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Djordjevic M, Farhang S, Shirzadi M, Mousavi SB, Bruggeman R, Malek A, Mohagheghi A, Ranjbar F, Shafiee-Kandjani AR, Jongsma HE, Veling W. Self-stigma, religiosity, and perceived social support in people with recent-onset psychosis in the Islamic Republic of Iran: Associations with symptom severity and psychosocial functioning. Int J Soc Psychiatry 2024; 70:542-553. [PMID: 38312047 PMCID: PMC11067409 DOI: 10.1177/00207640231221090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
AIMS Most evidence on psychosocial factors in recent-onset psychosis comes from high-income countries in Europe, Australia, Canada and the USA, while these factors are likely to differ under varying sociocultural and economic circumstances. In this study, we aimed to investigate associations of self-stigma, religiosity and perceived social support with symptom severity and psychosocial functioning in an Iranian cohort of people with recent-onset psychosis (i.e. illness duration of <2 years). METHODS We used baseline data of 361 participants (N = 286 [74%] male, mean age = 34 years [Standard Deviation = 10.0]) from the Iranian Azeri Recent-onset Acute Phase Psychosis Survey (ARAS). We included assessments of self-stigma (Internalized Stigma of Mental Illness, ISMI), religiosity (based on Stark & Glock), perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS), symptom severity (Positive And Negative Syndrome Scale, PANSS) and psychosocial functioning (clinician-rated Global Assessment of Functioning Scale, GAF, and self-reported World Health Organization Disability Assessment Schedule 2.0, WHODAS 2.0). Descriptive analyses were employed to characterize the study sample. Covariate-adjusted ordinal and multivariable linear regression analyses were performed to investigate cross-sectional associations of baseline ISMI, religiosity and MSPSS with concurrent PANSS, GAF and WHODAS 2.0. RESULTS Higher self-stigma was associated with poorer self-reported functioning (B = 0.375 [95% Confidence Interval (CI): 0.186, 0.564]) and more severe concurrent symptoms (B = 0.436 [95% CI: 0.275, 0.597]). Being more religious was associated with poorer clinician-rated functioning (OR = 0.967 [95% CI: 0.944, 0.991]), but with less severe symptoms (B = -0.258 [95% CI: -0.427, -0.088]). Stronger social support was associated with poorer clinician-rated (OR = 0.956 [95% CI: 0.935, 0.978]) and self-reported functioning (B = 0.337 [95% CI: 0.168, 0.507]). CONCLUSION This study shows that self-stigma, religiosity and perceived social support were associated with symptom severity and clinician-rated as well as self-reported psychosocial functioning in an Iranian cohort of people with recent-onset psychosis. The findings extend previous evidence on these psychosocial factors to one of the largest countries in the Middle East, and suggest that it may be worthwhile to develop strategies aimed at tackling stigma around psychosis and integrate the role of religiosity and social support in mental ill-health prevention and therapy.
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Affiliation(s)
- M Djordjevic
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - S Farhang
- Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - M Shirzadi
- Clinical Research Development Center, Imam Khomeini, Mohammad Kermanshahi and Farabi Hospitals, Kermanshah University of Medical
Sciences, Kermanshah, Iran
| | - SB Mousavi
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - R Bruggeman
- Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - A Malek
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - A Mohagheghi
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - F Ranjbar
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - AR Shafiee-Kandjani
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Iran
| | - HE Jongsma
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - W Veling
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
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Brand AM, Groen SPN, Destoop N, Jongsma HE, Ghane S, Sabbe BGC, van Velsen H, van Houten K, Becan Ö, Al Alyan D, Braakman MH. The effect of the cultural formulation interview on therapeutic working alliance: a study protocol. Front Psychiatry 2024; 15:1322356. [PMID: 38501082 PMCID: PMC10945007 DOI: 10.3389/fpsyt.2024.1322356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/14/2024] [Indexed: 03/20/2024] Open
Abstract
Background The Cultural Formulation Interview (CFI) is designed to improve understanding of patients' mental health care needs. The lack of empirical evidence on the impact and effectiveness of CFI use in clarifying people's perspectives, experiences, context, and identity, and in preventing cultural misunderstandings between migrant patients and clinicians, inspired this study. The objective is to examine the effect of the CFI on the strength of therapeutic working alliances, and the potential mediating or moderating role of perceived empathy. Materials and methods A multicenter randomized controlled trial will be conducted, involving migrant patients, their confidants, and clinicians. The CFI will be administered in the intervention group, but not in the control group. Validated questionnaires will be used to assess therapeutic working alliances and perceived empathy. T-tests and linear regression analyses will be conducted to investigate between-group differences and possible mediating or moderating effects. Results This study will indicate whether or not the CFI strengthens the therapeutic working alliance between patients and clinicians, as moderated and/or mediated by perceived empathy. Discussion Research on the effect and impact of using the CFI in mental health care for migrant patients is important to clarify whether its use strengthens the therapeutic working alliance with clinicians. This can lead to a reduction in cultural misunderstandings and improve mental health care for migrant patients. The results may also be important for the implementation of the CFI as a standard of care. Ethics and dissemination This research protocol was tailored to the needs of patients in collaboration with experts by experience. It was approved by the Ethical Review Board of the Tilburg Law School and registered in the Clinical Trials Register under number NCT05788315. Positive results may stimulate further implementation of the CFI in clinical practice, and contribute to improving the impact of the CFI on the therapeutic working alliances.
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Affiliation(s)
- Alma M Brand
- Tilburg Law School, Tilburg University, Tilburg, Netherlands
| | - Simon P N Groen
- De Evenaar, Center for Transcultural Psychiatry, GGZ Drenthe, Beilen, Netherlands
| | - Nathalie Destoop
- Mobile 2B Team SPITT and Culture-sensitive Care POZAH, Psychiatric Hospital Sint-Alexius Grimbergen, Brussels, Belgium
| | - Hannah E Jongsma
- Center for Transcultural Psychiatry Veldzicht, Balkbrug, Netherlands
- University Center of Psychiatry, University Medical Center Groningen (UMCG), Groningen, Netherlands
| | | | - Bernard G C Sabbe
- Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute, University of Antwerpen, Antwerpen, Belgium
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D'Andrea G, Quattrone D, Malone K, Tripoli G, Trotta G, Spinazzola E, Gayer-Anderson C, Jongsma HE, Sideli L, Stilo SA, La Cascia C, Ferraro L, Lasalvia A, Tosato S, Tortelli A, Velthorst E, de Haan L, Llorca PM, Rossi Menezes P, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, Rutten BP, Van Os J, Selten JP, Vassos E, Schürhoff F, Szöke A, Pignon B, O'Donovan M, Richards A, Morgan C, Di Forti M, Tarricone I, Murray RM. Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study. Psychol Med 2024:1-14. [PMID: 38288603 DOI: 10.1017/s0033291723003781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND Incidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP. METHODS We used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately. RESULTS Schizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia. CONCLUSIONS Schizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.
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Affiliation(s)
- Giuseppe D'Andrea
- University of Montreal Hospital Reseach Centre (CRCHUM), Montréal, Québec, Canada
- Douglas Mental Health University Institute, Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Montréal, Québec, Canada
- Community Mental Health Center of Sassuolo, Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kathryn Malone
- Central and North West London NHS Foundation Trust, London, UK
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche, Palermo, Italy
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Hannah E Jongsma
- Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, The Netherlands
- University Centre for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands
| | - Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy
| | - Simona A Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, Verona, Italy
| | | | - Eva Velthorst
- Department of Research, Community Mental Health Service, GGZ Noord-Holland-Noord, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Paulo Rossi Menezes
- University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz", Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, Ineuropa, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, ISCIII, Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- School for Mental Health and Neuroscience, University of Maastricht, Maastricht, The Netherlands
| | - Jean-Paul Selten
- School for Mental Health and Neuroscience, University of Maastricht, Maastricht, The Netherlands
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Franck Schürhoff
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, Creteil, France
| | - Andrei Szöke
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, Creteil, France
| | - Baptiste Pignon
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, Creteil, France
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Alexander Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Craig Morgan
- ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Department of Mental Health and Pathological Addiction, AUSL Bologna, Bologna, Italy
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Spinazzola E, Quattrone D, Rodriguez V, Trotta G, Alameda L, Tripoli G, Gayer-Anderson C, Freeman TP, Johnson EC, Jongsma HE, Stilo S, La Cascia C, Ferraro L, La Barbera D, Lasalvia A, Tosato S, Tarricone I, D'Andrea G, Galatolo M, Tortelli A, Tagliabue I, Turco M, Pompili M, Selten JP, de Haan L, Rossi Menezes P, Del Ben CM, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, O'Donovan M, Rutten BP, Van Os J, Morgan C, Sham PC, Austin-Zimmerman I, Li Z, Vassos E, Murray RM, Di Forti M. The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study. Psychol Med 2023; 53:7418-7427. [PMID: 37129249 PMCID: PMC10719678 DOI: 10.1017/s0033291723001071] [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: 09/21/2022] [Revised: 01/23/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis. METHODS We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status. RESULTS Controls (86.1%) and FEPp (75.63%) were most likely to report 'because of friends' as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: 'to feel better' as their RFUC (χ2 = 50.97; p < 0.001). RFUC 'to feel better' was associated with being a FEPp (OR 1.74; 95% CI 1.03-2.95) while RFUC 'with friends' was associated with being a control (OR 0.56; 95% CI 0.37-0.83). The path model indicated an association between RFUC 'to feel better' with heavy cannabis use and with FEPp-control status. CONCLUSIONS Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use 'to feel better'. People who reported their reason for first using cannabis to 'feel better' were more likely to progress to heavy use and develop a psychotic disorder than those reporting 'because of friends'.
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Affiliation(s)
- Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- National Institute for Health Research, Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne, University Hospital (CHUV), Lausanne, Switzerland
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM); Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Simona Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Caterina La Cascia
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Michela Galatolo
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Andrea Tortelli
- Institut Mondor de recherché biomedicale, Creteil, France
- Etablissement Public de Sante Maison Blanche, Paris, France
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
| | - Marco Turco
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Section, AmsterdamUMC, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Cristina M Del Ben
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz”, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - James B Kirkbride
- Reader; Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pak C Sham
- Department of Psychiatry, Centre for PanorOmic Sciences, and State Key Laboratory of Brain and Cognitive Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Isabelle Austin-Zimmerman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Zhikun Li
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - EU-GEI WP2 Group
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
- Research Foundation, National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and the NIHR BRC at University College London, London, UK
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Trotta G, Rodriguez V, Quattrone D, Spinazzola E, Tripoli G, Gayer-Anderson C, Freeman TP, Jongsma HE, Sideli L, Aas M, Stilo SA, La Cascia C, Ferraro L, La Barbera D, Lasalvia A, Tosato S, Tarricone I, D'Andrea G, Tortelli A, Schürhoff F, Szöke A, Pignon B, Selten JP, Velthorst E, de Haan L, Llorca PM, Rossi Menezes P, Del Ben CM, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, Richards A, Rutten BP, Van Os J, Austin-Zimmerman I, Li Z, Morgan C, Sham PC, Vassos E, Wong C, Bentall R, Fisher HL, Murray RM, Alameda L, Di Forti M. Cannabis use as a potential mediator between childhood adversity and first-episode psychosis: results from the EU-GEI case-control study. Psychol Med 2023; 53:7375-7384. [PMID: 38078747 PMCID: PMC10719680 DOI: 10.1017/s0033291723000995] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/21/2023] [Accepted: 03/27/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Childhood adversity and cannabis use are considered independent risk factors for psychosis, but whether different patterns of cannabis use may be acting as mediator between adversity and psychotic disorders has not yet been explored. The aim of this study is to examine whether cannabis use mediates the relationship between childhood adversity and psychosis. METHODS Data were utilised on 881 first-episode psychosis patients and 1231 controls from the European network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Detailed history of cannabis use was collected with the Cannabis Experience Questionnaire. The Childhood Experience of Care and Abuse Questionnaire was used to assess exposure to household discord, sexual, physical or emotional abuse and bullying in two periods: early (0-11 years), and late (12-17 years). A path decomposition method was used to analyse whether the association between childhood adversity and psychosis was mediated by (1) lifetime cannabis use, (2) cannabis potency and (3) frequency of use. RESULTS The association between household discord and psychosis was partially mediated by lifetime use of cannabis (indirect effect coef. 0.078, s.e. 0.022, 17%), its potency (indirect effect coef. 0.059, s.e. 0.018, 14%) and by frequency (indirect effect coef. 0.117, s.e. 0.038, 29%). Similar findings were obtained when analyses were restricted to early exposure to household discord. CONCLUSIONS Harmful patterns of cannabis use mediated the association between specific childhood adversities, like household discord, with later psychosis. Children exposed to particularly challenging environments in their household could benefit from psychosocial interventions aimed at preventing cannabis misuse.
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Affiliation(s)
- Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Tom P Freeman
- University of Bath Department of Pharmacy and Pharmacology: University of Bath Department of Life Sciences, Bath, UK
| | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, UK
| | - Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy
| | - Monica Aas
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simona A Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Caterina La Cascia
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Laura Ferraro
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Daniele La Barbera
- University of Palermo Department of Biomedicine Neuroscience and Advanced Diagnostics: Universita degli Studi di Palermo Dipartimento di Biomedicina Neuroscienze e Diagnostica avanzata, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- University of Bologna Department of Medical and Surgical Sciences: Universita degli Studi di Bologna Dipartimento di Scienze Mediche e Chirurgiche, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Franck Schürhoff
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Andrei Szöke
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Baptiste Pignon
- Univ Paris Est Creteil (UPEC), AP-HP, Hopitaux Universitaires ‘H. Mondor’, DMU IMPACT, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010 Creteil, France
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands
| | - Eva Velthorst
- Mount Sinai School of Medicine Department of Psychiatry: Icahn School of Medicine, New York, NY, USA
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Cristina M Del Ben
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirao Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Jose Luis Santos
- Department of Psychiatry, Hospital ‘Virgen de la Luz’, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigation Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Centro de Investigation Biomedica en Red de Salud Mental, School of Medicine, Universidad de Valencia, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Department of Medicine, Neuroscience Institute, University of Barcelona, Institute d'investigations Biomediques, August Pi I Sunyer, Centro de Investigation Biomedica en Red de Salud Mental, Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Maranon, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | - Alexander Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Isabelle Austin-Zimmerman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Zhikun Li
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Pak C Sham
- Hong Kong University: University of Hong Kong, Hong Kong
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Chloe Wong
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard Bentall
- The University of Sheffield Department of Psychology, Sheffield, UK
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - EU-GEI WP2 Group
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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6
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Sideli L, Aas M, Quattrone D, La Barbera D, La Cascia C, Ferraro L, Alameda L, Velthorst E, Trotta G, Tripoli G, Schimmenti A, Fontana A, Gayer-Anderson C, Stilo S, Seminerio F, Sartorio C, Marrazzo G, Lasalvia A, Tosato S, Tarricone I, Berardi D, D'Andrea G, Arango C, Arrojo M, Bernardo M, Bobes J, Sanjuán J, Santos JL, Menezes PR, Del-Ben CM, Jongsma HE, Jones PB, Kirkbride JB, Llorca PM, Tortelli A, Pignon B, de Haan L, Selten JP, Van Os J, Rutten BP, Bentall R, Di Forti M, Murray RM, Morgan C, Fisher HL. The relationship between genetic liability, childhood maltreatment, and IQ: findings from the EU-GEI multicentric case-control study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1573-1580. [PMID: 37335320 PMCID: PMC10460355 DOI: 10.1007/s00127-023-02513-0] [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: 01/24/2023] [Accepted: 06/04/2023] [Indexed: 06/21/2023]
Abstract
This study investigated if the association between childhood maltreatment and cognition among psychosis patients and community controls was partially accounted for by genetic liability for psychosis. Patients with first-episode psychosis (N = 755) and unaffected controls (N = 1219) from the EU-GEI study were assessed for childhood maltreatment, intelligence quotient (IQ), family history of psychosis (FH), and polygenic risk score for schizophrenia (SZ-PRS). Controlling for FH and SZ-PRS did not attenuate the association between childhood maltreatment and IQ in cases or controls. Findings suggest that these expressions of genetic liability cannot account for the lower levels of cognition found among adults maltreated in childhood.
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Affiliation(s)
- Lucia Sideli
- Department of Human Science, LUMSA University, Piazza delle Vaschette, 101, 00193, Rome, Italy.
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England.
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy.
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- NORMENT Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- Department of Behavioural Sciences, OsloMet, Oslo Metropolitan University, Oslo, Norway
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Seville, Spain
- Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Seville, Spain
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Eva Velthorst
- Department of Research, Mental Health Service Organization 'GGZ Noord-Holland-Noord', Hoorn, The Netherlands
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Andrea Fontana
- Department of Human Science, LUMSA University, Piazza delle Vaschette, 101, 00193, Rome, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Simona Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Giovanna Marrazzo
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum - Bologna University, Bologna, Italy
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Hospital "Virgen de La Luz", Cuenca, Spain
| | | | | | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, England
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
- EA 7280 Npsydo, Université Clermont Auvergne, Clermont-Ferrand, France
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, England
| | | | - Andrea Tortelli
- Establissement Public de Santé, Maison Blanche, Paris, France
| | - Baptiste Pignon
- AP-HP, Groupe Hospitalier "Mondor", Pôle de Psychiatrie, Créteil, France
- Institut National de la Santé et de la Recherche Médicale, U955, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Richard Bentall
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- ESRC Centre for Society and Mental Health, King's College London, London, UK
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7
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D'Andrea G, Lal J, Tosato S, Gayer-Anderson C, Jongsma HE, Stilo SA, van der Ven E, Quattrone D, Velthorst E, Berardi D, Rossi Menezes P, Arango C, Parellada M, Lasalvia A, La Cascia C, Ferraro L, La Barbera D, Sideli L, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Tripoli G, Llorca PM, de Haan L, Selten JP, Tortelli A, Szöke A, Muratori R, Rutten BP, van Os J, Jones PB, Kirkbride JB, Murray RM, di Forti M, Tarricone I, Morgan C. Child maltreatment, migration and risk of first-episode psychosis: results from the multinational EU-GEI study. Psychol Med 2023; 53:6150-6160. [PMID: 36305570 PMCID: PMC10520604 DOI: 10.1017/s003329172200335x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Child maltreatment (CM) and migrant status are independently associated with psychosis. We examined prevalence of CM by migrant status and tested whether migrant status moderated the association between CM and first-episode psychosis (FEP). We further explored whether differences in CM exposure contributed to variations in the incidence rates of FEP by migrant status. METHODS We included FEP patients aged 18-64 years in 14 European sites and recruited controls representative of the local populations. Migrant status was operationalized according to generation (first/further) and region of origin (Western/non-Western countries). The reference population was composed by individuals of host country's ethnicity. CM was assessed with Childhood Trauma Questionnaire. Prevalence ratios of CM were estimated using Poisson regression. We examined the moderation effect of migrant status on the odds of FEP by CM fitting adjusted logistic regressions with interaction terms. Finally, we calculated the population attributable fractions (PAFs) for CM by migrant status. RESULTS We examined 849 FEP cases and 1142 controls. CM prevalence was higher among migrants, their descendants and migrants of non-Western heritage. Migrant status, classified by generation (likelihood test ratio:χ2 = 11.3, p = 0.004) or by region of origin (likelihood test ratio:χ2 = 11.4, p = 0.003), attenuated the association between CM and FEP. PAFs for CM were higher among all migrant groups compared with the reference populations. CONCLUSIONS The higher exposure to CM, despite a smaller effect on the odds of FEP, accounted for a greater proportion of incident FEP cases among migrants. Policies aimed at reducing CM should consider the increased vulnerability of specific subpopulations.
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Affiliation(s)
- Giuseppe D'Andrea
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Community Mental Health Center of Sassuolo, Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy
| | - Jatin Lal
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Charlotte Gayer-Anderson
- ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Hannah E Jongsma
- Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, The Netherlands
- University Centre for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands
| | - Simona A Stilo
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Els van der Ven
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Section of Psychiatry, University of Bologna, Bologna, Italy
| | - Paulo Rossi Menezes
- University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, Ineuropa, CIBERSAM, Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz", Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Cristina Marta Del-Ben
- Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche, 290127 Palermo, Italy
| | | | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- School for Mental Health and Neuroscience, University of Maastricht, Maastricht, The Netherlands
| | | | - Andrei Szöke
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, F-94010 Créteil, France
| | - Roberto Muratori
- Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marta di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy
| | - Craig Morgan
- ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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8
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Rodríguez-Toscano E, Alloza C, Fraguas D, Durán-Cutilla M, Roldán L, Sánchez-Gutiérrez T, López-Montoya G, Parellada M, Moreno C, Gayer-Anderson C, Jongsma HE, Di Forti M, Quattrone D, Velthorst E, de Haan L, Selten JP, Szöke A, Llorca PM, Tortelli A, Bobes J, Bernardo M, Sanjuán J, Luis Santos J, Arrojo M, Tarricone I, Berardi D, Ruggeri M, Lasalvia A, Ferraro L, La Cascia C, La Barbera D, Menezes PR, Del-Ben CM, Rutten BP, van Os J, Jones PB, Murray RM, Kirkbride JB, Morgan C, Díaz-Caneja CM, Arango C. Differences in Patterns of Stimulant Use and Their Impact on First-Episode Psychosis Incidence: An Analysis of the EUGEI Study. Schizophr Bull 2023; 49:1269-1280. [PMID: 37467351 PMCID: PMC10483438 DOI: 10.1093/schbul/sbad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Use of illegal stimulants is associated with an increased risk of psychotic disorder. However, the impact of stimulant use on odds of first-episode psychosis (FEP) remains unclear. Here, we aimed to describe the patterns of stimulant use and examine their impact on odds of FEP. METHODS We included patients with FEP aged 18-64 years who attended psychiatric services at 17 sites across 5 European countries and Brazil, and recruited controls representative of each local population (FEP = 1130; controls = 1497). Patterns of stimulant use were described. We computed fully adjusted logistic regression models (controlling for age, sex, ethnicity, cannabis use, and education level) to estimate their association with odds of FEP. Assuming causality, we calculated the population-attributable fractions for stimulant use associated with the odds for FEP. FINDINGS Prevalence of lifetime and recent stimulant use in the FEP sample were 14.50% and 7.88% and in controls 10.80% and 3.8%, respectively. Recent and lifetime stimulant use was associated with increased odds of FEP compared with abstainers [fully adjusted odds ratio 1.74,95% confidence interval (CI) 1.20-2.54, P = .004 and 1.62, 95% CI 1.25-2.09, P < .001, respectively]. According to PAFs, a substantial number of FEP cases (3.35% [95% CI 1.31-4.78] for recent use and 7.61% [95% CI 3.68-10.54] for lifetime use) could have been prevented if stimulants were no longer available and the odds of FEP and PAFs for lifetime and recent stimulant use varied across countries. INTERPRETATION Illegal stimulant use has a significant and clinically relevant influence on FEP incidence, with varying impacts across countries.
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Affiliation(s)
- Elisa Rodríguez-Toscano
- Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos, IdISSC, School of Medicine, Universidad Complutense, Madrid, Spain
- Faculty of Psychology, Universidad Complutense, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Clara Alloza
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - David Fraguas
- Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos, IdISSC, School of Medicine, Universidad Complutense, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Manuel Durán-Cutilla
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Laura Roldán
- Faculty of Psychology, Universidad Complutense, Madrid, Spain
| | | | - Gonzalo López-Montoya
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
- Faculty of Health Science, Universidad Internacional de la Rioja (UNIR), Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Charlotte Gayer-Anderson
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Marta Di Forti
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Diego Quattrone
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Andrei Szöke
- Institut National de la Santé et de la Recherche Médicale, U955, Equipe 15 Neuro-Psychiatrie Translationnelle, Créteil, France
- AP-HP, Pôle de Psychiatrie des Hôpitaux Universitaires Henri Mondor, Créteil, France
- Fondation FondaMental, Créteil, France
| | | | - Andrea Tortelli
- Pôle Psychiatrie Précarité, Groupe Hospitalier Universitaire Paris Psychiatrie and Neurosciences, 75014 Paris, France
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic of Barcelona; Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB); Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS); CIBERSAM, ISCIII, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - José Luis Santos
- Department of Psychiatry, Hospital “Virgen de la Luz”, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Ilaria Tarricone
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorium Università di Bologna, Bologna, Italy
| | | | - Mirella Ruggeri
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience and advanced Diagnostic (BiND), Psychiatry section, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and advanced Diagnostic (BiND), Psychiatry section, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and advanced Diagnostic (BiND), Psychiatry section, University of Palermo, Palermo, Italy
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, Universidade de São Paulo, São Paulo, Brazil
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, UK
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Covadonga M Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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9
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Rodriguez V, Alameda L, Quattrone D, Tripoli G, Gayer-Anderson C, Spinazzola E, Trotta G, Jongsma HE, Stilo S, La Cascia C, Ferraro L, La Barbera D, Lasalvia A, Tosato S, Tarricone I, Bonora E, Jamain S, Selten JP, Velthorst E, de Haan L, Llorca PM, Arrojo M, Bobes J, Bernardo M, Arango C, Kirkbride J, Jones PB, Rutten BP, Richards A, Sham PC, O'Donovan M, Van Os J, Morgan C, Di Forti M, Murray RM, Vassos E. Use of multiple polygenic risk scores for distinguishing schizophrenia-spectrum disorder and affective psychosis categories in a first-episode sample; the EU-GEI study. Psychol Med 2023; 53:3396-3405. [PMID: 35076361 PMCID: PMC10277719 DOI: 10.1017/s0033291721005456] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 07/12/2021] [Revised: 12/05/2021] [Accepted: 12/15/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Schizophrenia (SZ), bipolar disorder (BD) and depression (D) run in families. This susceptibility is partly due to hundreds or thousands of common genetic variants, each conferring a fractional risk. The cumulative effects of the associated variants can be summarised as a polygenic risk score (PRS). Using data from the EUropean Network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) first episode case-control study, we aimed to test whether PRSs for three major psychiatric disorders (SZ, BD, D) and for intelligent quotient (IQ) as a neurodevelopmental proxy, can discriminate affective psychosis (AP) from schizophrenia-spectrum disorder (SSD). METHODS Participants (842 cases, 1284 controls) from 16 European EU-GEI sites were successfully genotyped following standard quality control procedures. The sample was stratified based on genomic ancestry and analyses were done only on the subsample representing the European population (573 cases, 1005 controls). Using PRS for SZ, BD, D, and IQ built from the latest available summary statistics, we performed simple or multinomial logistic regression models adjusted for 10 principal components for the different clinical comparisons. RESULTS In case-control comparisons PRS-SZ, PRS-BD and PRS-D distributed differentially across psychotic subcategories. In case-case comparisons, both PRS-SZ [odds ratio (OR) = 0.7, 95% confidence interval (CI) 0.54-0.92] and PRS-D (OR = 1.31, 95% CI 1.06-1.61) differentiated AP from SSD; and within AP categories, only PRS-SZ differentiated BD from psychotic depression (OR = 2.14, 95% CI 1.23-3.74). CONCLUSIONS Combining PRS for severe psychiatric disorders in prediction models for psychosis phenotypes can increase discriminative ability and improve our understanding of these phenotypes. Our results point towards the potential usefulness of PRSs in specific populations such as high-risk or early psychosis phases.
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Affiliation(s)
- Victoria Rodriguez
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Luis Alameda
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Instituto de Investigación Sanitaria de Sevilla, IBiS, Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Sevilla, Spain
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Diego Quattrone
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Giada Tripoli
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giulia Trotta
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Hannah E. Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Simona Stilo
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Caterina La Cascia
- Section of Psychiatry, Department of Biomedicine, Neuroscience and advanced Diagnostic (BiND), University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Section of Psychiatry, Department of Biomedicine, Neuroscience and advanced Diagnostic (BiND), University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Section of Psychiatry, Department of Biomedicine, Neuroscience and advanced Diagnostic (BiND), University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Science, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Elena Bonora
- Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Science, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Stéphane Jamain
- Neuropsychiatrie Translationnelle, INSERM, U955, Faculté de Santé, Université Paris Est, Créteil, France
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Julio Bobes
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - James Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Bart P. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Alexander Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Pak C. Sham
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Jim Van Os
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin M. Murray
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Evangelos Vassos
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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10
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Alameda L, Liu Z, Sham PC, Aas M, Trotta G, Rodriguez V, Di Forti M, Stilo SA, Kandaswamy R, Arango C, Arrojo M, Bernardo M, Bobes J, de Haan L, Del-Ben CM, Gayer-Anderson C, Sideli L, Jones PB, Jongsma HE, Kirkbride JB, La Cascia C, Lasalvia A, Tosato S, Llorca PM, Menezes PR, van Os J, Quattrone D, Rutten BP, Santos JL, Sanjuán J, Selten JP, Szöke A, Tarricone I, Tortelli A, Velthorst E, Morgan C, Dempster E, Hannon E, Burrage J, Dwir D, Arumuham A, Mill J, Murray RM, Wong CCY. Exploring the mediation of DNA methylation across the epigenome between childhood adversity and First Episode of Psychosis-findings from the EU-GEI study. Mol Psychiatry 2023; 28:2095-2106. [PMID: 37062770 DOI: 10.1038/s41380-023-02044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 03/04/2023] [Accepted: 03/20/2023] [Indexed: 04/18/2023]
Abstract
ABTRACT Studies conducted in psychotic disorders have shown that DNA-methylation (DNAm) is sensitive to the impact of Childhood Adversity (CA). However, whether it mediates the association between CA and psychosis is yet to be explored. Epigenome wide association studies (EWAS) using the Illumina Infinium-Methylation EPIC array in peripheral blood tissue from 366 First-episode of psychosis and 517 healthy controls was performed. Adversity scores were created for abuse, neglect and composite adversity with the Childhood Trauma Questionnaire (CTQ). Regressions examining (I) CTQ scores with psychosis; (II) with DNAm EWAS level and (III) between DNAm and caseness, adjusted for a variety of confounders were conducted. Divide-Aggregate Composite-null Test for the composite null-hypothesis of no mediation effect was conducted. Enrichment analyses were conducted with missMethyl package and the KEGG database. Our results show that CA was associated with psychosis (Composite: OR = 1.68; p = <0.001; abuse: OR = 2.16; p < 0.001; neglect: OR = 2.27; p = <0.001). None of the CpG sites significantly mediated the adversity-psychosis association after Bonferroni correction (p < 8.1 × 10-8). However, 28, 34 and 29 differentially methylated probes associated with 21, 27, 20 genes passed a less stringent discovery threshold (p < 5 × 10-5) for composite, abuse and neglect respectively, with a lack of overlap between abuse and neglect. These included genes previously associated to psychosis in EWAS studies, such as PANK1, SPEG TBKBP1, TSNARE1 or H2R. Downstream gene ontology analyses did not reveal any biological pathways that survived false discovery rate correction. Although at a non-significant level, DNAm changes in genes previously associated with schizophrenia in EWAS studies may mediate the CA-psychosis association. These results and associated involved processes such as mitochondrial or histaminergic disfunction, immunity or neural signalling requires replication in well powered samples. The lack of overlap between mediating genes associated with abuse and neglect suggests differential biological trajectories linking CA subtypes and psychosis.
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Affiliation(s)
- Luis Alameda
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, UK.
- Instituto de Investigación Sanitaria de Sevilla, IbiS, Hospital Universitario Virgen del Rocío, Department of Psychiatry, Universidad de Sevilla, Seville, Spain.
| | - Zhonghua Liu
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - Pak C Sham
- Department of Psychiatry, State Key Laboratory of Brain and Cognitive Sciences, and Centre for PanorOmic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Monica Aas
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Giulia Trotta
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Victoria Rodriguez
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, UK
| | - Marta Di Forti
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Simona A Stilo
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Radhika Kandaswamy
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain
| | - Julio Bobes
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Cristina Marta Del-Ben
- Neuroscience and Behaviour Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Lucia Sideli
- LUMSA University, Department of Human Science and Department of Psychosis Studies, KCL, Rome, Italy
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Caterina La Cascia
- Section of Psychiatry, Department of Biomedicine, Neuroscience and advanced Diagnostic (BiND), University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Jim van Os
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Diego Quattrone
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hos"ital "Virgen de"a Luz", C/Hermandad de Donantes de Sangre, 16002, Cuenca, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Avda. Blasco Ibáñez 15, 46010, Valencia, Spain
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
| | - Andrei Szöke
- University of Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires, H. Mondor, DMU IMPACT, Creteil, France
| | - Ilaria Tarricone
- Bologna Transcultural Psychosomatic Team (BoTPT), Department of Medical and Surgical Science, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | | | - Eva Velthorst
- GGZ (Mental Health Services) Noord Holland Noord, Heerhugowaard, the Netherlands
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Emma Dempster
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Eilis Hannon
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Joe Burrage
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Daniella Dwir
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Atheeshaan Arumuham
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, UK
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Clinical Sciences (ICS), Faculty of Medicine, Imperial College London, London, UK
| | - Jonathan Mill
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Robin M Murray
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, UK
| | - Chloe C Y Wong
- Social, Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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11
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Aas M, Alameda L, Di Forti M, Quattrone D, Dazzan P, Trotta A, Ferraro L, Rodriguez V, Vassos E, Sham P, Tripoli G, Cascia CL, Barbera DL, Tarricone I, Muratori R, Berardi D, Lasalvia A, Tosato S, Szöke A, Llorca PM, Arango C, Tortelli A, de Haan L, Velthorst E, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Menezes PR, Selten JP, Jones PB, Jongsma HE, Kirkbride JB, Rutten BPF, van Os J, Gayer-Anderson C, Murray RM, Morgan C. Synergistic effects of childhood adversity and polygenic risk in first-episode psychosis: the EU-GEI study. Psychol Med 2023; 53:1970-1978. [PMID: 37310339 PMCID: PMC10106300 DOI: 10.1017/s0033291721003664] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 04/26/2021] [Revised: 08/08/2021] [Accepted: 08/18/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND A history of childhood adversity is associated with psychotic disorder, with an increase in risk according to the number of exposures. However, it is not known why only some exposed individuals go on to develop psychosis. One possibility is pre-existing polygenic vulnerability. Here, we investigated, in the largest sample of first-episode psychosis (FEP) cases to date, whether childhood adversity and high polygenic risk scores for schizophrenia (SZ-PRS) combine synergistically to increase the risk of psychosis, over and above the effect of each alone. METHODS We assigned a schizophrenia-polygenic risk score (SZ-PRS), calculated from the Psychiatric Genomics Consortium (PGC2), to all participants in a sample of 384 FEP patients and 690 controls from the case-control component of the EU-GEI study. Only participants of European ancestry were included in the study. A history of childhood adversity was collected using the Childhood Trauma Questionnaire (CTQ). Synergistic effects were estimated using the interaction contrast ratio (ICR) [odds ratio (OR)exposure and PRS - ORexposure - ORPRS + 1] with adjustment for potential confounders. RESULTS There was some evidence that the combined effect of childhood adversities and polygenic risk was greater than the sum of each alone, as indicated by an ICR greater than zero [i.e. ICR 1.28, 95% confidence interval (CI) -1.29 to 3.85]. Examining subtypes of childhood adversities, the strongest synergetic effect was observed for physical abuse (ICR 6.25, 95% CI -6.25 to 20.88). CONCLUSIONS Our findings suggest possible synergistic effects of genetic liability and childhood adversity experiences in the onset of FEP, but larger samples are needed to increase precision of estimates.
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Affiliation(s)
- Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
- Norment, Oslo University Hospital, Oslo, Norway
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Instituto de Investigación Biomédica de Sevilla, Universidad de Sevilla, Seville, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AE, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AE, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Antonella Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Laura Ferraro
- Biomedicine, Neuroscience and Advanced Diagnostic (BiND) Department, University of Palermo, Palermo, Italy
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AE, UK
| | - Pak Sham
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
- Biomedicine, Neuroscience and Advanced Diagnostic (BiND) Department, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Biomedicine, Neuroscience and Advanced Diagnostic (BiND) Department, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Biomedicine, Neuroscience and Advanced Diagnostic (BiND) Department, University of Palermo, Palermo, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, 40126 Bologna, Italy
| | - Roberto Muratori
- Department of Mental Health and Pathological Addiction, Bologna Local Health Authority, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, 40126 Bologna, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Andrei Szöke
- INSERM U955, Equipe 15, Institut National de la Santé et de la Recherche Médicale, 94010 Créteil, France
| | - Pierre-Michel Llorca
- CMPB CHU Clermont-Ferrand, EA 7280, University Clermont Auvergne, Clermont-Ferrand, France
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), 28007 Madrid, Spain
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, 75020 Paris, France
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Julio Bobes
- Faculty of Medicine and Health Sciences – Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, 33006 Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, University of Barcelona; IDIBAPS, CIBERSAM, 08036 Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 46010 Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital ‘Virgen de la Luz’, 16002 Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatry Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo 14049-900, Brazil
| | - Paulo Rossi Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo 01246-903, Brazil
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, 2333 ZZ Leiden, The Netherlands
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Hannah E. Jongsma
- Psylife Group, Division of Psychiatry, University College London, London W1T 7NF, UK
| | - James B. Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London W1T 7NF, UK
| | - Bart P. F. Rutten
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
| | - Charlotte Gayer-Anderson
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Craig Morgan
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
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12
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Bastien RJB, Ding T, Gonzalez-Valderrama A, Valmaggia L, Kirkbride JB, Jongsma HE. The incidence of non-affective psychotic disorders in low and middle-income countries: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:523-536. [PMID: 36547685 PMCID: PMC10066134 DOI: 10.1007/s00127-022-02397-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 10/29/2021] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Global understanding of the epidemiological landscape of non-affective psychotic disorders (NAPD) is predominantly based on studies from high-income countries. We sought to systematically review and meta-analyse all incidence studies conducted in low and middle-income countries (LMICs). METHODS We systematically searched four databases using terms for NAPD, incidence and LMICs. Citations were eligible for inclusion if: published between 1 January 1960 and 31 May 2022; wholly or partially conducted in an LMIC, and; containing data on NAPD incidence in the general adult population. Two independent raters assessed study quality according to previously published criteria. We conducted a narrative synthesis and random-effects meta-analyses where sufficient studies were available (N ≥ 5). RESULTS We retrieved 11 421 records, of which 23 citations met inclusion criteria from 18 unique studies across 19 settings in 10 LMICs. Median study quality was 4 out of 7 (interquartile range: 3-6). The crude incidence of NAPD varied around 4.2 times, from 10.0 per 100,000 person-years (95% confidence interval [CI] 8.7-11.4) in Brazil to 42.0 (95%CI 32.2-54.8) in India, with marked heterogeneity in methodologies and rates. Our 60-year review highlights the dearth of robust evidence on the incidence of psychotic disorders in LMICs. CONCLUSION Without reliable, contemporary estimates of this fundamental cornerstone of population health, it is impossible to understand the true burden, distribution or causes of psychotic disorders in over 87% of the world's population. A new, more equitable global mental health evidence base for NAPD is now urgently required.
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Affiliation(s)
| | - Tao Ding
- Department of Statistical Sciences, UCL, London, UK
| | - Alfonso Gonzalez-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- South London and Maudsley NHS Trust, London, UK
- Clinical Psychiatry, KU Louvain, Louvain, Belgium
| | | | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, UCL, London, UK
- Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, The Netherlands
- University Centre for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands
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13
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Jongsma HE, van der Ven EMA, Velthorst E, de Haan L, Rutten BPF, van Os J. [Linguistic distance and psychosis in ethnic minorities]. Tijdschr Psychiatr 2023; 65:175-180. [PMID: 36951775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Ethnic minorities in the Netherlands face an excess psychosis risk, and understanding of causality remains limited. Linguistic disadvantage and other indicators of societal exclusion might play a role, and offer potential targets for public health interventions. AIM To establish the contribution of linguistic disadvantage, indicators of social distance and perceived discrimination to the increased risk of psychoses in migrants and ethnic minorities. METHODS We used the Dutch data from an international case-control study into psychotic disorders (the EU-GEI study). A first episode of psychosis was our outcome variable, and we used well-defined data on established confounders (e.g. age and sex) and indicators of ethnicity, social distance, linguistic disadvantage and perceived discrimination as our predictor variables. RESULTS Ethnic minorities face an increased psychosis risk. This appears to be the case for both first- and second- generation migrants and so-called ‘Western’ and non-Western migrants. Though confounders and social distance appear to contribute, linguistic disadvantage appears to play a role in the excess psychosis risk in first-generation migrants. CONCLUSION Reducing the social consequences of linguistic disadvantage or social distance might be a starting point for concrete public health interventions aimed at preventing the increased psychosis risk faced by first-generation migrants.
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14
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Tarricone I, D'Andrea G, Jongsma HE, Tosato S, Gayer-Anderson C, Stilo SA, Suprani F, Iyegbe C, van der Ven E, Quattrone D, di Forti M, Velthorst E, Rossi Menezes P, Arango C, Parellada M, Lasalvia A, La Cascia C, Ferraro L, Bobes J, Bernardo M, Sanjuán I, Santos JL, Arrojo M, Del-Ben CM, Tripoli G, Llorca PM, de Haan L, Selten JP, Tortelli A, Szöke A, Muratori R, Rutten BP, van Os J, Jones PB, Kirkbride JB, Berardi D, Murray RM, Morgan C. Migration history and risk of psychosis: results from the multinational EU-GEI study. Psychol Med 2022; 52:2972-2984. [PMID: 33563347 PMCID: PMC9693676 DOI: 10.1017/s003329172000495x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 11/18/2020] [Accepted: 11/25/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration. METHODS We used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case-control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models. RESULTS In total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06-2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02-3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03-1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672-2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose-response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06-96.47, p = 0.007). CONCLUSIONS The cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants.
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Affiliation(s)
- Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Hannah E. Jongsma
- PsyLife Group, Division of Psychiatry, UCL, London, England
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - Simona A. Stilo
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Federico Suprani
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Els van der Ven
- Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Marta di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Paulo Rossi Menezes
- University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129, Palermo, Italy
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129, Palermo, Italy
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Iulio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital ‘Virgen de la Luz’, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Department of Biomedicine, neurosciences, and advanced diagnostics, University of Palermo, Italy
| | | | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Andrei Szöke
- Univ Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, Fondation FondaMental, F-94010 Creteil, France
| | - Roberto Muratori
- Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy
| | - Bart P. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | | | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
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15
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Termorshuizen F, van der Ven E, Tarricone I, Jongsma HE, Gayer-Anderson C, Lasalvia A, Tosato S, Quattrone D, La Cascia C, Szöke A, Berardi D, Llorca PM, de Haan L, Velthorst E, Bernardo M, Sanjuán J, Arrojo M, Murray RM, Rutten BP, Jones PB, van Os J, Kirkbride JB, Morgan C, Selten JP. The incidence of psychotic disorders among migrants and minority ethnic groups in Europe: findings from the multinational EU-GEI study. Psychol Med 2022; 52:1376-1385. [PMID: 32958094 PMCID: PMC9157293 DOI: 10.1017/s0033291720003219] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/03/2020] [Accepted: 08/17/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND In Europe, the incidence of psychotic disorder is high in certain migrant and minority ethnic groups (hence: 'minorities'). However, it is unknown how the incidence pattern for these groups varies within this continent. Our objective was to compare, across sites in France, Italy, Spain, the UK and the Netherlands, the incidence rates for minorities and the incidence rate ratios (IRRs, minorities v. the local reference population). METHODS The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study was conducted between 2010 and 2015. We analyzed data on incident cases of non-organic psychosis (International Classification of Diseases, 10th edition, codes F20-F33) from 13 sites. RESULTS The standardized incidence rates for minorities, combined into one category, varied from 12.2 in Valencia to 82.5 per 100 000 in Paris. These rates were generally high at sites with high rates for the reference population, and low at sites with low rates for the reference population. IRRs for minorities (combined into one category) varied from 0.70 (95% CI 0.32-1.53) in Valencia to 2.47 (95% CI 1.66-3.69) in Paris (test for interaction: p = 0.031). At most sites, IRRs were higher for persons from non-Western countries than for those from Western countries, with the highest IRRs for individuals from sub-Saharan Africa (adjusted IRR = 3.23, 95% CI 2.66-3.93). CONCLUSIONS Incidence rates vary by region of origin, region of destination and their combination. This suggests that they are strongly influenced by the social context.
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Affiliation(s)
- Fabian Termorshuizen
- Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands
| | - Els van der Ven
- Mailman School of Public Health, Columbia University, New York City, USA
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Bologna Transcultural Psychosomatic Team (BoTPT), Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
- Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, 40126 Bologna, Italy
| | - Hannah E. Jongsma
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, SE5 8AF, London, UK
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Diego Quattrone
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill SE5 8AF, London, UK
| | - Caterina La Cascia
- Unit of Psychiatry, “P. Giaccone” General Hospital, Via G. La Loggia n.1, 90129 Palermo, Italy
| | - Andrei Szöke
- INSERM, U955, Equipe 15, 51 Avenue de Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Domenico Berardi
- Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, 40126 Bologna, Italy
| | - Pierre-Michel Llorca
- CMPB CHU Clermont-Ferrand, EA 7280, University Clermont Auvergne, Clermont-Ferrand, France
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, location AMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry and Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Avda. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatry Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill SE5 8AF, London, UK
| | - Bart P. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill SE5 8AF, London, UK
- Department Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - James B. Kirkbride
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, SE5 8AF, London, UK
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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16
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González-Valderrama A, Jongsma HE, Mena C, Castañeda CP, Nachar R, Undurraga J, Crossley N, Aceituno D, Iruretagoyena B, Gallardo C, Mondaca P, Monje M, Irarrazaval M, Zavala C, Valmaggia L, Kirkbride JB. The incidence of non-affective psychotic disorders in Chile between 2005 and 2018: results from a national register of over 30 000 cases. Psychol Med 2022; 52:914-923. [PMID: 32758314 PMCID: PMC9005445 DOI: 10.1017/s0033291720002664] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/22/2020] [Accepted: 07/07/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Evidence suggests the incidence of non-affective psychotic disorders (NAPDs) varies across persons and places, but data from the Global South is scarce. We aimed to estimate the treated incidence of NAPD in Chile, and variance by person, place and time. METHODS We used national register data from Chile including all people, 10-65 years, with the first episode of NAPD (International Classification of Diseases, Tenth Revision: F20-F29) between 1 January 2005 and 29 August 2018. Denominators were estimated from Chilean National Census data. Our main outcome was treated incidence of NAPD and age group, sex, calendar year and regional-level population density, multidimensional poverty and latitude were exposures of interest. RESULTS We identified 32 358 NAPD cases [12 136 (39.5%) women; median age-at-first-contact: 24 years (interquartile range 18-39 years)] during 171.1 million person-years [crude incidence: 18.9 per 100 000 person-years; 95% confidence interval (CI) 18.7-19.1]. Multilevel Poisson regression identified a strong age-sex interaction in incidence, with rates peaking in men (57.6 per 100 000 person-years; 95% CI 56.0-59.2) and women (29.5 per 100 000 person-years; 95% CI 28.4-30.7) between 15 and 19 years old. Rates also decreased (non-linearly) over time for women, but not men. We observed a non-linear association with multidimensional poverty and latitude, with the highest rates in the poorest regions and those immediately south of Santiago; no association with regional population density was observed. CONCLUSION Our findings inform the aetiology of NAPDs, replicating typical associations with age, sex and multidimensional poverty in a Global South context. The absence of association with population density suggests this risk may be context-dependent.
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Affiliation(s)
- Alfonso González-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Hannah E. Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Cristián Mena
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
| | - Carmen Paz Castañeda
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
| | - Rubén Nachar
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
- Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Nicolás Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago Metropolitan Region, Chile
- Biomedical Imaging Center, Pontificia Universidad Católica de Chile, Santiago Metropolitan Region, Chile
- Department of Psychosis Studies, King's College London, Institute of Psychology, Psychiatry, and Neuroscience, London, UK
| | - David Aceituno
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago Metropolitan Region, Chile
- Department of Health Service and Population Research, King's College London, Institute of Psychology, Psychiatry, and Neuroscience, London, UK
| | - Barbara Iruretagoyena
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago Metropolitan Region, Chile
| | - Carlos Gallardo
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
| | - Pilar Mondaca
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
| | - Matías Monje
- Early Intervention Program, Instituto Psiquiátrico Dr J Horwitz Barak, Santiago, Chile
| | - Matías Irarrazaval
- Department of Mental Health, Ministry of Health, Santiago, Chile
- Millennium Institute for Research in Depression and Personality, Santiago, Chile
- Faculty of Medicine, Clínica Psiquiátrica Universitaria, University of Chile, Santiago, Chile
| | - Cynthia Zavala
- Department of Mental Health, Ministry of Health, Santiago, Chile
| | - Lucia Valmaggia
- Department of Psychology, King's College London, Institute of Psychology, Psychiatry, and Neuroscience, London, UK
| | - James B. Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
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17
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Tripoli G, Quattrone D, Ferraro L, Gayer-Anderson C, La Cascia C, La Barbera D, Sartorio C, Seminerio F, Rodriguez V, Tarricone I, Berardi D, Jamain S, Arango C, Tortelli A, Llorca PM, de Haan L, Velthorst E, Bobes J, Bernardo M, Sanjuán J, Luis Santos J, Arrojo M, Marta Del-Ben C, Rossi Menezes P, van der Ven E, Jones PB, Jongsma HE, Kirkbride JB, Tosato S, Lasalvia A, Richards A, O’Donovan M, Rutten BPF, van Os J, Morgan C, Sham PC, Di Forti M, Murray RM, Murray GK. Facial Emotion Recognition in Psychosis and Associations With Polygenic Risk for Schizophrenia: Findings From the Multi-Center EU-GEI Case-Control Study. Schizophr Bull 2022; 48:1104-1114. [PMID: 35325253 PMCID: PMC9434422 DOI: 10.1093/schbul/sbac022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND HYPOTHESIS Facial Emotion Recognition is a key domain of social cognition associated with psychotic disorders as a candidate intermediate phenotype. In this study, we set out to investigate global and specific facial emotion recognition deficits in first-episode psychosis, and whether polygenic liability to psychotic disorders is associated with facial emotion recognition. STUDY DESIGN 828 First Episode Psychosis (FEP) patients and 1308 population-based controls completed assessments of the Degraded Facial Affect Recognition Task (DFAR) and a subsample of 524 FEP and 899 controls provided blood or saliva samples from which we extracted DNA, performed genotyping and computed polygenic risk scores for schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MD). STUDY RESULTS A worse ability to globally recognize facial emotion expressions was found in patients compared with controls [B= -1.5 (0.6), 95% CI -2.7 to -0.3], with evidence for stronger effects on negative emotions (fear [B = -3.3 (1.1), 95% CI -5.3 to -1.2] and anger [B = -2.3 (1.1), 95% CI -4.6 to -0.1]) than on happiness [B = 0.3 (0.7), 95% CI -1 to 1.7]. Pooling all participants, and controlling for confounds including case/control status, facial anger recognition was associated significantly with Schizophrenia Polygenic Risk Score (SZ PRS) [B = -3.5 (1.7), 95% CI -6.9 to -0.2]. CONCLUSIONS Psychosis is associated with impaired recognition of fear and anger, and higher SZ PRS is associated with worse facial anger recognition. Our findings provide evidence that facial emotion recognition of anger might play a role as an intermediate phenotype for psychosis.
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Affiliation(s)
- Giada Tripoli
- To whom correspondence should be addressed; Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy, tel: +39(0)916555641, e-mail:
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, London, UK,Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany and National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, UK
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Stéphane Jamain
- Institut National de la Santé et de la Recherche Médicale, Faculté de Médecine, Université Paris-Est, Creteil, France
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health. Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | | | | | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital clinic, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz”, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Els van der Ven
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands,Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Alex Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Michael O’Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands,Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Pak C Sham
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK,Institute for Molecular Bioscience, University of Queensland, Australia
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18
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Jongsma HE, Gayer-Anderson C, van der Ven E, Quattrone D, di Forti M, Arango C, Cascia CL, Bernardo M, Morgan C, Jones PB, Kirkbride JB. Authors' reply to 'on the existence of a linguistic distance in schizophrenia'. Psychol Med 2022; 52:798-799. [PMID: 32878668 DOI: 10.1017/s0033291720003013] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, UCL, London, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Charlotte Gayer-Anderson
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Els van der Ven
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Diego Quattrone
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marta di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | | | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, UK
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19
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Sideli L, Schimmenti A, La Barbera D, La Cascia C, Ferraro L, Aas M, Alameda L, Velthorst E, Fisher HL, Caretti V, Trotta G, Tripoli G, Quattrone D, Gayer-Anderson C, Seminerio F, Sartorio C, Marrazzo G, Lasalvia A, Tosato S, Tarricone I, Berardi D, D’Andrea G, Arango C, Arrojo M, Bernardo M, Bobes J, Sanjuán J, Santos JL, Menezes PR, Del-Ben CM, Jongsma HE, Jones PB, Kirkbride JB, Llorca PM, Tortelli A, Pignon B, de Haan L, Selten JP, Van Os J, Rutten BP, Di Forti M, Morgan C, Murray RM. Childhood Maltreatment, Educational Attainment, and IQ: Findings From a Multicentric Case-control Study of First-episode Psychosis (EU-GEI). Schizophr Bull 2022; 48:575-589. [PMID: 35137235 PMCID: PMC9077421 DOI: 10.1093/schbul/sbac004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND HYPOTHESIS Evidence suggests that childhood maltreatment (ie, childhood abuse and childhood neglect) affects educational attainment and cognition. However, the association between childhood maltreatment and Intelligence Quotient (IQ) seems stronger among controls compared to people with psychosis. We hypothesised that: the association between childhood maltreatment and poor cognition would be stronger among community controls than among people with first-episode of psychosis (FEP); compared to abuse, neglect would show stronger associations with educational attainment and cognition; the association between childhood maltreatment and IQ would be partially accounted for by other risk factors; and the association between childhood maltreatment, educational attainment, and IQ would be stronger among patients with affective psychoses compared to those with nonaffective psychoses. STUDY DESIGN 829 patients with FEP and 1283 community controls from 16 EU-GEI sites were assessed for child maltreatment, education attainment, and IQ. STUDY RESULTS In both the FEP and control group, childhood maltreatment was associated with lower educational attainment. The association between childhood maltreatment and lower IQ was robust to adjustment for confounders only among controls. Whereas childhood neglect was consistently associated with lower attainment and IQ in both groups, childhood abuse was associated with IQ only in controls. Among both patients with affective and nonaffective psychoses, negative associations between childhood maltreatment and educational attainment were observed, but the crude association with IQ was only evident in affective psychoses. CONCLUSIONS Our findings underscore the role of childhood maltreatment in shaping academic outcomes and cognition of people with FEP as well as controls.
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Affiliation(s)
- Lucia Sideli
- To whom correspondence should be addressed; Department of Human Science, LUMSA University, Piazza delle Vaschette, 101 – 00193 Rome, Italy; tel: +39 06 684 221, e-mail:
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,NORMENT, Centre for Research On Mental Disorders, Oslo University Hospital and University of Oslo, Norway,Department of Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Norway
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Departamento de Psiquiatria, Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, USA,Early Psychosis Section, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Helen L Fisher
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England,ESRC Centre for Society and Mental Health, King’s College London, London, UK
| | | | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Diego Quattrone
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England
| | - Charlotte Gayer-Anderson
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England,Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Giovanna Marrazzo
- Department of Biomedicine, Neuroscience, and Advanced Diagnostic, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Italy
| | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Giuseppe D’Andrea
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de
Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Department of Medicine, Neuroscience Institute, University of Barcelona, Institut d’Investigacions Biomèdiques, August Pi I Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Centro de Investigación Biomédica en Red de Salud Mental, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Hospital “Virgen de la Luz”, Cuenca, Spain
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, Universidade de São Paulo, São Paulo, Brazil
| | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, University College London, London, England,Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Peter B Jones
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England,EA 7280 Npsydo, Université Clermont Auvergne, Clermont-Ferrand, France
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, England
| | | | - Andrea Tortelli
- Establissement Public de Santé, Maison Blanche, Paris, France
| | - Baptiste Pignon
- AP-HP, Groupe Hospitalier “Mondor,” Pôle de Psychiatrie, Créteil, France,Institut National de la Santé et de la Recherche Médicale, U955, Créteil, France,Fondation Fondamental, Créteil, France
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Institute for Mental Health, GGZ Rivierduinen, Leiden, The Netherlands,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands,Department Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marta Di Forti
- King’s College London, Social, Genetic, & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, England
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King’s College London, London, UK,Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, England
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20
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Ferraro L, La Cascia C, La Barbera D, Sanchez-Gutierrez T, Tripoli G, Seminerio F, Sartorio C, Marrazzo G, Sideli L, Arango C, Arrojo M, Bernardo M, Bobes J, Del-Ben CM, Gayer-Anderson C, Jongsma HE, Kirkbride JB, Lasalvia A, Tosato S, Llorca PM, Menezes PR, Rutten BP, Santos JL, Sanjuán J, Selten JP, Szöke A, Tarricone I, Muratori R, Tortelli A, Velthorst E, Rodriguez V, Quattrone A, Jones PB, Van Os J, Vassos E, Morgan C, de Haan L, Reininghaus U, Cardno AG, Di Forti M, Murray RM, Quattrone D. The relationship of symptom dimensions with premorbid adjustment and cognitive characteristics at first episode psychosis: Findings from the EU-GEI study. Schizophr Res 2021; 236:69-79. [PMID: 34403965 PMCID: PMC8473991 DOI: 10.1016/j.schres.2021.08.008] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 07/14/2021] [Accepted: 08/04/2021] [Indexed: 01/19/2023]
Abstract
Premorbid functioning and cognitive measures may reflect gradients of developmental impairment across diagnostic categories in psychosis. In this study, we sought to examine the associations of current cognition and premorbid adjustment with symptom dimensions in a large first episode psychosis (FEP) sample. We used data from the international EU-GEI study. Bifactor modelling of the Operational Criteria in Studies of Psychotic Illness (OPCRIT) ratings provided general and specific symptom dimension scores. Premorbid Adjustment Scale estimated premorbid social (PSF) and academic adjustment (PAF), and WAIS-brief version measured IQ. A MANCOVA model examined the relationship between symptom dimensions and PSF, PAF, and IQ, having age, sex, country, self-ascribed ethnicity and frequency of cannabis use as confounders. In 785 patients, better PSF was associated with fewer negative (B = -0.12, 95% C.I. -0.18, -0.06, p < 0.001) and depressive (B = -0.09, 95% C.I. -0.15, -0.03, p = 0.032), and more manic (B = 0.07, 95% C.I. 0.01, 0.14, p = 0.023) symptoms. Patients with a lower IQ presented with slightly more negative and positive, and fewer manic, symptoms. Secondary analysis on IQ subdomains revealed associations between better perceptual reasoning and fewer negative (B = -0.09, 95% C.I. -0.17, -0.01, p = 0.023) and more manic (B = 0.10, 95% C.I. 0.02, 0.18, p = 0.014) symptoms. Fewer positive symptoms were associated with better processing speed (B = -0.12, 95% C.I. -0.02, -0.004, p = 0.003) and working memory (B = -0.10, 95% C.I. -0.18, -0.01, p = 0.024). These findings suggest that the negative and manic symptom dimensions may serve as clinical proxies of different neurodevelopmental predisposition in psychosis.
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Affiliation(s)
- Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy.
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | | | - Giada Tripoli
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Giovanna Marrazzo
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Lucia Sideli
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), Section of Psychiatry, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), C/Doctor Esquerdo 46, 28007 Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Julián Clavería s/n, 33006 Oviedo, Spain
| | - Cristina Marta Del-Ben
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Hannah E. Jongsma
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK
| | - James B. Kirkbride
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | | | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Bart P. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz", C/Hermandad de Donantes de Sangre, 16002 Cuenca, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Avda. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200, MD, Maastricht, the Netherlands,Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZLeiden, the Netherlands
| | - Andrei Szöke
- INSERM, U955, Equipe 15, 51 Avenue de Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
| | - Roberto Muratori
- Dapertment of Mental Health and pathological addictions, Bologna Local Health Authority, Italy
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris 75020, France
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Andrea Quattrone
- National Health Service, Villa Betania Institute, Reggio Calabria, Italy
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK,Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, the Netherlands
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Ulrich Reininghaus
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200, MD, Maastricht, the Netherlands,Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alastair G. Cardno
- Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK,Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
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21
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Quattrone D, Reininghaus U, Richards AL, Tripoli G, Ferraro L, Quattrone A, Marino P, Rodriguez V, Spinazzola E, Gayer-Anderson C, Jongsma HE, Jones PB, La Cascia C, La Barbera D, Tarricone I, Bonora E, Tosato S, Lasalvia A, Szöke A, Arango C, Bernardo M, Bobes J, Del Ben CM, Menezes PR, Llorca PM, Santos JL, Sanjuán J, Arrojo M, Tortelli A, Velthorst E, Berendsen S, de Haan L, Rutten BPF, Lynskey MT, Freeman TP, Kirkbride JB, Sham PC, O’Donovan MC, Cardno AG, Vassos E, van Os J, Morgan C, Murray RM, Lewis CM, Di Forti M. The continuity of effect of schizophrenia polygenic risk score and patterns of cannabis use on transdiagnostic symptom dimensions at first-episode psychosis: findings from the EU-GEI study. Transl Psychiatry 2021; 11:423. [PMID: 34376640 PMCID: PMC8355107 DOI: 10.1038/s41398-021-01526-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 06/16/2021] [Accepted: 06/30/2021] [Indexed: 12/22/2022] Open
Abstract
Diagnostic categories do not completely reflect the heterogeneous expression of psychosis. Using data from the EU-GEI study, we evaluated the impact of schizophrenia polygenic risk score (SZ-PRS) and patterns of cannabis use on the transdiagnostic expression of psychosis. We analysed first-episode psychosis patients (FEP) and controls, generating transdiagnostic dimensions of psychotic symptoms and experiences using item response bi-factor modelling. Linear regression was used to test the associations between these dimensions and SZ-PRS, as well as the combined effect of SZ-PRS and cannabis use on the dimensions of positive psychotic symptoms and experiences. We found associations between SZ-PRS and (1) both negative (B = 0.18; 95%CI 0.03-0.33) and positive (B = 0.19; 95%CI 0.03-0.35) symptom dimensions in 617 FEP patients, regardless of their categorical diagnosis; and (2) all the psychotic experience dimensions in 979 controls. We did not observe associations between SZ-PRS and the general and affective dimensions in FEP. Daily and current cannabis use were associated with the positive dimensions in FEP (B = 0.31; 95%CI 0.11-0.52) and in controls (B = 0.26; 95%CI 0.06-0.46), over and above SZ-PRS. We provide evidence that genetic liability to schizophrenia and cannabis use map onto transdiagnostic symptom dimensions, supporting the validity and utility of the dimensional representation of psychosis. In our sample, genetic liability to schizophrenia correlated with more severe psychosis presentation, and cannabis use conferred risk to positive symptomatology beyond the genetic risk. Our findings support the hypothesis that psychotic experiences in the general population have similar genetic substrates as clinical disorders.
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Affiliation(s)
- Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, London, UK. .,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK. .,Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, 68159, Germany.
| | - Ulrich Reininghaus
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, 68159 Germany ,grid.13097.3c0000 0001 2322 6764Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK ,grid.412966.e0000 0004 0480 1382Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Alex L. Richards
- grid.5600.30000 0001 0807 5670Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, CF24 4HQ UK
| | - Giada Tripoli
- grid.10776.370000 0004 1762 5517Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Laura Ferraro
- grid.10776.370000 0004 1762 5517Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Andrea Quattrone
- National Health Care System, Villa Betania Psychological Institute, 89100 Reggio Calabria, Italy
| | - Paolo Marino
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Victoria Rodriguez
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Edoardo Spinazzola
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Charlotte Gayer-Anderson
- grid.13097.3c0000 0001 2322 6764Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Hannah E. Jongsma
- grid.83440.3b0000000121901201Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK ,grid.4494.d0000 0000 9558 4598Centre for Transcultural Psychiatry “Veldzicht” Balkbrug, the Netherlands, VR Mental Health Group, University Center for Psychiatry, Univerisity Medical Centre Groningen, Groningen, The Netherlands
| | - Peter B. Jones
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ UK ,grid.450563.10000 0004 0412 9303CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF UK
| | - Caterina La Cascia
- National Health Care System, Villa Betania Psychological Institute, 89100 Reggio Calabria, Italy
| | - Daniele La Barbera
- National Health Care System, Villa Betania Psychological Institute, 89100 Reggio Calabria, Italy
| | - Ilaria Tarricone
- grid.6292.f0000 0004 1757 1758Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
| | - Elena Bonora
- grid.6292.f0000 0004 1757 1758Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
| | - Sarah Tosato
- grid.5611.30000 0004 1763 1124Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Antonio Lasalvia
- grid.5611.30000 0004 1763 1124Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Andrei Szöke
- grid.7429.80000000121866389INSERM, U955, Equipe 15, 51 Avenue de Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Celso Arango
- grid.4795.f0000 0001 2157 7667Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Doctor Esquerdo 46, 28007 Madrid, Spain
| | - Miquel Bernardo
- grid.5841.80000 0004 1937 0247Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- grid.10863.3c0000 0001 2164 6351Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
| | - Cristina Marta Del Ben
- grid.11899.380000 0004 1937 0722Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- grid.11899.380000 0004 1937 0722Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Pierre-Michel Llorca
- grid.494717.80000000115480420University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - Jose Luis Santos
- grid.413507.40000 0004 1765 7383Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz,”, Cuenca, Spain
| | - Julio Sanjuán
- grid.5338.d0000 0001 2173 938XDepartment of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Manuel Arrojo
- grid.411048.80000 0000 8816 6945Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | | | - Eva Velthorst
- grid.7177.60000000084992262Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands ,grid.59734.3c0000 0001 0670 2351Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Steven Berendsen
- grid.7177.60000000084992262Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Lieuwe de Haan
- grid.7177.60000000084992262Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Bart P. F. Rutten
- grid.412966.e0000 0004 0480 1382Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Michael T. Lynskey
- grid.13097.3c0000 0001 2322 6764National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London, SE5 8BB UK
| | - Tom P. Freeman
- grid.13097.3c0000 0001 2322 6764National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 4 Windsor Walk, London, SE5 8BB UK ,grid.7340.00000 0001 2162 1699Department of Psychology, University of Bath, 10 West, Bath, BA2 7AY UK
| | - James B. Kirkbride
- grid.83440.3b0000000121901201Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Pak C. Sham
- grid.194645.b0000000121742757Department of Psychiatry, the University of Hong Kong, Pok Fu Lam, Hong Kong ,grid.194645.b0000000121742757Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Michael C. O’Donovan
- grid.5600.30000 0001 0807 5670Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, CF24 4HQ UK
| | - Alastair G. Cardno
- grid.9909.90000 0004 1936 8403Division of Psychological and Social Medicine, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9NL UK
| | - Evangelos Vassos
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF, London, UK ,grid.13097.3c0000 0001 2322 6764National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, London, UK
| | - Jim van Os
- grid.412966.e0000 0004 0480 1382Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands ,grid.7692.a0000000090126352Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- grid.13097.3c0000 0001 2322 6764Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Robin M. Murray
- grid.10776.370000 0004 1762 5517Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy ,grid.13097.3c0000 0001 2322 6764National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, London, UK
| | - Cathryn M. Lewis
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF, London, UK ,grid.13097.3c0000 0001 2322 6764National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, London, UK
| | - Marta Di Forti
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, SE5 8AF, London, UK ,grid.13097.3c0000 0001 2322 6764National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, London, UK
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22
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Velthorst E, Mollon J, Murray RM, de Haan L, Germeys IM, Glahn DC, Arango C, van der Ven E, Di Forti M, Bernardo M, Guloksuz S, Delespaul P, Mezquida G, Amoretti S, Bobes J, Saiz PA, García-Portilla MP, Santos JL, Jiménez-López E, Sanjuan J, Aguilar EJ, Arrojo M, Carracedo A, López G, González-Peñas J, Parellada M, Atbaşoğlu C, Saka MC, Üçok A, Alptekin K, Akdede B, Binbay T, Altınyazar V, Ulaş H, Yalınçetin B, Gümüş-Akay G, Beyaz BC, Soygür H, Cankurtaran EŞ, Kaymak SU, Maric NP, Mihaljevic MM, Petrovic SA, Mirjanic T, Del-Ben CM, Ferraro L, Gayer-Anderson C, Jones PB, Jongsma HE, Kirkbride JB, La Cascia C, Lasalvia A, Tosato S, Llorca PM, Menezes PR, Morgan C, Quattrone D, Menchetti M, Selten JP, Szöke A, Tarricone I, Tortelli A, McGuire P, Valmaggia L, Kempton MJ, van der Gaag M, Riecher-Rössler A, Bressan RA, Barrantes-Vidal N, Nelson B, McGorry P, Pantelis C, Krebs MO, Ruhrmann S, Sachs G, Rutten BPF, van Os J, Alizadeh BZ, van Amelsvoort T, Bartels-Velthuis AA, Bruggeman R, van Beveren NJ, Luykx JJ, Cahn W, Simons CJP, Kahn RS, Schirmbeck F, van Winkel R, Reichenberg A. Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings. Mol Psychiatry 2021; 26:4529-4543. [PMID: 33414498 DOI: 10.1038/s41380-020-00969-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/03/2020] [Accepted: 11/18/2020] [Indexed: 01/29/2023]
Abstract
Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = -0.45 to -0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = -0.14 to -0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = -0.88 to -0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = -0.13 to -0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = -0.21 to -0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders.
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Affiliation(s)
- Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Seaver Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Josephine Mollon
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.,Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Inez Myin Germeys
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - David C Glahn
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain
| | - Els van der Ven
- Mailman School of Public Health, Columbia University, New York, NY, USA.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marta Di Forti
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK.,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Philippe Delespaul
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.,Mondriaan Mental Health Care, Heerlen/Maastricht, The Netherlands
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Julio Bobes
- Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, Mental Health Services of Principado de Asturias (SESPA), Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), INEUROPA, CIBERSAM, Oviedo, Spain
| | - Pilar A Saiz
- Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, Mental Health Services of Principado de Asturias (SESPA), Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), INEUROPA, CIBERSAM, Oviedo, Spain
| | - María Paz García-Portilla
- Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, Mental Health Services of Principado de Asturias (SESPA), Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), INEUROPA, CIBERSAM, Oviedo, Spain
| | - José Luis Santos
- Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, Mental Health Services of Principado de Asturias (SESPA), Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), INEUROPA, CIBERSAM, Oviedo, Spain.,Neurobiological Research Group, Institute of Technology, Universidad de Castilla-La Mancha, Cuenca, Spain.,Department of Psychiatry, Hospital "Virgen de la Luz", Cuenca, Spain
| | - Estela Jiménez-López
- Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, Mental Health Services of Principado de Asturias (SESPA), Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), INEUROPA, CIBERSAM, Oviedo, Spain.,Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | - Julio Sanjuan
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, INCLIVA, CIBERSAM, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Eduardo J Aguilar
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, INCLIVA, CIBERSAM, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Angel Carracedo
- Grupo de Medicina Xenómica, Fundación Pública Galega de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Galician Health Service (SERGAS), Santiago de Compostela, Spain.,Centro de Investigación en Red de Enfermedades Raras (CIBERER) y Centro Nacional de Genotipado (CEGEN-PRB3), Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Gonzalo López
- Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, Mental Health Services of Principado de Asturias (SESPA), Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), INEUROPA, CIBERSAM, Oviedo, Spain
| | - Javier González-Peñas
- Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, Mental Health Services of Principado de Asturias (SESPA), Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), INEUROPA, CIBERSAM, Oviedo, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain
| | - Cem Atbaşoğlu
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Meram Can Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alp Üçok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Dokuz Eylül University, School of Medicine, Izmir, Turkey.,Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Berna Akdede
- Department of Psychiatry, Dokuz Eylül University, School of Medicine, Izmir, Turkey
| | - Tolga Binbay
- Department of Psychiatry, Dokuz Eylül University, School of Medicine, Izmir, Turkey
| | - Vesile Altınyazar
- Department of Psychiatry, Adnan Menderes University, School of Medicine, Aydın, Turkey
| | - Halis Ulaş
- Department of Psychiatry, Dokuz Eylül University, School of Medicine, Izmir, Turkey
| | - Berna Yalınçetin
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Güvem Gümüş-Akay
- Department of Physiology, School of Medicine, Ankara University, Ankara, Turkey.,Brain Research Center, Ankara University, Ankara, Turkey
| | - Burçin Cihan Beyaz
- Department of Psychology, Middle East Technical University, Ankara, Turkey
| | - Haldun Soygür
- Turkish Federation of Schizophrenia Associations, Ankara, Turkey
| | | | | | - Nadja P Maric
- Faculty of Medicine, University of Belgrade & Institute of Mental Health, Belgrade, Serbia
| | - Marina M Mihaljevic
- Faculty of Medicine, University of Belgrade & Institute of Mental Health, Belgrade, Serbia
| | - Sanja Andric Petrovic
- Faculty of Medicine, University of Belgrade & Clinic for Psychiatry, Belgrade, Serbia
| | - Tijana Mirjanic
- Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia
| | | | - Laura Ferraro
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK
| | - Hannah E Jongsma
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK.,PsyLife Group, Division of Psychiatry, UCL, London, England, UK
| | | | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | | | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK.,ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Diego Quattrone
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.,Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
| | | | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | | | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Mark van der Gaag
- Amsterdam Public Mental Health Research Institute, Department of Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Rodrigo A Bressan
- LiNC-Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.,Fundació Sanitària Sant Pere Claver, Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia.,Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Carlton South, VIC, Australia
| | - Chris Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Carlton South, VIC, Australia
| | - Marie-Odile Krebs
- University of Paris, GHU-Paris, Sainte-Anne, C'JAAD, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, The Netherlands
| | - Richard Bruggeman
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, The Netherlands.,Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Nico J van Beveren
- Antes Center for Mental Health Care, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands.,Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Jurjen J Luykx
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Outpatient Second Opinion Clinic, GGNet Mental Health, Apeldoorn, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Altrecht Science, Altrecht Mental Health Care, Utrecht, The Netherlands
| | - Claudia J P Simons
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.,GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
| | - Rene S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Department of Veterans Affairs Medical Center, New York, NY, USA
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.,Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Neurosciences, Psychiatry Research Group, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | | | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Seaver Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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23
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Jongsma HE, Gayer-Anderson C, Tarricone I, Velthorst E, van der Ven E, Quattrone D, di Forti M, Menezes PR, Del-Ben CM, Arango C, Lasalvia A, Berardi D, La Cascia C, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, de Haan L, Tortelli A, Szöke A, Murray RM, Rutten BP, van Os J, Morgan C, Jones PB, Kirkbride JB. Social disadvantage, linguistic distance, ethnic minority status and first-episode psychosis: results from the EU-GEI case-control study. Psychol Med 2021; 51:1536-1548. [PMID: 32122439 PMCID: PMC8311819 DOI: 10.1017/s003329172000029x] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/15/2020] [Accepted: 01/28/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Ethnic minority groups in Western countries face an increased risk of psychotic disorders. Causes of this long-standing public health inequality remain poorly understood. We investigated whether social disadvantage, linguistic distance and discrimination contributed to these patterns. METHODS We used case-control data from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, carried out in 16 centres in six countries. We recruited 1130 cases and 1497 population-based controls. Our main outcome measure was first-episode ICD-10 psychotic disorder (F20-F33), and exposures were ethnicity (white majority, black, mixed, Asian, North-African, white minority and other), generational status, social disadvantage, linguistic distance and discrimination. Age, sex, paternal age, cannabis use, childhood trauma and parental history of psychosis were included as a priori confounders. Exposures and confounders were added sequentially to multivariable logistic models, following multiple imputation for missing data. RESULTS Participants from any ethnic minority background had crude excess odds of psychosis [odds ratio (OR) 2.03, 95% confidence interval (CI) 1.69-2.43], which remained after adjustment for confounders (OR 1.61, 95% CI 1.31-1.98). This was progressively attenuated following further adjustment for social disadvantage (OR 1.52, 95% CI 1.22-1.89) and linguistic distance (OR 1.22, 95% CI 0.95-1.57), a pattern mirrored in several specific ethnic groups. Linguistic distance and social disadvantage had stronger effects for first- and later-generation groups, respectively. CONCLUSION Social disadvantage and linguistic distance, two potential markers of sociocultural exclusion, were associated with increased odds of psychotic disorder, and adjusting for these led to equivocal risk between several ethnic minority groups and the white majority.
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Affiliation(s)
- Hannah E. Jongsma
- PsyLife Group, Division of Psychiatry, UCL, London, England
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Charlotte Gayer-Anderson
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Ilaria Tarricone
- Transcultural Psychosomatic Team (BoTPT), Department of Surgical and Medical Sciences, Bologna University, Bologna, Italy
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Preventative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Els van der Ven
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Diego Quattrone
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Marta di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | | | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Christina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integra di Verona, Verona, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, 40126Bologna, Italy
| | | | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, Instituto Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital ‘Virgen de la Luz’, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Lieuwe de Haan
- Early Psychosis Section, Department of Psychiatry, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | | | - Andrei Szöke
- Institut National de la Santé et de la Recherche Médicale, U955, Créteil, France
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Bart P. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
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24
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Quattrone D, Ferraro L, Tripoli G, La Cascia C, Quigley H, Quattrone A, Jongsma HE, Del Peschio S, Gatto G, Gayer-Anderson C, Jones PB, Kirkbride JB, La Barbera D, Tarricone I, Berardi D, Tosato S, Lasalvia A, Szöke A, Arango C, Bernardo M, Bobes J, Del Ben CM, Menezes PR, Llorca PM, Santos JL, Sanjuán J, Tortelli A, Velthorst E, de Haan L, Rutten BPF, Lynskey MT, Freeman TP, Sham PC, Cardno AG, Vassos E, van Os J, Morgan C, Reininghaus U, Lewis CM, Murray RM, Di Forti M. Daily use of high-potency cannabis is associated with more positive symptoms in first-episode psychosis patients: the EU-GEI case-control study. Psychol Med 2021; 51:1329-1337. [PMID: 32183927 PMCID: PMC8223239 DOI: 10.1017/s0033291720000082] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/27/2019] [Accepted: 01/08/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Daily use of high-potency cannabis has been reported to carry a high risk for developing a psychotic disorder. However, the evidence is mixed on whether any pattern of cannabis use is associated with a particular symptomatology in first-episode psychosis (FEP) patients. METHOD We analysed data from 901 FEP patients and 1235 controls recruited across six countries, as part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. We used item response modelling to estimate two bifactor models, which included general and specific dimensions of psychotic symptoms in patients and psychotic experiences in controls. The associations between these dimensions and cannabis use were evaluated using linear mixed-effects models analyses. RESULTS In patients, there was a linear relationship between the positive symptom dimension and the extent of lifetime exposure to cannabis, with daily users of high-potency cannabis having the highest score (B = 0.35; 95% CI 0.14-0.56). Moreover, negative symptoms were more common among patients who never used cannabis compared with those with any pattern of use (B = -0.22; 95% CI -0.37 to -0.07). In controls, psychotic experiences were associated with current use of cannabis but not with the extent of lifetime use. Neither patients nor controls presented differences in depressive dimension related to cannabis use. CONCLUSIONS Our findings provide the first large-scale evidence that FEP patients with a history of daily use of high-potency cannabis present with more positive and less negative symptoms, compared with those who never used cannabis or used low-potency types.
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Affiliation(s)
- Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
- Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Harriet Quigley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Andrea Quattrone
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98100, Messina, Italy
| | - Hannah E. Jongsma
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | | | | | - EU-GEI group
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - James B. Kirkbride
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Daniele La Barbera
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Domenico Berardi
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134Verona, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134Verona, Italy
| | - Andrei Szöke
- INSERM, U955, Equipe 15, 51 Avenue de Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, C/Doctor Esquerdo 46, 28007Madrid, Spain
| | - Miquel Bernardo
- Department of Medicine, Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Faculty of Medicine and Health Sciences – Psychiatry, Universidad de Oviedo, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
| | - Cristina Marta Del Ben
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | | | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital ‘Virgen de la Luz’, Cuenca, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | | | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Bart P. F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Michael T. Lynskey
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, London, SE5 8BB, UK
| | - Tom P. Freeman
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, London, SE5 8BB, UK
- Department of Psychology, University of Bath, 10 West, Bath, BA2 7AY, UK
| | - Pak C. Sham
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
- Li KaShing Faculty of Medicine, Centre for Genomic Sciences, The University of Hong Kong, Hong Kong, China
| | - Alastair G. Cardno
- Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Ulrich Reininghaus
- Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Cathryn M. Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Robin M. Murray
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
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25
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Ajnakina O, Rodriguez V, Quattrone D, di Forti M, Vassos E, Arango C, Berardi D, Bernardo M, Bobes J, de Haan L, Del-Ben CM, Gayer-Anderson C, Jongsma HE, Lasalvia A, Tosato S, Llorca PM, Menezes PR, Rutten BP, Santos JL, Sanjuán J, Selten JP, Szöke A, Tarricone I, D’Andrea G, Richards A, Tortelli A, Velthorst E, Jones PB, Arrojo Romero M, La Cascia C, Kirkbride JB, van Os J, O’Donovan M, Murray RM. Duration of Untreated Psychosis in First-Episode Psychosis is not Associated With Common Genetic Variants for Major Psychiatric Conditions: Results From the Multi-Center EU-GEI Study. Schizophr Bull 2021; 47:1653-1662. [PMID: 33963865 PMCID: PMC8562562 DOI: 10.1093/schbul/sbab055] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Duration of untreated psychosis (DUP) is associated with clinical outcomes in people with a diagnosis of first-episode psychosis (FEP), but factors associated with length of DUP are still poorly understood. Aiming to obtain insights into the possible biological impact on DUP, we report genetic analyses of a large multi-center phenotypically well-defined sample encompassing individuals with a diagnosis of FEP recruited from 6 countries spanning 17 research sites, as part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. Genetic propensity was measured using polygenic scores for schizophrenia (SZ-PGS), bipolar disorder (BD-PGS), major depressive disorder (MDD-PGS), and intelligence (IQ-PGS), which were calculated based on the results from the most recent genome-wide association meta-analyses. Following imputation for missing data and log transformation of DUP to handle skewedness, the association between DUP and polygenic scores (PGS), adjusting for important confounders, was investigated with multivariable linear regression models. The sample comprised 619 individuals with a diagnosis of FEP disorders with a median age at first contact of 29.0 years (interquartile range [IQR] = 22.0-38.0). The median length of DUP in the sample was 10.1 weeks (IQR = 3.8-30.8). One SD increases in SZ-PGS, BD-PGS, MDD-PGS or IQ-PGS were not significantly associated with the length of DUP. Our results suggest that genetic variation does not contribute to the DUP in patients with a diagnosis of FEP disorders.
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Affiliation(s)
- Olesya Ajnakina
- Department of Biostatistics & Health Informatics,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, University of London, London,
UK,Department of Behavioural Science and Health, Institute of
Epidemiology and Health Care, University College London,
London, UK,Department of Clinical Medicine, Aarhus
University, Aarhus, Denmark,To whom correspondence should be addressed; Department of
Biostatistics and Health Informatics, Institute of Psychiatry, Psychology &
Neuroscience, King’s College London, PO20, 16 De Crespigny Park, London
SE5 8AF, UK; tel: +44(0)20 7848 0938, e-mail:
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London,
London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, London, UK
| | - Marta di Forti
- Social, Genetic and Developmental Psychiatry Centre,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, London, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, London, UK
| | - Celso Arango
- Child and Adolescent Psychiatry Department, Institute of
Psychiatry and Mental Health, Hospital General Universitario Gregorio
Marañón, School of Medicine, Universidad Complutense,
Madrid, Spain
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences,
Psychiatry Unit, Alma Mater Studiorum Università di Bologna,
Bologna, Italy
| | - Miguel Bernardo
- Department of Psychiatry, Barcelona Clinic Schizophrenia
Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of
Barcelona, IDIBAPS, CIBERSAM, Barcelona,
Spain
| | - Julio Bobes
- Faculty of Medicine and Health Sciences –
Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM,
Oviedo, Spain
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section,
Amsterdam UMC, University of Amsterdam,
Amsterdam, The
Netherlands
| | - Cristina Marta Del-Ben
- Neuroscience and Behavior Department, Ribeirão Preto
Medical School, University of São Paulo, São
Paulo, Brazil
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, De Crespigny Park, Denmark Hill, London,
UK
| | - Hannah E Jongsma
- Centre for Longitudinal Studies, University College
London, London, UK,Centre for Transcultural Psychiatry
Veldzicht, Balkbrug, The Netherlands,University Centre for Psychiatry, University Medical
Centre Groningen, Groningen, The Netherlands
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience,
Biomedicine and Movement Sciences, University of Verona,
Verona,Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience,
Biomedicine and Movement Sciences, University of Verona,
Verona,Italy
| | - Pierre-Michel Llorca
- Université Clermont Auvergne, CMP-B CHU, CNRS,
Clermont Auvergne INP, Institut Pascal,
Clermont-Ferrand, France
| | - Paulo Rossi Menezes
- Department of Preventative Medicine, Faculdade de Medicina
FMUSP, University of São Paulo, São
Paulo, Brazil
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for
Mental Health and Neuroscience, South Limburg Mental Health Research and
Teaching Network, Maastricht University Medical Centre,
Maastricht, The
Netherlands
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría
Hospital “Virgen de la Luz,”Cuenca, Spain
| | - Julio Sanjuán
- Department of Psychiatry, Hospital Clínico
Universitario de Valencia, INCLIVA, CIBERSAM, School of Medicine, Universidad de
Valencia, Valencia, Spain
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health
Care, Sandifortdreef 19, 2333 ZZ Leiden,
The Netherlands
| | - Andrei Szöke
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires “ H. Mondor ,” DMU IMPACT, Fondation
FondaMental, Creteil, France
| | - Ilaria Tarricone
- Division of Psychological Medicine and Clinical
Neurosciences, Cardiff, UK
| | - Giuseppe D’Andrea
- Department of Biomedical and Neuromotor Sciences,
Psychiatry Unit, Alma Mater Studiorum Università di Bologna,
Bologna, Italy
| | - Alexander Richards
- Division of Psychological Medicine and Clinical
Neurosciences, Cardiff, UK
| | | | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section,
Academic Medical Centre, University of Amsterdam,
Amsterdam, The
Netherlands,Department of Psychiatry, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Herchel
Smith Building for Brain & Mind Sciences,
Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire &
Peterborough NHS Foundation Trust,
Cambridge, UK
| | - Manuel Arrojo Romero
- Department of Psychiatry, Psychiatric Genetic Group,
Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo
Hospitalario Universitario de Santiago de Compostela,
Santiago de Compostela, Spain
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical
Neuroscience, University of Palermo,
Palermo, Italy
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College
London, London, UK
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London,
London, UK,Department of Psychiatry and Neuropsychology, School for
Mental Health and Neuroscience, South Limburg Mental Health Research and
Teaching Network, Maastricht University Medical Centre,
Maastricht, The
Netherland,UMC Utrecht Brain Centre, Utrecht University Medical
Centre, Utrecht, The
Netherlands
| | - Mick O’Donovan
- Division of Psychological Medicine and Clinical
Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff
University, Cardiff, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry,
Psychology and Neuroscience, King’s College London,
London, UK,Department of Psychiatry, Experimental Biomedicine and
Clinical Neuroscience, University of Palermo,
Palermo, Italy
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26
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Berendsen S, Kapitein P, Schirmbeck F, van Tricht MJ, McGuire P, Morgan C, Gayer-Anderson C, Kempton MJ, Valmaggia L, Quattrone D, di Forti M, van der Gaag M, Kirkbride JB, Jongsma HE, Jones PB, Parellada M, Arango C, Arrojo M, Bernardo M, Sanjuán J, Santos JL, Szöke A, Tortelli A, Llorca PM, Tarricone I, Tripoli G, Ferraro L, La Cascia C, Lasalvia A, Tosato S, Menezes PR, Del-Ben CM, Nelson B, Riecher-Rössler A, Bressan R, Barrantes-Vidal N, Krebs MO, Nordentoft M, Ruhrmann S, Sachs G, Rutten BPF, van Os J, Velthorst E, de Haan L. Pre-training inter-rater reliability of clinical instruments in an international psychosis research project. Schizophr Res 2021; 230:104-107. [PMID: 33243716 DOI: 10.1016/j.schres.2020.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/30/2020] [Accepted: 08/04/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Steven Berendsen
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands; Arkin Institute for Mental Health, Amsterdam, The Netherlands.
| | - Pim Kapitein
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | | | | | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diego Quattrone
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Marta di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Mark van der Gaag
- Amsterdam Public Mental Health Research Institute, Department of Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Hannah E Jongsma
- PsyLife Group, Division of Psychiatry, UCL, London, England, UK; Department of Psychiatry, University of Cambridge, Cambridge, England, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK
| | - Maria Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spanish Mental Health Research Network (CIBERSAM), Spain
| | - Julio Sanjuán
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, Valencia, Spain
| | - José Luis Santos
- Department of Psychiatry, Hospital "Virgen de la Luz", Cuenca, Spanish Mental Health Research Network (CIBERSAM), Spain; INSERM, U955, Créteil, France
| | - Andrei Szöke
- INSERM, U955, "Translational NeuroPsychiatry Lab", Créteil 94000, France
| | | | | | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Giada Tripoli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | | | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Rodrigo Bressan
- LiNC-Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain; Fundació Sanitària Sant Pere Claver, Spanish Mental Health Research Network (CIBERSAM), Spain
| | - Marie-Odile Krebs
- University of Paris, GHU-Paris, Sainte-Anne, C'JAAD, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands; Seaver Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands; Arkin Institute for Mental Health, Amsterdam, The Netherlands
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27
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Misra S, Gelaye B, Williams DR, Koenen KC, Borba CPC, Quattrone D, Di Forti M, Tripoli G, La Cascia C, La Barbera D, Ferraro L, Tarricone I, Berardi D, Lasalvia A, Tosato S, Szöke A, Llorca PM, Arango C, Tortelli A, de Haan L, Velthorst E, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Menezes PR, Selten JP, Jones PB, Jongsma HE, Kirkbride JB, Rutten BPF, van Os J, Murray RM, Gayer-Anderson C, Morgan C. Perceived major experiences of discrimination, ethnic group, and risk of psychosis in a six-country case-control study. Psychol Med 2021; 52:1-9. [PMID: 33648622 DOI: 10.1017/s0033291721000453] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Perceived discrimination is associated with worse mental health. Few studies have assessed whether perceived discrimination (i) is associated with the risk of psychotic disorders and (ii) contributes to an increased risk among minority ethnic groups relative to the ethnic majority. METHODS We used data from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions Work Package 2, a population-based case-control study of incident psychotic disorders in 17 catchment sites across six countries. We calculated odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between perceived discrimination and psychosis using mixed-effects logistic regression models. We used stratified and mediation analyses to explore differences for minority ethnic groups. RESULTS Reporting any perceived experience of major discrimination (e.g. unfair treatment by police, not getting hired) was higher in cases than controls (41.8% v. 34.2%). Pervasive experiences of discrimination (≥3 types) were also higher in cases than controls (11.3% v. 5.5%). In fully adjusted models, the odds of psychosis were 1.20 (95% CI 0.91-1.59) for any discrimination and 1.79 (95% CI 1.19-1.59) for pervasive discrimination compared with no discrimination. In stratified analyses, the magnitude of association for pervasive experiences of discrimination appeared stronger for minority ethnic groups (OR = 1.73, 95% CI 1.12-2.68) than the ethnic majority (OR = 1.42, 95% CI 0.65-3.10). In exploratory mediation analysis, pervasive discrimination minimally explained excess risk among minority ethnic groups (5.1%). CONCLUSIONS Pervasive experiences of discrimination are associated with slightly increased odds of psychotic disorders and may minimally help explain excess risk for minority ethnic groups.
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Affiliation(s)
- Supriya Misra
- Department of Public Health, San Francisco State University, San Francisco, CA94132, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA02115, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA02115, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA02115, USA
| | - Christina P C Borba
- Department of Psychiatry, Boston Medical Center; Boston University School of Medicine, Boston, MA02118, USA
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AE, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AE, UK
| | - Giada Tripoli
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129Palermo, Italy
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129Palermo, Italy
| | - Daniele La Barbera
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129Palermo, Italy
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, 90129Palermo, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Bologna Transcultural Psychosomatic Team, (BoTPT), Alma Mater Studiorum Università di Bologna, 40126Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater, Studiorum Università di Bologna, 40126Bologna, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134Verona, Italy
| | - Andrei Szöke
- INSERM U955, Equipe 15, Institut National de la Santé et de la Recherche Médicale, 94010Créteil, France
| | | | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad, Complutense, IiSGM, CIBERSAM, 28007Madrid, Spain
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, 75020Paris, France
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic, Medical Centre, University of Amsterdam, 1105AZAmsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic, Medical Centre, University of Amsterdam, 1105AZAmsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Julio Bobes
- Faculty of Medicine and Health Sciences - Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, 33006Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, 08036Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de, Investigación Biomédica en Red de Salud Mental (CIBERSAM), 46010Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz,", 16002Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatry Genetic Group, Instituto de Investigación Sanitaria de, Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, 15706Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo14049-900, Brazil
| | - Paulo Rossi Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo01246-903, Brazil
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, 2333 ZZLeiden, The Netherlands
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, CambridgeCB2 0SZ, UK
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, LondonW1T 7NF, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, LondonW1T 7NF, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, 6200MDMaastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, 6200MDMaastricht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, LondonSE5 8AF, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, LondonSE5 8AF, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, LondonSE5 8AF, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, LondonSE5 8AF, UK
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Tripoli G, Quattrone D, Ferraro L, Gayer-Anderson C, Rodriguez V, La Cascia C, La Barbera D, Sartorio C, Seminerio F, Tarricone I, Berardi D, Szöke A, Arango C, Tortelli A, Llorca PM, de Haan L, Velthorst E, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Menezes PR, Selten JP, Jones PB, Jongsma HE, Kirkbride JB, Lasalvia A, Tosato S, Richards A, O’Donovan M, Rutten BPF, van Os J, Morgan C, Sham PC, Murray RM, Murray GK, Di Forti M. Jumping to conclusions, general intelligence, and psychosis liability: findings from the multi-centre EU-GEI case-control study. Psychol Med 2021; 51:623-633. [PMID: 32327005 PMCID: PMC8020493 DOI: 10.1017/s003329171900357x] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/07/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The 'jumping to conclusions' (JTC) bias is associated with both psychosis and general cognition but their relationship is unclear. In this study, we set out to clarify the relationship between the JTC bias, IQ, psychosis and polygenic liability to schizophrenia and IQ. METHODS A total of 817 first episode psychosis patients and 1294 population-based controls completed assessments of general intelligence (IQ), and JTC, and provided blood or saliva samples from which we extracted DNA and computed polygenic risk scores for IQ and schizophrenia. RESULTS The estimated proportion of the total effect of case/control differences on JTC mediated by IQ was 79%. Schizophrenia polygenic risk score was non-significantly associated with a higher number of beads drawn (B = 0.47, 95% CI -0.21 to 1.16, p = 0.17); whereas IQ PRS (B = 0.51, 95% CI 0.25-0.76, p < 0.001) significantly predicted the number of beads drawn, and was thus associated with reduced JTC bias. The JTC was more strongly associated with the higher level of psychotic-like experiences (PLEs) in controls, including after controlling for IQ (B = -1.7, 95% CI -2.8 to -0.5, p = 0.006), but did not relate to delusions in patients. CONCLUSIONS Our findings suggest that the JTC reasoning bias in psychosis might not be a specific cognitive deficit but rather a manifestation or consequence, of general cognitive impairment. Whereas, in the general population, the JTC bias is related to PLEs, independent of IQ. The work has the potential to inform interventions targeting cognitive biases in early psychosis.
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Affiliation(s)
- Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AF, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Daniele La Barbera
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Fabio Seminerio
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129Palermo, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Domenico Berardi
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
| | - Andrei Szöke
- INSERM, U955, Equipe 15, 51 Avenue de Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), C/Doctor Esquerdo 46, 28007Madrid, Spain
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris75020, France
| | | | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZAmsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZAmsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Julián Clavería s/n, 33006Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Avda. Blasco Ibáñez 15, 46010Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz”, C/Hermandad de Donantes de Sangre, 16002Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZLeiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
| | | | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road London, W1T 7NF, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road London, W1T 7NF, UK
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Alex Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Michael O’Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Bart PF Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Pak C Sham
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AF, UK
- Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, LondonSE5 8AF, UK
| | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, LondonSE5 8AF, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
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Jongsma HE, Karlsen S, Kirkbride JB, Jones PB. Understanding the excess psychosis risk in ethnic minorities: the impact of structure and identity. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1913-1921. [PMID: 34427699 PMCID: PMC8519854 DOI: 10.1007/s00127-021-02042-8] [Citation(s) in RCA: 7] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 01/29/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE Psychotic disorders, which are associated with substantially increased morbidity and mortality, are up to five times more common in some ethnic minority groups compared with the white majority in Western countries. This long-standing and well-replicated public mental health disparity has hitherto largely eluded adequate explanation. We argue that this might have arisen in part due to the lack of attention given to theoretical work characterising the complex and multidimensional social nature of ethnicity by those epidemiological investigations that have dominated the literature. METHODS To bridge this gap, we draw on theoretical and empirical literature from across the social sciences considering the ontological significance of ethnicity (as biology, migration, racialised structures and identity) and its relationships with psychotic disorders to illuminate probable drivers of excess psychosis risk. RESULTS The largest gains in our theoretical understanding of excess psychosis risk among ethnic minority groups are to be made by considering ethnicity in relation to disempowerment resulting from structural and identity-based exclusion. The former is readily studied through the social gradient in health: socioeconomic disadvantage clusters in some ethnic minorities and increases the risk of poor health outcomes, including psychosis. Furthermore, limitations on identity acquisition and expression imposed by the ethnic majority can further contribute to alienate ethnic minorities and increase psychosocial disempowerment (a lack of control over one's life). CONCLUSION We theorise that structural and identity-based exclusion act as the primary drivers shaping variation in rates of psychotic disorder by ethnic minority status.
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Affiliation(s)
- Hannah E. Jongsma
- grid.83440.3b0000000121901201PsyLife Group, Division of Psychiatry, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7DN UK ,grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge, CB2 0SZ UK ,Present Address: Centre for Transcultural Psychiatry ‘Veldzicht’, Ommerweg 67, 7707 AT Balkbrug, The Netherlands
| | - Saffron Karlsen
- grid.5337.20000 0004 1936 7603School of Sociology, Politics and International Studies, University of Bristol, 11 Priory Road, Bristol, BS8 1TU UK
| | - James B. Kirkbride
- grid.83440.3b0000000121901201PsyLife Group, Division of Psychiatry, UCL, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7DN UK
| | - Peter B. Jones
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Herchel Smith Building, Forvie Site, Robinson Way, Cambridge, CB2 0SZ UK ,grid.450563.10000 0004 0412 9303CAMEO, Cambridgeshire and Peterborough NHS Foundation Trust, Elizabeth House, Fulbourn Hospital, Cambridge, CB21 5EF UK
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John-Baptiste Bastien R, Jongsma HE, Kabadayi M, Billings J. The effectiveness of psychological interventions for post-traumatic stress disorder in children, adolescents and young adults: a systematic review and meta-analysis. Psychol Med 2020; 50:1598-1612. [PMID: 32624017 DOI: 10.1017/s0033291720002007] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Children and adolescents display different symptoms of post-traumatic stress disorder (PTSD) than adults. Whilst evidence for the effectiveness of psychological interventions has been synthesised for adults, this is not directly applicable to younger people. Therefore, this systematic review and meta-analysis synthesised studies investigating the effectiveness of psychological interventions for PTSD in children, adolescents and young adults. It provides an update to previous reviews investigating interventions in children and adolescents, whilst investigating young adults for the first time. METHODS We searched published and grey literature to obtain randomised control trials assessing psychological interventions for PTSD in young people published between 2011 and 2019. Quality of studies was assessed using the Cochrane Risk of Bias tool. Data were analysed using univariate random-effects meta-analysis. RESULTS From 15 373 records, 27 met criteria for inclusion, and 16 were eligible for meta-analysis. There was a medium pooled effect size for all psychological interventions (d = -0.44, 95% CI -0.68 to -0.20), as well as for Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR) (d = -0.30, 95% CI -0.58 to -0.02); d = -0.46, 95% CI -0.81 to -0.12). CONCLUSIONS Some, but not all, psychological interventions commonly used to treat PTSD in adults were effective in children, adolescents and young adults. Interventions specifically adapted for younger people were also effective. Our results support the National Institute for Health and Care Excellence guidelines which suggest children and adolescents be offered TF-CBT as a first-line treatment because of a larger evidence base, despite EMDR being more effective.
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Affiliation(s)
| | | | | | - Jo Billings
- Division of Psychiatry, UCL, London, England
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Ferraro L, La Cascia C, Quattrone D, Sideli L, Matranga D, Capuccio V, Tripoli G, Gayer-Anderson C, Morgan C, Sami MB, Sham P, de Haan L, Velthorst E, Jongsma HE, Kirkbride JB, Rutten BPF, Richards AL, Roldan L, Arango C, Bernardo M, Bobes J, Sanjuan J, Santos JL, Arrojo M, Tarricone I, Tortelli A, Szöke A, Del-Ben CM, Selten JP, Lynskey M, Jones PB, Van Os J, La Barbera D, Murray RM, Di Forti M. Premorbid Adjustment and IQ in Patients With First-Episode Psychosis: A Multisite Case-Control Study of Their Relationship With Cannabis Use. Schizophr Bull 2020; 46:517-529. [PMID: 31361020 PMCID: PMC7147569 DOI: 10.1093/schbul/sbz077] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = -0.3, 95% CI = [-0.5; -0.2]) and never-users (Mdiff = -0.4, 95% CI = [-0.6; -0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders.
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Affiliation(s)
- Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,To whom correspondence should be addressed; Via Gaetano La Loggia, 1, 90129 Palermo, Italy; tel: 091-6555175, fax: 091-6555164, e-mail:
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Lucia Sideli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Domenica Matranga
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Veronica Capuccio
- Department of Economic, Management and Statistical Sciences (DSEAS) University of Palermo, Palermo, Italy
| | - Giada Tripoli
- 2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Musa B Sami
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Pak Sham
- Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands,Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hannah E Jongsma
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Cambridge, UK,Psylife Group, Division of Psychiatry, University College London, London, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Alexander L Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Laura Roldan
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuan
- Department of Psychiatry, School of Medicine, Universidad de Valencia, CIBERSAM, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz,” Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris, France,INSERM, Créteil, France
| | | | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands,Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
| | - Michael Lynskey
- Department of Addiction, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jim Van Os
- 2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | | | - Robin M Murray
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Marta Di Forti
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
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Affiliation(s)
- Hannah E Jongsma
- ESRC Postdoctoral Fellow, PsyLife Group, Division of Psychiatry, University College London, London
| | - Peter B Jones
- Professor of Psychiatry, Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ
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Quattrone D, Di Forti M, Gayer-Anderson C, Ferraro L, Jongsma HE, Tripoli G, La Cascia C, La Barbera D, Tarricone I, Berardi D, Szöke A, Arango C, Lasalvia A, Tortelli A, Llorca PM, de Haan L, Velthorst E, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Menezes PR, Selten JP, Jones PB, Kirkbride JB, Richards AL, O'Donovan MC, Sham PC, Vassos E, Rutten BPF, van Os J, Morgan C, Lewis CM, Murray RM, Reininghaus U. Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study. Psychol Med 2019; 49:1378-1391. [PMID: 30282569 PMCID: PMC6518388 DOI: 10.1017/s0033291718002131] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 07/01/2018] [Accepted: 07/24/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment. METHOD This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions. RESULTS A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions. CONCLUSIONS Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.
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Affiliation(s)
- Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Hannah E Jongsma
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Daniele La Barbera
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
| | - Domenico Berardi
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126 Bologna, Italy
| | - Andrei Szöke
- INSERM, U955, Equipe 15, 51 Avenue de Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), C/Doctor Esquerdo 46, 28007 Madrid, Spain
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris 75020, France
| | | | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Julián Clavería s/n, 33006 Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital clinic, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/Avda. Blasco Ibáñez 15, 46010 Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz”, C/Hermandad de Donantes de Sangre, 16002 Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZ Leiden, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK
| | - Alexander L Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff CF24 4HQ, UK
| | - Michael C O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff CF24 4HQ, UK
| | - Pak C Sham
- Department of Psychiatry, the University of Hong Kong, Hong Kong, China
- Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Bart PF Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Robin M Murray
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Ulrich Reininghaus
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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34
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Di Forti M, Quattrone D, Freeman TP, Tripoli G, Gayer-Anderson C, Quigley H, Rodriguez V, Jongsma HE, Ferraro L, La Cascia C, La Barbera D, Tarricone I, Berardi D, Szöke A, Arango C, Tortelli A, Velthorst E, Bernardo M, Del-Ben CM, Menezes PR, Selten JP, Jones PB, Kirkbride JB, Rutten BP, de Haan L, Sham PC, van Os J, Lewis CM, Lynskey M, Morgan C, Murray RM. The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study. Lancet Psychiatry 2019; 6:427-436. [PMID: 30902669 PMCID: PMC7646282 DOI: 10.1016/s2215-0366(19)30048-3] [Citation(s) in RCA: 418] [Impact Index Per Article: 83.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 01/20/2019] [Accepted: 01/21/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cannabis use is associated with increased risk of later psychotic disorder but whether it affects incidence of the disorder remains unclear. We aimed to identify patterns of cannabis use with the strongest effect on odds of psychotic disorder across Europe and explore whether differences in such patterns contribute to variations in the incidence rates of psychotic disorder. METHODS We included patients aged 18-64 years who presented to psychiatric services in 11 sites across Europe and Brazil with first-episode psychosis and recruited controls representative of the local populations. We applied adjusted logistic regression models to the data to estimate which patterns of cannabis use carried the highest odds for psychotic disorder. Using Europe-wide and national data on the expected concentration of Δ9-tetrahydrocannabinol (THC) in the different types of cannabis available across the sites, we divided the types of cannabis used by participants into two categories: low potency (THC <10%) and high potency (THC ≥10%). Assuming causality, we calculated the population attributable fractions (PAFs) for the patterns of cannabis use associated with the highest odds of psychosis and the correlation between such patterns and the incidence rates for psychotic disorder across the study sites. FINDINGS Between May 1, 2010, and April 1, 2015, we obtained data from 901 patients with first-episode psychosis across 11 sites and 1237 population controls from those same sites. Daily cannabis use was associated with increased odds of psychotic disorder compared with never users (adjusted odds ratio [OR] 3·2, 95% CI 2·2-4·1), increasing to nearly five-times increased odds for daily use of high-potency types of cannabis (4·8, 2·5-6·3). The PAFs calculated indicated that if high-potency cannabis were no longer available, 12·2% (95% CI 3·0-16·1) of cases of first-episode psychosis could be prevented across the 11 sites, rising to 30·3% (15·2-40·0) in London and 50·3% (27·4-66·0) in Amsterdam. The adjusted incident rates for psychotic disorder were positively correlated with the prevalence in controls across the 11 sites of use of high-potency cannabis (r = 0·7; p=0·0286) and daily use (r = 0·8; p=0·0109). INTERPRETATION Differences in frequency of daily cannabis use and in use of high-potency cannabis contributed to the striking variation in the incidence of psychotic disorder across the 11 studied sites. Given the increasing availability of high-potency cannabis, this has important implications for public health. FUNDING SOURCE Medical Research Council, the European Community's Seventh Framework Program grant, São Paulo Research Foundation, National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London and the NIHR BRC at University College London, Wellcome Trust.
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Affiliation(s)
- Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK.
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Giada Tripoli
- Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - Harriet Quigley
- Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Victoria Rodriguez
- Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Hannah E Jongsma
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Laura Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Domenico Berardi
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Andrei Szöke
- INSERM U955, Equipe 15, Institut National de la Santé et de la Recherche Médicale, Créteil, Paris, France
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), Madrid, Spain
| | | | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital clinic, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Leiden, Netherlands
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK; CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Bart Pf Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Pak C Sham
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK; Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jim van Os
- Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK; Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK
| | - Michael Lynskey
- Department of Addiction, Institute of Psychiatry, King's College London, London, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - Robin M Murray
- Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK
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Jongsma HE, Turner C, Kirkbride JB, Jones PB. International incidence of psychotic disorders, 2002-17: a systematic review and meta-analysis. Lancet Public Health 2019; 4:e229-e244. [PMID: 31054641 PMCID: PMC6693560 DOI: 10.1016/s2468-2667(19)30056-8] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/18/2019] [Accepted: 03/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The last comprehensive systematic review of the incidence of psychotic disorders was published in 2004. New epidemiological data from different settings now permit a broader understanding of global variation. We examined the variation in psychosis by demographic characteristics and study method. METHODS For this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, PsycINFO, and bibliographies, and directly contacted first authors. We sought to obtain citations of original research published between Jan 1, 2002, and Dec 31, 2017, on incidence of non-organic adult-onset psychotic disorder. We included papers that were published or in grey literature and had no language restrictions. Data were extracted from published reports, where possible, by sex, age, and ethnic group. Quality of yield was assessed. Data were assessed using univariable random-effects meta-analysis and meta-regression. We registered our systematic review on PROSPERO, number CRD42018086800. FINDINGS From 56 721 records identified, 177 met inclusion criteria. The pooled incidence of all psychotic disorders was 26·6 per 100 000 person-years (95% CI 22·0-31·7). Heterogeneity was high (I2≥98·5%). Men were at higher risk of all psychotic disorders (incidence rate ratio 1·44 [1·27-1·62]) and non-affective disorders (1·60 [1·44-1·77]) than women, but not affective psychotic disorders (0·87 [0·75-1·00]). Ethnic minorities were also at excess risk of all psychotic disorders (1·75 [1·53-2·00]), including non-affective disorders (1·71 [1·40-2·09]). Meta-regression revealed that population registers reported higher rates of non-affective disorders (9·64 [2·72-31·82]), schizophrenia (2·51 [1·24-5·21]), and bipolar disorder (4·53 [2·41-8·51]) than first contact study designs. INTERPRETATION We found marked variation in incidence of psychotic disorders by personal characteristics and place. Some geographical variation could be partially explained by differences in case ascertainment methods. FUNDING None.
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Affiliation(s)
- Hannah E Jongsma
- Department of Psychiatry, University of Cambridge, Cambridge, UK; PsyLife Group, Division of Psychiatry, University College London, London, UK.
| | - Caitlin Turner
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - James B Kirkbride
- PsyLife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK; CAMEO, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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36
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Affiliation(s)
- Hannah E Jongsma
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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37
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Jongsma HE, Gayer-Anderson C, Lasalvia A, Quattrone D, Mulè A, Szöke A, Selten JP, Turner C, Arango C, Tarricone I, Berardi D, Tortelli A, Llorca PM, de Haan L, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Menezes PR, Murray RM, Rutten BP, Jones PB, van Os J, Morgan C, Kirkbride JB. Treated Incidence of Psychotic Disorders in the Multinational EU-GEI Study. JAMA Psychiatry 2018; 75:36-46. [PMID: 29214289 PMCID: PMC5833538 DOI: 10.1001/jamapsychiatry.2017.3554] [Citation(s) in RCA: 182] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/01/2017] [Indexed: 01/23/2023]
Abstract
Importance Psychotic disorders contribute significantly to the global disease burden, yet the latest international incidence study of psychotic disorders was conducted in the 1980s. Objectives To estimate the incidence of psychotic disorders using comparable methods across 17 catchment areas in 6 countries and to examine the variance between catchment areas by putative environmental risk factors. Design, Setting, and Participants An international multisite incidence study (the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions) was conducted from May 1, 2010, to April 1, 2015, among 2774 individuals from England (2 catchment areas), France (3 catchment areas), Italy (3 catchment areas), the Netherlands (2 catchment areas), Spain (6 catchment areas), and Brazil (1 catchment area) with a first episode of nonorganic psychotic disorders (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision [ICD-10] codes F20-F33) confirmed by the Operational Criteria Checklist. Denominator populations were estimated using official national statistics. Exposures Age, sex, and racial/ethnic minority status were treated as a priori confounders. Latitude, population density, percentage unemployment, owner-occupied housing, and single-person households were treated as catchment area-level exposures. Main Outcomes and Measures Incidence of nonorganic psychotic disorders (ICD-10 codes F20-F33), nonaffective psychoses (ICD-10 codes F20-F29), and affective psychoses (ICD-10 codes F30-F33) confirmed by the Operational Criteria Checklist. Results A total of 2774 patients (1196 women and 1578 men; median age, 30.5 years [interquartile range, 23.0-41.0 years]) with incident cases of psychotic disorders were identified during 12.9 million person-years at risk (crude incidence, 21.4 per 100 000 person-years; 95% CI, 19.4-23.4 per 100 000 person-years). A total of 2183 patients (78.7%) had nonaffective psychotic disorders. After direct standardization for age, sex, and racial/ethnic minority status, an 8-fold variation was seen in the incidence of all psychotic disorders, from 6.0 (95% CI, 3.5-8.6) per 100 000 person-years in Santiago, Spain, to 46.1 (95% CI, 37.3-55.0) per 100 000 person-years in Paris, France. Rates were elevated in racial/ethnic minority groups (incidence rate ratio, 1.6; 95% CI, 1.5-1.7), were highest for men 18 to 24 years of age, and were lower in catchment areas with more owner-occupied homes (incidence rate ratio, 0.8; 95% CI, 0.7-0.8). Similar patterns were observed for nonaffective psychoses; a lower incidence of affective psychoses was associated with higher area-level unemployment (incidence rate ratio, 0.3; 95% CI, 0.2-0.5). Conclusions and Relevance This study confirmed marked heterogeneity in risk for psychotic disorders by person and place, including higher rates in younger men, racial/ethnic minorities, and areas characterized by a lower percentage of owner-occupied houses.
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Affiliation(s)
- Hannah E. Jongsma
- Department of Psychiatry, University of Cambridge, Cambridge, England
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, England
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Diego Quattrone
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, England
| | - Alice Mulè
- Unit of Psychiatry, “P. Giaccone” General Hospital, Palermo, Italy
| | - Andrei Szöke
- Institut National de la Santé et de la Recherche Médicale, U955, Créteil, France
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Leiden, the Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Caitlin Turner
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, England
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Investigación Sanitaria del Hospital Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Domenico Berardi
- Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | | | | | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Department of Medicine, University of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - José Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz,” Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, England
| | - Bart P. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, England
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, the Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, England
| | - James B. Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, England
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