1
|
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.
Collapse
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
| |
Collapse
|
2
|
Takayanagi Y, Kulason S, Sasabayashi D, Takahashi T, Katagiri N, Sakuma A, Ohmuro N, Katsura M, Nishiyama S, Kido M, Furuichi A, Noguchi K, Matsumoto K, Mizuno M, Ratnanather JT, Suzuki M. Volume Reduction of the Dorsal Lateral Prefrontal Cortex Prior to the Onset of Frank Psychosis in Individuals with an At-Risk Mental State. Cereb Cortex 2021; 32:2245-2253. [PMID: 34649274 DOI: 10.1093/cercor/bhab353] [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: 04/13/2021] [Revised: 08/11/2021] [Accepted: 08/30/2021] [Indexed: 11/14/2022] Open
Abstract
Although some individuals with at-risk mental states (ARMS) develop overt psychosis, surrogate markers which can reliably predict a future onset of psychosis are not well established. The dorsal lateral prefrontal cortex (DLPFC) is thought to be involved in psychotic disorders such as schizophrenia. In this study, 73 ARMS patients and 74 healthy controls underwent 1.5-T 3D magnetic resonance imaging scans at three sites. Using labeled cortical distance mapping, cortical thickness, gray matter (GM) volume, and surface area of DLPFC were estimated. These measures were compared across the diagnostic groups. We also evaluated cognitive function among 36 ARMS subjects to clarify the relationships between the DLPFC morphology and cognitive performance. The GM volume of the right DLPFC was significantly reduced in ARMS subjects who later developed frank psychosis (ARMS-P) relative to those who did not (P = 0.042). There was a positive relationship between the right DLPFC volume and the duration prior to the onset of frank psychosis in ARMS-P subjects (r = 0.58, P = 0.018). Our data may suggest that GM reduction of the DLPFC might be a potential marker of future onset of psychosis in individuals with ARMS.
Collapse
Affiliation(s)
- Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama 9300194, Japan.,Arisawabashi Hospital, Toyama 9392704, Japan
| | - Sue Kulason
- Center for Imaging Science and Institute for Computational Medicine, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21211, USA
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama 9300194, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama 9300194, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama 9300194, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama 9300194, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo 1438541, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi 9808574, Japan
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi 9808574, Japan.,Osaki Citizen Hospital, Sendai, Miyagi 9896183, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi 9808574, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama 9300194, Japan.,Health Administration Center, University of Toyama, Toyama 9308555, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama 9300194, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama 9300194, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama 9300194, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama 9300194, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama 9300194, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi 9808574, Japan.,Kokoro no Clinic OASIS, Sendai, Miyagi 9800802, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo 1438541, Japan
| | - J Tilak Ratnanather
- Center for Imaging Science and Institute for Computational Medicine, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21211, USA
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama 9300194, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama 9300194, Japan
| |
Collapse
|
3
|
Sato Y, Sakuma A, Ohmuro N, Katsura M, Abe K, Tomimoto K, Iizuka K, Ito F, Tomita H, Matsumoto K. White matter volume not associated with hallucinations in clinical high risk and first-episode psychosis: A voxel-based morphometry study. Psychiatry Clin Neurosci 2021; 75:299-301. [PMID: 34191366 DOI: 10.1111/pcn.13284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 06/14/2021] [Accepted: 06/22/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Yutaro Sato
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Noriyuki Ohmuro
- Department of Psychiatry, Osaki Citizen Hospital, Osaki, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Koichi Abe
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Kazuho Tomimoto
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Kunio Iizuka
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Fumiaki Ito
- National Hospital Organization Hanamaki Hospital, Hanamaki, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Kokoro no Clinic OASIS, Sendai, Japan
| |
Collapse
|
4
|
Mitsunaga-Ohmuro N, Ohmuro N. Longitudinal changes in personal recovery in individuals with psychotic disorders through hospitalisation in a psychiatric ward: preliminary findings. BMC Psychiatry 2021; 21:340. [PMID: 34238286 PMCID: PMC8265086 DOI: 10.1186/s12888-021-03347-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 03/13/2021] [Accepted: 06/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed to investigate whether personal recovery indices in individuals with psychotic disorders would change through hospitalisation in a psychiatric ward and to identify factors associated with these changes. METHODS Participants underwent assessments for personal recovery using the Questionnaire about the Process of Recovery, Recovery Assessment Scale, and Self-Identified Stage of Recovery Part A and B; clinical symptoms using the Positive And Negative Syndrome Scale; self-efficacy using the General Self-Efficacy Scale; and self-esteem using the Rosenberg Self-Esteem Scale at baseline and before hospital discharge. Wilcoxon signed-rank tests were administered for longitudinal comparisons between baseline and follow-up. Spearman's rank correlation tests were conducted to assess correlations of longitudinal changes in personal recovery with baseline values of personal recovery as well as baseline values or changes in the Positive And Negative Syndrome Scale, General Self-Efficacy Scale, and Rosenberg Self-Esteem Scale. RESULTS Thirty-four individuals with psychotic disorders completed the assessments. The average duration of the current hospitalisation was 81.9 days (SD, 15.3; median, 85.0; range, 51-128 days). No significant changes were observed in personal recovery, self-efficacy, and self-esteem, although clinical symptoms significantly improved. Significant correlations were found between positive changes in the Recovery Assessment Scale and improvements in negative symptoms; between positive changes in the General Self-Efficacy Scale and those in personal recovery assessed with the Questionnaire about the Process of Recovery, Recovery Assessment Scale, and Self-Identified Stage of Recovery part A; and between positive changes in the Rosenberg Self-Esteem Scale and those in the Self-Identified Stage of Recovery part B. CONCLUSION This study revealed longitudinal relationships between changes in personal recovery and amelioration of negative symptoms or enhancement of self-efficacy and self-esteem through moderate length of hospitalisation in individuals with psychotic disorders. Considering the small sample size in this study, further studies with a larger sample size are needed to confirm the present finding. TRIAL REGISTRATION The protocol of this study is registered in the UMIN Clinical Trials Registry (UMIN-CTR; ID: UMIN000035131 ).
Collapse
Affiliation(s)
- Norika Mitsunaga-Ohmuro
- Department of Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Noriyuki Ohmuro
- grid.459827.50000 0004 0641 2751Department of Psychiatry, Osaki Citizen Hospital, Osaki, Miyagi Japan
| |
Collapse
|
5
|
Takayanagi Y, Kulason S, Sasabayashi D, Takahashi T, Katagiri N, Sakuma A, Ohmuro N, Katsura M, Nishiyama S, Nakamura M, Kido M, Furuichi A, Noguchi K, Matsumoto K, Mizuno M, Ratnanather JT, Suzuki M. Structural MRI Study of the Planum Temporale in Individuals With an At-Risk Mental State Using Labeled Cortical Distance Mapping. Front Psychiatry 2020; 11:593952. [PMID: 33329144 PMCID: PMC7732500 DOI: 10.3389/fpsyt.2020.593952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/12/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Recent studies have demonstrated brain structural changes that predate or accompany the onset of frank psychosis, such as schizophrenia, among individuals with an at-risk mental state (ARMS). The planum temporale (PT) is a brain region involved in language processing. In schizophrenia patients, gray matter volume reduction and lack of normal asymmetry (left > right) of PT have repeatedly been reported. Some studies showed progressive gray matter reduction of PT in first-episode schizophrenia patients, and in ARMS subjects during their development of psychosis. Methods: MRI scans (1.5 T field strength) were obtained from 73 ARMS subjects and 74 gender- and age-matched healthy controls at three sites (University of Toyama, Toho University and Tohoku University). Participants with ARMS were clinically monitored for at least 2 years to confirm whether they subsequently developed frank psychosis. Cortical thickness, gray matter volume, and surface area of PT were estimated using FreeSurfer-initiated labeled cortical distance mapping (FSLCDM). PT measures were compared among healthy controls, ARMS subjects who later developed overt psychosis (ARMS-P), and those who did not (ARMS-NP). In each statistical model, age, sex, intracranial volume, and scanning sites were treated as nuisance covariates. Results: Of 73 ARMS subjects, 18 developed overt psychosis (12 schizophrenia and 6 other psychoses) within the follow-up period. There were no significant group differences of PT measures. In addition, significant asymmetries of PT volume and surface area (left > right) were found in all diagnostic groups. PT measures did not correlate with the neurocognitive performance of ARMS subjects. Discussion: Our results suggest that the previously-reported gray matter reduction and lack of normal anatomical asymmetry of PT in schizophrenia patients may not emerge during the prodromal stage of psychosis; taken together with previous longitudinal findings, such PT structural changes may occur just before or during the onset of psychosis.
Collapse
Affiliation(s)
- Yoichiro Takayanagi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Arisawabashi Hospital, Toyama, Japan
| | - Sue Kulason
- Center for Imaging Science and Institute for Computational Medicine, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Osaki Citizen Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Health Administration Center, University of Toyama, Toyama, Japan
| | - Mihoko Nakamura
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Mikio Kido
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Atsushi Furuichi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Kyo Noguchi
- Department of Radiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Kokoro no Clinic OASIS, Sendai, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - J Tilak Ratnanather
- Center for Imaging Science and Institute for Computational Medicine, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.,Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| |
Collapse
|
6
|
Matsumoto K, Ohmuro N, Tsujino N, Nishiyama S, Abe K, Hamaie Y, Katsura M, Inoue N, Matsuoka H, Kawasaki Y, Kishimoto T, Suzuki M, Mizuno M. Open-label study of cognitive behavioural therapy for individuals with at-risk mental state: Feasibility in the Japanese clinical setting. Early Interv Psychiatry 2019; 13:137-141. [PMID: 29357194 DOI: 10.1111/eip.12541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/05/2017] [Revised: 11/13/2017] [Accepted: 12/17/2017] [Indexed: 11/29/2022]
Abstract
AIM To date, most cognitive behavioural therapy (CBT) trials for individuals with at-risk metal state (ARMS) have been conducted in few Western countries and its feasibility in other regions, including Japan, has not been established. METHODS We designed an open-label pilot study. Fourteen ARMS participants received CBT over 6 months and were followed-up for 6 months. RESULTS Thirteen individuals completed the CBT intervention and assessments. The mean total score on the Positive and Negative Syndrome Scale improved from 60.2 to 46.0 after the intervention (Cohen's d = 1.1). The effects were maintained at the follow-up assessment. One participant transitioned to psychosis after the CBT intervention, and was the only patient who received antipsychotics. CONCLUSIONS We confirmed the feasibility of the provision of CBT for ARMS in Japan. Since overprescription of antipsychotics is a matter of great concern in Japan, CBT could be a valuable alternative treatment strategy.
Collapse
Affiliation(s)
- Kazunori Matsumoto
- Department of Psychiatry, Tohoku University, Graduate School of Medicine, Sendai, Japan.,Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Department of Preventive Psychiatry, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University, School of Medicine, Tokyo, Japan
| | - Shimako Nishiyama
- Department of Neuropsychiatry, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Koichi Abe
- Department of Psychiatry, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Yumiko Hamaie
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Naomi Inoue
- Department of Neuropsychiatry, Toho University, School of Medicine, Tokyo, Japan
| | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University, Graduate School of Medicine, Sendai, Japan.,Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.,Department of Preventive Psychiatry, Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - Yasuhiro Kawasaki
- Department of Neuropsychiatry, Kanazawa Medical University, Uchinada, Japan
| | - Toshifumi Kishimoto
- Psychiatry and Behavioral Neuroscience, Nara Medical University, Kashihara, Japan
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University, School of Medicine, Tokyo, Japan
| |
Collapse
|
7
|
Sakuma A, Obara C, Katsura M, Ito F, Ohmuro N, Iizuka K, Kikuchi T, Miyakoshi T, Matsuoka H, Matsumoto K. No regional gray matter volume reduction observed in young Japanese people at ultra-high risk for psychosis: A voxel-based morphometry study. Asian J Psychiatr 2018; 37:167-171. [PMID: 30293050 DOI: 10.1016/j.ajp.2018.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 07/04/2018] [Revised: 08/28/2018] [Accepted: 09/26/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Structural brain magnetic resonance imaging studies of individuals at ultra-high risk (UHR) for psychosis have shown subtle but widespread reductions in baseline gray matter volume (GMV) in the frontal, temporal, and limbic regions compared with healthy controls (HC). These regions coincide with regions of reduced GMV in patients with established psychosis and have led to the consideration of structural changes in UHR as a potential biomarker for future transition to psychosis. However, most studies have been from Europe, North America, and Australia, with few reports from other regions, and two recent studies from Asian countries have failed to detect regional GMV reduction in UHR, suggesting the need for further analysis of an Asian sample. In this study, we investigated GMV reduction in Japanese UHR subjects. RESULTS The study used voxel-based morphometry to compare magnetic resonance imaging brain scans between 45 UHR individuals recruited by a specialist and 33 HCs. This showed no significant GMV reduction in the UHR group compared with the healthy control group. This negative result may be attributable to characteristics of Asian samples, such as a low prevalence of illicit drug use, or to the heterogeneous nature of UHR subjects.
Collapse
Affiliation(s)
- Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Chika Obara
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Psychiatry, Sendai City Hospital, 1-1 Asuto-nagamachi, Taihaku-ku, Sendai, Miyagi, 982-8502, Japan.
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Fumiaki Ito
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Kunio Iizuka
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Tatsuo Kikuchi
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Tetsuo Miyakoshi
- Sapporo Prison, 2-1-5-1 Higashi-naebo, Higashi-ku, Sapporo, 007-8601, Japan.
| | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan; Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| |
Collapse
|
8
|
Hamaie Y, Ohmuro N, Katsura M, Obara C, Kikuchi T, Ito F, Miyakoshi T, Matsuoka H, Matsumoto K. Correction: Criticism and Depression among the Caregivers of At-Risk Mental State and First-Episode Psychosis Patients. PLoS One 2016; 11:e0156590. [PMID: 27232502 PMCID: PMC4883782 DOI: 10.1371/journal.pone.0156590] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
9
|
Hamaie Y, Ohmuro N, Katsura M, Obara C, Kikuchi T, Ito F, Miyakoshi T, Matsuoka H, Matsumoto K. Criticism and Depression among the Caregivers of At-Risk Mental State and First-Episode Psychosis Patients. PLoS One 2016; 11:e0149875. [PMID: 26918629 PMCID: PMC4769225 DOI: 10.1371/journal.pone.0149875] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 09/18/2015] [Accepted: 02/06/2016] [Indexed: 11/30/2022] Open
Abstract
Expressed emotion (EE), especially criticism, is an important predictor of outcomes for the patient for a wide range of mental health problems. To understand complex links between EE and various relevant variables in early phase psychosis, this study examined criticism, distress of caregivers, other patients’, and caregivers’ variables, and links between criticism and these variables in those with at-risk mental state (ARMS) for psychosis and first-episode psychosis (FEP). The participants were 56 patients (mean age 18.8 ± 4.2 years) with ARMS and their caregivers (49.4 ± 5.8 years) and 43 patients (21.7 ± 5.2 years) with FEP and their caregivers (49.3 ± 7.4 years). We investigated criticisms made by caregivers using the Japanese version of the Family Attitude Scale and caregiver depressive symptoms via the self-report Beck Depression Inventory. We also assessed psychiatric symptoms and functioning of the patients. Approximately one-third of caregivers of patients with ARMS or FEP had depressive symptoms, predominately with mild-to-moderate symptom levels, whereas only a small portion exhibited high criticism. The level of criticism and depression were comparable between ARMS and FEP caregivers. The link between criticism, caregivers’ depression, and patients’ symptoms were observed in FEP but not in ARMS caregivers. These findings imply that the interaction between criticism and caregivers’ and patients’ mental states may develop during or after the onset of established psychosis and interventions for the caregivers should be tailored to the patient’s specific stage of illness. Interventions for FEP caregivers should target their emotional distress and include education about patient’s general symptoms.
Collapse
Affiliation(s)
- Yumiko Hamaie
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi, Japan
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- * E-mail:
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tatsuo Kikuchi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Fumiaki Ito
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi, Japan
| | | | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Hospital, Sendai, Miyagi, Japan
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| |
Collapse
|
10
|
Ito S, Nemoto T, Tsujino N, Ohmuro N, Matsumoto K, Matsuoka H, Tanaka K, Nishiyama S, Suzuki M, Kinoshita H, Ozawa H, Fujita H, Shimodera S, Kishimoto T, Matsumoto K, Hasegawa T, Mizuno M. Differential impacts of duration of untreated psychosis (DUP) on cognitive function in first-episode schizophrenia according to mode of onset. Eur Psychiatry 2015; 30:995-1001. [DOI: 10.1016/j.eurpsy.2015.08.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 08/17/2015] [Accepted: 08/18/2015] [Indexed: 01/10/2023] Open
Abstract
AbstractBackgroundThe mode of onset and the course of schizophrenia illness exhibit substantial individual variations. Previous studies have pointed out that the mode of onset affects the duration of untreated psychosis (DUP) and clinical outcomes, such as cognitive and social functioning. This study attempted to clarify the association between the DUP and clinical features, taking the different modes of onset into consideration, in a prospective longitudinal study examining patients with first-episode schizophrenia.MethodsThis study was conducted in six areas of Japan. Patients with first-episode schizophrenia were followed for over 18 months. Cognitive function, psychopathology, and social functioning were assessed at baseline and at 6, 12, and 18-month follow-up points.ResultsWe identified 168 patients and sufficient information was available to determine the DUP and the mode of onset for 156 patients (92.9%): 79 had an acute onset, and 77 had an insidious onset. The DUP was significantly associated with quality of life (QOL), social functioning, and cognitive function at most of the follow-up points in the insidious-onset group. The DUP and negative symptoms at baseline were significant predictors of cognitive function at the 18-month follow-up in the insidious-onset group.ConclusionsThe present results further support the hypothesis that the DUP affects QOL, social functioning, and cognitive function over the course of illness, especially in patients with an insidious onset. Effective strategies for detecting and caring for individuals with insidious onset early during the course of schizophrenia will be essential for achieving a full patient recovery.
Collapse
|
11
|
Ohmuro N, Matsumoto K, Katsura M, Obara C, Kikuchi T, Hamaie Y, Sakuma A, Iizuka K, Ito F, Matsuoka H. The association between cognitive deficits and depressive symptoms in at-risk mental state: a comparison with first-episode psychosis. Schizophr Res 2015; 162:67-73. [PMID: 25618299 DOI: 10.1016/j.schres.2015.01.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 05/21/2014] [Revised: 01/03/2015] [Accepted: 01/04/2015] [Indexed: 10/24/2022]
Abstract
Cognitive deficits and a high prevalence of depressive symptoms have been reported in at-risk mental state (ARMS) for psychosis, but the relationships between these variables remain unclear. The Brief Assessment of Cognition in Schizophrenia (BACS) was administered to 50 individuals with ARMS, 50 with first-episode psychosis (FEP), and 30 healthy controls (HC). Clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS) and the Beck Depression Inventory-2nd edition (BDI-II). Composite z-scores in BACS were compared between the three groups. Pearson correlations between composite z-scores on the BACS and indices of clinical symptoms were compared in the ARMS and FEP groups. The mean composite z-scores on the BACS for the ARMS (-2.82) and FEP (-2.85) groups were significantly lower than the HC group (P<0.001); no differences between the ARMS and FEP groups emerged (P=0.995). Cognitive deficits and depressive symptoms were significantly correlated in the ARMS group (PANSS depression: r=-0.36, P=0.010; BDI-II: r=-0.34, P=0.02), while the correlation between cognitive deficits and negative symptoms was significant in the FEP group (r=-0.46, P=0.001) and approached significance in the ARMS group (r=-0.25, P=0.08). The correlation between cognitive deficits and depressive symptoms significantly differed between the ARMS and FEP groups (PANSS depression: Z=2.50, P=0.012; BDI-II: Z=1.96, P=0.0499). Thus, a relationship between cognitive deficits and depression appears to be specific to ARMS compared to FEP.
Collapse
Affiliation(s)
- Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan; Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Chika Obara
- Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Tatsuo Kikuchi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Yumiko Hamaie
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Kunio Iizuka
- Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| | - Fumiaki Ito
- Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan; Department of Psychiatry, Tohoku Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, Japan.
| | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
| |
Collapse
|
12
|
Katsura M, Ohmuro N, Obara C, Kikuchi T, Ito F, Miyakoshi T, Matsuoka H, Matsumoto K. A naturalistic longitudinal study of at-risk mental state with a 2.4 year follow-up at a specialized clinic setting in Japan. Schizophr Res 2014; 158:32-8. [PMID: 25034763 DOI: 10.1016/j.schres.2014.06.013] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 05/07/2014] [Accepted: 06/01/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The notion of at-risk mental state (ARMS) is valuable for identifying individuals in a putative prodromal state of psychosis and for reducing conversion risk by pharmacological and psychological interventions. However, further systematic study is required because 1) diagnostic reliability in various clinical settings is not yet established; 2) predictive ability is insufficient; 3) optimal interventions in diversified populations are elusive; and 4) little evidence from non-Western regions exists. METHODS A naturalistic longitudinal study was conducted at a specialized clinic for early psychosis at a university hospital in Sendai, Japan. Individuals with ARMS (n=106) were recruited and followed up with case-by-case treatment. RESULTS Two-thirds of the participants were psychiatrist referrals, and 83 were followed up for at-least 1 year (mean follow-up=2.4 years). Fourteen developed psychosis and the estimated (by Kaplan-Meier) cumulative transition rate was 11.1% at 12, 15.4% at 24, and 17.5% at 30 months. At the end-point, about 30% of the 83 followed-up participants including 11 converters received antipsychotic medication. Compared to non-converters, converters showed more severe attenuated psychotic symptoms, including ego-boundary disturbance, formal thought disorder, and emotional disturbance. CONCLUSIONS The present study replicated previous major Western longitudinal studies, in terms of clinical characteristics, psychosis transition rate, and antipsychotic prescription rate. Our results emphasize the importance of phenomenological assessment of ARMS and intensive care in a clinical setting.
Collapse
Affiliation(s)
- Masahiro Katsura
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan
| | - Chika Obara
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tatsuo Kikuchi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Fumiaki Ito
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Psychiatry, Tohoku Pharmaceutical University Hospital, Sendai, Japan
| | | | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan; Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazunori Matsumoto
- Department of Psychiatry, Tohoku University Hospital, Sendai, Japan; Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
13
|
Uchida T, Matsumoto K, Ito F, Ohmuro N, Miyakoshi T, Ueno T, Matsuoka H. Relationship between cognitive insight and attenuated delusional symptoms in individuals with at-risk mental state. Psychiatry Res 2014; 217:20-4. [PMID: 24656897 DOI: 10.1016/j.psychres.2014.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 05/09/2013] [Revised: 10/10/2013] [Accepted: 01/01/2014] [Indexed: 10/25/2022]
Abstract
Cognitive insight, defined as the ability to evaluate and correct one׳s own distorted beliefs and misinterpretations, is hypothesized to contribute to the development of psychotic symptoms. We investigated cognitive insight in individuals with at-risk mental state (ARMS), which is associated with a clinically high risk of psychosis. Sixty individuals with ARMS were compared with 200 healthy controls in terms of cognitive insight measured using the Beck Cognitive Insight Scale. We also investigated the relationship between cognitive insight and attenuated delusional symptoms. In addition, we examined differences in the cognitive insight of individuals with ARMS with or without near-threshold delusional symptoms and differences in the cognitive insight of individuals with ARMS with or without later transition to psychosis. The results showed that individuals with ARMS exhibited higher self-certainty than healthy controls, indicating impairments in cognitive insight in the former. More importantly, our results revealed that self-certainty was correlated with attenuated delusional symptoms and that individuals with ARMS who had near threshold delusional symptoms had higher self-certainty. These findings indicate that overconfidence in one׳s own beliefs or judgments might be related to the formation and maintenance of attenuated delusions in individuals with ARMS.
Collapse
Affiliation(s)
- Tomohiro Uchida
- Department of Preventive Psychiatry, Tohoku University, Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
| | - Kazunori Matsumoto
- Department of Preventive Psychiatry, Tohoku University, Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan
| | - Fumiaki Ito
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Ohmuro
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Takashi Ueno
- Division of Clinical Psychology, Tohoku University, Graduate School of Education, Sendai, Japan
| | - Hiroo Matsuoka
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
14
|
Ito F, Matsumoto K, Miyakoshi T, Ohmuro N, Uchida T, Matsuoka H. Emotional processing during speech communication and positive symptoms in schizophrenia. Psychiatry Clin Neurosci 2013; 67:526-31. [PMID: 24147562 DOI: 10.1111/pcn.12103] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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] [Received: 04/23/2012] [Revised: 06/28/2013] [Accepted: 08/14/2013] [Indexed: 01/12/2023]
Abstract
AIMS The recognition of emotion is often impaired in patients with schizophrenia. The relationship of this deficit with symptoms of psychosis remains unclear. In the current study, we investigated the relationship between emotional processing and positive psychotic symptoms in schizophrenia. METHODS Twenty-eight patients with schizophrenia and 37 healthy participants were included in the study. They were instructed to listen to a set of sentences and judge whether the emotional valence expressed verbally and that expressed by affective prosody were congruous or incongruous. RESULTS Overall, the patients with schizophrenia had more inaccurate responses than the healthy participants and the poor performance was prominent when the patients processed affectively negative scenarios. The percentage of accurate responses negatively correlated with the severity of positive symptoms when the scenarios and/or the affective prosody had a negative valence. CONCLUSION Patients with schizophrenia appear to have impaired function in the processing of negative verbal information. Impaired processing of negative verbal and prosodic information seems to be associated with positive symptoms in schizophrenia.
Collapse
Affiliation(s)
- Fumiaki Ito
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | | | | |
Collapse
|
15
|
Matsumoto K, Hamaie Y, Mitsunaga N, Uchida T, Sunakawa E, Ohmuro N, Katsura M, Matsuoka H. [Application of cognitive behavioral therapy to early phase of psychosis]. Seishin Shinkeigaku Zasshi 2013; 115:390-398. [PMID: 23789321] [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: 06/02/2023]
Abstract
Attempts to apply cognitive-behavioral therapy (CBT) to treat patients in the early stage of psychosis, including those with First-Episode Psychosis (FEP) and those with an At-Risk Mental State (ARMS), have recently attracted considerable attention. Such CBT for FEP focuses on promoting the recovery process and relapse prevention, although evidence on its efficacy is currently limited. Further, studies on CBT for ARMS have not consistently demonstrated its effectiveness. Some reports affirm the effectiveness of CBT in FEP prevention, while others claim that the treatment leads to no compelling difference in comparison to nonspecific treatment such as supportive therapy and treatment as usual. It is evident that psychosocial interventions play a fundamental role in the treatment of early stages of psychosis. Therapeutic approaches based on CBT have been applied to various cases: however, further research is necessary in order to produce more concrete results and obtain the evidence needed to approve this method.
Collapse
Affiliation(s)
- Kazunori Matsumoto
- Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Miyakoshi T, Matsumoto K, Ito F, Ohmuro N, Matsuoka H. Application of the Comprehensive Assessment of At-Risk Mental States (CAARMS) to the Japanese population: reliability and validity of the Japanese version of the CAARMS. Early Interv Psychiatry 2009; 3:123-30. [PMID: 21352185 DOI: 10.1111/j.1751-7893.2009.00118.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [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: 11/28/2022]
Abstract
AIM The putative prodromal state of schizophrenia has been conceptualized as an at-risk mental state (ARMS), which is identified on the basis of ultra-high-risk (UHR) criteria, and the Comprehensive Assessment of At-Risk Mental States (CAARMS) has been developed as a specific instrument. However, the generalizability of CAARMS and the concept of ARMS have not been established. In this study, we tested the reliability and validity of the Japanese version of CAARMS (CAARMS-J). METHODS The participants were recruited from a specialized clinic for ARMS. The inter-rater reliability of CAARMS-J was examined. The Positive and Negative Syndrome Scale (PANSS) subscale scores and the basic symptoms of the CAARMS-J-defined UHR-positive group were compared with those of first-episode psychosis (FEP) and UHR-negative groups. The predictive validity was examined by following up the UHR-positive individuals. The 12-month transition rate to psychosis and the antipsychotics prescription rate were calculated. RESULTS The CAARMS-J showed good inter-rater reliability. The PANSS-positive symptoms subscale scores of the UHR-positive group were intermediate between the FEP and the UHR-negative groups, and the UHR-positive group scored higher than the UHR-negative group in some basic symptoms. The positive and negative symptoms scores of the CAARMS-J significantly correlated with the corresponding scores of the PANSS. After 12 months, 3 out of 28 (10.7%) UHR-positive cases had transitioned to psychosis and 11 (39.2%) individuals were prescribed antipsychotics. CONCLUSIONS The CAARMS-J is a reliable and valid tool for assessing and detecting ARMS in Japanese clinical settings, suggesting that the concept of ARMS is applicable in Japan.
Collapse
Affiliation(s)
- Tetsuo Miyakoshi
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | | | | | | | | |
Collapse
|