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Keown-Stoneman CD, Goodday SM, Preisig M, Vandeleur C, Castelao E, Grof P, Horrocks J, King N, Duffy A. Development and validation of a risk calculator for major mood disorders among the offspring of bipolar parents using information collected in routine clinical practice. EClinicalMedicine 2021; 39:101083. [PMID: 34466794 PMCID: PMC8382986 DOI: 10.1016/j.eclinm.2021.101083] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Family history is a significant risk factor for bipolar disorders (BD), but the magnitude of risk varies considerably between individuals within and across families. Accurate risk estimation may increase motivation to reduce modifiable risk exposures and identify individuals appropriate for monitoring over the peak risk period. Our objective was to develop and independently replicate an individual risk calculator for bipolar spectrum disorders among the offspring of BD parents using data collected in routine clinical practice. METHODS Data from the longitudinal Canadian High-Risk Offspring cohort study collected from 1996 to 2020 informed the development of a 5 and 10-year risk calculator using parametric time-to-event models with a cure fraction and a generalized gamma distribution. The calculator was then externally validated using data from the Lausanne-Geneva High-Risk Offspring cohort study collected from 1996 to 2020. A time-varying C-index by age in years was used to estimate the probability that the model correctly classified risk. Bias corrected estimates and 95% confidence limits were derived using a jackknife resampling approach. FINDINGS The primary outcome was age of onset of a major mood disorder. The risk calculator was most accurate at classifying risk in mid to late adolescence in the Canadian cohort (n = 285), and a similar pattern was replicated in the Swiss cohort (n = 128). Specifically, the time-varying C-index indicated that there was approximately a 70% chance that the model would correctly predict which of two 15-year-olds would be more likely to develop the outcome in the future. External validation within a smaller Swiss cohort showed mixed results. INTERPRETATION Findings suggest that this model may be a useful clinical tool in routine practice for improved individualized risk estimation of bipolar spectrum disorders among the adolescent offspring of a BD parent; however, risk estimation in younger high-risk offspring is less accurate, perhaps reflecting the evolving nature of psychopathology in early childhood. Based on external validation with a Swiss cohort, the risk calculator may not be as predictive in more heterogenous high-risk populations. FUNDING The Canadian High-Risk Study has been funded by consecutive operating grants from the Canadian Institutes for Health Research, currently CIHR PJT Grant 152796 he Lausanne-Geneva high-risk study was and is supported by five grants from the Swiss National Foundation (#3200-040,677, #32003B-105,969, #32003B-118,326, #3200-049,746 and #3200-061,974), three grants from the Swiss National Foundation for the National Centres of Competence in Research project "The Synaptic Bases of Mental Diseases" (#125,759, #158,776, and #51NF40 - 185,897), and a grant from GlaxoSmithKline Clinical Genetics.
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Affiliation(s)
- Charles D.G. Keown-Stoneman
- Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Sarah M. Goodday
- Department of Psychiatry, University of Oxford, Oxford, UK
- 4YouandMe, Seattle, USA
| | - Martin Preisig
- Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne. Lausanne, Switzerland
| | - Caroline Vandeleur
- Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne. Lausanne, Switzerland
| | - Enrique Castelao
- Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne. Lausanne, Switzerland
| | - Paul Grof
- Mood Disorders Centre of Ottawa, Ottawa, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Julie Horrocks
- Department of Mathematics and Statistics, Guelph University, Ontario, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen's University, Ontario, Canada
| | - Anne Duffy
- Department of Psychiatry, University of Oxford, Oxford, UK
- Mood Disorders Centre of Ottawa, Ottawa, Ontario, Canada
- Department of Psychiatry, Queen's University, Ontario, Canada
- Corresponding author.
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Ajdacic-Gross V, Ajdacic L, Xu Y, Müller M, Rodgers S, Wyss C, Olbrich S, Buadze A, Seifritz E, Wagner EYN, Radovanovic D, von Wyl V, Steinemann N, Landolt MA, Castelao E, Strippoli MPF, Gholamrezaee MM, Glaus J, Vandeleur C, Preisig M, von Känel R. Backtracing persistent biomarker shifts to the age of onset: A novel procedure applied to men’s and women’s white blood cell counts in post-traumatic stress disorder. Biomark Neuropsychiatry 2021. [DOI: 10.1016/j.bionps.2021.100030] [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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Xu Y, Vandeleur C, Müller M, Seifritz E, Kleim B, von Känel R, Wagner EYN, Strippoli MPF, Castelao E, Gholamrezaee MM, Preisig M, Ajdacic-Gross V. Retrospectively assessed trajectories of PTSD symptoms and their subsequent comorbidities. J Psychiatr Res 2021; 136:71-79. [PMID: 33578109 DOI: 10.1016/j.jpsychires.2021.01.049] [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: 09/03/2020] [Revised: 01/11/2021] [Accepted: 01/29/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Dynamic trajectories of psychopathology, such as post-traumatic stress disorder (PTSD) provide a key to understanding human adjustment processes after trauma exposure. Recent studies have suggested more heterogeneous mental health outcomes than the initially identified four adjustment trajectories. To explore this heterogeneity, we investigated the after-trauma adjustment patterns of psychopathology based on retrospective lifetime data. This was first carried out on the PTSD symptoms (PTSS, including no symptoms, few symptoms, partial and full PTSD), and secondly together with their post-trauma comorbidities. METHODS Data of trauma and the post-trauma mental disorders were collected for a large and randomly selected community sample, resulting in a N = 960 trauma-exposed subsample. Pattern recognition as carried out by latent class analysis (LCA) was implemented on this subsample. LCA was first exploited to identify the potential trajectory patterns of PTSS and next to explore the patterns of mental adjustments when additional post-trauma comorbid disorders, such as anxiety, mood and substance use disorders, were assessed. RESULTS Four PTSS trajectory patterns were found, namely resilient, chronic, recovered, and delayed onset, consistent with findings from longitudinal PTSD studies. When post-trauma comorbidities were evaluated, other than the trajectory pattern of delayed onset which retained a low comorbidity profile, the other three split respectively and paired up with either low, moderate or high comorbidity profile. CONCLUSIONS Mental health outcomes after trauma exposure were considerably more complex than the four previously established adjustment trajectories. Here, we uncovered additional and more heterogeneous adjustment patterns comprised of PTSS trajectories and post-trauma comorbidity profiles.
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Affiliation(s)
- Yanhua Xu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
| | - Caroline Vandeleur
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - En-Young N Wagner
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mehdi M Gholamrezaee
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
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Khazaal Y, Elowe J, Kloucek P, Preisig M, Tadri M, Vandeleur C, Vandenberghe F, Verloo H, Ros T, Von Guntenb A. [Psychiatry]. Rev Med Suisse 2021; 17:85-89. [PMID: 33443837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Covid-19 pandemic has a major impact on psychiatry by its social consequences and possible direct effect of certain forms of Covid-19 on mental health. During this crisis, the accessibility of technology meets a state of necessity, which has propelled telepsychiatry from the shadows into the light. The contribution of several technologies (i.e. virtual reality, actigraphy, computational psychiatry) combining clinical data and neuroscience underlines the great neurobehavioural variability even within the same diagnostic category, calling for greater precision in therapeutic offers as suggested e.g. by developments in neurofeedback. The place of intranasal esketamin in the panoply of antidepressent drug treatments for resistant depression has not yet been defined.
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Affiliation(s)
- Yasser Khazaal
- Service de médecine des addictions, Département de psychiatrie, CHUV, 1011 Lausanne
- Faculté de biologie et de médecine, Université de Lausanne, 1005 Lausanne
- Département de psychiatrie et d'addictologie, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal (Québec) H3C 3J7, Canada
| | - Julien Elowe
- Service de psychiatrie de l'adulte, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Petr Kloucek
- Service universitaire de psychiatrie de l'âge avancé, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Martin Preisig
- Centre d'épidémiologie psychiatrique et de psychopathologie, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Myriam Tadri
- Service universitaire de psychiatrie de l'âge avancé, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Caroline Vandeleur
- Faculté de biologie et de médecine, Université de Lausanne, 1005 Lausanne
- Centre d'épidémiologie psychiatrique et de psychopathologie, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Frederik Vandenberghe
- Unité de pharmacogénétique et de psychopharmacologie clinique, Centre de neurosciences psychiatriques, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Henk Verloo
- Service universitaire de psychiatrie de l'âge avancé, Département de psychiatrie, CHUV, 1011 Lausanne
| | - Tomas Ros
- Functional Brain Mapping Lab, Université de Genève, 1211 Genève 4
- Centre d'imagerie biomédicale, Université de Genève, 1211 Genève 4
| | - Armin Von Guntenb
- Faculté de biologie et de médecine, Université de Lausanne, 1005 Lausanne
- Service universitaire de psychiatrie de l'âge avancé, Département de psychiatrie, CHUV, 1011 Lausanne
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Müller M, Ajdacic-Gross V, Vetrella AB, Preisig M, Castelao E, Lasserre A, Rodgers S, Rössler W, Vetter S, Seifritz E, Vandeleur C. Subtypes of alcohol use disorder in the general population: A latent class analysis. Psychiatry Res 2020; 285:112712. [PMID: 31837815 DOI: 10.1016/j.psychres.2019.112712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 09/18/2018] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 02/04/2023]
Abstract
Alcohol use disorders (AUD) are often comorbid with other disorders with high levels of impairment, which is of relevance for the development and the progression of the disease. Evidence shows that AUD varies greatly with regard to its aetiology, which might lead to distinct clinical representations with important implications for treatment. The current study aimed to apply latent class analysis (LCA) techniques to investigate how comorbidity patterns in AUD vary with regard to specific explanatory factors. A Swiss community sample of N=439 individuals with AUD was subjected to LCA in order to find empirical AUD subtypes of comorbid psychiatric conditions. The subtypes were further validated based on a range of external criteria, including clinical and psycho-social factors as well as treatment variables. A three-class solution of empirical subtypes of AUD comorbidity (low, depressive-anxious, and drug-dependent antisocial) provided the best fit to the data. The three AUD subtypes showed homogeneous comorbidity patterns but varied along dimensions of psycho-social risk factors, consumption patterns and consequences as well as treatment history. Our findings provide strong evidence that AUD in non-treated samples can be described as a multidimensional disorder in terms of its comorbidity structure with distinct etiological factors and important consequences for treatment.
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Affiliation(s)
- Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Centre for Disaster and Military Psychiatry, University of Zurich, Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland.
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Antonio Besi Vetrella
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Aurélie Lasserre
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Wulf Rössler
- Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil; Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - University Medicine Berlin, Germany
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Centre for Disaster and Military Psychiatry, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Caroline Vandeleur
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Ballard ED, Cui L, Vandeleur C, Castelao E, Zarate CA, Preisig M, Merikangas KR. Familial Aggregation and Coaggregation of Suicide Attempts and Comorbid Mental Disorders in Adults. JAMA Psychiatry 2019; 76:826-833. [PMID: 30916728 PMCID: PMC6583867 DOI: 10.1001/jamapsychiatry.2019.0248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/11/2022]
Abstract
IMPORTANCE Clarification of the joint influence of familial patterns of suicide attempts and comorbid mental disorders can enhance the understanding and prevention of suicide attempts. OBJECTIVE To investigate the familial patterns of suicide attempts and comorbid mental disorders and their associations in a 2-site family study of mood and anxiety disorders. DESIGN, SETTING, AND PARTICIPANTS Data were obtained from 2 parallel community-based family studies conducted in the United States (National Institute of Mental Health [NIMH] study) and in Lausanne, Switzerland (PsyCoLaus study), on the comorbidity of mood and anxiety disorders. The study sample comprised 1119 adult probands and 5355 first-degree relatives. Data were collected and analyzed from October 2004 to December 2016. MAIN OUTCOMES AND MEASURES Lifetime suicide attempt and mental disorders in first-degree relatives, obtained through direct interviews or family history reports. RESULTS The study included 1119 adult probands (675 female [60.3%] and a mean [SD] age of 50 [12.0] years) and 5355 first-degree relatives (2752 female [51.4%] and a mean [SD] age of 52 [1.5] years). Of these participants, 90 (8.0%) of 1119 probands and 199 (3.7%) of 5355 relatives had a lifetime history of suicide attempt. Those with such a history had higher rates of all mental disorders, a greater number of disorders, and statistically significantly poorer current and lifetime global functioning. After adjustment for age and sex, a statistically significant association between suicide attempts in probands and in relatives was found at the NIMH site (OR, 2.6; 95% CI, 1.5-4.7), at the Lausanne site (OR, 3.1; 95% CI, 1.6-6.0), and in the combined data (OR, 2.9; 95% CI, 1.9-4.5). All mood disorder subtypes and substance use disorders were statistically significantly associated with suicide attempts. The familial association between lifetime suicide attempts in probands and relatives was not statistically significant for the combined sample (OR, 1.6; 95% CI, 1.0-2.7) after adjustment for comorbid conditions in probands and relatives. Social anxiety disorder in probands was associated with suicide attempts in relatives (OR, 2.4; 95% CI, 1.7-3.5) after controlling for comorbid mood, anxiety, and substance use disorders. CONCLUSIONS AND RELEVANCE Familiality of suicide attempts appears to be explained by a history of mental disorders among those with suicide attempts; the novel finding of a common familial diathesis for suicide attempts and social anxiety, particularly in combination with mood disorders, has heuristic value for future research and may be a risk marker that can inform prevention efforts.
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Affiliation(s)
- Elizabeth D. Ballard
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Carlos A. Zarate
- Experimental Therapeutics & Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
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Ajdacic-Gross V, Mutsch M, Rodgers S, Tesic A, Müller M, Seifritz E, Wagner EYN, von Känel R, Landolt MA, Steinemann N, von Wyl V, Castelao E, Strippoli MPF, Glaus J, Vandeleur C, Marques-Vidal PM, Vollenweider P, Preisig M. A step beyond the hygiene hypothesis-immune-mediated classes determined in a population-based study. BMC Med 2019; 17:75. [PMID: 30961604 PMCID: PMC6454751 DOI: 10.1186/s12916-019-1311-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/26/2018] [Accepted: 03/25/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Comorbidity patterns of childhood infections, atopic diseases, and adverse childhood experiences (ACE) are related to immune system programming conditions. The aim of this study was to make a step beyond the hygiene hypothesis and to comprehensively classify these patterns with latent class analysis (LCA). A second aim was to characterize the classes by associations with immunological, clinical, and sociodemographic variables. METHODS LCA was applied to data from the CoLaus|PsyCoLaus study (N = 4874, age range 35-82 years) separately for men and women. It was based on survey information on chickenpox, measles, mumps, rubella, herpes simplex, pertussis, scarlet fever, hay fever, asthma, eczema, urticaria, drug allergy, interparental violence, parental maltreatment, and trauma in early childhood. Subsequently, we examined how immune-mediated classes were reflected in leukocyte counts, inflammatory markers (IL-1β, IL-6, TNF-α, hsCRP), chronic inflammatory diseases, and mental disorders, and how they differed across social classes and birth cohorts. RESULTS LCA results with five classes were selected for further analysis. Latent classes were similar in both sexes and were labeled according to their associations as neutral, resilient, atopic, mixed (comprising infectious and atopic diseases), and ACE class. They came across with specific differences in biomarker levels. Mental disorders typically displayed increased lifetime prevalence rates in the atopic, the mixed, and the ACE classes, and decreased rates in the resilient class. The same patterns were apparent in chronic inflammatory diseases, except that the ACE class was relevant specifically in women but not in men. CONCLUSIONS This is the first study to systematically determine immune-mediated classes that evolve early in life. They display characteristic associations with biomarker levels and somatic and psychiatric diseases occurring later in life. Moreover, they show different distributions across social classes and allow to better understand the mechanisms beyond the changes in the prevalence of chronic somatic and psychiatric diseases.
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Affiliation(s)
- Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 2019, CH-8021, Zurich, Switzerland.
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
| | - Margot Mutsch
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 2019, CH-8021, Zurich, Switzerland
| | - Anja Tesic
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 2019, CH-8021, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 2019, CH-8021, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 2019, CH-8021, Zurich, Switzerland
| | - En-Young N Wagner
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital, Zurich, Switzerland
| | - Markus A Landolt
- University Children's Hospital Zurich and Children's Research Center, Zurich, Switzerland
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Nina Steinemann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
| | - Jennifer Glaus
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Caroline Vandeleur
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
| | | | | | - Martin Preisig
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
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Wagner EYN, Ajdacic-Gross V, Strippoli MPF, Gholam-Rezaee M, Glaus J, Vandeleur C, Castelao E, Vollenweider P, Preisig M, von Känel R. Associations of Personality Traits With Chronic Low-Grade Inflammation in a Swiss Community Sample. Front Psychiatry 2019; 10:819. [PMID: 31798472 PMCID: PMC6863063 DOI: 10.3389/fpsyt.2019.00819] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 10/17/2019] [Indexed: 12/15/2022] Open
Abstract
Objective: Among the major dimensions of personality, high Neuroticism and low Conscientiousness have frequently been linked to worse health-related behaviors and poor health outcomes. However, studies on the association between personality traits and biomarkers of chronic low-grade inflammation reflecting increased morbidity and mortality risk are sparse; therefore, the aim of this study was to explore this association. Methods: A population-based Swiss sample of 2,182 persons (40-82 years, 42% men) completed a comprehensive personality questionnaire (NEO Five-Factor Inventory-Revised). Circulating levels of inflammatory markers, including C-reactive protein, interleukin (IL)-1β, IL-6, tumor necrosis factor-α, and levels of the "cardioprotective" adipo(cyto)kine adiponectin were also determined. Analyses controlled for sociodemographic factors, traditional cardiovascular risk factors and lifetime psychiatric disorders using a validated semi-structured psychiatric interview. The role of gender as a moderator of the personality-inflammation link was additionally explored. Results: Controlling for all covariates, higher Extraversion (β = 0.092, 95%CI 0.004-0.180) was positively associated with higher IL-6 levels, and higher Conscientiousness (β = -0.095, 95%CI -0.180-[-0.009]) were significantly associated with lower IL-6 levels (all p-values < 0.05). Neuroticism and Agreeableness showed no significant association with any inflammatory biomarker. The associations between personality traits and inflammatory markers were not moderated by gender. Conclusions: Conscientiousness seems to be inversely related to chronic low-grade inflammation as measured by IL-6 levels, compatible with protection from the cardiovascular risk. The opposite may apply to Extraversion. Further research is needed to better understand the underlying mechanisms and their impact for health outcomes in the community.
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Affiliation(s)
- En-Young N Wagner
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland.,Department of BioMedical Research, Bern University Hospital, Bern, Switzerland
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mehdi Gholam-Rezaee
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jennifer Glaus
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Caroline Vandeleur
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
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Ajdacic-Gross V, Bechtiger L, Rodgers S, Müller M, Kawohl W, von Känel R, Mutsch M, Rössler W, Seifritz E, Castelao E, Strippoli MPF, Vandeleur C, Preisig M, Howell P. Subtypes of stuttering determined by latent class analysis in two Swiss epidemiological surveys. PLoS One 2018; 13:e0198450. [PMID: 30086147 PMCID: PMC6080750 DOI: 10.1371/journal.pone.0198450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 05/18/2018] [Indexed: 02/03/2023] Open
Abstract
Aims Associations between stuttering in childhood and a broad spectrum of risk factors, associated factors and comorbidities were examined in two large epidemiological studies. Subtypes of stuttering were then identified based on latent class analysis (LCA). Methods Data were from two representative Swiss population samples: PsyCoLaus (N = 4,874, age 35–82 years) and the ZInEP Epidemiology Survey (N = 1,500, age 20–41 years). Associations between stuttering and sociodemographic characteristics, familial aggregation, comorbidity and psychosocial risk / associated factors were investigated in both samples. LCAs were conducted on selected items from people in both samples who reported having stuttered in childhood. Results Initial analyses linked early anxiety disorders, such as separation anxiety disorder and overanxious disorder, to stuttering (PsyCoLaus). ADHD was associated with stuttering in both datasets. In the analyses of risk / associated factors, dysfunctional parental relationships, inter-parental violence and further childhood adversities were mutual predictors of stuttering. Moreover, comorbidities were seen with hay fever, asthma, eczema and psoriasis (PsyCoLaus). Subsequent LCA identified an unspecific group of persons who self-reported that they stuttered and a group defined by associations with psychosocial adversities (ZINEP, PsyCoLaus) and atopic diseases (PsyCoLaus). Conclusions The two subtypes of developmental stuttering have different risk / associated factors and comorbidity patterns. Most of the factors are associated with vulnerability mechanisms that occur early in life and that have also been linked with other neurodevelopmental disorders. Both psychosocial and biological factors appear to be involved in the etiopathogenesis of stuttering.
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Affiliation(s)
- Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- * E-mail: (VA); (PH)
| | - Laura Bechtiger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
| | - Wolfram Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Margot Mutsch
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
- Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
- Institute of Psychiatry, Laboratory of Neuroscience (LIM27), University of Sao Paulo, Sao Paulo, Brazil
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | | | - Caroline Vandeleur
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Peter Howell
- Department of Experimental Psychology, University College, London, United Kingdom
- * E-mail: (VA); (PH)
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Müller M, Ajdacic-Gross V, Rodgers S, Kleim B, Seifritz E, Vetter S, Egger ST, Rössler W, Castelao E, Preisig M, Vandeleur C. Predictors of remission from PTSD symptoms after sexual and non-sexual trauma in the community: A mediated survival-analytic approach. Psychiatry Res 2018; 260:262-271. [PMID: 29220684 DOI: 10.1016/j.psychres.2017.11.068] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 11/17/2016] [Revised: 10/31/2017] [Accepted: 11/25/2017] [Indexed: 01/07/2023]
Abstract
Epidemiological data on the chronicity of posttraumatic stress disorder (PTSD) symptoms in relation to trauma type and underlying pathways are rare. The current study explored how PTSD symptoms change over time across different trauma types and examined mediators of their persistence. A trauma-exposed community sample, whereof approximately one quarter met diagnostic criteria for PTSD, provided retrospective data on the duration of PTSD symptoms. Those who remitted and those who had not at the time of assessment were compared regarding worst trauma, symptom severity, comorbidity, demographic and treatment-seeking variables. Time to remission was estimated using Cox proportional hazard models including candidate predictors of remission. A mediated survival analysis was used to explore indirect pathways that explain trauma-specific differences in remission times. Both the full sample and PTSD subgroup were analyzed separately. Overall, lower socio-economic status, lifetime and childhood sexual trauma, symptom severity, comorbid depression and past treatment were associated with non- and longer remissions. PTSD avoidance symptoms and comorbid depression were found to mediate longer remission times after lifetime or childhood sexual trauma. Our findings provide insight into the mechanisms and complicating factors of remission from PTSD symptoms after trauma, which might have important implications for therapeutic interventions.
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Affiliation(s)
- Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Centre for Disaster and Military Psychiatry, University of Zurich, Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland.
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
| | - Birgit Kleim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Centre for Disaster and Military Psychiatry, University of Zurich, Zurich, Switzerland
| | - Stephan T Egger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Wulf Rössler
- Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil; Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - University Medicine Berlin, Germany
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Duffy A, Vandeleur C, Heffer N, Preisig M. The clinical trajectory of emerging bipolar disorder among the high-risk offspring of bipolar parents: current understanding and future considerations. Int J Bipolar Disord 2017; 5:37. [PMID: 29164495 PMCID: PMC5698240 DOI: 10.1186/s40345-017-0106-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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] [Received: 08/23/2017] [Accepted: 09/25/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Relatively little is known about the onset of bipolar disorder, yet the early illness course is already associated with significant morbidity and mortality. Therefore, characterizing the bipolar illness trajectory is key to risk prediction and early intervention advancement. MAIN BODY In this narrative review, we discuss key findings from prospective longitudinal studies of the high-risk offspring of bipolar parents and related meta-analyses that inform us about the clinical trajectory of emerging bipolar disorder. Challenges such as phenotypic and etiologic heterogeneity and the non-specificity of early symptoms and syndromes are highlighted. Implications of the findings for both research and clinical practice are discussed. CONCLUSION Bipolar disorder in young people at familial risk does not typically onset with a hypomanic or manic episode. Rather the first activated episode is often preceded by years of impairing psychopathological states that vary over development and across emerging bipolar subtype. Taking heterogeneity into account and adopting a more comprehensive approach to diagnosis seems necessary to advance earlier identification and our understanding of the onset of bipolar disorder.
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Affiliation(s)
- A Duffy
- Student Wellness Centre, Department of Psychiatry, Queen's University, 146 Stuart Street, Kingston, ON, K7L3N6, Canada.
| | - C Vandeleur
- Department of Psychiatry Lausanne, University Hospital of Lausanne, Lausanne, Switzerland
| | - N Heffer
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - M Preisig
- Department of Psychiatry Lausanne, University Hospital of Lausanne, Lausanne, Switzerland
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12
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Antoniades A, Aristodimou A, Georgousopoulos C, Forgó N, Gledson A, Hasapis P, Vandeleur C, Perakis K, Sahay R, Mehdi M, Demetriou CA, Strippoli MPF, Giotaki V, Ioannidi M, Tian D, Tozzi F, Keane J, Pattichis C. Advancing clinical research by semantically interconnecting aggregated medical data information in a secure context. Health Technol 2017. [DOI: 10.1007/s12553-017-0188-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ajdacic-Gross V, Aleksandrowicz A, Rodgers S, Mutsch M, Tesic A, Müller M, Kawohl W, Rössler W, Seifritz E, Castelao E, Strippoli MPF, Vandeleur C, von Känel R, Paolicelli R, Landolt MA, Witthauer C, Lieb R, Preisig M. Infectious, atopic and inflammatory diseases, childhood adversities and familial aggregation are independently associated with the risk for mental disorders: Results from a large Swiss epidemiological study. World J Psychiatry 2016; 6:419-430. [PMID: 28078206 PMCID: PMC5183994 DOI: 10.5498/wjp.v6.i4.419] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/08/2016] [Accepted: 10/09/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To examine the associations between mental disorders and infectious, atopic, inflammatory diseases while adjusting for other risk factors.
METHODS We used data from PsyCoLaus, a large Swiss Population Cohort Study (n = 3720; age range 35-66). Lifetime diagnoses of mental disorders were grouped into the following categories: Neurodevelopmental, anxiety (early and late onset), mood and substance disorders. They were regressed on infectious, atopic and other inflammatory diseases adjusting for sex, educational level, familial aggregation, childhood adversities and traumatic experiences in childhood. A multivariate logistic regression was applied to each group of disorders. In a complementary analysis interactions with sex were introduced via nested effects.
RESULTS Associations with infectious, atopic and other chronic inflammatory diseases were observable together with consistent effects of childhood adversities and familial aggregation, and less consistent effects of trauma in each group of mental disorders. Streptococcal infections were associated with neurodevelopmental disorders (men), and measles/mumps/rubella-infections with early and late anxiety disorders (women). Gastric inflammatory diseases took effect in mood disorders (both sexes) and in early disorders (men). Similarly, irritable bowel syndrome was prominent in a sex-specific way in mood disorders in women, and, moreover, was associated with early and late anxiety disorders. Atopic diseases were associated with late anxiety disorders. Acne (associations with mood disorders in men) and psoriasis (associations with early anxiety disorders in men and mood disorders in women) contributed sex-specific results. Urinary tract infections were associated with mood disorders and, in addition, in a sex-specific way with late anxiety disorders (men), and neurodevelopmental and early anxiety disorders (women).
CONCLUSION Infectious, atopic and inflammatory diseases are important risk factors for all groups of mental disorders. The sexual dimorphism of the associations is pronounced.
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Egger ST, Vetter S, Weniger G, Vandeleur C, Seifritz E, Müller M. The Use of the Health of the Nation Outcome Scales for Assessing Functional Change in Treatment Outcome Monitoring of Patients with Chronic Schizophrenia. Front Public Health 2016; 4:220. [PMID: 27790607 PMCID: PMC5062760 DOI: 10.3389/fpubh.2016.00220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/30/2016] [Accepted: 09/23/2016] [Indexed: 11/13/2022] Open
Abstract
Background Schizophrenia is a severe mental disorder that is characterized not only by symptomatic severity but also by high levels of functional impairment. An evaluation of clinical outcome in treatment of schizophrenia should therefore target not only assessing symptom change but also alterations in functioning. This study aimed to investigate whether there is an agreement between functional- and symptom-based outcomes in a clinical sample of admissions with chronic forms of schizophrenia. Methods A full 3-year cohort of consecutive inpatient admissions for schizophrenia (N = 205) was clinically rated with the Positive and Negative Symptom Scale (PANSS) and the Health of the Nation Outcome Scales (HoNOS) as measures of functioning at the time of admission and discharge. The sample was stratified twofold: first, according to the degree of PANSS symptom improvement during treatment with the sample being divided into three treatment response groups: non-response, low response, and high response. Second, achievement of remission was defined using the Remission in Schizophrenia Working Group criteria based on selected PANSS symptoms. Repeated measures analyses were used to compare the change of HoNOS scores over time across groups. Results More than a half of all admissions achieved a symptom reduction of at least 20% during treatment and around one quarter achieved remission at discharge. Similarly, HoNOS scores improved significantly between admission and discharge. Interaction analyses indicated higher functional improvements to be associated with increasing levels of treatment response. Conclusion Functional improvement in individuals treated for schizophrenia was linked to a better clinical outcome, which implies a functional association. Thus, improvement of functioning represents an important therapeutic target in the treatment of schizophrenia.
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Affiliation(s)
- Stephan T Egger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry , Zurich , Switzerland
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry , Zurich , Switzerland
| | - Godehard Weniger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry , Zurich , Switzerland
| | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Lausanne , Lausanne , Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry , Zurich , Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry , Zurich , Switzerland
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Müller M, Vandeleur C, Weniger G, Prinz S, Vetter S, Egger ST. The performance of the Health of the Nation Outcome Scales as measures of clinical severity. Psychiatry Res 2016; 239:20-7. [PMID: 27137958 DOI: 10.1016/j.psychres.2016.02.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 02/04/2015] [Revised: 02/12/2016] [Accepted: 02/27/2016] [Indexed: 11/26/2022]
Abstract
The aim of this study was to examine the performance of the Health of the Nation Outcome Scales (HoNOS) against other measures of functioning and mental health in a full three-year cohort of admissions to a psychiatric hospital. A sample of N=1719 patients (35.3% females, aged 17-78 years) was assessed using observer-rated measures and self-reports of psychopathology at admission. Self-reports were available from 51.7% of the sample (34.4% females, aged 17-76 years). Functioning and psychopathology were compared across five ICD-10 diagnostic groups: substance use disorders, schizophrenia and psychotic disorders, affective disorders, anxiety/somatoform disorders and personality disorders. Associations between the measures were examined, stratifying by diagnostic subgroup. The HoNOS were strongly linked to other measures primarily in psychotic disorders (except for the behavioral subscale), while those with substance use disorders showed rather poor links. Those with anxiety/somatoform disorders showed null or only small associations. This study raises questions about the overall validity of the HoNOS. It seems to entail different levels of validity when applied to different diagnostic groups. In clinical practice the HoNOS should not be used as a stand-alone instrument to assess outcome but rather as part of a more comprehensive battery including diagnosis-specific measures.
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Affiliation(s)
- Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland.
| | | | - Godehard Weniger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Susanne Prinz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Stefan Vetter
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Stephan T Egger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
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Ajdacic-Gross V, Aleksandrowicz A, Rodgers S, Müller M, Kawohl W, Rössler W, Castelao E, Vandeleur C, von Känel R, Mutsch M, Lieb R, Preisig M. Social Phobia Is Associated with Delayed Onset of Chickenpox, Measles, and Mumps Infections. Front Psychiatry 2016; 7:203. [PMID: 28082921 PMCID: PMC5186793 DOI: 10.3389/fpsyt.2016.00203] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/08/2016] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE Evidence showing that infectious diseases in childhood play an important role in the etiopathogenesis of neurodevelopmental and other mental disorders is growing. The aim of this study was to explore the timing of common childhood diseases in early-onset anxiety disorders. MATERIALS AND METHODS We analyzed data from PsyCoLaus, a large Swiss Population Cohort Study (N = 3720). In this study, we regressed overanxious disorder, separation anxiety disorder, social phobia, and specific phobias on the age of onset of several childhood diseases, always adjusting for the other anxiety disorders listed above and for sex. RESULTS The timing of viral childhood diseases (chickenpox, measles, and mumps) was consistently delayed in social phobia, notably both in men and women. We found no evidence for a reversed sequence of onset of phobia symptoms before that of the infections included. CONCLUSION Social phobia was the only early anxiety disorder to show an association with a delayed onset of common viral childhood diseases.
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Affiliation(s)
- Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland; Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Aleksandra Aleksandrowicz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich , Zürich , Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich , Zürich , Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich , Zürich , Switzerland
| | - Wolfram Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich , Zürich , Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland; Collegium Helveticum, Swiss Federal Institute of Technology, University of Zürich, Zürich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM27), University of Sao Paulo, Sao Paulo, Brazil
| | - Enrique Castelao
- Department of Psychiatry, University Hospital of Lausanne , Lausanne , Switzerland
| | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Lausanne , Lausanne , Switzerland
| | - Roland von Känel
- Department of Neurology, Bern University Hospital, Clinic Barmelweid , Barmelweid , Switzerland
| | - Margot Mutsch
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich , Zürich , Switzerland
| | - Roselind Lieb
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel , Basel , Switzerland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne , Lausanne , Switzerland
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Müller M, Rodgers S, Rössler W, Castelao E, Preisig M, Ajdacic-Gross V, Vandeleur C. Discrepancies between clinical needs and helpseeking behaviors in co-occurring posttraumatic stress and alcohol use disorders. Compr Psychiatry 2015; 62:209-17. [PMID: 26343486 DOI: 10.1016/j.comppsych.2015.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 06/25/2015] [Accepted: 07/22/2015] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of the study was to compare subjects dually diagnosed with posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) to those with only one or none of these conditions regarding helpseeking needs and behaviors. METHOD Data from a large community sample (N=3694) were used to assess the associations among lifetime PTSD and AUD, other psychiatric disorders, clinical characteristics and lifetime helpseeking behaviors derived from a semi-structured interview. RESULTS Comorbid individuals had more severe clinical profiles and were more impaired than individuals with either PTSD or AUD alone or those with no/other psychiatric conditions. However, they did not differ in overall helpseeking behavior from any other group. Those with comorbid PTSD/AUD were even less likely than the other groups to seek help for depression and anxiety disorders through specific treatment facilities or the use of prescribed psychotropic drugs. CONCLUSIONS Despite a greater need for treatment the comorbid group did not seek more help than the others. Their lower use of prescribed drugs supports the self-medication hypothesis, suggesting that those individuals relieve their symptoms through higher alcohol use instead. Our findings underline the need for health care facilities to encourage helpseeking behavior in the aftermath of stressful life events.
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Affiliation(s)
- Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland.
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland; Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil
| | - Enrique Castelao
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
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Müller M, Vandeleur C, Rodgers S, Rössler W, Castelao E, Preisig M, Ajdacic-Gross V. Childhood adversities as specific contributors to the co-occurrence of posttraumatic stress and alcohol use disorders. Psychiatry Res 2015; 228:251-6. [PMID: 26163721 DOI: 10.1016/j.psychres.2015.06.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 06/12/2014] [Revised: 06/11/2015] [Accepted: 06/16/2015] [Indexed: 11/18/2022]
Abstract
There is much evidence that alcohol use disorders (AUD) often co-occur with posttraumatic stress disorders (PTSD), and that the comorbid condition is associated with a more severe clinical profile than that of PTSD without AUD. However, little is known about the role of childhood adversities as specific risk factors for the development of AUD in individuals presenting with PTSD. The aim of the study was to explore whether specific stressors from the spectrum of trauma and childhood adversities contribute to the development of AUD among subjects with PTSD. From a large community sample, of N=140 individuals with PTSD, N=24 (17.14%) received an additional diagnosis of AUD with an onset after the onset of PTSD. Those with comorbid PTSD/AUD and those with PTSD only were compared regarding type and features of their trauma, childhood adversities and psychiatric comorbidity. Compared to PTSD alone, PTSD/AUD was associated with higher levels of stress in terms of childhood adversities; in particular, sexual abuse below the age of 16, but also with having been brought up in a foster home. PTSD/AUD was also associated with an earlier age of adverse events. Treatment of AUD should include standardized assessments of trauma, especially of trauma experienced during childhood.
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Affiliation(s)
- Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland.
| | | | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland
| | - Wulf Rössler
- Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland
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Müller M, Vandeleur C, Rodgers S, Rössler W, Castelao E, Preisig M, Ajdacic-Gross V. Posttraumatic stress avoidance symptoms as mediators in the development of alcohol use disorders after exposure to childhood sexual abuse in a Swiss community sample. Child Abuse Negl 2015; 46:8-15. [PMID: 25828861 DOI: 10.1016/j.chiabu.2015.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 03/03/2015] [Accepted: 03/11/2015] [Indexed: 06/04/2023]
Abstract
This study examined the role of posttraumatic stress disorder (PTSD) symptoms of re-experience, avoidance, and hyperarousal in the relationship between different types of trauma and alcohol use disorders (AUD). We used data from 731 trauma-exposed individuals who participated in the first wave of the PsyCoLaus-study. Trauma characteristics were assessed relatively to the occurrence of lifetime PTSD symptoms and AUD. The results suggest that lifetime and childhood sexual abuse as well as overall childhood trauma were directly linked to AUD and PTSD symptoms, in particular to avoidance symptoms. From single symptom clusters PTSD avoidance was found to specifically mediate the trauma-AUD pathway. Both childhood and sexual trauma strongly contribute to the comorbidity of PTSD and AUD and avoidance-type symptoms appear to play a central role in maintaining this association. Hence, the alleviation of avoidance symptoms might be an important target for therapeutic intervention among victims of sexual abuse before specific addiction treatment is initiated.
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Affiliation(s)
- Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Militärstrasse 8, 8021 Zurich, Switzerland
| | - Caroline Vandeleur
- Department of Psychiatry, CHUV, Site de Cery, 1008 Prilly, Lausanne, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Militärstrasse 8, 8021 Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Militärstrasse 8, 8021 Zurich, Switzerland; Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Schmelzbergstrasse 25, 8092 Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Medical School, 05403-010 Sao Paulo, SP, Brazil
| | - Enrique Castelao
- Department of Psychiatry, CHUV, Site de Cery, 1008 Prilly, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, CHUV, Site de Cery, 1008 Prilly, Lausanne, Switzerland
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Militärstrasse 8, 8021 Zurich, Switzerland
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Fassassi S, Vandeleur C, Aubry JM, Castelao E, Preisig M. Prevalence and correlates of DSM-5 bipolar and related disorders and hyperthymic personality in the community. J Affect Disord 2015; 167:198-205. [PMID: 24995887 DOI: 10.1016/j.jad.2014.06.004] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 06/02/2014] [Accepted: 06/04/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND To 1) establish the lifetime and 12-month prevalence of DSM-5 bipolar and related disorders including the new algorithmically defined conditions grouped within Other Specified Bipolar and Related Disorders (OSBARD) as well as hyperthymic personality in a randomly selected community sample, and 2) determine the clinical relevance of the OSBARD category in terms of sociodemographic characteristics, course, comorbidity and treatment patterns by comparing the subjects of this category to those with bipolar-I (BP-I), bipolar-II (BP-II), major depressive disorder (MDD), and those with no history of mood disorders. METHODS The semi-structured Diagnostic Interview for Genetic Studies was administered by masterslevel psychologists to a random sample of an urban area (n=3'719). RESULTS The lifetime prevalence was 1.0% for BP-I, 0.8% for BP-II, 1.0% for OSBARD and 3% for hyperthymic personality. Subjects with OSBARD were more severely affected than subjects without a history of mood disorders regarding almost all clinical correlates. Compared to those with MDD, they also revealed an elevated risk of suicidal attempts, lower global functioning, more treatment seeking and more lifetime comorbidity including anxiety, substance use and impulse-control disorders. However, they did not differ from subjects with BP-II. LIMITATIONS Small sample sizes for bipolar and related disorders and potential inaccurate recall of symptoms. CONCLUSIONS The modifications of diagnostic criteria for manic/hypomanic episodes according to the DSM-5 only marginally affect the prevalence estimates for BP-I and BP-II. The new DSM-5 OSBARD category is associated with significant clinical burden, is hardly distinct from BP-II with respect to clinical correlates and deserves similar clinical attention.
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Affiliation(s)
| | | | - Jean-Michel Aubry
- Department of Mental Health and Psychiatry, Geneva University, Switzerland
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21
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Fossion P, Leys C, Vandeleur C, Kempenaers C, Braun S, Verbanck P, Linkowski P. Transgenerational transmission of trauma in families of Holocaust survivors: the consequences of extreme family functioning on resilience, sense of coherence, anxiety and depression. J Affect Disord 2015; 171:48-53. [PMID: 25285898 DOI: 10.1016/j.jad.2014.08.054] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 02/23/2014] [Revised: 06/20/2014] [Accepted: 08/31/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND The psychological transmission of the noxious effects of a major trauma from one generation to the next remains unclear. The present study aims to identify possible mechanisms explaining this transmission among families of Holocaust Survivors (HS). We hypothesized that the high level of depressive and anxiety disorders (DAD) among HS impairs family systems, which results in damaging coping strategies of their children (CHS) yielding a higher level of DAD. METHODS 49 CHS completed the Resilience Scale for Adults, the Hopkins Symptom Check List-25, the 13-Item Sense of Coherence (SOC) scale, and the Family Adaptability and Cohesion Scale. We test a mediation model with Family types as the predictor; coping strategies (i.e. Resilience or SOC) as the mediator; and DAD as the outcome variable. RESULTS Results confirm that the CHS׳ family types are more often damaged than in general population. Moreover, growing in a damaged family seems to impede development of coping strategies and, therefore, enhances the occurrence of DAD. LIMITATIONS The present investigation is correlational and should be confirmed by other prospective investigations. CONCLUSIONS At a theoretical level we propose a mechanism of transmission of the noxious effects of a major trauma from one generation to the next through family structure and coping strategies. At a clinical level, our results suggest to investigate the occurrence of trauma among parents of patients consulting for DAD and to reinforce their coping strategies.
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Affiliation(s)
- Pierre Fossion
- Brugmann University Hospital, Université Libre de Bruxelles, Belgium
| | - Christophe Leys
- Faculty of Psychology, Université Libre de Bruxelles, Belgium.
| | | | | | - Stéphanie Braun
- Erasme University Hospital, Université Libre de Bruxelles, Belgium
| | - Paul Verbanck
- Brugmann University Hospital, Université Libre de Bruxelles, Belgium
| | - Paul Linkowski
- Erasme University Hospital, Université Libre de Bruxelles, Belgium
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22
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Müller M, Vandeleur C, Rodgers S, Rössler W, Castelao E, Preisig M, Ajdacic-Gross V. Factors associated with comorbidity patterns in full and partial PTSD: findings from the PsyCoLaus study. Compr Psychiatry 2014; 55:837-48. [PMID: 24560408 DOI: 10.1016/j.comppsych.2014.01.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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] [Received: 10/28/2013] [Revised: 01/03/2014] [Accepted: 01/13/2014] [Indexed: 12/21/2022] Open
Abstract
Subtypes of comorbid conditions and their associated trauma and clinical characteristics in full and partial PTSD were examined. Data from 289 subjects from the general population that met criteria for full or partial PTSD were analyzed. Latent class analyses (LCA) were performed to derive homogeneous patterns of DSM-IV Axis-I disorders and anti-social personality comorbid to PTSD. Logistic regression models were conducted to characterize these classes by trauma-related and clinical features. The LCA revealed three classes: (1) low comorbidity; (2) high comorbidity with primarily substance-related disorders and a higher proportion of males; and (3) more severe PTSD-symptomatology and higher comorbid anxiety disorders and depression, almost entirely represented by females. Exposure to sexual abuse was more likely in the substance-dependent class and contributed strongly to the distinction between classes. Affective disorders tended to precede the onset of PTSD in the substance-dependent class, whereas phobias were more likely to follow PTSD in the depressed-anxious class. Posttrauma onset of alcohol use disorders in the substance dependent class confirmed the self-medication hypothesis. The three classes of comorbidity and their sequence of onset with PTSD suggest different mechanisms involved in their development. Our findings suggest that PTSD-related comorbidity subtypes also apply to individuals with partial PTSD.
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Affiliation(s)
- Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland.
| | | | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland; Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland; Institute of Psychiatry, University of Sao Paulo, Brasil
| | | | | | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Switzerland
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23
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Glaus J, Vandeleur C, Gholam-Rezaee M, Castelao E, Perrin M, Rothen S, Bovet P, Marques-Vidal P, von Känel R, Merikangas K, Mooser V, Waterworth DM, Waeber G, Vollenweider P, Preisig M. Atypical depression and alcohol misuse are related to the cardiovascular risk in the general population. Acta Psychiatr Scand 2013; 128:282-93. [PMID: 23216242 DOI: 10.1111/acps.12057] [Citation(s) in RCA: 16] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2012] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aims of the present study were to assess the associations between mood, anxiety and substance use disorders, including their subtypes, and the prevalence of cardiovascular risk factors (CVRFs). METHOD Thorough physical investigations, biological measures and standardized interview techniques were used to assess 3716 subjects of an urban area, aged 35-66 years. RESULTS Atypical depression was associated with increased prevalence of overweight, diabetes and the metabolic syndrome (OR = 1.5, 95% C.I. 1.1-2.0; OR = 2.0, 95% C.I. 1.1-3.5, OR = 1.6, 95% C.I. 1.0-2.4 respectively), whereas decreased prevalence of overweight was found in melancholic (OR = 0.7, 95% C.I. 0.6-0.9) and unspecified depression (OR = 0.8, 95% C.I. 0.7-1.0). Alcohol abuse was associated with diabetes (OR = 1.8, 95% C.I. 1.1-2.9) and dyslipidemia (OR = 1.3, 95% C.I. 1.0-1.8), alcohol dependence with dyslipidemia only (OR = 1.4, 95% C.I. 1.0-2.0). Almost all mental disorders were associated with a lifetime history of regular cigarette smoking, and atypical depression, alcohol misuse and drug dependence were associated with inactivity. CONCLUSION To conclude results emphasize the need to subtype depression and to pay particular attention to the atypical subtype. Comorbid alcohol misuse may further increase the cardiovascular risk. Efforts to diminish smoking in subjects with mental disorders could be crucial measures to reduce their high incidence of cardiovascular disease.
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Affiliation(s)
- J Glaus
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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24
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Vandeleur C, Rothen S, Gholam-Rezaee M, Castelao E, Vidal S, Favre S, Ferrero F, Halfon O, Fumeaux P, Merikangas KR, Aubry JM, Burstein M, Preisig M. Mental disorders in offspring of parents with bipolar and major depressive disorders. Bipolar Disord 2012; 14:641-53. [PMID: 22938168 PMCID: PMC7041416 DOI: 10.1111/j.1399-5618.2012.01048.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [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] [Indexed: 01/19/2023]
Abstract
OBJECTIVES There is limited information on the specificity of associations between parental bipolar disorder (BPD) and major depressive disorder (MDD) and the risk of psychopathology in offspring. The chief aim of the present study was to investigate the association between mood disorder subtypes in the two parents and mental disorders in the offspring. METHODS A total of 376 offspring (aged 6.0-17.9 years; mean=11.5years) of 72 patients with BPD (139 offspring), 56 patients with MDD (110 offspring), and 66 controls (127 offspring) participated in a family study conducted in two university hospital centers in Switzerland. Probands, offspring, and biological co-parents were interviewed by psychologists blind to proband diagnoses, using a semi-structured diagnostic interview. RESULTS Rates of mood and anxiety disorders were elevated among offspring of BPD probands (34.5% any mood; 42.5% any anxiety) and MDD probands (25.5% any mood; 44.6% any anxiety) as compared to those of controls (12.6% any mood; 22.8% any anxiety). Moreover, recurrent MDD was more frequent among offspring of BPD probands (7.9%) than those of controls (1.6%). Parental concordance for bipolar spectrum disorders was associated with a further elevation in the rates of mood disorders in offspring (64.3% both parents versus 27.2% one parent). CONCLUSIONS These findings provide unique information on the broad manifestations of parental mood disorders in their offspring. The earlier onset and increased risk of recurrent MDD in the offspring of parents with BPD compared to those of controls suggests that the episodicity characterizing BPD may emerge in childhood and adolescence.
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Affiliation(s)
- Caroline Vandeleur
- Department of Mental Health and Psychiatry, University Hospital of Geneva.
| | - Stéphane Rothen
- Department of Mental Health and Psychiatry, University
Hospital of Geneva, Lausanne, Switzerland,Department of Psychiatry, University Hospital of Lausanne,
Lausanne, Switzerland
| | - Mehdi Gholam-Rezaee
- Department of Psychiatry, University Hospital of Lausanne,
Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, University Hospital of Lausanne,
Lausanne, Switzerland
| | - Sonia Vidal
- Department of Mental Health and Psychiatry, University
Hospital of Geneva, Lausanne, Switzerland,Department of Psychiatry, University Hospital of Lausanne,
Lausanne, Switzerland
| | - Sophie Favre
- Department of Mental Health and Psychiatry, University
Hospital of Geneva, Lausanne, Switzerland
| | - François Ferrero
- Department of Mental Health and Psychiatry, University
Hospital of Geneva, Lausanne, Switzerland
| | - Olivier Halfon
- Department of Psychiatry, University Hospital of Lausanne,
Lausanne, Switzerland
| | - Pierre Fumeaux
- Department of Psychiatry, University Hospital of Lausanne,
Lausanne, Switzerland
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research
Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Jean-Michel Aubry
- Department of Mental Health and Psychiatry, University
Hospital of Geneva, Lausanne, Switzerland
| | - Marcy Burstein
- Genetic Epidemiology Research Branch, Intramural Research
Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne,
Lausanne, Switzerland
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25
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Vidal S, Vandeleur C, Halfon O, Aubry JM, Martin P. P-106 - Risk of mental disorders in children of parents with alcohol or heroin dependence: a controlled high risk study. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)74273-6] [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: 11/17/2022] Open
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26
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Vidal SI, Vandeleur C, Rothen S, Gholam-Rezaee M, Castelao E, Halfon O, Aubry JM, Ferrero F, Preisig M. Risk of mental disorders in children of parents with alcohol or heroin dependence: a controlled high-risk study. Eur Addict Res 2012; 18:253-64. [PMID: 22688665 DOI: 10.1159/000337328] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [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: 10/31/2011] [Accepted: 02/16/2012] [Indexed: 11/19/2022]
Abstract
AIM To assess the specific effect of alcohol dependence (AD) or heroin dependence (HD) in patients and their spouses on the risk of psychopathology in their 276 6.0- to 17.9- year-old children (mean 11.3 years). METHODS The sample included 101 offspring of patients with AD, 23 of patients with HD, and 152 of medical controls, as well as their 2 parents. Participants were assessed using semistructured diagnostic interviews and family history reports by psychologists blind to patient diagnoses. RESULTS Children of HD and AD patients had largely elevated rates of recurrent major depressive disorder. Children of HD patients were also at an increased risk for attention deficit hyperactivity disorder and substance use disorders (SUD). There were interactions between SUD in the 2 parents to increase the risk of SUD in offspring. CONCLUSIONS These results emphasize the need for prompt identification and treatment of these children and highlight the need to pay clinical attention not only to the patient, but also to the co-parent in order to optimize prevention in offspring.
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Affiliation(s)
- Sonia I Vidal
- Department of Mental Health and Psychiatry, University Hospital of Geneva, Geneva, Switzerland.
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27
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Preisig M, Waeber G, Vollenweider P, Bovet P, Rothen S, Vandeleur C, Guex P, Middleton L, Waterworth D, Mooser V, Tozzi F, Muglia P. The PsyCoLaus study: methodology and characteristics of the sample of a population-based survey on psychiatric disorders and their association with genetic and cardiovascular risk factors. BMC Psychiatry 2009; 9:9. [PMID: 19292899 PMCID: PMC2667506 DOI: 10.1186/1471-244x-9-9] [Citation(s) in RCA: 154] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 03/17/2009] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Psychiatric arm of the population-based CoLaus study (PsyCoLaus) is designed to: 1) establish the prevalence of threshold and subthreshold psychiatric syndromes in the 35 to 66 year-old population of the city of Lausanne (Switzerland); 2) test the validity of postulated definitions for subthreshold mood and anxiety syndromes; 3) determine the associations between psychiatric disorders, personality traits and cardiovascular diseases (CVD), 4) identify genetic variants that can modify the risk for psychiatric disorders and determine whether genetic risk factors are shared between psychiatric disorders and CVD. This paper presents the method as well as sociodemographic and somatic characteristics of the sample. METHODS All 35 to 66 year-old persons previously selected for the population-based CoLaus survey on risk factors for CVD were asked to participate in a substudy assessing psychiatric conditions. This investigation included the Diagnostic Interview for Genetic Studies to elicit diagnostic criteria for threshold disorders according to DSM-IV and algorithmically defined subthreshold syndromes. Complementary information was collected on potential risk and protective factors for psychiatric disorders, migraine and on the morbidity of first-degree relatives, whereas the collection of DNA and plasma samples was already part of the original CoLaus survey. RESULTS A total of 3,691 individuals completed the psychiatric evaluation (67% participation). The gender distribution of the sample did not differ significantly from that of the general population in the same age range. Although the youngest 5-year band of the cohort was underrepresented and the oldest 5-year band overrepresented, participants of PsyCoLaus and individuals who refused to participate revealed comparable scores on the General Health Questionnaire, a self-rating instrument completed at the somatic exam. CONCLUSION Despite limitations resulting from the relatively low participation in the context of a comprehensive and time-consuming investigation, the PsyCoLaus study should significantly contribute to the current understanding of psychiatric disorders and comorbid somatic conditions by: 1) establishing the clinical relevance of specific psychiatric syndromes below the DSM-IV threshold; 2) determining comorbidity between risk factors for CVD and psychiatric disorders; 3) assessing genetic variants associated with common psychiatric disorders and 4) identifying DNA markers shared between CVD and psychiatric disorders.
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Affiliation(s)
| | - Gérard Waeber
- Department of Medicine, Internal Medicine, CHUV, Lausanne, Switzerland
| | | | - Pascal Bovet
- Department of Medicine, Internal Medicine, CHUV, Lausanne, Switzerland
| | | | - Caroline Vandeleur
- Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Patrice Guex
- Department of Psychiatry, CHUV, Lausanne, Switzerland
| | - Lefkos Middleton
- Division of Neurosciences and Mental Health, Imperial College, London, UK
| | - Dawn Waterworth
- Medical Genetics, GlaxoSmithKline, Philadelphia, Pennsylvania, USA
| | - Vincent Mooser
- Medical Genetics, GlaxoSmithKline, Philadelphia, Pennsylvania, USA
| | - Federica Tozzi
- Genetics Division, Drug Discovery, GlaxoSmithKline R&D, Verona, Italy
| | - Pierandrea Muglia
- Genetics Division, Drug Discovery, GlaxoSmithKline R&D, Verona, Italy
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