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Khazaie H, Rezaei F, Faridmarandi B, Zakiei A, Jananeh M, Mahdavi S, Nazari A, Komasi S. The sensitivity of the ICD-11 trait model to the symptoms of clinical disorders in young adults. Personal Ment Health 2024. [PMID: 38741371 DOI: 10.1002/pmh.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/25/2024] [Accepted: 04/28/2024] [Indexed: 05/16/2024]
Abstract
Hierarchical psychopathology contributes to providing a broader picture of the links between emerging personality structures such as the DSM-5/ICD-11 trait models and clinical disorders. The present study aimed to predict the specific and general clinical symptoms by the less studied constructs of the ICD-11 model (negative affectivity, detachment, dissociality, disinhibition, and anankastia). Data from 642 young adults from Iran (63% female, 18-34 years) were collected by three mental symptom scales and the Personality Inventory for DSM-5 (PID-5), which was recently used to harmonize the constructs of the DSM-5 and ICD-11 trait models. Multiple linear regressions showed that the ICD-11 model significantly predicted both the specific clinical symptoms (ranging from R2 = 0.15 to 0.40) and the general factor of clinical symptoms extracted by exploratory factor analysis (R2 = 0.40, all p < 0.001). Negative affectivity was the strongest construct correlated with both the specific symptoms (ranging from β = 0.36 to 0.69) and the general symptom factor (β = 0.59, all p < 0.001). Because the ICD-11 trait model is a practical structure related to the clinical psychopathology in young adults, screening for maladaptive traits can help clinicians in case formulation for diagnosis and treatment.
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Affiliation(s)
- Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzin Rezaei
- Roozbeh Hospital, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Behrooz Faridmarandi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Ali Zakiei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Minoo Jananeh
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Sahar Mahdavi
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Amin Nazari
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Saeid Komasi
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
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Reeder RR, Sala G, van Leeuwen TM. A novel model of divergent predictive perception. Neurosci Conscious 2024; 2024:niae006. [PMID: 38348335 PMCID: PMC10860603 DOI: 10.1093/nc/niae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
Predictive processing theories state that our subjective experience of reality is shaped by a balance of expectations based on previous knowledge about the world (i.e. priors) and confidence in sensory input from the environment. Divergent experiences (e.g. hallucinations and synaesthesia) are likely to occur when there is an imbalance between one's reliance on priors and sensory input. In a novel theoretical model, inspired by both predictive processing and psychological principles, we propose that predictable divergent experiences are associated with natural or environmentally induced prior/sensory imbalances: inappropriately strong or inflexible (i.e. maladaptive) high-level priors (beliefs) combined with low sensory confidence can result in reality discrimination issues, a characteristic of psychosis; maladaptive low-level priors (sensory expectations) combined with high sensory confidence can result in atypical sensory sensitivities and persistent divergent percepts, a characteristic of synaesthesia. Crucially, we propose that whether different divergent experiences manifest with dominantly sensory (e.g. hallucinations) or nonsensory characteristics (e.g. delusions) depends on mental imagery ability, which is a spectrum from aphantasia (absent or weak imagery) to hyperphantasia (extremely vivid imagery). We theorize that imagery is critically involved in shaping the sensory richness of divergent perceptual experience. In sum, to predict a range of divergent perceptual experiences in both clinical and general populations, three factors must be accounted for: a maladaptive use of priors, individual level of confidence in sensory input, and mental imagery ability. These ideas can be expressed formally using nonparametric regression modeling. We provide evidence for our theory from previous work and deliver predictions for future research.
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Affiliation(s)
- Reshanne R Reeder
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - Giovanni Sala
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - Tessa M van Leeuwen
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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Salaminios G, Sprüngli-Toffel E, Michel C, Morosan L, Eliez S, Armando M, Fonseca-Pedrero E, Derome M, Schultze-Lutter F, Debbané M. The role of mentalizing in the relationship between schizotypal personality traits and state signs of psychosis risk captured by cognitive and perceptive basic symptoms. Front Psychiatry 2023; 14:1267656. [PMID: 37810595 PMCID: PMC10557948 DOI: 10.3389/fpsyt.2023.1267656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Objective Schizotypal traits and disturbances in mentalizing (the capacity to understand the mental states driving one's own and others' behaviors) have been implicated in increased vulnerability for psychosis. Therefore, we explored the associations linking schizotypal traits, mentalizing difficulties and their interactions to clinical high-risk for psychosis (CHR-P), as captured by the Basic Symptoms (BS) approach, during adolescence and young adulthood. Methods Eighty-seven adolescents and young adults from the general population (46% male, 44% female; age: 14-23 years) were assessed with the Schizophrenia Proneness Interview (SPI-CY/A) for 11 perceptive and cognitive BS, with the Schizotypal Personality Questionnaire (SPQ) for schizotypal traits, and with the Reflective Functioning Questionnaire (RFQ) for self-reported mentalizing abilities. The RFQ evaluates the level of certainty (RFQc scale) and uncertainty (RFQu scale) with which individuals use mental state information to explain their own and others' behaviors. Results Logistic regression models showed significant positive effects of the SPQ disorganization scale on perceptive BS and of the SPQ interpersonal scale on cognitive BS. Post-hoc analyses revealed that schizotypal features pertaining to odd speech and social anxiety, respectively, were associated with perceptive and cognitive BS. Furthermore, higher scores on the RFQu scale and lower scores on the RFQc scale independently explained the presence of cognitive BS. Finally, significant interaction effects between RFQc and SPQ odd speech on perceptive BS, and between RFQc and SPQ social anxiety on cognitive BS were found. Conclusion Our findings suggest that schizotypal traits and mentalizing significantly relate both independently and through their interactions to the presence of cognitive and perceptive BS included in CHR-P criteria. Furthermore, mentalizing dysfunction may contribute in the relation between schizotypal traits and early state signs of CHR-P. Mentalizing may support both detection and early treatment of CHR-P among adolescents and young adults who present with trait risk for psychosis.
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Affiliation(s)
- George Salaminios
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Research Department, British Association for Counselling and Psychotherapy, Lutterworth, United Kingdom
| | - Elodie Sprüngli-Toffel
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
- Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Chantal Michel
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Larisa Morosan
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Marco Armando
- Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | | | - Melodie Derome
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Martin Debbané
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
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Zwir I, Arnedo J, Mesa A, Del Val C, de Erausquin GA, Cloninger CR. Temperament & Character account for brain functional connectivity at rest: A diathesis-stress model of functional dysregulation in psychosis. Mol Psychiatry 2023; 28:2238-2253. [PMID: 37015979 PMCID: PMC10611583 DOI: 10.1038/s41380-023-02039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/06/2023]
Abstract
The human brain's resting-state functional connectivity (rsFC) provides stable trait-like measures of differences in the perceptual, cognitive, emotional, and social functioning of individuals. The rsFC of the prefrontal cortex is hypothesized to mediate a person's rational self-government, as is also measured by personality, so we tested whether its connectivity networks account for vulnerability to psychosis and related personality configurations. Young adults were recruited as outpatients or controls from the same communities around psychiatric clinics. Healthy controls (n = 30) and clinically stable outpatients with bipolar disorder (n = 35) or schizophrenia (n = 27) were diagnosed by structured interviews, and then were assessed with standardized protocols of the Human Connectome Project. Data-driven clustering identified five groups of patients with distinct patterns of rsFC regardless of diagnosis. These groups were distinguished by rsFC networks that regulate specific biopsychosocial aspects of psychosis: sensory hypersensitivity, negative emotional balance, impaired attentional control, avolition, and social mistrust. The rsFc group differences were validated by independent measures of white matter microstructure, personality, and clinical features not used to identify the subjects. We confirmed that each connectivity group was organized by differential collaborative interactions among six prefrontal and eight other automatically-coactivated networks. The temperament and character traits of the members of these groups strongly accounted for the differences in rsFC between groups, indicating that configurations of rsFC are internal representations of personality organization. These representations involve weakly self-regulated emotional drives of fear, irrational desire, and mistrust, which predispose to psychopathology. However, stable outpatients with different diagnoses (bipolar or schizophrenic psychoses) were highly similar in rsFC and personality. This supports a diathesis-stress model in which different complex adaptive systems regulate predisposition (which is similar in stable outpatients despite diagnosis) and stress-induced clinical dysfunction (which differs by diagnosis).
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Affiliation(s)
- Igor Zwir
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
- University of Granada, Department of Computer Science, Granada, Spain
- University of Texas, Rio Grande Valley School of Medicine, Institute of Neuroscience, Harlingen, TX, USA
| | - Javier Arnedo
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA
- University of Granada, Department of Computer Science, Granada, Spain
| | - Alberto Mesa
- University of Granada, Department of Computer Science, Granada, Spain
| | - Coral Del Val
- University of Granada, Department of Computer Science, Granada, Spain
| | - Gabriel A de Erausquin
- University of Texas, Long School of Medicine, Department of Neurology, San Antonio, TX, USA
- Laboratory of Brain Development, Modulation and Repair, Glenn Biggs Institute of Alzheimer's & Neurodegenerative Disorders, San Antonio, TX, USA
| | - C Robert Cloninger
- Washington University School of Medicine, Department of Psychiatry, St. Louis, MO, USA.
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TÖRE T. Comparative Examination of ICD-11 and DSM-5 Alternative Model in Personality Disorders. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1071669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Personality disorders tried to be explained by changing diagnoses and approaches varying from school to school throughout history. With the updated approaches and scientific developments in today's diagnostic booklets, developing and more understandable diagnostic categories for personality disorders are created. New models can be an important resource for diagnosis, treatment and common language among clinicians. Both ICD-11 and DSM-5 main part section III. have highlighted new models beyond the previous personality disorders diagnostic approach. In both models, personality disorders are examined according to severity levels and prominent personality features model. Moreover, personality disorder includes structures that take into account the course of basic personality traits such as self, identity and bilateral relations. While DSM-5 part III. Alternative model on personality disorders section has a content of 5 prominent features, 25 sub-features and functionality which are all for evaluating the disorder, the ICD-11 model includes an approach that includes five features and borderline pattern and definitions, and a 4-dimensional structure in which functionality is evaluated. Although both models include models of features that stand out in personality but not completely overlap with each other. For example, while Psychoticism finds its place as a personality trait in alternative model in section III of DSM-5, as it is not accepted in personality feature in ICD-11. In contrast, the borderline pattern is not named as a feature in DSM-5 in section III, but the ICD-11 treats the borderline pattern as a kind of feature. This is one of the important differences between the two guidelines. Similarly, the criteria by which functionality and impairment are evaluated are not compatible with each other and do not progress in parallel. This means that two different guidelines accept different severity levels as thresholds. However, it can be said that both models accept the personality disorders approach, which includes longitudinal processes in which personality traits can be seen instead of categorical models. The differences between the new models can be interpreted as an obstacle to the development of a common language in terms of diagnosis and treatment.
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Abbasi Sarajehlou S, Khajeh S, Masrour C, Azizi M. Comparison of executive functions in individuals with high and low levels of schizotypal trait. Front Psychol 2023; 13:1071777. [PMID: 36814885 PMCID: PMC9940730 DOI: 10.3389/fpsyg.2022.1071777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/29/2022] [Indexed: 01/28/2023] Open
Abstract
The dimensional approach to Schizotypal Personality Disorder (SPD) indicates that SPD includes a constellation of maladaptive personality traits on a continuum with general personality functioning. This study aimed to compare executive functions (EFs) in low and high-level schizotypal individuals. Using a convenient sampling method, we recruited 120 individuals, from which 30 individuals with high schizotypal trait levels (fourth quartile) and 30 participants with lower schizotypal trait levels (first quartile) were selected based on their scores on the schizotypal personality disorder questionnaire. Then, participants from the two groups were administered the Corsi Block-Tapping Test (CBTT), Wisconsin Card Sorting Test (WCST), and Continuance Performance Test (CPT). The results indicated individuals with higher schizotypy trait levels performed significantly poorer in tasks measuring working-visual-spatial memory, cognitive flexibility, sustained attention, and response inhibition. This pattern of results indicated that EF dysfunctions in individuals with higher schizotypy trait levels would cause significant disturbances in multiple areas of life. The practical implications of the findings are further discussed.
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Affiliation(s)
- Saeid Abbasi Sarajehlou
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran,*Correspondence: Saeid Abbasi Sarajehlou, ✉
| | - Somayeh Khajeh
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
| | - Cheeman Masrour
- Department of Psychology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Morteza Azizi
- Department of Psychology, Sarab Branch, Islamic Azad University, Sarab, Iran
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Fekih-Romdhane F, Farah N, Malaeb D, Cheour M, Obeid S, Hallit S. Validation of the Arabic Version of the Community Assessment of Psychic Experiences (CAPE-42) in a Large Sample of Young Adults from the General Population. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01011-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Stoliker D, Egan GF, Friston KJ, Razi A. Neural Mechanisms and Psychology of Psychedelic Ego Dissolution. Pharmacol Rev 2022; 74:876-917. [PMID: 36786290 DOI: 10.1124/pharmrev.121.000508] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/22/2022] Open
Abstract
Neuroimaging studies of psychedelics have advanced our understanding of hierarchical brain organization and the mechanisms underlying their subjective and therapeutic effects. The primary mechanism of action of classic psychedelics is binding to serotonergic 5-HT2A receptors. Agonist activity at these receptors leads to neuromodulatory changes in synaptic efficacy that can have a profound effect on hierarchical message-passing in the brain. Here, we review the cognitive and neuroimaging evidence for the effects of psychedelics: in particular, their influence on selfhood and subject-object boundaries-known as ego dissolution-surmised to underwrite their subjective and therapeutic effects. Agonism of 5-HT2A receptors, located at the apex of the cortical hierarchy, may have a particularly powerful effect on sentience and consciousness. These effects can endure well after the pharmacological half-life, suggesting that psychedelics may have effects on neural plasticity that may play a role in their therapeutic efficacy. Psychologically, this may be accompanied by a disarming of ego resistance that increases the repertoire of perceptual hypotheses and affords alternate pathways for thought and behavior, including those that undergird selfhood. We consider the interaction between serotonergic neuromodulation and sentience through the lens of hierarchical predictive coding, which speaks to the value of psychedelics in understanding how we make sense of the world and specific predictions about effective connectivity in cortical hierarchies that can be tested using functional neuroimaging. SIGNIFICANCE STATEMENT: Classic psychedelics bind to serotonergic 5-HT2A receptors. Their agonist activity at these receptors leads to neuromodulatory changes in synaptic efficacy, resulting in a profound effect on information processing in the brain. Here, we synthesize an abundance of brain imaging research with pharmacological and psychological interpretations informed by the framework of predictive coding. Moreover, predictive coding is suggested to offer more sophisticated interpretations of neuroimaging findings by bridging the role between the 5-HT2A receptors and large-scale brain networks.
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Affiliation(s)
- Devon Stoliker
- Turner Institute for Brain and Mental Health (D.S., G.F.E., A.R.) and Monash Biomedical Imaging (G.F.E., A.R.), Monash University, Clayton, Victoria, Australia; Wellcome Centre for Human Neuroimaging, UCL, London, United Kingdom (K.J.F., A.R.); and CIFAR Azrieli Global Scholar, CIFAR, Toronto, Canada (A.R.)
| | - Gary F Egan
- Turner Institute for Brain and Mental Health (D.S., G.F.E., A.R.) and Monash Biomedical Imaging (G.F.E., A.R.), Monash University, Clayton, Victoria, Australia; Wellcome Centre for Human Neuroimaging, UCL, London, United Kingdom (K.J.F., A.R.); and CIFAR Azrieli Global Scholar, CIFAR, Toronto, Canada (A.R.)
| | - Karl J Friston
- Turner Institute for Brain and Mental Health (D.S., G.F.E., A.R.) and Monash Biomedical Imaging (G.F.E., A.R.), Monash University, Clayton, Victoria, Australia; Wellcome Centre for Human Neuroimaging, UCL, London, United Kingdom (K.J.F., A.R.); and CIFAR Azrieli Global Scholar, CIFAR, Toronto, Canada (A.R.)
| | - Adeel Razi
- Turner Institute for Brain and Mental Health (D.S., G.F.E., A.R.) and Monash Biomedical Imaging (G.F.E., A.R.), Monash University, Clayton, Victoria, Australia; Wellcome Centre for Human Neuroimaging, UCL, London, United Kingdom (K.J.F., A.R.); and CIFAR Azrieli Global Scholar, CIFAR, Toronto, Canada (A.R.)
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Tse NY, Tu S, Chen Y, Caga J, Dobson-Stone C, Kwok JB, Halliday GM, Ahmed RM, Hodges JR, Piguet O, Kiernan MC, Devenney EM. Schizotypal traits across the amyotrophic lateral sclerosis-frontotemporal dementia spectrum: pathomechanistic insights. J Neurol 2022; 269:4241-4252. [PMID: 35279757 PMCID: PMC9294025 DOI: 10.1007/s00415-022-11049-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Psychiatric presentations similar to that observed in primary psychiatric disorders are well described across the amyotrophic lateral sclerosis-frontotemporal dementia (ALS-FTD) spectrum. Despite this, schizotypal personality traits associated with increased risks of clinical psychosis development and poor psychosocial outcomes have never been examined. The current study aimed to provide the first exploration of schizotypal traits and its neural underpinnings in the ALS-FTD spectrum to gain insights into a broader spectrum of psychiatric overlap with psychiatric disorders. METHODS Schizotypal traits were assessed using the targeted Schizotypal Personality Questionnaire in 99 participants (35 behavioural variant FTD, 10 ALS-FTD and 37 ALS patients, and 17 age-, sex- and education-matched healthy controls). Voxel-based morphometry analysis of whole-brain grey matter volume was conducted. RESULTS Relative to controls, pervasive schizotypal personality traits across positive and negative schizotypy and disorganised thought disorders were identified in behavioural variant FTD, ALS (with the exception of negative schizotypy) and ALS-FTDALS-FTD patients (all p < .013), suggesting the presence of a wide spectrum of subclinical schizotypal symptoms beyond classic psychotic symptoms. Atrophy in frontal, anterior cingulate and insular cortices, and caudate and thalamus was involved in positive schizotypy, while integrity of the cerebellum was associated with disorganised thought disorder traits. CONCLUSIONS The frontal-striatal-limbic regions underpinning manifestation of schizotypy in the ALS-FTDALS-FTD spectrum are similar to that established in previous schizophrenia research. This finding expands the concept of a psychiatric overlap in ALS-FTD and schizophrenia, and suggests potentially common underlying mechanisms involving disruptions to frontal-striatal-limbic networks, warranting a transdiagnostic approach for future investigations.
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Affiliation(s)
- Nga Yan Tse
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Sicong Tu
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Yu Chen
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Jashelle Caga
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Carol Dobson-Stone
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - John B Kwok
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Glenda M Halliday
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
- Neuroscience Research Australia, Randwick, Australia
| | - Rebekah M Ahmed
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, Australia
| | - John R Hodges
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Olivier Piguet
- School of Psychology and Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Matthew C Kiernan
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia
| | - Emma M Devenney
- The Brain and Mind Centre, University of Sydney; and Royal Prince Alfred Hospital, 94 Mallet Street, Camperdown, Sydney, NSW, 2050, Australia.
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10
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Strachan LP, Paulik G, McEvoy PM. A narrative review of psychological theories of post-traumatic stress disorder, voice hearing, and other psychotic symptoms. Clin Psychol Psychother 2022; 29:1791-1811. [PMID: 35578567 PMCID: PMC10084244 DOI: 10.1002/cpp.2754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Most voice hearers report childhood trauma. Many voice hearers report comorbid post-traumatic stress symptoms and that the content of their voices (auditory verbal hallucinations) is directly (voices repeat phrases spoken by perpetrators) or indirectly (voice content and trauma is thematically similar) related to their trauma. The factors that maintain trauma-related voices are unknown, and there is limited research in this area. This study aimed to identify potential maintaining factors of trauma-related voices by reviewing models of post-traumatic stress disorder (PTSD) and positive symptoms of psychosis. METHOD Models of PTSD and positive symptoms were reviewed to identify potential factors that are unique and common to both sets of symptoms. RESULTS We reviewed 10 models of PTSD, 4 models of positive symptoms, and 2 trauma-informed models of voice hearing. One model provided a theoretical explanation of different types of trauma-related voices. Twenty-one factors were extracted from 16 theoretical models. No existing model incorporated all these factors. DISCUSSION Existing PTSD and positive symptom models present a range of common and unique factors. There may be value in extending existing integrative models to include a broader range of potential factors that could explain different pathways to, and expressions of, trauma-related voices. A future research agenda is presented to investigate how such an extension could lead to more complete individualized case formulations and targeted treatments.
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Affiliation(s)
- Laura P Strachan
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Georgie Paulik
- School of Psychology, Murdoch University, Perth, Western Australia, Australia.,Perth Voices Clinic, Murdoch, Western Australia, Australia.,School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Peter M McEvoy
- School of Population Health, Curtin University, Perth, Western Australia, Australia.,enAble Institute, Curtin University, Perth, Western Australia, Australia.,Centre for Clinical Interventions, Perth, Western Australia, Australia
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11
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Nenadić I, Meller T, Schmitt S, Stein F, Brosch K, Mosebach J, Ettinger U, Grant P, Meinert S, Opel N, Lemke H, Fingas S, Förster K, Hahn T, Jansen A, Andlauer TFM, Forstner AJ, Heilmann-Heimbach S, Hall ASM, Awasthi S, Ripke S, Witt SH, Rietschel M, Müller-Myhsok B, Nöthen MM, Dannlowski U, Krug A, Streit F, Kircher T. Polygenic risk for schizophrenia and schizotypal traits in non-clinical subjects. Psychol Med 2022; 52:1069-1079. [PMID: 32758327 DOI: 10.1017/s0033291720002822] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Schizotypy is a putative risk phenotype for psychosis liability, but the overlap of its genetic architecture with schizophrenia is poorly understood. METHODS We tested the hypothesis that dimensions of schizotypy (assessed with the SPQ-B) are associated with a polygenic risk score (PRS) for schizophrenia in a sample of 623 psychiatrically healthy, non-clinical subjects from the FOR2107 multi-centre study and a second sample of 1133 blood donors. RESULTS We did not find correlations of schizophrenia PRS with either overall SPQ or specific dimension scores, nor with adjusted schizotypy scores derived from the SPQ (addressing inter-scale variance). Also, PRS for affective disorders (bipolar disorder and major depression) were not significantly associated with schizotypy. CONCLUSIONS This important negative finding demonstrates that despite the hypothesised continuum of schizotypy and schizophrenia, schizotypy might share less genetic risk with schizophrenia than previously assumed (and possibly less compared to psychotic-like experiences).
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Affiliation(s)
- Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Johannes Mosebach
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Ulrich Ettinger
- Department of Psychology, Rheinische Friedrich-Wilhelms-Universität Bonn, Kaiser-Karl-Ring 9, 53111 Bonn, Germany
| | - Phillip Grant
- Psychology School, Fresenius University of Applied Sciences, Marienburgstr. 6, 60528 Frankfurt, Germany
- Faculty of Life Science Engineering, Technische Hochschule Mittelhessen University of Applied Sciences, Giessen, Germany
| | - Susanne Meinert
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
| | - Nils Opel
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
| | - Hannah Lemke
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
| | - Stella Fingas
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
| | - Katharina Förster
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
| | - Tim Hahn
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
| | - Till F M Andlauer
- Max-Planck-Institute of Psychiatry, Kraepelinstr. 2-10, 80804 Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
- Centre for Human Genetics, Philipps-Universität Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Alisha S M Hall
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston MA 02114, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge MA 02142, USA
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Bertram Müller-Myhsok
- Max-Planck-Institute of Psychiatry, Kraepelinstr. 2-10, 80804 Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Feodor-Lynen-Str. 17, 81377 Munich, Germany
- Institute of Translational Medicine, University of Liverpool, Crown St., Liverpool L69 3BX, UK
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149 Münster, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University and University Hospital Marburg, UKGM, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032 Marburg, Germany
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12
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Meller T, Schmitt S, Ettinger U, Grant P, Stein F, Brosch K, Grotegerd D, Dohm K, Meinert S, Förster K, Hahn T, Jansen A, Dannlowski U, Krug A, Kircher T, Nenadić I. Brain structural correlates of schizotypal signs and subclinical schizophrenia nuclear symptoms in healthy individuals. Psychol Med 2022; 52:342-351. [PMID: 32578531 PMCID: PMC8842196 DOI: 10.1017/s0033291720002044] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/23/2020] [Accepted: 05/27/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Subclinical psychotic-like experiences (PLE), resembling key symptoms of psychotic disorders, are common throughout the general population and possibly associated with psychosis risk. There is evidence that such symptoms are also associated with structural brain changes. METHODS In 672 healthy individuals, we assessed PLE and associated distress with the symptom-checklist-90R (SCL-90R) scales 'schizotypal signs' (STS) and 'schizophrenia nuclear symptoms' (SNS) and analysed associations with voxel- and surfaced-based brain structural parameters derived from structural magnetic resonance imaging at 3 T with CAT12. RESULTS For SNS, we found a positive correlation with the volume in the left superior parietal lobule and the precuneus, and a negative correlation with the volume in the right inferior temporal gyrus [p < 0.05 cluster-level Family Wise Error (FWE-corrected]. For STS, we found a negative correlation with the volume of the left and right precentral gyrus (p < 0.05 cluster-level FWE-corrected). Surface-based analyses did not detect any significant clusters with the chosen statistical threshold of p < 0.05. However, in exploratory analyses (p < 0.001, uncorrected), we found a positive correlation of SNS with gyrification in the left insula and rostral middle frontal gyrus and of STS with the left precuneus and insula, as well as a negative correlation of STS with gyrification in the left temporal pole. CONCLUSIONS Our results show that brain structures in areas implicated in schizophrenia are also related to PLE and its associated distress in healthy individuals. This pattern supports a dimensional model of the neural correlates of symptoms of the psychotic spectrum.
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Affiliation(s)
- Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
| | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111Bonn, Germany
| | - Phillip Grant
- Psychology School, Fresenius University of Applied Sciences, Marienburgstr. 6, 60528Frankfurt am Main, Germany
- Faculty of Life Science Engineering, Technische Hochschule Mittelhessen University of Applied Sciences, Giessen, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
| | - Dominik Grotegerd
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Katharina Dohm
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Susanne Meinert
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Katharina Förster
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Tim Hahn
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
- Core-Facility BrainImaging, Faculty of Medicine, Philipps-Universität, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, Westfälische Wilhelms-Universität Münster, Albert-Schweitzer-Campus 1, Building A9, 48149Münster, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
- Marburg University Hospital – UKGM, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
- Marburg University Hospital – UKGM, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), Hans-Meerwein-Str. 6, 35032Marburg, Germany
- Marburg University Hospital – UKGM, Rudolf-Bultmann-Str. 8, 35039Marburg, Germany
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13
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Kirschner M, Hodzic-Santor B, Antoniades M, Nenadic I, Kircher T, Krug A, Meller T, Grotegerd D, Fornito A, Arnatkeviciute A, Bellgrove MA, Tiego J, Dannlowski U, Koch K, Hülsmann C, Kugel H, Enneking V, Klug M, Leehr EJ, Böhnlein J, Gruber M, Mehler D, DeRosse P, Moyett A, Baune BT, Green M, Quidé Y, Pantelis C, Chan R, Wang Y, Ettinger U, Debbané M, Derome M, Gaser C, Besteher B, Diederen K, Spencer TJ, Fletcher P, Rössler W, Smigielski L, Kumari V, Premkumar P, Park HRP, Wiebels K, Lemmers-Jansen I, Gilleen J, Allen P, Kozhuharova P, Marsman JB, Lebedeva I, Tomyshev A, Mukhorina A, Kaiser S, Fett AK, Sommer I, Schuite-Koops S, Paquola C, Larivière S, Bernhardt B, Dagher A, Grant P, van Erp TGM, Turner JA, Thompson PM, Aleman A, Modinos G. Cortical and subcortical neuroanatomical signatures of schizotypy in 3004 individuals assessed in a worldwide ENIGMA study. Mol Psychiatry 2022; 27:1167-1176. [PMID: 34707236 PMCID: PMC9054674 DOI: 10.1038/s41380-021-01359-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 10/02/2021] [Accepted: 10/08/2021] [Indexed: 02/04/2023]
Abstract
Neuroanatomical abnormalities have been reported along a continuum from at-risk stages, including high schizotypy, to early and chronic psychosis. However, a comprehensive neuroanatomical mapping of schizotypy remains to be established. The authors conducted the first large-scale meta-analyses of cortical and subcortical morphometric patterns of schizotypy in healthy individuals, and compared these patterns with neuroanatomical abnormalities observed in major psychiatric disorders. The sample comprised 3004 unmedicated healthy individuals (12-68 years, 46.5% male) from 29 cohorts of the worldwide ENIGMA Schizotypy working group. Cortical and subcortical effect size maps with schizotypy scores were generated using standardized methods. Pattern similarities were assessed between the schizotypy-related cortical and subcortical maps and effect size maps from comparisons of schizophrenia (SZ), bipolar disorder (BD) and major depression (MDD) patients with controls. Thicker right medial orbitofrontal/ventromedial prefrontal cortex (mOFC/vmPFC) was associated with higher schizotypy scores (r = 0.067, pFDR = 0.02). The cortical thickness profile in schizotypy was positively correlated with cortical abnormalities in SZ (r = 0.285, pspin = 0.024), but not BD (r = 0.166, pspin = 0.205) or MDD (r = -0.274, pspin = 0.073). The schizotypy-related subcortical volume pattern was negatively correlated with subcortical abnormalities in SZ (rho = -0.690, pspin = 0.006), BD (rho = -0.672, pspin = 0.009), and MDD (rho = -0.692, pspin = 0.004). Comprehensive mapping of schizotypy-related brain morphometry in the general population revealed a significant relationship between higher schizotypy and thicker mOFC/vmPFC, in the absence of confounding effects due to antipsychotic medication or disease chronicity. The cortical pattern similarity between schizotypy and schizophrenia yields new insights into a dimensional neurobiological continuity across the extended psychosis phenotype.
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Affiliation(s)
- Matthias Kirschner
- grid.14709.3b0000 0004 1936 8649McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montréal, QC Canada ,grid.7400.30000 0004 1937 0650Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Benazir Hodzic-Santor
- grid.14709.3b0000 0004 1936 8649McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montréal, QC Canada
| | - Mathilde Antoniades
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, King’s College London, London, UK
| | - Igor Nenadic
- grid.10253.350000 0004 1936 9756University of Marburg, Marburg, Germany
| | - Tilo Kircher
- grid.10253.350000 0004 1936 9756University of Marburg, Marburg, Germany
| | - Axel Krug
- grid.10253.350000 0004 1936 9756University of Marburg, Marburg, Germany ,grid.10388.320000 0001 2240 3300Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Tina Meller
- grid.10253.350000 0004 1936 9756University of Marburg, Marburg, Germany
| | - Dominik Grotegerd
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Alex Fornito
- grid.1002.30000 0004 1936 7857Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Melbourne, VIC Australia
| | - Aurina Arnatkeviciute
- grid.1002.30000 0004 1936 7857Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Melbourne, VIC Australia
| | - Mark A. Bellgrove
- grid.1002.30000 0004 1936 7857Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Melbourne, VIC Australia
| | - Jeggan Tiego
- grid.1002.30000 0004 1936 7857Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging, Monash University, Melbourne, VIC Australia
| | - Udo Dannlowski
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Katharina Koch
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Carina Hülsmann
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Harald Kugel
- grid.5949.10000 0001 2172 9288University Clinic for Radiology, University of Münster, Münster, Germany
| | - Verena Enneking
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Melissa Klug
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Elisabeth J. Leehr
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Joscha Böhnlein
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - David Mehler
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany
| | - Pamela DeRosse
- grid.416477.70000 0001 2168 3646Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY USA ,grid.250903.d0000 0000 9566 0634The Feinstein Institutes for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY USA ,grid.512756.20000 0004 0370 4759Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY USA
| | - Ashley Moyett
- grid.416477.70000 0001 2168 3646Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY USA
| | - Bernhard T. Baune
- grid.5949.10000 0001 2172 9288Department of Psychiatry, University of Münster, Münster, Germany ,grid.1008.90000 0001 2179 088XDepartment of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC Australia
| | - Melissa Green
- grid.1005.40000 0004 4902 0432School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW Australia ,grid.250407.40000 0000 8900 8842Neuroscience Research Australia (NeuRA), Randwick, NSW Australia
| | - Yann Quidé
- grid.1005.40000 0004 4902 0432School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW Australia ,grid.250407.40000 0000 8900 8842Neuroscience Research Australia (NeuRA), Randwick, NSW Australia
| | - Christos Pantelis
- grid.1008.90000 0001 2179 088XMelbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, VIC Australia
| | - Raymond Chan
- grid.9227.e0000000119573309Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yi Wang
- grid.9227.e0000000119573309Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Ulrich Ettinger
- grid.10388.320000 0001 2240 3300University of Bonn, Bonn, Germany
| | - Martin Debbané
- grid.8591.50000 0001 2322 4988University of Geneva, Geneva, Switzerland
| | - Melodie Derome
- grid.8591.50000 0001 2322 4988University of Geneva, Geneva, Switzerland
| | - Christian Gaser
- grid.275559.90000 0000 8517 6224Jena University Hospital, Jena, Germany
| | - Bianca Besteher
- grid.275559.90000 0000 8517 6224Jena University Hospital, Jena, Germany
| | - Kelly Diederen
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, King’s College London, London, UK
| | - Tom J. Spencer
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, King’s College London, London, UK
| | - Paul Fletcher
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Wulf Rössler
- grid.412004.30000 0004 0478 9977Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland ,grid.6363.00000 0001 2218 4662Department of Psychiatry and Psychotherapy, Charité University Medicine, Berlin, Germany ,grid.11899.380000 0004 1937 0722Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Lukasz Smigielski
- grid.412004.30000 0004 0478 9977Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Veena Kumari
- grid.7728.a0000 0001 0724 6933Brunel University London, Uxbridge, UK
| | - Preethi Premkumar
- grid.7728.a0000 0001 0724 6933Brunel University London, Uxbridge, UK
| | - Haeme R. P. Park
- grid.9654.e0000 0004 0372 3343School of Psychology, University of Auckland, Auckland, New Zealand
| | - Kristina Wiebels
- grid.9654.e0000 0004 0372 3343School of Psychology, University of Auckland, Auckland, New Zealand
| | | | - James Gilleen
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, King’s College London, London, UK ,grid.35349.380000 0001 0468 7274University of Roehampton, London, UK
| | - Paul Allen
- grid.35349.380000 0001 0468 7274University of Roehampton, London, UK
| | - Petya Kozhuharova
- grid.35349.380000 0001 0468 7274University of Roehampton, London, UK
| | - Jan-Bernard Marsman
- grid.4830.f0000 0004 0407 1981Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Irina Lebedeva
- grid.466467.10000 0004 0627 319XMental Health Research Center, Moscow, Russian Federation
| | - Alexander Tomyshev
- grid.466467.10000 0004 0627 319XMental Health Research Center, Moscow, Russian Federation
| | - Anna Mukhorina
- grid.466467.10000 0004 0627 319XMental Health Research Center, Moscow, Russian Federation
| | - Stefan Kaiser
- grid.150338.c0000 0001 0721 9812Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Anne-Kathrin Fett
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, King’s College London, London, UK ,grid.28577.3f0000 0004 1936 8497City, University London, London, UK
| | - Iris Sommer
- grid.4830.f0000 0004 0407 1981Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Sanne Schuite-Koops
- grid.4830.f0000 0004 0407 1981Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Casey Paquola
- grid.14709.3b0000 0004 1936 8649McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montréal, QC Canada
| | - Sara Larivière
- grid.14709.3b0000 0004 1936 8649McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montréal, QC Canada
| | - Boris Bernhardt
- grid.14709.3b0000 0004 1936 8649McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montréal, QC Canada
| | - Alain Dagher
- grid.14709.3b0000 0004 1936 8649McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Montréal, QC Canada
| | - Phillip Grant
- grid.440934.e0000 0004 0593 1824Fresenius University of Applied Sciences, Frankfurt am Main, Germany
| | - Theo G. M. van Erp
- grid.266093.80000 0001 0668 7243Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA USA ,grid.266093.80000 0001 0668 7243Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA USA
| | - Jessica A. Turner
- grid.256304.60000 0004 1936 7400Imaging Genetics and Neuroinformatics Lab, Georgia State University, Atlanta, GA USA
| | - Paul M. Thompson
- grid.42505.360000 0001 2156 6853Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA USA
| | - André Aleman
- grid.4830.f0000 0004 0407 1981Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gemma Modinos
- Department of Psychosis Studies, King's College London, London, UK. .,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK.
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14
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Basic self-disturbance trajectories in clinical high risk for psychosis: a one-year follow-up study. Eur Arch Psychiatry Clin Neurosci 2022; 272:1007-1019. [PMID: 34783878 PMCID: PMC9388413 DOI: 10.1007/s00406-021-01349-6] [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: 02/20/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022]
Abstract
Basic self-disturbance (BSD) has been proposed as a driver of symptom development in schizophrenia spectrum disorders (SSDs). In a one-year follow-up of 32 patients (15-30 years) at putative risk for psychosis, we investigated trajectories of BSD levels from baseline to follow-up, and associations between clinical characteristics at baseline and follow-up, including follow-up levels of BSD (assessed with the EASE). Clinical high risk (CHR) for psychosis status and symptom severity were assessed with the SIPS/SOPS scales and also according to the cognitive basic symptoms high-risk criteria (COGDIS). DSM-IV diagnoses, functioning and other clinical characteristics were assessed with standard clinical instruments. Higher severity of negative symptoms and meeting COGDIS criteria at baseline were associated with higher BSD levels at follow-up. All measured at follow-up, higher BSD levels correlated with higher severity of positive, negative, disorganization and general symptoms, and with a lower level of global functioning. We found higher BSD levels at follow-up in subjects with schizotypal personality disorder (SPD) at baseline (n = 5) and in SSDs at follow-up (n = 12, including nine with SPD). Mean BSD levels decreased significantly from baseline to follow-up, but individual trajectories varied considerably. Increased BSD levels were associated with higher baseline BSD levels, non-remission of positive symptoms and functional decline. Overall, the current study indicates that subgroups in the CHR population with a higher risk of non-remission or deterioration may be identified by supplementing CHR criteria with assessment of BSD and negative symptoms.
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15
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Dizinger JMB, Doll CM, Rosen M, Gruen M, Daum L, Schultze-Lutter F, Betz L, Kambeitz J, Vogeley K, Haidl TK. Does childhood trauma predict schizotypal traits? A path modelling approach in a cohort of help-seeking subjects. Eur Arch Psychiatry Clin Neurosci 2022; 272:909-922. [PMID: 34982217 PMCID: PMC9279245 DOI: 10.1007/s00406-021-01373-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 12/16/2021] [Indexed: 12/27/2022]
Abstract
Schizotypy constitutes a susceptibility to beneficial and deleterious schizotypal traits, ranging from coping mechanisms to schizotypal personality disorder on a psychosis continuum. Growing evidence indicates a relationship between childhood adversity and trauma and schizotypy. However, the exact influence of childhood adversity and trauma on schizotypy and its relation to sex is not sufficiently understood. Therefore, we investigated sex-adjusted connections between childhood adversity and trauma subdomains (emotional/physical/sexual abuse, emotional/physical neglect) and positive (magical ideation, perceptual aberration) as well as negative schizotypy (physical/social anhedonia). In total, 240 outpatients of the Early Detection and Intervention Centre of the University Hospital Cologne were assessed with the Trauma and Distress Scale for childhood adversity and trauma and the Wisconsin Schizotypy Scales for schizotypy. Path analyses were performed to investigate sex-adjusted correlations. The well-fitting path model of the total sample linked emotional abuse to magical ideation (p = 0.03; SE = 0.20) and emotional neglect to social anhedonia (p = 0.01; SE = 0.26). In females, physical abuse predicted magical ideation (p = 0.01; SE = 0.33), while emotional neglect forecasted physical anhedonia (p = 0.03; SE = 0.34) and social anhedonia (p = 0.03; SE = 0.32). In males, sexual abuse predicted perceptive aberration (p = 0.04; SE = 0.19) and emotional abuse forecasted magical ideation (p = 0.03; SE = 0.27). Overall, the significance of sex-specific interrelations between trauma and schizotypy were highlighted. Magical ideation and perceptive aberration occurred prominently in the absence of negative and disorganized schizotypy, thus positive schizotypy could be discussed as a beneficial expression of coping with emotional, physical and sexual abuse. Furthermore, emotional neglect should be addressed particularly to prevent deleterious negative schizotypy in females.Trial registration number (20-1243), date of registration (May 19th 2020), retrospectively registered.
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Affiliation(s)
- Julian Max Bernhard Dizinger
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Carolin Martha Doll
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Michael Gruen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Lukas Daum
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Linda Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
- Research Center Jülich, Institute of Neuroscience and Medicine-Cognitive Neuroscience (INM3), Jülich, Germany
| | - Theresa Katharina Haidl
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
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16
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Smigielski L, Papiol S, Theodoridou A, Heekeren K, Gerstenberg M, Wotruba D, Buechler R, Hoffmann P, Herms S, Adorjan K, Anderson-Schmidt H, Budde M, Comes AL, Gade K, Heilbronner M, Heilbronner U, Kalman JL, Klöhn-Saghatolislam F, Reich-Erkelenz D, Schaupp SK, Schulte EC, Senner F, Anghelescu IG, Arolt V, Baune BT, Dannlowski U, Dietrich DE, Fallgatter AJ, Figge C, Jäger M, Juckel G, Konrad C, Nieratschker V, Reimer J, Reininghaus E, Schmauß M, Spitzer C, von Hagen M, Wiltfang J, Zimmermann J, Gryaznova A, Flatau-Nagel L, Reitt M, Meyers M, Emons B, Haußleiter IS, Lang FU, Becker T, Wigand ME, Witt SH, Degenhardt F, Forstner AJ, Rietschel M, Nöthen MM, Andlauer TFM, Rössler W, Walitza S, Falkai P, Schulze TG, Grünblatt E. Polygenic risk scores across the extended psychosis spectrum. Transl Psychiatry 2021; 11:600. [PMID: 34836939 PMCID: PMC8626446 DOI: 10.1038/s41398-021-01720-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/24/2021] [Accepted: 10/29/2021] [Indexed: 12/23/2022] Open
Abstract
As early detection of symptoms in the subclinical to clinical psychosis spectrum may improve health outcomes, knowing the probabilistic susceptibility of developing a disorder could guide mitigation measures and clinical intervention. In this context, polygenic risk scores (PRSs) quantifying the additive effects of multiple common genetic variants hold the potential to predict complex diseases and index severity gradients. PRSs for schizophrenia (SZ) and bipolar disorder (BD) were computed using Bayesian regression and continuous shrinkage priors based on the latest SZ and BD genome-wide association studies (Psychiatric Genomics Consortium, third release). Eight well-phenotyped groups (n = 1580; 56% males) were assessed: control (n = 305), lower (n = 117) and higher (n = 113) schizotypy (both groups of healthy individuals), at-risk for psychosis (n = 120), BD type-I (n = 359), BD type-II (n = 96), schizoaffective disorder (n = 86), and SZ groups (n = 384). PRS differences were investigated for binary traits and the quantitative Positive and Negative Syndrome Scale. Both BD-PRS and SZ-PRS significantly differentiated controls from at-risk and clinical groups (Nagelkerke's pseudo-R2: 1.3-7.7%), except for BD type-II for SZ-PRS. Out of 28 pairwise comparisons for SZ-PRS and BD-PRS, 9 and 12, respectively, reached the Bonferroni-corrected significance. BD-PRS differed between control and at-risk groups, but not between at-risk and BD type-I groups. There was no difference between controls and schizotypy. SZ-PRSs, but not BD-PRSs, were positively associated with transdiagnostic symptomology. Overall, PRSs support the continuum model across the psychosis spectrum at the genomic level with possible irregularities for schizotypy. The at-risk state demands heightened clinical attention and research addressing symptom course specifiers. Continued efforts are needed to refine the diagnostic and prognostic accuracy of PRSs in mental healthcare.
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Affiliation(s)
- Lukasz Smigielski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland.
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Anastasia Theodoridou
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Karsten Heekeren
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy I, LVR-Hospital, Cologne, Germany
| | - Miriam Gerstenberg
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Diana Wotruba
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Roman Buechler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Per Hoffmann
- Department of Biomedicine, Human Genomics Research Group, University Hospital and University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Stefan Herms
- Department of Biomedicine, Human Genomics Research Group, University Hospital and University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Heike Anderson-Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | | | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sabrina K Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ion-George Anghelescu
- Department of Psychiatry and Psychotherapy, Mental Health Institute, Berlin, Germany
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Detlef E Dietrich
- AMEOS Clinical Center Hildesheim, Hildesheim, Germany
- Center for Systems Neuroscience (ZSN), Hannover, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg, Germany
| | - Markus Jäger
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Jens Reimer
- Department of Psychiatry, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Max Schmauß
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, Augsburg University, Medical Faculty, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Martin von Hagen
- Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, Eschwege, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
| | - Anna Gryaznova
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Laura Flatau-Nagel
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Markus Reitt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Milena Meyers
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Barbara Emons
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Ida Sybille Haußleiter
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Fabian U Lang
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Thomas Becker
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Moritz E Wigand
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Wulf Rössler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, Universidade de São Paulo, São Paulo, Brazil
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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17
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Henriques-Calado J, Gonçalves B, Marques C, Paulino M, Gama Marques J, Grácio J, Pires R. In light of the DSM-5 dimensional model of personality: Borderline personality disorder at the crossroads with the bipolar spectrum. J Affect Disord 2021; 294:897-907. [PMID: 34375218 DOI: 10.1016/j.jad.2021.07.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/22/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND State-of-the-art research highlights that borderline personality disorder (PD) and bipolar spectrum disorders have clinical characteristics in common, which imply uncertainty in differential diagnoses. Although there is a growing body of literature on the DSM-5 dimensional model of personality disorder, its discriminative features between these clinical samples are still understudied. In this study, we seek to identify the best set of predictors that differentiate between borderline PD and bipolar spectrum, based on pathological and normative personality traits and symptoms. METHODS A cross-sectional study of three clinical samples: 1) Borderline PD group of 63 participants; 2) Major depressive disorder group of 89 participants; 3) Bipolar disorder group of 65 participants. Self-reported assessment: Personality Inventory for DSM-5; Brief Symptom Inventory; FFM Inventory. A series of one-way ANOVAs and logistic regression analyses were computed. RESULTS The major set of data emerging as common discriminants of borderline PD across the bipolar spectrum are unusual beliefs & experiences, paranoid ideation, obsession-compulsion and extraversion. Depressivity (OR: 34.95) and impulsivity (OR: 22.35) pathological traits displayed the greatest predictive values in the differential diagnosis. LIMITATIONS The small size of the samples; a lack of data from participants' previous clinical history. CONCLUSIONS Findings support the DSM-5 pathological traits as differentiating borderline PD through bipolar spectrum, and reinforcing the joint use of symptom-related pathological functioning and normal-range personality traits. Alongside the bipolar spectrum, borderline pathology sheds light upon a hypothetical overlap along the depressive and schizoaffective/schizophrenia spectra, representing a borderland space at a crossroads with the psychopathology of a meta-spectrum.
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Affiliation(s)
- Joana Henriques-Calado
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal; CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal.
| | - Bruno Gonçalves
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal; CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Catarina Marques
- Instituto Universitário de Lisboa (ISCTE-IUL), Business Research Unit, Av. das Forças Armadas, 1649-026 Lisboa, Portugal
| | - Marco Paulino
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - João Gama Marques
- Clínica de Psiquiatria Geral e Transcultural, Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Avenida do Brasil, 53, 1749-002 Lisboa, Portugal; Clínica Universitária de Psiquiatra e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Jaime Grácio
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal; Champalimaud Research, Champalimaud Centre for the Unknown, Champalimaud Foundation, Lisbon, Portugal; NOVA Medical School/ Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Rute Pires
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal; CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal
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18
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Daimer S, Mihatsch L, Ronan L, Murray GK, Knolle F. Subjective Impact of the COVID-19 Pandemic on Schizotypy and General Mental Health in Germany and the United Kingdom, for Independent Samples in May and in October 2020. Front Psychol 2021; 12:667848. [PMID: 34393901 PMCID: PMC8355554 DOI: 10.3389/fpsyg.2021.667848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Studies reported a strong impact on mental health during the first wave of the COVID-19 pandemic in March-June, 2020. In this study, we assessed the impact of the pandemic on mental health in general and on schizotypal traits in two independent general population samples of the United Kingdom (May sample N: 239, October sample N: 126; participation at both timepoints: 21) and in two independent general population samples of Germany (May sample N: 543, October sample N: 401; participation at both timepoints: 100) using online surveys. Whereas general psychological symptoms (global symptom index, GSI) and percentage of responders above clinical cut-off for further psychological investigation were higher in the May sample compared to the October sample, schizotypy scores (Schizotypal Personality Questionnaire) were higher in the October sample. We investigated potential associations, using general linear regression models (GLM). For schizotypy scores, we found that loneliness, use of drugs, and financial burden were more strongly corrected with schizotypy in the October compared to the May sample. We identified similar associations for GSI, as for schizotypy scores, in the May and October samples. We furthermore found that living in the United Kingdom was related to higher schizotypal scores or GSI. However, individual estimates of the GLM are highly comparable between the two countries. In conclusion, this study shows that while the general psychological impact is lower in the October than the May sample, potentially showing a normative response to an exceptional situation; schizotypy scores are higher at the second timepoint, which may be due to a stronger impact of estimates of loneliness, drug use, and financial burden. The ongoing, exceptional circumstances within this pandemic might increase the risk for developing psychosis in some individuals. The development of general psychological symptoms and schizotypy scores over time requires further attention and investigation.
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Affiliation(s)
- Sarah Daimer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lorenz Mihatsch
- Institute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Munich, Germany
| | - Lisa Ronan
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Franziska Knolle
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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19
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Tannenbaum L, Rodzen M. Traits Versus States. PHYSICIAN ASSISTANT CLINICS 2021. [DOI: 10.1016/j.cpha.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hsu MC, Lee SC, Ouyang WC. Use of Charlson Comorbidity Index and Nomogram to Predict Mortality in Elderly Patients with Late-Life Schizophrenia. Healthcare (Basel) 2021; 9:healthcare9070783. [PMID: 34206232 PMCID: PMC8304975 DOI: 10.3390/healthcare9070783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/29/2022] Open
Abstract
Objectives: Comorbid illness burden signifies a poor prognosis in schizophrenia. The aims of this study were to estimate the severity of comorbidities in elderly patients with schizophrenia, determine risk factors associated with mortality, and establish a reliable nomogram for predicting 1-, 3- and 5-year mortality and survival. Methods: This population-based study rigorously selected schizophrenia patients (≥65 years) having their first admission due to schizophrenia during the study period (2000–2013). Comorbidity was scored using the updated Charlson Comorbidity Index (CCI). Results: This study comprised 3827 subjects. The mean stay of first admission due to schizophrenia was 26 days. Mean numbers of schizophrenia and non-schizophrenia-related hospitalization (not including the first admission) were 1.80 and 3.58, respectively. Mean ages at death were 73.50, 82.14 and 89.32 years old, and the mean times from first admission to death were 4.24, 3.33, and 1.87 years in three different age groups, respectively. Nearly 30% were diagnosed with ≥3 comorbidities. The most frequent comorbidities were dementia, chronic pulmonary disease and diabetes. The estimated 1-, 3- and 5-year survival rates were 90%, 70%, and 64%, respectively. Schizophrenia patients with comorbid diseases are at increased risk of hospitalization and mortality (p < 0.05). Conclusion: The nomogram, composed of age, sex, the severity of comorbidity burden, and working type could be applied to predict mortality risk in the extremely fragile patients.
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Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Shang-Chi Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan 71742, Taiwan
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-6-2795019
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Værnes TG, Røssberg JI, Melle I, Nelson B, Romm KL, Møller P. Basic self-disturbance in subjects at clinical high risk for psychosis: Relationship with clinical and functional outcomes at one year follow-up. Psychiatry Res 2021; 300:113942. [PMID: 33940444 DOI: 10.1016/j.psychres.2021.113942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
Basic self-disturbance (BSD) is assumed to drive symptom development in schizophrenia spectrum disorders and in clinical high-risk (CHR) for psychosis. We investigated the relationship between BSD at baseline, assessed with the Examination of Anomalous Self-Experience (EASE), and symptoms and functional outcome after one year in 32 patients, including 26 CHR and six with non-progressive attenuated psychotic symptoms. Correlations between baseline BSD levels and positive, negative and disorganization symptoms, and global functioning level at follow-up were significant. Hierarchical regression analyses revealed that higher levels of baseline BSD predicted more severe positive symptoms and lower global functioning at follow-up, after adjusting for baseline positive symptoms and functioning. Subjects who were not in symptomatic and functional remission after one year had higher levels of BSD and negative symptoms, and lower functioning level, at baseline. Baseline BSD in participants with schizophrenia spectrum diagnoses at follow-up (9 of 12 were schizotypal personality disorder) were at the levels seen in schizotypal disorders in previous studies, but not significantly different from the other participants. Early identification and assessment of BSD may constitute a useful prognostic tool and a signal for therapeutic targets in CHR conditions. Further CHR studies investigating these relationships with larger samples are recommended.
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Affiliation(s)
- Tor Gunnar Værnes
- Early Intervention in Psychosis Advisory Unit for South-East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Jan Ivar Røssberg
- Psychiatric Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, the University of Melbourne, Parkville, Victoria, Australia
| | - Kristin Lie Romm
- Early Intervention in Psychosis Advisory Unit for South-East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Møller
- Department for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
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Nenadić I, Meller T, Evermann U, Schmitt S, Pfarr JK, Abu-Akel A, Grezellschak S. Subclinical schizotypal vs. autistic traits show overlapping and diametrically opposed facets in a non-clinical population. Schizophr Res 2021; 231:32-41. [PMID: 33744683 DOI: 10.1016/j.schres.2021.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 02/03/2021] [Accepted: 02/27/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND The overlap of autism spectrum disorder (ASD) and psychosis or schizophrenia spectrum disorders (SSD) has exposed problems central to conceptualising and understanding co-morbidity in psychiatric disorders. METHODS In the present study, we demonstrate that a deep phenotyping approach aids clarification of both overlapping and diametrically opposed features of ASD and SSD on the level of trait facets. RESULTS We first show overlap of negative and disorganised (but not positive) features of schizotypy with autistic traits in a sample of n = 376 German non-clinical subjects using multiple psychometric measures of schizotypy (MSS multidimensional schizotypy scale, OLIFE Oxford-Liverpool Inventory of Feelings and Experiences, and SPQ-B schizotypal personality questionnaire - brief) and the AQ autism spectrum quotient, with control measures for affective spectrum pathology (BDI). Findings were then replicated in a French-Swiss sample (n = 264) using MSS, OLIFE, AQ, and in addition the Community Assessment of Psychic Experiences (CAPE). Additional principal component analysis confirmed our finding of the co-existence of both overlapping (loss of function, social communication deficit, and negative schizotypy) as well as diametrically opposed features (AQ attention to detail, positive schizotypy) across the two spectra. Results were validated with Horn's parallel analyses, affirming two component solutions, and PCA using sample-specific, factor-analysis-derived schizotypy scores. CONCLUSIONS Providing a framework for multi-dimensional transdiagnostic characterisation of ASD vs. SSD phenotypes we point out overlapping vs. discriminating facets. In addition to the use of novel multidimensional schizotypy scales, it also shows transcultural consistency of findings, and highlights a particular role for the attention to detail AQ subscale.
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Affiliation(s)
- Igor Nenadić
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Germany; Marburg University Hospital - UKGM, Marburg, Germany.
| | - Tina Meller
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Germany
| | - Ulrika Evermann
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Germany
| | - Simon Schmitt
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Germany
| | - Julia-Katharina Pfarr
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Germany
| | - Ahmad Abu-Akel
- Institute of Psychology, University of Lausanne, Quartier UNIL-Mouline, Géopolis, Lausanne, Switzerland
| | - Sarah Grezellschak
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Germany; Marburg University Hospital - UKGM, Marburg, Germany
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Premkumar P, Alahakoon P, Smith M, Kumari V, Babu D, Baker J. Mild-to-moderate schizotypal traits relate to physiological arousal from social stress. Stress 2021; 24:303-317. [PMID: 32686572 DOI: 10.1080/10253890.2020.1797674] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Schizotypy denotes psychosis-like experiences, such as perceptual aberration, magical ideation, and social anxiety. Altered physiological arousal from social stress is found in people with high schizotypal traits. Two experiments aimed to determine the relationship of schizotypy to physiological arousal from social stress. Experiment 1 tested the hypotheses that heart rate from social stress would be greater in high, than mild-to-moderate, schizotypal traits, and disorganized schizotypy would explain this effect because of distress from disorganisation. Experiment 1 tested social stress in 16 participants with high schizotypal traits and 10 participants with mild-to-moderate schizotypal traits. The social stress test consisted of a public speech and an informal discussion with strangers. The high schizotypal group had a higher heart rate than the mild-to-moderate schizotypal group during the informal discussion with strangers, but not during the public speech. Disorganized schizotypy accounted for this group difference. Experiment 2 tested the hypothesis that mild-to-moderate schizotypal traits would have a linear relationship with physiological arousal from social stress. Experiment 2 tested 24 participants with mild-to-moderate schizotypal traits performing the abovementioned social stress test while their heart rate and skin conductance responses were measured. Mild-to-moderate schizotypal traits had a linear relationship with physiological arousal during the discussion with strangers. Distress in disorganized schizotypy may explain the heightened arousal from close social interaction with strangers in high schizotypy than mild-to-moderate schizotypy. Mild-to-moderate schizotypal traits may have a linear relationship with HR during close social interaction because of difficulty with acclimatizing to the social interaction.
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Affiliation(s)
- Preethi Premkumar
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Prasad Alahakoon
- Department of Agricultural Extension, Faculty of Agriculture, University of Peradeniya, Sri Lanka
| | - Madelaine Smith
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Veena Kumari
- Centre for Cognitive Neuroscience, College of Life and Health Sciences, Brunel University London, Uxbridge, UK
| | - Diviesh Babu
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Joshua Baker
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
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Walter EE, Fernandez F, Barkus E. Not all stress is created equal: Acute, not ambient stress, impairs learning in high schizotypes. Psych J 2021; 11:179-193. [PMID: 33915603 DOI: 10.1002/pchj.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/08/2022]
Abstract
Learning from feedback is essential for daily functioning, with factors that impact learning having implications for healthy and clinical populations. Reinforcement learning appears impaired across the psychosis continuum, with deficits reported in patients with psychotic disorders as well as high schizotypes from the general population. Stress can impair learning, and sensitivity to stress is present along the psychosis continuum. The aim of the present study was to understand if stress impairs reinforcement learning in those at the lower end of the psychosis continuum. We investigated both naturalistic stress in everyday life using daily hassles (Study 1: n = 70; 31% male, M age = 22.67 years) and acute psychosocial stress using the Trier Social Stress Test (Study 2: n = 57; 32% male, M age = 22.43 years). In the presence of naturalistic stress, learning did not differ across schizotypes. However, under acute psychosocial stress, high schizotypes experienced impaired learning. Our results suggest trail-and-error learning is robust to the ebbs and flows of everyday stress for high schizotypes; however, acute stress is associated with decrements in learning. This indicates that the magnitude of stressors should be considered when designing cognitive and functional interventions for those along the psychosis continuum.
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Affiliation(s)
- Emma E Walter
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Francesca Fernandez
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Emma Barkus
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
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Elek Z, Rónai Z, Hargitai R, Réthelyi J, Arndt B, Matuz A, Csathó Á, Polner B, Kállai J. Magical thinking as a bio-psychological developmental disposition for cognitive and affective symptoms intensity in schizotypy: Traits and genetic associations. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hur JW, Kim T, Cho KIK, Kwon JS. Attenuated Resting-State Functional Anticorrelation between Attention and Executive Control Networks in Schizotypal Personality Disorder. J Clin Med 2021; 10:jcm10020312. [PMID: 33467694 PMCID: PMC7829946 DOI: 10.3390/jcm10020312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 11/18/2022] Open
Abstract
Exploring the disruptions to intrinsic resting-state networks (RSNs) in schizophrenia-spectrum disorders yields a better understanding of the disease-specific pathophysiology. However, our knowledge of the neurobiological underpinnings of schizotypal personality disorders mostly relies on research on schizotypy or schizophrenia. This study aimed to investigate the RSN abnormalities of schizotypal personality disorder (SPD) and their clinical implications. Using resting-state data, the intra- and inter-network of the higher-order functional networks (default mode network, DMN; frontoparietal network, FPN; dorsal attention network, DAN; salience network, SN) were explored in 22 medication-free, community-dwelling, non-help seeking individuals diagnosed with SPD and 30 control individuals. Consequently, while there were no group differences in intra-network functional connectivity across DMN, FPN, DAN, and SN, the SPD participants exhibited attenuated anticorrelation between the right frontal eye field region of the DAN and the right posterior parietal cortex region of the FPN. The decreases in anticorrelation were correlated with increased cognitive–perceptual deficits and disorganization factors of the schizotypal personality questionnaire, as well as reduced independence–performance of the social functioning scale for all participants together. This study, which links SPD pathology and social functioning deficits, is the first evidence of impaired large-scale intrinsic brain networks in SPD.
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Affiliation(s)
- Ji-Won Hur
- Department of Psychology, Korea University, Seoul 02841, Korea;
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Korea;
| | - Taekwan Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Korea;
| | - Kang Ik K. Cho
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA;
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Korea;
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-2072-2972; Fax: +82-2-747-9063
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27
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Schizotypy in Parkinson's disease predicts dopamine-associated psychosis. Sci Rep 2021; 11:759. [PMID: 33437004 PMCID: PMC7804198 DOI: 10.1038/s41598-020-80765-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/22/2020] [Indexed: 11/08/2022] Open
Abstract
Psychosis is the most common neuropsychiatric side-effect of dopaminergic therapy in Parkinson’s disease (PD). It is still unknown which factors determine individual proneness to psychotic symptoms. Schizotypy is a multifaceted personality trait related to psychosis-proneness and dopaminergic neurotransmission in healthy subjects. We investigated whether (1) PD patients exhibit lower schizotypy than controls and (2) dopamine-related neuropsychiatric side-effects can be predicted by higher schizotypy. In this cross-sectional study, we used the Oxford-Liverpool Inventory of Feelings and Experiences in 56 PD patients (12 women, mean ± sd age: 61 ± 11 years) receiving their usual dopaminergic medication and 32 age-matched healthy controls (n = 32; 18 women, mean ± sd age: 57 ± 6 years). We further compared schizotypy scores of patients with (n = 18, 32.1%) and without previously experienced psychosis. We found that patients exhibited lower schizotypy than controls. Further, patients with a history of psychosis exhibited higher schizotypy than patients without these symptoms. Using an information theoretic measure and a machine learning approach, we show that schizotypy yields the greatest predictive value for dopamine-associated hallucinations compared to other patient characteristics and disease related factors. Our results indicate an overlap between neural networks associated with schizotypy and the pathophysiology of PD and a relationship between schizotypy and psychotic side-effects of dopaminergic medication.
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28
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The Relationship between PID-5 Personality Traits and Mental States. A Study on a Group of Young Adults at Risk of Psychotic Onset. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57010033. [PMID: 33401519 PMCID: PMC7823839 DOI: 10.3390/medicina57010033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/26/2020] [Accepted: 12/29/2020] [Indexed: 01/10/2023]
Abstract
Background and Objectives: The diagnosis of psychosis is a challenge for the scientific community, both in terms of its definition and treatment. Some recent studies have investigated the relationship between personality and psychosis onset to prevent or intervene early. Materials and Methods: Sixty young adults were recruited during their first access in 2019 near the Community Mental Health Service of Niguarda Hospital, Milan, Italy. The assessment included the Social and Occupational Functioning Assessment Scale (SOFAS), the Global Assessment of Functioning (GAF) (clinician scales), the 16-item Version of the Prodromal Questionnaire (PQ-16), the Personality Inventory for DSM-5 (PID-5) (self-report), and a clinical session. Statistical analysis was performed by SPSS. Results: The results show a negative correlation between the Detachment domain and the GAF scores. Correlational analysis also highlights that all PID-5 domains, except for Antagonism, have positive correlations with high scores in the PQ-16. The multivariate analysis of variance showed that patients diagnosed with versus without a psychotic disorder significantly differed on Detachment, Antagonism and Psychoticism PID-5 domains. Conclusions: The involvement of the personality construct in psychopathological development is displayed. In particular, higher levels of Detachment and Psychoticism can distinguish people who are more vulnerable to psychosis or who already have overt psychosis from those who do not have a psychotic predisposition. The study highlights the fundamental role of personality traits, emerging from PID-5, to distinguish young adults at risk of onset.
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29
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Sharma P, Riehm KE, Young AS, Reynolds MD, Tarter RE, Horner MS, Hammond CJ. Do the Transmissible Liability Index (TLI) and Adolescent Cannabis Use Predict Paranoid and Schizotypal Symptoms at Young Adulthood? Subst Use Misuse 2021; 56:2026-2034. [PMID: 34402373 DOI: 10.1080/10826084.2021.1964086] [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] [Indexed: 10/20/2022]
Abstract
Background: Adolescent cannabis use is an established risk factor for the development of psychosis, but the premorbid vulnerability factors and specificity versus generality of the psychotic symptom domains affected in cannabis-psychosis relationships remain incompletely understood. To improve our understanding of these relationships, we used longitudinal data to examine the individual and interactive effects of preadolescent transmissible liability to substance use disorders (SUD), measured via the transmissible liability index (TLI), and adolescent cannabis use on the development of two distinct psychotic symptom domains, paranoid and schizotypal personality traits in young adulthood. Methods: We performed secondary analysis of data from the Center for Education and Drug Abuse (CEDAR) study, which longitudinally assessed offspring of men with (N = 211) and without (N = 237) lifetime history of SUD at ages 10-12, and across adolescence as they transitioned to young adulthood. TLI scores were calculated at age 10-12, self-reported cannabis use was assessed at age 16, and paranoid and schizotypal symptoms were assessed at age 19. Results: Cannabis use at age 16 and family history of SUD were significantly associated with paranoid and schizotypal symptoms at age 19, but TLI scores were not. The interactive effect of TLI x cannabis use was also not significant. Paranoid and schizotypal symptoms showed different dose-dependent sensitivities to cannabis exposure at age 16. Conclusions: These findings indicate that adolescent cannabis use and family history of SUD differentially contribute to the development of paranoid and schizotypal personality traits through mechanisms that do not include behavioral disinhibition.
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Affiliation(s)
- Pravesh Sharma
- Department of Psychiatry, Mayo Clinic Health System, Eau Claire, WI, USA
| | - Kira E Riehm
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrea S Young
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Ralph E Tarter
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michelle S Horner
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Alfimova MV, Lezheiko TV, Sergeev NV, Plakunova VV, Golimbet VE. [Structure of schizotypal traits in the Russian population]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:94-101. [PMID: 32790982 DOI: 10.17116/jnevro202012007194] [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: 11/18/2022]
Abstract
Establishing the structure of schizotypal traits and its cross-cultural and demographic universality is an important condition for increasing the effectiveness of prognosis of schizophrenic spectrum disorders and basic research on their etiology. The present study aimed to explore the structure of schizotypal traits measured by the Schizotypal Personality Questionnaire (SPQ-74) in the Russian population. Exploratory and confirmatory factor analyses of the factor structure of SPQ-74 were performed using a sample of 1316 people of a wide age range. It is shown that, in the Russian population, the four-factor «paranoid» model of N. Stefanis et al. had the best fit for the data. The multivariate confirmatory analysis evidenced the gender invariance of the model.
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Affiliation(s)
| | | | - N V Sergeev
- Moscow State Academy of Physical Education, Moscow, Russia
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31
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Tagami U, Imaizumi S. No Correlation Between Perception of Meaning and Positive Schizotypy in a Female College Sample. Front Psychol 2020; 11:1323. [PMID: 32595575 PMCID: PMC7304487 DOI: 10.3389/fpsyg.2020.01323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
We visually perceive meaning from stimuli in the external world. There are inter-individual variations in the perception of meaning. A candidate factor to explain this variation is positive schizotypy, which is a personality analogous to positive symptoms of schizophrenia (e.g., visual hallucination). The present study investigated the relationship between positive schizotypy, and the perception of meaning derived from meaningful and meaningless visual stimuli. Positive schizotypy in Japanese female undergraduates (n = 35) was assessed by the Cognitive-Perceptual dimension of the Schizotypal Personality Questionnaire. The participants were asked to report what they saw in noise-degraded images of meaningful objects (Experiment 1) and to respond whether the objects were meaningful (Experiment 2A) and which paired objects were meaningful (Experiment 2B). Positive schizotypy (i.e., Cognitive-Perceptual score) did not correlate with time to detect meaningful objects, and with false-alarm rates, sensitivity, and response criterion in the perception of meaning from meaningful and meaningless stimuli. These results were against our hypothesis and contradicted previous findings. The inconsistencies are discussed in terms of different methods (e.g., stimulus category) and conditions (e.g., paranormal beliefs).
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Affiliation(s)
- Ubuka Tagami
- Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - Shu Imaizumi
- Institute for Education and Human Development, Ochanomizu University, Tokyo, Japan
- *Correspondence: Shu Imaizumi,
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Entwicklung einer psychoanalytisch begründeten Typologie von psychotischen Erkrankungen. FORUM DER PSYCHOANALYSE 2020. [DOI: 10.1007/s00451-020-00390-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ZusammenfassungDer Artikel begründet die Notwendigkeit eines genuin psychoanalytischen und gleichsam in der empirischen Psychotherapieforschung anschlussfähigen Beitrags zum Verständnis psychotischer Erkrankungen. Die sequenziell erklärende Mixed-Methods-Studie „Therapie und Psychodynamik von Patient*innen mit psychotischen Symptomen“ (T3PS-Studie) fokussiert auf die Binnendifferenzierung psychotischer Erkrankungen. Hierfür soll eine psychoanalytisch begründete Typologie dieser Patient*innen anhand messender und hermeneutischer Methoden entwickelt und validiert werden. Zur Entwicklung der Typologie sieht das Studiendesign psychodynamische, psychopathologische und weitere diagnostische Interviews mit stationären Patientinnen und Patienten (N = 100) vor. Zusätzlich werden am Ende der Behandlung Beziehungsepisodeninterviews mit Mitgliedern des Behandlungsteams geführt und Fragebogen eingesetzt. Mittels zunächst statistischer Modellierung und anschließender qualitativer Konzeptbildung sollen schließlich Prototypen psychotischer Erkrankungen entlang der in der Operationalisierten Psychodynamischen Diagnostik (OPD) erfassbaren psychoanalytischen Konzepte von Konflikt, Struktur und Beziehungsdynamik identifiziert werden. Die klinische Nützlichkeit dieser Typologie soll durch systematische Untersuchungen einzelner Behandlungsverläufe nach dem Hermeneutic Single-Case Efficacy Design (HSCED) geprüft werden.
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Grant P, Hennig J. Schizotypy, social stress and the emergence of psychotic-like states - A case for benign schizotypy? Schizophr Res 2020; 216:435-442. [PMID: 31796309 DOI: 10.1016/j.schres.2019.10.052] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/28/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
Abstract
Schizotypy is a personality-organisation related to schizophrenia-liability as well as the emergence of psychotic symptoms and psychotic-like experiences (PLEs) in non-schizophrenic individuals. It has been suggested that some non-schizophrenic individuals may exhibit PLEs frequently, but in a fashion that is not distressing but life-enhancing ("benign schizotypy"). In schizophrenia and at-risk individuals, however, psychotic symptoms are not only distressing, but also triggered stress. To further investigate questions of causality and examine how PLEs may present as distressing symptoms in some individuals and as benign experiences in others, we explored how schizotypy-facets moderated PLEs-variability under experimentally induced social stress.We performed a standardised social stress-paradigm in 107 healthy adults (77 female, 30 male; average age 22,5 years), measuring changes in psychometrically assessed PLEs and the moderation of changes under stress through positive, negative and disorganised schizotypy. Results suggest two discrete effects: On the one hand, individuals high in disorganised and negative schizotypy showed stress-dependent increases in PLEs; without added effects of positive schizotypy. On the other, individuals low in negative and disorganised schizotypy showed higher levels of PLEs solely as a function of positive schizotypy but not stress. We discuss these findings in light of the fully-dimensional model of schizotypy and hypothesize that PLEs in individuals high in schizotypy-facets suggested to convey risk-for-schizophrenia (negative and disorganised) may reflect qualitatively different entities than PLEs in individuals with low values in these facets, but high expressions of positive schizotypy ("happy schizotypes"). Additionally, we emphasize the importance of not overlooking the disorganised schizotypy-facet in related research.
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Affiliation(s)
- Phillip Grant
- Psychopathology and Psychosis Research, Psychology School, Hochschule Fresenius University of Applied Sciences, Frankfurt a. M., Germany; Faculty of Life Science Engineering, Technische Hochschule Mittelhessen University of Applied Sciences, Giessen, Germany.
| | - Juergen Hennig
- Biological Psychology and Individual Differences, Department of Psychology, Justus-Liebig-University, Giessen, Germany
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Walger H, Antonucci LA, Pigoni A, Upthegrove R, Salokangas RKR, Lencer R, Chisholm K, Riecher-Rössler A, Haidl T, Meisenzahl E, Rosen M, Ruhrmann S, Kambeitz J, Kambeitz-Ilankovic L, Falkai P, Ruef A, Hietala J, Pantelis C, Wood SJ, Brambilla P, Bertolino A, Borgwardt S, Koutsouleris N, Schultze-Lutter F. Basic Symptoms Are Associated With Age in Patients With a Clinical High-Risk State for Psychosis: Results From the PRONIA Study. Front Psychiatry 2020; 11:552175. [PMID: 33312133 PMCID: PMC7707000 DOI: 10.3389/fpsyt.2020.552175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/22/2020] [Indexed: 12/16/2022] Open
Abstract
In community studies, both attenuated psychotic symptoms (APS) and basic symptoms (BS) were more frequent but less clinically relevant in children and adolescents compared to adults. In doing so, they displayed differential age thresholds that were around age 16 for APS, around age 18 for perceptive BS, and within the early twenties for cognitive BS. Only the age effect has previously been studied and replicated in clinical samples for APS. Thus, we examined the reported age effect on and age thresholds of 14 criteria-relevant BS in a patient sample at clinical-high risk of psychosis (N = 261, age 15-40 yrs.), recruited within the European multicenter PRONIA-study. BS and the BS criteria, "Cognitive Disturbances" (COGDIS) and "Cognitive-perceptive BS" (COPER), were assessed with the "Schizophrenia Proneness Instrument, Adult version" (SPI-A). Using logistic regressions, prevalence rates of perceptive and cognitive BS, and of COGDIS and COPER, as well as the impact of social and role functioning on the association between age and BS were studied in three age groups (15-18 years, 19-23 years, 24-40 years). Most patients (91.2%) reported any BS, 55.9% any perceptive and 87.4% any cognitive BS. Furthermore, 56.3% met COGDIS and 80.5% COPER. Not exhibiting the reported differential age thresholds, both perceptive and cognitive BS, and, at trend level only, COPER were less prevalent in the oldest age group (24-40 years); COGDIS was most frequent in the youngest group (15-18 years). Functional deficits did not better explain the association with age, particularly in perceptive BS and cognitive BS meeting the frequency requirement of BS criteria. Our findings broadly confirmed an age threshold in BS and, thus, the earlier assumed link between presence of BS and brain maturation processes. Yet, age thresholds of perceptive and cognitive BS did not differ. This lack of differential age thresholds might be due to more pronounced the brain abnormalities in this clinical sample compared to earlier community samples. These might have also shown in more frequently occurring and persistent BS that, however, also resulted from a sampling toward these, i.e., toward COGDIS. Future studies should address the neurobiological basis of CHR criteria in relation to age.
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Affiliation(s)
- Helene Walger
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Linda A Antonucci
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Foundation Major Hospital Polyclinic, University of Milan, Milan, Italy.,MoMiLab Research Unit, Institutions, Markets, Technologies (IMT) School for Advanced Studies Lucca, Lucca, Italy
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | | | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, and Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
| | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom.,Department of Psychology, Aston University, Birmingham, United Kingdom
| | - Anita Riecher-Rössler
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - Theresa Haidl
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Jarmo Hietala
- Department of Psychiatry, Medical Faculty, University of Turku, Turku, Finland
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton, VIC, Australia
| | - Stephen J Wood
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom.,Orygen, The National Centre of Excellence for Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Foundation Major Hospital Polyclinic, University of Milan, Milan, Italy
| | - Alessandro Bertolino
- Group of Psychiatric Neuroscience, Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Stefan Borgwardt
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Frauke Schultze-Lutter
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy.,Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
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Boldrini T, Tanzilli A, Di Cicilia G, Gualco I, Lingiardi V, Salcuni S, Tata MC, Vicari S, Pontillo M. Personality Traits and Disorders in Adolescents at Clinical High Risk for Psychosis: Toward a Clinically Meaningful Diagnosis. Front Psychiatry 2020; 11:562835. [PMID: 33363479 PMCID: PMC7753018 DOI: 10.3389/fpsyt.2020.562835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022] Open
Abstract
Aims: Recent meta-analytic data show that approximately 40% of individuals at clinical high risk for psychosis (CHR) receive at least one personality disorder (PD) diagnosis. Personality pathology could significantly influence CHR patients' prognosis and response to treatment. We aimed at exploring the PD traits of CHR adolescents, in order to outline a prototypic description of their most frequently observed personality characteristics. Methods: One hundred and twenty-three psychiatrists and psychologists used a Q-sort procedure [i.e., the Shedler-Westen Assessment Procedure-200 for Adolescents (SWAP-200-A)] to assess personality traits and disorders in 58 (30 male; mean age = 16 years, range = 13-19 years) CHR adolescents and two gender- and age-matched samples, respectively, with (n = 60) and without PDs (n = 59). Results: Differences between the CHR, PD, and clinical groups showed that CHR adolescents had pervasive and more clinically relevant schizoid, schizotypal, borderline, and avoidant traits, as well as poorer adaptive functioning. Moreover, by collecting the highest mean SWAP-200-A items, we empirically outlined a prototypic description of CHR youths, comprised of avoidance of social relationships; suspiciousness; obsessional thoughts; lack of psychological insight; dysphoric and overwhelming feelings of anxiety and depression; odd and anomalous reasoning processes or perceptual experiences; symptoms of depersonalization and derealization; and negative symptoms of avolition, abulia, blunted affects, and impaired role functioning. Conclusions: The results suggest that avoidant interpersonal strategies, impaired mentalization, and difficulties in emotional regulation could become important targets for psychosocial interventions with CHR adolescent populations.
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Affiliation(s)
- Tommaso Boldrini
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Di Cicilia
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Ivan Gualco
- Center for Individual and Couple Therapy, Genoa, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Maria Cristina Tata
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesú, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesú, IRCCS, Rome, Italy.,Department of Life Sciences and Public Health, Catholic University, Rome, Italy
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesú, IRCCS, Rome, Italy
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