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Gifford G, Cullen AE, Vieira S, Searle A, McCutcheon RA, Modinos G, Stone WS, Hird E, Barnett J, van Hell HH, Catalan A, Millgate E, Taptiklis N, Cormack F, Slot ME, Dazzan P, Maat A, de Haan L, Facorro BC, Glenthøj B, Lawrie SM, McDonald C, Gruber O, van Amelsvoort T, Arango C, Kircher T, Nelson B, Galderisi S, Bressan RA, Kwon JS, Weiser M, Mizrahi R, Sachs G, Kirschner M, Reichenberg A, Kahn R, McGuire P. PsyCog: A computerised mini battery for assessing cognition in psychosis. Schizophr Res Cogn 2024; 37:100310. [PMID: 38572271 PMCID: PMC10987298 DOI: 10.1016/j.scog.2024.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/05/2024]
Abstract
Despite the functional impact of cognitive deficit in people with psychosis, objective cognitive assessment is not typically part of routine clinical care. This is partly due to the length of traditional assessments and the need for a highly trained administrator. Brief, automated computerised assessments could help to address this issue. We present data from an evaluation of PsyCog, a computerised, non-verbal, mini battery of cognitive tests. Healthy Control (HC) (N = 135), Clinical High Risk (CHR) (N = 233), and First Episode Psychosis (FEP) (N = 301) participants from a multi-centre prospective study were assessed at baseline, 6 months, and 12 months. PsyCog was used to assess cognitive performance at baseline and at up to two follow-up timepoints. Mean total testing time was 35.95 min (SD = 2.87). Relative to HCs, effect sizes of performance impairments were medium to large in FEP patients (composite score G = 1.21, subtest range = 0.52-0.88) and small to medium in CHR patients (composite score G = 0.59, subtest range = 0.18-0.49). Site effects were minimal, and test-retest reliability of the PsyCog composite was good (ICC = 0.82-0.89), though some practice effects and differences in data completion between groups were found. The present implementation of PsyCog shows it to be a useful tool for assessing cognitive function in people with psychosis. Computerised cognitive assessments have the potential to facilitate the evaluation of cognition in psychosis in both research and in clinical care, though caution should still be taken in terms of implementation and study design.
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Affiliation(s)
| | - Alexis E. Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Sandra Vieira
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | | | - Gemma Modinos
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
| | - William S. Stone
- Harvard Medical School Department of Psychiatry at the Beth Israel Deaconess Medical Center and the Massachusetts Mental Health Center, United States of America
| | - Emily Hird
- Institute of Cognitive Neuroscience, UCL, London, UK
| | - Jennifer Barnett
- Cambridge Cognition Ltd, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Hendrika H. van Hell
- University Medical Center, Division of Neurosciences, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Ana Catalan
- Basurto University Hospital, Bilbo, Bizkaia, Spain
| | | | | | | | - Margot E. Slot
- University Medical Center, Division of Neurosciences, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
| | - Arija Maat
- University Medical Center, Division of Neurosciences, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Lieuwe de Haan
- Amsterdam UMC, University of Amsterdam, Psychiatry, Department Early Psychosis, Meibergdreef 9, Amsterdam, the Netherlands
| | - Benedicto Crespo Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Sevilla, Spain
- University Hospital Virgen del Rocio, IBIS-CSIC, Department of Psychiatry, School of Medicine, University of Sevilla, Sevilla, Spain
| | - Birte Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- University of Copenhagen, Faculty of Health and Medical Sciences, Dept. of Clinical Medicine, Copenhagen, Denmark
| | - Stephen M. Lawrie
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Galway Neuroscience Centre, University of Galway, H91 TK33 Galway, Ireland
| | - Oliver Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Celso Arango
- Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañon, Universidad Complutense Madrid, Spain, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Tilo Kircher
- Dept of Psychiatry, University of Marburg, Rudolf-Bultmann-Straße 8, D-35039 Marburg, Germany
| | - Barnaby Nelson
- Orygen, 35 Poplar Road, Parkville, Victoria, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Silvana Galderisi
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy
| | - Rodrigo A. Bressan
- Department of Psychiatry, Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, 101 Dahakno, Jongno-gu, Seoul, Republic of Korea
| | - Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer 52621, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Romina Mizrahi
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Switzerland
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America
| | - PSYSCAN Consortium
- University of Oxford, Oxford, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Cambridge Cognition Ltd, Cambridge, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, KCL, London, UK
- Harvard Medical School Department of Psychiatry at the Beth Israel Deaconess Medical Center and the Massachusetts Mental Health Center, United States of America
- Institute of Cognitive Neuroscience, UCL, London, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- University Medical Center, Division of Neurosciences, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
- Basurto University Hospital, Bilbo, Bizkaia, Spain
- Amsterdam UMC, University of Amsterdam, Psychiatry, Department Early Psychosis, Meibergdreef 9, Amsterdam, the Netherlands
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Sevilla, Spain
- University Hospital Virgen del Rocio, IBIS-CSIC, Department of Psychiatry, School of Medicine, University of Sevilla, Sevilla, Spain
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- University of Copenhagen, Faculty of Health and Medical Sciences, Dept. of Clinical Medicine, Copenhagen, Denmark
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Galway Neuroscience Centre, University of Galway, H91 TK33 Galway, Ireland
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
- Servicio de Psiquiatría del Niño y del Adolescente, Hospital General Universitario Gregorio Marañon, Universidad Complutense Madrid, Spain, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Dept of Psychiatry, University of Marburg, Rudolf-Bultmann-Straße 8, D-35039 Marburg, Germany
- Orygen, 35 Poplar Road, Parkville, Victoria, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy
- Department of Psychiatry, Interdisciplinary Lab for Clinical Neurosciences (LiNC), Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
- Department of Psychiatry, Seoul National University College of Medicine, 101 Dahakno, Jongno-gu, Seoul, Republic of Korea
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer 52621, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Switzerland
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America
| | - René Kahn
- University Medical Center, Division of Neurosciences, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY 10029-6574, United States of America
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Jimenez-Labaig P, Aymerich C, Braña I, Rullan A, Cacicedo J, González-Torres MÁ, Harrington KJ, Catalan A. A comprehensive examination of mental health in patients with head and neck cancer: Systematic review and meta-analysis. JNCI Cancer Spectr 2024:pkae031. [PMID: 38702757 DOI: 10.1093/jncics/pkae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/04/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Patients with head and neck cancer (HNC) present particularly significant levels of emotional distress. However, the actual rates of clinically relevant mental health symptoms and disorders among this population remain unknown. METHODS A PRISMA/MOOSE-compliant systematic review and quantitative random-effects meta-analysis was performed to determine suicide incidence and the prevalence of depression, anxiety, distress, post-traumatic stress, and insomnia in this population. MEDLINE, WebofScience, Cochrane Central Register, KCI-Korean Journal, SciELO, Russian Science Citation Index and Ovid/PsycINFO databases were searched from database inception to August 1, 2023 (PROSPERO: CRD42023441432). Subgroup analyzes and meta-regressions were performed to investigate the effect of clinical, therapeutical, and methodological factors. RESULTS 208 studies (n = 654,413, median age 60.7; 25.5% female) were identified. 19.5% patients reported depressive symptoms (95% confidence intervals [CI]=17-21%), 17.8% anxiety symptoms (95%CI = 14-21%), 34.3% distress (95%CI = 29-39%), 17.7% post-traumatic symptoms (95%CI = 6-41%) and 43.8% insomnia symptoms (95%CI = 35-52%). Diagnostic criteria assessments revealed lower prevalence of disorders: 10.3% depression (95%CI = 7-13%), 5.6% anxiety (95%CI = 2-10%), 9.6% insomnia (95%CI = 1-40%), and 1% post-traumatic stress (95%CI = 0-84.5%). Suicide pooled incidence was 161.16 per 100,000 individuals per year (95%CI = 82-239). Meta-regressions found a statistically significant higher prevalence of anxiety in patients undergoing primary chemoradiation compared to surgery, and increased distress in smokers and advanced tumor staging. European samples exhibited lower prevalence of distress. CONCLUSIONS Patients with HNC presented significant prevalence of mental health concerns in all domains. Suicide remains a highly relevant concern. The prevalence of criteria-meeting disorders is significantly lower than clinically relevant symptoms. Investigating the effectiveness of targeted assessments for disorders in highly symptomatic patients is essential.
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Affiliation(s)
- Pablo Jimenez-Labaig
- Head and Neck Unit., The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute. OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Irene Braña
- Lung and Head & Neck Tumors Unit. Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Antonio Rullan
- Head and Neck Unit., The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre, London, United Kingdom
| | - Jon Cacicedo
- Radiotherapy Department, Cruces University Hospital, Barakaldo, Spain
- Biobizkaia Health Research Institute. OSI Ezkerraldea Enkarterri Cruces, Barakaldo, Spain
- Faculty of Medicine, University of the Basque Country, Leioa, Spain
| | - Miguel Ángel González-Torres
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute. OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Kevin J Harrington
- Head and Neck Unit., The Royal Marsden NHS Foundation Trust, London, United Kingdom
- The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre, London, United Kingdom
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute. OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Sancho-Echeverria R, Aymerich C, Rodríguez-Sánchez JM, Gil P, Pedruzo B, González-Torres MÁ, Fusar-Poli P, Arango C, Catalan A. Effect of long-acting antipsychotic treatment on psychiatric hospitalization rate in early psychosis patients: a naturalistic study. Ther Adv Psychopharmacol 2024; 14:20451253241243273. [PMID: 38644940 PMCID: PMC11032064 DOI: 10.1177/20451253241243273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/28/2024] [Indexed: 04/23/2024] Open
Abstract
Background The effectiveness of long-acting injectable (LAI) antipsychotics in preventing relapses of first-episode psychosis is currently debated. Objectives The study aimed to investigate the number of psychiatric hospitalizations comparing the LAI cohort versus the oral cohort during different phases of the illness, pre-LAI treatment, during LAI treatment, and after LAI treatment. Design A naturalistic study was conducted on two independent cohorts of early psychosis patients receiving treatment from a specific early intervention service. The first cohort comprised 228 patients who received LAIs, while the second cohort comprised 667 patients who had never received LAIs. Methods This study was designed as a longitudinal observational study conducted within a naturalistic clinical setting in two cohorts of early psychosis patients. Repeated series ANCOVA (ANCOVA-r) was used to study the number of hospitalizations in the different study periods (T1 = from the date of the first psychiatric record to the beginning of the mirror period; T2 = the mirror period; T3 = from the LAI implementation to the LAI discontinuation; and T4 = from the LAI discontinuation to the end). In all cases, discontinuation of LAI involved the return to oral treatment. In all, 35 patients had not T4 as they were still on LAI treatment at the time of database closing (September 2020), and their data were not included in the analysis of the effect of the LAI discontinuation. Results The patients in the LAI cohort were younger, more frequently males, presented more schizophrenia diagnoses, and had a higher number of hospitalizations (2.50 ± 2.61 versus 1.19 ± 1.69; p < 0.001) than the oral cohort. The number of hospitalizations at the end of the follow-up was higher in the LAI cohort [0.20 (standard deviation (SD)) = 0.79] versus 0.45 [SD = 0.45 (SD = 1.13); F(23.90), p < 0.001]. However, after the introduction of LAIs, the differences in hospitalization rates between the two cohorts became less pronounced. Once LAI treatment was ceased, the hospitalization rate increased again. Conclusion In our study, early psychosis patients receiving LAIs experienced a greater decrease in hospitalizations after introducing the LAI treatment than those treated solely with oral medication. These findings support using LAIs as a viable strategy for preventing rehospitalization and improving the overall course of treatment for individuals with early psychosis.
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Affiliation(s)
- Raúl Sancho-Echeverria
- Red de Salud Mental, Biocruces Bizkaia Health Research Institute, c/Ronda, Bilbao, Bizkaia, Spain
| | - Claudia Aymerich
- Biobizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- Basurto University Hospital, OSI Bilbao-Basurto, Bilbao, Bizkaia, Spain
- Centro de Investigación en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Patxi Gil
- Red de Salud Mental, Biocruces Bizkaia Health Research Institute, c/Ronda, Bilbao, Bizkaia, Spain
| | - Borja Pedruzo
- Basurto University Hospital, OSI Bilbao-Basurto, Bilbao, Bizkaia, Spain
| | - Miguel Ángel González-Torres
- Biobizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- Basurto University Hospital, OSI Bilbao-Basurto, Bizkaia, Spain
- University of the Basque Country (UPV/EHU), Barrio Sarriena, Leioa, Bizkaia, Spain
- Centro de Investigación en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- OASIS Service, South London and Maudsley National Health Service Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, UK
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación en Red de Salud Mental, Madrid, Spain
| | - Ana Catalan
- Basurto University Hospital, OSI Bilbao-Basurto, Av, Montevideo 18, 48013 Bilbao, Bizkaia, Spain
- Biobizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- University of the Basque Country (UPV/EHU), Barrio Sarriena, Leioa, Bizkaia, Spain
- Centro de Investigación en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Aymerich C, Pedruzo B, Salazar de Pablo G, Olazabal N, Catalan A, González-Torres MÁ. Number and nature of psychiatric emergency department visits in a tertiary hospital before, during, and after coronavirus pandemic. Front Psychiatry 2024; 15:1380401. [PMID: 38699456 PMCID: PMC11063275 DOI: 10.3389/fpsyt.2024.1380401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction The COVID-19 pandemic has significantly impacted mental health globally, leading to a deterioration in the overall mental health of the population and changes across all healthcare levels, including emergency departments (ED). However, the evolution of the quantity and nature of psychiatric ED visits in the post-pandemic period remains uncertain. Aims To examine changes in the number and nature of psychiatric emergencies at a general hospital before, during, and after the COVID-19 pandemic. Materials and methods Psychiatric ED visits from a tertiary hospital in the Basque Country (Spain) between January 2019 and November 2023 were investigated. Electronical health registers detailing the number and nature of psychiatric care consultations were analyzed for the study timeframe. Three periods were then compared: pre-pandemic (from January 2019 to February 2020), pandemic (from March 2020 to January 2022), and post-pandemic (from February 2022 onwards). Results 16,969 psychiatric ED visits were recorded for the study period. The number of psychiatric ED visits remained stable from pre-pandemic (269.93 visits/month) to pandemic (264.48 visits/month) periods but experienced a significant rise during the post-pandemic period (330.00 visits/month; t=-6.42; p<0.001), which was not reflected in medical and traumatological visits. The proportion of visits for anxiety (Z=-2.97; p=0.003), suicidal ideation (Z=-5.48; p<0.001), and administrative and social consultations (Z=-5.69; p<0.001) increased over the course of the pandemic. In contrast, visits for schizophrenia and other psychotic disorders (Z=4.85; p<0.001), as well as unspecified behavioral alterations (Z=2.51; p=0.012), significantly decreased. Conclusion The COVID-19 pandemic and its aftermath have altered the patterns of urgent psychiatric care, characterized by a sharp increase of average monthly number of consultations and a shift in their nature. Future efforts should focus on characterizing this surge in demand and enhancing both emergency services and outpatient settings.
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Affiliation(s)
- Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Child and Adolescent Mental Health Services, South London and Maudsley, NHS Foundation Trust, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Nora Olazabal
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Miguel Ángel González-Torres
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
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Aymerich C, Pacho M, Catalan A, Yousaf N, Pérez-Rodríguez V, Hollocks MJ, Parellada M, Krebs G, Clark B, Salazar de Pablo G. Prevalence and Correlates of the Concurrence of Autism Spectrum Disorder and Obsessive Compulsive Disorder in Children and Adolescents: A Systematic Review and Meta-Analysis. Brain Sci 2024; 14:379. [PMID: 38672028 PMCID: PMC11048346 DOI: 10.3390/brainsci14040379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) are two common and impairing neurodevelopmental conditions with partial symptomatic overlap. The aim of this study is to systematically and meta-analytically examine the following: (i) the prevalence of an OCD diagnosis among young people with ASD, (ii) the prevalence of an ASD diagnosis among young people with OCD, and (iii) the clinical and therapeutic implications of such comorbidity. METHOD A multistep literature search was performed from database inception until 17 November 2023. This PRISMA/MOOSE-compliant systematic review, registered in PROSPERO (CRD42023480543), identified studies reporting on the prevalence, sociodemographic, psychopathologic, prognostic, and therapeutic correlates of OCD and ASD concurrence in children and adolescents. A quantitative meta-analysis with random effects was conducted to analyse the pooled prevalence of OCD among samples with a mean age of < 18 years old with ASD and the prevalence of ASD among individuals under 18 with OCD. Sensitivity analyses were performed to investigate the effect of diagnostic criteria and different continents. Meta-regression analyses were conducted to examine the effect of gender, age, IQ, and OCD severity scores. A narrative review of the clinical and therapeutical implications of the comorbidity was provided. RESULTS 42 studies were selected for the systematic review (SR), and 31 of them were also included in one of the meta-analyses. The pooled prevalence of OCD among ASD youth samples (n = 8916, mean age = 10.6 ± 1.6; 16.4% female) was 11.6% (95% confidence intervals [CI] = 6.9%; 18.8%), and the pooled prevalence of ASD among OCD children and adolescent samples (n = 6209, mean age = 14.1 ± 1.4; 45.7% female) was 9.5% (95% CI = 6.0%; 14.7%). Meta-regressions found a statistically higher prevalence of ASD among samples with a lower prevalence of females (β = -4.7; 95%CI = -8.6; -0.8). Children with both OCD and ASD present higher rates of functional impairment, psychopathology, and other comorbidities, compared to youth with either of the disorders alone. CONCLUSIONS OCD and ASD are highly concurrent conditions in youth, with symptomatic, prognostic, severity, and therapeutic implications. Future research should focus on conducting longitudinal cohort studies prospectively to determine development trajectories, along with randomized controlled trials to assess the efficacy of specific therapeutic interventions.
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Affiliation(s)
- Claudia Aymerich
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
- Biobizkaia Health Research Institute, Basque Country University, Basurto University Hospital, OSI Bilbao-Basurto, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 48903 Barakaldo, Spain
| | - Malein Pacho
- Biobizkaia Health Research Institute, Basque Country University, Basurto University Hospital, OSI Bilbao-Basurto, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 48903 Barakaldo, Spain
| | - Ana Catalan
- Biobizkaia Health Research Institute, Basque Country University, Basurto University Hospital, OSI Bilbao-Basurto, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 48903 Barakaldo, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
| | - Noorulain Yousaf
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Violeta Pérez-Rodríguez
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Matthew J. Hollocks
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
- Service for Complex Autism & Associated Neurodevelopmental Disorders, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Centro de Investigación en Red en Salud Mental (CIBERSAM), 28007 Madrid, Spain
| | - Georgina Krebs
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Bruce Clark
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Centro de Investigación en Red en Salud Mental (CIBERSAM), 28007 Madrid, Spain
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6
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Salazar de Pablo G, Guinart D, Armendariz A, Aymerich C, Catalan A, Alameda L, Rogdaki M, Martinez Baringo E, Soler-Vidal J, Oliver D, Rubio JM, Arango C, Kane JM, Fusar-Poli P, Correll CU. Duration of Untreated Psychosis and Outcomes in First-Episode Psychosis: Systematic Review and Meta-analysis of Early Detection and Intervention Strategies. Schizophr Bull 2024:sbae017. [PMID: 38491933 DOI: 10.1093/schbul/sbae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND The role of duration of untreated psychosis (DUP) as an early detection and intervention target to improve outcomes for individuals with first-episode psychosis is unknown. STUDY DESIGN PRISMA/MOOSE-compliant systematic review to identify studies until February 1, 2023, with an intervention and a control group, reporting DUP in both groups. Random effects meta-analysis to evaluate (1) differences in DUP in early detection/intervention services vs the control group, (2) the efficacy of early detection strategies regarding eight real-world outcomes at baseline (service entry), and (3) the efficacy of early intervention strategies on ten real-world outcomes at follow-up. We conducted quality assessment, heterogeneity, publication bias, and meta-regression analyses (PROSPERO: CRD42020163640). STUDY RESULTS From 6229 citations, 33 intervention studies were retrieved. The intervention group achieved a small DUP reduction (Hedges' g = 0.168, 95% CI = 0.055-0.283) vs the control group. The early detection group had better functioning levels (g = 0.281, 95% CI = 0.073-0.488) at baseline. Both groups did not differ regarding total psychopathology, admission rates, quality of life, positive/negative/depressive symptoms, and employment rates (P > .05). Early interventions improved quality of life (g = 0.600, 95% CI = 0.408-0.791), employment rates (g = 0.427, 95% CI = 0.135-0.718), negative symptoms (g = 0.417, 95% CI = 0.153-0.682), relapse rates (g = 0.364, 95% CI = 0.117-0.612), admissions rates (g = 0.335, 95% CI = 0.198-0.468), total psychopathology (g = 0.298, 95% CI = 0.014-0.582), depressive symptoms (g = 0.268, 95% CI = 0.008-0.528), and functioning (g = 0.180, 95% CI = 0.065-0.295) at follow-up but not positive symptoms or remission (P > .05). CONCLUSIONS Comparing interventions targeting DUP and control groups, the impact of early detection strategies on DUP and other correlates is limited. However, the impact of early intervention was significant regarding relevant outcomes, underscoring the importance of supporting early intervention services worldwide.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Daniel Guinart
- Institut de Salut Mental, Hospital del Mar, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Psychiatry, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Alvaro Armendariz
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Etiopatogenia i Tractament Dels Trastorns Mental Severs (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Barakaldo, Bizkaia, Spain
| | - Ana Catalan
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Barakaldo, Bizkaia, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Department of Psychiatry, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, University of Sevilla, Sevilla, Spain
| | - Maria Rogdaki
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Estrella Martinez Baringo
- Department of Child and Adolescent Psychiatry, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain
| | - Joan Soler-Vidal
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Hospital Benito Menni CASM, Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Dominic Oliver
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jose M Rubio
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, UK
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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7
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Salazar de Pablo G, Aymerich C, Guinart D, Catalan A, Alameda L, Trotta G, Armendariz A, Martinez Baringo E, Soler-Vidal J, Rubio JM, Garrido-Torres N, Gómez-Vallejo S, Kane JM, Howes O, Fusar-Poli P, Correll CU. What is the duration of untreated psychosis worldwide? - A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies. Psychol Med 2024; 54:652-662. [PMID: 38087871 DOI: 10.1017/s0033291723003458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Duration of untreated psychosis (DUP) has been associated with poor mental health outcomes. We aimed to meta-analytically estimate the mean and median DUP worldwide, evaluating also the influence of several moderating factors. This PRISMA/MOOSE-compliant meta-analysis searched for non-overlapping individual studies from inception until 9/12/2022, reporting mean ± s.d. or median DUP in patients with first episode psychosis (FEP), without language restrictions. We conducted random-effect meta-analyses, stratified analyses, heterogeneity analyses, meta-regression analyses, and quality assessment (PROSPERO:CRD42020163640). From 12 461 citations, 369 studies were included. The mean DUP was 42.6 weeks (95% confidence interval (CI) 40.6-44.6, k = 283, n = 41 320), varying significantly across continents (p < 0.001). DUP was (in descending order) 70.0 weeks (95% CI 51.6-88.4, k = 11, n = 1508) in Africa; 48.8 weeks (95% CI 43.8-53.9, k = 73, n = 12 223) in Asia; 48.7 weeks (95% CI 43.0-54.4, k = 36, n = 5838) in North America; 38.6 weeks (95% CI 36.0-41.3, k = 145, n = 19 389) in Europe; 34.9 weeks (95% CI 23.0-46.9, k = 11, n = 1159) in South America and 28.0 weeks (95% CI 20.9-35.0, k = 6, n = 1203) in Australasia. There were differences depending on the income of countries: DUP was 48.4 weeks (95% CI 43.0-48.4, k = 58, n = 5635) in middle-low income countries and 41.2 weeks (95% CI 39.0-43.4, k = 222, n = 35 685) in high income countries. Longer DUP was significantly associated with older age (β = 0.836, p < 0.001), older publication year (β = 0.404, p = 0.038) and higher proportion of non-White FEP patients (β = 0.232, p < 0.001). Median DUP was 14 weeks (Interquartile range = 8.8-28.0, k = 206, n = 37 215). In conclusion, DUP is high throughout the world, with marked variation. Efforts to identify and intervene sooner in patients with FEP, and to promote global mental health and access to early intervention services (EIS) are critical, especially in developing countries.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Barakaldo, Bizkaia, Spain
| | - Daniel Guinart
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Institut de Salut Mental, Hospital del Mar Research Institute (CIBERSAM), Barcelona, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Barakaldo, Bizkaia, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- University Hospital Virgen del Rocio-IBIS Sevilla, CIBERSAM, ISCIII Spanish Network for Research in Mental Health, Sevilla, Spain
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alvaro Armendariz
- Unidad Terapéutica Centre Educatiu Els Til·lers, Parc Sanitari Sant Joan de Déu, Barcelona
- Grup MERITT: Etiopatogènia i tractament dels trastorns mentals greus
| | - Estrella Martinez Baringo
- Department of Psychiatry and Psychology, Hospital Sant Joan de Déu de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Soler-Vidal
- FIDMAG Germanas Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Benito Menni CASM, Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Jose M Rubio
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Nathalia Garrido-Torres
- University Hospital Virgen del Rocio-IBIS Sevilla, CIBERSAM, ISCIII Spanish Network for Research in Mental Health, Sevilla, Spain
| | - Sandra Gómez-Vallejo
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Faculty of Medicine, Institute of Clinical Sciences, Imperial College London, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) service, South London and Maudsley (SLaM) NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Berlin, Germany
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Berlin, Germany
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8
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Salazar de Pablo G, Rodriguez V, Besana F, Civardi SC, Arienti V, Maraña Garceo L, Andrés-Camazón P, Catalan A, Rogdaki M, Abbott C, Kyriakopoulos M, Fusar-Poli P, Correll CU, Arango C. Umbrella Review: Atlas of the Meta-Analytical Evidence of Early-Onset Psychosis. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00006-6. [PMID: 38280414 DOI: 10.1016/j.jaac.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVE Early-onset psychosis (EOP) refers to the development of psychosis before the age of 18 years. We aimed to summarize, for the first time, the meta-analytical evidence in the field of this vulnerable population and to provide evidence-based recommendations. METHOD We performed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant, pre-registered (PROSPERO: CRD42022350868) systematic review of several databases and registers to identify meta-analyses of studies conducted in EOP individuals to conduct an umbrella review. Literature search, screening, data extraction, and quality assessment were carried out independently. Results were narratively reported, clustered across core domains. Quality assessment was performed with the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. RESULTS A total of 30 meta-analyses were included (373 individual studies, 25,983 participants, mean age 15.1 years, 38.3% female). Individuals with EOP showed more cognitive impairments compared with controls and individuals with adult/late-onset psychosis. Abnormalities were observed meta-analytically in neuroimaging markers but not in oxidative stress and inflammatory response markers. In all, 60.1% of EOP individuals had a poor prognosis. Clozapine was the antipsychotic with the highest efficacy for overall, positive, and negative symptoms. Tolerance to medication varied among the evaluated antipsychotics. The risk of discontinuation of antipsychotics for any reason or side effects was low or equal compared to placebo. CONCLUSION EOP is associated with cognitive impairment, involuntary admissions, and poor prognosis. Antipsychotics can be efficacious in EOP, but tolerability and safety need to be taken into consideration. Clozapine should be considered in EOP individuals who are resistant to 2 non-clozapine antipsychotics. Further meta-analytical research is needed on response to psychological interventions and other prognostic factors. STUDY PREREGISTRATION INFORMATION Early Onset Psychosis: Umbrella Review on Diagnosis, Prognosis and Treatment factors; https://www.crd.york.ac.uk/PROSPERO/; CRD42022350868.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
| | - Victoria Rodriguez
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | | | | | | | - P Andrés-Camazón
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Ana Catalan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Biobizkaia Health Research Institute. Basurto University Hospital, OSI Bilbao-Basurto, and the University of the Basque Country UPV/EHU. Centro de Investigación en Red de Salud Mental (CIBERSAM), Vizcaya, Spain
| | - Maria Rogdaki
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Francis Crick Institute, London, United Kingdom
| | - Chris Abbott
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Marinos Kyriakopoulos
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, United Kingdom; National and Kapodistrian University of Athens, Athens, Greece
| | - Paolo Fusar-Poli
- University of Pavia, Pavia, Italy; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; LMU Munich, Munich, Germany; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; and National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Christoph U Correll
- Charité Universitätsmedizin, Berlin, Germany; The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York; Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, New York; and the German Center for Mental Health (DZPG), partner site Berlin, Germany
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
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9
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Catalan A, McCutcheon RA, Aymerich C, Pedruzo B, Radua J, Rodríguez V, Salazar de Pablo G, Pacho M, Pérez JL, Solmi M, McGuire P, Giuliano AJ, Stone WS, Murray RM, Gonzalez-Torres MA, Fusar-Poli P. The magnitude and variability of neurocognitive performance in first-episode psychosis: a systematic review and meta-analysis of longitudinal studies. Transl Psychiatry 2024; 14:15. [PMID: 38191534 PMCID: PMC10774360 DOI: 10.1038/s41398-023-02718-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
Neurocognitive deficits are a core feature of psychotic disorders, but it is unclear whether they affect all individuals uniformly. The aim of this systematic review and meta-analysis was to synthesize the evidence on the magnitude, progression, and variability of neurocognitive functioning in individuals with first-episode psychosis (FEP). A multistep literature search was conducted in several databases up to November 1, 2022. Original studies reporting on neurocognitive functioning in FEP were included. The researchers extracted the data and clustered the neurocognitive tasks according to the seven Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) domains and six additional domains. Random-effect model meta-analyses, assessment of publication biases and study quality, and meta-regressions were conducted. The primary effect size reported was Hedges g of (1) neurocognitive functioning in individuals at FEP measuring differences with healthy control (HC) individuals or (2) evolution of neurocognitive impairment across study follow-up intervals. Of 30,384 studies screened, 54 were included, comprising 3,925 FEP individuals and 1,285 HC individuals. Variability analyses indicated greater variability in FEP compared to HC at baseline and follow-up. We found better neurocognitive performance in the HC group at baseline and follow-up but no differences in longitudinal neurocognitive changes between groups. Across the 13 domains, individuals with FEP showed improvement from baseline in all studied domains, except for visual memory. Metaregressions showed some differences in several of the studied domains. The findings suggest that individuals with FEP have marked cognitive impairment, but there is greater variability in cognitive functioning in patients than in HC. This suggests that subgroups of individuals suffer severe disease-related cognitive impairments, whereas others may be much less affected. While these impairments seem stable in the medium term, certain indicators may suggest potential further decline in the long term for a specific subgroup of individuals, although more research is needed to clarify this. Overall, this study highlights the need for tailored neurocognitive interventions for individuals with FEP based on their specific deficits and progression.
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Affiliation(s)
- Ana Catalan
- Department of Neuroscience, University of the Basque Country UPV/EHU; Psychiatry Department. Basurto University Hospital; Biobizkaia Health Research Institute; Centro de Investigación en Red de Salud Mental. (CIBERSAM) Instituto de Salud Carlos III , OSI Bilbao-Basurto, Av. Montevideo 18, 48013, Bilbao, Spain.
- Early Psychosis Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry. University of Oxford, Warneford Hospital, Headington, OX3 7JX, UK
- Oxford Health NHS foundation trust, Oxford, UK
| | - Claudia Aymerich
- Department of Neuroscience, University of the Basque CountryUPV/EHU. Psychiatry Department. Basurto University Hospital. BiBiobizkaia Health Research Institute. Centro de Investigaciónen Red de Salud Mental. (CIBERSAM), Instituto de Salud Carlos III, Avenida de Montevideo 18, 48013, Bilbao, Spain
| | - Borja Pedruzo
- Psychiatry Department. Basurto University Hospital, OSI Bilbao-Basurto, Bizkaia, Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain
| | - Victoria Rodríguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gonzalo Salazar de Pablo
- Early Psychosis Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health. Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Malein Pacho
- Psychiatry Department. Basurto University Hospital, OSI Bilbao-Basurto, Bizkaia, Spain
| | - Jose Luis Pérez
- Psychiatry Department. Basurto University Hospital, OSI Bilbao-Basurto, Bizkaia, Spain
| | - Marco Solmi
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
- SCIENCES lab, Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry. University of Oxford, Warneford Hospital, Headington, OX3 7JX, UK
| | - Anthony J Giuliano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Miguel Angel Gonzalez-Torres
- Department of Neuroscience, University of the Basque Country UPV/EHU; Psychiatry Department. Basurto University Hospital; Biobizkaia Health Research Institute; Centro de Investigación en Red de Salud Mental. (CIBERSAM) Instituto de Salud Carlos III , OSI Bilbao-Basurto, Av. Montevideo 18, 48013, Bilbao, Spain
| | - Paolo Fusar-Poli
- Early Psychosis Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, , Pavia, Italy
- Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
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Pacho M, Aymerich C, Pedruzo B, Salazar de Pablo G, Sesma E, Bordenave M, Dieguez R, Lopez-Zorroza I, Herrero J, Laborda M, Fernandez-Rivas A, Garcia-Rizo C, Gonzalez-Torres MA, Catalan A. Substance use during pregnancy and risk of postpartum depression: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1264998. [PMID: 38025481 PMCID: PMC10666188 DOI: 10.3389/fpsyt.2023.1264998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Postpartum depression (PPD) is a prevalent mental health condition affecting women globally within the first year following childbirth. Substance use during pregnancy has been associated with an increased risk of developing PPD, but the evidence remains inconclusive. This meta-analysis aims to comprehensively assess the effects of different substances on PPD risk, exploring potential modifiers and confounding factors. Objectives To examine the proportion of PPD among substance users during pregnancy, compared to non-users, and investigate the specific risk associated with different substances (tobacco, alcohol, and non-specified substance use/multiple substance use). Methods A systematic literature search was conducted from inception to November 2022 using the Web of Science database (Clarivate Analytics), incorporating Web of Science Core Collection, the BIOSIS Citation Index, the KCI-Korean Journal Database, MEDLINE®, the Russian Science Citation Index, the SciELO Citation Index, and the Cochrane Central Register of Reviews, and Ovid/PsycINFO databases. Inclusion criteria comprised original studies with pregnant women, using validated depression scales and substance use reporting. Results Among the 26 included studies, encompassing 514,441 women, the pooled prevalence of PPD among substance users during pregnancy was 29% (95% CI 25-33). Meta-analyzes revealed an overall odds ratio (OR) of 3.67 (95% CI 2.31-5.85, p < 0.01) indicating a significantly higher risk of PPD among substance users compared to non-users. Subgroup analyzes demonstrated a higher risk for women with non-specified or multiple substance use (OR 4.67, 95% CI 2.59-8.41; p < 0.01) and tobacco use (OR 4.01, 95% CI 2.23-7.20; p < 0.01). Alcohol use showed a trend toward higher risk that did not reach statistical significance (OR 1.88, 95% CI 1.00-3.55; p = 0.051). Conclusion This meta-analysis provides evidence of an increased risk of PPD among pregnant substance users, particularly those using multiple substances or tobacco. However, caution is needed in interpreting the association with alcohol use due to its non-significant result. Systematic review registration This study protocol was registered at PROSPERO (registration number: CCRD42022375500).
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Affiliation(s)
- Malein Pacho
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Eva Sesma
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Rodrigo Dieguez
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Itziar Lopez-Zorroza
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Maria Laborda
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
| | - Aranzazu Fernandez-Rivas
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Medicine, Institut de Neurociències, Universitat de Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Miguel Angel Gonzalez-Torres
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIH Oxford Health Biomedical Research Centre, Oxford, United Kingdom
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
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Catalan A, Tognin S, Hammoud R, Aymerich C, Pedruzo B, Bilbao-Gonzalez A, Salazar de Pablo G, Pacho M, Fusar-Poli P, Gonzalez-Torres MÁ. Understanding the relationship between time spent outdoors, mental well-being and health-related behaviours in a Spanish sample: A real time smartphone-based study. Psychiatry Res 2023; 329:115494. [PMID: 37783095 DOI: 10.1016/j.psychres.2023.115494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION COVID-19 pandemic has affected our lifestyle and physical and mental well-being. We aimed to study the effect of being outdoors and mental well-being after the COVID-19 pandemic. MATERIAL AND METHODS We used smartphone based ecological momentary assessments (EMA) (Urban Mind app) to study the mental well-being of the Spanish general population. We collected socio-demographic data, past and current physical and mental health, and social and physical environment. Participants were recruited during 5 months (February to June 2021). Longitudinal associations between EMA and anxiety, depression, loneliness, tiredness, and happiness during the assessments were investigated using random intercept ordinal logistic regression models. RESULTS 274 subjects downloaded the app and completed the baseline assessment. 66 participants completed at least 50 % of the assessments. Being outdoors was related to a lower likelihood of anxiety (OR: 0.48, 95 %CI 0.34-0.66), depression (OR: 0.40, 95 %CI 0.28-0.56), tiredness (OR: 0.47, 95 %CI 0.35-0.63), and loneliness (OR: 0.59, 95 %CI 0.42-0.84), and a higher likelihood of happiness (OR: 2.14, 95 %CI 1.57-2.93). CONCLUSIONS Being outdoors is related to better mental health in the general population independently of other factors (baseline mental well-being or socio-demographic characteristics). Public policies should include measurements to promote outdoor spaces in urban settings.
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Affiliation(s)
- Ana Catalan
- Biobizkaia Health Research Institute, Barakaldo, Spain; OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain; Neuroscience Department, University of the Basque Country UPV/EHU, Leioa, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King´s College London, London, UK.
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King´s College London, London, UK; Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ryan Hammoud
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King´s College London, London, UK
| | - Claudia Aymerich
- Biobizkaia Health Research Institute, Barakaldo, Spain; OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Borja Pedruzo
- OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain
| | - Amaia Bilbao-Gonzalez
- Osakidetza Basque Health Service, Basurto University Hospital, Research and Innovation Unit, Bilbao, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Bilbao, Spain; Kronikgune Institute for Health Services Research, Barakaldo, Spain; Department of Medicine, Faculty of Health Sciences, University of Deusto, Bilbao, Spain; Health Services Research on Chronic Patients Network (REDISSEC), Spain
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Italy; Child and Adolescent Mental Health Services (CAMHS), South London and Maudsley NHS Foundation Trust, London, UK
| | - Malein Pacho
- OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King´s College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Italy; Outreach and Support in South-London (OASIS) service, South London and Maudlsey (SLaM) NHS Foundation Trust, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Miguel Ángel Gonzalez-Torres
- Biobizkaia Health Research Institute, Barakaldo, Spain; OSI Bilbao-Basurto, Basurto University Hospital, Bilbao, Spain; Neuroscience Department, University of the Basque Country UPV/EHU, Leioa, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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12
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Aymerich C, Pedruzo B, Pacho M, Herrero J, Laborda M, Bordenave M, Salazar de Pablo G, Sesma E, Fernández‐Rivas A, Catalan A, González‐Torres MÁ. Relationship between elimination disorders and internalizing-externalizing problems in children: A systematic review and meta-analysis. JCPP Adv 2023; 3:e12185. [PMID: 37720580 PMCID: PMC10501701 DOI: 10.1002/jcv2.12185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 06/09/2023] [Indexed: 09/19/2023] Open
Abstract
Background Elimination disorders are highly prevalent in childhood and often associated with clinically relevant comorbid psychological disorders. The aim of this study is to determine if, and to what extent, children with elimination disorders show higher internalizing and externalizing problems than their healthy peers. Methods A multistep literature search was performed from database inception until May 1st, 2022. PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022303555) were used to identify studies reporting on internalizing and/or externalizing symptoms in children with an elimination disorder and a healthy control (HC) group. First, a systematic review was provided. Second, where data allowed for it, a quantitative meta-analysis with random effects model was conducted to analyze the differences between the elimination disorder and the HC groups for internalizing and externalizing symptoms. Effect size was standardized mean difference. Meta-regression analyses were conducted to examine the effect of sex, age, and study quality. Funnel plots were used to detect a publication bias. Where found, the trim and fill method was used to correct it. Results 36 articles were included, 32 of them reporting on enuresis (n = 3244; mean age = 9.4; SD = 3.4; 43.84% female) and 7 of them on encopresis (n = 214; mean age = 8.6; SD = 2.3; 36.24% female). Children with an elimination disorder presented significantly lower self-concept (ES:0.42; 95%CI [0.08; 9.76]; p = 0.017) and higher symptom scores for thought problems (ES:-0.26; 95%CI: -0.43;-0.09]; p = 0.003), externalizing symptoms (ES: -0.20; 95%CI [-0.37;-0.03]; p = 0.020), attention problems (ES:-0.37; 95%CI [-0.51;-0.22]; p = 0.0001), aggressive behavior (ES:-0.33; 95%CI [-0.62;-0.04]; p = 0.025) and social problems (ES:-0.39; 95%CI [-0.58;-0.21]; p = 0.0001). Significant publication biases were found across several of the studied domains. No significant effect of sex, age or quality of the study score was found. Conclusions Children with an elimination disorder may have significant internalizing and externalizing problems, as well as impaired self-concept. It is recommendable to screen for them in children with enuresis or encopresis and provide appropriate interventions.
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Affiliation(s)
- Claudia Aymerich
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
- Psychiatry Department. Biocruces Bizkaia Health Research InstituteBilbaoSpain
- Centro de Investigación en Red de Salud Mental (CIBERSAM)MadridSpain
| | - Borja Pedruzo
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
| | - Malein Pacho
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
| | - Jon Herrero
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
| | - María Laborda
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
| | | | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent PsychiatryInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
- Department of Psychosis StudiesEarly Psychosis: Interventions and Clinical‐detection (EPIC) LabInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
- Child and Adolescent Mental Health Services (CAMHS)South London and Maudsley NHS Foundation TrustLondonUK
| | - Eva Sesma
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
- Psychiatry Department. Biocruces Bizkaia Health Research InstituteBilbaoSpain
- Centro de Investigación en Red de Salud Mental (CIBERSAM)MadridSpain
- Neuroscience DepartmentUniversity of the Basque Country (UPV/EHU)LeioaSpain
| | - Aranzazu Fernández‐Rivas
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
- Psychiatry Department. Biocruces Bizkaia Health Research InstituteBilbaoSpain
- Centro de Investigación en Red de Salud Mental (CIBERSAM)MadridSpain
- Neuroscience DepartmentUniversity of the Basque Country (UPV/EHU)LeioaSpain
| | - Ana Catalan
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
- Psychiatry Department. Biocruces Bizkaia Health Research InstituteBilbaoSpain
- Centro de Investigación en Red de Salud Mental (CIBERSAM)MadridSpain
- Neuroscience DepartmentUniversity of the Basque Country (UPV/EHU)LeioaSpain
- Department of Psychosis StudiesInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Miguel Ángel González‐Torres
- Psychiatry DepartmentBasurto University HospitalBilbaoSpain
- Psychiatry Department. Biocruces Bizkaia Health Research InstituteBilbaoSpain
- Centro de Investigación en Red de Salud Mental (CIBERSAM)MadridSpain
- Neuroscience DepartmentUniversity of the Basque Country (UPV/EHU)LeioaSpain
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Solmi M, Cortese S, Vita G, De Prisco M, Radua J, Dragioti E, Köhler-Forsberg O, Madsen NM, Rohde C, Eudave L, Aymerich C, Pedruzo B, Rodriguez V, Rosson S, Sabé M, Hojlund M, Catalan A, de Luca B, Fornaro M, Ostuzzi G, Barbui C, Salazar-de-Pablo G, Fusar-Poli P, Correll CU. An umbrella review of candidate predictors of response, remission, recovery, and relapse across mental disorders. Mol Psychiatry 2023; 28:3671-3687. [PMID: 37957292 PMCID: PMC10730397 DOI: 10.1038/s41380-023-02298-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/21/2023] [Accepted: 10/06/2023] [Indexed: 11/15/2023]
Abstract
We aimed to identify diagnosis-specific/transdiagnostic/transoutcome multivariable candidate predictors (MCPs) of key outcomes in mental disorders. We conducted an umbrella review (protocol link ), searching MEDLINE/Embase (19/07/2022), including systematic reviews of studies reporting on MCPs of response, remission, recovery, or relapse, in DSM/ICD-defined mental disorders. From published predictors, we filtered MCPs, validating MCP criteria. AMSTAR2/PROBAST measured quality/risk of bias of systematic reviews/individual studies. We included 117 systematic reviews, 403 studies, 299,888 individuals with mental disorders, testing 796 prediction models. Only 4.3%/1.2% of the systematic reviews/individual studies were at low risk of bias. The most frequently targeted outcome was remission (36.9%), the least frequent was recovery (2.5%). Studies mainly focused on depressive (39.4%), substance-use (17.9%), and schizophrenia-spectrum (11.9%) disorders. We identified numerous MCPs within disorders for response, remission and relapse, but none for recovery. Transdiagnostic MCPs of remission included lower disease-specific symptoms (disorders = 5), female sex/higher education (disorders = 3), and quality of life/functioning (disorders = 2). Transdiagnostic MCPs of relapse included higher disease-specific symptoms (disorders = 5), higher depressive symptoms (disorders = 3), and younger age/higher anxiety symptoms/global illness severity/ number of previous episodes/negative life events (disorders = 2). Finally, positive trans-outcome MCPs for depression included less negative life events/depressive symptoms (response, remission, less relapse), female sex (response, remission) and better functioning (response, less relapse); for schizophrenia, less positive symptoms/higher depressive symptoms (remission, less relapse); for substance use disorder, marital status/higher education (remission, less relapse). Male sex, younger age, more clinical symptoms and comorbid mental/physical symptoms/disorders were poor prognostic factors, while positive factors included social contacts and employment, absent negative life events, higher education, early access/intervention, lower disease-specific and comorbid mental and physical symptoms/conditions, across mental disorders. Current data limitations include high risk of bias of studies and extraction of single predictors from multivariable models. Identified MCPs can inform future development, validation or refinement of prediction models of key outcomes in mental disorders.
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Affiliation(s)
- Marco Solmi
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- DiMePRe-J-Department of Precision and Regenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy
| | - Giovanni Vita
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Michele De Prisco
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Elena Dragioti
- University of Ioannina, Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, Ioannina, Greece
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden
| | - Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Nanna M Madsen
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Christopher Rohde
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Luis Eudave
- Faculty of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Claudia Aymerich
- Biobizkaia Health Research Institute, Basurto University Hospital, OSI Bilbao-Basurto. University of the Basque Country UPV/EHU. Centro de Investigación en Red de Salud Mental. (CIBERSAM), Instituto de Salud Carlos III. Plaza de Cruces 12, 48903, Barakaldo, Bizkaia, Spain
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | | | - Stella Rosson
- Mental Health Department, Local Health Unit ULSS3 Serenissima, Venice, Italy
| | - Michel Sabé
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland
| | - Mikkel Hojlund
- Department of Psychiatry Aabenraa, Mental Health Services Region of Southern Denmark, Aabenraa, Denmark
- Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region of Denmark, Copenhagen, Denmark
| | - Ana Catalan
- Biobizkaia Health Research Institute, Basurto University Hospital, OSI Bilbao-Basurto. University of the Basque Country UPV/EHU. Centro de Investigación en Red de Salud Mental. (CIBERSAM), Instituto de Salud Carlos III. Plaza de Cruces 12, 48903, Barakaldo, Bizkaia, Spain
| | - Beatrice de Luca
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Michele Fornaro
- Department of Psychiatry, Federico II of Naples, Naples, Italy
| | - Giovanni Ostuzzi
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine, and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Gonzalo Salazar-de-Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South London (OASIS) service, NHS South London and Maudsley Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany.
- The Zucker Hillside Hospital, Northwell Health, New York, NY, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
- The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, NY, USA.
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Atkins M, Taylor D, Catalan A, Desouza N, Chesney E, Reilly TJ, Baburina I, Hilaire MR, Dratcu L, Harland R, Salamone SJ, McGuire P. Point of care assay for blood aripiprazole concentrations: development, validation and utility. Br J Psychiatry 2023; 223:389-393. [PMID: 37254587 DOI: 10.1192/bjp.2023.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The antipsychotic aripiprazole is often used in the treatment of first-episode psychosis. Measuring aripiprazole blood levels provides an objective measure of treatment adherence, but this currently involves taking a venous blood sample and sending to a laboratory for analysis. AIMS To detail the development, validation and utility of a new point of care (POC) test for finger-stick capillary blood concentrations of aripiprazole. METHOD Analytical performance (sensitivity, precision, recovery and linearity) of the assay were established using spiked whole blood and control samples of varying aripiprazole concentration. Assay validation was performed over a 14-month period starting in July 2021. Eligible patients were asked to provide a finger-stick capillary sample in addition to their usual venous blood sample. Capillary blood samples were tested by the MyCare™ Insite POC analyser, which provided measurement of aripiprazole concentration in 6 min, and the venous blood sample was tested by the standard laboratory method. RESULTS A total of 101 patients agreed to measurements by the two methods. Venous blood aripiprazole concentrations as assessed by the laboratory method ranged from 17 to 909 ng/mL, and from 1 to 791 ng/mL using POC testing. The correlation coefficient between the two methods (r) was 0.96 and there was minimal bias (slope 0.91, intercept 4 ng/ml). CONCLUSIONS The MyCare Insite POC analyser is sufficiently accurate and reliable for clinical use. The availability of this technology will improve the assessment of adherence to aripiprazole and the optimising of aripiprazole dosing.
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Affiliation(s)
- Matthew Atkins
- MSc, Pharmacy Department, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK; and Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - David Taylor
- PhD, Pharmacy Department, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK; and Institute of Pharmaceutical Science, King's College London, UK
| | - Ana Catalan
- PhD, Department of Psychiatry, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain; Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain; and Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Neville Desouza
- MSc, Pharmacy Department, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
| | - Edward Chesney
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | - Thomas J Reilly
- South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Irina Baburina
- PhD, Saladax Biomedical, Inc., Bethlehem, Pennsylvania, USA
| | | | - Luiz Dratcu
- FRCPsych, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | - Robert Harland
- MRCPsych, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | | | - Philip McGuire
- FMedSci, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; and NIHR Oxford Health Biomedical Research Centre, Oxford, UK
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15
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Catalan A, Aymerich C, Bilbao A, Pedruzo B, Pérez JL, Aranguren N, Salazar de Pablo G, Hedges E, Gil P, Segarra R, González-Pinto A, Fernández-Rivas A, Inchausti L, McGuire P, Fusar-Poli P, González-Torres MÁ. Psychosis and substance abuse increase the COVID-19 mortality risk. Psychol Med 2023; 53:4236-4244. [PMID: 35410632 PMCID: PMC9114752 DOI: 10.1017/s0033291722000976] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has been a global challenge. High mortality rates have been reported in some risk groups, including patients with pre-existing mental disorders. METHODS We used electronic health records to retrospectively identify people infected due to COVID-19 (between March 2020 and March 2021) in the three territories of the Basque Country. COVID-19 cases were defined as individuals who had tested positive on a reverse transcription-polymerase chain reaction (PCR) test. Univariate and multivariate logistic regression models and multilevel analyses with generalized estimated equations were used to determine factors associated with COVID-19-related mortality and hospital admission. RESULTS The COVID-19 mortality rate was increased for patients with psychotic disorders [odds ratio (OR) adjusted: 1.45, 95% confidence interval (CI) (1.09-1.94), p = 0.0114] and patients with substance abuse [OR adjusted: 1.88, 95% CI (1.13-3.14, p < 0.0152)]. The mortality rate was lower for patients with affective disorders [OR adjusted: 0.80, 95% CI (0.61-0.99), p = 0.0407]. Hospital admission rates due to COVID-19 were higher in psychosis [OR adjusted: 2.90, 95% CI (2.36-3.56), p < 0.0001] and anxiety disorder groups [OR adjusted: 1.54, 95% CI (1.37-1.72), p < 0.0001]. Among admitted patients, COVID-19 mortality rate was decreased for those with affective disorders rate [OR adjusted: 0.72, 95% CI (0.55-0.95), p = 0.0194]. CONCLUSIONS COVID-19-related mortality and hospitalizations rates were higher for patients with a pre-existing psychotic disorder.
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Affiliation(s)
- Ana Catalan
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Claudia Aymerich
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Amaia Bilbao
- Osakidetza Basque Health Service, Basurto University Hospital, Research Unit, Bilbao, Bizkaia, Spain
- Health Service Research Network on Chronic Diseases (REDISSEC), Madrid, Spain
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Borja Pedruzo
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - José Luis Pérez
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | | | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health. Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emily Hedges
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Patxi Gil
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Bizkaia Mental Health Network, Programa Lehenak, Bilbao, Spain
| | - Rafael Segarra
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
- Psychiatry Department, Cruces University Hospital, Barakaldo, Spain
| | - Ana González-Pinto
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
- Bioaraba. CIBERSAM. Psychiatry Department, Hospital Universitario de Alava, Vitoria-Gasteiz, Spain
| | - Aranzazu Fernández-Rivas
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Lucía Inchausti
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach and Support in South London Service, South London and Maudsley National Health Service Foundation Trust, London, UK
- National Institute for Health Research Biomedical Research Centre, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Kronikgune Institute for Health Services Research, Barakaldo, Spain
- National Institute for Health Research Biomedical Research Centre, London, UK
| | - Miguel Ángel González-Torres
- Osakidetza Basque Health Service, Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Facultad de Medicina y Odontología, University of the Basque Country, UPV/EHU, Leioa, Spain
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16
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Aymerich C, Catalan A, Salazar de Pablo G. RE: Longitudinal effect of clozapine-associated sedation on motivation in schizophrenia: naturalistic longitudinal study. Br J Psychiatry 2023; 223:336. [PMID: 37424201 DOI: 10.1192/bjp.2023.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Affiliation(s)
- Claudia Aymerich
- Psychiatrist, Bilbao University Hospital, Bilbao, Spain; and Junior Researcher, Biocruces Biobizkaia Health Research Institute, Bilbao, Spain.
| | - Ana Catalan
- Consultant Psychiatrist, Bilbao University Hospital, Bilbao, Spain; Senior Researcher, Biocruces Biobizkaia Health Research Institute, Bilbao, Spain; Senior Researcher, CIBERSAM, Madrid, Spain; and Senior Researcher, Basque Country University, Bilbao, Spain
| | - Gonzalo Salazar de Pablo
- Senior Clinical Lecturer, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and Honorary Consultant Psychiatrist, South London and Maudsley NHS Foundation Trust, London, UK
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Beldarrain G, Hilario E, Lara-Celador I, Chillida M, Catalan A, Álvarez-Diaz AÁ, Alonso-Alconada D. The Long-Term Neuroprotective Effect of the Endocannabinoid 2-AG and Modulation of the SGZ's Neurogenic Response after Neonatal Hypoxia-Ischemia. Pharmaceutics 2023; 15:1667. [PMID: 37376115 DOI: 10.3390/pharmaceutics15061667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Neonatal hypoxia-ischemia (HI) often causes hypoxic-ischemic encephalopathy (HIE), a neurological condition that can lead to overall disability in newborns. The only treatment available for affected neonates is therapeutic hypothermia; however, cooling is not always effective to prevent the deleterious effects of HI, so compounds such as cannabinoids are currently under research as new therapies. Modulating the endocannabinoid system (ECS) may reduce brain damage and/or stimulate cell proliferation at the neurogenic niches. Further, the long-term effects of cannabinoid treatment are not so clear. Here, we studied the middle- and long-term effects of 2-AG, the most abundant endocannabinoid in the perinatal period after HI in neonatal rats. At middle-term (postnatal day 14), 2-AG reduced brain injury and increased SGZ's cell proliferation and the number of neuroblasts. At post-natal day 90, the treatment with the endocannabinoid showed global and local protection, suggesting long-lasting neuroprotective effects of 2-AG after neonatal HI in rats.
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Affiliation(s)
- Gorane Beldarrain
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Enrique Hilario
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Idoia Lara-Celador
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Marc Chillida
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Ana Catalan
- Psychiatry Department, OSI Bilbao-Basurto, Basurto University Hospital, 48013 Bilbao, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), 48013 Leioa, Spain
- Biobizkaia Health Research Institute, 48903 Barakaldo, Spain
- CIBERSAM, Centro Investigación Biomédica en Red de Salud Mental, 28007 Madrid, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Antonia Ángeles Álvarez-Diaz
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Daniel Alonso-Alconada
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
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18
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Pedruzo B, Aymerich C, Pacho M, Herrero J, Laborda M, Bordenave M, Giuliano AJ, McCutcheon RA, Gutiérrez-Rojas L, McGuire P, Stone WS, Fusar-Poli P, González-Torres MÁ, Catalan A. Longitudinal change in neurocognitive functioning in children and adolescents at clinical high risk for psychosis: a systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02221-9. [PMID: 37199754 DOI: 10.1007/s00787-023-02221-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/29/2023] [Indexed: 05/19/2023]
Abstract
Clinical high risk of psychosis (CHR-P) population has become an attractive area of interest in preventing transitions to psychosis. The consequences of developing a psychotic disorder may be worse in cases of early onset. Thus, childhood and adolescence represent a critical developmental window, where opportunities to gain social and adaptive abilities depend on the individuals' neurocognitive performance. There have been previous syntheses of the evidence regarding neurocognitive functioning in CHR-P individuals and its longitudinal changes. However, there has been less focus on children and adolescents at CHR-P. A multistep literature search was performed from database inception until July 15th, 2022. PRIMSA/MOOSE compliant systematic review and PROSPERO protocol were used to identify studies reporting on longitudinal changes in neurocognitive functioning in children and adolescents (mean age of sample ≤ 18 years) at CHR-P and matched healthy control (HC) group. A systematic review of identified studies was then undertaken. Three articles were included, resulting in a total sample size of 151 CHR-P patients [mean (SD) age, 16.48 (2.41) years; 32.45% female] and 64 HC individuals [mean (SD) age, 16.79 (2.38) years; 42.18% female]. CHR-P individuals had worse outcomes in verbal learning, sustained attention and executive functioning domains compared to HC. Individuals taking antidepressants had better outcomes in verbal learning in contrast with those taking antipsychotics. In children and adolescents, neurocognition may be already impaired before the psychosis onset, and remains stable during the transition to psychosis. Further study should be performed to obtain more robust evidence.
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Affiliation(s)
- Borja Pedruzo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.
| | - Claudia Aymerich
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Malein Pacho
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Jon Herrero
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - María Laborda
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Marta Bordenave
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Anthony J Giuliano
- Worcester Recovery Center and Hospital, Massachusetts Department of Mental Health, Boston, USA
| | - Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre, London, UK
- Outreach and Support in South London Service, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Paolo Fusar-Poli
- National Institute for Health Research Biomedical Research Centre, London, UK
- Outreach and Support in South London Service, South London and Maudsley National Health Service Foundation Trust, London, UK
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Miguel Ángel González-Torres
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM. Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Ana Catalan
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Neuroscience Department, University of Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- CIBERSAM. Centro Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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19
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Salazar de Pablo G, Catalan A, Vaquerizo Serrano J, Pedruzo B, Alameda L, Sandroni V, Armendariz A, Rodriguez V, Arango C, Moreno C, Downs J, Abbott C, Shin JI, Solmi M, Fusar-Poli P, Correll CU. Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis. Br J Psychiatry 2023:1-13. [PMID: 37194556 DOI: 10.1192/bjp.2022.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Early-onset psychosis (EOP) refers to the development of a first episode of psychosis before 18 years of age. Individuals at clinical high risk for psychosis (CHR-P) include adolescents and young adults, although most evidence has focused on adults. Negative symptoms are important prognostic indicators in psychosis. However, research focusing on children and adolescents is limited. AIMS To provide meta-analytical evidence and a comprehensive review of the status and advances in the diagnosis, prognosis and treatment of negative symptoms in children and adolescents with EOP and at CHR-P. METHOD PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022360925) from inception to 18 August 2022, in any language, to identify individual studies conducted in EOP/CHR-P children and adolescents (mean age <18 years) providing findings on negative symptoms. Findings were systematically appraised. Random-effects meta-analyses were performed on the prevalence of negative symptoms, carrying out sensitivity analyses, heterogeneity analyses, publication bias assessment and quality assessment using the Newcastle-Ottawa Scale. RESULTS Of 3289 articles, 133 were included (n = 6776 EOP, mean age 15.3 years (s.d. = 1.6), males = 56.1%; n = 2138 CHR-P, mean age 16.1 years (s.d. = 1.0), males = 48.6%). There were negative symptoms in 60.8% (95% CI 46.4%-75.2%) of the children and adolescents with EOP and 79.6% (95% CI 66.3-92.9%) of those at CHR-P. Prevalence and severity of negative symptoms were associated with poor clinical, functional and intervention outcomes in both groups. Different interventions were piloted, with variable results requiring further replication. CONCLUSIONS Negative symptoms are common in children and adolescents at early stages of psychosis, particularly in those at CHR-P, and are associated with poor outcomes. Future intervention research is required so that evidence-based treatments will become available.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; and Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; and Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Vizcaya, Spain
| | - Julio Vaquerizo Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Borja Pedruzo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, University Hospital (CHUV), Lausanne, Switzerland; and Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Veronica Sandroni
- Department of Psychiatry, Faculty of Medicine, Université Paris Cité, Paris, France; and Department of Psychiatry, Groupe Hospitalier Paul Guiraud, Villejuif, France
| | - Alvaro Armendariz
- Department of Psychiatry and Psychology, Hospital Sant Joan de Déu de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Johnny Downs
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Chris Abbott
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada; and Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; and National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany; Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York, USA; and Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
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20
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Aymerich C, Pedruzo B, Pacho M, Laborda M, Herrero J, Pillinger T, McCutcheon RA, Alonso-Alconada D, Bordenave M, Martínez-Querol M, Arnaiz A, Labad J, Fusar-Poli P, González-Torres MÁ, Catalan A. Prolactin and morning cortisol concentrations in antipsychotic naïve first episode psychosis: A systematic review and meta-analysis. Psychoneuroendocrinology 2023; 150:106049. [PMID: 36758330 DOI: 10.1016/j.psyneuen.2023.106049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/02/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
IMPORTANCE Alterations in prolactin and cortisol levels have been reported in antipsychotic naïve patients with first episode psychosis (FEP). However, it has been studied in very small samples, and inter-group variability has never been studied before. OBJECTIVE To provide estimates of standardized mean differences (SMD) and inter-group variability for prolactin, cortisol awakening response (CAR) and morning cortisol concentrations in antipsychotic naïve FEP (AN-FEP) patients and healthy controls (HC). DATA SOURCES BIOSIS, KCI, MEDLINE, Russian Science Citation Index, SciELO, Cochrane, PsycINFO, Web of Science were searched from inception to February 28, 2022. STUDY SELECTION Peer-reviewed cohort studies that reported on prolactin or cortisol blood concentrations in AN- FEP patients and HC were included. DATA EXTRACTION AND SYNTHESIS Study characteristics, means and standard deviations (SD) were extracted from each article. Inter group differences in magnitude of effect were estimated using Hedges g. Inter-group variability was estimated with the coefficient of variation ratio (CVR). In both cases estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using meta-regression. PRISMA guideline was followed (No. CRD42022303555). MAIN OUTCOMES AND MEASURES Prolactin, CAR and morning cortisol blood concentrations in AN-FEP group in relation to HC group. RESULTS Fourteen studies for prolactin (N = 761 for AN-FEP group, N = 687 for HC group) and twelve studies for morning cortisol (N = 434 for AN-FEP group, N = 528 for HC group) were included. No studies were found in CAR in AN-FEP patients. Mean SMD for prolactin blood concentration was 0.88 (95% CI 0.57, 1.20) for male and 0.56 (95% CI 0.26, 0.87) for female. As a group, AN-FEP presented greater inter-group variability for prolactin levels than HC (CVR=1.28, 95% CI 1.02, 1.62). SMD for morning cortisol concentrations was non-significant: 0.34 (95% CI -0.01, 0.69) and no inter-group variability significant differences were detected: CVR= 1.05 (95% CI 0.91, 1.20). Meta-regression analyses for age and quality were non-significant. Funnel plots did not suggest a publication bias. CONCLUSIONS AND RELEVANCE Increased prolactin levels were found in AN-FEP patients. A greater inter-group variability in the AN-FEP group suggests the existence of patient subgroups with different prolactin levels. No significant abnormalities were found in morning cortisol levels. Further research is needed to clarify whether prolactin concentrations could be used as an illness biomarker.
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Affiliation(s)
- Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Basque Health Service (Osakidetza), Bilbao, Spain. Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.
| | - Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Basque Health Service (Osakidetza), Bilbao, Spain
| | - Malein Pacho
- Psychiatry Department, Basurto University Hospital, Basque Health Service (Osakidetza), Bilbao, Spain
| | - María Laborda
- Psychiatry Department, Basurto University Hospital, Basque Health Service (Osakidetza), Bilbao, Spain
| | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Basque Health Service (Osakidetza), Bilbao, Spain
| | - Toby Pillinger
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; MRC London Institute of Medical Sciences, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, London, UK
| | - Robert A McCutcheon
- Department of Psychiatry, University of Oxford, UK. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Psychiatric Imaging Group, Medical Research Council, London Institute of Medical Sciences, Hammersmith Hospital, London, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Daniel Alonso-Alconada
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Basque Health Service (Osakidetza), Bilbao, Spain
| | | | - Ainara Arnaiz
- Erandio Mental Health Center, Basque Health Service (Osakidetza), Erandio, Spain. Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Javier Labad
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Spain. Salut Mental Taulí, Parc Taulí University Hospital, I3PT, Autonomous University of Barcelona, Sabadell, Barcelona, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Section of Psychiatry, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Miguel Ángel González-Torres
- Psychiatry Department. Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto. School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain; Centro de Investigación en Red de Salud Mental. (CIBERSAM), Instituto de Salud Carlos III, Plaza de Cruces 12, 48903 Barakaldo, Biscay, Spain
| | - Ana Catalan
- Psychiatry Department. Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto. School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain; Centro de Investigación en Red de Salud Mental. (CIBERSAM), Instituto de Salud Carlos III, Plaza de Cruces 12, 48903 Barakaldo, Biscay, Spain
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21
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Hird EJ, Ohmuro N, Allen P, Moseley P, Kempton MJ, Modinos G, Sachs G, van der Gaag M, de Haan L, Gadelha A, Bressan R, Barrantes-Vidal N, Ruhrmann S, Catalan A, McGuire P. Speech Illusions in People at Clinical High Risk for Psychosis Linked to Clinical Outcome. Schizophr Bull 2023; 49:339-349. [PMID: 36516396 PMCID: PMC10016413 DOI: 10.1093/schbul/sbac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND HYPOTHESIS Around 20% of people at clinical high risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions [SIs]) in noise in CHR participants and examined whether this was associated with adverse clinical outcomes. STUDY DESIGN At baseline, 344 CHR participants and 67 healthy controls were presented with a computerized white noise task and asked whether they heard speech, and whether speech was neutral, affective, or whether they were uncertain about its valence. After 2 years, we assessed whether participants transitioned to psychosis, or remitted from the CHR state, and their functioning. STUDY RESULTS CHR participants had a lower sensitivity to the task. Logistic regression revealed that a bias towards hearing targets in stimuli was associated with remission status (OR = 0.21, P = 042). Conversely, hearing SIs with uncertain valence at baseline was associated with reduced likelihood of remission (OR = 7.72. P = .007). When we assessed only participants who did not take antipsychotic medication at baseline, the association between hearing SIs with uncertain valence at baseline and remission likelihood remained (OR = 7.61, P = .043) and this variable was additionally associated with a greater likelihood of transition to psychosis (OR = 5.34, P = .029). CONCLUSIONS In CHR individuals, a tendency to hear speech in noise, and uncertainty about the affective valence of this speech, is associated with adverse outcomes. This task could be used in a battery of cognitive markers to stratify CHR participants according to subsequent outcomes.
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Affiliation(s)
- Emily J Hird
- To whom correspondence should be addressed; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, SE5 8AF, London, UK; e-mail:
| | | | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- School of Psychology, Whitelands College, University of Roehampton, Holybourne Ave, London, SW15 4JD, UK
| | - Peter Moseley
- Psychology Department, Northumbria University, College Lane, Newcastle-Upon-Tyne, NE1 8ST, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Mark van der Gaag
- Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- EMGO Institute for Health and Care Research, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands
| | - Lieuwe de Haan
- Department Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
- Arkin, Amsterdam, The Netherlands
| | - Ary Gadelha
- LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, Brazil
| | - Rodrigo Bressan
- LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Ana Catalan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Psychiatry Department, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain
| | - EU-GEI High Risk Study
McGuirePhilipDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKValmaggiaLucia RDepartment of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, 456, London, SE5 8AF, UKKemptonMatthew JDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKCalemMariaDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKTogninStefaniaDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKModinosGemmaDepartment of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark 458 Hill, London, SE5 8AF, UKde HaanLieuweDepartment Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The NetherlandsArkin, Amsterdam, The Netherlandsvan der GaagMarkFaculty of Behavioural and Movement Sciences, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, van der Boechorststraat 1, 1081 BT Amsterdam, The NetherlandsDepartment of Psychosis Research, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, The NetherlandsVelthorstEvaDepartment Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The NetherlandsDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave, New York, NY 10029, USAKraanTamar CDepartment Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlandsvan DamDaniella SDepartment Early Psychosis, AMC, Academic Psychiatric Centre, Meibergdreef 5, 1105 AZ Amsterdam, The NetherlandsBurgerNadineDepartment of Psychosis Research, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN The Hague, The NetherlandsNelsonBarnabyCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaMcGorryPatrickCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaPaul AmmingerGünterCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaPantelisChristosCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaPolitisAthenaCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaGoodallJoanneCentre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, AustraliaRiecher-RösslerAnitaUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandBorgwardtStefanUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandRappCharlotteUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandIttigSarahUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandStuderusErichUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandSmieskovaRenataUniversity Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, SwitzerlandBressanRodrigoLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilGadelhaAryLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilBrietzkeElisaDepto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilAsevedoGraccielleLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilAsevedoElsonLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilZugmanAndreLiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, BrazilBarrantes-VidalNeusDepartament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Barcelona, SpainDomínguez-MartínezTecelliCONACYT-Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (México), Mexico City, MexicoTorrecillaPilarDepartament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Barcelona, SpainKwapilThomas RDepartment of Psychology, University of Illinois at Urbana-Champaign, IL, USAMonsonetManelDepartament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Barcelona, SpainHinojosaLídiaDepartament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Barcelona, SpainKazesMathildeUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceDabanClaireUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceBourginJulieUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceGayOlivierUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceMam-Lam-FookCéliaUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceKrebsMarie-OdileUniversity Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, FranceNordholmDorteMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkRandersLasseMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkKrakauerKristineMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkGlenthøjLouiseMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkGlenthøjBirteCentre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, DenmarkNordentoftMereteMental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, DenmarkRuhrmannStephanDepartment of Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanyGebhardDominikaDepartment of Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanyArnholdJuliaPsyberlin, Berlin, GermanyKlosterkötterJoachimDepartment of Psychiatry and Psychotherapy, University of Cologne, Cologne, GermanySachsGabrieleDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaLasserIrisDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaWinklbaurBernadetteDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, AustriaDelespaulPhilippe ADepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD 464 Maastricht, The NetherlandsMondriaan Mental Health Trust, PO Box 4436 CX Heerlen, The NetherlandsRuttenBart PDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD 464 Maastricht, The Netherlandsvan Os1JimDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD 464 Maastricht, The Netherlands
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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22
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Salazar de Pablo G, Cabras A, Pereira J, Castro Santos H, de Diego H, Catalan A, González-Pinto A, Birmaher B, Correll CU, Fusar-Poli P. Predicting bipolar disorder I/II in individuals at clinical high-risk: Results from a systematic review. J Affect Disord 2023; 325:778-786. [PMID: 36657494 DOI: 10.1016/j.jad.2023.01.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023]
Abstract
INTRODUCTION No systematic review has estimated the consistency and the magnitude of the risk of developing bipolar disorder I-II (BD-I/II) in individuals at clinical high risk for bipolar disorder (CHR-BD). METHODS PubMed and Web of Science databases were searched until April 2022 in this pre-registered (PROSPERO CRD42022346515) PRISMA-compliant systematic review to identify longitudinal studies in individuals meeting pre-defined CHR-BD criteria. The risk of bias was assessed using the Newcastle-Ottawa Scale, and results were systematically synthesized around CHR-BD criteria across follow-up periods and different subgroups. RESULTS Altogether, 13 studies were included reporting on nine prospective independent cohorts (n = 678 individuals at CHR-BD). The mean age of participants was 15.7 years (range 10.1-22.6 years), and 54.2 % were females. The most common CHR-BD subgroup was subthreshold mania (55.5 %), followed by BD-Not Otherwise Specified (BD-NOS: 33.3 %). Development of BD I/II ranged from 7.1 % to 23.4 % after 2 years. Development of BD-I ranged from 3.4 % at 4 years to 23 % at 8 years. Development of BD-II ranged from 10 % at 2 years to 63.8 % at 4 years. The risk of developing BD-I appeared highest in those meeting BD-NOS criteria (23 % at eight years). Predictors of development of BD were identified but remained mostly unreplicated. The quality of the included studies was moderate (NOS = 5.2 ± 1.1). CONCLUSIONS Emerging data from research studies point towards the promising utility of CHR-BD criteria. These studies may pave the way to the next generation of research, implementing detection, prognostication, and preventive interventions in individuals at CHR-BD identified and followed in clinical practice.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
| | - Anna Cabras
- Department of Neurology and Psychiatry, University of Rome La Sapienza, Rome, Italy
| | - Joana Pereira
- Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | | | - Héctor de Diego
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Psychiatry Department, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Centro de Investigación en Red de Salud Mental, (CIBERSAM), Instituto de Salud Carlos III, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain
| | - Ana González-Pinto
- Departmennt of Psychiatry, Araba University Hospital, Bioaraba Research Institute, CIBER-ISCIII-Salud Mental, Vitoria, Spain; Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
| | - Boris Birmaher
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, PA, USA
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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23
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Oliver D, Davies C, Zelaya F, Selvaggi P, De Micheli A, Catalan A, Baldwin H, Arribas M, Modinos G, Crossley NA, Allen P, Egerton A, Jauhar S, Howes OD, McGuire P, Fusar-Poli P. Parsing neurobiological heterogeneity of the clinical high-risk state for psychosis: A pseudo-continuous arterial spin labelling study. Front Psychiatry 2023; 14:1092213. [PMID: 36970257 PMCID: PMC10031088 DOI: 10.3389/fpsyt.2023.1092213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/15/2023] [Indexed: 03/10/2023] Open
Abstract
Introduction The impact of the clinical high-risk for psychosis (CHR-P) construct is dependent on accurately predicting outcomes. Individuals with brief limited intermittent psychotic symptoms (BLIPS) have higher risk of developing a first episode of psychosis (FEP) compared to individuals with attenuated psychotic symptoms (APS). Supplementing subgroup stratification with information from candidate biomarkers based on neurobiological parameters, such as resting-state, regional cerebral blood flow (rCBF), may help refine risk estimates. Based on previous evidence, we hypothesized that individuals with BLIPS would exhibit increased rCBF compared to APS in key regions linked to dopaminergic pathways. Methods Data from four studies were combined using ComBat (to account for between-study differences) to analyse rCBF in 150 age- and sex-matched subjects (n = 30 healthy controls [HCs], n = 80 APS, n = 20 BLIPS and n = 20 FEP). Global gray matter (GM) rCBF was examined in addition to region-of-interest (ROI) analyses in bilateral/left/right frontal cortex, hippocampus and striatum. Group differences were assessed using general linear models: (i) alone; (ii) with global GM rCBF as a covariate; (iii) with global GM rCBF and smoking status as covariates. Significance was set at p < 0.05. Results Whole-brain voxel-wise analyses and Bayesian ROI analyses were also conducted. No significant group differences were found in global [F(3,143) = 1,41, p = 0.24], bilateral frontal cortex [F(3,143) = 1.01, p = 0.39], hippocampus [F(3,143) = 0.63, p = 0.60] or striatum [F(3,143) = 0.52, p = 0.57] rCBF. Similar null findings were observed in lateralized ROIs (p > 0.05). All results were robust to addition of covariates (p > 0.05). No significant clusters were identified in whole-brain voxel-wise analyses (p > 0.05FWE). Weak-to-moderate evidence was found for an absence of rCBF differences between APS and BLIPS in Bayesian ROI analyses. Conclusion On this evidence, APS and BLIPS are unlikely to be neurobiologically distinct. Due to this and the weak-to-moderate evidence for the null hypothesis, future research should investigate larger samples of APS and BLIPS through collaboration across large-scale international consortia.
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Affiliation(s)
- Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Fernando Zelaya
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Pierluigi Selvaggi
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Bari, Italy
| | - Andrea De Micheli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Mental Health Department, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, Biocruces Bizkaia Health Research Institute, UPV/EHU, University of the Basque Country, Barakaldo, Spain
| | - Helen Baldwin
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, United Kingdom
| | - Maite Arribas
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Nicolas A. Crossley
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychology, University of Roehampton, London, United Kingdom
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Sameer Jauhar
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Oliver D. Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, National Institute for Health Research, London, United Kingdom
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, National Institute for Health Research, London, United Kingdom
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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24
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Mensi MM, Orlandi M, Casini E, Catalan A, de Pablo GS, Fusar-Poli P, Borgatti R. Neurocognition and functioning in adolescents at clinical high risk for psychosis. Child Adolesc Psychiatry Ment Health 2023; 17:22. [PMID: 36755293 PMCID: PMC9909975 DOI: 10.1186/s13034-023-00567-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/28/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Once psychosis has set in, it is difficult for patients to achieve full recovery. Prevention of psychosis and early intervention are promising for improving the outcomes of this disorder. In the last two decades, neurocognition has been studied as a biomarker for clinical-high risk for psychosis (CHR-P). However, neurocognitive functioning has been under-investigated in adolescents. METHODS We enrolled 116 adolescents from 12 to 17 years old (mean = 15.27, SD = 1.56; 76 females). This 3-year cohort study aimed to identify differences in neurocognitive and overall functioning in three groups of adolescent patients divided according to the semi-structured interview Comprehensive Assessment of At-Risk Mental States (CAARMS): adolescents with established psychosis, adolescents with CHR-P, and adolescents not meeting either criteria (non-CHR-P). To differentiate the profiles, clinicians administered cognitive evaluation and neuropsychological tasks. Moreover, they filled in scales to assess their global, social, and role functioning and a questionnaire to assess the severity of the disease. RESULTS We made a between-group comparison on neurocognitive measures and found that the CHR-P and the psychosis groups differed in processing speed (TMT-A; p = .002 in BVN categorial fluency (p = .018), and Rey-Osterrieth complex figure drawing from memory task (p = .014), with psychosis group showing worse performance. No differences emerged between non-CHR-P and CHR-P (p = .014) individuals. CHR-P had better functioning than the psychosis group but worse than the non-CHR-P one. CONCLUSIONS These results confirm that neurocognition can be a helpful biomarker in identifying specific subgroups of adolescents with emerging psychopathology and help clinicians develop stratified preventive approaches.
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Affiliation(s)
- Martina Maria Mensi
- grid.419416.f0000 0004 1760 3107Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy
| | - Marika Orlandi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy.
| | - Erica Casini
- grid.419416.f0000 0004 1760 3107Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy
| | - Ana Catalan
- grid.452310.1Psychiatry Department, Facultad de Medicina y Odontología, Centro de Investigación en Red de Salud Menta (CIBERSAM), Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, University of the Basque Country UPV/EHU, Instituto de Salud Carlos III, Barakaldo, Bizkaia Spain ,grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Gonzalo Salazar de Pablo
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, Psychology & Neuroscience, London, UK ,grid.37640.360000 0000 9439 0839Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK ,grid.4795.f0000 0001 2157 7667Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Paolo Fusar-Poli
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, UK ,grid.37640.360000 0000 9439 0839OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK ,grid.8982.b0000 0004 1762 5736Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Renato Borgatti
- grid.419416.f0000 0004 1760 3107Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy ,grid.8982.b0000 0004 1762 5736Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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25
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Tognin S, Catalan A, Kempton MJ, Nelson B, McGorry P, Riecher-Rössler A, Bressan R, Barrantes-Vidal N, Krebs MO, Nordentoft M, Ruhrmann S, Sachs G, Rutten BPF, van Os J, de Haan L, van der Gaag M, McGuire P, Valmaggia LR. Impact of adverse childhood experiences on educational achievements in young people at clinical high risk of developing psychosis. Eur Psychiatry 2023; 66:e16. [PMID: 36649929 PMCID: PMC9970149 DOI: 10.1192/j.eurpsy.2022.2351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACE) can affect educational attainments, but little is known about their impact on educational achievements in people at clinical high risk of psychosis (CHR). METHODS In total, 344 CHR individuals and 67 healthy controls (HC) were recruited as part of the European Community's Seventh Framework Programme-funded multicenter study the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI). The brief version of the Child Trauma Questionnaire was used to measure ACE, while educational attainments were assessed using a semi-structured interview. RESULTS At baseline, compared with HC, the CHR group spent less time in education and had higher rates of ACE, lower rates of employment, and lower estimated intelligence quotient (IQ). Across both groups, the total number of ACE was associated with fewer days in education and lower level of education. Emotional abuse was associated with fewer days in education in HC. Emotional neglect was associated with a lower level of education in CHR, while sexual abuse was associated with a lower level of education in HC. In the CHR group, the total number of ACE, physical abuse, and neglect was significantly associated with unemployment, while emotional neglect was associated with employment. CONCLUSIONS ACE are strongly associated with developmental outcomes such as educational achievement. Early intervention for psychosis programs should aim at integrating specific interventions to support young CHR people in their educational and vocational recovery. More generally, public health and social interventions focused on the prevention of ACE (or reduce their impact if ACE occur) are recommended.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Ana Catalan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Biobizkaia Health Research Institute, Basurto University Hospital, OSI Bilbao-Basurto, University of the Basque Country UPV/EHU, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto deSalud Carlos III, Barakaldo, Spain
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,National Institute for Health Research (NIHR), Biomedical Research Centre (BRC), London, United Kingdom
| | - Barnaby Nelson
- The National Centre of Excellence in Youth Mental Health, Orygen, Parkville, Victoria3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Parkville, Victoria3052, Australia
| | - Patrick McGorry
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Rodrigo Bressan
- LiNC - Lab Integrative Neuroscience, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- INSERM, IPNP UMR S1266, Laboratoire de Physiopathologie des Maladies Psychiatriques, Université Paris Descartes, Université de Paris, CNRS, GDR3557-Institut de Psychiatrie, Paris, France.,Faculté de Médecine Paris Descartes, GHU Paris - Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark.,Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Amsterdam UMC, Early Psychosis Department, Amsterdam, The Netherlands
| | - Mark van der Gaag
- VU University, Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology and Amsterdam Public Mental Health Research Institute, Amsterdam, The Netherlands.,Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | | | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,National Institute for Health Research (NIHR), Biomedical Research Centre (BRC), London, United Kingdom
| | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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26
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Catalan A, Höhna S, Lower SE, Duchen P. Inferring the demographic history of the North American firefly Photinus pyralis. J Evol Biol 2022; 35:1488-1499. [PMID: 36168726 DOI: 10.1111/jeb.14094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/13/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
The firefly Photinus pyralis inhabits a wide range of latitudinal and ecological niches, with populations living from temperate to tropical habitats. Despite its broad distribution, its demographic history is unknown. In this study, we modelled and inferred different demographic scenarios for North American populations of P. pyralis, which were collected from Texas to New Jersey. We used a combination of ABC techniques (for multi-population/colonization analyses) and likelihood inference (dadi, StairwayPlot2, PoMo) for single-population demographic inference, which proved useful with our RAD data. We uncovered that the most ancestral North American population lays in Texas, which further colonized the Central region of the US and more recently the North Eastern coast. Our study confidently rejects a demographic scenario where the North Eastern populations colonized more southern populations until reaching Texas. To estimate the age of divergence between of P. pyralis, which provides deeper insights into the history of the entire species, we assembled a multi-locus phylogenetic data covering the genus Photinus. We uncovered that the phylogenetic node leading to P. pyralis lies at the end of the Miocene. Importantly, modelling the demographic history of North American P. pyralis serves as a null model of nucleotide diversity patterns in a widespread native insect species, which will serve in future studies for the detection of adaptation events in this firefly species, as well as a comparison for future studies of other North American insect taxa.
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Affiliation(s)
- Ana Catalan
- Division of Evolutionary Biology, Ludwig-Maximilians-Universität München, Planegg-Martinsried, Germany
| | - Sebastian Höhna
- GeoBio-Center, Ludwig-Maximilians-Universität München, Munich, Germany.,Department of Earth and Environmental Sciences, Paleontology & Geobiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Sarah E Lower
- Department of Biology, Bucknell University, Lewisburg, PA, USA
| | - Pablo Duchen
- Institute for Organismal and Molecular Evolutionary Biology, Johannes Gutenberg University of Mainz, Mainz, Germany
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27
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Pedruzo B, Catalan A, Aymerich C, Bordenave M, Estevez O, Gómez DA, Herrero J, Laborda M, Mancebo G, Martínez A, Pacho M, Paniagua A, Pérez JL, González-Torres MÁ. Psychological impact of COVID-19 lockdown on a population with serious mental illness. A prospective cohort study. Rev Psiquiatr Salud Ment 2022; 16:59-67. [PMID: 35755489 PMCID: PMC9212956 DOI: 10.1016/j.rpsm.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/04/2022] [Indexed: 12/12/2022]
Abstract
Introduction COVID-19 has spread worldwide since its appearance at the end of 2019. In Spain, 99-day long home confinement was set from March 15th 2020. Previous studies about events requiring situations of isolation suggested that mental health problems may occur among the general population and, more specifically, vulnerable groups such as individuals with serious mental illness (SMI). This study aims to assess the psychological effect of confinement in patients with mental illness admitted to an inpatient psychiatric unit. Method In this longitudinal study, IDER (State-Trait Depression Inventory) and STAI (State-Trait Anxiety Inventory) questionnaires were used at two different times (at the beginning and after the lockdown) of the pandemic to evaluate the depression and anxiety symptoms, respectively, in a population of patients who had been previously admitted to the Psychiatry Unit of the Basurto University Hospital. Results 95 participants completed the IDER questionnaire in the first measurement, with a mean score of 24.56 (SD = 8.18) for state and 23.57 (SD = 8.14) for trait. In the case of STAI, the mean score was 27.86 (SD = 15.19) for the state and 30.49 (SD = 14.71) for the trait. No differences between the first and the second time were found in anxiety and depression levels. People with personality disorders presented high levels of anxiety. Conclusions Individuals with a personality disorder showed the highest scores in anxiety and depression. Nevertheless, strict confinement did not affect this population, despite the literature that evidences that the pandemic has worsened people's mental health with SMI.
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Affiliation(s)
- Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neuroscience Department, University of the Basque Country, UPV/EHU, Leioa, Spain.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Olatz Estevez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | | | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - María Laborda
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Gonzalo Mancebo
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ania Martínez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Malein Pacho
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ana Paniagua
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - José Luis Pérez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Miguel Ángel González-Torres
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neuroscience Department, University of the Basque Country, UPV/EHU, Leioa, Spain
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28
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Catalan A, Tognin S, Kempton MJ, Stahl D, Salazar de Pablo G, Nelson B, Pantelis C, Riecher-Rössler A, Bressan R, Barrantes-Vidal N, Krebs MO, Nordentoft M, Ruhrmann S, Sachs G, Rutten BPF, van Os J, de Haan L, van der Gaag M, Valmaggia LR, McGuire P. Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis. Psychol Med 2022; 52:1569-1577. [PMID: 33019957 PMCID: PMC9226382 DOI: 10.1017/s0033291720003396] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/18/2020] [Accepted: 09/01/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Psychosis is associated with a reasoning bias, which manifests as a tendency to 'jump to conclusions'. We examined this bias in people at clinical high-risk for psychosis (CHR) and investigated its relationship with their clinical outcomes. METHODS In total, 303 CHR subjects and 57 healthy controls (HC) were included. Both groups were assessed at baseline, and after 1 and 2 years. A 'beads' task was used to assess reasoning bias. Symptoms and level of functioning were assessed using the Comprehensive Assessment of At-Risk Mental States scale (CAARMS) and the Global Assessment of Functioning (GAF), respectively. During follow up, 58 (16.1%) of the CHR group developed psychosis (CHR-T), and 245 did not (CHR-NT). Logistic regressions, multilevel mixed models, and Cox regression were used to analyse the relationship between reasoning bias and transition to psychosis and level of functioning, at each time point. RESULTS There was no association between reasoning bias at baseline and the subsequent onset of psychosis. However, when assessed after the transition to psychosis, CHR-T participants showed a greater tendency to jump to conclusions than CHR-NT and HC participants (55, 17, 17%; χ2 = 8.13, p = 0.012). There was a significant association between jumping to conclusions (JTC) at baseline and a reduced level of functioning at 2-year follow-up in the CHR group after adjusting for transition, gender, ethnicity, age, and IQ. CONCLUSIONS In CHR participants, JTC at baseline was associated with adverse functioning at the follow-up. Interventions designed to improve JTC could be beneficial in the CHR population.
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Affiliation(s)
- Ana Catalan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Deparment of Mental Health, Biocruces Bizkaia Health Research Institute. Basurto University Hospital. Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia, Spain
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, Likondon, UK
| | - Matthew J. Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
| | - Daniel Stahl
- Department of Biostatistics and Health Informatics, King´s College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia
| | | | - Rodrigo Bressan
- Depto Psiquiatria, LiNC – Lab Integrative Neuroscience, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver, Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- INSERM, IPNP UMR S1266, Laboratoire de Physiopathologie des Maladies Psychiatriques, Université de Paris, Institut de Psychiatrie (CNRS GDR 3557), Paris, France
- Faculté de Médecine Paris Descartes, GHU Paris – Sainte-Anne, Pôle Hospitalo Universitaire PEPIT C'JAAD, Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P. F. Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark van der Gaag
- VU University, Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology and Amsterdam Public Mental Health research institute, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | | | - Lucia R. Valmaggia
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, Likondon, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
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Catalan A, Radua J, McCutcheon R, Aymerich C, Pedruzo B, González-Torres MÁ, Baldwin H, Stone WS, Giuliano AJ, McGuire P, Fusar-Poli P. Examining the variability of neurocognitive functioning in individuals at clinical high risk for psychosis: a meta-analysis. Transl Psychiatry 2022; 12:198. [PMID: 35551176 PMCID: PMC9098884 DOI: 10.1038/s41398-022-01961-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/18/2022] [Accepted: 04/27/2022] [Indexed: 11/09/2022] Open
Abstract
This study aims to meta-analytically characterize the presence and magnitude of within-group variability across neurocognitive functioning in young people at Clinical High-Risk for psychosis (CHR-P) and comparison groups. Multistep, PRISMA/MOOSE-compliant systematic review (PROSPERO-CRD42020192826) of the Web of Science database, Cochrane Central Register of Reviews and Ovid/PsycINFO and trial registries up to July 1, 2020. The risk of bias was assessed using a modified version of the NOS for cohort and cross-sectional studies. Original studies reporting neurocognitive functioning in individuals at CHR-P compared to healthy controls (HC) or first-episode psychosis (FEP) patients were included. The primary outcome was the random-effect meta-analytic variability ratios (VR). Secondary outcomes included the coefficient of variation ratios (CVR). Seventy-eight studies were included, relating to 5162 CHR-P individuals, 2865 HC and 486 FEP. The CHR-P group demonstrated higher variability compared to HC (in descending order of magnitude) in visual memory (VR: 1.41, 95% CI 1.02-1.94), executive functioning (VR: 1.31, 95% CI 1.18-1.45), verbal learning (VR: 1.29, 95% CI 1.15-1.45), premorbid IQ (VR: 1.27, 95% CI 1.09-1.49), processing speed (VR: 1.26, 95% CI 1.07-1.48), visual learning (VR: 1.20, 95% CI 1.07-1.34), and reasoning and problem solving (VR: 1.17, 95% CI 1.03-1.34). In the CVR analyses the variability in CHR-P population remains in the previous neurocognitive domains and emerged in attention/vigilance, working memory, social cognition, and visuospatial ability. The CHR-P group transitioning to psychosis showed greater VR in executive functioning compared to those not developing psychosis and compared to FEP groups. Clinical high risk for psychosis subjects shows increased variability in neurocognitive performance compared to HC. The main limitation of this study is the validity of the VR and CVR as an index of variability which has received debate. This finding should be explored by further individual-participant data research and support precision medicine approaches.
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Affiliation(s)
- Ana Catalan
- Mental Health Department. Basurto University Hospital. Biocruces Bizkaia Health Research Institute. Department of Neuroscience, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia, Spain. .,Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Joaquim Radua
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.10403.360000000091771775Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Mental Health Research Networking Center (CIBERSAM), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Robert McCutcheon
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, King’s College London, London, UK
| | - Claudia Aymerich
- grid.414269.c0000 0001 0667 6181Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Borja Pedruzo
- grid.414269.c0000 0001 0667 6181Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Miguel Ángel González-Torres
- grid.11480.3c0000000121671098Mental Health Department. Basurto University Hospital. Biocruces Bizkaia Health Research Institute. Department of Neuroscience, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia Spain
| | - Helen Baldwin
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - William S. Stone
- grid.239395.70000 0000 9011 8547Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA
| | - Anthony J. Giuliano
- grid.435881.30000 0001 0394 0960Worcester Recovery Center & Hospital, Massachusetts Department of Mental Health, Boston, MA USA
| | - Philip McGuire
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paolo Fusar-Poli
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.8982.b0000 0004 1762 5736Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy ,grid.451056.30000 0001 2116 3923National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK ,grid.37640.360000 0000 9439 0839Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, London, UK
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Aymerich C, Pedruzo B, Pérez JL, Laborda M, Herrero J, Blanco J, Mancebo G, Andrés L, Estévez O, Fernandez M, Salazar de Pablo G, Catalan A, González-Torres MÁ. COVID-19 PANDEMIC EFFECTS ON HEALTH WORKERS’ MENTAL HEALTH: SYSTEMATIC REVIEW AND META-ANALYSIS. Eur Psychiatry 2022; 65:e10. [PMID: 35060458 PMCID: PMC8828390 DOI: 10.1192/j.eurpsy.2022.1] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Catalan A, García L, Sanchez-Alonso S, Gil P, Díaz-Marsá M, Olivares JM, Rivera-Baltanás T, Pérez-Martín J, Torres MÁG, Ovejero S, Tost M, Bergé D, Rodríguez A, Labad J. Early intervention services, patterns of prescription and rates of discontinuation of antipsychotic treatment in first-episode psychosis. Early Interv Psychiatry 2021; 15:1584-1594. [PMID: 33289317 DOI: 10.1111/eip.13098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/26/2020] [Accepted: 11/14/2020] [Indexed: 01/22/2023]
Abstract
AIMS Non-compliance is still an important problem in psychotic patients. Although antipsychotic (AP) treatment leads to a decrease in psychotic relapses, there are no clear recommendations about how long treatment should be maintained after first-episode psychosis (FEP) and no indication of the rates and causes of treatment withdrawal in this group. METHODS We evaluated a large sample of patients with FEP for 2 years to compare the time to all-cause treatment discontinuation of AP drugs and the time to the first relapse. We collected the sociodemographic and psychopathological characteristics of the sample. The number of relapses was also recorded. RESULTS A total of 310 FEP patients were assessed across seven early intervention teams (mean age = 30.2 years; SD = 11.2). The most prevalent diagnosis at baseline was psychotic disorder not otherwise specified (36.1%), and the most commonly used APs were risperidone (26.5%) and olanzapine (18.7%). A lack of efficacy was the most frequent reason for the withdrawal of the first AP prescribed, followed by non-compliance. There were no differences in the relapse rates between different APs. Patients treated with long-acting injectable (LAI) APs presented less disengagement from services than patients treated with oral APs. CONCLUSIONS Although there were no differences between the different APs in terms of relapse rates, LAIs had higher retention rates than oral APs in early intervention services. Compliance is still an important issue in Psychiatry, so clinicians should use different strategies to encourage it, such as the use of LAI treatments.
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Affiliation(s)
- Ana Catalan
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, Bizkaia, Spain
| | - Lorena García
- Department of Psychiatry, Hospital Universitario de San Juan, Alicante, Spain.,Department of Clinical Medicine, Universidad Miguel Hernández, Edificio Muhammad Al-Shafra, Alicante, Spain
| | | | - Patxi Gil
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Early Intervention Service, Bizkaia Mental Health System, Bilbao, Bizkaia, Spain
| | - Marina Díaz-Marsá
- Psychiatry Department, Universitary Hospital Clinico San Carlos de Madrid, IddISC, Madrid, Spain
| | - José Manuel Olivares
- Department of Psychiatry, Hospital Alvaro Cunqueiro, University of Vigo, Translational Neuroscience Group, Galicia Sur Health Research Institute (CIBERSAM), Vigo, Spain
| | - Tania Rivera-Baltanás
- Department of Psychiatry, Hospital Alvaro Cunqueiro, University of Vigo, Translational Neuroscience Group, Galicia Sur Health Research Institute (CIBERSAM), Vigo, Spain
| | - Jorge Pérez-Martín
- Department of Psychiatry, Hospital Universitario de San Juan, Alicante, Spain.,Department of Clinical Medicine, Universidad Miguel Hernández, Edificio Muhammad Al-Shafra, Alicante, Spain
| | - Miguel Ángel González Torres
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, Bizkaia, Spain
| | - Santiago Ovejero
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain
| | - Meritxell Tost
- Early Intervention Service for Psychosis, Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Universitat Autònoma de Barcelona (Department of Psychiatry and Forensic Medicine), CIBERSAM, Sabadell, Spain
| | - Daniel Bergé
- Institut de Neuropsiquiatria I Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain.,Fundació Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Javier Labad
- Early Intervention Service for Psychosis, Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Universitat Autònoma de Barcelona (Department of Psychiatry and Forensic Medicine), CIBERSAM, Sabadell, Spain
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Catalan A, Richter A, Salazar de Pablo G, Vaquerizo-Serrano J, Mancebo G, Pedruzo B, Aymerich C, Solmi M, González-Torres MÁ, Gil P, McGuire P, Fusar-Poli P. Proportion and predictors of remission and recovery in first-episode psychosis: Systematic review and meta-analysis. Eur Psychiatry 2021; 64:e69. [PMID: 34730080 PMCID: PMC8668449 DOI: 10.1192/j.eurpsy.2021.2246] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background To determine the proportion of patients in symptomatic remission and recovery following a first-episode of psychosis (FEP). Methods A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, and trial registries from database inception to November 5, 2020, was performed. Cohort studies and randomized control trials (RCT) investigating the proportion of remission and recovery following a FEP were included. Two independent researchers searched, following PRISMA and MOOSE guidelines and using a PROSPERO protocol. We performed meta-analyses regarding the proportion of remission/recovery (symptomatic plus functional outcomes). Heterogeneity was measured employing Q statistics and I2 test. To identify potential predictors, meta-regression analyses were conducted, as well as qualitative reporting of studies included in a systematic review. Sensitivity analyses were performed regarding different times of follow-up and type of studies. Results One hundred articles (82 cohorts and 18 RCTs) were included in the meta-analysis. The pooled proportion of symptomatic remission was 54% (95%CI [30, 49–58]) over a mean follow-up period of 43.57 months (SD = 51.82) in 76 studies. After excluding RCT from the sample, the proportion of remission remained similar (55%). The pooled proportion of recovery was 32% (95%CI [27–36]) over a mean follow-up period of 71.85 months (SD = 73.54) in 40 studies. After excluding RCT from the sample, the recovery proportion remained the same. No significant effect of any sociodemographic or clinical predictor was found. Conclusions Half of the patients are in symptomatic remission around 4 years after the FEP, while about a third show recovery after 5.5 years.
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Affiliation(s)
- Ana Catalan
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Barakaldo, Spain.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Anja Richter
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Julio Vaquerizo-Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Gonzalo Mancebo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Borja Pedruzo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Claudia Aymerich
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, University of Ottawa, Ontario, Canada.,Department of Mental Health, The Ottawa Hospital, Ontario, Canada.,Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario
| | - Miguel Á González-Torres
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Barakaldo, Spain
| | - Patxi Gil
- Mental Health Department, Biocruces Bizkaia Health Research Institute, Early Intervention Service, Bizkaia Mental Health System, Bilbao, Spain
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Salazar de Pablo G, Radua J, Pereira J, Bonoldi I, Arienti V, Besana F, Soardo L, Cabras A, Fortea L, Catalan A, Vaquerizo-Serrano J, Coronelli F, Kaur S, Da Silva J, Shin JI, Solmi M, Brondino N, Politi P, McGuire P, Fusar-Poli P. Probability of Transition to Psychosis in Individuals at Clinical High Risk: An Updated Meta-analysis. JAMA Psychiatry 2021; 78:970-978. [PMID: 34259821 PMCID: PMC8281006 DOI: 10.1001/jamapsychiatry.2021.0830] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Estimating the current likelihood of transitioning from a clinical high risk for psychosis (CHR-P) to psychosis holds paramount importance for preventive care and applied research. OBJECTIVE To quantitatively examine the consistency and magnitude of transition risk to psychosis in individuals at CHR-P. DATA SOURCES PubMed and Web of Science databases until November 1, 2020. Manual search of references from previous articles. STUDY SELECTION Longitudinal studies reporting transition risks in individuals at CHR-P. DATA EXTRACTION AND SYNTHESIS Meta-analysis compliant with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines; independent data extraction, manually and through digitalization of Kaplan-Meier curves. MAIN OUTCOME AND MEASURES Primary effect size was cumulative risk of transition to psychosis at 0.5, 1, 1.5, 2, 2.5, 3, 4, and more than 4 years' follow-up, estimated using the numbers of individuals at CHR-P transitioning to psychosis at each time point. These analyses were complemented by meta-analytical Kaplan-Meier curves and speed of transition to psychosis (hazard rate). Random-effects meta-analysis, between-study heterogeneity analysis, study quality assessment, and meta-regressions were conducted. RESULTS A total of 130 studies and 9222 individuals at CHR-P were included. The mean (SD) age was 20.3 (4.4) years, and 5100 individuals (55.3%) were male. The cumulative transition risk was 0.09 (95% CI, 0.07-0.10; k = 37; n = 6485) at 0.5 years, 0.15 (95% CI, 0.13-0.16; k = 53; n = 7907) at 1 year, 0.20 (95% CI, 0.17-0.22; k = 30; n = 5488) at 1.5 years, 0.19 (95% CI, 0.17-0.22; k = 44; n = 7351) at 2 years, 0.25 (95% CI, 0.21-0.29; k = 19; n = 3114) at 2.5 years, 0.25 (95% CI, 0.22-0.29; k = 29; n = 4029) at 3 years, 0.27 (95% CI, 0.23-0.30; k = 16; n = 2926) at 4 years, and 0.28 (95% CI, 0.20-0.37; k = 14; n = 2301) at more than 4 years. The cumulative Kaplan-Meier transition risk was 0.08 (95% CI, 0.08-0.09; n = 4860) at 0.5 years, 0.14 (95% CI, 0.13-0.15; n = 3408) at 1 year, 0.17 (95% CI, 0.16-0.19; n = 2892) at 1.5 years, 0.20 (95% CI, 0.19-0.21; n = 2357) at 2 years, 0.25 (95% CI, 0.23-0.26; n = 1444) at 2.5 years, 0.27 (95% CI, 0.25-0.28; n = 1029) at 3 years, 0.28 (95% CI, 0.26-0.29; n = 808) at 3.5 years, 0.29 (95% CI, 0.27-0.30; n = 737) at 4 years, and 0.35 (95% CI, 0.32-0.38; n = 114) at 10 years. The hazard rate only plateaued at 4 years' follow-up. Meta-regressions showed that a lower proportion of female individuals (β = -0.02; 95% CI, -0.04 to -0.01) and a higher proportion of brief limited intermittent psychotic symptoms (β = 0.02; 95% CI, 0.01-0.03) were associated with an increase in transition risk. Heterogeneity across the studies was high (I2 range, 77.91% to 95.73%). CONCLUSIONS AND RELEVANCE In this meta-analysis, 25% of individuals at CHR-P developed psychosis within 3 years. Transition risk continued increasing in the long term. Extended clinical monitoring and preventive care may be beneficial in this patient population.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom,Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom,Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain,Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Joana Pereira
- Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | - Ilaria Bonoldi
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom
| | - Vincenzo Arienti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Filippo Besana
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Livia Soardo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Anna Cabras
- Department of Neurology and Psychiatry, University of Rome La Sapienza, Rome, Italy
| | - Lydia Fortea
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom,Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Bizkaia, Spain
| | - Julio Vaquerizo-Serrano
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom,Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Francesco Coronelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Simi Kaur
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom
| | - Josette Da Silva
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom,Neurosciences Department, University of Padova, Padova, Italy
| | - Natascia Brondino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Philip McGuire
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom,OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King’s College London, London, United Kingdom,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Catalan A, Salazar de Pablo G, Aymerich C, Damiani S, Sordi V, Radua J, Oliver D, McGuire P, Giuliano AJ, Stone WS, Fusar-Poli P. Neurocognitive Functioning in Individuals at Clinical High Risk for Psychosis: A Systematic Review and Meta-analysis. JAMA Psychiatry 2021; 78:2781288. [PMID: 34132736 PMCID: PMC8209603 DOI: 10.1001/jamapsychiatry.2021.1290] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/26/2021] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Neurocognitive functioning is a potential biomarker to advance detection, prognosis, and preventive care for individuals at clinical high risk for psychosis (CHR-P). The current consistency and magnitude of neurocognitive functioning in individuals at CHR-P are undetermined. OBJECTIVE To provide an updated synthesis of evidence on the consistency and magnitude of neurocognitive functioning in individuals at CHR-P. DATA SOURCES Web of Science database, Cochrane Central Register of Reviews, and Ovid/PsycINFO and trial registries up to July 1, 2020. STUDY SELECTION Multistep literature search compliant with Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology performed by independent researchers to identify original studies reporting on neurocognitive functioning in individuals at CHR-P. DATA EXTRACTION AND SYNTHESIS Independent researchers extracted the data, clustering the neurocognitive tasks according to 7 Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) domains and 8 CHR-P domains. Random-effect model meta-analyses, assessment of publication biases and study quality, and meta-regressions were conducted. MAIN OUTCOMES AND MEASURES The primary effect size measure was Hedges g of neurocognitive functioning in individuals at CHR-P (1) compared with healthy control (HC) individuals or (2) compared with individuals with first-episode psychosis (FEP) or (3) stratified for the longitudinal transition to psychosis. RESULTS A total of 78 independent studies were included, consisting of 5162 individuals at CHR-P (mean [SD; range] age, 20.2 [3.3; 12.0-29.0] years; 2529 [49.0%] were female), 2865 HC individuals (mean [SD; range] age, 21.1 [3.6; 12.6-29.2] years; 1490 [52.0%] were female), and 486 individuals with FEP (mean [SD; range] age, 23.0 [2.0; 19.1-26.4] years; 267 [55.9%] were female). Compared with HC individuals, individuals at CHR-P showed medium to large deficits on the Stroop color word reading task (g = -1.17; 95% CI, -1.86 to -0.48), Hopkins Verbal Learning Test-Revised (g = -0.86; 95% CI, -1.43 to -0.28), digit symbol coding test (g = -0.74; 95% CI, -1.19 to -0.29), Brief Assessment of Cognition Scale Symbol Coding (g = -0.67; 95% CI, -0.95 to -0.39), University of Pennsylvania Smell Identification Test (g = -0.55; 95% CI, -0.97 to -0.12), Hinting Task (g = -0.53; 95% CI, -0.77 to -0.28), Rey Auditory Verbal Learning Test (g = -0.50; 95% CI, -0.78 to -0.21), California Verbal Learning Test (CVLT) (g = -0.50; 95% CI, -0.64 to -0.36), and National Adult Reading Test (g = -0.52; 95% CI, -1.01 to -0.03). Individuals at CHR-P were less impaired than individuals with FEP. Longitudinal transition to psychosis from a CHR-P state was associated with medium to large deficits in the CVLT task (g = -0.58; 95% CI, -1.12 to -0.05). Meta-regressions found significant effects for age and education on processing speed. CONCLUSIONS AND RELEVANCE Findings from this meta-analysis support neurocognitive dysfunction as a potential detection and prognostic biomarker in individuals at CHR-P. These findings may advance clinical research and inform preventive approaches.
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Affiliation(s)
- Ana Catalan
- Psychiatry Department, Basurto University
Hospital, Bilbao, Spain
- Biocruces Bizkaia Health Research Institute,
Barakaldo, Spain
- Facultad de Medicina y Odontología.
University of the Basque Country, UPV/EHU, Leioa, Spain
- Early Psychosis: Interventions and
Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of
Psychiatry, Psychology & Neuroscience, King’s College London, London,
United Kingdom
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and
Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of
Psychiatry, Psychology & Neuroscience, King’s College London, London,
United Kingdom
- Department of Child and Adolescent Psychiatry,
Institute of Psychiatry and Mental Health. Hospital General Universitario Gregorio
Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense,
IiSGM, CIBERSAM, Madrid, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University
Hospital, Bilbao, Spain
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences,
University of Pavia, Pavia, Italy
| | - Veronica Sordi
- Department of Brain and Behavioral Sciences,
University of Pavia, Pavia, Italy
| | - Joaquim Radua
- Early Psychosis: Interventions and
Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of
Psychiatry, Psychology & Neuroscience, King’s College London, London,
United Kingdom
- Imaging of Mood- and Anxiety-Related Disorders
Group, Mental Health Research Networking Center, Institut d’Investigacions
Biomèdiques August Pi i Sunyer, CIBERSAM, Barcelona, Spain
- Department of Clinical Neuroscience, Centre for
Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Dominic Oliver
- Early Psychosis: Interventions and
Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of
Psychiatry, Psychology & Neuroscience, King’s College London, London,
United Kingdom
| | - Philip McGuire
- National Institute for Health Research
Biomedical Research Centre, London, United Kingdom
- Department of Psychosis Studies, Institute of
Psychiatry, Psychology & Neuroscience, King’s College London, London,
United Kingdom
- Outreach and Support in South London Service,
South London and Maudsley National Health Service Foundation Trust, London, United
Kingdom
| | - Anthony J. Giuliano
- Worcester Recovery Center & Hospital,
Massachusetts Department of Mental Health, Boston
| | - William S. Stone
- Department of Psychiatry, Beth Israel
Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and
Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of
Psychiatry, Psychology & Neuroscience, King’s College London, London,
United Kingdom
- Department of Brain and Behavioral Sciences,
University of Pavia, Pavia, Italy
- National Institute for Health Research
Biomedical Research Centre, London, United Kingdom
- Outreach and Support in South London Service,
South London and Maudsley National Health Service Foundation Trust, London, United
Kingdom
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Salazar de Pablo G, Besana F, Arienti V, Catalan A, Vaquerizo-Serrano J, Cabras A, Pereira J, Soardo L, Coronelli F, Kaur S, da Silva J, Oliver D, Petros N, Moreno C, Gonzalez-Pinto A, Díaz-Caneja CM, Shin JI, Politi P, Solmi M, Borgatti R, Mensi MM, Arango C, Correll CU, McGuire P, Fusar-Poli P. Longitudinal outcome of attenuated positive symptoms, negative symptoms, functioning and remission in people at clinical high risk for psychosis: a meta-analysis. EClinicalMedicine 2021; 36:100909. [PMID: 34189444 PMCID: PMC8219991 DOI: 10.1016/j.eclinm.2021.100909] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/26/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Little is known about clinical outcomes other than transition to psychosis in people at Clinical High-Risk for psychosis (CHR-P). Our aim was to comprehensively meta-analytically evaluate for the first time a wide range of clinical and functional outcomes beyond transition to psychosis in CHR-P individuals. METHODS PubMed and Web of Science were searched until November 2020 in this PRISMA compliant meta-analysis (PROSPERO:CRD42020206271). Individual longitudinal studies conducted in individuals at CHR-P providing data on at least one of our outcomes of interest were included. We carried out random-effects pairwise meta-analyses, meta-regressions, and assessed publication bias and study quality. Analyses were two-tailed with α=0.05. FINDINGS 75 prospective studies were included (n=5,288, age=20.0 years, females=44.5%). Attenuated positive symptoms improved at 12 (Hedges' g=0.753, 95%CI=0.495-1.012) and 24 (Hedges' g=0.836, 95%CI=0.463-1.209), but not ≥36 months (Hedges' g=0.315. 95%CI=-0.176-0.806). Negative symptoms improved at 12 (Hedges' g=0.496, 95%CI=0.315-0.678), but not 24 (Hedges' g=0.499, 95%CI=-0.137-1.134) or ≥36 months (Hedges' g=0.033, 95%CI=-0.439-0.505). Depressive symptoms improved at 12 (Hedges' g=0.611, 95%CI=0.441-0.782) and 24 (Hedges' g=0.583, 95%CI=0.364-0.803), but not ≥36 months (Hedges' g=0.512 95%CI=-0.337-1.361). Functioning improved at 12 (Hedges' g=0.711, 95%CI=0.488-0.934), 24 (Hedges' g=0.930, 95%CI=0.553-1.306) and ≥36 months (Hedges' g=0.392, 95%CI=0.117-0.667). Remission from CHR-P status occurred in 33.4% (95%CI=22.6-44.1%) at 12 months, 41.4% (95%CI=32.3-50.5%) at 24 months and 42.4% (95%CI=23.4-61.3%) at ≥36 months. Heterogeneity across the included studies was significant and ranged from I2=53.6% to I2=96.9%. The quality of the included studies (mean±SD) was 4.6±1.1 (range=2-8). INTERPRETATION CHR-P individuals improve on symptomatic and functional outcomes over time, but these improvements are not maintained in the longer term, and less than half fully remit. Prolonged duration of care may be needed for this patient population to optimize outcomes. FUNDING None.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
- Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Filippo Besana
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Vincenzo Arienti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ana Catalan
- Mental Health Department - Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Faculty of Medicine and Dentistry, UPV/EHU, Vizcaya, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Julio Vaquerizo-Serrano
- Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Anna Cabras
- Department of Neurology and Psychiatry, University of Rome La Sapienza, Rome, Italy
| | - Joana Pereira
- Lisbon Psychiatric Hospital Centre, Lisbon, Portugal
| | - Livia Soardo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesco Coronelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Simi Kaur
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Josette da Silva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Natalia Petros
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Carmen Moreno
- Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Ana Gonzalez-Pinto
- Hospital Universitario Araba, Servicio de Psiquiatria, UPV/EHU, Bioaraba, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Covadonga M Díaz-Caneja
- Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
- Neurosciences Department, University of Padova, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Child and Adolescent Neuropsychiatric Unit, Italy
| | - Martina Maria Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Child and Adolescent Neuropsychiatric Unit, Italy
| | - Celso Arango
- Institute of Psychiatry and Mental Health. Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- OASIS Service, South London and Maudsley National Health Service Foundation Trust, UK
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- OASIS Service, South London and Maudsley National Health Service Foundation Trust, UK
- National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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36
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Catalan A, Salazar de Pablo G, Vaquerizo Serrano J, Mosillo P, Baldwin H, Fernández-Rivas A, Moreno C, Arango C, Correll CU, Bonoldi I, Fusar-Poli P. Annual Research Review: Prevention of psychosis in adolescents - systematic review and meta-analysis of advances in detection, prognosis and intervention. J Child Psychol Psychiatry 2021; 62:657-673. [PMID: 32924144 DOI: 10.1111/jcpp.13322] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/20/2020] [Accepted: 07/31/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The clinical high-risk state for psychosis (CHR-P) paradigm has facilitated the implementation of psychosis prevention into clinical practice; however, advancements in adolescent CHR-P populations are less established. METHODS We performed a PRISMA/MOOSE-compliant systematic review of the Web of Science database, from inception until 7 October 2019, to identify original studies conducted in CHR-P children and adolescents (mean age <18 years). Findings were systematically appraised around core themes: detection, prognosis and intervention. We performed meta-analyses (employing Q statistics and I 2 test) regarding the proportion of CHR-P subgroups, the prevalence of baseline comorbid mental disorders, the risk of psychosis onset and the type of interventions received at baseline. Quality assessment and publication bias were also analysed. RESULTS Eighty-seven articles were included (n = 4,667 CHR-P individuals). Quality of studies ranged from 3.5 to 8 (median 5.5) on a modified Newcastle-Ottawa scale. Detection: Individuals were aged 15.6 ± 1.2 years (51.5% males), mostly (83%) presenting with attenuated positive psychotic symptoms. CHR-P psychometric accuracy improved when caregivers served as additional informants. Comorbid mood (46.4%) and anxiety (31.4%) disorders were highly prevalent. Functioning and cognition were impaired. Neurobiological studies were inconclusive. PROGNOSIS Risk for psychosis was 10.4% (95%CI: 5.8%-18.1%) at 6 months, 20% (95%CI: 15%-26%) at 12 months, 23% (95%CI: 18%-29%) at 24 months and 23.3% (95%CI: 17.3%-30.7%) at ≥36 months. INTERVENTIONS There was not enough evidence to recommend one specific treatment (including cognitive behavioural therapy) over the others (including control conditions) to prevent the transition to psychosis in this population. Randomised controlled trials suggested that family interventions, cognitive remediation and fish oil supplementation may improve cognition, symptoms and functioning. At baseline, 30% of CHR-P adolescents were prescribed antipsychotics and 60% received psychotherapy. CONCLUSIONS It is possible to detect and formulate a group-level prognosis in adolescents at risk for psychosis. Future interventional research is required.
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Affiliation(s)
- Ana Catalan
- Mental Health Department - Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Faculty of Medicine and Dentistry, University of the Basque Country - UPV/EHU, Biscay, Spain.,Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Complutense University of Madrid, Madrid, Spain
| | - Julio Vaquerizo Serrano
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Complutense University of Madrid, Madrid, Spain
| | - Pierluca Mosillo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Faculty of Medicine and Surgery, University of Pavia, Pavia, Italy
| | - Helen Baldwin
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Aranzazu Fernández-Rivas
- Mental Health Department - Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Faculty of Medicine and Dentistry, University of the Basque Country - UPV/EHU, Biscay, Spain
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Complutense University of Madrid, Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, IiSGM, CIBERSAM, Complutense University of Madrid, Madrid, Spain
| | - Christoph U Correll
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA.,Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA.,Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Ilaria Bonoldi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,OASIS service, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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Salazar de Pablo G, De Micheli A, Nieman DH, Correll CU, Kessing LV, Pfennig A, Bechdolf A, Borgwardt S, Arango C, van Amelsvoort T, Vieta E, Solmi M, Oliver D, Catalan A, Verdino V, Di Maggio L, Bonoldi I, Vaquerizo-Serrano J, Baccaredda Boy O, Provenzani U, Ruzzi F, Calorio F, Nosari G, Di Marco B, Famularo I, Molteni S, Filosi E, Mensi M, Balottin U, Politi P, Shin JI, Fusar-Poli P. Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis. Eur Neuropsychopharmacol 2020; 41:28-39. [PMID: 33162291 DOI: 10.1016/j.euroneuro.2020.10.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/24/2020] [Accepted: 10/16/2020] [Indexed: 12/31/2022]
Abstract
Promotion of good mental health in young people is important. Our aim was to evaluate the consistency and magnitude of the efficacy of universal/selective interventions to promote good mental health. A systematic PRISMA/RIGHT-compliant meta-analysis (PROSPERO: CRD42018088708) search of Web of Science until 04/31/2019 identified original studies comparing the efficacy of universal/selective interventions for good mental health vs a control group, in samples with a mean age <35 years. Meta-analytical random-effects model, heterogeneity statistics, assessment of publication bias, study quality and sensitivity analyses investigated the efficacy (Hedges' g=effect size, ES) of universal/selective interventions to promote 14 good mental health outcomes defined a-priori. 276 studies were included (total participants: 159,508, 79,142 interventions and 80,366 controls), mean age=15.0 (SD=7.4); female=56.0%. There was a significant overall improvement in 10/13 good mental health outcome categories that could be meta-analysed: compared to controls, interventions significantly improved (in descending order of magnitude) mental health literacy (ES=0.685, p<0.001), emotions (ES=0.541, p<0.001), self-perceptions and values (ES=0.49, p<0.001), quality of life (ES=0.457, p=0.001), cognitive skills (ES=0.428, p<0.001), social skills (ES=0.371, p<0.001), physical health (ES=0.285, p<0.001), sexual health (ES=0.257, p=0.017), academic/occupational performance (ES=0.211, p<0.001) and attitude towards mental disorders (ES=0.177, p=0.006). Psychoeducation was the most effective intervention for promoting mental health literacy (ES=0.774, p<0.001) and cognitive skills (ES=1.153, p=0.03). Physical therapy, exercise and relaxation were more effective than psychoeducation and psychotherapy for promoting physical health (ES=0.498, p<0.001). In conclusion, several universal/selective interventions can be effective to promote good mental health in young people. Future research should consolidate and extend these findings.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Andrea De Micheli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, the Netherlands
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience; The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Centre (FRITZ), Vivantes Klinikum Am Urban, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Klinikum im Friedrichshain, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; ORYGEN, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Neurosciences Department, University of Padova, Italy
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Spain
| | - Valeria Verdino
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Molecular and Developmental Medicine, Division on Psychiatry, University of Siena, Italy
| | - Lucia Di Maggio
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ilaria Bonoldi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Julio Vaquerizo-Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ottone Baccaredda Boy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Umberto Provenzani
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesca Ruzzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Federica Calorio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Benedetto Di Marco
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Irene Famularo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Silvia Molteni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Eleonora Filosi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Martina Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Child and Adolescent Neuropsychiatric Unit
| | - Umberto Balottin
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK.
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Salazar de Pablo G, Vaquerizo-Serrano J, Catalan A, Arango C, Moreno C, Ferre F, Shin JI, Sullivan S, Brondino N, Solmi M, Fusar-Poli P. Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis. J Affect Disord 2020; 275:48-57. [PMID: 32658823 PMCID: PMC7314697 DOI: 10.1016/j.jad.2020.06.022] [Citation(s) in RCA: 354] [Impact Index Per Article: 88.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Health care workers (HCW) are at high risk of developing physical/mental health outcomes related to coronavirus syndromes. Nature and frequency of these outcomes are undetermined. METHODS PRISMA/MOOSE-compliant (PROSPERO-CRD42020180205) systematic review of Web of Science/grey literature until 15th April 2020, to identify studies reporting physical/mental health outcomes in HCW infected/exposed to Severe Acute Respiratory Syndrome -SARS-, Middle East Respiratory Syndrome -MERS-, Novel coronavirus -COVID-19-. Proportion random effect meta-analyses, I2 statistic, quality assessment and sensitivity analysis. RESULTS 115 articles were included (n=60,458 HCW, age 36.1±7.1, 77.1% female). Physical health outcomes: 75.9% HCW infected by SARS/MERS/COVID-19 reported fever (95%CI=65.9-83.7%, k=12, n=949), 47.9% cough (95%CI=39.2-56.8%, k=14, n=970), 43.6% myalgias (95%CI=31.9-56.0%, k=13, n=898), 42.3% chills (95%CI=20.2-67.9%, k=7, n=716), 41.2% fatigue (95%CI=18.2-68.8%, k=6, n=386), 34.6% headaches (95%CI=23.1-48.2%, k=11, n=893), 31.2% dyspnoea (95%CI=23.2-40.5%, k=12, n=1003), 25.3% sore throat (95%CI=18.8-33.2%, k=8, n=747), 22.2% nausea/vomiting (95%CI=14.9-31.8%, k=6, n=662), 18.8% diarrhoea (95%CI=11.9-28.4%, k=9, n=824). Mental health outcomes: 62.5% HCW exposed to SARS/MERS/COVID-19 reported general health concerns (95%CI=57.0-67,8%, k=2, n=2254), 43.7% fear (95%CI=33.9-54.0%, k=4, n=584), 37.9% insomnia (95%CI=30.9-45.5%, k=6, n=5067), 37.8% psychological distress (95%CI=28.4-48.2%, k=15, n=24,346), 34.4% burnout (95%CI=19.3-53.5%, k=3, n=1337), 29.0% anxiety features (95%CI=14.2-50.3%, k=6, n=9191), 26.3% depressive symptoms (95%CI=12.5-47.1%, k=8, n=9893), 20.7% post-traumatic stress disorder features (95%CI=13.2-31%, k=11, n=3826), 16.1% somatisation (95%CI=0.2-96.0%, k=2, n=2184), 14.0% stigmatisation feelings (95%CI=6.4-28.1%, k=2, n=411). LIMITATIONS Limited amount of evidence for some outcomes and suboptimal design in several studies included. CONCLUSIONS SARS/MERS/COVID-19 have a substantial impact on the physical and mental health of HCW, which should become a priority for public health strategies.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
| | - Julio Vaquerizo-Serrano
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital. Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Bizkaia, Spain
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Carmen Moreno
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Francisco Ferre
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Madrid, Spain
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sarah Sullivan
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Natascia Brondino
- Section of Psychiatry, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Neurosciences Department, University of Padua, Padua, Italy; Padua Neuroscience Center, University of Padua, Padua, Italy
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Section of Psychiatry, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
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Salazar de Pablo G, Studerus E, Vaquerizo-Serrano J, Irving J, Catalan A, Oliver D, Baldwin H, Danese A, Fazel S, Steyerberg EW, Stahl D, Fusar-Poli P. Implementing Precision Psychiatry: A Systematic Review of Individualized Prediction Models for Clinical Practice. Schizophr Bull 2020; 47:284-297. [PMID: 32914178 PMCID: PMC7965077 DOI: 10.1093/schbul/sbaa120] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The impact of precision psychiatry for clinical practice has not been systematically appraised. This study aims to provide a comprehensive review of validated prediction models to estimate the individual risk of being affected with a condition (diagnostic), developing outcomes (prognostic), or responding to treatments (predictive) in mental disorders. METHODS PRISMA/RIGHT/CHARMS-compliant systematic review of the Web of Science, Cochrane Central Register of Reviews, and Ovid/PsycINFO databases from inception until July 21, 2019 (PROSPERO CRD42019155713) to identify diagnostic/prognostic/predictive prediction studies that reported individualized estimates in psychiatry and that were internally or externally validated or implemented. Random effect meta-regression analyses addressed the impact of several factors on the accuracy of prediction models. FINDINGS Literature search identified 584 prediction modeling studies, of which 89 were included. 10.4% of the total studies included prediction models internally validated (n = 61), 4.6% models externally validated (n = 27), and 0.2% (n = 1) models considered for implementation. Across validated prediction modeling studies (n = 88), 18.2% were diagnostic, 68.2% prognostic, and 13.6% predictive. The most frequently investigated condition was psychosis (36.4%), and the most frequently employed predictors clinical (69.5%). Unimodal compared to multimodal models (β = .29, P = .03) and diagnostic compared to prognostic (β = .84, p < .0001) and predictive (β = .87, P = .002) models were associated with increased accuracy. INTERPRETATION To date, several validated prediction models are available to support the diagnosis and prognosis of psychiatric conditions, in particular, psychosis, or to predict treatment response. Advancements of knowledge are limited by the lack of implementation research in real-world clinical practice. A new generation of implementation research is required to address this translational gap.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, UK,Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERSAM, Madrid, Spain,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Erich Studerus
- Division of Personality and Developmental Psychology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Julio Vaquerizo-Serrano
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, UK,Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERSAM, Madrid, Spain,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Jessica Irving
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, UK
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, UK,Department of Psychiatry, Basurto University Hospital, Bilbao, Spain,Mental Health Group, BioCruces Health Research Institute, Bizkaia, Spain,Neuroscience Department, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, UK
| | - Helen Baldwin
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, UK
| | - Andrea Danese
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, UK,National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands,Department of Public Health, Erasmus MC, Rotterdam, the Netherlands
| | - Daniel Stahl
- Biostatistics Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, UK,OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK,To whom correspondence should be addressed; tel: +44-0-20-7848-0900, fax:+44-0-20-7848-0976, e-mail:
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Merritt K, Catalan A, Cowley S, Demjaha A, Taylor M, McGuire P, Cooper R, Morrison P. Glyceryl trinitrate in first-episode psychosis unmedicated with antipsychotics: A randomised controlled pilot study. J Psychopharmacol 2020; 34:839-847. [PMID: 32436761 PMCID: PMC7376621 DOI: 10.1177/0269881120922967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND There is a pressing need for new classes of treatment for psychosis. A key therapeutic target for novel compounds is the NMDA receptor, which may be modulated by nitric oxide donors such as sodium nitroprusside (SNP). Recent studies of SNP in patients with psychosis have mixed results, and the drug has to be administered intravenously. Glyceryl trinitrate (GTN) is a well-established cardiovascular medicine that is also a nitric oxide donor, and can be given orally. AIMS We explored the safety and potential effects of GTN in unmedicated patients with a first episode of psychosis. METHODS This was a single-centre, randomised, double-blind, placebo-controlled trial from December 2016 to April 2019 (ClinicalTrials.gov identifier: NCT02906553). Patients received 3 × sprays of GTN or placebo for three consecutive days, and were re-assessed on Days 1, 2, 3 and 7. The primary outcome was cognition (Jumping to Conclusions task), secondary outcomes were symptoms (Positive and Negative Syndrome Scale (PANSS)), verbal memory (Hopkins Verbal Learning task), and mood (Bond-Lader Visual Analogue Scales). RESULTS Nineteen patients were randomised, and 13 participants were included in the analyses. Compared with placebo, GTN was well tolerated, but was not associated with significant effects on cognition, symptoms, or mood. Bayesian statistics indicate that our results were 2× more likely under the null hypothesis than the alternative hypothesis, providing anecdotal evidence that GTN does not improve psychotic symptoms. CONCLUSIONS We found no indication of an effect of GTN on symptoms of psychosis or cognition.
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Affiliation(s)
- Kate Merritt
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK,Division of Psychiatry, University College London, London, UK,Kate Merritt, Department of Psychosis Studies, Institute of Psychiatry, Psychology &
Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Ana Catalan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK,Osakidetza Basque Health Service, Department Psychiatry, Basurto University Hospital, Bilbao, Spain,Department of Neuroscience, University of the Basque Country, Leioa, Spain
| | - Samuel Cowley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Arsime Demjaha
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Matthew Taylor
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK,University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Ruth Cooper
- Newham Centre for Mental Health, Unit for Social and Community Psychiatry, Queen Mary University of London, UK,East London NHS Foundation Trust, Newham Centre for Mental Health, London, UK
| | - Paul Morrison
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Tognin S, Catalan A, Modinos G, Kempton MJ, Bilbao A, Nelson B, Pantelis C, Riecher-Rössler A, Bressan R, Barrantes-Vidal N, Krebs MO, Nordentoft M, Ruhrmann S, Sachs G, Rutten BPF, van Os J, de Haan L, van der Gaag M, McGuire P, Valmaggia LR. Emotion Recognition and Adverse Childhood Experiences in Individuals at Clinical High Risk of Psychosis. Schizophr Bull 2020; 46:823-833. [PMID: 32080743 PMCID: PMC7345818 DOI: 10.1093/schbul/sbz128] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the association between facial affect recognition (FAR) and type of adverse childhood experiences (ACEs) in a sample of clinical high risk (CHR) individuals and a matched sample of healthy controls (HCs). METHODS In total, 309 CHR individuals and 51 HC were recruited as part of an European Union-funded multicenter study (EU-GEI) and included in this work. During a 2-year follow-up period, 65 CHR participants made a transition to psychosis (CHR-T) and 279 did not (CHR-NT). FAR ability was measured using a computerized version of the Degraded Facial Affect Recognition (DFAR) task. ACEs were measured using the Childhood Experience of Care and Abuse Questionnaire, the Childhood Trauma Questionnaire, and the Bullying Questionnaire. Generalized regression models were used to investigate the relationship between ACE and FAR. Logistic regressions were used to investigate the relationship between FAR and psychotic transition. RESULTS In CHR individuals, having experienced emotional abuse was associated with decreased total and neutral DFAR scores. CHR individuals who had experienced bullying performed better in the total DFAR and in the frightened condition. In HC and CHR, having experienced the death of a parent during childhood was associated with lower DFAR total score and lower neutral DFAR score, respectively. Analyses revealed a modest increase of transition risk with increasing mistakes from happy to angry faces. CONCLUSIONS Adverse experiences in childhood seem to have a significant impact on emotional processing in adult life. This information could be helpful in a therapeutic setting where both difficulties in social interactions and adverse experiences are often addressed.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK,To whom correspondence should be addressed; tel: +44(0)2078480415, fax: +44 (0)20 7848 0287, e-mail:
| | - Ana Catalan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Department of Psychiatry, Basurto University Hospital, Bilbao, Spain,Department of Neuroscience, University of the Basque Country, Leioa, Spain
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
| | - Amaia Bilbao
- Research Unit, Basurto University Hospital, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Christos Pantelis
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Rodrigo Bressan
- LiNC – Lab Integrative Neuroscience, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver, Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- INSERM, IPNP UMR S1266, Laboratoire de Physiopathologie des Maladies Psychiatriques, Université Paris Descartes, Université de Paris, CNRS, GDR3557-Institut de Psychiatrie, Paris, France,Faculté de Médecine Paris Descartes, GHU Paris – Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands,Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Department of Early Psychosis, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Amsterdam Public Mental Health research institute, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands,Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | | | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK,Outreach and Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK,National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
| | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
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Abstract
IMPORTANCE Since the release of the DSM-5 diagnosis of attenuated psychosis syndrome (DSM-5-APS) in 2013, several research studies have investigated its clinical validity. Although critical and narrative reviews have reviewed these progresses, no systematic review has comprehensively summarized the available evidence regarding the clinical validity of DSM-5-APS. OBJECTIVE To provide current evidence on the clinical validity of DSM-5-APS, focusing on recent advances in diagnosis, prognosis, and treatment. EVIDENCE REVIEW A multistep literature search using the Web of Science database, Cochrane Central Register of Reviews, Ovid/PsychINFO, conference proceedings, and trial registries from database inception to June 16, 2019, was conducted following PRISMA and MOOSE guidelines and PROSPERO protocol. Studies with original data investigating individuals diagnosed using DSM-5-APS or meeting comparable criteria were included. The results of the systematic review were summarized in tables and narratively synthesized against established evidence-based antecedent, concurrent, and prognostic validators. A quantitative meta-analysis was conducted to explore the cumulative risk of psychosis onset at 6, 12, 24, and 36 months in individuals diagnosed using DSM-5-APS criteria. FINDINGS The systematic review included 56 articles, which reported on 124 validators, including 15 antecedent, 55 concurrent, and 54 prognostic validators. The epidemiological prevalence of the general non-help-seeking young population meeting DSM-5-APS criteria was 0.3%; the prevalence of individuals meeting DSM-5-APS criteria was variable in clinical samples. The interrater reliability for DSM-5-APS criteria was comparable with that of other DSM-5 mental disorders and can be optimized by the use of specific psychometric instruments. DSM-5-APS criteria were associated with frequent depressive comorbid disorders, distress, suicidality, and functional impairment. The meta-analysis included 23 prospective cohort studies, including 2376 individuals. The meta-analytical risk of psychosis onset was 11% at 6 months, 15% at 12 months, 20% at 24 months, and 23% at 36 months. Research into predisposing and precipitating epidemiological factors, neurobiological correlates, and effective treatments for DSM-5-APS criteria has been limited. CONCLUSIONS AND RELEVANCE Over recent years, DSM-5-APS criteria have received substantial concurrent and prognostic validation, mostly driven by research into the clinical high-risk state for psychosis. Precipitating and predisposing factors, neurobiological correlates, and effective treatments are undetermined to date.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Institute of Psychiatry and Mental Health, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.,Mental Health Group, BioCruces Health Research Institute, Bizkaia, Spain.,Neuroscience Department, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Catalan A, Díaz A, Angosto V, Zamalloa I, Martínez N, Guede D, Aguirregomoscorta F, Bustamante S, Larrañaga L, Osa L, Maruottolo C, Fernández-Rivas A, Bilbao A, Gonzalez-Torres MA. Can childhood trauma influence facial emotion recognition independently from a diagnosis of severe mental disorder? Rev Psiquiatr Salud Ment (Engl Ed) 2018; 13:140-149. [PMID: 30558956 DOI: 10.1016/j.rpsm.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 04/07/2018] [Accepted: 10/17/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Facial emotion recognition (FER) is a fundamental component in social interaction. We know that FER is disturbed in patients with severe mental disorder (SMD), as well as those with a history of childhood trauma. MATERIAL AND METHODS We intend to analyze the possible relationship between the existence of trauma in childhood irrespective of a SMD, measured by the CTQ scale and facial expression recognition, in a sample of three types of subjects (n=321): healthy controls (n=179), patients with BPD (n=69) and patients with a first psychotic episode (n=73). Likewise, clinical and socio-demographic data were collected. The relationship was analyzed by a technique of multivariate regression adjusting for sex, age, IQ, current consumption of drugs and group to which the subject belonged. RESULTS Sexual and/or physical trauma in childhood related independently to the existence of SMD with a worse total FER ratio, as well as to a worse rate of recognition in expressions of happiness. Furthermore, the subjects with a history of childhood trauma attributed expressions of anger and fear more frequently to neutral and happy faces, irrespective of other variables. CONCLUSIONS The existence of trauma in childhood seems to influence the ability of subjects to recognize facial expressions, irrespective of SMD. Trauma is a preventable factor with specific treatment; therefore, attention should be paid to the existence of this background in clinical populations.
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Affiliation(s)
- Ana Catalan
- Departamento de Neurociencias, Universidad del País-Vasco-Euskal Herriko Unibertsitatea, Leioa, Vizcaya, España; Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España; Instituto de Investigación de BioCruces, Barakaldo, Vizcaya, España.
| | - Aida Díaz
- Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España
| | - Virxinia Angosto
- Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España
| | - Iker Zamalloa
- Departamento de Neurociencias, Universidad del País-Vasco-Euskal Herriko Unibertsitatea, Leioa, Vizcaya, España
| | - Nuria Martínez
- Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España
| | - David Guede
- Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España
| | | | - Sonia Bustamante
- Departamento de Neurociencias, Universidad del País-Vasco-Euskal Herriko Unibertsitatea, Leioa, Vizcaya, España; Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España; Instituto de Investigación de BioCruces, Barakaldo, Vizcaya, España
| | - Lorea Larrañaga
- Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España
| | - Luis Osa
- Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España
| | | | - Arantza Fernández-Rivas
- Departamento de Neurociencias, Universidad del País-Vasco-Euskal Herriko Unibertsitatea, Leioa, Vizcaya, España; Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España; Instituto de Investigación de BioCruces, Barakaldo, Vizcaya, España
| | - Amaia Bilbao
- Research Unit - REDISSEC, Basurto University Hospital, Bilbao, Vizcaya, España
| | - Miguel Angel Gonzalez-Torres
- Departamento de Neurociencias, Universidad del País-Vasco-Euskal Herriko Unibertsitatea, Leioa, Vizcaya, España; Departamento de Psiquiatría, Hospital Universitario Basurto, Bilbao, Vizcaya, España; Instituto de Investigación de BioCruces, Barakaldo, Vizcaya, España
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Gonzalez de Artaza M, Catalan A, Angosto V, Valverde C, Bilbao A, van Os J, Gonzalez-Torres MA. Can an experimental white noise task assess psychosis vulnerability in adult healthy controls? PLoS One 2018; 13:e0192373. [PMID: 29447186 PMCID: PMC5813930 DOI: 10.1371/journal.pone.0192373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/21/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This is an extension of a paper published earlier. We investigated the association between the tendency to detect speech illusion in random noise and levels of positive schizotypy in a sample of 185 adult healthy controls. MATERIALS AND METHODS Subclinical positive, negative and depressive symptoms were assessed with the Community Assessment of Psychic Experiences (CAPE); positive and negative schizotypy was assessed with the Structured Interview for Schizotypy-Revised (SIS-R). RESULTS Speech illusions were associated with positive schizotypy (OR: 4.139, 95% CI: 1.074-15.938; p = 0.039) but not with negative schizotypy (OR: 1.151, 95% CI: 0.183-7.244; p = 0.881). However, the association of positive schizotypy with speech illusions was no longer significant after adjusting for age, sex and WAIS-III (OR: 2.577, 95% CI: 0.620-10.700; p = 0.192). Speech illusions were not associated with self-reported CAPE measures. CONCLUSIONS The association between schizotypy and the tendency to assign meaning in random noise in healthy controls may be mediated by cognitive ability and not constitute an independent trait.
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Affiliation(s)
| | - Ana Catalan
- Department of Neuroscience, University of the Basque Country, Leioa, Basque Country, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Virxinia Angosto
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Cristina Valverde
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Amaia Bilbao
- Research Unit, Basurto University Hospital, Bilbao, Spain
| | - Jim van Os
- Department of Psychiatry and Psychology, South Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
- King´s College London, King´s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
| | - Miguel Angel Gonzalez-Torres
- Department of Neuroscience, University of the Basque Country, Leioa, Basque Country, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
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Catalan A, de Artaza MG, Fernández-Rivas A, Angosto V, Aguirregomoscorta F, Bustamante S, Díaz A, Zamalloa I, Olazabal N, Bilbao A, Maruottolo C, Gonzalez-Torres MA. Affectively salient signal to random noise might be used to identify psychosis vulnerability in severe mental disorders. Eur Psychiatry 2018; 49:37-42. [PMID: 29366846 DOI: 10.1016/j.eurpsy.2017.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/25/2017] [Accepted: 12/15/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Subclinical psychotic symptoms are present in the general population. Furthermore, they are quite common in diagnostic categories beyond psychosis, such as BPD patients. METHODS We want to assess the differences between 3 groups: BPD (n = 68), FEP (n = 83) and controls (n = 203) in an experimental paradigm measuring the presence of speech illusions in white noise. The Positive and Negative Syndrome Scale was administered in the patient group, the Structured Interview for Schizotypy-Revised, and the Community Assessment of Psychic Experiences in the control and BPD group. The white noise task was also analysed within a signal detection theory (SDT) framework. Logistic regression analyses and the general linear models were used to analyse the adjusted differences between groups. RESULTS Differences were more prevalent in signals that were perceived as affectively salient in patients groups (9.6% in FEP vs 5.9% in BPD and 1% in controls; OR: 10.7; 95%CI: 2.2-51.6, p = 0.003 in FEP; OR: 6.3; 95%CI: 1.1-35.0, p = 0.036 in BPD). Besides, we found a worse general performance and more false alarms in the task for FEP group using SDT framework. CONCLUSIONS Experimental paradigms indexing the tendency to detect affectively salient signals in noise may be used to identify liability to psychosis in people with vulnerability. Its predictable value in other diagnostic categories and general population requires further research.
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Affiliation(s)
- Ana Catalan
- Department of Neuroscience, University of the Basque Country, Leioa, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain; BioCruces Research Institute, Barakaldo, Spain.
| | | | - Arantza Fernández-Rivas
- Department of Neuroscience, University of the Basque Country, Leioa, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain; BioCruces Research Institute, Barakaldo, Spain
| | - Virxinia Angosto
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | | | - Sonia Bustamante
- Department of Neuroscience, University of the Basque Country, Leioa, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain; BioCruces Research Institute, Barakaldo, Spain
| | - Aida Díaz
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Iker Zamalloa
- Department of Neuroscience, University of the Basque Country, Leioa, Basque Country, Spain
| | - Nora Olazabal
- Department of Neuroscience, University of the Basque Country, Leioa, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain; BioCruces Research Institute, Barakaldo, Spain
| | - Amaia Bilbao
- Research Unit - REDISSEC, Basurto University Hospital, Bilbao, Spain
| | | | - Miguel Angel Gonzalez-Torres
- Department of Neuroscience, University of the Basque Country, Leioa, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain; BioCruces Research Institute, Barakaldo, Spain
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Catalan A, Angosto V, Díaz A, Valverde C, de Artaza MG, Sesma E, Maruottolo C, Galletero I, Bustamante S, Bilbao A, van Os J, Gonzalez-Torres MA. Relation between psychotic symptoms, parental care and childhood trauma in severe mental disorders. Psychiatry Res 2017; 251:78-84. [PMID: 28189941 DOI: 10.1016/j.psychres.2017.02.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/15/2016] [Accepted: 02/05/2017] [Indexed: 10/20/2022]
Abstract
A relation between different types of parental care, trauma in childhood and psychotic symptoms in adulthood has been proposed. The nature of this association is not clear and if it is more related to psychotic disorders per se or to a cluster of symptoms such as positive psychotic symptoms remains undefined. We have analysed the presence of childhood trauma using the CTQ scale and types of parental care using the PBI scale in three groups of subjects: borderline personality disorder patients (n=36), first psychotic episode patients (n=61) and healthy controls (n=173). Positive psychotic symptomatology was assessed with the CAPE scale. General linear models were used to study the relation between positive psychotic symptomatology and variables of interest. BPD patients had the highest rate of any kind of trauma, followed by FEP patients. We found a positive relationship between psychotic symptomatology and the existence of trauma in childhood in all groups. Moreover, an affectionless control rearing style was directly associated with the existence of trauma. Furthermore, subjects with trauma presented less probability of having an optimal parenting style in childhood. The relation between psychotic symptoms and trauma remained statistically significant after adjusting for other variables including parental rearing style. There seems to be a link between trauma in childhood and psychotic symptomatology across different populations independently of psychiatric diagnosis. Taking into account that there is an association between trauma and psychosis and that trauma is a modifiable factor, clinicians should pay special attention to these facts.
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Affiliation(s)
- Ana Catalan
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain.
| | - Virxina Angosto
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Aida Díaz
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Cristina Valverde
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | | | - Eva Sesma
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | | | | | - Sonia Bustamante
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Amaia Bilbao
- Research Unit, Basurto University Hospital, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Vizcaya, Spain
| | - Jim van Os
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
| | - Miguel Angel Gonzalez-Torres
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
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Catalan A, Simons CJP, Bustamante S, Olazabal N, Ruiz E, Gonzalez de Artaza M, Penas A, Maruottolo C, González A, van Os J, Gonzalez-Torres MA. Correction: Data Gathering Bias: Trait Vulnerability to Psychotic Symptoms? PLoS One 2015; 10:e0135761. [PMID: 26252896 PMCID: PMC4529250 DOI: 10.1371/journal.pone.0135761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Catalan A, Simons CJP, Bustamante S, Olazabal N, Ruiz E, Gonzalez de Artaza M, Penas A, Maurottolo C, González A, van Os J, Gonzalez-Torres MA. Data Gathering Bias: Trait Vulnerability to Psychotic Symptoms? PLoS One 2015; 10:e0132442. [PMID: 26147948 PMCID: PMC4493127 DOI: 10.1371/journal.pone.0132442] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 06/15/2015] [Indexed: 12/13/2022] Open
Abstract
Background Jumping to conclusions (JTC) is associated with psychotic disorder and psychotic symptoms. If JTC represents a trait, the rate should be (i) increased in people with elevated levels of psychosis proneness such as individuals diagnosed with borderline personality disorder (BPD), and (ii) show a degree of stability over time. Methods The JTC rate was examined in 3 groups: patients with first episode psychosis (FEP), BPD patients and controls, using the Beads Task. PANSS, SIS-R and CAPE scales were used to assess positive psychotic symptoms. Four WAIS III subtests were used to assess IQ. Results A total of 61 FEP, 26 BPD and 150 controls were evaluated. 29 FEP were revaluated after one year. 44% of FEP (OR = 8.4, 95% CI: 3.9–17.9) displayed a JTC reasoning bias versus 19% of BPD (OR = 2.5, 95% CI: 0.8–7.8) and 9% of controls. JTC was not associated with level of psychotic symptoms or specifically delusionality across the different groups. Differences between FEP and controls were independent of sex, educational level, cannabis use and IQ. After one year, 47.8% of FEP with JTC at baseline again displayed JTC. Conclusions JTC in part reflects trait vulnerability to develop disorders with expression of psychotic symptoms.
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Affiliation(s)
- Ana Catalan
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
- * E-mail:
| | - Claudia J. P. Simons
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
- GGzE, Eindhoven, The Netherlands
| | - Sonia Bustamante
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Nora Olazabal
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Eduardo Ruiz
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | | | - Alberto Penas
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Claudio Maurottolo
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain
- Clínica Servicios Médicos AMSA, Bilbao, Vizcaya, Spain
| | | | - Jim van Os
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
- King’s College London, King’s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
| | - Miguel Angel Gonzalez-Torres
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
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Catalan A, Simons CJP, Bustamante S, Drukker M, Madrazo A, de Artaza MG, Gorostiza I, van Os J, Gonzalez-Torres MA. Novel evidence that attributing affectively salient signal to random noise is associated with psychosis. PLoS One 2014; 9:e102520. [PMID: 25020079 PMCID: PMC4097069 DOI: 10.1371/journal.pone.0102520] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 06/19/2014] [Indexed: 11/25/2022] Open
Abstract
We wished to replicate evidence that an experimental paradigm of speech illusions is associated with psychotic experiences. Fifty-four patients with a first episode of psychosis (FEP) and 150 healthy subjects were examined in an experimental paradigm assessing the presence of speech illusion in neutral white noise. Socio-demographic, cognitive function and family history data were collected. The Positive and Negative Syndrome Scale (PANSS) was administered in the patient group and the Structured Interview for Schizotypy-Revised (SIS-R), and the Community Assessment of Psychic Experiences (CAPE) in the control group. Patients had a much higher rate of speech illusions (33.3% versus 8.7%, ORadjusted: 5.1, 95% CI: 2.3–11.5), which was only partly explained by differences in IQ (ORadjusted: 3.4, 95% CI: 1.4–8.3). Differences were particularly marked for signals in random noise that were perceived as affectively salient (ORadjusted: 9.7, 95% CI: 1.8–53.9). Speech illusion tended to be associated with positive symptoms in patients (ORadjusted: 3.3, 95% CI: 0.9–11.6), particularly affectively salient illusions (ORadjusted: 8.3, 95% CI: 0.7–100.3). In controls, speech illusions were not associated with positive schizotypy (ORadjusted: 1.1, 95% CI: 0.3–3.4) or self-reported psychotic experiences (ORadjusted: 1.4, 95% CI: 0.4–4.6). Experimental paradigms indexing the tendency to detect affectively salient signals in noise may be used to identify liability to psychosis.
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Affiliation(s)
- Ana Catalan
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Claudia J P Simons
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; GGzE, Eindhoven, The Netherlands
| | - Sonia Bustamante
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Marjan Drukker
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Aranzazu Madrazo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | | | - Iñigo Gorostiza
- Research Unit REDISSEC, Basurto University Hospital, Bilbao, Spain
| | - Jim van Os
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
| | - Miguel A Gonzalez-Torres
- Department of Neuroscience, University of the Basque Country, Basque Country, Spain; Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
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Catalan A, Segarra R, Prieto M, Eguiluz I, Bravo E, Enjuto S, Gutierrez M. Sex differences in prodrome of first psychosis episodes. Eur Psychiatry 2008. [DOI: 10.1016/j.eurpsy.2008.01.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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