784808 DOI: 10.1017/s2045796017000518] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
AIMS We have previously reported an association between childhood abuse and psychotic experiences (PEs) in survey data from South East London. Childhood abuse is related to subsequent adulthood adversity, which could form one pathway to PEs. We aimed to investigate evidence of mediation of the association between childhood abuse and PEs by adverse life events. METHODS Data were analysed from the South East London Community Health Study (SELCoH, n = 1698). Estimates of the total effects on PEs of any physical or sexual abuse while growing up were partitioned into direct (i.e. unmediated) and indirect (total and specific) effects, mediated via violent and non-violent life events. RESULTS There was strong statistical evidence for direct (OR 1.58, 95% CI: 1.19-2.1) and indirect (OR 1.51, 95% CI: 1.32-1.72) effects of childhood abuse on PEs after adjustment for potential confounders, indicating partial mediation of this effect via violent and non-violent life events. An estimated 47% of the total effect of abuse on PEs was mediated via adulthood adverse life events, of which violent life events made up 33% and non-violent life events the remaining 14%. CONCLUSIONS The association between childhood abuse and PEs is partly mediated through the experience of adverse life events in adulthood. There is some evidence that a larger proportion of this effect was mediated through violent life events than non-violent life events.
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23
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Susceptibility or Resilience to Maltreatment Can Be Explained by Specific Differences in Brain Network Architecture. Biol Psychiatry 2019; 85:690-702. [PMID: 30528381 PMCID: PMC6440838 DOI: 10.1016/j.biopsych.2018.10.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/15/2018] [Accepted: 10/26/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Childhood maltreatment is a major risk factor for psychopathology. However, some maltreated individuals appear remarkably resilient to the psychiatric effects while manifesting the same array of brain abnormalities as maltreated individuals with psychopathology. Hence, a critical aim is to identify compensatory brain alterations that enable resilient individuals to maintain mental well-being despite alterations in stress-susceptible regions. METHODS Network models were constructed from diffusion tensor imaging and tractography in physically healthy unmedicated 18- to 25-year-old participants (N = 342, n = 192 maltreated) to develop network-based explanatory models. RESULTS First, we determined that susceptible and resilient individuals had the same alterations in global fiber stream network architecture using two different definitions of resilience: 1) no lifetime history of Axis I or II disorders, and 2) no clinically significant symptoms of anxiety, depression, anger-hostility, or somatization. Second, we confirmed an a priori hypothesis that right amygdala nodal efficiency was lower in asymptomatic resilient than in susceptible participants or control subjects. Third, we identified eight other nodes with reduced nodal efficiency in resilient individuals and showed that nodal efficiency moderated the relationship between maltreatment and psychopathology. Fourth, we found that models based on global network architecture and nodal efficiency could delineate group membership (control, susceptible, resilient) with 75%, 82%, and 80% cross-validated accuracy. CONCLUSIONS Together these findings suggest that sparse fiber networks with increased small-worldness following maltreatment render individuals vulnerable to psychopathology if abnormalities occur in specific nodes, but that decreased ability of certain nodes to propagate information throughout the network mitigates the effects and leads to resilience.
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24
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Ortín S, Úbeda Y, Garriga RM, Llorente M. Bushmeat trade consequences predict higher anxiety, restraint, and dominance in chimpanzees. Dev Psychobiol 2019; 61:874-887. [PMID: 30957221 DOI: 10.1002/dev.21853] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 02/20/2019] [Accepted: 03/01/2019] [Indexed: 01/20/2023]
Abstract
More data are needed for a better understanding of the long-term influence of wider and combined stressful events in chimpanzee personality development. We evaluated the effects of bushmeat trade outcomes on the personality development in 84 African sanctuary chimpanzees. The chimpanzees presented different backgrounds regarding maternal care, social exposure, and abuse. We evaluated personality traits in chimpanzees using the Cattell 16PF personality questionnaire, the first application of this questionnaire in this species. We found that chimpanzees were rated as higher in anxiety after long social deprivation during infancy and juvenility, and if high human exposure was experienced. Mother-reared chimpanzees were rated as lower in restraint than hand-reared chimpanzees. Finally, mother-reared chimpanzees were rated as less dominant than hand-reared chimpanzees and rated higher when they had experienced severe mistreatment. Results suggest a wide range of possible stressful events could be potentially shaping rescued chimpanzees' personality and demonstrating the detrimental outcomes and consequences of the bushmeat and pet trade.
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Affiliation(s)
- Sara Ortín
- Unitat de Recerca i Etologia, Girona, Spain.,Fundació Universitat de Girona: Innovació i Formació, Girona, Spain
| | | | - Rosa M Garriga
- Tacugama Chimpanzee Sanctuary, Western Area Peninsula National Park, Freetown, Sierra Leone
| | - Miquel Llorente
- Unitat de Recerca i Etologia, Girona, Spain.,IPRIM, Institut de Recerca i Estudis en Primatologia, Girona, Spain.,Universitat de Girona, Girona, Spain
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25
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Mansueto G, Schruers K, Cosci F, van Os J. Childhood adversities and psychotic symptoms: The potential mediating or moderating role of neurocognition and social cognition. Schizophr Res 2019; 206:183-193. [PMID: 30527930 DOI: 10.1016/j.schres.2018.11.028] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 10/03/2018] [Accepted: 11/23/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Childhood abuse and neglect are risk factors for psychotic symptoms. Early adversities may contribute to alterations in neuro/social cognition, which in turn is associated with psychosis. This study explored the possible mediating/moderating role of neuro/social cognition between childhood abuse and neglect on the one hand, and psychotic symptoms on the other. METHOD The sampling frame was 1.119 patients with a psychotic disorder. Childhood adversity was evaluated with the Dutch version of the Childhood Trauma Questionnaire. Psychotic symptoms were assessed with the Positive and Negative Syndrome Scale. Verbal learning-memory, attention-vigilance, working memory, information processing speed, reasoning-problem solving were evaluated as measures of neurocognition using the Word Learning Task, the Continuous Performance Test, the Wechsler Adult Intelligence Scale 3rd. Mentalization was evaluated as a measure of social cognition using the Hinting Task. Correlation, mediation, moderation, 95% Bias Corrected and accelerated (BCaCI) bootstrapped analyses were performed, considering possible sex differences. RESULTS In male psychotic patients, attention and vigilance mediated the association between childhood neglect and negative symptoms (indirect effect: 0.18, BCaCI: 0.03-0.54), disorganization (indirect effect: 0.26, BCaCI: 0.05-0.61), excitement (indirect effect: 0.07, BCaCI: 0.004-0.23); mentalization mediated the association between childhood neglect and negative symptoms (indirect effect: 0.21, BCaCI: 0.02-0.51), excitement (indirect effect: 0.07, BCaCI: 0.01-0.20) disorganization (indirect effect: 0.29, BCaCI: 0.02-0.64); working memory mediated the association between childhood abuse and disorganization (indirect effect: 0.28, BCaCI: 0.05-0.57), excitement (indirect effect: 0.08, BCaCI: 0.01-0.20), emotional distress (indirect effect: 0.10, BCaCI: 0.01-0.27). DISCUSSION In psychotic disorder, sex-specific mediation of neurocognition and mentalization may exist in the association between childhood adversity and psychotic symptoms.
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Affiliation(s)
- Giovanni Mansueto
- Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands; Department of Health Sciences, University of Florence, Florence, Italy.
| | - Koen Schruers
- Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands
| | - Fiammetta Cosci
- Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands; Department of Health Sciences, University of Florence, Florence, Italy
| | - Jim van Os
- Maastricht University Medical Center, Dept. of Psychiatry & Psychology, School for Mental Health & Neuroscience, Maastricht, the Netherlands; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; King's College London, King's Health Partners, Dept. of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
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Kirli U, Binbay T, Drukker M, Elbi H, Kayahan B, Gökçelli DK, Özkınay F, Onay H, Alptekin K, van Os J. Is BDNF-Val66Met polymorphism associated with psychotic experiences and psychotic disorder outcome? Evidence from a 6 years prospective population-based cohort study. Am J Med Genet B Neuropsychiatr Genet 2019; 180:113-121. [PMID: 29785763 DOI: 10.1002/ajmg.b.32641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 04/05/2018] [Accepted: 04/23/2018] [Indexed: 12/19/2022]
Abstract
There is little research on genetic risk for the extended psychosis phenotype ranging from psychotic experiences (PEs) to psychotic disorders (PDs). In this general population-based prospective cohort study, the longitudinal associations between BDNF-Val66Met polymorphism and the different levels of the extended psychosis phenotype were investigated. Addresses were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighborhoods at baseline (n = 4011). A nested case-control study (n = 366) recruited individuals with PEs and PDs as well as individuals with no psychotic symptoms. In this subgroup, blood sampling for genetic analysis and assessment of environmental exposures were carried out, followed by clinical re-appraisal at follow-up 6 years later (n = 254). The BDNF-Val66Met polymorphism was significantly associated with the extended psychosis phenotype. The pattern of the association was that the BDNF-Val66Met polymorphism impacted in a dose-response but extra-linear fashion, with stronger impact at the PD end of the extended psychosis phenotype. Associations were still significant after adjusting for sociodemographic factors and environmental exposures including life events, childhood adversity, socioeconomic status, urbanicity, and cannabis use. The BDNF-Val66Met polymorphism may index susceptibility to expression of psychosis along a spectrum.
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Affiliation(s)
- Umut Kirli
- Department of Psychiatry, Van Education and Research Hospital, Van, Turkey.,School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Tolga Binbay
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Marjan Drukker
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Hayriye Elbi
- Faculty of Medicine, Department of Psychiatry, Ege University, Izmir, Turkey
| | - Bülent Kayahan
- Faculty of Medicine, Department of Psychiatry, Ege University, Izmir, Turkey
| | | | - Ferda Özkınay
- Faculty of Medicine, Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Hüseyin Onay
- Faculty of Medicine, Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Köksal Alptekin
- Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
| | - Jim van Os
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, King's College, King's Health Partners, London, United Kingdom.,Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
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Karatekin C, Almy B, Mason SM, Borowsky I, Barnes A. Mental and Physical Health Profiles of Maltreated Youth. CHILD ABUSE & NEGLECT 2018; 84:23-33. [PMID: 30036690 DOI: 10.1016/j.chiabu.2018.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/10/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
To examine both mental and physical health profiles of children diagnosed as maltreated in the community, we studied diagnoses in the electronic health records (EHRs) of youth assigned maltreatment-related diagnoses (N = 406) and well-matched youth without a maltreatment-related diagnosis (N = 406) during a four-year period in a large healthcare system that covers eight hospitals and over 40 clinics. Data extracted automatically from the EHRs was supplemented by manual chart review. The odds of the maltreated group being assigned a code for mental illness was 2.69 times higher than the odds for the comparison group, with large differences in mood and anxiety disorders and suicidality. The odds of having an injury or poisoning diagnosis were 3.45 times higher in maltreated than in comparison youth. Maltreated youth were also less likely to have been immunized. Nevertheless, contrary to our hypothesis, maltreated youth had significantly lower rates of diagnoses across almost all major physical disease categories assessed and did not differ from comparison youth in terms of body mass index (BMI). Furthermore, maltreated youth were assigned fewer diagnoses than comparison youth whether they came in for at least one preventive visit or not. Findings suggest a need for health care professionals to be prepared to address the high rates of mental disorders in maltreated youth, to be more vigilant about possible physical disorders in this population, and to take greater advantage of opportunities to immunize these youth.
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Affiliation(s)
- Canan Karatekin
- Institute of Child Development, University of Minnesota, United States.
| | - Brandon Almy
- Institute of Child Development, University of Minnesota, United States
| | | | - Iris Borowsky
- Department of Pediatrics, University of Minnesota, United States
| | - Andrew Barnes
- Department of Pediatrics, University of Minnesota, United States
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Kilian S, Asmal L, Chiliza B, Olivier MR, Phahladira L, Scheffler F, Seedat S, Marder SR, Green MF, Emsley R. Childhood adversity and cognitive function in schizophrenia spectrum disorders and healthy controls: evidence for an association between neglect and social cognition. Psychol Med 2018; 48:2186-2193. [PMID: 29268811 DOI: 10.1017/s0033291717003671] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Childhood adversity is associated with cognitive impairments in schizophrenia. However, findings to date are inconsistent and little is known about the relationship between social cognition and childhood trauma. We investigated the relationship between childhood abuse and neglect and cognitive function in patients with a first-episode of schizophrenia or schizophreniform disorder (n = 56) and matched healthy controls (n = 52). To the best of our knowledge, this is the first study assessing this relationship in patients and controls exposed to similarly high levels of trauma. METHODS Pearson correlational coefficients were used to assess correlations between Childhood Trauma Questionnaire abuse and neglect scores and cognition. For the MCCB domains displaying significant (p < 0.05) correlations, within group hierarchical linear regression, was done to assess whether abuse and neglect were significant predictors of cognition after controlling for the effect of education. RESULTS Patients and controls reported similarly high levels of abuse and neglect. Cognitive performance was poorer for patients compared with controls for all cognitive domains except working memory and social cognition. After controlling for education, exposure to childhood neglect remained a significant predictor of impairment in social cognition in both patients and controls. Neglect was also a significant predictor of poorer verbal learning in patients and of attention/vigilance in controls. However, childhood abuse did not significantly predict cognitive impairments in either patients or controls. CONCLUSION These findings are cross sectional and do not infer causality. Nonetheless, they indicate that associations between one type of childhood adversity (i.e. neglect) and social cognition are present and are not illness-specific.
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Affiliation(s)
- S Kilian
- Department of Psychiatry,Stellenbosch University,Cape Town,South Africa
| | - L Asmal
- Department of Psychiatry,Stellenbosch University,Cape Town,South Africa
| | - B Chiliza
- Department of Psychiatry,University of KwaZulu-Natal,Durban,South Africa
| | - M R Olivier
- Department of Psychiatry,Stellenbosch University,Cape Town,South Africa
| | - L Phahladira
- Department of Psychiatry,Stellenbosch University,Cape Town,South Africa
| | - F Scheffler
- Department of Psychiatry,Stellenbosch University,Cape Town,South Africa
| | - S Seedat
- Department of Psychiatry,Stellenbosch University,Cape Town,South Africa
| | - S R Marder
- Department of Psychiatry and Biobehavioral Sciences,Geffen School of Medicine at UCLA,Los Angeles,USA
| | - M F Green
- Department of Psychiatry and Biobehavioral Sciences,Geffen School of Medicine at UCLA,Los Angeles,USA
| | - R Emsley
- Department of Psychiatry,Stellenbosch University,Cape Town,South Africa
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Abstract
Schizophrenia and other types of psychosis incur suffering, high health care costs and loss of human potential, due to the combination of early onset and poor response to treatment. Our ability to prevent or cure psychosis depends on knowledge of causal mechanisms. Molecular genetic studies show that thousands of common and rare variants contribute to the genetic risk for psychosis. Epidemiological studies have identified many environmental factors associated with increased risk of psychosis. However, no single genetic or environmental factor is sufficient to cause psychosis on its own. The risk of developing psychosis increases with the accumulation of many genetic risk variants and exposures to multiple adverse environmental factors. Additionally, the impact of environmental exposures likely depends on genetic factors, through gene-environment interactions. Only a few specific gene-environment combinations that lead to increased risk of psychosis have been identified to date. An example of replicable gene-environment interaction is a common polymorphism in the AKT1 gene that makes its carriers sensitive to developing psychosis with regular cannabis use. A synthesis of results from twin studies, molecular genetics, and epidemiological research outlines the many genetic and environmental factors contributing to psychosis. The interplay between these factors needs to be considered to draw a complete picture of etiology. To reach a more complete explanation of psychosis that can inform preventive strategies, future research should focus on longitudinal assessments of multiple environmental exposures within large, genotyped cohorts beginning early in life.
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Affiliation(s)
- Alyson Zwicker
- Department of Pathology,Dalhousie University,Halifax,NS,Canada
| | | | - Rudolf Uher
- Department of Pathology,Dalhousie University,Halifax,NS,Canada
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30
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Khan A, Powell SB. Sensorimotor gating deficits in "two-hit" models of schizophrenia risk factors. Schizophr Res 2018; 198:68-83. [PMID: 29070440 PMCID: PMC5911431 DOI: 10.1016/j.schres.2017.10.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 10/03/2017] [Accepted: 10/06/2017] [Indexed: 02/07/2023]
Abstract
Genetic and environmental models of neuropsychiatric disease have grown exponentially over the last 20years. One measure that is often used to evaluate the translational relevance of these models to human neuropsychiatric disease is prepulse inhibition of startle (PPI), an operational measure of sensorimotor gating. Deficient PPI characterizes several neuropsychiatric disorders but has been most extensively studied in schizophrenia. It has become a useful tool in translational neuropharmacological and molecular genetics studies because it can be measured across species using almost the same experimental parameters. Although initial studies of PPI in rodents were pharmacological because of the robust predictive validity of PPI for antipsychotic efficacy, more recently, PPI has become standard common behavioral measures used in genetic and neurodevelopmental models of schizophrenia. Here we review "two hit" models of schizophrenia and discuss the utility of PPI as a tool in phenotyping these models of relevant risk factors. In the review, we consider approaches to rodent models of genetic and neurodevelopmental risk factors and selectively review "two hit" models of gene×environment and environment×environment interactions in which PPI has been measured.
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Affiliation(s)
- Asma Khan
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States; Research Service, VA San Diego Healthcare System, La Jolla, CA, United States
| | - Susan B Powell
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093, United States; Research Service, VA San Diego Healthcare System, La Jolla, CA, United States.
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31
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Misiak B, Stramecki F, Gawęda Ł, Prochwicz K, Sąsiadek MM, Moustafa AA, Frydecka D. Interactions Between Variation in Candidate Genes and Environmental Factors in the Etiology of Schizophrenia and Bipolar Disorder: a Systematic Review. Mol Neurobiol 2018; 55:5075-5100. [PMID: 28822116 PMCID: PMC5948257 DOI: 10.1007/s12035-017-0708-y] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 08/01/2017] [Indexed: 12/29/2022]
Abstract
Schizophrenia and bipolar disorder (BD) are complex and multidimensional disorders with high heritability rates. The contribution of genetic factors to the etiology of these disorders is increasingly being recognized as the action of multiple risk variants with small effect sizes, which might explain only a minor part of susceptibility. On the other site, numerous environmental factors have been found to play an important role in their causality. Therefore, in recent years, several studies focused on gene × environment interactions that are believed to bridge the gap between genetic underpinnings and environmental insults. In this article, we performed a systematic review of studies investigating gene × environment interactions in BD and schizophrenia spectrum phenotypes. In the majority of studies from this field, interacting effects of variation in genes encoding catechol-O-methyltransferase (COMT), brain-derived neurotrophic factor (BDNF), and FK506-binding protein 5 (FKBP5) have been explored. Almost consistently, these studies revealed that polymorphisms in COMT, BDNF, and FKBP5 genes might interact with early life stress and cannabis abuse or dependence, influencing various outcomes of schizophrenia spectrum disorders and BD. Other interactions still require further replication in larger clinical and non-clinical samples. In addition, future studies should address the direction of causality and potential mechanisms of the relationship between gene × environment interactions and various categories of outcomes in schizophrenia and BD.
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Affiliation(s)
- Błażej Misiak
- Department of Genetics, Wroclaw Medical University, 1 Marcinkowski Street, 50-368, Wroclaw, Poland.
| | - Filip Stramecki
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367, Wroclaw, Poland
| | - Łukasz Gawęda
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- II Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | - Maria M Sąsiadek
- Department of Genetics, Wroclaw Medical University, 1 Marcinkowski Street, 50-368, Wroclaw, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, Western Sydney University, Penrith, NSW, Australia
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, 10 Pasteur Street, 50-367, Wroclaw, Poland
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Bi XJ, Lv XM, Ai XY, Sun MM, Cui KY, Yang LM, Wang LN, Yin AH, Liu LF. Childhood trauma interacted with BDNF Val66Met influence schizophrenic symptoms. Medicine (Baltimore) 2018; 97:e0160. [PMID: 29595641 PMCID: PMC5895403 DOI: 10.1097/md.0000000000010160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The gene - environment (G × E) interaction effect is involved in severe mental disorders. However, whether the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism participates in the childhood-abuse influenced schizophrenic symptoms remains unclear. We examined the interaction between BDNF Val66Met, and childhood trauma (ChT) on psychotic symptoms in a Chinese Han population.To estimate the G × E interaction, psychiatric interviews, self-report questionnaires for ChT, and genotyping for BDNF Val66Met were carried out on 201 schizophrenic patients. G × E interactions were analyzed by generalized multifactor dimensionality reduction (GMDR).Among all patients, 11.9%, 19.4%, 23.4%, 26.4%, and 73.6% reported emotional abuses, physical abuses (PA), sexual abuses (SA), emotional neglects (EN), and physical neglects (PN), respectively. Significant negative correlations were observed between anxiety/depression factors, and ChT total scores. Patients with 3 different BDNF genotypes showed significant differences in anxiety/depression scores. Significant 2-way interactions were found for Val66Met × PN, 3-way interactions were found for Val66Met × PN × PA, and four-way interactions were found for Val66Met × PN × PA × EN with regard to the excitement scores.Our findings suggested an involvement of BDNF Val66Met polymorphism after ChT in terms of risk for schizophrenia symptoms.
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Assary E, Vincent JP, Keers R, Pluess M. Gene-environment interaction and psychiatric disorders: Review and future directions. Semin Cell Dev Biol 2017; 77:133-143. [PMID: 29051054 DOI: 10.1016/j.semcdb.2017.10.016] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 12/11/2022]
Abstract
Empirical studies suggest that psychiatric disorders result from a complex interplay between genetic and environmental factors. Most evidence for such gene-environment interaction (GxE) is based on single candidate gene studies conducted from a Diathesis-Stress perspective. Recognizing the short-comings of candidate gene studies, GxE research has begun to focus on genome-wide and polygenic approaches as well as drawing on different theoretical concepts underlying GxE, such as Differential Susceptibility. After reviewing evidence from candidate GxE studies and presenting alternative theoretical frameworks underpinning GxE research, more recent approaches and findings from whole genome approaches are presented. Finally, we suggest how future GxE studies may unpick the complex interplay between genes and environments in psychiatric disorders.
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Affiliation(s)
- Elham Assary
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, London, E14NS, United Kingdom.
| | - John Paul Vincent
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, London, E14NS, United Kingdom.
| | - Robert Keers
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, London, E14NS, United Kingdom.
| | - Michael Pluess
- Department of Biological and Experimental Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, London, E14NS, United Kingdom.
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Cristóbal‐Narváez P, Sheinbaum T, Myin‐Germeys I, Kwapil TR, de Castro‐Catala M, Domínguez‐Martínez T, Racioppi A, Monsonet M, Hinojosa‐Marqués L, van Winkel R, Rosa A, Barrantes‐Vidal N. The role of stress-regulation genes in moderating the association of stress and daily-life psychotic experiences. Acta Psychiatr Scand 2017; 136:389-399. [PMID: 28865405 PMCID: PMC5697578 DOI: 10.1111/acps.12789] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The interaction of single nucleotide polymorphisms with both distal and proximal environmental factors across the extended psychosis phenotype is understudied. This study examined (i) the interaction of relevant SNPs with both early-life adversity and proximal (momentary) stress on psychotic experiences (PEs) in an extended psychosis sample; and (ii) differences between early-psychosis and non-clinical groups for these interactions. METHODS Two hundred and forty-two non-clinical and 96 early-psychosis participants were prompted randomly eight times daily for 1 week to complete assessments of current experiences, including PEs and stress. Participants also reported on childhood trauma and were genotyped for 10 SNPs on COMT, RGS4, BDNF, FKBP5, and OXTR genes. RESULTS Unlike genetic variants, distal and proximal stressors were associated with PEs in both samples and were more strongly associated with PEs in the early-psychosis than in the non-clinical group. The RGS4 TA and FKBP5 CATT haplotypes interacted with distal stress, whereas the A allele of OXTR (rs2254298) interacted with proximal stress, increasing momentary levels of PEs in the early-psychosis group. No interactions emerged with COMT or BDNF variants. CONCLUSION Individual differences in relevant stress-regulation systems interact with both distal and proximal psychosocial stressors in shaping the daily-life manifestation of PEs across the psychosis continuum.
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Affiliation(s)
- P. Cristóbal‐Narváez
- Departament de Psicologia Clínica i de la SalutUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - T. Sheinbaum
- Departament de Psicologia Clínica i de la SalutUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - I. Myin‐Germeys
- Department of NeuroscienceCentre for Contextual PsychiatryKU Leuven–University of LeuvenLeuvenBelgium
| | - T. R. Kwapil
- University of Illinois at Urbana‐ChampaignChampaignILUSA
| | - M. de Castro‐Catala
- Secció de Zoologia i Antropologia BiològicaDepartament de Biologia EvolutivaEcologia i Ciències AmbientalsFacultat de BiologiaUniversitat de Barcelona (UB)BarcelonaSpain,Institut de Biomedicina de la Universitat de BarcelonaBarcelonaSpain
| | - T. Domínguez‐Martínez
- CONACYT‐Dirección de Investigaciones Epidemiológicas y PsicosocialesInstituto Nacional de Psiquiatría Ramón de la Fuente MuñizCiudad de MéxicoMéxico
| | - A. Racioppi
- Departament de Psicologia Clínica i de la SalutUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - M. Monsonet
- Departament de Psicologia Clínica i de la SalutUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - L. Hinojosa‐Marqués
- Departament de Psicologia Clínica i de la SalutUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain
| | - R. van Winkel
- Department of NeuroscienceCentre for Contextual PsychiatryKU Leuven–University of LeuvenLeuvenBelgium
| | - A. Rosa
- Secció de Zoologia i Antropologia BiològicaDepartament de Biologia EvolutivaEcologia i Ciències AmbientalsFacultat de BiologiaUniversitat de Barcelona (UB)BarcelonaSpain,Institut de Biomedicina de la Universitat de BarcelonaBarcelonaSpain,Centre for Biomedical Research Network on Mental HealthInstituto de Salud Carlos III (CIBERSAM)MadridSpain
| | - N. Barrantes‐Vidal
- Departament de Psicologia Clínica i de la SalutUniversitat Autònoma de Barcelona (UAB)BarcelonaSpain,Centre for Biomedical Research Network on Mental HealthInstituto de Salud Carlos III (CIBERSAM)MadridSpain,Sant Pere Claver – Fundació SanitàriaBarcelonaSpain
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Murínová J, Hlaváčová N, Chmelová M, Riečanský I. The Evidence for Altered BDNF Expression in the Brain of Rats Reared or Housed in Social Isolation: A Systematic Review. Front Behav Neurosci 2017; 11:101. [PMID: 28620285 PMCID: PMC5449742 DOI: 10.3389/fnbeh.2017.00101] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 05/12/2017] [Indexed: 12/16/2022] Open
Abstract
There is evidence that development and maintenance of neural connections are disrupted in major mental disorders, which indicates that neurotrophic factors could play a critical role in their pathogenesis. Stress is a well-established risk factor for psychopathology and recent research suggests that disrupted signaling via brain-derived neurotrophic factor (BDNF) may be involved in mediating the negative effects of stress on the brain. Social isolation of rats elicits chronic stress and is widely used as an animal model of mental disorders such as schizophrenia and depression. We carried out a systematic search of published studies to review current evidence for an altered expression of BDNF in the brain of rats reared or housed in social isolation. Across all age groups (post-weaning, adolescent, adult), majority of the identified studies (16/21) reported a decreased expression of BDNF in the hippocampus. There are far less published data on BDNF expression in other brain regions. Data are also scarce to assess the behavioral changes as a function of BDNF expression, but the downregulation of BDNF seems to be associated with increased anxiety-like symptoms. The reviewed data generally support the putative involvement of BDNF in the pathogenesis of stress-related mental illness. However, the mechanisms linking chronic social isolation, BDNF expression and the elicited behavioral alterations are currently unknown.
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Affiliation(s)
- Jana Murínová
- Laboratory of Cognitive Neuroscience, Institute of Normal and Pathological Physiology, Slovak Academy of SciencesBratislava, Slovakia
| | - Nataša Hlaváčová
- Laboratory of Pharmacological Neuroendocrinology, Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of SciencesBratislava, Slovakia
| | - Magdaléna Chmelová
- Laboratory of Pharmacological Neuroendocrinology, Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of SciencesBratislava, Slovakia
| | - Igor Riečanský
- Laboratory of Cognitive Neuroscience, Institute of Normal and Pathological Physiology, Slovak Academy of SciencesBratislava, Slovakia
- Social, Cognitive and Affective Neuroscience Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of ViennaVienna, Austria
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Notaras MJ, Hill RA, Gogos JA, van den Buuse M. BDNF Val66Met Genotype Interacts With a History of Simulated Stress Exposure to Regulate Sensorimotor Gating and Startle Reactivity. Schizophr Bull 2017; 43:665-672. [PMID: 27262112 PMCID: PMC5464110 DOI: 10.1093/schbul/sbw077] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Reduced expression of Brain-Derived Neurotrophic Factor (BDNF) has been implicated in the pathophysiology of schizophrenia. The BDNF Val66Met polymorphism, which results in deficient activity-dependent secretion of BDNF, is associated with clinical features of schizophrenia. We investigated the effect of this polymorphism on Prepulse Inhibition (PPI), a translational model of sensorimotor gating which is disrupted in schizophrenia. We utilized humanized BDNFVal66Met (hBDNFVal66Met) mice which have been modified to carry the Val66Met polymorphism, as well as express humanized BDNF in vivo. We also studied the long-term effect of chronic corticosterone (CORT) exposure in these animals as a model of history of stress. PPI was assessed at 30ms and 100ms interstimulus intervals (ISI). Analysis of PPI at the commonly used 100ms ISI identified that, irrespective of CORT treatment, the hBDNFVal/Met genotype was associated with significantly reduced PPI. In contrast, PPI was not different between hBDNFMet/Met and hBDNFVal/Val genotype mice. At the 30ms ISI, CORT treatment selectively disrupted sensorimotor gating of hBDNFVal/Met heterozygote mice but not hBDNFVal/Val or hBDNFMet/Met mice. Analysis of startle reactivity revealed that chronic CORT reduced startle reactivity of hBDNFVal/Val male mice by 51%. However, this was independent of the effect of CORT on PPI. In summary, we provide evidence of a distinct BDNFVal66Met heterozygote-specific phenotype using the sensorimotor gating endophenotype of schizophrenia. These data have important implications for clinical studies where, if possible, the BDNFVal/Met heterozygote genotype should be distinguished from the BDNFMet/Met genotype.
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Affiliation(s)
- Michael J. Notaras
- Behavioural Neuroscience Laboratory, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia;,Psychoneuroendocrinology Laboratory, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Rachel A. Hill
- Psychoneuroendocrinology Laboratory, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Joseph A. Gogos
- Departments of Biophysics and Neuroscience, Columbia University, New York, NY
| | - Maarten van den Buuse
- Behavioural Neuroscience Laboratory, Florey Institute of Neuroscience and Mental Health, Melbourne, Australia;,School of Psychology and Public Health, La Trobe University, Melbourne, Australia;,The College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
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Childhood maltreatment is associated with alteration in global network fiber-tract architecture independent of history of depression and anxiety. Neuroimage 2017; 150:50-59. [PMID: 28213111 DOI: 10.1016/j.neuroimage.2017.02.037] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/31/2016] [Accepted: 02/13/2017] [Indexed: 11/21/2022] Open
Abstract
Childhood maltreatment is a major risk factor for psychopathology. It is also associated with alterations in the network architecture of the brain, which we hypothesized may play a significant role in the development of psychopathology. In this study, we analyzed the global network architecture of physically healthy unmedicated 18-25 year old subjects (n=262) using diffusion tensor imaging (DTI) MRI and tractography. Anatomical networks were constructed from fiber streams interconnecting 90 cortical or subcortical regions for subjects with no-to-low (n=122) versus moderate-to-high (n=140) exposure to maltreatment. Graph theory analysis revealed lower degree, strength, global efficiency, and maximum Laplacian spectra, higher pathlength, small-worldness and Laplacian skewness, and less deviation from artificial networks in subjects with moderate-to-high exposure to maltreatment. On balance, local clustering was similar in both groups, but the different clusters were more strongly interconnected in the no-to-low exposure group. History of major depression, anxiety and attention deficit hyperactivity disorder did not have a significant impact on global network measures over and above the effect of maltreatment. Maltreatment is an important factor that needs to be taken into account in studies examining the relationship between network differences and psychopathology.
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Misiak B, Krefft M, Bielawski T, Moustafa AA, Sąsiadek MM, Frydecka D. Toward a unified theory of childhood trauma and psychosis: A comprehensive review of epidemiological, clinical, neuropsychological and biological findings. Neurosci Biobehav Rev 2017; 75:393-406. [PMID: 28216171 DOI: 10.1016/j.neubiorev.2017.02.015] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/09/2017] [Accepted: 02/14/2017] [Indexed: 01/05/2023]
Abstract
There is a growing body of research focused on the relationship between childhood trauma and the risk of developing psychosis. Numerous studies, including many large-scale population-based studies, controlling for possible mediating variables, provide persuasive evidence of a dose-response association and are indicative of a causal relationship. Existing evidence supports the specificity model, showing differential associations between particular adversities and clinical symptoms, with cumulative adversity causing less favorable clinical and functional outcomes in psychotic patients. To date, several psychological and biological models have been proposed to search for underlying developmental trajectories leading to the onset of psychosis, influencing psychopathological manifestation and negative functional outcomes due to a history of childhood trauma. In this article, we provide a unified review on the relationship between childhood trauma and psychosis by integrating results of epidemiological, clinical, neuropsychological and biological studies. The question whether psychosis with a positive history of childhood trauma should be considered as a new psychotic phenotype, requiring specific therapeutic interventions, warrants further investigation.
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Affiliation(s)
- Błażej Misiak
- Department of Genetics, 1 Marcinkowski Street, 50-368 Wroclaw, Poland.
| | - Maja Krefft
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Tomasz Bielawski
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, University of Western Sydney, Penrith, NSW, Australia
| | - Maria M Sąsiadek
- Department of Genetics, 1 Marcinkowski Street, 50-368 Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, 10 Pasteur Street, 50-367 Wroclaw, Poland
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Pruessner M, Cullen AE, Aas M, Walker EF. The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities. Neurosci Biobehav Rev 2017; 73:191-218. [DOI: 10.1016/j.neubiorev.2016.12.013] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 12/09/2016] [Accepted: 12/12/2016] [Indexed: 01/29/2023]
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Stevens LH, Spencer HM, Turkington D. Identifying Four Subgroups of Trauma in Psychosis: Vulnerability, Psychopathology, and Treatment. Front Psychiatry 2017; 8:21. [PMID: 28243211 PMCID: PMC5303718 DOI: 10.3389/fpsyt.2017.00021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/25/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lucy H Stevens
- Tees Esk and Wear Valley NHS Mental Health Foundation Trust , Cleveland , UK
| | - Helen M Spencer
- Northumberland, Tyne and Wear NHS Mental Health Foundation Trust , Newcastle upon Tyne , UK
| | - Douglas Turkington
- Northumberland, Tyne and Wear NHS Mental Health Foundation Trust , Newcastle upon Tyne , UK
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41
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de Castro-Catala M, van Nierop M, Barrantes-Vidal N, Cristóbal-Narváez P, Sheinbaum T, Kwapil TR, Peña E, Jacobs N, Derom C, Thiery E, van Os J, van Winkel R, Rosa A. Childhood trauma, BDNF Val66Met and subclinical psychotic experiences. Attempt at replication in two independent samples. J Psychiatr Res 2016; 83:121-129. [PMID: 27596955 DOI: 10.1016/j.jpsychires.2016.08.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 08/19/2016] [Accepted: 08/19/2016] [Indexed: 02/06/2023]
Abstract
Childhood trauma exposure is a robust environmental risk factor for psychosis. However, not all exposed individuals develop psychotic symptoms later in life. The Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism (rs6265) has been suggested to moderate the psychosis-inducing effects of childhood trauma in clinical and nonclinical samples. Our study aimed to explore the interaction effect between childhood trauma and the BDNF Val66Met polymorphism on subclinical psychotic experiences (PEs). This was explored in two nonclinical independent samples: an undergraduate and technical-training school student sample (n = 808, sample 1) and a female twin sample (n = 621, sample 2). Results showed that childhood trauma was strongly associated with positive and negative PEs in nonclinical individuals. A BDNF Val66Met x childhood trauma effect on positive PEs was observed in both samples. These results were discordant in terms of risk allele: while in sample 1 Val allele carriers, especially males, were more vulnerable to the effects of childhood trauma regarding PEs, in sample 2 Met carriers presented higher PEs scores when exposed to childhood trauma, compared with Val carriers. Moreover, in sample 2, a significant interaction was also found in relation to negative PEs. Our study partially replicates previous findings and suggests that some individuals are more prone to develop PEs following childhood trauma because of a complex combination of multiple factors. Further studies including genetic, environmental and epigenetic factors may provide insights in this field.
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Affiliation(s)
- Marta de Castro-Catala
- Secció de Zoologia i Antropologia Biològica, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Martine van Nierop
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Centre for Contextual Psychiatry, Leuven, Belgium
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain; Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States; Sant Pere Claver - Fundació Sanitària, Barcelona, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Paula Cristóbal-Narváez
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Tamara Sheinbaum
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Elionora Peña
- Secció de Zoologia i Antropologia Biològica, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Nele Jacobs
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Centre for Contextual Psychiatry, Leuven, Belgium; Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Catherine Derom
- Centre of Human Genetics, University Hospital Leuven, Department of Human Genetics, Leuven, Belgium
| | - Evert Thiery
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, King's Health Partners, London, United Kingdom; Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht, The Netherlands
| | - Ruud van Winkel
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Centre for Contextual Psychiatry, Leuven, Belgium; University Psychiatric Center, Katholieke Universiteit Leuven, Belgium
| | - Araceli Rosa
- Secció de Zoologia i Antropologia Biològica, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain; Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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Vargas Alves Nunes A, Odebrecht Vargas Nunes S, Strano T, Pascolat G, Schier Doria GM, Nasser Ehlke M. Folie à Deux and its interaction with early life stress: a case report. J Med Case Rep 2016; 10:339. [PMID: 27906088 PMCID: PMC5134243 DOI: 10.1186/s13256-016-1128-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 11/01/2016] [Indexed: 11/10/2022] Open
Abstract
Background Folie à deux is a very rare psychiatric syndrome in which a psychotic symptom is transmitted from one individual to another. We present a case of folie à deux occurring during childhood, which is not an usual presentation of this syndrome. In this case, the disorder is correlated with child abuse and neglect, which possibly had a role in the development of the symptoms in our case. Case presentation We present a case of folie à deux between an “induced” 9-year-old black Brazilian boy and the “inducer”, his grandmother. They were found to be sharing similar auditory and visual hallucinations and delusional beliefs. The boy was neglected by his parents and was being cared for by his grandmother, who had a history of mental disorder. Conclusions The close relationship between the boy and his grandmother, the family history of first-degree psychosis, and the child abuse and neglect suffered by the boy may have altered his vulnerability to early-onset psychosis and, in this case, folie à deux.
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Affiliation(s)
- Alessandra Vargas Alves Nunes
- Pediatrics Department, Hospital Universitário Evangélico de Curitiba, 2885 Padre Agostinho, apto 1304 torre barigui, ZIP 80710-000, Curitiba, Paraná, Brazil.
| | | | - Talita Strano
- Pediatrics Department, Hospital Universitário Evangélico de Curitiba, 2885 Padre Agostinho, apto 1304 torre barigui, ZIP 80710-000, Curitiba, Paraná, Brazil
| | - Gilberto Pascolat
- Pediatrics Department, Hospital Universitário Evangélico de Curitiba, 2885 Padre Agostinho, apto 1304 torre barigui, ZIP 80710-000, Curitiba, Paraná, Brazil
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Walter EE, Fernandez F, Snelling M, Barkus E. Genetic Consideration of Schizotypal Traits: A Review. Front Psychol 2016; 7:1769. [PMID: 27895608 PMCID: PMC5108787 DOI: 10.3389/fpsyg.2016.01769] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/27/2016] [Indexed: 12/19/2022] Open
Abstract
Schizotypal traits are of interest and importance in their own right and also have theoretical and clinical associations with schizophrenia. These traits comprise attenuated psychotic symptoms, social withdrawal, reduced cognitive capacity, and affective dysregulation. The link between schizotypal traits and psychotic disorders has long since been debated. The status of knowledge at this point is such schizotypal traits are a risk for psychotic disorders, but in and of themselves only confer liability, with other risk factors needing to be present before a transition to psychosis occurs. Investigation of schizotypal traits also has the possibility to inform clinical and research pursuits concerning those who do not make a transition to psychotic disorders. A growing body of literature has investigated the genetic underpinnings of schizotypal traits. Here, we review association, family studies and describe genetic disorders where the expression of schizotypal traits has been investigated. We conducted a thorough review of the existing literature, with multiple search engines, references, and linked articles being searched for relevance to the current review. All articles and book chapters in English were sourced and reviewed for inclusion. Family studies demonstrate that schizotypal traits are elevated with increasing genetic proximity to schizophrenia and some chromosomal regions have been associated with schizotypy. Genes associated with schizophrenia have provided the initial start point for the investigation of candidate genes for schizotypal traits; neurobiological pathways of significance have guided selection of genes of interest. Given the chromosomal regions associated with schizophrenia, some genetic disorders have also considered the expression of schizotypal traits. Genetic disorders considered all comprise a profile of cognitive deficits and over representation of psychotic disorders compared to the general population. We conclude that genetic variations associated with schizotypal traits require further investigation, perhaps with targeted phenotypes narrowed to assist in refining the clinical end point of significance.
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Affiliation(s)
- Emma E. Walter
- School of Psychology, University of WollongongWollongong, NSW, Australia
| | - Francesca Fernandez
- Illawarra Health and Medical Research Institute, University of WollongongWollongong, NSW, Australia
| | - Mollie Snelling
- Illawarra Health and Medical Research Institute, University of WollongongWollongong, NSW, Australia
| | - Emma Barkus
- School of Psychology, University of WollongongWollongong, NSW, Australia
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Kim JS, Lee SH. Influence of interactions between genes and childhood trauma on refractoriness in psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2016; 70:162-9. [PMID: 26827636 DOI: 10.1016/j.pnpbp.2016.01.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/08/2016] [Accepted: 01/28/2016] [Indexed: 01/18/2023]
Abstract
Psychiatric disorders are excellent disease models in which gene-environmental interaction play a significant role in the pathogenesis. Childhood trauma has been known as a significant environmental factor in the progress of, and prognosis for psychiatric illness. Patients with refractory illness usually have more severe symptoms, greater disability, lower quality of life and are at greater risk of suicide than other psychiatric patients. Our literature review uncovered some important clinical factors which modulate response to treatment in psychiatric patients who have experienced childhood trauma. Childhood trauma seems to be a critical determinant of treatment refractoriness in psychotic disorder, bipolar disorder, major depressive disorder, and post-traumatic stress disorder. In patients with psychotic disorders, the relationship between childhood trauma and treatment-refractoriness appears to be mediated by cognitive impairment. In the case of bipolar disorder, the relationship appears to be mediated by greater affective disturbance and earlier onset, while in major depressive disorder the mediating factors are persistent, severe symptoms and frequent recurrence. In suicidal individuals, childhood maltreatment was associated with violent suicidal attempts. In the case of PTSD patients, it appears that childhood trauma makes the brain more vulnerable to subsequent trauma, thus resulting in more severe, refractory symptoms. Given that several studies have suggested that there are distinct subtypes of genetic vulnerability to childhood trauma, it is important to understand how gene-environment interactions influence the course of psychiatric illnesses in order to improve therapeutic strategies.
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Affiliation(s)
- Ji Sun Kim
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea; Department of Psychiatry, Inje University College of Medicine, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Goyang, Republic of Korea; Department of Psychiatry, Inje University College of Medicine, Goyang, Republic of Korea.
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Sahu G, Malavade K, Jacob T. Cognitive Impairment in Schizophrenia: Interplay of BDNF and Childhood Trauma? A Review of Literature. Psychiatr Q 2016; 87:559-69. [PMID: 26603624 DOI: 10.1007/s11126-015-9409-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cognitive impairment is a core feature of schizophrenia. These deficits can also serve as an endophenotype for the illness in genetic studies. There is evidence that suggests that cognition can be considered a reasonable target for intervention in both schizophrenia and bipolar disorder. One of the most studied genetic phenotypes for psychosis is brain-derived neurotrophic factor (BDNF) Val66Met polymorphisms. BDNF has an established role in neuronal development and cell survival in response to stress and is abnormally expressed in schizophrenia. Studies have shown that childhood trauma is associated with poor prognosis of schizophrenic patients. BDNF-Val66Met polymorphism has been shown to moderate the impact of childhood adversity on later expression of affective symptoms, suggesting the possibility of gene environment interactions. Considering the recent advances of neuroscience an up to date review of relevant literature is warranted in this field. This article reviews the current literature available regarding associations between the Val66Met polymorphism, childhood trauma and cognitive dysfunction in schizophrenia.
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Affiliation(s)
- Geetanjali Sahu
- Department of Psychiatry, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY, 11219, USA
| | - Kishor Malavade
- Department of Psychiatry, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY, 11219, USA
- Department of Population Health, Maimonides Medical Center, Brooklyn, NY, USA
| | - Theresa Jacob
- Department of Psychiatry, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY, 11219, USA.
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Gibson LE, Alloy LB, Ellman LM. Trauma and the psychosis spectrum: A review of symptom specificity and explanatory mechanisms. Clin Psychol Rev 2016; 49:92-105. [PMID: 27632064 DOI: 10.1016/j.cpr.2016.08.003] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/17/2016] [Accepted: 08/30/2016] [Indexed: 01/14/2023]
Abstract
Traumatic life events have been robustly associated with various psychosis outcomes, including increased risk of psychotic disorders, the prodrome of psychosis, and dimensional measures of psychotic symptoms, such as attenuated positive psychotic symptoms. However, trauma exposure has been linked to various mental disorders; therefore, the specificity of trauma exposure to psychosis remains unclear. This review focuses on two understudied areas of the trauma and psychosis literature: 1) the specificity between trauma and psychosis in relation to other disorders that often result post-trauma, and 2) proposed mechanisms that uniquely link trauma to psychosis. We begin by discussing the underlying connection between trauma exposure and the entire psychosis spectrum with a focus on the influence of trauma type and specific psychotic symptoms. We then consider how the principles of multifinality and equifinality can be useful in elucidating the trauma-psychosis relationship versus the trauma-other disorder relationship. Next, we discuss several cognitive and neurobiological mechanisms that might uniquely account for the association between trauma and psychosis, as well as the role of gender. Lastly, we review important methodological issues that complicate the research on trauma and psychosis, ending with clinical implications for the field.
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Affiliation(s)
- Lauren E Gibson
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA, USA.
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Santacana M, Arias B, Mitjans M, Bonillo A, Montoro M, Rosado S, Guillamat R, Vallès V, Pérez V, Forero CG, Fullana MA. Predicting Response Trajectories during Cognitive-Behavioural Therapy for Panic Disorder: No Association with the BDNF Gene or Childhood Maltreatment. PLoS One 2016; 11:e0158224. [PMID: 27355213 PMCID: PMC4927091 DOI: 10.1371/journal.pone.0158224] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 06/13/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Anxiety disorders are highly prevalent and result in low quality of life and a high social and economic cost. The efficacy of cognitive-behavioural therapy (CBT) for anxiety disorders is well established, but a substantial proportion of patients do not respond to this treatment. Understanding which genetic and environmental factors are responsible for this differential response to treatment is a key step towards "personalized medicine". Based on previous research, our objective was to test whether the BDNF Val66Met polymorphism and/or childhood maltreatment are associated with response trajectories during exposure-based CBT for panic disorder (PD). METHOD We used Growth Mixture Modeling to identify latent classes of change (response trajectories) in patients with PD (N = 97) who underwent group manualized exposure-based CBT. We conducted logistic regression to investigate the effect on these trajectories of the BDNF Val66Met polymorphism and two different types of childhood maltreatment, abuse and neglect. RESULTS We identified two response trajectories ("high response" and "low response"), and found that they were not significantly associated with either the genetic (BDNF Val66Met polymorphism) or childhood trauma-related variables of interest, nor with an interaction between these variables. CONCLUSIONS We found no evidence to support an effect of the BDNF gene or childhood trauma-related variables on CBT outcome in PD. Future studies in this field may benefit from looking at other genotypes or using different (e.g. whole-genome) approaches.
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Affiliation(s)
- Martí Santacana
- Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Bárbara Arias
- Anthropology Unit, Department of Animal Biology, Universitat de Barcelona, Barcelona, Spain
- CIBERSAM (Centro de Investigaciones Biomédicas en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - Marina Mitjans
- CIBERSAM (Centro de Investigaciones Biomédicas en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Albert Bonillo
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - María Montoro
- Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Sílvia Rosado
- Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
| | - Roser Guillamat
- Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Vicenç Vallès
- Department of Mental Health, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Víctor Pérez
- CIBERSAM (Centro de Investigaciones Biomédicas en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
- Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
| | - Carlos G. Forero
- CIBERESP (Centro de Investigaciones Biomédicas en Red, Epidemiología y Salud Pública), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Department of Experimental and Life Sciences (DCEXS), Universitat Pompeu Fabra, Barcelona, Spain
| | - Miquel A. Fullana
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
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Morgan C, Gayer‐Anderson C. Childhood adversities and psychosis: evidence, challenges, implications. World Psychiatry 2016; 15:93-102. [PMID: 27265690 PMCID: PMC4911761 DOI: 10.1002/wps.20330] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
There is a substantial body of research reporting evidence of associations between various forms of childhood adversity and psychosis, across the spectrum from experiences to disorder. This has been extended, more recently, to include studies of cumulative effects, of interactions with other factors, of specific effects, and of putative biological and psychological mechanisms. In this paper we evaluate this research and highlight the remaining methodological issues and gaps that temper, but do not dismiss, conclusions about the causal role of childhood adversity. We also consider the emerging work on cumulative, synergistic, and specific effects and on mechanisms; and discuss the broader implications of this line of research for our understanding of psychosis. We conclude that the current balance of evidence is that childhood adversities - particularly exposure to multiple adversities involving hostility and threat - do, in some people, contribute to the onset of psychotic experiences and psychotic disorders.
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Affiliation(s)
- Craig Morgan
- Society and Mental Health Research Group, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College LondonLondonUK
| | - Charlotte Gayer‐Anderson
- Society and Mental Health Research Group, Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College LondonLondonUK
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Alemany S, Moya J, Ibáñez MI, Villa H, Mezquita L, Ortet G, Gastó C, Fañanás L, Arias B. Research Letter: Childhood trauma and the rs1360780 SNP of FKBP5 gene in psychosis: a replication in two general population samples. Psychol Med 2016; 46:221-223. [PMID: 26399750 DOI: 10.1017/s0033291715001695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- S Alemany
- Department of Animal Biology,Faculty of Biology,Anthropology Unit,University of Barcelona,Barcelona,Spain
| | - J Moya
- CIBER on Mental Health (CIBERSAM),Spain
| | | | - H Villa
- Department of Basic and Clinical Psychology and Psychobiology,Faculty of Health Sciences,Universitat Jaume I,Castelló,Spain
| | - L Mezquita
- Department of Basic and Clinical Psychology and Psychobiology,Faculty of Health Sciences,Universitat Jaume I,Castelló,Spain
| | - G Ortet
- CIBER on Mental Health (CIBERSAM),Spain
| | - C Gastó
- CIBER on Mental Health (CIBERSAM),Spain
| | - L Fañanás
- Department of Animal Biology,Faculty of Biology,Anthropology Unit,University of Barcelona,Barcelona,Spain
| | - B Arias
- Department of Animal Biology,Faculty of Biology,Anthropology Unit,University of Barcelona,Barcelona,Spain
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Abstract
BACKGROUND Two discourses exist in mental health research and practice. The first focuses on the limitations associated with disability arising from mental disorder. The second focuses on the possibilities for living well with mental health problems. DISCUSSION This article was prompted by a review to inform disability policy. We identify seven findings from this review: recovery is best judged by experts or using standardised assessment; few people with mental health problems recover; if a person no longer meets criteria for a mental illness, they are in remission; diagnosis is a robust basis for characterising groups and predicting need; treatment and other supports are important factors for improving outcome; the barriers to receiving effective treatment are availability, financing and client awareness; and the impact of mental illness, in particular schizophrenia, is entirely negative. We selectively review a wider range of evidence which challenge these findings, including the changing understanding of recovery, national mental health policies, systematic review methodology and undertainty, epidemiological evidence about recovery rates, reasoning biased due to assumptions about mental illness being an illness like any other, the contested nature of schizophrenia, the social construction of diagnoses, alternative explanations for psychosis experiences including the role of trauma, diagnostic over-shadowing, stigma, the technological paradigm, the treatment gap, social determinants of mental ill-health, the prevalence of voice-hearing in the general population, and the sometimes positive impact of psychosis experience in relation to perspective and purpose. CONCLUSION We propose an alternative seven messages which are both empirically defensible and more helpful to mental health stakeholders: Recovery is best judged by the person living with the experience; Many people with mental health problems recover; If a person no longer meets criteria for a mental illness, they are not ill; Diagnosis is not a robust foundation; Treatment is one route among many to recovery; Some people choose not to use mental health services; and the impact of mental health problems is mixed.
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Affiliation(s)
- Mike Slade
- King's College London, Health Service and Population Research Department (Box P029), Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill, London, SE5 8AF, UK.
| | - Eleanor Longden
- Institute of Psychology, Health and Society, University of Liverpool, Block B, 2nd Floor, Waterhouse Building, Liverpool, L69 3GL, UK.
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