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Raucher-Chéné D, Henry A, Obert A, Traykova M, Vucurovic K, Gobin P, Barrière S, Portefaix C, Gierski F, Caillies S, Kaladjian A. Impact of hypomanic personality traits on brain functional connectivity during a dynamic theory-of-mind task. Psychiatry Res Neuroimaging 2024; 337:111759. [PMID: 38011763 DOI: 10.1016/j.pscychresns.2023.111759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/02/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023]
Abstract
Hypomanic personality traits are present in the general population and represent a risk factor for developing bipolar disorder. This personality style, notably its social component, is linked to difficulties in theory of mind (i.e., ability to infer mental states). Exploring the neural correlates of mental states' inference in individuals with these personality traits can provide meaningful insights into the development of bipolar disorder. The aim of the present study was therefore to investigate the potential impact of hypomanic traits on brain activation and task-based connectivity strength during a dynamic theory of mind task in a nonclinical population. A total of 52 nonclinical participants were recruited, and hypomanic traits were assessed with the Hypomanic Personality Scale. The severity of hypomanic traits was positively associated with right middle and inferior frontal gyri activations (in high vs. low inference in nonemotional condition and emotion vs. no emotion in high inference, respectively). It was also associated with stronger connectivity between the salience network (i.e., bilateral putamen and pallidum) and bilateral superior temporal gyri (high inference in nonemotional condition), and between cerebellar and temporal areas (high inference in emotional condition). These changes may either reflect adaptations or differential processing, and further studies are therefore mandatory.
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Affiliation(s)
- Delphine Raucher-Chéné
- Department of Psychiatry, Reims University Hospital, EPSMM, Reims, France; Laboratoire C2S (Cognition, Santé, Société), Université de Reims Champagne Ardenne, EA, 6291, France; Douglas Research Centre, McGill University, Montreal, QC, Canada.
| | - Audrey Henry
- Department of Psychiatry, Reims University Hospital, EPSMM, Reims, France; Laboratoire C2S (Cognition, Santé, Société), Université de Reims Champagne Ardenne, EA, 6291, France
| | - Alexandre Obert
- Cognition Sciences, Technology & Ergonomics Laboratory, National University Institute Champollion, University of Toulouse, Albi, France
| | - Martina Traykova
- Department of Psychiatry, Reims University Hospital, EPSMM, Reims, France
| | - Ksenija Vucurovic
- Laboratoire C2S (Cognition, Santé, Société), Université de Reims Champagne Ardenne, EA, 6291, France
| | - Pamela Gobin
- Laboratoire C2S (Cognition, Santé, Société), Université de Reims Champagne Ardenne, EA, 6291, France
| | - Sarah Barrière
- Department of Psychiatry, Reims University Hospital, EPSMM, Reims, France
| | - Christophe Portefaix
- Department of Radiology, Reims University Hospital, Reims, France; Laboratoire CReSTIC, Université de Reims Champagne Ardenne, EA, 3804, France
| | - Fabien Gierski
- Department of Psychiatry, Reims University Hospital, EPSMM, Reims, France; Laboratoire C2S (Cognition, Santé, Société), Université de Reims Champagne Ardenne, EA, 6291, France
| | - Stéphanie Caillies
- Laboratoire C2S (Cognition, Santé, Société), Université de Reims Champagne Ardenne, EA, 6291, France
| | - Arthur Kaladjian
- Department of Psychiatry, Reims University Hospital, EPSMM, Reims, France; Laboratoire C2S (Cognition, Santé, Société), Université de Reims Champagne Ardenne, EA, 6291, France; Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
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2
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Dratch L, Mu W, Wood EM, Morgan B, Massimo L, Clyburn C, Bardakjian T, Grossman M, Irwin DJ, Cousins KA. Evaluation of an educational conference for persons affected by hereditary frontotemporal degeneration and amyotrophic lateral sclerosis. PEC Innov 2023; 2:100108. [PMID: 37214502 PMCID: PMC10194235 DOI: 10.1016/j.pecinn.2022.100108] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 05/24/2023]
Abstract
Objective There are limited studies exploring the support and education needs of individuals at-risk for or diagnosed with hereditary frontotemporal degeneration (FTD) and/or amyotrophic lateral sclerosis (ALS). This study evaluated a novel conference for this population to assess conference efficacy, probe how participants assessed relevant resources, and identify outstanding needs of persons at-risk/diagnosed. Methods We implemented a post-conference electronic survey that probed participants' satisfaction, prior experience with resources, and unmet needs. Along with multiple-choice, free-text items were included to gather qualitative context. Results Survey completion rate was 31% (115/376 attendees who were emailed the survey). There was positive interest in pursuing genetic counseling among eligible responders: 61% indicated they planned to seek genetic counseling because of the conference, which was significantly more than those who were undecided (21%) or did not plan to seek genetic counseling (18%). Qualitative data demonstrated need for additional education, support, and research opportunities. Conclusion Conference reactions indicate this is a valued resource. Results indicated the importance of raising awareness about existing resources, and the need for further resource development, especially for at-risk communities. Innovation While most resources are developed for caregivers' needs, this unique program targets at-risk individuals and unites ALS and FTD communities.
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Affiliation(s)
- Laynie Dratch
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Weiyi Mu
- Department of Genetic Medicine, Johns Hopkins University, Baltimore, USA
| | | | - Brianna Morgan
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Cynthia Clyburn
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Tanya Bardakjian
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - David J. Irwin
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Katheryn A.Q. Cousins
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
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Chamberlain SR, Aslan B, Quinn A, Anilkumar A, Robinson J, Grant JE, Sinclair J. Autism and gambling: A systematic review, focusing on neurocognition. Neurosci Biobehav Rev 2023; 147:105071. [PMID: 36738812 DOI: 10.1016/j.neubiorev.2023.105071] [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: 08/04/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
Autism spectrum disorders (hereafter autism) are prevalent and often associated with elevated rates of substance use disorders. A subset of people who gamble develop gambling disorder, which is functionally impairing. Characterization of relationships between autism and gambling, particularly as relates to cognition, may have important implications. We conducted a systematic review of the literature. Nine out of 343 publications were found eligible for inclusion. Most studies examined decision-making using cognitive tasks, showing mixed results (less, equivalent or superior performance in autistic people compared to non-autistic people). The most consistent cognitive finding was relatively slower responses in autistic people on gambling tasks, compared to non-autistic people. One study reported a link between problem gambling and autism scores, in people who gamble at least occasionally. This systematic review highlights a profound lack of research on the potential neurocognitive overlap between autism and gambling. Future work should address the link between autism and behavioral addictions in adequately powered samples, using validated tools.
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Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
| | - Betul Aslan
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK
| | - Anthony Quinn
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK
| | - Amith Anilkumar
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK
| | - Janine Robinson
- Chitra Sethia Autism Centre, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, Cambridge, UK; NHS, UK
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Julia Sinclair
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK.
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Demirlek C, Atas F, Yalincetin B, Gurbuz MS, Cesim E, Demir M, Ozbek SU, Sut E, Baykara B, Akdede BB, Kaya M, Bora E. Choroidal structural analysis in ultra-high risk and first-episode psychosis. Eur Neuropsychopharmacol 2023; 70:72-80. [PMID: 36931136 DOI: 10.1016/j.euroneuro.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/02/2023] [Accepted: 02/22/2023] [Indexed: 03/19/2023]
Abstract
Both structural and functional alterations in the retina and the choroid of the eye, as parts of the central nervous system, have been shown in psychotic disorders, especially in schizophrenia. In addition, genetic and imaging studies indicate vascular and angiogenesis anomalies in the psychosis spectrum disorders. In this ocular imaging study, choroidal structure and vascularity were investigated using enhanced depth imaging (EDI) optical coherence tomography (OCT) in first-episode psychosis (FEP), ultra-high risk for psychosis (UHR-P), and age- and gender- matched healthy controls (HCs). There were no significant differences between groups in central choroidal thickness, stromal choroidal area (SCA), luminal choroidal area (LCA) and total subfoveal choroidal area. The LCA/SCA ratio (p<0.001) and the choroidal vascularity index (CVI) (p<0.001) were significantly different between FEP, UHR-P and HCs. CVI and LCA/SCA ratio were significantly higher in patients with FEP compared to help-seeking youth at UHR-P. CVI and LCA/SCA ratio were not different between UHR-P and HCs. However, CVI was higher in UHR-P compared to HCs after excluding the outliers for the sensitivity analysis (p = 0.002). Current findings suggest that choroidal thickness is normal, but there are abnormalities in choroidal microvasculature in prodromal and first-episode psychosis. Further longitudinal studies are needed to investigate oculomics, especially CVI, as a promising biomarker for the prediction of conversion to psychosis in individuals at clinical high-risk.
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LaGoy AD, Mayeli A, Smagula SF, Ferrarelli F. Relationships between rest-activity rhythms, sleep, and clinical symptoms in individuals at clinical high risk for psychosis and healthy comparison subjects. J Psychiatr Res 2022; 155:465-470. [PMID: 36183600 PMCID: PMC10729940 DOI: 10.1016/j.jpsychires.2022.09.009] [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] [Received: 04/08/2022] [Revised: 08/11/2022] [Accepted: 09/12/2022] [Indexed: 11/18/2022]
Abstract
Sleep-wake disturbances in individuals at clinical high risk (CHR) of psychosis may relate to increased symptom severity and contribute to disease progression. Here, we examined differences in rest-activity rhythms (RAR) measures, derived from actigraphy, and objective sleep outcomes, derived from electroencephalography (EEG), between 12 CHR and 16 healthy comparison (HC) individuals. Further, we examined the relationships between RAR disturbances, objective sleep outcomes and clinical psychosis symptoms (i.e., negative, positive, disorganized, general symptoms). Sleep-wake behaviors were monitored via actigraphy for 3-7 days (CHR: 5.7 ± 1.7 days; HC: 6.3 ± 1.2 days) prior to participants spending a night in the sleep laboratory, which was monitored with EEG. Separate regressions were used to examine the effect of clinical group on RAR measures and objective sleep outcomes after controlling for age and gender. CHR participants were found to be less active, specifically during the evening (17:00-20:00; β = 1.145, SE = 0.362, p = .004) and nighttime (21:00-24:00; β = 1.152, SE = 0.326, p = .002) relative to HC. Further, CHR participants had more fragmented sleep (wake after sleep onset: β = 0.888, SE = 0.395, p = .034) and more hyperarousal during sleep (NREM gamma activity: β = 1.087, SE = 0.348, p = .005), but these sleep disturbances were not related to reduced activity or clinical symptoms, whereas lower nighttime activity was related to more disorganized symptoms (ρ = -.640, p = .025). Thus, increasing activity through behavioral interventions may have additional beneficial effects on CHR clinical symptoms.
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Affiliation(s)
- Alice D LaGoy
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA; Department of Sports Medicine and Nutrition, University of Pittsburgh, 3600 Atwood Street, Pittsburgh, PA, 15260, USA
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Stephen F Smagula
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
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Kantor JR, Gur RC, Calkins ME, Moore TM, Port AM, Ruparel K, Scott JC, Troyan S, Gur RE, Roalf DR. Comparison of two cognitive screening measures in a longitudinal sample of youth at-risk for psychosis. Schizophr Res 2022; 246:216-224. [PMID: 35809354 PMCID: PMC10838490 DOI: 10.1016/j.schres.2022.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/13/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Validated screening tools are needed to detect subtle cognitive impairment in individuals at-risk for developing psychosis. Here, the utility of the Mini-Mental Status Examination (MMSE) and Penn Computerized Neurocognitive Battery (CNB) were evaluated for detecting cognitive impairment in individuals with psychosis spectrum (PS) symptoms. METHODS Participants (n = 229; 54 % female) completed the MMSE and CNB at baseline and two-year follow-up. PS (n = 91) and typically developing (TD; n = 138) participants were enrolled at baseline based on the presence or absence of PS symptoms. After two years, 65 participants remained PS, 104 participants remained TD, 23 participants had Emergent (EP) subthreshold PS symptoms, and 37 participants were experiencing Other Psychopathology (OP). RESULTS Generally, those with PS had lower scores than TD on both the MMSE (p < 0.0001) and CNB (p < 0.0001). Additionally, OP participants performed lower on the MMSE than TD (p = 0.02). Receiver operating characteristic (ROC) analyses indicated similar area under the curve (AUCs) for the two instruments (0.67); the MMSE showed higher specificity (0.71 vs. 0.62), while the CNB showed higher sensitivity (0.66 vs 0.52). Use of the MMSE and CNB in combination provided the highest diagnostic classification. CONCLUSION The MMSE and CNB can be used to screen for cognitive impairment in PS. The MMSE is better at ruling out PS-related cognitive impairment while the CNB is better at ruling in PS-related cognitive impairment. Overall, our results indicate that both tests are useful in screening for cognitive impairment, particularly in combination, in a PS population.
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Affiliation(s)
- Jenna R Kantor
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Ruben C Gur
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Monica E Calkins
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Tyler M Moore
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Allison M Port
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - J Cobb Scott
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA 19104, USA
| | - Scott Troyan
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Raquel E Gur
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - David R Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA.
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Janssen N, Handels RL, Wimo A, Antikainen R, Laatikainen T, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Evers SMAA, Verhey FRJ, Ngandu T. Association Between Cognition, Health Related Quality of Life, and Costs in a Population at Risk for Cognitive Decline. J Alzheimers Dis 2022; 89:623-632. [PMID: 35912737 PMCID: PMC9535559 DOI: 10.3233/jad-215304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The association between health-related quality of life (HRQoL) and care costs in people at risk for cognitive decline is not well understood. Studying this association could reveal the potential benefits of increasing HRQoL and reducing care costs by improving cognition. Objective: In this exploratory data analysis we investigated the association between cognition, HRQoL utilities and costs in a well-functioning population at risk for cognitive decline. Methods: An exploratory data analysis was conducted using longitudinal 2-year data from the FINGER study (n = 1,120). A change score analysis was applied using HRQoL utilities and total medical care costs as outcome. HRQoL utilities were derived from the Short Form Health Survey-36 (SF-36). Total care costs comprised visits to a general practitioner, medical specialist, nurse, and days at hospital. Analyses were adjusted for activities of daily living (ADL) and depressive symptoms. Results: Although univariable analysis showed an association between cognition and HRQoL utilities, multivariable analysis showed no association between cognition, HRQoL utilities and total care costs. A one-unit increase in ADL limitations was associated with a -0.006 (p < 0.001) decrease in HRQoL utilities and a one-unit increase in depressive symptoms was associated with a -0.004 (p < 0.001) decrease in HRQoL utilities. Conclusion: The level of cognition in people at-risk for cognitive decline does not seem to be associated with HRQoL utilities. Future research should examine the level at which cognitive decline starts to affect HRQoL and care costs. Ideally, this would be done by means of cross-validation in populations with various stages of cognitive functioning and decline.
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Affiliation(s)
- Niels Janssen
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ron L Handels
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden
| | - Anders Wimo
- Department of Neurobiology, Care Science and Society, Division of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden.,Centre for Research & Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden
| | - Riitta Antikainen
- Center for life course health research/Geriatrics, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.,Joint municipal authority for North Karelia Social and Health Services (Siun sote), Finland
| | - Hilkka Soininen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Timo Strandberg
- Institute of Health Sciences/Geriatrics, University of Oulu and Oulu University Hospital, Oulu, Finland.,Department of Medicine, Geriatric Clinic, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland.,South Ostrobothnia Central Hospital, Seinajoki, Finland.,Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Miia Kivipelto
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Silvia M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands.,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Centre for Economic Evaluation Utrecht, The Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
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8
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Oakley S, Bouchet J, Costello P, Parker J. Influenza vaccine uptake among at-risk adults (aged 16-64 years) in the UK: a retrospective database analysis. BMC Public Health 2021; 21:1734. [PMID: 34560879 PMCID: PMC8460844 DOI: 10.1186/s12889-021-11736-2] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background In the UK, annual influenza vaccination is currently recommended for adults aged 16–64 years who are in a clinical at-risk group. Despite recommendations, rates of vaccine uptake in the UK have historically been low and below national and international targets. This study aims to analyse vaccine uptake among adults in clinical at-risk groups from the 2015–2016 influenza season to the present. Methods A retrospective analysis of influenza vaccine coverage in the UK was conducted using data extracted from publicly available sources. Clinically at-risk individuals (as defined by Public Health England), including pregnant women, aged 16–64 years, were included in this study. Results Influenza vaccination coverage rates across the UK in adults aged 16–64 years in a clinical at-risk group have been consistently low over the past 5 years, with only 48.0, 42.4, 44.1 and 52.4% of eligible patients in England, Scotland, Wales and Northern Ireland receiving their annual influenza vaccination during the 2018–2019 influenza season. Influenza vaccine coverage was lowest in patients with morbid obesity and highest in patients with diabetes in 2018–2019. Coverage rates were below current national ambitions of ≥75% in all clinical risk groups. In these clinical at-risk groups, influenza vaccine coverage decreased between 2015 and 2019, and there was considerable regional variation. Conclusions Uptake of the influenza vaccine by adults aged 16–64 years in a clinical at-risk group was substantially below the national ambitions. As a result, many individuals in the UK remain at high risk of developing severe influenza or complications. Given that people who are vulnerable to COVID-19 are also at increased risk of complications from influenza, during the 2020–2021 season, there is a heightened need for healthcare professionals across the UK to address suboptimal vaccine uptake, particularly in at-risk patients. Healthcare professionals and policymakers should consider measures targeted at increasing access to and awareness of the clinical benefits of the influenza vaccine.
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Affiliation(s)
- Simon Oakley
- Sanofi Pasteur, 410 Thames Valley Park Drive, Reading, RG6 1PT, UK.
| | - Julien Bouchet
- Sanofi Pasteur, Campus Sanofi Lyon Carteret, A2-6ème et. 14, Espace Henry Vallée, 69007, Lyon, France
| | - Paul Costello
- Sanofi Pasteur, 410 Thames Valley Park Drive, Reading, RG6 1PT, UK
| | - James Parker
- Sanofi Pasteur, 410 Thames Valley Park Drive, Reading, RG6 1PT, UK
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9
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Jella TK, Desai A, Jella T, Steinmetz M, Kimmell K, Wright J, Wright CH. Geospatial Distribution of Neurosurgeons Age 60 and Older Relative to the Spread of COVID-19. World Neurosurg 2021; 145:e259-e266. [PMID: 33065354 PMCID: PMC7553865 DOI: 10.1016/j.wneu.2020.10.037] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To perform an ecological study to analyze the geospatial distribution of neurosurgeons ≥60 years old and compare these data with the spread of 2019 novel coronavirus disease (COVID-19) across the United States. METHODS Data regarding distribution of COVID-19 cases were collected from the Environmental Systems Research Institute, and demographic statistics were collected from the American Association of Medical Colleges 2019 State Workforce Reports. These figures were analyzed using geospatial mapping software. RESULTS As of July 5, 2020, the 10 states with the highest number of COVID-19 cases showed older neurosurgical workforce proportions (the proportion of active surgeons ≥60 years old) of 20.6%-38.9%. Among states with the highest number of COVID-19 deaths, the older workforce proportions were 25.0%-43.4%. Connecticut demonstrated the highest with 43.4% of neurosurgeons ≥60 years old. CONCLUSIONS Regional COVID-19 hotspots may coincide with areas where a substantial proportion of the neurosurgical workforce is ≥60 years old. Continuous evaluation and adjustment of local and national clinical practice guidelines are warranted throughout the pandemic era.
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Affiliation(s)
- Tarun K Jella
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Ansh Desai
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Taral Jella
- College of Arts and Sciences, Emory University, Atlanta, Georgia, USA
| | - Michael Steinmetz
- Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Kristopher Kimmell
- Department of Neurosurgery, Rochester Regional Health and University of Rochester Medical Center, Rochester, New York, USA
| | - James Wright
- Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA; Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Christina Huang Wright
- Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA; Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
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Furdock R, Luhmann SJ. The value of preoperative labs in identifying " at-risk" patients for developing surgical site infections after pediatric neuromuscular spine deformity surgery. Spine Deform 2020; 8:517-522. [PMID: 31925757 DOI: 10.1007/s43390-019-00003-5] [Citation(s) in RCA: 6] [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] [Received: 06/28/2019] [Accepted: 10/19/2019] [Indexed: 10/25/2022]
Abstract
STUDY DESIGN This is a retrospective cohort study via a single surgeon, two-hospital database. OBJECTIVE PSF in NMS patients is a high-risk surgery, with rates of SSI up to 24%. There is conflicting evidence in the literature regarding a possible association between low preoperative nutritional lab values and heightened risk of SSI after PSF. A retrospective analysis of a 20-year cohort of 111 pediatric neuromuscular scoliosis (NMS) patients that underwent posterior spinal fusion (PSF) with instrumentation was performed. Overall, seven patients (6.3%) developed a postoperative surgical site infection (SSI). With the possible exception of transferrin, low preoperative lab values (prealbumin, Hgb/Hct, WBC, TLC, total protein, albumin) were not associated with SSI. These findings question the utility of the current methodology of preoperative laboratory evaluation in identifying patients at elevated risk for SSI following PSF. METHODS A single-surgeon, two-hospital database was reviewed to identify all patients who underwent PSF for NMS. Diagnoses included cerebral palsy (n = 82), myelomeningocele (n = 13), spinal muscular atrophy (n = 4), and other (n = 12). Medical records for 117 patients were examined; 6 were excluded due to missing lab values. SSI was defined as an infection necessitating a return to the operating room for irrigation and debridement of the surgical site. Demographic information, preoperative lab values, spinal deformity magnitude, and surgical procedure data were recorded. RESULTS There were 50 males and 61 females with a mean age of 14 years and 2.5 months (8-20 years). Seven patients (6.3%) experienced postoperative SSI. SSI rate for PSF to pelvis was 7.7% vs. PSF to lumbar spine, 3.0% (NS; p = 0.672). Length of PSF was not statistically associated with SSI (p = 0.172). SSI due to gram positives and polymicrobial gram negatives occurred with equal incidence. Preoperative lab values of transferrin, prealbumin, albumin, WBC count, total lymphocyte count, and total protein were not associated with SSI. Patients with postoperative SSI had higher mean Hct compared to controls (p = 0.041). While 40.6% of controls had low Hgb (< 13.8 g/dl), all patients who developed SSI had Hgb within the normal range (p = 0.043). Similarly, while 37.6% of controls had low Hct (< 40.7%), all patients who developed SSI had Hct within the normal range (p = 0.05). CONCLUSION Low preoperative nutritional labs, Hgb/Hct, and TLC values were not found to be associated with an increased incidence of SSI in this analysis. These findings question the utility of preoperative lab values in identifying "at-risk" populations for SSI after PSF for NMS. LEVEL OF EVIDENCE IV Therapeutic.
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Affiliation(s)
- Ryan Furdock
- Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Scott J Luhmann
- Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, MO, USA. .,St Louis Children's Hospital, 1 Children's Place, Suite 4S60, St. Louis, MO, 63110, USA.
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11
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Gregory S, Bunnik EM, Callado AB, Carrie I, De Boer C, Duffus J, Fauria K, Forster S, Gove D, Knezevic I, Laquidain A, Pennetier D, Saunders S, Sparks S, Rice J, Ritchie CW, Milne R. Involving research participants in a pan-European research initiative: the EPAD participant panel experience. Res Involv Engagem 2020; 6:62. [PMID: 33088590 PMCID: PMC7566117 DOI: 10.1186/s40900-020-00236-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/01/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Including participants in patient and public involvement activities is increasingly acknowledged as a key pillar of successful research activity. Such activities can influence recruitment and retention, as well as researcher experience and contribute to decision making in research studies. However, there are few established methodologies of how to set up and manage participant involvement activities. Further, there is little discussion of how to do so when dealing with collaborative projects that run across countries and operate in multiple linguistic and regulatory contexts. METHODS In this paper we describe the set-up, running and experiences of the EPAD participant panel. The EPAD study was a pan-European cohort study with the aim to understand risks for developing Alzheimer's disease and build a readiness cohort for Phase 2 clinical trials. Due to the longitudinal nature of this study, combined with the enrolment of healthy volunteers and those with mild cognitive impairments, the EPAD team highlighted participant involvement as crucial to the success of this project. The EPAD project employed a nested model, with local panels meeting in England, France, Scotland, Spain and The Netherlands, and feeding into a central study panel. The local panels were governed by terms of reference which were adaptable to local needs. RESULTS The impact of the panels has been widespread, and varies from feedback on documentation, to supporting with design of media materials and representation of the project at national and international meetings. CONCLUSIONS The EPAD panels have contributed to the success of the project and the model established is easily transferable to other disease areas investigating healthy or at-risk populations.
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Affiliation(s)
- S. Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - E. M. Bunnik
- Department of Medical Ethics and Philosophy of Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - A. B. Callado
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | - I. Carrie
- Centre de Recherche Clinique du Gérontopôle, Toulouse University Hospital, Toulouse, France
| | - C. De Boer
- VUmc Alzheimercentrum, Amsterdam, The Netherlands
| | - J. Duffus
- Participant panel member, Barcelona, Spain
| | - K. Fauria
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | - S. Forster
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - D. Gove
- Alzheimer Europe, Luxembourg, Luxembourg
| | - I. Knezevic
- BarcelonaBeta Brain Research Center, Pasqual Maragall Fundation, Barcelona, Spain
| | | | - D. Pennetier
- Centre de Recherche Clinique du Gérontopôle, Toulouse University Hospital, Toulouse, France
| | - S. Saunders
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - S. Sparks
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J. Rice
- Participant panel member, Barcelona, Spain
| | - C. W. Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - R. Milne
- Institute of Public Health, University of Cambridge, Cambridge, UK
- Society and Ethics Research, Wellcome Genome Campus, Hinxton, UK
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Daunic AP, Smith SW, Aydin B, Barber B. Lowering Risk for Significant Behavior Problems Through Cognitive-Behavioral Intervention: Effects of the Tools for Getting Along Curriculum 2 Years Following Implementation. J Prim Prev 2019; 40:463-482. [PMID: 31363945 DOI: 10.1007/s10935-019-00554-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To address the needs of students at risk for significant behavior problems, educators need efficient, effective, and feasible preventive classroom interventions that increase students' ability to regulate their own behavior. Tools for Getting Along is a universally delivered cognitive-behavioral curriculum designed to address early emotional and behavioral risk among fourth and fifth grade students within the general classroom setting. We used latent growth model statistical methodology to investigate the effects of Tools for Getting Along 2 years following treatment cessation on students who evidenced baseline risk relative to peers. We followed an average of 455 students across measure-specific baseline risk groups at pretest, posttest, 1-year post-treatment, and 2-years post-treatment. Growth models fit data for four (behavior regulation, metacognition, aggression, and behavioral adjustment) of the eight factors used to assess emotional and behavioral outcomes. Findings indicated a long-term positive treatment effect for students at baseline risk on behavior regulation and general behavioral adjustment. We discuss how findings related to long-term treatment benefits add to prior research on Tools for Getting Along and to the evaluation of preventive treatment effects on emotional and behavioral risk over time.
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13
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Weintraub MJ, Weisman de Mamani A, Villano WJ, Evans TC, Millman ZB, Hooley JM, Timpano KR. Affective and physiological reactivity to emotional comments in individuals at elevated risk for psychosis. Schizophr Res 2019; 206:428-435. [PMID: 30337153 DOI: 10.1016/j.schres.2018.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 11/22/2017] [Revised: 08/06/2018] [Accepted: 10/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Individuals with schizophrenia are at increased risk of relapse when they live in highly critical (i.e., high expressed emotion; EE) family environments. It remains less clear, however, how individuals at elevated risk for a psychotic disorder react to the social stress of EE. Here we examined whether individuals at elevated risk for developing schizophrenia report greater subjective changes in affect and have increased physiological reactivity after hearing critical, praising and neutral comments. METHOD Measures of heart rate, heart rate variability, skin conductance, and self-reported affective ratings were used to assess differential responses to EE-type stimuli in 38 individuals at elevated-risk for psychosis and 38 low-risk controls. RESULTS The elevated-risk group and low-risk controls, did not differ in their initial affective and physiological reactivity to criticism. However, during the recovery period following the criticism, the elevated-risk group demonstrated greater heart rate activation. They also showed more sensitivity to praise. Although elevated-risk participants initially had higher baseline levels of negative affect and heart rate, following praise, these levels reduced and became indistinguishable from the levels of low-risk controls. CONCLUSIONS These findings suggest that at-risk individuals may have more difficulty recovering from criticism than their self-report data might suggest. They may also derive physiological and affective benefits from praise. Important clinical implications of these findings are discussed.
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Affiliation(s)
- Marc J Weintraub
- University of Miami, Department of Psychology, Coral Gables, FL, United States of America; University of California, Los Angeles, Semel Institute, Los Angeles, CA, United States of America.
| | - Amy Weisman de Mamani
- University of Miami, Department of Psychology, Coral Gables, FL, United States of America
| | - William J Villano
- University of Miami, Department of Psychology, Coral Gables, FL, United States of America
| | - Travis C Evans
- University of Miami, Department of Psychology, Coral Gables, FL, United States of America
| | - Zachary B Millman
- University of Maryland, Baltimore County, Department of Psychology, Baltimore, MD, United States of America
| | - Jill M Hooley
- Harvard University, Department of Psychology, Cambridge, MA, United States of America
| | - Kiara R Timpano
- University of Miami, Department of Psychology, Coral Gables, FL, United States of America
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14
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Levi D, Ibrahim R, Malcolm R, MacBeth A. Mellow Babies and Mellow Toddlers: Effects on maternal mental health of a group-based parenting intervention for at-risk families with young children. J Affect Disord 2019; 246:820-827. [PMID: 30795486 DOI: 10.1016/j.jad.2018.12.120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/24/2018] [Revised: 11/15/2018] [Accepted: 12/24/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Parental risk factors can have a significant detrimental impact on child development, yet most parenting interventions do not address parental mental health. There is also a dearth of evidence regarding parenting interventions for families with children under two years old. Mellow Parenting (MP) is a suite of parenting interventions targeting at-risk families with complex needs, including those with very young children. Preliminary studies suggest that MP can improve both parent and child outcomes, but no evaluation has been conducted in routine practice. METHODS Using a real-world design we analysed routine data from a UK cohort of n = 183 mother-child dyads, collected over a 21-month period. Data were gathered immediately pre- and post-intervention. Outcomes included maternal mental health, parenting confidence, daily parenting stress, and child behaviour. Intention-to-treat and 'completer' analyses were performed. Associations between attendance, participant demographics, and pre-post change in outcomes were modelled. RESULTS MP participation was associated with improvements in maternal mental health (d = 0.36), parenting confidence (d = 0.42), and a component of child psychosocial behaviour (conduct problems; d = 0.36), but not overall child difficulties, or daily parenting stress. Mothers with a partner experienced larger benefits in mental health and parenting confidence compared to single mothers. Younger mothers, and those with a history of mental health problems, attended more intervention sessions. LIMITATIONS The study used real-world data and was thus uncontrolled, limiting causal interpretations. CONCLUSIONS This is the first study to explore MP participation on a multi-site national level and suggests that group-based parenting interventions may be effective for at-risk families. These results should be expanded upon via controlled studies that incorporate follow-up data.
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15
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Lau P, Hawes DJ, Hunt C, Frankland A, Roberts G, Mitchell PB. Prevalence of psychopathology in bipolar high-risk offspring and siblings: a meta-analysis. Eur Child Adolesc Psychiatry 2018; 27:823-37. [PMID: 28936622 DOI: 10.1007/s00787-017-1050-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 09/13/2017] [Indexed: 02/08/2023]
Abstract
This meta-analysis aimed to update existing data on the comparison of prevalence rates of psychopathology primarily among offspring with at least one parent with bipolar disorder (BD) and offspring of parents without psychiatric illness. Seventeen studies were derived from a systematic search of PsychInfo, Medline, Scopus and Embase. Inclusion criteria were use of a control offspring group, standardized diagnostic procedures and reporting of clear frequency data. Risk of psychopathology was estimated by aggregating frequency data from selected studies. Compared to control offspring, high-risk BD offspring are nine times more likely to have a bipolar-type disorder, almost two and a half times more likely to develop a non-BD affective disorder and over two times more likely to develop at least one anxiety disorder. High-risk offspring also showed a significant increased risk of other non-mood psychopathology such as attention deficit hyperactivity disorder (ADHD), any type of behavioral disorder and substance use disorder (SUDs). Risk of developing a broad range of affective and non-affective psychopathology is significantly higher in high-risk BD offspring. Identifying clinical presentations of this genetically high-risk cohort is important in establishing appropriate preventative treatment.
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16
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Ratheesh A, Cotton SM, Davey CG, Lin A, Wood S, Yuen HP, Bechdolf A, McGorry PD, Yung A, Berk M, Nelson B. Pre-onset risk characteristics for mania among young people at clinical high risk for psychosis. Schizophr Res 2018; 192:345-350. [PMID: 28768599 DOI: 10.1016/j.schres.2017.04.036] [Citation(s) in RCA: 5] [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: 01/08/2017] [Revised: 03/18/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Psychosis and mania share conceptual, genetic and clinical features, which suggest the possibility that they have common antecedents. Participants identified to be at-risk for psychosis might also be at-risk for mania. We aimed to identify the rate and predictors of transition to mania in a cohort of youth with clinical or familial risk for psychosis. METHODS Among a cohort of 416 young people with an at-risk mental state for psychosis defined using the Ultra-High-Risk (UHR) criteria, 74.7% were followed up between 5 and 13years from their baseline assessment. We undertook a matched case-control examination of those who developed mania over the follow-up period compared to those who did not develop mania or psychosis. Transition to mania was determined using either a structured clinical interview, or diagnoses from a state-wide public mental health contact registry. Clinical characteristics and risk factors were examined at baseline using information from structured interviews, clinical file notes, rating scales and unstructured assessments. RESULTS Eighteen participants developed mania (UHR-Manic transition or UHR-M, 4.3%). In comparison with participants matched on age, gender and baseline-study who developed neither mania nor psychosis, more UHR-M participants had subthreshold manic symptoms or were prescribed antidepressants at baseline. They also had lower global functioning. DISCUSSION In addition to the UHR criteria, features such as subthreshold manic symptoms and antidepressant use may help identify at-risk groups that predict the onset of mania in addition to transition to psychosis. Presence of manic symptoms may also indicate syndrome specificity early in the prodromal phase.
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Affiliation(s)
- Aswin Ratheesh
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia.
| | - Susan M Cotton
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Christopher G Davey
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Stephen Wood
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia; School of Psychology, University of Birmingham, UK
| | - Hok Pan Yuen
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Andreas Bechdolf
- Vivantes Hospital am Urban and Vivantes Hopital im Friedrichshain, Charite Medical University, Berlin, Germany
| | - Patrick D McGorry
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Alison Yung
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Michael Berk
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Deakin University, IMPACT Strategic Research Centre, Barwon Health, Geelong, Australia
| | - Barnaby Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
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Nery FG, Norris M, Eliassen JC, Weber WA, Blom TJ, Welge JA, Barzman DA, Strawn JR, Adler CM, Strakowski SM, DelBello MP. White matter volumes in youth offspring of bipolar parents. J Affect Disord 2017; 209:246-253. [PMID: 27936454 PMCID: PMC10530655 DOI: 10.1016/j.jad.2016.11.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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] [Received: 08/08/2016] [Revised: 10/25/2016] [Accepted: 11/15/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Studying youth at high risk of developing bipolar disorder may clarify neurobiological factors associated with vulnerability to this illness. We present here a baseline characterization of brain structure in youth at-risk for bipolar disorder. METHODS Magnetic resonance images were obtained from 115 child and adolescent offspring of bipolar disorder type I subjects and 57 healthy child and adolescent offspring of healthy parents (healthy control offspring). Offspring of parents with bipolar disorder were divided into healthy bipolar offspring (n=47) or symptomatic bipolar offspring (n=68), according to presence or absence of childhood-onset psychopathology. All bipolar offspring were free of major mood and psychotic disorders. Gray (GM) and white matter (WM) volumes were compared between groups using voxel-based morphometry. RESULTS No differences in GM volumes were found across groups. Healthy bipolar offspring presented with decreased WM volumes in areas of the right frontal, temporal and parietal lobes, and in the left temporal and parietal lobes compared to healthy control offspring. Symptomatic bipolar offspring did not present with any differences in WM volumes compared to either healthy bipolar offspring or healthy control offspring. LIMITATIONS Cross-sectional design and heterogeneous sample of symptomatic bipolar offspring. CONCLUSIONS WM volume decreases in areas of the frontal, occipital, and parietal lobes are present in bipolar offspring prior to the development of any psychiatric symptoms, and may be a correlate of familial risk to bipolar disorder. In this large cohort, we have not found evidence for regional GM volume abnormalities as an endophenotype for bipolar disorder.
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Affiliation(s)
- Fabiano G Nery
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Matthew Norris
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James C Eliassen
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Wade A Weber
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Thomas J Blom
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jeffrey A Welge
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Drew A Barzman
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jeffrey R Strawn
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Caleb M Adler
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen M Strakowski
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Cardenas SA, Kassem L, Brotman MA, Leibenluft E, McMahon FJ. Neurocognitive functioning in euthymic patients with bipolar disorder and unaffected relatives: A review of the literature. Neurosci Biobehav Rev 2016; 69:193-215. [PMID: 27502749 DOI: 10.1016/j.neubiorev.2016.08.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 07/28/2016] [Accepted: 08/01/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Neurocognitive deficits are present in bipolar disorder (BD) patients and their unaffected (nonbipolar) relatives, but it is not clear which domains are most often impaired and the extent of the impairment resulting from shared genetic factors. In this literature review, we address these issues and identify specific neurocognitive tasks most sensitive to cognitive deficits in patients and unaffected relatives. METHOD We conducted a systematic review in Web of Science, PubMed/Medline and PsycINFO databases. RESULTS Fifty-one articles assessing cognitive functioning in BD patients (23 studies) and unaffected relatives (28 studies) were examined. Patients and, less so, relatives show impairments in attention, processing speed, verbal learning/memory, and verbal fluency. CONCLUSION Studies were more likely to find impairment in patients than relatives, suggesting that some neurocognitive deficits may be a result of the illness itself and/or its treatment. However, small sample sizes, differences among relatives studied (e.g., relatedness, diagnostic status, age), and differences in assessment instruments may contribute to inconsistencies in reported neurocognitive performance among relatives. Additional studies addressing these issues are needed.
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Affiliation(s)
- Stephanie A Cardenas
- National Institutes of Health, 10 Center Drive, RM 3D54, MSC 1264, Bethesda, MD 20814-1264, USA.
| | - Layla Kassem
- National Institutes of Health, 35 Convent Drive, RM 1A202, MSC 3719, Bethesda, MD 20892-3719, USA.
| | - Melissa A Brotman
- National Institutes of Health, 15K North Drive, Room 211, Bethesda, MD 20892, USA.
| | - Ellen Leibenluft
- National Institutes of Health, 15K North Drive, RM 210, MSC 2670 Bethesda, MD 20892-2670, USA.
| | - Francis J McMahon
- National Institutes of Health, 35 Convent Drive, RM 1A201, MSC 3719, Bethesda, MD, 20892-3719, USA.
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Choi TK, Worley MJ, Trim RS, Howard D, Brown SA, Hopfer CJ, Hewitt JK, Wall TL. Effect of adolescent substance use and antisocial behavior on the development of early adulthood depression. Psychiatry Res 2016; 238:143-149. [PMID: 27086224 PMCID: PMC5094832 DOI: 10.1016/j.psychres.2016.02.036] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 02/05/2016] [Accepted: 02/16/2016] [Indexed: 11/24/2022]
Abstract
Major depressive disorder (MDD) is a prevalent and frequently comorbid psychiatric disorder. This study evaluates the development of depressive symptoms, MDD diagnosis, and suicidal ideation in a high-risk sample (N=524) diagnosed with conduct disorder (CD) and substance use disorder (SUD) symptoms as youth and re-assessed approximately 6.5 years later. Dual trajectory classes of both alcohol and other drug use (AOD) and antisocial behavior (ASB), previously identified using latent class growth analyses (LCGA), were used to predict depression outcomes. The Dual Chronic, Increasing AOD/Persistent ASB, and Decreasing Drugs/Persistent ASB classes had higher past-week depression scores, more past-year MDD symptoms, and were more likely to have past-year MDD than the Resolved class. The Dual Chronic and Decreasing Drugs/Persistent ASB classes also had more past-year MDD symptoms than the Persistent AOD/Adolescent ASB class. Youth at highest risk for developing or maintaining depression in adulthood had the common characteristic of persistent antisocial behavior. This suggests young adulthood depression is associated more with persistent antisocial behavior than with persistent substance use in comorbid youth. As such, interventions targeting high-risk youth, particularly those with persistent antisocial behavior, are needed to help reduce the risk of severe psychosocial consequences (including risk for suicide) in adulthood.
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Affiliation(s)
- Tai Kiu Choi
- CHA Bundang Medical Center, CHA University Department of Psychiatry, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-712, Republic of Korea
| | - Matthew J Worley
- University of California, San Diego Department of Psychiatry, 9500 Gilman Drive La Jolla, CA 92093, USA; VA San Diego Healthcare System, 3350 La Jolla Village Drive, 116B, San Diego, CA 92161, USA
| | - Ryan S Trim
- University of California, San Diego Department of Psychiatry, 9500 Gilman Drive La Jolla, CA 92093, USA; VA San Diego Healthcare System, 3350 La Jolla Village Drive, 116B, San Diego, CA 92161, USA
| | - David Howard
- University of California, San Diego Department of Psychiatry, 9500 Gilman Drive La Jolla, CA 92093, USA
| | - Sandra A Brown
- University of California, San Diego Department of Psychiatry, 9500 Gilman Drive La Jolla, CA 92093, USA
| | - Christian J Hopfer
- University of Colorado Denver Department of Psychiatry, 12469 E 17th Place, Bldg 400, Aurora, CO 80045, USA
| | - John K Hewitt
- University of Colorado Institute for Behavioral Genetics, 1480 30th St Boulder, CO 80309, USA
| | - Tamara L Wall
- University of California, San Diego Department of Psychiatry, 9500 Gilman Drive La Jolla, CA 92093, USA; VA San Diego Healthcare System, 3350 La Jolla Village Drive, 116B, San Diego, CA 92161, USA.
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20
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Foster DW, Hoff RA, Pilver CE, Yau YH, Steinberg MA, Wampler J, Krishnan-Sarin S, Potenza MN. Correlates of gambling on high-school grounds. Addict Behav 2015; 51:57-64. [PMID: 26232102 DOI: 10.1016/j.addbeh.2015.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/02/2015] [Accepted: 07/16/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study examined adolescent gambling on school grounds (GS+) and how such behavior was associated with gambling-related attitudes. Further, we examined whether GS+ moderated associations between at-risk problem-gambling (ARPG) and gambling behaviors related to gambling partners. METHOD Participants were 1988 high-school students who completed survey materials. Demographic, perceptions, attitudes, and gambling variables were stratified by problem-gambling severity (ARPG versus recreational gambling) and GS+ status. Chi-square and adjusted logistic regression models were used to examine relationships among study variables. RESULTS Nearly 40% (39.58%) of students reported past-year GS+, with 12.91% of GS+ students, relative to 2.63% of those who did not report gambling on school grounds (GS-), meeting DSM-IV criteria for pathological gambling (p<0.0001). In comparison to GS- students, GS+ students were more likely to report poorer academic achievement and more permissive attitudes towards gambling behaviors. Weaker links in GS+ students, in comparison with GS-, students, were observed between problem-gambling severity and gambling with family members (interaction odds ratio (IOR)=0.60; 95% CI=0.39-0.92) and gambling with friends (IOR=0.21; 95% CI=0.11-0.39). CONCLUSIONS GS+ is common and associated with pathological gambling and more permissive attitudes towards gambling. The finding that GS+ (relative to GS-) youth show differences in how problem-gambling is related to gambling partners (friends and family) warrants further investigation regarding whether and how peer and familial interactions might be improved to diminish youth problem-gambling severity. The high frequency of GS+ and its relationship with ARPG highlights a need for school administrators and personnel to consider interventions that target school-based gambling.
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Frederick KE, Ivey Hatz J, Lanning B. Not Just Horsing Around: The Impact of Equine-Assisted Learning on Levels of Hope and Depression in At-Risk Adolescents. Community Ment Health J 2015; 51:809-17. [PMID: 25698076 DOI: 10.1007/s10597-015-9836-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
Equine-assisted learning (EAL) is an experiential modality which utilizes horses to provide a unique learning experience for personal growth. Research by Damon et al. (Appl Dev Sci 7:119-128, 2003) suggests a positive relationship between hope and positive developmental trajectories. Hagen et al. (Am J Orthopsychiatr 75:211-219, 2005) showed hope to be a protective factor associated with adaptive functioning in at-risk youth. Ashby et al. (J Couns Dev 89:131-139, 2011) found a significant inverse relationship between hope and depression: as hope increases, depression decreases. The current study investigates the impact of a non-riding EAL curriculum entitled L.A.S.S.O. (Leading Adolescents to Successful School Outcomes) on levels of hope and depression in at-risk youth. The study uses an experimental design with longitudinal, repeated measures. Participants were randomly assigned to treatment and control groups. Participants in the treatment received 5 weeks of EAL, while participants in the control group received treatment as usual. Repeated measures ANOVA of participants' levels of hope and depression showed statistically significant improvements in the treatment group as compared with the control group. Even a brief (5-week) intervention of EAL had a positive impact on the lives and attitudes of at-risk adolescents, with increased levels of hope and decreased levels of depression.
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Ratheesh A, Cotton SM, Betts JK, Chanen A, Nelson B, Davey CG, McGorry PD, Berk M, Bechdolf A. Prospective progression from high-prevalence disorders to bipolar disorder: Exploring characteristics of pre-illness stages. J Affect Disord 2015; 183:45-8. [PMID: 26001662 DOI: 10.1016/j.jad.2015.04.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 03/20/2015] [Revised: 04/10/2015] [Accepted: 04/10/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Identification of risk factors within precursor syndromes, such as depression, anxiety or substance use disorders (SUD), might help to pinpoint high-risk stages where preventive interventions for Bipolar Disorder (BD) could be evaluated. METHODS We examined baseline demographic, clinical, quality of life, and temperament measures along with risk clusters among 52 young people seeking help for depression, anxiety or SUDs without psychosis or BD. The risk clusters included Bipolar At-Risk (BAR) and the Bipolarity Index as measures of bipolarity and the Ultra-High Risk assessment for psychosis. The participants were followed up for 12 months to identify conversion to BD. Those who converted and did not convert to BD were compared using Chi-Square and Mann Whitney U tests. RESULTS The sample was predominantly female (85%) and a majority had prior treatment (64%). Four participants converted to BD over the 1-year follow up period. Having an alcohol use disorder at baseline (75% vs 8%, χ(2)=14.1, p<0.001) or a family history of SUD (67% vs 12.5%, χ(2)=6.0, p=0.01) were associated with development of BD. The sub-threshold mania subgroup of BAR criteria was also associated with 12-month BD outcomes. The severity of depressive symptoms and cannabis use had high effects sizes of association with BD outcomes, without statistical significance. CONCLUSIONS AND LIMITATIONS The small number of conversions limited the power of the study to identify associations with risk factors that have previously been reported to predict BD. However, subthreshold affective symptoms and SUDs might predict the onset of BD among help-seeking young people with high-prevalence disorders.
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Affiliation(s)
- Aswin Ratheesh
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia.
| | - Susan M Cotton
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Jennifer K Betts
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Andrew Chanen
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Barnaby Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Christopher G Davey
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Patrick D McGorry
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Michael Berk
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; IMPACT Strategic Research Centre, Deakin University, Geelong, Australia; Florey Institute of Neurosciences and Mental Health, Parkville, Australia
| | - Andreas Bechdolf
- Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia; Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum am Urban, Charite Medical University, Berlin, Germany; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
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Orkibi H, Ronen T. High self-control protects the link between social support and positivity ratio for Israeli students exposed to contextual risk. J Sch Psychol 2015; 53:283-93. [PMID: 26270273 DOI: 10.1016/j.jsp.2015.06.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 05/27/2015] [Accepted: 06/01/2015] [Indexed: 10/23/2022]
Abstract
This study examined how Israeli students, despite exposure to contextual risk factors, may experience a high ratio of self-reported positive to negative emotions (i.e., positivity ratio). Self-control skills and perceived social support were tested as protective factors, where each was posited to moderate the relation between risk status and positivity ratio. The participants were 460 Israeli students (51% girls) in grades 8-10. Contrary to expectations, students attending a school with high contextual risks did not differ from students attending a school with low contextual risks in their scores on self-control skills, perceived social support, or positivity ratio. However, an exploratory follow-up moderation analysis revealed a significant three-way interaction, indicating that while low self-control skills eliminate the link between social support and positivity ratio for students attending the school defined as at-risk, high self-control protects this link. These results suggest that neither contextual risk in itself nor initial differences in self-control or social support account for differences in students' positivity ratio. Rather, it is the way these factors interact with each other that matters. Study limitations and implications are discussed.
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Affiliation(s)
- Hod Orkibi
- Graduate School of Creative Arts Therapies, University of Haifa, 199 Aba Khoushy Av., Mount Carmel, Haifa 31905, Israel.
| | - Tammie Ronen
- The Bob Shapell School of Social Work, Tel-Aviv University, 55 Haim Levanon St., Tel-Aviv 6997801, Israel.
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Lin A, Brewer WJ, Yung AR, Nelson B, Pantelis C, Wood SJ. Olfactory identification deficits at identification as ultra-high risk for psychosis are associated with poor functional outcome. Schizophr Res 2015; 161:156-62. [PMID: 25476117 DOI: 10.1016/j.schres.2014.10.051] [Citation(s) in RCA: 21] [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: 12/03/2013] [Revised: 10/27/2014] [Accepted: 10/27/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND We have previously reported that olfactory identification (OI) deficits are a promising premorbid marker of transition from ultra-high risk (UHR) to schizophrenia, but not to psychotic illness more generally. Whether this remains the case at longer follow-up, and whether there is decline in OI ability are unclear. METHOD The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 81 participants at baseline (identification of risk for psychosis) and 254 individuals at follow-up. Forty-nine participants underwent UPSIT assessment at both time points. UPSIT scores were investigated at an average of 7.08years after identification of risk in relation to transition to psychosis, a diagnosis of schizophrenia, and psychosocial/functional outcome. RESULTS UPSIT scores at baseline and follow-up did not differ between participants who transitioned to psychosis and those who did not. Similarly, there were no significant differences on UPSIT scores at baseline or follow-up between individuals with a diagnosis of schizophrenia and transitioned individuals without schizophrenia. Those with a poor functional outcome showed significantly lower baseline UPSIT scores than participants with good outcome. There was no significant association between functional outcome and follow-up UPSIT scores. There were no significant changes in UPSIT over time for any group. CONCLUSIONS These results suggest that impaired OI is not a good marker of the onset of psychosis and schizophrenia, but may differentiate UHR individuals who experience a poor functional outcome, regardless of transition status.
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Affiliation(s)
- A Lin
- Telethon Kids Institute, The University of Western Australia, Australia.
| | - W J Brewer
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - A R Yung
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia; Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - B Nelson
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia
| | - S J Wood
- Telethon Kids Institute, The University of Western Australia, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia
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Shek DTL, Ma CMS, Siu AMH. Validation of a subjective outcome evaluation tool for participants in a positive youth development program in Hong Kong. J Pediatr Adolesc Gynecol 2014; 27 Suppl:S26-31. [PMID: 24792760 DOI: 10.1016/j.jpag.2014.02.009] [Citation(s) in RCA: 4] [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] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVES Using confirmatory factor analyses, this study examined the factor structure and reliability of a subjective outcome evaluation tool for students with greater psychosocial needs within the context of the Project P.A.T.H.S. in Hong Kong. DESIGN To assess the views of program participants on the program content, implementer qualities, and program effectiveness of the Tier 2 Program of the Project P.A.T.H.S., the Subjective Outcome Evaluation Form for Participants (Form C) was used. Data were collected from 8,893 Grade 7 participants after they had completed the Tier 2 Program. RESULTS The findings based on confirmatory factor analyses are generally consistent with the original hypotheses, providing support for the 3-factor model and the higher-order factor model containing 3 primary factors. Support for different types of factorial invariance based on 2 randomly split subsamples was also found. High coefficient alphas were found for the total scale and the 3 subscales. CONCLUSION Confirmatory factor analyses support the conceptual model underlying the Form C. Reliability analyses showed that the total scale and subscales possess excellent internal consistency.
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Affiliation(s)
- Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, P.R. China; Centre for Innovative Programmes for Adolescents and Families, The Hong Kong Polytechnic University, Hong Kong, P.R. China; Department of Social Work, East China Normal University, Shanghai, P.R. China; Kiang Wu Nursing College of Macau, Macau, P.R. China.
| | - Cecilia M S Ma
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, P.R. China
| | - Andrew M H Siu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, P.R. China
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Healey DM, Halperin JM. Enhancing Neurobehavioral Gains with the Aid of Games and Exercise (ENGAGE): Initial open trial of a novel early intervention fostering the development of preschoolers' self-regulation. Child Neuropsychol 2014; 21:465-80. [PMID: 24735230 DOI: 10.1080/09297049.2014.906567] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Poor self-regulation during the preschool years predicts a wide array of adverse adult outcomes and, as such, is an important treatment target. We assessed the efficacy of a novel early intervention aimed at fostering the development of preschoolers' self-regulation. Enhancing Neurobehavioral Gains with the Aid of Games and Exercise (ENGAGE) involves parents and children playing a wide range of games targeting self-regulation on a daily basis over a 5-week period. Twenty-five New Zealand families, in whom parents identified their children as difficult to manage, took part in this study. Parent hyperactivity, aggression, and attention problems ratings on the BASC-2 were used to assess improvements in behavioral self-regulation, and subtests of the Stanford Binet-5 and NEPSY-2 were used to assess improvements in cognitive control. Improvements in parent-rated hyperactivity, aggression, and attention problems were maintained throughout the 12-month follow-up. In addition, improvements were found in two neurocognitive areas associated with self-regulation. While more rigorous randomized controlled trials are necessary, ENGAGE shows promise as a novel intervention for developing self-regulation in at-risk preschoolers.
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Affiliation(s)
- Dione M Healey
- a Department of Psychology , University of Otago , Dunedin , Otago , New Zealand
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DeVylder J, Yang L, Harkavy-Friedman J, Azimov N, Walder D, Corcoran C. Assessing depression in youth at clinical high risk for psychosis: a comparison of three measures. Psychiatry Res 2014; 215:323-8. [PMID: 24370335 PMCID: PMC3945159 DOI: 10.1016/j.psychres.2013.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 05/10/2013] [Revised: 08/21/2013] [Accepted: 12/02/2013] [Indexed: 12/25/2022]
Abstract
Depressive symptoms are prevalent among individuals at clinical high-risk (CHR) for psychosis. Prior studies have used the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), and the "dysphoric mood" item of the Scale of Prodromal Symptoms (SOPS) to assess depressive symptoms in CHR samples. We compared the psychometric properties of these instruments in a CHR cohort, to support the selection of appropriate depressive symptoms measures in future studies and in clinical settings. Internal consistency was assessed using Cronbach's alpha. Construct validity was assessed through correlations with SOPS items that were expected or not expected to be related to depressive symptoms. Criterion validity was assessed by comparing scores between patients with and without a major depressive disorder diagnosis. We hypothesized based on the schizophrenia literature that the BDI would have superior internal consistency and discriminant validity compared to the HDRS, and that all three measures would show convergent validity and criterion validity. The BDI demonstrated superior internal consistency and construct validity in this at-risk sample. The BDI and HDRS differentiated patients with major depressive disorder, but SOPS dysphoria did not. This has implications for the choice of depression measures in future CHR studies and for the interpretation of past findings.
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Affiliation(s)
- Jordan DeVylder
- Columbia University School of Social Work, 1255 Amsterdam Ave, New York, NY 10027, USA,Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Lawrence Yang
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 1610, New York, NY 10032, USA
| | - Jill Harkavy-Friedman
- American Foundation for Suicide Prevention, 120 Wall Street, 29th Floor, New York, NY 10005, USA
| | - Neyra Azimov
- Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
| | - Deborah Walder
- Department of Psychology, Brooklyn College of The City University of New York, Room 5315 James Hall, 2900 Bedford Ave, Brooklyn, NY 11210, USA,The Graduate Center of The City University of New York, 365 5th Ave, New York, NY 10016, USA
| | - Cheryl Corcoran
- Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
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Abstract
Developmental psychopathology is increasingly recognizing the importance of distinguishing causal processes (i.e., the mechanisms that cause a disease) from developmental outcomes (i.e., the symptoms of the disorder as it is eventually diagnosed). Targeting causal processes early in disordered development may be more effective than waiting until outcomes are established and then trying to reverse the pathogenic process. In this review, I evaluate evidence suggesting that neural and behavioral plasticity may be greatest at very early stages of development. I also describe correlational evidence suggesting that, across a number of conditions, early emerging individual differences in attentional control and working memory may play a role in mediating later-developing differences in academic and other forms of learning. I review the currently small number of studies that applied direct and indirect cognitive training targeted at young individuals and discuss methodological challenges associated with targeting this age group. I also discuss a number of ways in which early, targeted cognitive training may be used to help us understand the developmental mechanisms subserving typical and atypical cognitive development.
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Affiliation(s)
- Sam V. Wass
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
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29
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Geoffroy PA, Leboyer M, Scott J. [Predicting bipolar disorder: what can we learn from prospective cohort studies?]. Encephale 2013; 41:10-6. [PMID: 24094986 DOI: 10.1016/j.encep.2013.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 05/13/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Bipolar disorder (BD) is a life course illness; and there is increasing awareness of the many personal, social and economic consequences of the illness in older adults. However, it is important to emphasize that BD usually begins in late adolescence or early adulthood and 75 % cases have a first episode in this age period. This early onset and the associated level of disability mean that BD is the 4th leading cause of global disease burden in adolescents and young adults. Internationally, mental health services are increasingly striving to diagnose and treat BD as early as possible to try to prevent poor outcomes. In addition, researchers are using methods employed previously in psychosis studies as these may help us to recognise the earliest manifestations of BD. If it is possible to identify sub-threshold and 'ultra high risk' syndromes for BD, this might lead to new interventions that could target the prevention of first episodes of mania. One approach to understanding these risk syndromes is to examine prospective community cohort studies and BD offspring studies. METHODS This paper reviews prospective cohort studies that identify robust risk factors in early illness onset, which was defined as age at onset of BD between 15-25 years. RESULTS We found that although > 50 % of individuals who developed BD had developed a putative BD prodrome prior to 14 years of age, this usually began with non-specific symptoms that overlap with similar presentations for those who later develop psychosis or severe depression. However, there are some features that seem to better identify groups with a BD "at-risk" syndrome. This syndrome is frequently composed of several factors such as mood lability, depressive episodes, prior anxiety, sleep and/or conduct disorders, attention and concentration impairment, altered energy patterns, and a family history of mania and/or depression. The course of these early predictors suggests the precursor syndromes are composed of mini-clusters of symptoms many of which are episodic and change over time. During the early phases of BD, most of the affective disturbances reported were depressive in polarity and started during adolescence, there were few manic or mixed or psychotic episodes with an onset before puberty. The pathogenesis of BD demonstrates a gradual progression from non-specific to more specific symptoms and then to frank BD features. CONCLUSION Prospective community and offspring BD cohort studies are approaches that together can help us understand the evolution of BD and allow us to define the developmental pathways. Further, identifying subjects with BD "at-risk" syndrome using a clinical staging model may allow benign interventions to be used as first-line treatment - such as neuroprotective agents like essential fatty acids; second line treatments, with a less benign risk to benefit ratio should be reserved for severe or resistant cases.
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Affiliation(s)
- P A Geoffroy
- Inserm, U955, service de psychiatrie génétique, 94000 Créteil, France; Pôle de psychiatrie (Pr Leboyer), centre expert bipolaire, hôpital Henri-Mondor - Albert-Chenevier, AP-HP, 40, rue de Mesly, 94000 Créteil cedex, France; Pôle de psychiatrie, université Lille Nord de France, CHRU de Lille, 59000 Lille, France; Fondation FondaMental, 94000 Créteil, France.
| | - M Leboyer
- Inserm, U955, service de psychiatrie génétique, 94000 Créteil, France; Faculté de médecine, université Paris Est, 94000 Créteil, France; Pôle de psychiatrie (Pr Leboyer), centre expert bipolaire, hôpital Henri-Mondor - Albert-Chenevier, AP-HP, 40, rue de Mesly, 94000 Créteil cedex, France; Fondation FondaMental, 94000 Créteil, France
| | - J Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, UK; Centre for Affective Disorders, Institute of Psychiatry, London, UK
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Elsabbagh M, Gliga T, Pickles A, Hudry K, Charman T, Johnson MH. The development of face orienting mechanisms in infants at-risk for autism. Behav Brain Res 2013; 251:147-54. [PMID: 22846849 PMCID: PMC3730054 DOI: 10.1016/j.bbr.2012.07.030] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 07/18/2012] [Accepted: 07/19/2012] [Indexed: 12/18/2022]
Abstract
A popular idea related to early brain development in autism is that a lack of attention to, or interest in, social stimuli early in life interferes with the emergence of social brain networks mediating the typical development of socio-communicative skills. Compelling as it is, this developmental account has proved difficult to verify empirically because autism is typically diagnosed in toddlerhood, after this process of brain specialization is well underway. Using a prospective study, we directly tested the integrity of social orienting mechanisms in infants at-risk for autism by virtue of having an older diagnosed sibling. Contrary to previous accounts, infants who later develop autism exhibit a clear orienting response to faces that are embedded within an array of distractors. Nevertheless, infants at-risk for autism as a group, and irrespective of their subsequent outcomes, had a greater tendency to select and sustain attention to faces. This pattern suggests that interactions among multiple social and attentional brain systems over the first two years give rise to variable pathways in infants at-risk.
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Affiliation(s)
- Mayada Elsabbagh
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
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