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Sut E, Akgül Ö, Bora E. Minor physical anomalies in schizophrenia and first-degree relatives in comparison to healthy controls: A systematic review and meta-analysis. Eur Neuropsychopharmacol 2024; 86:55-64. [PMID: 38943776 DOI: 10.1016/j.euroneuro.2024.05.007] [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: 03/07/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 07/01/2024]
Abstract
Minor physical anomalies (MPAs) are anatomical variations that are markers of aberrant early neurodevelopment. Schizophrenia is associated with increased MPA frequency, however, the frequency and distribution of MPAs exhibit substantial heterogeneity in schizophrenia and are not exclusive to this disorder. MPAs at different localizations might represent different developmental origins and might be related to latent genetic predisposition or vulnerability to develop full-blown psychosis. Therefore, we conducted a thorough review of minor physical anomalies (MPAs) in schizophrenia (Sch) and first-degree relatives (SchRel). Analyzing 52 studies published from January 1980 to October 2023, the meta-analysis compared MPA scores between 3780 schizophrenia patients and 3871 controls, as well as 1415 SchRel and 1569 controls. The total MPA score was significantly increased in schizophrenia compared to controls (g = 0.78 [0.63-0.93], p<0.001). In regional MPA meta-analyses, effect sizes ranged from 0.56 to 0.78. The difference between SchRel and controls was moderate (g = 0.44 [0.28-0.61], p<0.001). When individual MPA items were analyzed separately, fine electric hair, malformed ear, asymmetrical ear, curved 5th finger were anomalies that were shared between both schizophrenia and SchRel. Also, direct comparisons of the frequency of MPAs in schizophrenia and their relatives were conducted. Additionally, the early age of onset of schizophrenia was associated with mouth anomalies (Z=-2.13, p = 0.03), and ear anomalies were associated with a higher percentage of males in the schizophrenia group (Z = 2.64, p = 0.008). These findings support the notion that different MPAs might be associated with genetic susceptibility as well as vulnerability to developing full-blown psychosis. Studies investigating clinical and neurobiological correlates of MPAs in schizophrenia might be helpful in characterizing subtypes of psychoses that are associated with different developmental processes.
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Affiliation(s)
- Ekin Sut
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
| | - Özge Akgül
- Department of Psychology, Izmir Democracy University, Izmir, Turkey
| | - Emre Bora
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia
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Hostalet N, González A, Salgado-Pineda P, Gonzàlez-Colom R, Canales-Rodríguez EJ, Aguirre C, Guerrero-Pedraza A, Llanos-Torres M, Salvador R, Pomarol-Clotet E, Sevillano X, Martínez-Abadías N, Fatjó-Vilas M. Face-brain correlates as potential sex-specific biomarkers for schizophrenia and bipolar disorder. Psychiatry Res 2024; 339:116027. [PMID: 38954892 DOI: 10.1016/j.psychres.2024.116027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/13/2024] [Accepted: 06/10/2024] [Indexed: 07/04/2024]
Abstract
Given the shared ectodermal origin and integrated development of the face and the brain, facial biomarkers emerge as potential candidates to assess vulnerability for disorders in which neurodevelopment is compromised, such as schizophrenia (SZ) and bipolar disorder (BD). The sample comprised 188 individuals (67 SZ patients, 46 BD patients and 75 healthy controls (HC)). Using a landmark-based approach on 3D facial reconstructions, we quantified global and local facial shape differences between SZ/BD patients and HC using geometric morphometrics. We also assessed correlations between facial and brain cortical measures. All analyses were performed separately by sex. Diagnosis explained 4.1 % - 5.9 % of global facial shape variance in males and females with SZ, and 4.5 % - 4.1 % in BD. Regarding local facial shape, we detected 43.2 % of significantly different distances in males and 47.4 % in females with SZ as compared to HC, whereas in BD the percentages decreased to 35.8 % and 26.8 %, respectively. We detected that brain area and volume significantly explained 2.2 % and 2 % of facial shape variance in the male SZ - HC sample. Our results support facial shape as a neurodevelopmental marker for SZ and BD and reveal sex-specific pathophysiological mechanisms modulating the interplay between the brain and the face.
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Affiliation(s)
- Noemí Hostalet
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals (BEECA), Facultat de Biologia, Universitat de Barcelona (UB), Spain; CIBERSAM, Biomedical Research Network in Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro González
- HER - Human-Environment Research Group, La Salle, Universitat Ramon Llull, Spain
| | - Pilar Salgado-Pineda
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM, Biomedical Research Network in Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Rubèn Gonzàlez-Colom
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals (BEECA), Facultat de Biologia, Universitat de Barcelona (UB), Spain
| | - Erick J Canales-Rodríguez
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM, Biomedical Research Network in Mental Health, Instituto de Salud Carlos III, Madrid, Spain; Signal Processing Laboratory (LTS5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Candibel Aguirre
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; Consorci Sanitari de Terrassa (CST). Hospital de Dia de Salut Mental de Terrassa, Spain
| | - Amalia Guerrero-Pedraza
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; Hospital Benito Menni CASM, Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain
| | - María Llanos-Torres
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; Hospital Mare de Déu de la Mercè, Germanes Hospitalàries, Barcelona, Spain
| | - Raymond Salvador
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM, Biomedical Research Network in Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Edith Pomarol-Clotet
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; CIBERSAM, Biomedical Research Network in Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Xavier Sevillano
- HER - Human-Environment Research Group, La Salle, Universitat Ramon Llull, Spain
| | - Neus Martínez-Abadías
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals (BEECA), Facultat de Biologia, Universitat de Barcelona (UB), Spain.
| | - Mar Fatjó-Vilas
- FIDMAG, Germanes Hospitalàries Research Foundation, Barcelona, Spain; Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals (BEECA), Facultat de Biologia, Universitat de Barcelona (UB), Spain; CIBERSAM, Biomedical Research Network in Mental Health, Instituto de Salud Carlos III, Madrid, Spain.
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Bhattacharyya U, John J, Lencz T, Lam M. Dissecting Schizophrenia Biology Using Pleiotropy with Cognitive Genomics. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.16.24305885. [PMID: 38699340 PMCID: PMC11065000 DOI: 10.1101/2024.04.16.24305885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Given the increasingly large number of loci discovered by psychiatric GWAS, specification of the key biological pathways underlying these loci has become a priority for the field. We have previously leveraged the pleiotropic genetic relationships between schizophrenia and two cognitive phenotypes (educational attainment and cognitive task performance) to differentiate two subsets of illness-relevant SNPs: (1) those with "concordant" alleles, which are associated with reduced cognitive ability/education and increased schizophrenia risk; and (2) those with "discordant" alleles linked to reduced educational and/or cognitive levels but lower schizophrenia susceptibility. In the present study, we extend our prior work, utilizing larger input GWAS datasets and a more powerful statistical approach to pleiotropic meta-analysis, the Pleiotropic Locus Exploration and Interpretation using Optimal test (PLEIO). Our pleiotropic meta-analysis of schizophrenia and the two cognitive phenotypes revealed 768 significant loci (159 novel). Among these, 347 loci harbored concordant SNPs, 270 encompassed discordant SNPs, and 151 "dual" loci contained concordant and discordant SNPs. Competitive gene-set analysis using MAGMA related concordant SNP loci with neurodevelopmental pathways (e.g., neurogenesis), whereas discordant loci were associated with mature neuronal synaptic functions. These distinctions were also observed in BrainSpan analysis of temporal enrichment patterns across developmental periods, with concordant loci containing more prenatally expressed genes than discordant loci. Dual loci were enriched for genes related to mRNA translation initiation, representing a novel finding in the schizophrenia literature.
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Uğurpala C, Berberoğlu E, Özkan U, Genç SA, Tanrıverdi NÇ, İnhanlı D, Ali C, Üçok A. Minor physical anomalies may be related to treatment resistance in patients with schizophrenia. Asian J Psychiatr 2023; 88:103729. [PMID: 37633160 DOI: 10.1016/j.ajp.2023.103729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/28/2023]
Abstract
This study investigates the relationship between minor physical anomalies (MPA) and treatment resistance in schizophrenia (TRS). We evaluated 137 patients and 100 healthy controls by using a modified Waldrup MPA scale. Thirteen MPA items were found more frequently in the schizophrenia group than in the controls. The total MPA score was higher in TRS, and MPAs in the eye and mouth regions were more frequent in TRS (n = 57) than in non-TRS. Total MPA score was correlated to Brief Psychiatric Rating Scale-Expanded (BPRS-E) total and BPRS-positive scores in TRS. Our findings suggest that MPA might contribute to treatment resistance in schizophrenia.
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Affiliation(s)
- Can Uğurpala
- Vezirkopru State Hospital, Department of Psychiatry, Samsun, Turkey
| | - Ertuğ Berberoğlu
- Korkuteli State Hospital, State Hospital, Department of Psychiatry, Antalya, Turkey
| | | | | | | | - Damla İnhanlı
- Luleburgaz State Hospital, Department of Psychiatry, Turkey
| | - Chouda Ali
- Valeara MVZ Bottrop GmbH, Bottrop, Germany
| | - Alp Üçok
- Istanbul Faculty of Medicine, Istanbul University, Department of Psychiatry, Istanbul, Turkey.
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Bora E. Minor physical anomalies in bipolar disorder in comparison to healthy controls and schizophrenia: A systematic review and meta-analysis. Eur Neuropsychopharmacol 2022; 65:4-11. [PMID: 36150369 DOI: 10.1016/j.euroneuro.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 12/01/2022]
Abstract
Minor physical anomalies (MPAs) are markers of abnormalities in early foetal development and are well established findings in schizophrenia. It has been suggested that neurodevelopmental abnormalities might play a role not only in schizophrenia but also in bipolar disorder (BD). Therefore, according to neurodevelopmental theory of BD, one might expect increased prevalence of MPAs in BD. A meta-analysis of 11 studies was conducted to quantitatively review MPAs in BD in comparison to schizophrenia and healthy controls. The current meta-analysis compared MPA scores of 584 BD patients and 723 healthy controls, and 401 BD and 612 schizophrenia patients. Patients with BD had significantly higher MPA scores than healthy controls (g=0.47, CI=0.28-0.67). This was true both for craniofacial (g=0.57, CI=0.34-0.79) and periphery (g=0.46, CI=0.18-0.73) MPAs. BD was associated with a less severe increase in MPA score compared to schizophrenia, however, between-group difference was small (g=0.19, CI=0.05-0.33). The outcome of this meta-analysis suggests that BD is associated with medium effect size increase in MPAs which is only minimally less severe than schizophrenia. This finding supports the hypothesis that early developmental insult in brain development plays a role not only in schizophrenia but also BD. Studies investigating clinical, neurocognitive, neuroanatomical and other biological correlates of MPAs in BD might helpful in characterizing subtype (s) of BD that is associated with pronounced deviations in brain development.
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Affiliation(s)
- Emre Bora
- Dokuz Eylül University, Faculty of Medicine, Department of Psychiatry, Mithatpaşa cad. no 1606 inciraltı, yerleşkesi, Balçova, Izmir 35340, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Dokuz Eylul University, Health Sciences Institute, Department of Neurosciences, Izmir, Turkey.
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Wang XY, Lin JJ, Lu MK, Jang FL, Tseng HH, Chen PS, Chen PF, Chang WH, Huang CC, Lu KM, Tan HP, Lin SH. Development and validation of a web-based prediction tool on minor physical anomalies for schizophrenia. SCHIZOPHRENIA 2022; 8:4. [PMID: 35210439 PMCID: PMC8873231 DOI: 10.1038/s41537-021-00198-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/06/2021] [Indexed: 11/09/2022]
Abstract
AbstractIn support of the neurodevelopmental model of schizophrenia, minor physical anomalies (MPAs) have been suggested as biomarkers and potential pathophysiological significance for schizophrenia. However, an integrated, clinically useful tool that used qualitative and quantitative MPAs to visualize and predict schizophrenia risk while characterizing the degree of importance of MPA items was lacking. We recruited a training set and a validation set, including 463 schizophrenia patients and 281 healthy controls to conduct logistic regression and the least absolute shrinkage and selection operator (Lasso) regression to select the best parameters of MPAs and constructed nomograms. Two nomograms were built to show the weights of these predictors. In the logistic regression model, 11 out of a total of 68 parameters were identified as the best MPA items for distinguishing between patients with schizophrenia and controls, including hair whorls, epicanthus, adherent ear lobes, high palate, furrowed tongue, hyperconvex fingernails, a large gap between first and second toes, skull height, nasal width, mouth width, and palate width. The Lasso regression model included the same variables of the logistic regression model, except for nasal width, and further included two items (interpupillary distance and soft ears) to assess the risk of schizophrenia. The results of the validation dataset verified the efficacy of the nomograms with the area under the curve 0.84 and 0.85 in the logistic regression model and lasso regression model, respectively. This study provides an easy-to-use tool based on validated risk models of schizophrenia and reflects a divergence in development between schizophrenia patients and healthy controls (https://www.szprediction.net/).
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Sreeraj VS, Puzhakkal JC, Holla B, Nadella RK, Sheth S, Balachander S, Ithal D, Ali F, Viswanath B, Muralidharan K, Venkatasubramanian G, John JP, Benegal V, Murthy P, Varghese M, Reddy YJ, Jain S. Cross-diagnostic evaluation of minor physical anomalies in psychiatric disorders. J Psychiatr Res 2021; 142:54-62. [PMID: 34325233 DOI: 10.1016/j.jpsychires.2021.07.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/11/2021] [Accepted: 07/16/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Minor physical anomalies (MPA) are markers of impaired neurodevelopment during the prenatal stage. Assessing MPA across psychiatric disorders may help understand their shared nature. In addition, MPA in family members would indicate a shared liability and endophenotype potential. We examined familial aggregation of MPA and their role as transdiagnostic and disorder-specific markers of 5 major psychiatric/neuropsychiatric conditions (schizophrenia, bipolar disorder, substance dependence, obsessive-compulsive disorder, and Alzheimer's dementia). METHODS Modified Waldrop's MPA scale was applied on 1321 individuals from 439 transdiagnostic multiplex families and 125 healthy population controls (HC). Stage of fetal development (morphogenetic/phenogenetic)- and anatomical location (craniofacial/peripheral)-based sub-scores were calculated. Familiality and endophenotypic potential of MPA were analyzed with serial negative binomial mixed-effect regression. Cross-diagnostic differences and the effect of family history density (FHD) of each diagnosis on MPA were assessed. Mixed-effects Cox models estimated the influence of MPA on age-at-onset of illness (AAO). RESULTS MPA were found to be heritable in families with psychiatric disorders, with a familiality of 0.52. MPA were higher in psychotic disorders after controlling for effects of sex and intrafamilial correlation. Morphogenetic variant MPA was noted to be lower in dementia in comparison to HC. FHD of schizophrenia and bipolar disorder predicted higher, and that of dementia and substance dependence predicted lower MPA. MPA brought forward the AAO [HR:1.07 (1.03-1.11)], and this was more apparent in psychotic disorders. CONCLUSION MPA are transmissible in families, are specifically related to the risk of developing psychoses, and predict an earlier age at onset. Neurodevelopmentally informed classification of MPA has the potential to enhance the etiopathogenic and translational understanding of psychiatric disorders.
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Affiliation(s)
- Vanteemar S Sreeraj
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | - Joan C Puzhakkal
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Bharath Holla
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Ravi Kumar Nadella
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sweta Sheth
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Srinivas Balachander
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Dhruva Ithal
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Furkhan Ali
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Biju Viswanath
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Kesavan Muralidharan
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | - John P John
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | - Vivek Benegal
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Pratima Murthy
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Mathew Varghese
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Yc Janardhan Reddy
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Sanjeev Jain
- Department of Psychiatry, National Institute for Mental Health and Neurosciences (NIMHANS), Bangalore, India.
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Early magnetic resonance imaging biomarkers of schizophrenia spectrum disorders: Toward a fetal imaging perspective. Dev Psychopathol 2021; 33:899-913. [PMID: 32489161 DOI: 10.1017/s0954579420000218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There is mounting evidence to implicate the intrauterine environment as the initial pathogenic stage for neuropsychiatric disease. Recent developments in magnetic resonance imaging technology are making a multimodal analysis of the fetal central nervous system a reality, allowing analysis of structural and functional parameters. Exposures to a range of pertinent risk factors whether preconception or in utero can now be indexed using imaging techniques within the fetus' physiological environment. This approach may determine the first "hit" required for diseases that do not become clinically manifest until adulthood, and which only have subtle clinical markers during childhood and adolescence. A robust characterization of a "multi-hit" hypothesis may necessitate a longitudinal birth cohort; within this investigative paradigm, the full range of genetic and environmental risk factors can be assessed for their impact on the early developing brain. This will lay the foundation for the identification of novel biomarkers and the ability to devise methods for early risk stratification and disease prevention. However, these early markers must be followed over time: first, to account for neural plasticity, and second, to assess the effects of postnatal exposures that continue to drive the individual toward disease. We explore these issues using the schizophrenia spectrum disorders as an illustrative paradigm. However, given the potential richness of fetal magnetic resonance imaging, and the likely overlap of biomarkers, these concepts may extend to a range of neuropsychiatric conditions.
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Paquin V, Lapierre M, Veru F, King S. Early Environmental Upheaval and the Risk for Schizophrenia. Annu Rev Clin Psychol 2021; 17:285-311. [PMID: 33544627 DOI: 10.1146/annurev-clinpsy-081219-103805] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Why does prenatal exposure to wars, natural disasters, urbanicity, or winter increase the risk for schizophrenia? Research from the last two decades has provided rich insight about the underlying chains of causation at play during environmental upheaval, from conception to early infancy. In this review, we appraise the evidence linking schizophrenia spectrum disorder to prenatal maternal stress, obstetric complications, early infections, and maternal nutrition and other lifestyle factors. We discuss putative mechanisms, including the maternal stress system, perinatal hypoxia, and maternal-offspring immune activation. We propose that gene-environment interactions, timing during development, and sex differentiate the neuropsychiatric outcomes. Future research should pursue the translation of animal studies to humans and the longitudinal associations between early exposures, intermediate phenotypes, and psychiatric disorders. Finally, to paint a comprehensive model of risk and to harness targets for prevention, we argue that risk factors should be situated within the individual's personal ecosystem.
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Affiliation(s)
- Vincent Paquin
- Department of Psychiatry, McGill University, Montréal, Québec H3A 1A1, Canada; .,Douglas Research Centre, Montréal, Québec H4H 1R3, Canada
| | - Mylène Lapierre
- Douglas Research Centre, Montréal, Québec H4H 1R3, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec H2V 2S9, Canada
| | - Franz Veru
- Department of Psychiatry, McGill University, Montréal, Québec H3A 1A1, Canada; .,Douglas Research Centre, Montréal, Québec H4H 1R3, Canada
| | - Suzanne King
- Department of Psychiatry, McGill University, Montréal, Québec H3A 1A1, Canada; .,Douglas Research Centre, Montréal, Québec H4H 1R3, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec H2V 2S9, Canada
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Tsehay B, Shitie D. Minor Physical Anomalies Among Schizophrenic Patients as a Biomarker of Its Developmental Origin in Northwest Ethiopia. Neuropsychiatr Dis Treat 2020; 16:2491-2497. [PMID: 33149590 PMCID: PMC7604434 DOI: 10.2147/ndt.s275582] [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: 08/12/2020] [Accepted: 10/23/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Although there are highly precise and advanced diagnostic methods, the etiology and pathophysiology of schizophrenia remain poorly understood. There are several theories about schizophrenia origin, among which the neurodevelopmental theory is widely accepted. Our study aimed to assess minor physical anomalies among schizophrenic patients as putative indices of its developmental origin in North West Ethiopia 2018-2019. PATIENTS AND METHODS Institutional-based comparative cross-sectional study design was conducted in Debre Markos comprehensive, specialized hospitals in 190 schizophrenic patients, 190 healthy controls, and 190 1st-degree relatives. Data were collected using standard methods, entered into EpiData version 3.1, and exported to SPSS version 24 for analysis. Descriptive data were analyzed using descriptive statistics, and discriminant function analysis was conducted and a value of 0.03 was taken as the cutoff point for prediction of group status of the study samples. RESULTS Five hundred seventy study samples, male 375 (65.8%), and female 195 (34.2%), were included in this study. The discriminate function 1 and 2 revealed a significant association between groups and all predictors, accounting for 83.5% and 16.5% of between-group variability, respectively. However, closer analysis of the structure matrix revealed longitudinally furrowed tongue, ≥Five palate ridges, high steeples palate, transversely and randomly furrowed tongue, protruding supraorbital ridge as significant predictors. CONCLUSION Depending on predictor variables in this study, minor physical anomalies can serve as a biomarker for early screening of schizophrenic patients and clue for its developmental origin.
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Affiliation(s)
- Binalfew Tsehay
- Department of Biomedical Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Desalegn Shitie
- Department of Biomedical Sciences, Debre Markos University, Debre Markos, Ethiopia
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11
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Katina S, Kelly BD, Rojas MA, Sukno FM, McDermott A, Hennessy RJ, Lane A, Whelan PF, Bowman AW, Waddington JL. Refining the resolution of craniofacial dysmorphology in bipolar disorder as an index of brain dysmorphogenesis. Psychiatry Res 2020; 291:113243. [PMID: 32593068 PMCID: PMC7487763 DOI: 10.1016/j.psychres.2020.113243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 11/17/2022]
Abstract
As understanding of the genetics of bipolar disorder increases, controversy endures regarding whether the origins of this illness include early maldevelopment. Clarification would be facilitated by a 'hard' biological index of fetal developmental abnormality, among which craniofacial dysmorphology bears the closest embryological relationship to brain dysmorphogenesis. Therefore, 3D laser surface imaging was used to capture the facial surface of 21 patients with bipolar disorder and 45 control subjects; 21 patients with schizophrenia were also studied. Surface images were subjected to geometric morphometric analysis in non-affine space for more incisive resolution of subtle, localised dysmorphologies that might distinguish patients from controls. Complex and more biologically informative, non-linear changes distinguished bipolar patients from control subjects. On a background of minor dysmorphology of the upper face, maxilla, midface and periorbital regions, bipolar disorder was characterised primarily by the following dysmorphologies: (a) retrusion and shortening of the premaxilla, nose, philtrum, lips and mouth (the frontonasal prominences), with (b) some protrusion and widening of the mandible-chin. The topography of facial dysmorphology in bipolar disorder indicates disruption to early development in the frontonasal process and, on embryological grounds, cerebral dysmorphogenesis in the forebrain, most likely between the 10th and 15th week of fetal life.
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Affiliation(s)
- Stanislav Katina
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK,Institute of Mathematics and Statistics, Masaryk University, Brno, Czech Republic,Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Brendan D. Kelly
- St. John of God Hospital, Stillorgan, Co., Dublin, Ireland,Department of Psychiatry, Trinity Centre for Health Sciences, Tallaght University Hospital, Dublin, Ireland
| | - Mario A. Rojas
- Centre for Image Processing & Analysis, Dublin City University, Dublin, Ireland,Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Federico M. Sukno
- Centre for Image Processing & Analysis, Dublin City University, Dublin, Ireland,Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Aoibhinn McDermott
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Robin J. Hennessy
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Abbie Lane
- St. John of God Hospital, Stillorgan, Co., Dublin, Ireland,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Paul F. Whelan
- Centre for Image Processing & Analysis, Dublin City University, Dublin, Ireland
| | - Adrian W. Bowman
- School of Mathematics and Statistics, University of Glasgow, Glasgow, UK
| | - John L. Waddington
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland,Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric Disorders, College of Pharmaceutical Sciences, Soochow University, Suzhou, China,Corresponding author at: Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2, Ireland.
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12
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Stephan-Otto C, Lombardini F, Núñez C, Senior C, Ochoa S, Usall J, Brébion G. Fluctuating asymmetry in patients with schizophrenia is related to hallucinations and thought disorganisation. Psychiatry Res 2020; 285:112816. [PMID: 32036154 DOI: 10.1016/j.psychres.2020.112816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 01/21/2020] [Accepted: 01/25/2020] [Indexed: 11/26/2022]
Abstract
Fluctuating asymmetry represents the degree to which the right and left side of the body are asymmetrical, and is a sign of developmental instability. Higher levels of fluctuating asymmetry have been observed in individuals within the schizophrenia spectrum. We aimed to explore the associations of fluctuating asymmetry with psychotic and affective symptoms in schizophrenia patients, as well as with propensity to these symptoms in non-clinical individuals. A measure of morphological fluctuating asymmetry was calculated for 39 patients with schizophrenia and 60 healthy individuals, and a range of clinical and subclinical psychiatric symptoms was assessed. Regression analyses of the fluctuating asymmetry measure were conducted within each group. In the patient cohort, fluctuating asymmetry was significantly associated with the hallucination and thought disorganisation scores. T-test comparisons revealed that the patients presenting either hallucinations or thought disorganisation were significantly more asymmetrical than were the healthy individuals, while the patients without these key symptoms were equivalent to the healthy individuals. A positive association with the anxiety score emerged in a subsample of 36 healthy participants who were rated on affective symptoms. These findings suggest that fluctuating asymmetry may be an indicator of clinical hallucinations and thought disorganisation rather than an indicator of schizophrenia disease.
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Affiliation(s)
- Christian Stephan-Otto
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Christian Núñez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Carl Senior
- School of Life & Health Sciences, Aston University, Birmingham, UK; Research and Development Unit - Parc Sanitari Sant Joan de Déu, c/ Dr. Antoni Pujadas, 42, 08830 - Sant Boi de Llobregat, Barcelona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Gildas Brébion
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
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13
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The Cavan-Monaghan First Episode Psychosis Study (CAMFEPS): arbitrary diagnostic boundaries across the gene–environment interface and within evolving models of care. Ir J Psychol Med 2019; 36:293-303. [DOI: 10.1017/ipm.2019.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As research into psychotic illness evolves along established lines, insights are emerging that deviate from those lines and challenge more fundamentally our understanding. On the background of a new generation of studies on first-episode psychosis, investigations across the gene–environment interface and the intersection with ‘normal’ human mentation heighten these concerns. Using findings from the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS) as an exemplar, we here review the complexity of these challenges from the perspective of this real-world setting. They range from trans-diagnostic epidemiology and clinical characterisation, through molecular genetics, social milieu, developmental pathobiology and functional outcome across arbitrary diagnostic boundaries, to the evidence base for early intervention and more radical conceptualisations and structures for provision of mental health care.
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14
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Jordan K, Wild TSN, Fromberger P, Müller I, Müller JL. Are There Any Biomarkers for Pedophilia and Sexual Child Abuse? A Review. Front Psychiatry 2019; 10:940. [PMID: 32038314 PMCID: PMC6985439 DOI: 10.3389/fpsyt.2019.00940] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/27/2019] [Indexed: 12/13/2022] Open
Abstract
The use of biomarkers in medicine is a common and valuable approach in several clinical fields. Understanding the relationship between measurable biological processes and clinical outcomes not only is indispensable in the face of understanding physiological processes in healthy as well as in diseased organisms but also for understanding and evaluating treatment effects. Therefore, also in the context of forensic psychiatry, biomarkers and their potentially beneficial effects are of growing interest. The objective of this review is to examine if there are biomarkers that may serve as a tool to support diagnostic process, treatment evaluation, and risk assessment of pedophilic individuals and child sexual offenders. In the first part, we present an overview of the current neurobiological, as well as physiological and psychophysiological approaches to characterize pedophilia and child sexual offending. Secondly, we discuss and evaluate the impact of these approaches on the development of biomarkers for diagnosis, therapy, and risk assessment in pedophilic subjects and child sexual offenders. We conclude that a lot of research has already enhanced our neurobiological knowledge about pedophilia and child sexual offending. Although there surely exist promising parameters and approaches, in our view currently none of these is ready yet to serve as a clinically applicable diagnostic, response, or predictive biomarker for pedophilia and child sexual offending. Therefore, further work remains to be done. The development of a composite diagnostic biomarker to assess deviant sexual interest, combining several measures like functional magnetic resonance imaging, electroencephalogram, eye tracking, and behavioral approaches seems to be most promising. A valid and reliable measurement of deviant sexual interest, insensitive to manipulations could significantly support clinical diagnostic process. Similarly, regarding therapy evaluation and risk assessment, a composite biomarker to assess inhibitory control functions seems to be promising. Furthermore, the application of the Research Domain Criteria-approach, a new approach for investigating and classifying mental disorders, offers the possibility to take research to a new level.
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Affiliation(s)
- Kirsten Jordan
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Tamara Sheila Nadine Wild
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Peter Fromberger
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany
| | - Isabel Müller
- Asklepios Forensic Psychiatric Hospital, Goettingen, Germany
| | - Jürgen Leo Müller
- Forensic Psychiatry and Psychotherapy, Clinic of Psychiatry and Psychotherapy, University Medical Center, University of Goettingen, Goettingen, Germany.,Asklepios Forensic Psychiatric Hospital, Goettingen, Germany
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15
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Lu L, Zeng LN, Zong QQ, Rao WW, Ng CH, Ungvari GS, Li J, An FR, Xiang YT. Quality of life in Chinese patients with schizophrenia: A meta-analysis. Psychiatry Res 2018; 268:392-399. [PMID: 30125870 DOI: 10.1016/j.psychres.2018.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/27/2018] [Accepted: 07/04/2018] [Indexed: 12/19/2022]
Abstract
The impact of schizophrenia on quality of life (QOL) is significantly influenced by sociocultural factors. This meta-analysis systematically compared QOL between patients with schizophrenia and healthy controls in China. PubMed, PsycINFO, Embase, Chinese National Knowledge Infrastructure (CNKI), SinoMed and WanFang databases were searched to identify case-control studies. Standardized mean differences (SMDs) and 95% confidence interval (CI) were calculated using random effect models. Eighteen case-control studies comparing QOL between schizophrenia patients (n = 2,425) and healthy controls (n = 2,072) were included in the analyses. Compared with healthy controls, schizophrenia patients had significantly poorer overall QOL [11 studies; SMD:-1.07 (95%CI:-1.44, -0.70), P < 0.001] as well as in the physical, psychological, social and environmental QOL domains. Subgroup analyses revealed that poorer QOL was significantly associated with diagnostic criteria, study location, female gender, older age and inpatient status. Older schizophrenia patients had lower physical and psychological QOL, while inpatients had lower psychological QOL. In conclusion, compared with healthy controls, schizophrenia patients in China have significantly lower QOL.
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Affiliation(s)
- Li Lu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Liang-Nan Zeng
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Chee H Ng
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Gabor S Ungvari
- University of Notre Dame Australia & Graylands Hospital, Perth, Australia
| | - Jun Li
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao, SAR, China.
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16
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Fountoulakis KN, Gonda X, Siamouli M, Panagiotidis P, Moutou K, Nimatoudis I, Kasper S. Paternal and maternal age as risk factors for schizophrenia: a case-control study. Int J Psychiatry Clin Pract 2018; 22:170-176. [PMID: 29069946 DOI: 10.1080/13651501.2017.1391292] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Advanced parental age might constitute a generic risk factor for mental and somatic disorders. The current study tested whether this concerns also patients with schizophrenia. METHODS A total of 231 schizophrenic, 56 other severe mental disorders patients and 204 controls were diagnosed according to DSM-IV-TR. Data were tested with ANOVA models including relative risk and odds ratios. RESULTS Patients with schizophrenia manifested higher paternal (32.55 ± 6.35 vs. 29.42 ± 6.07, p < .001) and maternal age (27.66 ± 5.57 vs. 25.46 ± 4.52, p < .001). Patients with other mental disorders had higher paternal (33.29 ± 8.35; p = .001) but not maternal age (26.69 ± 5.89; p = .296) compared to controls. There was no difference between the two patient groups concerning either paternal or maternal age (p > .05). There seems to be a higher risk for the development of schizophrenia in offspring with paternal age above 25 years and maternal age above 22 years at delivery. CONCLUSIONS The current study provides further support for the suggestion that advanced paternal age constitutes a risk factor (in a non-dose dependent and gender-independent way) for the development of schizophrenia but also for other mental disorders. In contrast, advanced maternal age characterises schizophrenia specifically. The higher risk is evident after 25 years of paternal and 22 years of maternal age, respectively.
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Affiliation(s)
- Konstantinos N Fountoulakis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Xenia Gonda
- b Department of Psychiatry and Psychotherapy , Semmelweis University , Budapest , Hungary.,c MTA-SE Neuropsychopharmacology and Neurochemistry Research Group , Hungarian Academy of Sciences, Semmelweis University , Budapest , Hungary
| | - Melina Siamouli
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Panagiotis Panagiotidis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | | | - Ioannis Nimatoudis
- a Third Department of Psychiatry , School of Medicine, Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Siegfried Kasper
- e Universitätsklinik für Psychiatrie und Psychotherapie , Medizinische Universität , Vienna , Austria
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17
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Tsai MC, Lee CT, Tsai IN, Gan ST, Liang YL, Lin SH. Minor physical anomalies in adolescents at risk for substance use and early sex. Medicine (Baltimore) 2018; 97:e11147. [PMID: 29901645 PMCID: PMC6023981 DOI: 10.1097/md.0000000000011147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Minor physical anomalies (MPAs) are associated with disruptions of fetal development. We propose that the same genetic compositions that contribute to the presence of MPAs, also predispose individuals to health-compromising behaviors, thus considering MPAs as particular endophenotypes.We developed a screening questionnaire for problematic conduct, substance abuse, and early sexual practice. A total of 108 adolescents (55 males, 50.9%) aged 11 to 19 years were recruited and further divided into case and control groups according to their answers to the questions of health behaviors mentioned above. We then measured their MPAs that included qualitative and quantitative physical features. Stepwise logistic regression and the receiver operating characteristic (ROC) analyses were used to determine the predictive values of MPAs for behavioral outcomes.The obliquity of palpebral fissure and the head MPAs were negatively associated with substance use. In the ROC analysis, the model provided an area under curve (AUC) of 0.91 with prediction indices being 0.89 for sensitivity and 0.85 for specificity. In addition, the feet MPAs and outer canthal distance were positively, whereas the obliquity of palpebral fissure and ear rotation was negatively associated with early sexual practices. The AUC for early sexual practice was 0.91 and the prediction indexes were 0.87 for sensitivity and 0.88 for specificity.Certain MPAs were associated with adolescent substance use and early sex, which suggests a neurodevelopmental etiology for behavioral outcomes.
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Affiliation(s)
- Meng-Che Tsai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
- Department of Pediatrics
| | - Chih-Ting Lee
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - I-Ning Tsai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
| | - Shu-Ting Gan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
| | - Yi-Lin Liang
- Department of Internal Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
- Department of Public Health, College of Medicine
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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18
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Latham K, Kirkpatrick B. Meta-analysis of adult height and birth length in schizophrenia. Schizophr Res 2018; 195:110-114. [PMID: 29126609 DOI: 10.1016/j.schres.2017.09.002] [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: 05/19/2017] [Revised: 09/01/2017] [Accepted: 09/02/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE As a group, people with schizophrenia have a number of subtle anatomical abnormalities as well as physiological abnormalities that precede antipsychotic treatment. Some studies have also found shorter birth length or shorter adult height in people with schizophrenia compared to control subjects. We performed a systematic review and meta-analysis of studies of birth length and adult height in schizophrenia, following PRISMA guidelines (Prospero Registration # CRD42016043718). DATA SOURCES We searched the PsycInfo, Web of Science, and PubMed databases for articles published 1947-2016. STUDY SELECTION Articles were included if they had data for patients diagnosed with schizophrenia and a matched control group of subjects without a psychotic disorder; both groups were measured for birth length and/or adult height (18years or older); and the paper was published in English. DATA EXTRACTION One author extracted the data, which was verified by the other. RESULTS For adult height, six studies with 1,122 patients and 250,200 control subjects were included in analyses. There were six birth length studies, which included 984 patients and 976,296 controls. The patients did not differ from comparison subjects in birth length (effect size estimate=-0.03; CI: -0.09, 0.03), but adults were slightly shorter than comparison subjects (-0.15; -0.24, -0.06). In meta-regression of adult studies, the variables of first episode versus clinical sample, and population registry versus non-registry were not significant. Matching for several important variables was usually lacking in these studies. CONCLUSIONS While there appears to be no difference in birth length between people with schizophrenia and comparison subjects, the former may be slighter shorter in adult life. The cause of such a discrepancy, if confirmed, is not clear, and lack of matching on potentially confounding variables undermines confidence in any conclusion.
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Affiliation(s)
- Keely Latham
- Department of Psychiatry & Behavioral Sciences, University of Nevada, Reno School of Medicine, Reno, NV, United States
| | - Brian Kirkpatrick
- Department of Psychiatry & Behavioral Sciences, University of Nevada, Reno School of Medicine, Reno, NV, United States.
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19
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Radua J, Ramella-Cravaro V, Ioannidis JPA, Reichenberg A, Phiphopthatsanee N, Amir T, Yenn Thoo H, Oliver D, Davies C, Morgan C, McGuire P, Murray RM, Fusar-Poli P. What causes psychosis? An umbrella review of risk and protective factors. World Psychiatry 2018; 17:49-66. [PMID: 29352556 PMCID: PMC5775150 DOI: 10.1002/wps.20490] [Citation(s) in RCA: 334] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Psychosis is a heterogeneous psychiatric condition for which a multitude of risk and protective factors have been suggested. This umbrella review aimed to classify the strength of evidence for the associations between each factor and psychotic disorders whilst controlling for several biases. The Web of Knowledge database was searched to identify systematic reviews and meta-analyses of observational studies which examined associations between socio-demographic, parental, perinatal, later factors or antecedents and psychotic disorders, and which included a comparison group of healthy controls, published from 1965 to January 31, 2017. The literature search and data extraction followed PRISMA and MOOSE guidelines. The association between each factor and ICD or DSM diagnoses of non-organic psychotic disorders was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of psychotic cases, random-effects p value, largest study 95% confidence interval, heterogeneity between studies, 95% prediction interval, small study effect, and excess significance bias. In order to assess evidence for temporality of association, we also conducted sensitivity analyses restricted to data from prospective studies. Fifty-five meta-analyses or systematic reviews were included in the umbrella review, corresponding to 683 individual studies and 170 putative risk or protective factors for psychotic disorders. Only the ultra-high-risk state for psychosis (odds ratio, OR=9.32, 95% CI: 4.91-17.72) and Black-Caribbean ethnicity in England (OR=4.87, 95% CI: 3.96-6.00) showed convincing evidence of association. Six factors were highly suggestive (ethnic minority in low ethnic density area, second generation immigrants, trait anhedonia, premorbid IQ, minor physical anomalies, and olfactory identification ability), and nine were suggestive (urbanicity, ethnic minority in high ethnic density area, first generation immigrants, North-African immigrants in Europe, winter/spring season of birth in Northern hemisphere, childhood social withdrawal, childhood trauma, Toxoplasma gondii IgG, and non-right handedness). When only prospective studies were considered, the evidence was convincing for ultra-high-risk state and suggestive for urbanicity only. In summary, this umbrella review found several factors to be associated with psychotic disorders with different levels of evidence. These risk or protective factors represent a starting point for further etiopathological research and for the improvement of the prediction of psychosis.
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Affiliation(s)
- Joaquim Radua
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- FIDMAG Germanes Hospitalàries, CIBERSAM, Sant Boi de Llobregat, Spain
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Valentina Ramella-Cravaro
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - John P A Ioannidis
- Department of Medicine, Stanford Prevention Research Center, Stanford, CA, USA
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
- Meta-Research Innovation Center at Stanford, Stanford University, Stanford, CA, USA
- Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA, USA
| | - Abraham Reichenberg
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Frieman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nacharin Phiphopthatsanee
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Taha Amir
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Hyi Yenn Thoo
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dominic Oliver
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Cathy Davies
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Center, London, UK
| | - Philip McGuire
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Center, London, UK
| | - Robin M Murray
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Center, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Center, London, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
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20
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Domany Y, Levy A, Cassan SM, Tarrasch R, Lifshitz T, Schreiber S, Shamir EZ. Clinical utility of biomarkers of the hand in the diagnosis of schizophrenia. Psychiatry Res 2018; 260:105-110. [PMID: 29179014 DOI: 10.1016/j.psychres.2017.11.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022]
Abstract
A number of biomarkers were assessed in photos and prints of the hands of 95 patients with a variety of mental disorders to determine whether patients with schizophrenia could be distinguished from the others. Patients were recruited as consecutive admissions from an outpatient psychiatric day hospital population. Fourteen patients were diagnosed with schizophrenia/schizoaffective disorder and 81 were diagnosed with other mental disorders. A discriminant analysis yielded an overall 80% correct classification, with a sensitivity (schizophrenia patients identified correctly) of 78.6% and a specificity (non-schizophrenia patients identified correctly) of 80.2%. Significant differences were noted in the proximal interphalangeal joint, eponychium of the middle digit and fingernails. To determine biomarker frequency distribution patients with bipolar disorder were then compared to those with schizophrenia/schizoaffective disorder and then to patients with PTSD. The former yielded an overall 78.6% correct classification, with a sensitivity of 71.4% and a specificity of 85.7% and with similar biomarker frequency distribution for bipolar disorder as for the entire non schizophrenia group. The latter comparison yielded an overall 58.6% correct classification, with no significant differences between the features. The application of these biomarkers in clinical practice could constitute an additional tool for the psychiatrist in cases lacking diagnostic clarity.
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Affiliation(s)
- Yoav Domany
- Department of Psychiatry, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Levy
- Abarbanel Mental Health Center, Psychiatric Day Hospital, Bat-Yam, Israel.
| | | | - Ricardo Tarrasch
- School of Education, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Tova Lifshitz
- Abarbanel Mental Health Center, Psychiatric Day Hospital, Bat-Yam, Israel
| | - Shaul Schreiber
- Department of Psychiatry, Tel Aviv Sourasky Medical Centre, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Zvi Shamir
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Abarbanel Mental Health Center, Psychiatric Day Hospital, Bat-Yam, Israel
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21
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Waddington JL, Katina S, O'Tuathaigh CMP, Bowman AW. Translational Genetic Modelling of 3D Craniofacial Dysmorphology: Elaborating the Facial Phenotype of Neurodevelopmental Disorders Through the "Prism" of Schizophrenia. Curr Behav Neurosci Rep 2017; 4:322-330. [PMID: 29201594 PMCID: PMC5694503 DOI: 10.1007/s40473-017-0136-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose of Review In the context of human developmental conditions, we review the conceptualisation of schizophrenia as a neurodevelopmental disorder, the status of craniofacial dysmorphology as a clinically accessible index of brain dysmorphogenesis, the ability of genetically modified mouse models of craniofacial dysmorphology to inform on the underlying dysmorphogenic process and how geometric morphometric techniques in mutant mice can extend quantitative analysis. Recent Findings Mutant mice with disruption of neuregulin-1, a gene associated meta-analytically with risk for schizophrenia, constitute proof-of-concept studies of murine facial dysmorphology in a manner analogous to clinical studies in schizophrenia. Geometric morphometric techniques informed on the topography of facial dysmorphology and identified asymmetry therein. Summary Targeted disruption in mice of genes involved in individual components of developmental processes and analysis of resultant facial dysmorphology using geometric morphometrics can inform on mechanisms of dysmorphogenesis at levels of incisiveness not possible in human subjects.
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Affiliation(s)
- John L Waddington
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2, Ireland.,Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric-Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, 215123 China
| | - Stanislav Katina
- School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QQ UK.,Institute of Mathematics and Statistics, Masaryk University, Brno, Czech Republic.,Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovakia
| | | | - Adrian W Bowman
- School of Mathematics and Statistics, University of Glasgow, Glasgow, G12 8QQ UK
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Trixler D, Tényi T. Iris structure and minor physical anomalies in schizophrenia. Psychiatry Res 2017; 256:412-416. [PMID: 28692922 DOI: 10.1016/j.psychres.2017.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/15/2017] [Accepted: 07/03/2017] [Indexed: 11/20/2022]
Abstract
This study compared five human iris characteristics and minor physical anomalies (MPAs) between patients with schizophrenia (n = 32) and controls (n = 31). Correlations between iris characteristics and MPAs were expected, due to their same ectodermic origin. Iris macro photos were taken and quantified in five categories mentioned before. MPAs were also examined in both groups. Our results show significant differences in the frequency of pigment dots of the iris and total number of MPAs between groups. Other significant differences were found in the extension of concentric furrows, as they were more common in healthy subjects, while Wolfflin nodules occurred significantly more often in patients with schizophrenia. Expected difference in Fuch's crypts could not be observed between groups. Light eye color was positively correlated to pigment dots and Wolfflin nodules, and negatively correlated with concentric furrows. Dark eye color showed positive correlation with concentric furrows, and negative correlation with pigment dots and concentric furrows. A gender effect could also been observed: male individuals showed moderate positive correlations between pigment dots and total MPAs frequency, while this couldn't be observed in the female group. Our findings suggest possible connections between iris characteristics and MPAs, where males are more prone to deviations.
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Affiliation(s)
- Dániel Trixler
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary.
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
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Evaluation of prolactin levels in male patients with first-episode schizophrenia and its correlation with psychopathology. MIDDLE EAST CURRENT PSYCHIATRY 2017. [DOI: 10.1097/01.xme.0000513069.03258.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Meta-analysis of glucose tolerance, insulin, and insulin resistance in antipsychotic-naïve patients with nonaffective psychosis. Schizophr Res 2017; 179:57-63. [PMID: 27743650 PMCID: PMC5564201 DOI: 10.1016/j.schres.2016.09.026] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/14/2016] [Accepted: 09/19/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Some studies have suggested that antipsychotic-naïve patients with nonaffective psychosis (NAP) have glucose intolerance. AIMS To conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR). METHOD We identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts. We required studies to include subjects with nonaffective psychosis and control subjects. RESULTS There were 911 patients and 870 control subjects in the analysis of FG; their average ages were respectively 28.7 and 29.5years. Significant differences were found for all four variables, with effect size estimates ranging from 0.21 to 0.58. CONCLUSIONS As a group, at the time of first clinical contact for psychosis, people with NAP have a slight increase in FG, which most of them maintain in the normal range despite a small increase in IR by secreting additional INS. When faced with a physiological challenge such as a glucose tolerance test or antipsychotics, they are no longer able to maintain a normal glucose concentration.
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Wang Y, Deng Y, Li Z, Li X, Zhang CY, Jin Z, Fan MX, Compton MT, Cheung EFC, Lim KO, Chan RCK. A trend toward smaller optical angles and medial-ocular distance in schizophrenia spectrum, but not in bipolar and major depressive disorders. Psych J 2016; 5:228-237. [DOI: 10.1002/pchj.138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 07/08/2016] [Accepted: 07/09/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health; Institute of Psychology; Beijing China
| | - Yi Deng
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health; Institute of Psychology; Beijing China
- Cognitive Analysis & Brain Imaging Laboratory, MIND Institute; University of California; Davis California USA
| | - Zhi Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health; Institute of Psychology; Beijing China
- The University of Chinese Academy of Sciences; Beijing China
| | - Xu Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health; Institute of Psychology; Beijing China
- The University of Chinese Academy of Sciences; Beijing China
| | - Chen-yuan Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health; Institute of Psychology; Beijing China
| | - Zhen Jin
- Beijing 306 Hospital; Beijing China
| | - Ming-xia Fan
- Shanghai Key Laboratory of Magnetic Resonance; East China Normal University; Shanghai China
| | - Michael T. Compton
- Department of Psychiatry; Lenox Hill Hospital; New York New York USA
- Department of Psychiatry, Hofstra Northwell School of Medicine; Hofstra University; Hempstead New York USA
| | | | - Kelvin O. Lim
- Department of Psychiatry; University of Minnesota; Minneapolis Minnesota USA
| | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health; Institute of Psychology; Beijing China
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Prolactin concentrations in antipsychotic-naïve patients with schizophrenia and related disorders: A meta-analysis. Schizophr Res 2016; 174:156-160. [PMID: 27068570 DOI: 10.1016/j.schres.2016.03.018] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/14/2016] [Accepted: 03/16/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The use of dopaminergic antagonist antipsychotics is associated with hyperprolactinemia, but some studies have found increased prolactin concentrations in antipsychotic-naive patients with schizophrenia and related disorders. We conducted a systematic review and meta-analysis of studies of prolactin in antipsychotic-naïve patient with these disorders (PRISMA No. CRD42015016337). DATA SOURCES PubMed (Medline), PsycInfo, and Web of Science were searched for articles from 1950 to the present in English. STUDY SELECTION Seven studies of males (N=141 for patients, N=191 for control subjects) and five studies of females (N=67 and N=116) met criteria for inclusion: data on blood prolactin concentrations for both control subjects and antipsychotic-naive patients with schizophrenia or a related disorder, with data available separately for males and females. DATA EXTRACTION Data was extracted from the papers by one author and independently verified by a second. RESULTS The mean effect size for males was 1.02 (95% CI, 0.77, 1.26; p<0.001) and 0.43 for females (95% CI 0.11, 0.76; p<0.01). Meta-regression analyses for age, smoking, body mass index (BMI), year of publication, and cortisol were not significant. Funnel plots did not suggest the presence of a publication bias. CONCLUSIONS Our meta-analyses found significantly increased prolactin levels in both male and female antipsychotic-naïve patients with schizophrenia and related disorders. The small number of studies and limited matching for potentially confounding variables in some of the studies were limitations of this analysis. Prolonged hyperprolactinemia may lead to sexual dysfunction and osteoporosis, and some antipsychotics cause additional elevation of prolactin concentrations.
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Tsai IN, Lin JJ, Lu MK, Tan HP, Jang FL, Gan ST, Lin SH. Improving risk assessment and familial aggregation of age at onset in schizophrenia using minor physical anomalies and craniofacial measures. Medicine (Baltimore) 2016; 95:e4406. [PMID: 27472737 PMCID: PMC5265874 DOI: 10.1097/md.0000000000004406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Age at onset is the most important feature of schizophrenia that could indicate its origin. Minor physical anomalies (MPAs) characterize potential marker indices of disturbances in early neurodevelopment. However, the association between MPAs and age at onset of schizophrenia is still unclear. We aimed to compare risk assessment and familial aggregation in patients with early-onset schizophrenia (EOS) and adult-onset schizophrenia (AOS) with MPAs and craniofacial measures.We estimated the risk assessment of MPAs among patients with EOS (n = 68), patients with AOS (n = 183), nonpsychotic relatives (n = 147), and healthy controls (n = 241) using 3 data-mining algorithms. In addition, we assessed the magnitude of familial aggregation of MPAs with respect to the age at onset of schizophrenia.The performance of EOS was superior to that of AOS, with discrimination accuracies of 89% and 76%, respectively. Combined MPA scores as the risk assessment were significantly higher in all schizophrenia subgroups and the nonpsychotic relatives of EOS patients than in the healthy controls. The recurrence risk ratio for familial aggregation of the MPA scores of EOS families (odds ratio 9.27) was substantially higher than that of AOS families (odds ratio 2.47).The results highlight that EOS improves risk assessment and has a severe magnitude of familial aggregation of MPAs. These findings indicate that EOS might result from a stronger genetic susceptibility to neurodevelopmental deficits.
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Affiliation(s)
- I-Ning Tsai
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
| | - Jin-Jia Lin
- Department of Psychiatry, Chimei Medical Center
| | - Ming-Kun Lu
- Department of Health, Jianan Mental Hospital
- Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science
| | - Hung-Pin Tan
- Department of Psychiatry, Kaohsiung Veterans General Hospital Tainan Branch
- Department of Acupressure Technology, Chung Hwa University of Medical Technology
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University
| | | | - Shu-Ting Gan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University
- Biostatistics Consulting Center, National Cheng Kung University Hospital, Tainan, Taiwan
- Correspondence: Sheng-Hsiang Lin, Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, 138, Shengli Road, Tainan, Taiwan (e-mail: )
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Hajnal A, Csábi G, Herold R, Jeges S, Halmai T, Trixler D, Simon M, Tóth ÁL, Tényi T. Minor physical anomalies are more common among the first-degree unaffected relatives of schizophrenia patients - Results with the Méhes Scale. Psychiatry Res 2016; 237:224-8. [PMID: 26803362 DOI: 10.1016/j.psychres.2016.01.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/28/2015] [Accepted: 01/15/2016] [Indexed: 02/05/2023]
Abstract
Minor physical anomalies are external markers of abnormal brain development,so the more common appearance of these signs among the relatives of schizophrenia patients can confirm minor physical anomalies as intermediate phenotypes. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in the first-degree unaffected relatives of patients with schizophrenia compared to matched normal control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 20 relatives of patients with the diagnosis of schizophrenia and as a comparison 20 matched normal control subjects were examined. Minor physical anomalies were more common in the head and mouth regions among the relatives of schizophrenia patients compared to normal controls. By the differentiation of minor malformations and phenogenetic variants, we have found that only phenogenetic variants were more common in the relatives of schizophrenia patients compared to the control group, however individual analyses showed, that one minor malformation (flat forehead) was more prevalent in the relative group. The results can promote the concept, that minor physical anomalies can be endophenotypic markers of the illness.
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Affiliation(s)
- András Hajnal
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Györgyi Csábi
- Department of Pediatrics, University of Pécs, Faculty of Medicine, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Sára Jeges
- Institute of Nursing and Patients Care, Faculty of Health Sciences, University of Pécs, Hungary
| | - Tamás Halmai
- Department of Clinical and Theoretical Mental Health, Semmelweis University, Faculty of Medicine, Hungary
| | - Dániel Trixler
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Maria Simon
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary
| | - Ákos Levente Tóth
- Institute of Physical Education and Sport Science, Faculty of Sciences, University of Pécs, Hungary
| | - Tamás Tényi
- Department of Psychiatry and Psychotherapy, University of Pécs, Faculty of Medicine, Rét u.2.H, 7623 Pécs, Hungary.
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Liu CH, Keshavan MS, Tronick E, Seidman LJ. Perinatal Risks and Childhood Premorbid Indicators of Later Psychosis: Next Steps for Early Psychosocial Interventions. Schizophr Bull 2015; 41:801-16. [PMID: 25904724 PMCID: PMC4466191 DOI: 10.1093/schbul/sbv047] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Schizophrenia and affective psychoses are debilitating disorders that together affect 2%-3% of the adult population. Approximately 50%-70% of the offspring of parents with schizophrenia manifest a range of observable difficulties including socioemotional, cognitive, neuromotor, speech-language problems, and psychopathology, and roughly 10% will develop psychosis. Despite the voluminous work on premorbid vulnerabilities to psychosis, especially on schizophrenia, the work on premorbid intervention approaches is scarce. While later interventions during the clinical high-risk (CHR) phase of psychosis, characterized primarily by attenuated positive symptoms, are promising, the CHR period is a relatively late phase of developmental derailment. This article reviews and proposes potential targets for psychosocial interventions during the premorbid period, complementing biological interventions described by others in this Special Theme issue. Beginning with pregnancy, parents with psychoses may benefit from enhanced prenatal care, social support, parenting skills, reduction of symptoms, and programs that are family-centered. For children at risk, we propose preemptive early intervention and cognitive remediation. Empirical research is needed to evaluate these interventions for parents and determine whether interventions for parents and children positively influence the developmental course of the offspring.
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Affiliation(s)
- Cindy H Liu
- Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA; Department of Psychology, University of Massachusetts, Boston, MA;
| | - Matcheri S Keshavan
- Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ed Tronick
- Department of Psychology, University of Massachusetts, Boston, MA; Department of Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Massachusetts Mental Health Center Division of Public Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA
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Lin AS, Chang SS, Lin SH, Peng YC, Hwu HG, Chen WJ. Minor physical anomalies and craniofacial measures in patients with treatment-resistant schizophrenia. Psychol Med 2015; 45:1839-1850. [PMID: 25515974 DOI: 10.1017/s0033291714002931] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Schizophrenia patients have higher rates of minor physical anomalies (MPAs) than controls, particularly in the craniofacial region; this difference lends support to the neurodevelopmental model of schizophrenia. Whether MPAs are associated with treatment response in schizophrenia remains unknown. The aim of this case-control study was to investigate whether more MPAs and specific quantitative craniofacial features in patients with schizophrenia are associated with operationally defined treatment resistance. METHOD A comprehensive scale, consisting of both qualitatively measured MPAs and quantitative measurements of the head and face, was applied in 108 patients with treatment-resistant schizophrenia (TRS) and in 104 non-TRS patients. Treatment resistance was determined according to the criteria proposed by Conley & Kelly (2001; Biological Psychiatry 50, 898-911). RESULTS Our results revealed that patients with TRS had higher MPA scores in the mouth region than non-TRS patients, and the two groups also differed in four quantitative measurements (facial width, lower facial height, facial height, and length of the philtrum), after controlling for multiple comparisons using the false discovery rate. Among these dysmorphological measurements, three MPA item types (mouth MPA score, facial width, and lower facial height) and earlier disease onset were further demonstrated to have good discriminant validity in distinguishing TRS from non-TRS patients in a multivariable logistic regression analysis, with an area under the curve of 0.84 and a generalized R 2 of 0.32. CONCLUSIONS These findings suggest that certain MPAs and craniofacial features may serve as useful markers for identifying TRS at early stages of the illness.
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Affiliation(s)
- A-S Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,17 Xu-Zhou Road,Taipei 100,Taiwan
| | - S-S Chang
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, University of Hong Kong,Hong Kong Special Administrative Region,People's Republic of China
| | - S-H Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University,Tainan,Taiwan
| | - Y-C Peng
- Department of General Psychiatry,Bali Psychiatric Center, Ministry of Health and Welfare,New Taipei City,Taiwan
| | - H-G Hwu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,17 Xu-Zhou Road,Taipei 100,Taiwan
| | - W J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University,17 Xu-Zhou Road,Taipei 100,Taiwan
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Debnath M, Venkatasubramanian G, Berk M. Fetal programming of schizophrenia: select mechanisms. Neurosci Biobehav Rev 2015; 49:90-104. [PMID: 25496904 PMCID: PMC7112550 DOI: 10.1016/j.neubiorev.2014.12.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 11/24/2014] [Accepted: 12/01/2014] [Indexed: 12/16/2022]
Abstract
Mounting evidence indicates that schizophrenia is associated with adverse intrauterine experiences. An adverse or suboptimal fetal environment can cause irreversible changes in brain that can subsequently exert long-lasting effects through resetting a diverse array of biological systems including endocrine, immune and nervous. It is evident from animal and imaging studies that subtle variations in the intrauterine environment can cause recognizable differences in brain structure and cognitive functions in the offspring. A wide variety of environmental factors may play a role in precipitating the emergent developmental dysregulation and the consequent evolution of psychiatric traits in early adulthood by inducing inflammatory, oxidative and nitrosative stress (IO&NS) pathways, mitochondrial dysfunction, apoptosis, and epigenetic dysregulation. However, the precise mechanisms behind such relationships and the specificity of the risk factors for schizophrenia remain exploratory. Considering the paucity of knowledge on fetal programming of schizophrenia, it is timely to consolidate the recent advances in the field and put forward an integrated overview of the mechanisms associated with fetal origin of schizophrenia.
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Affiliation(s)
- Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health & Neurosciences, Bangalore 560029, India.
| | - Ganesan Venkatasubramanian
- Translational Psychiatry Laboratory, Neurobiology Research Centre and Department of Psychiatry, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, India
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Geelong, Victoria, Australia; Department of Psychiatry, The Florey Institute of Neuroscience and Mental Health, and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia
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Ambrosio-Gallardo F, Cruz-Fuentes C, Heinze-Martin G, Caraveo-Anduaga J, Cortés-Sotres J. Study of minor physical anomalies in complete nuclear Mexican families. Evidence of neurodevelopmental problems in schizophrenia. PLoS One 2015; 10:e0117080. [PMID: 25612094 PMCID: PMC4303412 DOI: 10.1371/journal.pone.0117080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 12/15/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Minor physical anomalies (MPA) are dysmorphic features that reflect deviations in early development, are morphological variants that appear during the first trimester of pregnancy and could be used as a marker of disease risk in susceptible people. The literature agrees that the number of MPA is higher in patients with schizophrenia compared with their relatives and healthy subjects. The purpose of this study is to compare the MPA, assessed using the Gourion Scale, in complete nuclear families (families with a member with schizophrenia and control families) by determining the MPA mean, concordance and heritability for the total score on the MPA Gourion Scale for each anomaly. Method The sample consisted of 60 families with at least one schizophrenic patient (284 members) and 61 control families (249 members). Results: The mean total score for the scale was 5.72 ± 2.3 MPA in the case of families with at least one schizophrenic patient and 1.8 ± 4.46 MPA for control families. The average for families of patients without considering the patient in the analysis was 5.59 ± 2.3 MPA; for patients, the mean was 6.14 ± 2.4 MPA. In the analysis by anomaly differences were found only in eleven anomalies found no evidence of heritability or concordance. Conclusions MPA occur more frequently in patients, but a pattern of low consistency between them persists. It is concluded that MPA could be a marker of neurodevelopmental problems, but it is not suitable to consider them a Gourion scale as endophenotype.
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Affiliation(s)
| | - Carlos Cruz-Fuentes
- Departamento de Genética, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, Mexico
| | - Gerhard Heinze-Martin
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Autónoma de México, Mexico City, Mexico
| | - Jorge Caraveo-Anduaga
- Investigaciones Epidemiológicas y Sociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, Mexico
| | - José Cortés-Sotres
- Departamento de Apoyo Académico, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, Mexico
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Matheson SL, Shepherd AM, Carr VJ. How much do we know about schizophrenia and how well do we know it? Evidence from the Schizophrenia Library. Psychol Med 2014; 44:3387-3405. [PMID: 25065407 DOI: 10.1017/s0033291714000166] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND True findings about schizophrenia remain elusive; many findings are not replicated and conflicting results are common. Well-conducted systematic reviews have the ability to make robust, generalizable conclusions, with good meta-analyses potentially providing the closest estimate of the true effect size. In this paper, we undertake a systematic approach to synthesising the available evidence from well-conducted systematic reviews on schizophrenia. METHOD Reviews were identified by searching Medline, EMBASE, CINAHL, Current Contents and PsycINFO. The decision to include or exclude reviews, data extraction and quality assessments were conducted in duplicate. Evidence was graded as high quality if reviews contained large samples and robust results; and as moderate quality if reviews contained imprecision, inconsistency, smaller samples or study designs that may be prone to bias. RESULTS High- and moderate-quality evidence shows that numerous psychosocial and biomedical treatments are effective. Patients have relatively poor cognitive functioning, and subtle, but diverse, structural brain alterations, altered electrophysiological functioning and sleep patterns, minor physical anomalies, neurological soft signs, and sensory alterations. There are markers of infection, inflammation or altered immunological parameters; and there is increased mortality from a range of causes. Risk for schizophrenia is increased with cannabis use, pregnancy and birth complications, prenatal exposure to Toxoplasma gondii, childhood central nervous system viral infections, childhood adversities, urbanicity and immigration (first and second generation), particularly in certain ethnic groups. Developmental motor delays and lower intelligence quotient in childhood and adolescence are apparent. CONCLUSIONS We conclude that while our knowledge of schizophrenia is very substantial, our understanding of it remains limited.
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Affiliation(s)
- S L Matheson
- Schizophrenia Research Institute, Darlinghurst, Sydney, NSW,Australia
| | - A M Shepherd
- Schizophrenia Research Institute, Darlinghurst, Sydney, NSW,Australia
| | - V J Carr
- Schizophrenia Research Institute, Darlinghurst, Sydney, NSW,Australia
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Tikka SK, Nizamie SH, Goyal N, Pradhan N, Tikka DL, Katshu MZUH. Evaluation of spontaneous dense array gamma oscillatory activity and minor physical anomalies as a composite neurodevelopmental endophenotype in schizophrenia. Int J Dev Neurosci 2014; 40:43-51. [PMID: 25450528 DOI: 10.1016/j.ijdevneu.2014.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/14/2014] [Accepted: 11/09/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Minor physical anomalies (MPAs) and gamma oscillatory activity have been proposed as associated endophenotypes in schizophrenia. Combining these endophenotypes to create a composite endophenotype may help identify those at risk for schizophrenia better. The present study aims to investigate MPAs and gamma oscillatory activity in schizophrenia patients, their unaffected first degree relatives and healthy controls and appreciate whether they can be used together as a composite endophenotype. METHODS This was a cross sectional family study conducted at a tertiary care mental health setup. Ninety participants including schizophrenia patients, their first degree relatives and controls (thirty each) were assessed for MPAs on the Extended Waldrop Scale. All participants underwent an awake, resting 192-channel EEG recording. Spectral power and coherence in 30-100Hz gamma bands were estimated using Welch's averaged periodogram method. One-way ANOVA, chi square test were used for comparing socio-demographic-clinical variables. MANOVA supplemented by one-way ANOVAs (post hoc Tukey HSD) were done for comparison of spectral measures. Pearson's correlation, step-by-step linear discriminant functional and intra-familial correlation analysis were subsequently performed. RESULTS An endophenotype pattern of finding was found for MPAs in the craniofacial region, the total number of MPAs, spectral power in right temporal region on all bands and in the right parietal region in 50-70Hz and 70-100Hz gamma bands. The three groups were most accurately classified when MPA total score, right temporal 30-50Hz gamma power and right occipital 'intra hemispheric' 50-70Hz gamma coherence were considered together than when considered independently. Significant intra familial correlation was seen for MPA total score and right temporal gamma 30-50Hz power. CONCLUSION Composite evaluation of two developmentally linked markers i.e. MPAs and gamma spectral measures may prove useful in categorizing schizophrenia and identifying at-risk individuals.
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Affiliation(s)
- Sai Krishna Tikka
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India.
| | - S Haque Nizamie
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India
| | - Nishant Goyal
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India
| | - N Pradhan
- Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka 560029, India
| | - Deyashini Lahiri Tikka
- Department of Clinical Psychology, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India
| | - Mohammad Zia Ul Haq Katshu
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, NG7 2TU, United Kingdom
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Shamir EZ, Cassan SM, Levy A, Lifshitz T, Tarrasch R. Biometric parameters of the hand as an index of schizophrenia--a preliminary study. Psychiatry Res 2013; 210:716-20. [PMID: 23992790 DOI: 10.1016/j.psychres.2013.08.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 06/01/2013] [Accepted: 08/14/2013] [Indexed: 11/18/2022]
Abstract
Since abnormalities in distal upper limb development are among the minor physical anomalies associated with schizophrenia we attempted to determine whether patients with schizophrenia can be identified on the basis of specific morphologic and dermatoglyphic features of the hand. Photographs and prints of the hands of 38 patients with schizophrenia and those of 42 control subjects were evaluated and graded on 13 biometric parameters. Results were statistically evaluated. A combination of three of the parameters was found to have good predicting abilities to distinguish between schizophrenics and controls. Subjects having high values in these three parameters were found to have a higher propensity to be defined as schizophrenics. In order to define a simple rule for classifying subjects we chose a criterion of having a value of 3 (in a scale from 1 to 3) in at least one of these three discriminating variables. This rule yielded an overall accuracy of 81.2%. Among controls, 85.7% of subjects did not fulfill such criteria, while 14.3% were defined as false positives. Among schizophrenics 76.3% achieved this condition while 23.7% were false negatives. The technique's objectivity and ease of application could facilitate the diagnosis of this disease.
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Affiliation(s)
- Eyal Zvi Shamir
- Abarbanel Psychiatric Hospital, 15 KKL Street Bat-Yam, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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de Lacy N, King BH. Revisiting the relationship between autism and schizophrenia: toward an integrated neurobiology. Annu Rev Clin Psychol 2013; 9:555-87. [PMID: 23537488 DOI: 10.1146/annurev-clinpsy-050212-185627] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Schizophrenia and autism have been linked since their earliest descriptions. Both are disorders of cerebral specialization originating in the embryonic period. Genetic, molecular, and cytologic research highlights a variety of shared contributory mechanisms that may lead to patterns of abnormal connectivity arising from altered development and topology. Overt behavioral pathology likely emerges during or after neurosensitive periods in which resource demands overwhelm system resources and the individual's ability to compensate using interregional activation fails. We are at the threshold of being able to chart autism and schizophrenia from the inside out. In so doing, the door is opened to the consideration of new therapeutics that are developed based upon molecular, synaptic, and systems targets common to both disorders.
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Affiliation(s)
- Nina de Lacy
- University of Washington and Seattle Children's Hospital, Seattle, Washington 98195, USA
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Ambrosio Gallardo F, Cruz Fuentes CS, Heinze Martin G, Caraveo Anduaga J, Cortés Sotres J. Clinimetric properties of Gourion Minor Physical Anomalies Scale. Internal consistency, construct and diagnostic validity in families with a schizophrenic relative and in healthy families. Schizophr Res 2013; 147:406-7. [PMID: 23639670 DOI: 10.1016/j.schres.2013.03.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 03/26/2013] [Indexed: 11/29/2022]
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Lin Y, Ma X, Deng W, Han Y, Li M, Liu X, Loh EW, Li T. Minor physical anomalies in patients with schizophrenia in a Chinese population. Psychiatry Res 2012; 200:223-7. [PMID: 22884216 DOI: 10.1016/j.psychres.2012.07.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Revised: 06/15/2012] [Accepted: 07/13/2012] [Indexed: 02/05/2023]
Abstract
Studies have shown that minor physical anomalies (MPAs) may be associated with schizophrenia. However, it remains unclear whether any items of MPAs are more associated with schizophrenia than the others. We aimed to examine which specific MPAs are more associated with schizophrenia than others. A total of 154 patients with schizophrenia and 152 healthy controls were assessed using candidate MPAs items along with items from the Waldrop scale. Significant differences were found between the patients and controls in inner canthal distance, epicanthus, adherent ear lobe, cuspidal ear and length difference from section index to ring finger (2D:4D length difference) as well as gap between the first and the second toes. These six items were selected by the logistic regression model, which correctly classified 89.0% of patients with schizophrenia (sensitivity) and 96.7% of healthy controls (specificity). The overall classification success rate was 92.8%. MPAs are associated with neurodevelopment, especially 2D:4D associated with cerebral lateralisation. Hence, our present findings support that it is necessary to evaluate MPAs beyond the Waldrop scale, as some item, such as 2D:4D length difference may reflect the more detailed aberrant neurodevelopment of schizophrenia.
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Affiliation(s)
- Yin Lin
- The Psychiatric Laboratory & the Mental Health Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China
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Cermolacce M, Fakra E, Belzeaux R, Adida M, Azorin JM. Endophénotypes schizophréniques et bipolaires : le point de vue de la clinique. Encephale 2012; 38 Suppl 3:S57-61. [DOI: 10.1016/s0013-7006(12)70078-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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