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  • Altered functional connectivity of the thalamus induced by modified electroconvulsive therapy for schizophrenia
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-17
    Junjie Wang; Yuchao Jiang; Yingying Tang; Mengqing Xia; Adrian Curtin; Jin Li; Jianhua Sheng; Tianhong Zhang; Chunbo Li; Li Hui; Hongliang Zhu; Bharat B. Biswal; Qiufang Jia; Cheng Luo; Jijun Wang

    Background Electroconvulsive therapy (ECT) has been shown to be effective in schizophrenia (SZ), particularly in drug-refractory cases or when rapid symptom relief is needed. However, its precise mechanisms of action remain largely unclear. To clarify the mechanisms underlying modified electroconvulsive therapy (mECT) for SZ, we conducted a longitudinal cohort study evaluating functional connectivity of the thalamus before and after mECT treatment using sub-regions of thalamus as regions of interest (ROIs). Methods Twenty-one SZ individuals taking only antipsychotics (DSZ group) for 4 weeks and 21 SZ patients receiving a regular course of mECT combining with antipsychotics (MSZ group) were observed in parallel. All patients underwent magnetic resonance imaging scans at baseline (t1) and follow-up (t2, ~4 weeks) time points. Data were compared to a matched healthy control group (HC group) consisting of 23 persons who were only scanned at baseline. Group differences in changes of thalamic functional connectivity between two SZ groups over time, as well as in functional connectivity among two SZ groups and HC group were assessed. Results Significant interaction of group by time was found in functional connectivity of the right thalamus to right putamen during the course of about 4-week treatment. Post-hoc analysis showed a significantly enhanced functional connectivity of the right thalamus to right putamen in the MSZ group contrasting to the DSZ group. In addition, a decreased and an increased functional connectivity of the thalamus to sensory cortex were observed within the MSZ and DSZ group after 4-week treatment trial, respectively. Conclusion Our findings suggest that changes in functional connectivity of the thalamus may be associated with the brain mechanisms of mECT for schizophrenia.

    更新日期:2020-01-17
  • A symptom combination predicting treatment-resistant schizophrenia – A strategy for real-world clinical practice
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-16
    Bruno B. Ortiz; Cinthia H. Higuchi; Cristiano Noto; Dan W. Joyce; Christoph U. Correll; Rodrigo A. Bressan; Ary Gadelha

    Early identification of symptoms that can predict treatment-resistant schizophrenia (TRS) could help clinicians to avoid delays in clozapine therapy. This study aims to investigate symptom patterns that could predict TRS using a discovery/replication study design. First, we followed a cohort of inpatients with schizophrenia (n = 164) in which the most discriminative items at baseline of the Positive and Negative Syndrome Scale (PANSS) were determined using logistic regression with TRS status as an outcome. Using Receiver Operating Characteristic (ROC) curves, we tested the prediction performance of multiple combinations of the identified items. The same items' combination was tested in an independent replication sample of (n = 207) outpatients with schizophrenia. In the discovery sample, the best combination to predict TRS at the discharge was the sum of three baseline PANSS items – conceptual disorganization (P2), difficulty in abstract thinking (N5), and unusual thought content (G9). The P2 + N5 + G9 model yielded an area under the curve (AUC) of 0.881, a sensitivity of 77.8%, and a specificity of 83.3%. In the outpatient sample, the model P2 + N5 + G9 predictive accuracy for TRS was only in the range of “acceptable” with an AUC of 0.756 and sensitivity of 72.3% and a specificity of 74.4%. Overall, the P2 + N5 + G9 model corresponds to the construct of formal thought disorder composed of disorganized thinking, concrete thinking, and bizarre-idiosyncratic thinking. Pronounced levels of these symptoms are easily identifiable in clinical practice and may be a feasible strategy in TRS. Replicating in first-episode cohorts is desirable to understand the likely clinical utility.

    更新日期:2020-01-17
  • Aberrant cortical ensembles and schizophrenia-like sensory phenotypes in setd1a mice.
    Biol. Psychiatry (IF 11.501) Pub Date : 2020-01-16
    Jordan P. Hamm; Yuriy Shymkiv; Jun Mukai; Joseph A. Gogos; Rafael Yuste

    Background A breakdown of synchrony within neuronal ensembles leading to destabilization of network “attractors” could be a defining aspect of neuropsychiatric diseases like schizophrenia (SZ), representing a common downstream convergence point for the diverse etiological pathways associated with the disease. Using a mouse genetic model, here we demonstrate how altered ensembles are associated with pathological sensory cortical processing phenotypes resulting from loss of function mutations in the setd1a gene, a recently identified rare risk genotype with very high penetrance for SZ. Methods We employed fast two-photon calcium imaging of neuronal populations (GCaMP6s, 10Hz, 100-250 cells, layer 2/3 of primary visual cortex, i.e. V1) in awake head-fixed mice (setd1a+/- vs wildtype littermate controls) during rest and visual stimulation with moving full-field square-wave gratings (0.04 cpd; 2.0 cps; 100% contrast, 12 directions). Multielectrode recordings were analyzed in the time-frequency domain to assess stimulus induced oscillations and cross-layer phase synchrony. Results Neuronal activity and orientation/direction selectivity were unaffected in setd1a+/- mice, but correlations between cell pairs in V1 showed altered distributions compared to WT, in both ongoing and visually-evoked activity. Further, population-wide “ensemble activations” in setd1a+/- mice were markedly less reliable over time during rest and visual stimulation, resulting in unstable encoding of basic visual information. This alteration of ensembles coincided with reductions in alpha and high-gamma band phase synchrony within and between cortical layers. Conclusion These results provide new evidence for an ensemble hypothesis of SZ and highlight the utility of setd1a+/- mice for modeling sensory processing phenotypes.

    更新日期:2020-01-17
  • I seem to be what I'm not (you see)
    Lancet Psychiatry (IF 18.329) Pub Date : 2020-01-16
    Vaughan Bell
    更新日期:2020-01-17
  • Effects of risperidone monotherapy on the default-mode network in antipsychotic-naïve first-episode schizophrenia: Posteromedial cortex heterogeneity and relationship with the symptom improvements
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-15
    Xujun Duan; Maolin Hu; Xinyue Huang; Xia Dong; Xiaofen Zong; Changchun He; Jinming Xiao; Jinsong Tang; Xiaogang Chen; Huafu Chen

    The default mode network (DMN) has been consistently detected abnormally in schizophrenia. However, the effects of antipsychotics on this network are still under debate, and inconsistent findings may be due to the functional heterogeneity within the DMN, especially in the component regions of the posteromedial cortex (PMC). Here, we conducted a longitudinal research on the resting-state functional connectivity of the PMC subdivisions on 33 treatment-naive first-episode patients with schizophrenia at baseline and after 8 weeks of risperidone treatment through resting-state functional magnetic resonance imaging. At baseline, the patients demonstrated decreased connectivity of the three PMC seeds with several brain regions (target regions) compared with healthy controls. We then tested the effect of antipsychotic treatment on the functional connectivity between the three seeds and the target regions. We found that, one of the three seeds encompassed in PMC, namely, posterior cingulate cortex (PCC), was observed to have increased functional connectivity with the bilateral thalamus and the left lingual gyrus (LG). On the contrary, the functional connectivity between the target regions and the two remaining seeds, namely, the retrosplenial cortex and precuneus, was unaffected by risperidone treatment. Correlation analysis revealed a positive correlation between longitudinal change of PCC-LG connectivity and symptom improvement. These findings indicated the heterogeneity of the PMC in response to antipsychotic treatment and suggested the role of PCC as a treatment biomarker for schizophrenia.

    更新日期:2020-01-16
  • Antidepressant and neurocognitive effects of serial ketamine administration versus ECT in depressed patients
    J. Psychiatr. Res. (IF 3.917) Pub Date : 2020-01-16
    Laura Basso; Luisa Bönke; Sabine Aust; Matti Gärtner; Isabella Heuser-Collier; Christian Otte; Katja Wingenfeld; Malek Bajbouj; Simone Grimm

    Background While electroconvulsive therapy (ECT) is considered the gold standard for acute treatment of patients with otherwise treatment-resistant depression, ketamine has recently emerged as a fast-acting treatment alternative for these patients. Efficacy and onset of action are currently among the main factors that influence clinical decision making, however, the effect of these treatments on cognitive functions should also be a crucial point, given that cognitive impairment in depression is strongly related to disease burden and functional recovery. ECT is known to induce transient cognitive impairment, while little is known about ketamine's impact on cognition. This study therefore aims to compare ECT and serial ketamine administration not only with regard to their antidepressant efficacy but also to acute neurocognitive effects. Methods Fifty patients suffering from depression were treated with either serial ketamine infusions or ECT. Depression severity and cognitive functions were assessed before, during, and after treatment. Results ECT and ketamine administration were equally effective, however, the antidepressant effects of ketamine occurred faster. Ketamine improved neurocognitive functioning, especially attention and executive functions, whereas ECT was related to a small overall decrease in cognitive performance. Conclusions Due to its pro-cognitive effects and faster antidepressant effect, serial ketamine administration might be a more favorable short-term treatment option than ECT. Limitations As this research employed a naturalistic study design, patients were not systematically randomized, there was no control group and patients received concurrent and partially changing medications during treatment. Clinical trials registration Functional and Metabolic Changes in the Course of Antidepressive Treatment, https://clinicaltrials.gov/ct2/show/NCT02099630, NCT02099630.

    更新日期:2020-01-16
  • Sex differences in youth with mental health problems in inpatient, outpatient and youth justice settings
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-16
    Shannon L. Stewart; Elizabeth Thornley; Natalia Lapshina; Patricia Erickson; Evelyn Vingilis; Hayley Hamilton; Nathan Kolla

    Approximately 40–70% of justice-involved youth have untreated mental health problems. There is no current research that directly compares the mental health profiles of youth involved in the justice system to that of inpatients and outpatients. The research reported is significant because it directly compares the needs of these population by use of the same suite of standardized assessment tools. The sample consisted of 755 youth aged 16–19 years recruited from youth justice and mental health facilities in Ontario, Canada. Participants completed semi-structured assessment interviews using the interRAI child and youth suite of instruments to assess for internalizing and externalizing concerns as well as exposure to traumatic life events. Findings indicated that justice-involved youth experienced higher levels of certain types of trauma. Analyses examining sex differences indicated that, controlling for age, males in the youth justice group reported higher cumulative trauma compared to male outpatients but not inpatients. Females in the youth justice group reported experiencing higher cumulative trauma compared to female outpatients and inpatients. In addition, controlling for sex and age, the youth justice group reported lower internalizing symptoms scores than inpatients and outpatients. Finally, males in the youth justice group scored lower than inpatients in externalizing symptoms, whereas females within the youth justice group scored higher in externalizing symptoms compared to inpatients and outpatients. Results indicated that youth who are involved with the justice system exhibit significant psychosocial issues that represent complex service needs which require unique interventions in order to be addressed appropriately.

    更新日期:2020-01-16
  • Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-16
    Jerome Sarris; Justin Sinclair; Diana Karamacoska; Maggie Davidson; Joseph Firth

    Medicinal cannabis has received increased research attention over recent years due to loosening global regulatory changes. Medicinal cannabis has been reported to have potential efficacy in reducing pain, muscle spasticity, chemotherapy-induced nausea and vomiting, and intractable childhood epilepsy. Yet its potential application in the field of psychiatry is lesser known. The first clinically-focused systematic review on the emerging medical application of cannabis across all major psychiatric disorders was conducted. Current evidence regarding whole plant formulations and plant-derived cannabinoid isolates in mood, anxiety, sleep, psychotic disorders and attention deficit/hyperactivity disorder (ADHD) is discussed; while also detailing clinical prescription considerations (including pharmacogenomics), occupational and public health elements, and future research recommendations. The systematic review of the literature was conducted during 2019, assessing the data from all case studies and clinical trials involving medicinal cannabis or plant-derived isolates for all major psychiatric disorders (neurological conditions and pain were omitted). The present evidence in the emerging field of cannabinoid therapeutics in psychiatry is nascent, and thereby it is currently premature to recommend cannabinoid-based interventions. Isolated positive studies have, however, revealed tentative support for cannabinoids (namely cannabidiol; CBD) for reducing social anxiety; with mixed (mainly positive) evidence for adjunctive use in schizophrenia. Case studies suggest that medicinal cannabis may be beneficial for improving sleep and post-traumatic stress disorder, however evidence is currently weak. Preliminary research findings indicate no benefit for depression from high delta-9 tetrahydrocannabinol (THC) therapeutics, or for CBD in mania. One isolated study indicates some potential efficacy for an oral cannabinoid/terpene combination in ADHD. Clinical prescriptive consideration involves caution in the use of high-THC formulations (avoidance in youth, and in people with anxiety or psychotic disorders), gradual titration, regular assessment, and caution in cardiovascular and respiratory disorders, pregnancy and breast-feeding. There is currently encouraging, albeit embryonic, evidence for medicinal cannabis in the treatment of a range of psychiatric disorders. Supportive findings are emerging for some key isolates, however, clinicians need to be mindful of a range of prescriptive and occupational safety considerations, especially if initiating higher dose THC formulas.

    更新日期:2020-01-16
  • Chronic psychosocial stress during pregnancy affects maternal behavior and neuroendocrine function and modulates hypothalamic CRH and nuclear steroid receptor expression
    Transl. Psychiaty (IF 5.182) Pub Date : 2020-01-16
    Sandra P. Zoubovsky; Sarah Hoseus; Shivani Tumukuntala; Jay O. Schulkin; Michael T. Williams; Charles V. Vorhees; Louis J. Muglia
    更新日期:2020-01-16
  • Novel genetic susceptibility loci identified by family based whole exome sequencing in Han Chinese schizophrenia patients
    Transl. Psychiaty (IF 5.182) Pub Date : 2020-01-16
    Mo Li; Lu Shen; Luan Chen; Cong Huai; Hailiang Huang; Xi Wu; Chao Yang; Jingsong Ma; Wei Zhou; Huihui Du; Lingzi Fan; Lin He; Chunling Wan; Shengying Qin
    更新日期:2020-01-16
  • A broad autism phenotype expressed in facial morphology
    Transl. Psychiaty (IF 5.182) Pub Date : 2020-01-16
    Diana Weiting Tan; Murray T. Maybery; Syed Zulqarnain Gilani; Gail A. Alvares; Ajmal Mian; David Suter; Andrew J. O. Whitehouse
    更新日期:2020-01-16
  • Emotion–Action–Fusion, Intrusive Thoughts, and Psychosis
    Schizophr. Bull. (IF 7.289) Pub Date : 2020-01-16

    Corrigendum to “Emotion–Action–Fusion, Intrusive Thoughts, and Psychosis” by Anonymous. Schizophr Bull. 2019; doi:10.1093/schbul/sbz084.In the original publication of this article, the author’s name and contact details were made public, and have since been removed by the publisher. The author has requested that their authorship of this article be made anonymous.

    更新日期:2020-01-16
  • Addressing mental health in Aboriginal young people in Australia
    Lancet Psychiatry (IF 18.329) Pub Date : 2020-01-15
    Michael Wright; Nikayla Crisp; Elizabeth Newnham; Helen Flavell; Ashleigh Lin
    更新日期:2020-01-16
  • Mediation and moderation analyses: exploring the complex pathways between hope and quality of life among patients with schizophrenia
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-15
    Wei-Liang Wang; Yu-Qiu Zhou; Nan-Nan Chai; Guo-Hua Li; Dong-Wei Liu

    The underlying mechanism between hope and quality of life is as yet unknown. We aim to examine the potential mediating effect of depression and resilience and the moderated effect of sex in this well-established association. Two hundred seven patients diagnosed with schizophrenia were administered a questionnaire battery that measured hope, depression, resilience and QOL. A multiple mediation model was used to examine the mediating effect of resilience and depression on the association between hope and QOL. A subgroup analysis was performed and a moderated mediation model was examined to find and test the moderated effect of sex on the mediation model. We used Mplus to perform moderation and mediation analyses so that the mediators and moderator could function together in the same model. Sex was the moderator on the direct path between hope and QOL. The relationship between hope and QOL was mediated by resilience and depression in both sexes. When compared with female patients, the effect of hope on QOL was completely mediated by resilience and depression in males. In female patients, the model was partially mediated, and the direct effect of hope on QOL was significantly negatively correlated with the level of hope. We present a conceptual model containing the mediated effects of resilience and depression and the moderated effect of sex between hope and QOL, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve QOL.

    更新日期:2020-01-15
  • Posttraumatic stress disorder and risk of selected autoimmune diseases among US military personnel
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-15
    Deborah Boggs Bookwalter; Kimberly A. Roenfeldt; Cynthia A. LeardMann; So Yeon Kong; Mark S. Riddle; Rudolph P. Rull

    Increasing evidence suggests a link between posttraumatic stress disorder (PTSD) and physical health. Stress disorders may lead to impairment of the immune system and subsequent autoimmune disease. This study investigated the association between PTSD and risk of selected autoimmune diseases (i.e. rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel diseases, and multiple sclerosis) among US active duty service members. Using data from the Millennium Cohort Study, incident autoimmune cases between study initiation and September 2015 were identified from medical encounter records in the Military Health System Data Repository (MDR). Participants were classified as having a history of PTSD if they self-reported receiving a health care provider’s diagnosis of PTSD or if they screened positive using the PTSD Checklist−Civilian Version. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression models adjusted for demographics and history of another mental health condition. Among 120,572 participants followed for a mean of 5.2 years, risk of any of the selected autoimmune diseases was 58% higher for those with a history of PTSD (HR = 1.58, 95% CI: 1.25, 2.01) compared with no history of PTSD. Further adjustment for BMI, smoking status, and alcohol use had little impact on the effect estimates, and results were not appreciably different according to combat experience and history of physical or sexual trauma. Active duty military personnel with PTSD may have an elevated risk of a range of autoimmune diseases, regardless of combat experience or prior trauma. Future research is needed to understand potential mechanisms which may inform future mitigative strategies in reducing extra-neuropsychiatric health problems among those with PTSD.

    更新日期:2020-01-15
  • Genetic evidence of gender difference in autism spectrum disorder supports the female-protective effect
    Transl. Psychiaty (IF 5.182) Pub Date : 2020-01-15
    Yi Zhang; Na Li; Chao Li; Ze Zhang; Huajing Teng; Yan Wang; Tingting Zhao; Leisheng Shi; Kun Zhang; Kun Xia; Jinchen Li; Zhongsheng Sun
    更新日期:2020-01-15
  • Error in Quiz Answer
    JAMA Psychiatry (IF 15.916) Pub Date : 2020-01-15

    In the Clinical Challenge, “Treatment of First-Episode Schizophrenia in a Young Woman,”1 published online October 30, 2019, there was an error in a quiz answer choice. Answer A was corrected to “Consider the risk of adverse events and which drugs are approved for use” instead of “Commence treatment with oral amisulpride.” In addition, the Discussion and Patient Outcome sections have been corrected to note that the drug amisulpride is not approved for use in the United States but is approved for use in the United Kingdom where the patient was treated. This article has been corrected online.

    更新日期:2020-01-15
  • Is There an Association Between Social Media Use and Mental Health? The Timing of Confounding Measurement Matters—Reply
    JAMA Psychiatry (IF 15.916) Pub Date : 2020-01-15
    Kenneth A. Feder; Kira E. Riehm; Ramin Mojtabai

    In Reply In our study,1 we used 3 waves of data from the longitudinal Population Assessment of Tobacco and Health study to show that adolescents who report more frequent social media use report greater symptoms of psychopathology 1 year later. In their letter, Keyes and Kreski replicated our findings. They then showed that, after further adjusting for psychopathology measured concurrently with social media use, the prospective association we identified disappears, except for among the most frequent users of social media use.

    更新日期:2020-01-15
  • Is There an Association Between Social Media Use and Mental Health? The Timing of Confounding Measurement Matters
    JAMA Psychiatry (IF 15.916) Pub Date : 2020-01-15
    Katherine M. Keyes; Noah Kreski

    To the Editor Riehm et al1 report an association between social media use and increased risk of internalizing and combined internalizing/externalizing problems 1 year later (between waves 2 and 3 of Population Assessment of Tobacco and Health study data), controlling for psychopathology and alcohol/marijuana use at wave 1. However, the analytic strategy is vulnerable to substantial residual confounding.

    更新日期:2020-01-15
  • Risk of Subjection to Violence and Perpetration of Violence in Persons With Psychiatric Disorders in Sweden
    JAMA Psychiatry (IF 15.916) Pub Date : 2020-01-15
    Amir Sariaslan; Louise Arseneault; Henrik Larsson; Paul Lichtenstein; Seena Fazel
    更新日期:2020-01-15
  • Effects of Family-Focused Therapy vs Enhanced Usual Care for Symptomatic Youths at High Risk for Bipolar Disorder: A Randomized Clinical Trial
    JAMA Psychiatry (IF 15.916) Pub Date : 2020-01-15
    David J. Miklowitz; Christopher D. Schneck; Patricia D. Walshaw; Manpreet K. Singh; Aimee E. Sullivan; Robert L. Suddath; Marcy Forgey Borlik; Catherine A. Sugar; Kiki D. Chang
    更新日期:2020-01-15
  • Violent Acts and Being the Target of Violence Among People With Mental Illness—The Data and Their Limits
    JAMA Psychiatry (IF 15.916) Pub Date : 2020-01-15
    Paul S. Appelbaum

    Evidence has accumulated over the last 40 years indicating increased rates of violent perpetration and being the target of violence among people with mental illness. Landmark data collected in the early 1980s by the Epidemiologic Catchment Area study found a 12-month prevalence of 12% for any type of violence among people with mental disorders, which dropped to 7% if people with comorbid substance abuse (DSM-III) were excluded, compared with 2% in the general population.1 Similar magnitudes of increased risk have been found in subsequent studies2 and meta-analyses,3 although the absolute rates of violence vary, probably because of differences in the populations sampled, outcome measures, and means of ascertainment.4 However, despite the greater risk associated with mental disorders, the proportion of violence accounted for by mental disorder is small, with 1-year attributable risk estimated at 4% in the Epidemiologic Catchment Area analyses.1

    更新日期:2020-01-15
  • Leading the Next CBD Wave—Safety and Efficacy
    JAMA Psychiatry (IF 15.916) Pub Date : 2020-01-15
    Yasmin L. Hurd

    Cannabidiol (CBD), a phytocannabinoid with potential medicinal properties, has recently hit all levels of society with tidal wave force that very few saw coming. After being virtually unknown by most people not even a decade ago, CBD is now in the general lexicon with numerous companies riding the CBD wave: more than 1000 products are being sold through the internet, dispensaries, pharmacies, large national retail stores, boutique shops, and local bodegas. This, along with extensive media coverage, has made CBD a household name and spawned an international business with an estimated market value of more than $60 billion within the next few years.

    更新日期:2020-01-15
  • MicroRNA-298 reduces levels of human amyloid-β precursor protein (APP), β-site APP-converting enzyme 1 (BACE1) and specific tau protein moieties
    Mol. Psychiatry (IF 11.973) Pub Date : 2020-01-15
    Nipun Chopra; Ruizhi Wang; Bryan Maloney; Kwangsik Nho; John S. Beck; Naemeh Pourshafie; Alexander Niculescu; Andrew J. Saykin; Carlo Rinaldi; Scott E. Counts; Debomoy K. Lahiri
    更新日期:2020-01-15
  • Identifying Adolescents at Risk for Depression: A Prediction Score Performance in Cohorts Based in Three Different Continents
    J. Am. Acad. Child Adolesc. Psychiatry (IF 6.391) Pub Date : 2020-01-15
    Thiago Botter-Maio Rocha; Helen L. Fisher; Arthur Caye; Luciana Anselmi; Louise Arseneault; Fernando C. Barros; Avshalom Caspi; Andrea Danese; Helen Gonçalves; HonaLee Harrington; Renate Houts; Ana M.B. Menezes; Terrie E. Moffitt; Valeria Mondelli; Richie Poulton; Luis Augusto Rohde; Fernando Wehrmeister; Christian Kieling

    Objective Prediction models have become frequent in the medical literature, but most published studies are conducted in a single setting. Heterogeneity between development and validation samples has been posited as a major obstacle for the generalization of models. We aimed to develop a multivariable prognostic model using sociodemographic variables easily obtainable from adolescents at age 15 to predict a depressive disorder diagnosis at age 18, and to evaluate its generalizability in two samples from diverse socioeconomic and cultural settings. Method Data from the 1993 Pelotas Birth Cohort were used to develop the prediction model, and its generalizability was evaluated in two representative cohort studies: the Environmental Risk (E-Risk) Longitudinal Twin Study and the Dunedin Multidisciplinary Health and Development Study. Results At age 15, 2,192 adolescents with no evidence of current or previous depression were included (44.6% male). The apparent C-statistic of the models derived in Pelotas ranged from 0.76 to 0.79, and the model obtained from a penalized logistic regression was selected for subsequent external evaluation. Major discrepancies between the samples were identified, impacting the external prognostic performance of the model (Dunedin and E-Risk C-statistics of 0.63 and 0.59, respectively). The implementation of recommended strategies to account for this heterogeneity among samples improved the model’s calibration in both samples. Conclusion An adolescent depression risk score comprising easily obtainable predictors was developed with good prognostic performance in a Brazilian sample. Heterogeneity among settings was not trivial, but strategies to deal with sample diversity were identified as pivotal for providing better risk stratification across samples. Future efforts should focus on developing better methodological approaches for incorporating heterogeneity in prognostic research.

    更新日期:2020-01-15
  • An investigation of retinal layer thicknesses in unaffected first-degree relatives of schizophrenia patients
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-14
    Ayse Kurtulmus; Ahmet Elbay; Fatma Busra Parlakkaya; Tezer Kilicarslan; Mehmet Hakan Ozdemir; Ismet Kirpinar

    Introduction A large number of studies using different neuroimaging methods showed various structural changes both in patients and their unaffected first-degree relatives (FDRs) over the past years. Optical coherence tomography (OCT) is a relatively new, non-invasive imaging method used to obtain high-resolution cross-sectional images of the retina. A growing body of evidence reports thinning of retinal layers in patients with schizophrenia which is considered as a proxy for CNS alterations. We hypothesized that retinal layer changes would be observed in FDRs, in parallel with those seen in patients, as a potential endophenotype candidate. Methods Thirty-eight schizophrenia patients, 38 FDRs of schizophrenia and 38 age and gender-matched healthy subjects with no family history (HCs) were recruited to this study. OCT measurements were performed and peripapillary retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL) and macular thicknesses were measured. Results The groups did not differ on RNFL, macular or GCL thickness. However, IPL thickness was significantly lower in both patients and FDRs than HCs (p = .025 and p = .041, respectively). The difference between groups remained significant after controlling for confounders such as age, gender, smoking status, comorbid medical diseases and BMI (p = .016 patients vs HCs and p = .014 FDRs vs HCs). Conclusion Our findings suggest that IPL thinning may hold promise as a useful endophenotype for genetic and early detection studies. The evaluation of this area could provide an important avenue for elucidating some of the neurodevelopmental aberrations in the disorder.

    更新日期:2020-01-15
  • Associations between physiological responses to social-evaluative stress and daily functioning in first-episode schizophrenia
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-14
    Alexandra C. Reed; Junghee Lee; Michael F. Green; Holly K. Hamilton; Gregory A. Miller; Kenneth L. Subotnik; Joseph Ventura; Keith H. Nuechterlein; Cindy M. Yee

    Schizophrenia (SZ) is associated with impaired adaptive functioning, including difficulties managing the demands of independent living, work, school, and interpersonal relationships. Prior studies have linked the physiological stress response with less effective coping in daily life. Differences in stress-response tendencies may also support heterogeneity in daily functioning in SZ. The present study examined two established measures of the stress response in patients with first-episode SZ. Salivary cortisol was included as an index of hypothalamic–pituitary–adrenal response. Vagal suppression (VS), a measure of stress-related reduction in heart rate variability, was used to assess parasympathetic flexibility. Greater cortisol response and VS to social-evaluative stress were predicted to be associated with better functioning in SZ over and above relationships with social cognition and neurocognition, two well-established predictors of functional outcome. Thirty-eight first-episode SZ outpatients and 29 healthy comparison subjects (HC) provided social cognitive, neurocognitive, and physiological measurements before and after the Trier Social Stress Test (TSST). Although SZ and HC did not differ on VS to the TSST, patients exhibited significant associations between VS and functioning across all four domains of the Role Functioning Scale. Furthermore, greater VS predicted more effective functioning with friends, beyond the contributions associated with social cognition and neurocognition, and strengthened the positive effects of higher levels of social cognition on independent living/self-care. VS elicited by social-evaluative stress in the laboratory may reflect stress-response tendencies in daily life that are relevant for daily functioning in first-episode SZ.

    更新日期:2020-01-15
  • Gut microbial changes of patients with psychotic and affective disorders: A systematic review
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-14
    Nina Vindegaard; Helene Speyer; Merete Nordentoft; Simon Rasmussen; Michael Eriksen Benros

    Background Many diverse inflammatory pathophysiologic mechanisms have been linked to mental disorders, and through the past decade an increasing interest in the gut microbiota and its relation to mental health has been arising. We aimed to systematically review studies of alterations in gut microbiota of patients suffering from psychotic disorders, bipolar disorder or depression compared to healthy controls. Methods We systematically searched the databases CENTRAL, PubMed, EMBASE, PsycINFO and LILACS. Primary outcome was to compare the gut microbiota of patients suffering from psychotic disorders, bipolar disorder or depression with healthy controls. Results We identified 17 studies, covering 744 patients and 620 healthy controls. The most consistent microbiota changes were a tendency towards higher abundance of Actinobacteria and lower abundance of Firmicutes at the phylum level, lower abundance of Lachnospiraceae at family level and lower abundance of Faecalibacterium at genus level for the mental disorders overall. However, we found that all studies had risk of bias and that the included studies displayed great variability in methods of storage, analysis of the fecal samples, reporting of results and statistics used. Conclusion Due to the many limitations of the included studies the findings should be interpreted with caution. Larger studies (especially of schizophrenia and major depressive disorder) are needed, but it is also of great importance to gather information of and control for factors that influence the result of a microbiota analysis including body mass index (BMI), smoking, alcohol consumption, diet habits, antibiotics, sample handling, wet laboratory methods and statistics.

    更新日期:2020-01-15
  • Neighborhood-level predictors of age at onset and duration of untreated psychosis in first-episode psychotic disorders
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-14
    Benson S. Ku; Luca Pauselli; Marc Manseau; Michael T. Compton

    Objective Recent years have witnessed growing interest in the role of the social environment in the development and outcomes of schizophrenia. We investigated whether neighborhood characteristics are associated with two important prognostic factors in early-course psychosis, age at onset of psychosis (AOP) and duration of untreated psychosis (DUP). Methods Data were collected from patients admitted to the hospital for first-episode schizophrenia-spectrum disorder. We collected data on perceived neighborhood disorder during childhood/adolescence and extracted data on 13 neighborhood characteristics from the American Community Survey based upon individual addresses. Four neighborhood-level factors were derived from factor analysis. Multiple logistic regression analyses assessed the association between specific neighborhood characteristics and the two prognostic factors (earlier AOP and longer DUP) in early-course psychosis. Results 143 participants had valid addresses geo-coded. Neighborhood-level residential instability was associated with an earlier AOP (OR = 1.760; p = 0.022) even after controlling for known risk factors (OR = 2.026; p = 0.020) and also after controlling for individual-level residential instability (OR = 1.917; p = 0.037). The general socioeconomic status neighborhood factor (OR = 1.119; p = 0.019) and perceived neighborhood disorder (OR = 1.075; p = 0.005) were associated with a longer DUP. But only perceived neighborhood disorder (OR = 1.146; p = 0.011) remained significant, and general socioeconomic status was close to significant (OR = 1.215; p = 0.062), after controlling for individual-level predictors and socioeconomic status. Conclusions This study found evidence that neighborhood-level characteristics (in this case, residential instability) may be associated with earlier AOP, and perceptions of neighborhood disorder are associated with a longer treatment delay. Socioenvironmental factors should be more consistently considered going forward in research on early psychotic disorders.

    更新日期:2020-01-15
  • A suicide prevention strategy for youth presenting to the emergency department with suicide related behaviour: protocol for a randomized controlled trial
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-14
    Daphne J. Korczak; Yaron Finkelstein; Melanie Barwick; Gloria Chaim; Kristin Cleverley; Joanna Henderson; Suneeta Monga; Myla E. Moretti; Andrew Willan; Peter Szatmari

    Suicide is a leading cause of death among adolescents in North America. Youth who present to the Emergency Department (ED) with acute suicidality are at increased risk for eventual death by suicide, thereby presenting an opportunity for secondary prevention of suicide. The current study evaluates the effectiveness of a standardized individual and family-based suicidal behaviour risk reduction intervention targeting adolescents at high-risk for suicide. A randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of a manualized youth- and family- based suicide prevention strategy (SPS) as compared with case navigation (NAV) among adolescents aged 12 to 18 years of age who present to the ED with acute suicidal ideation (SI) or suicide risk behaviours (SRB). We will recruit 128 participants and compare psychiatric symptoms including SI/SRB, family communication, and functional impairment at baseline and follow-ups (post-intervention [6 weeks], 24 weeks). The primary outcome is change in suicidal ideation measured with the Suicide Ideation Questionnaire- Junior. SRBs are measured with the Suicide Behaviour Questionnaire. Secondary outcomes are change in depressive and anxious symptoms measured with semi-structured psychiatric interview and Screen for Child Anxiety Related Disorders; acute mental health crises measured by urgent medical (including ED) visits; family communication measured with Conflict Behaviour Questionnaire, functional impairment measured by Columbia Impairment Scale; cost effectiveness, and fidelity of implementation measured by audio recording and fidelity checklist. Results of this study will inform a larger multi-centre RCT that will include both community and academic hospitals in urban and rural settings. Study results will be shared at international psychiatry and emergency medicine meetings, in local rounds, and via publication in academic journals and clinician-oriented newsletters. If effective, the intervention may provide a brief, scalable, and transportable treatment program that may be implemented in a variety of settings, including those in which access to children’s mental health care services is challenging. ClinicalTrials.gov: NCT03488602, retrospectively registered April 4, 2018.

    更新日期:2020-01-15
  • Factors affecting current khat chewing among male adults 15–59 years in Ethiopia, 2016: a multi-level analysis from Ethiopian Demographic Health Survey
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-14
    Temesgen Yihunie Akalu; Adhanom Gebreegziabher Baraki; Haileab Fekadu Wolde; Ayenew Molla Lakew; Kedir Abdela Gonete

    Regular khat chewing causes gingivitis, tooth loss, gastric disorders, cardiac complications, male impotence, sleeplessness, and several mental health problems. Based on the Ethiopian Demographic and Health Survey (EDHS) 2016, 12% of women and 27% of men have reported having ever chewed khat. Even though khat addiction is a major public health problem, studies that consider both individual level and community level factors are limited. Therefore, this study aimed to determine the prevalence and factors affecting current khat chewing among male adults in Ethiopia. Data from EDHS, a community-based cross-sectional study conducted from January 18, 2016, to June 27, 2016, was used. A multistage stratified cluster sampling technique was used to select participants. Both descriptive and analytical statistics were done. Bi-variable and multivariable multilevel logistic regression analyses were performed to determine factors affecting current khat chewing. Adjusted Odds ratio (AOR) with 95% Confidence Interval (CI) for variables with P-value < 0.05 was used as a measure of association. A total of 12,595 male adults were included. The prevalence of current khat chewing was 23.61% (95% CI: 22.87, 24.36). Age 20–24 years; (AOR = 2.68, 95% CI: 2.02, 3.56), being uneducated (AOR = 1.62, 95% CI: 1.10, 2.39), professional/technical/managerial job (AOR = 3.59, 95% CI: 2.18, 5.91), Muslim religion (AOR = 18.30, 95% CI: 13.54, 24.74), poorest wealth index (AOR = 0.67, 95% CI: 0.51, 0.89), being divorced (AOR = 0.38, 95% CI: 0.21, 0.69), history of alcohol drinking in the last 30 days (AOR = 2.15, 95% CI: 1.69, 2.73), and history of cigarette smoking in the last 30 days (AOR = 14.92, 95% CI: 10.88, 20.47), and Amhara region (AOR = 0.07, 95% CI: 0.04, 0.14) were significantly associated with khat chewing. Khat chewing remains high in Ethiopia with certain regional variations. The uneducated, older age, Alcohol and cigarette users, Muslims, and professional workers were at higher risk of khat chewing whereas the poorest wealth index and being divorced reduced its risk. Policymakers should consider a multi-faceted policy approach that accounts for regional variation and the identified risk factors to alleviate the problem.

    更新日期:2020-01-15
  • Esketamine as a treatment for paediatric depression: questions of safety and efficacy
    Lancet Psychiatry (IF 18.329) Pub Date : 2020-01-14
    Kelsey S Zimmermann; Rick Richardson; Kathryn D Baker

    Adolescent-onset depression and anxiety represent a substantial, and growing, health-care burden. Unfortunately, traditional treatments for depression and anxiety that are effective in adults have small success rates in paediatric populations. Therefore, there is understandable enthusiasm for novel treatments that might help young people struggling with affective disorders. In March, 2019, esketamine was approved for treatment-resistant depression in adults, and clinical trials to test its efficacy in adolescents have already begun. However, considerable research from the field of schizophrenia suggests that repeated exposure to ketamine-like drugs during development can permanently disrupt neurodevelopment and have catastrophic long-term cognitive and behavioural outcomes. ,  As one of the principal prepsychotic symptoms of schizophrenia in adolescence is depression, repeated administration of esketamine as an antidepressant could represent a profound risk for at least some members of this highly vulnerable population.

    更新日期:2020-01-15
  • Reward anticipation in schizophrenia: A coordinate-based meta-analysis
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-14
    Arnaud Leroy; Ali Amad; Fabien D'Hondt; Delphine Pins; Nematollah Jaafari; Pierre Thomas; Renaud Jardri

    Reward processing impairments have been linked with positive and negative symptoms of schizophrenia. Here, we performed a coordinate-based meta-analysis that combined eleven BOLD-fMRI studies comparing reward anticipation signals between schizophrenia patients and healthy controls. We observed a reduced difference in activation in schizophrenia patients within a frontal-striatal network. Meta-regressions revealed that this functional signature was linked to the severity of psychotic symptoms and persisted even after controlling for the dose of antipsychotic medications.

    更新日期:2020-01-14
  • Are school difficulties an early sign for mental disorder diagnosis and suicide prevention? A comparative study of individuals who died by suicide and control group
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2020-01-14
    Fabienne Ligier; Charles-Edouard Giguère; Charles-Edouard Notredame; Alain Lesage; Johanne Renaud; Monique Séguin

    Suicide is the third leading cause of death worldwide among youth aged 10- to 19, and mental disorders are often associated in the etiology of suicidal behavior. Mental disorders are often under-diagnosed and under-treated in young people, a situation likely to increase the severity of the disorder and suicide risk. Presence of school difficulties may, in some cases, be a consequence of mental disorder, and theses difficulties are observable. Therefore, early detection and early intervention of school difficulties may alleviate the development of mental disorders and suicide vulnerability. The aim of this study is to understand the link between school difficulties and suicide risk. We used the data bank gathered by the McGill Group on Suicide Studies over the past two decades through interviews with the relatives of individuals who died by suicide and with individuals from the community as a control group. We included data on common sociodemographic characteristics, life events and mental health characteristics identified before age 18, among individuals who died before the age of 35 or were interviewed before the age of 35. We identified 200 individuals who died by suicide and 97 living controls. We compared groups according to gender and characteristics. Within the total sample, 74% were male, 13% had met with academic failure, 18% had engaged in inappropriate behavior at school, and 18% presented combined school difficulties. Combined school difficulties (academic failure and inappropriate behavior) for both sexes and academic failure alone for males were associated with higher suicide risk before the age of 35. School difficulties generally began in early childhood and were linked to mental disorders/difficulties and substance abuse before age 18. This study underlines the importance for parents, teachers, and educators to identify children with school difficulties—academic failure and behavioral difficulties at school—as early as possible in order to be able to propose adapted interventions. Early identification and proper diagnosis may prevent chronicity of some disorders, accumulation of adverse events, and even suicide.

    更新日期:2020-01-14
  • Research Domain Criteria: Controversial Paradigm
    Schizophr. Bull. (IF 7.289) Pub Date : 2020-01-14
    Carpenter W, Jr.

    Schizophrenia Bulletin is very glad for the initiation of a cascade journal and welcome Schizophrenia Bulletin Open. Silvana Galderisi and Steve Marder represent the best of our field and will assure a critical role for communication. Responding to an invitation from the editors, the following is my first opportunity to contribute to SBOpen.

    更新日期:2020-01-14
  • Mortality and risk assessment for anorexia nervosa in acute-care hospitals: a nationwide administrative database analysis
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-13
    Shunsuke Edakubo; Kiyohide Fushimi

    Anorexia nervosa (AN) is a common eating disorder with the highest mortality rate of all psychiatric diseases. However, few studies have examined inpatient characteristics and treatment for AN. This study aimed to characterise the association between mortality and risk factors in patients with AN in acute-care hospitals. We conducted a nationwide, retrospective analysis of the Japanese Diagnosis and Procedure Combination inpatient database. Data extraction occurred from April 2010 to March 2016. We estimated in–hospital mortality and identified independent risk factors, using multivariate logistic regression analysis to examine patient characteristics and physical and psychological comorbidities. We identified 6937 patients with AN aged ≥12 years in 885 acute-care hospitals. Of these, 361 (5.2%) were male. Male and female participants’ median ages at first admission were 34 (17–65) and 28 (17–41) years, respectively. In total, 195 in-hospital patient deaths, including 22 (6.1%) men and 173 (2.6%) women, it was observed that the unadjusted odds ratio of mortality for male patients was more than twice that for female patients (OR: 2.40, 95% CI: 1.45–3.81). Multivariate logistic regression analysis demonstrated an adjusted odds ratio of 2.19 (95% CI: 1.29–3.73). Age at first hospital admission, percentage of ideal body weight, comorbidities, and hypotension were significantly associated with increased mortality risk, but the frequency of hospitalization, bradycardia, and other psychiatric disorders were not. Treatment in a university hospital was associated with lower mortality risk (odds ratio: 0.45, 95% CI: 0.30–0.67). The results highlighted sex differences in mortality rates. Potential risk factors could contribute to improved treatment and outcomes. These retrospective findings indicate a need for further longitudinal examination of these patients.

    更新日期:2020-01-14
  • Reciprocal copy number variations at 22q11.2 produce distinct and convergent neurobehavioral impairments relevant for Schizophrenia and Autism Spectrum Disorder
    Biol. Psychiatry (IF 11.501) Pub Date : 2020-01-13
    Amy Lin; Ariana Vajdi; Leila Kushan-Wells; Gerhard Helleman; Laura Pacheco Hansen; Rachel K. Jonas; Maria Jalbrzikowski; Lyle Kingsbury; Armin Raznahan; Carrie E. Bearden

    Background 22q11.2 deletions and duplications are copy number variations (CNVs) that predispose to developmental neuropsychiatric disorders. Both CNVs are associated with autism spectrum disorder (ASD), while the deletion confers disproportionate risk for schizophrenia. Neurobehavioral profiles associated with these reciprocal CNVs in conjunction with brain imaging measures have not been reported. Method We profiled the impact of 22q11.2 CNVs on neurobehavioral measures relevant to ASD and psychosis in 106 22q11.2 deletion carriers, 38 22q11.2 duplication carriers, and 82 demographically-matched controls. To determine whether brain-behavior relationships were altered in CNV carriers, we further tested for interactions between group and regional brain structure on neurobehavioral domains. Results Cognitive deficits were observed in both CNV groups, with the lowest IQs in deletion carriers. ASD and dimensionally-measured ASD traits were elevated in both CNV groups; however, duplication carriers exhibited increased stereotypies compared to deletion carriers. Moreover, discriminant analysis using ASD sub-domains distinguished between CNV cases with 76% accuracy. Both psychotic disorder diagnosis and dimensionally-measured positive and negative symptoms were elevated in deletion carriers. Finally, control participants showed an inverse relationship between processing speed and cortical thickness in heteromodal association areas, which was absent in both CNV groups. Conclusions 22q11.2 CNVs differentially modulate intellectual functioning and psychosis-related symptomatology but converge on broad ASD-related symptomatology. However, subtle differences in ASD profiles distinguish CNV groups. Processing speed impairments, coupled with the lack of normative relationship between processing speed and cortical thickness in CNV carriers, implicate aberrant development of the cortical mantle in the pathology underlying impaired processing speed ability.

    更新日期:2020-01-14
  • Psilocybin induces time-dependent changes in global functional connectivity
    Biol. Psychiatry (IF 11.501) Pub Date : 2020-01-13
    Katrin H. Preller; Patricia Duerler; Joshua B. Burt; Jie Lisa Ji; Brendan Adkinson; Philipp Stämpfli; Erich Seifritz; Grega Repovs; John H. Krystal; John D. Murray; Alan Anticevic; Franz X. Vollenweider

    Background The use of Psilocybin in scientific and experimental clinical contexts has triggered renewed interest in the mechanism of action of psychedelics. However, its time-dependent systems-level neurobiology remains sparsely investigated in humans. Methods We therefore conducted a double-blind, randomized, counterbalanced, cross-over study during which 23 healthy human participants received placebo and 0.2 mg/kg of psilocybin p.o. on two different test days. Participants underwent MRI scanning at three time points between administration and peak effects: 20 mins, 40 mins, and 70 mins after administration. Resting-state functional connectivity was quantified via a data-driven global brain connectivity method and compared to cortical gene expression maps. Results Psilocybin reduced associative, but concurrently increased sensory brain-wide connectivity. This pattern emerged over time from administration to peak-effects. Furthermore, we show that baseline connectivity is associated with the extent of Psilocybin-induced changes in functional connectivity. Lastly, Psilocybin induced changes correlated time-dependently with spatial gene expression patterns of the 5-HTR2A and 5-HTR1A. Conclusions These results suggest that the integration of functional connectivity in sensory and the disintegration in associative regions may underlie the psychedelic state and pinpoint the critical role of the serotonin 2A and 1A receptor systems. Furthermore, baseline connectivity may represent a predictive marker of the magnitude of changes induced by psilocybin and may therefore contribute to a personalized medicine approach within the potential framework of psychedelic treatment.

    更新日期:2020-01-14
  • Evidence for efficacy of psychosocial interventions in LMICs
    Lancet Psychiatry (IF 18.329) Pub Date : 2020-01-13
    Kathryn L Lovero; Ali M Giusto; Milton L Wainberg
    更新日期:2020-01-14
  • Efficacy of psychosocial interventions for mental health outcomes in low-income and middle-income countries: an umbrella review
    Lancet Psychiatry (IF 18.329) Pub Date : 2020-01-13
    Corrado Barbui; Marianna Purgato; Jibril Abdulmalik; Ceren Acarturk; Julian Eaton; Chiara Gastaldon; Oye Gureje; Charlotte Hanlon; Mark Jordans; Crick Lund; Michela Nosè; Giovanni Ostuzzi; Davide Papola; Federico Tedeschi; Wietse Tol; Giulia Turrini; Vikram Patel; Graham Thornicroft
    更新日期:2020-01-14
  • Systematic Review and Meta-Analysis: Mental Health in Children With Neurogenetic Disorders Associated With Intellectual Disability
    J. Am. Acad. Child Adolesc. Psychiatry (IF 6.391) Pub Date : 2020-01-13
    Emma J. Glasson; Nicholas Buckley; Wai Chen; Helen Leonard; Amy Epstein; Rachel Skoss; Peter Jacoby; A. Marie Blackmore; Jenny Bourke; Jenny Downs

    Objective The behavioral phenotype of neurogenetic disorders associated with intellectual disability often includes psychiatric comorbidity. The objectives of this systematic review and meta-analysis were to systematically review the prevalence of psychiatric disorders and symptoms in children and adolescents with these disorders and compare phenotypic signatures between syndromes. Method MEDLINE and PsycINFO databases were searched for articles from inception to December 2018. Eligible articles were peer reviewed, published in English and reported prevalence data for psychiatric disorders and symptoms in children aged four to 21 years, using a formal psychiatric assessment or a standardized assessment of mental health symptomology. Pooled prevalence was determined using a random effects meta-analysis in studies with sufficient data. Prevalence estimates were compared with general population data using a test of binomial proportions. Results Of 2301 studies identified for review, 39 papers were included in the final pool which provided data on 4039 individuals. Ten syndromes were represented and five were predominant: Down syndrome, 22q11.2 deletion syndrome, Fragile X syndrome, Williams syndrome and Prader-Willi syndrome. The Child Behavior Checklist was the most commonly used assessment tool for psychiatric symptoms. The pooled prevalence with total scores above the clinical threshold was lowest for Down syndrome (32%; 95% CI, 19%-44%) and highest for Prader-Willi syndrome (74%; 95% CI, 65%-82%) with each syndrome associated with significantly higher prevalence than in the general population. Parallel trends were observed for the internalizing and externalizing domains and social subscale scores. Conclusion Differential vulnerability for ‘psychiatric phenotype’ expression across the disorders was observed. Syndromes with higher levels of social ability or competence appear to offer relative protection against developing psychopathology, and this preliminary finding merits further exploration.

    更新日期:2020-01-13
  • Screening for cognitive impairment in non-affective psychoses: A comparison between the SCIP and the MoCA
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-13
    Martino Belvederi Murri; Federica Folesani; Silvia Costa; Bruno Biancosino; Cristina Colla; Luigi Zerbinati; Rosangela Caruso; Maria Giulia Nanni; Scot E. Purdon; Luigi Grassi

    Background Neuropsychological performance has a strong impact on real-life functioning and clinical outcomes in psychosis. However, conducting lengthy cognitive assessments may not be feasible in routine clinical practice. Brief, reliable and cost-effective tools are highly needed, but few studies are available to guide clinician choice. Methods The purpose of this study was to compare the performance of two widely used, short instruments: the Screen for Cognitive Impairment in Psychiatry (SCIP) and the Montreal Cognitive Assessment (MoCA). These instruments were validated in a sample of patients with psychotic disorders and healthy controls, using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and other instruments to assess executive functions, as comparators. Results Patients fared worse than controls across almost all cognitive domains, with effect sizes ranging from 0 (MoCA naming) to 2.08 (SCIP total). Receiver Operator Curve analysis of patient and control performance suggested a better convergent validity for the SCIP (total score AUC: 0.85; 95%CI: 0.79–0.90; Se: 76%, Sp: 83%, PPV: 85%, NPV: 73%) than the MoCA (AUC: 0.78; 95%CI: 0.72–0.85; Se: 69%, Sp: 76%, PPV: 78.7%, NPV 66%). Conclusions The Screen for Cognitive Impairment in Psychiatry seems to be a more sensitive and specific screening tool than the MoCA to identify cognitive impairment among patients with psychotic disorders.

    更新日期:2020-01-13
  • Anatomical integrity within the inferior fronto-occipital fasciculus and semantic processing deficits in schizophrenia spectrum disorders
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-13
    Werner Surbeck; Jürgen Hänggi; Felix Scholtes; Petra V. Viher; André Schmidt; Katharina Stegmayer; Erich Studerus; Udine E. Lang; Anita Riecher-Rössler; Werner Strik; Erich Seifritz; Stefan Borgwardt; Boris B. Quednow; Sebastian Walther

    The core symptoms of schizophrenia spectrum disorders (SSD) include abnormal semantic processing which may rely on the ventral language stream of the human brain. Thus, structural disruption of the ventral language stream may play an important role in semantic deficits observed in SSD patients. Therefore, we compared white matter tract integrity in SSD patients and healthy controls using diffusion tensor imaging combined with probabilistic fiber tractography. For the ventral language stream, we assessed the inferior fronto-occipital fasciculus [IFOF], inferior longitudinal fasciculus, and uncinate fasciculus. The arcuate fasciculus and corticospinal tract were used as control tracts. In SSD patients, the relationship between semantic processing impairments and tract integrity was analyzed separately. Three-dimensional tract reconstructions were performed in 45/44 SSD patients/controls (“Bern sample”) and replicated in an independent sample of 24/24 SSD patients/controls (“Basel sample”). Multivariate analyses of fractional anisotropy, mean, axial, and radial diffusivity of the left IFOF showed significant differences between SSD patients and controls (p(FDR-corr) < 0.001, ηp2 = 0.23) in the Bern sample. Axial diffusivity (AD) of the left UF was inversely correlated with semantic impairments (r = −0.454, p(FDR-corr) = 0.035). In the Basel sample, significant group differences for the left IFOF were replicated (p < .01, ηp2 = 0.29), while the correlation between AD of the left IFOF and semantic processing decline (r = −0.376, p = .09) showed a statistical trend. No significant effects were found for the dorsal language stream. This is direct evidence for the importance of the integrity of the ventral language stream, in particular the left IFOF, in semantic processing deficits in SSD.

    更新日期:2020-01-13
  • Suicidal thoughts and behavior (STB) and psychosis-risk symptoms among psychiatrically hospitalized adolescents
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-13
    Elizabeth Thompson; Anthony Spirito; Elisabeth Frazier; Alysha Thompson; Jeffrey Hunt; Jennifer Wolff

    Background Individuals in the early stages of psychosis have a markedly high risk for suicidal thoughts and behavior (STB). It is not well understood if STB among those with psychosis-risk symptoms is accounted for by co-occurring psychopathology (e.g., depression), unique experiences specific to psychosis-spectrum symptomatology (e.g., hallucinations, delusions), or combined effects of different factors. This cross-sectional study explored the link between psychosis-spectrum symptoms, co-occurring disorders, and STB. Methods This record review included 569 adolescents (mean age = 14.83) admitted to a psychiatric inpatient hospital due to exhibiting behavior indicating they were an imminent threat to themselves or others. Upon intake to the hospital, participants completed a diagnostic interview and self-report measures of suicidal ideation, suicide attempt history, and psychosis-spectrum symptoms. The primary analysis used linear regression to predict suicidal ideation from psychosis-spectrum symptom scores, controlling for known characteristics associated with STB including specific psychiatric disorders (i.e. depressive, anxiety, post-traumatic stress, and psychotic disorders), biological sex, and race. Results Psychosis-spectrum symptoms predicted suicidal ideation above and beyond the significant effects of a depressive disorder diagnosis and sex, as well as the non-significant effects of anxiety, PTSD, full-threshold psychosis, and race. Item-level correlations demonstrated that several psychosis-spectrum symptoms were significantly associated with ideation and lifetime suicide attempts. Conclusions Results indicate that within this sample of psychiatrically hospitalized youth, psychosis-risk symptoms were uniquely linked to STB. These findings suggest that attention to psychosis-spectrum symptoms, including several specific psychosis-risk experiences, may be clinically important for better assessment and treatment of suicidal youth.

    更新日期:2020-01-13
  • Expressive deficits and amotivation as mediators of the associations between cognitive problems and functional outcomes: Results from two independent cohorts
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-13
    Edith J. Liemburg; Stefanie Enriquez-Geppert; Klaas J. Wardenaar; Richard Bruggeman; André Aleman

    Many individuals with severe mental disorders have difficulties in vocational and social functioning, which are regarded the most important outcomes, together with clinical symptoms. To understand the underlying mechanisms, research is increasingly focused on factors influencing functional outcomes. One established association has been shown between cognition and community functioning with negative symptoms as a possible mediator. Although it has been shown that negative symptoms consist of two subdomains, thus far negative symptoms have been assessed as one unitary construct. This study considers for the first time subdomains of negative symptoms as putative mediators (expressive deficits, amotivation) of the association between cognition (neuro- and social cognition) and functional outcome (living situation, occupation, social functioning). We expected that specific subdomains of negative symptoms (e.g. amotivation) would mediate the effect of cognition on specific functional outcomes (e.g. social functioning) independently from illness duration. To assess this, we included two independent cohorts, consisting of participants with different illness duration. These two independent cohorts consisted of patients with a recent-onset psychotic disorder: PROGR-S (first time treated; N = 1129) and GROUP (illness duration preferably <5 years; N = 1200). Using linear regression, mediation analyses were performed with two cognition domains (neurocognition and social cognition) as predictors, negative symptoms (Expressive deficits and Amotivation as indexed with items from the Positive and Negative Syndrome Scale) as mediators and three measures of functional outcomes (living situation, occupation and social functioning) as outcome measures. The analyses were repeated with the same outcome measures three years later. Three main results were obtained. I) Both in the cross-sectional and longitudinal analyses, the associations of neurocognition (both cohorts) and social cognition (GROUP) with social functioning were mediated by amotivation. II) The association between cognition and living situation was mediated by Expressive deficits in one cohort (GROUP) but not in the cohort assessing first-episode psychosis (PROGR-S). III) The association between cognition and occupation was mediated by Amotivation in PROGR-S and by Expressive deficits in GROUP. Conclusion The current results show a less robust mediating role for specific negative symptom domains regarding the associations of cognition with occupation and living situation that may depend on the duration of psychotic illness. However, Amotivation, mediates the association between cognition and social functioning, which holds true for patients experiencing a first-onset and patients with a longer illness duration alike. The results may have implications for the development of therapeutic approaches focusing on amotivation to improve social functioning. General scientific summary This study stresses the importance of distinguishing subdomains of negative symptoms, cognition and functioning. Our results show that specific negative symptom dimensions mediate the effects of cognition on specific functional outcomes.

    更新日期:2020-01-13
  • Optical coherence tomography of the retina in schizophrenia: Inter-device agreement and relations with perceptual function
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-11
    Margaret Miller; Vance Zemon; Rachel Nolan-Kenney; Laura J. Balcer; Donald C. Goff; Michelle Worthington; Lisena Hasanaj; Pamela D. Butler

    Background Optical coherence tomography (OCT) studies have demonstrated differences between people with schizophrenia and controls. Many questions remain including the agreement between scanners. The current study seeks to determine inter-device agreement of OCT data in schizophrenia compared to controls and to explore the relations between OCT and visual function measures. Methods Participants in this pilot study were 12 individuals with schizophrenia spectrum disorders and 12 age- and sex-matched controls. Spectralis and Cirrus OCT machines were used to obtain retinal nerve fiber layer (RNFL) thickness and macular volume. Cirrus was used to obtain ganglion cell layer + inner plexiform layer (GCL + IPL) thickness. Visual function was assessed with low-contrast visual acuity and the King-Devick test of rapid number naming. Results There was excellent relative agreement in OCT measurements between the two machines, but poor absolute agreement, for both patients and controls. On both machines, people with schizophrenia showed decreased macular volume but no difference in RNFL thickness compared to controls. No between-group difference in GCL + IPL thickness was found on Cirrus. Controls showed significant associations between King-Devick performance and RNFL thickness and macular volume, and between low-contrast visual acuity and GCL + IPL thickness. Patients did not show significant associations between OCT measurements and visual function. Conclusions Good relative agreement suggests that the offset between machines remains constant and should not affect comparisons between groups. Decreased macular volume in individuals with schizophrenia on both machines supports findings of prior studies and provides further evidence that similar results may be found irrespective of OCT device.

    更新日期:2020-01-13
  • Systematic review and meta-analysis of the relationship between genetic risk for schizophrenia and facial emotion recognition
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-11
    David Martin; Jazz Croft; Alice Pitt; Daniela Strelchuk; Sarah Sullivan; Stan Zammit

    Background Recent research has highlighted that facial emotion recognition deficits are more common in people with schizophrenia, but the reason for this association is not well understood. Comparing facial recognition deficits in unaffected individuals at higher genetic risk for schizophrenia with individuals at lower genetic risk could increase our understanding of this relationship. Methods We systematically reviewed studies reporting on the relationship between genetic risk of schizophrenia and facial emotion recognition deficits. Meta-analyses were performed where sufficient data were available, otherwise we conducted narrative summaries. Meta-analyses were performed both for generalised and specific facial emotion recognition deficits. Results 34 studies were included in this review with 23 included in meta-analyses. Meta-analysis indicated strong evidence of a deficit in facial emotion recognition in first-degree relatives of people with schizophrenia compared with controls (SMD 0.38 95% CI 0.26 to 0.51, p ≤ 0.001). Further meta-analyses demonstrated strong evidence of a deficit in the recognition of negative valence facial expressions (SMD 0.19 CI 0.06 to 0.32, p = 0.004) but no evidence of deficit in the recognition of neutral or positive valance. Conclusions There is strong evidence of facial emotion recognition deficits in first-degree relatives of people with schizophrenia. Our findings suggest that such deficits in people with schizophrenia arise prior to the onset of the disorder, though cannot inform whether that association is causal or due to confounding. Emotion recognition deficits, particularly to negative emotions, might be useful predictors of schizophrenia risk.

    更新日期:2020-01-13
  • Better care for less money: cost‐effectiveness of integrated care in multi‐episode patients with severe psychosis
    Acta Psychiat. Scand. (IF 4.694) Pub Date : 2020-01-12
    A. Karow; C. Brettschneider; H. Helmut König; C.U. Correll; D. Schöttle; D. Lüdecke; A. Rohenkohl; F. Ruppelt; V. Kraft; J. Gallinat; M. Lambert

    To compare cost‐effectiveness of integrated care with therapeutic assertive community treatment (IC‐TACT) versus standard care (SC) in multiple‐episode psychosis.

    更新日期:2020-01-13
  • Associations of negative cognitions, emotional regulation, and depression symptoms across four continents: International support for the cognitive model of depression
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-13
    Saghar Chahar Mahali; Shadi Beshai; Justin R. Feeney; Sandeep Mishra

    Cognitive-behavioral therapy (CBT) is one of the most widely tested and empirically supported psychological treatments for depression. Beck and other scholars established the theoretical foundations of CBT among North American populations, yet surprisingly few studies have examined central hypotheses of the cognitive model of depression among people living in non-Western regions. In the present study, we used the alignment method to minimize measurement bias to examine several central hypotheses of the cognitive model among adults living on four continents (n = 752): North America (n = 103; female = 29.1%), Europe (n = 404; female = 36.4%), South America (n = 108; female = 18.5%), and Asia (n = 136; female = 19.9%). Depressive symptoms were positively and strongly correlated with negative automatic thoughts about self (ATQ-N), and moderately associated with dysfunctional attitudes (DAS) among people living on the four continents. Further, use of emotional suppression strategies to regulate emotion (ERQ-Suppression) was moderately and positively associated with depressive symptoms among people on all four continents, while use of cognitive-reappraisal (ERQ-Reappraisal) was not systematically associated with depressive symptoms. Results of this study offer preliminary cross-continental support for foundational hypotheses of the cognitive model of depression. Negative thoughts appear to be associated with depression in all regions of the world, cementing this construct as a hallmark feature of the disorder.

    更新日期:2020-01-13
  • Corrigendum to: Towards Precision Medicine in Psychosis: Benefits and Challenges of Multimodal Multicenter Studies-PSYSCAN: Translating Neuroimaging Findings From Research into Clinical Practice
    Schizophr. Bull. (IF 7.289) Pub Date : 2020-01-12

    Corrigendum to “Towards Precision Medicine in Psychosis: Benefits and Challenges of Multimodal Multicenter Studies—PSYSCAN: Translating Neuroimaging Findings From Research into Clinical Practice” by Tognin et al. Schizophr Bull. 2019; doi: 10.1093/schbul/sbz067.

    更新日期:2020-01-13
  • Neurotrophic factor changes are essential for predict electroconvulsive therapy outcome in schizophrenia
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-10
    Jin Li; Xiaobin Zhang; Xiaowei Tang; Wenhuan Xiao; Fei Ye; Weiwei Sha; Qiufang Jia

    Brain-derived neurotrophic factor (BDNF) plays an important role in the treatment of schizophrenia with electroconvulsive therapy (ECT) or antipsychotic (AP) drugs. However, it is unclear whether BDNF is a mediator; we therefore assumed that baseline BDNF level can mediate the efficacy of ECT−AP treatment. A total of 160 patients with schizophrenia were examined; 80 received AP monotherapy and the other 80 were treated with a combination of ECT and AP. BDNF concentration was measured by enzyme-linked immunosorbent assay using the Emax Immunoassay System kit (Promega, Madison, WI, USA) according to the manufacturer’s instructions.Log-linear analyses were used to examine the relationship between demographic characteristics, BDNF level, and clinical features and response status. The baseline BDNF levels and BDNF level increment were the best predictors of clinical outcome (OR1 = 3.358, P = 0.000; OR2 = 3.243, P = 0.000).The higher baseline BDNF levels and greater BDNF level increment were found to be associated with good outcome.

    更新日期:2020-01-11
  • Age dependent association of inbreeding with risk for schizophrenia in Egypt
    Schizophr. Res. (IF 4.569) Pub Date : 2020-01-09
    Lora McClain; Hader Mansour; Ibtihal Ibrahim; Lambertus Klei; Warda Fathi; Joel Wood; Chowdari Kodavali; Alina Maysterchuk; Shawn Wood; Farha El-Chennawi; Nahed Ibrahim; Ahmed Eissa; Wafaa El-Bahaei; Hanan El Sayed; Amal Yassein; Salwa Tobar; Hala El-Boraie; Eman El-Sheshtawy; Vishwajit Nimgaonkar

    Background Self-reported consanguinity is associated with risk for schizophrenia (SZ) in several inbred populations, but estimates using DNA-based coefficients of inbreeding are unavailable. Further, it is not known whether recessively inherited risk mutations can be identified through homozygosity by descent (HBD) mapping. Methods We studied self-reported and DNA-based estimates of inbreeding among Egyptian patients with SZ (n = 421, DSM IV criteria) and adult controls without psychosis (n = 301), who were evaluated using semi-structured diagnostic interview schedules and genotyped using the Illumina Infinium PsychArray. Following quality control checks, coefficients of inbreeding (F) and regions of homozygosity (ROH) were estimated using PLINK software for HBD analysis. Exome sequencing was conducted in selected cases. Results Inbreeding was associated with schizophrenia based on self-reported consanguinity (χ2 = 4.506, 1 df, p = 0.034) and DNA-based estimates for inbreeding (F); the latter with a significant F × age interaction (β = 32.34, p = 0.0047). The association was most notable among patients older than age 40 years. Eleven ROH were over-represented in cases on chromosomes 1, 3, 6, 11, and 14; all but one region is novel for schizophrenia risk. Exome sequencing identified six recessively-acting genes in ROH with loss-of-function variants; one of which causes primary hereditary microcephaly. Conclusions We propose consanguinity as an age-dependent risk factor for SZ in Egypt. HBD mapping is feasible for SZ in adequately powered samples.

    更新日期:2020-01-11
  • Evaluation of childhood traumatic experience as a risk factor for alcohol use disorder in adulthood
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-09
    Lan Wang; Cui-Xia An; Mei Song; Na Li; Yuan-Yuan Gao; Xiao-Chuan Zhao; Lu-Lu Yu; Yu-Mei Wang; Xue-Yi Wang

    We aimed to investigate the effect of early-age (prenatal, infant, and childhood) trauma on adulthood alcohol use disorder. A total number of 1534 subjects who were born and live in the city of Tangshan were selected. The subjects were divided into three age groups. General demographic data, conditions of the mothers during pregnancy, and condition of the babies at birth, were collected. The diagnosis of alcohol use disorder was based on Structured Clinical Interviews for DSM-IV Axis Disorders (patient version) (SCID). The childhood trauma questionnaire short form (CTQ-SF) [1] and the Lifetime of Experience Questionnaire (LTE-Q) [2] were used to evaluate stress in childhood and adulthood, respectively. Only male subjects were diagnosed with lifelong alcohol abuse and alcohol dependence. There was no statistically significant difference in the prevalence of lifetime alcohol use disorder (X2 = 4.480, P = 0.345), current alcohol abuse, and current alcohol dependence among the three groups (X2abuse = 2.177, X2depedence = 2.198, P > 0.05). However, higher prevalence of lifetime alcohol use disorders was found in group with higher scores of CTQ (X2 = 9.315, P = 0.009), emotional abuse (X2 = 8.025, P = 0.018), physical abuse (X2 = 20.4080, P < 0.001), but not in the group with higher scores of emotional neglect (X2 = 1.226, P = 0.542), sexual abuse (X2 = 2.779, P = 0.249), physical neglect (X2 = 3.978, P = 0.137), LTE-Q (X2 = 5.415, P = 0.067), and PSQI (X2 = 5.238, P = 0.073). Protective factor for alcohol abuse for men was identified to be heavy drinking (OR = 0.085, 95%CI: 0.011–0.661), and the risk factors for alcohol abuse were identified to be frequent drinking (OR = 2.736, 95%CI: 1.500, 4.988), and consumption of low liquor (OR = 2.563, 95%CI: 1.387, 4.734). Risk factors for alcohol dependence in males were identified to be consumption of low liquor (OR = 5.501, 95%CI: 2.004, 15.103), frequent drinking (OR = 2.680, 95%CI: 1.164, 6.170), and childhood physical abuse (OR = 2.310, 95% CI: 1.026, 5.201). Traumatic experience during infant and prenatal periods does not have a strong statistical correlation with alcohol use disorders for male adults. However, subjects with high CTQ scores, experience of emotional abuse and physical abuse show a statistically higher prevalence of lifetime alcohol use disorders. Several risk factors including consumption of low liquor, frequent drinking, and childhood physical abuse contribute to alcohol dependence in male adults.

    更新日期:2020-01-11
  • Can participatory video reduce mental illness stigma? Results from a Canadian action-research study of feasibility and impact
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-09
    Rob Whitley; Kathleen C. Sitter; Gavin Adamson; Victoria Carmichael

    Evidence suggests that stigma against people with mental illness remains high. This demands innovative approaches to reduce stigma. One innovative stigma reduction method is participatory video (PV), whereby marginalized people come together to script, film and produce bottom-up educational videos about shared issues. These videos are then shown to target groups. This paper has two objectives (i) to examine the feasibility of using participatory video with people with severe mental illness (SMI); and (ii) to assess viewer impressions of the resultant videos and subsequent subjective impact. We conducted a participatory action research study with three workgroups of people with severe mental illness situated in different Canadian cities, who set out to create and disseminate locally-grounded mental-health themed videos. This involved process and outcome evaluation to assess feasibility and impact. Specifically, we (i) observed fidelity to a co-designed action-plan in all three workgroups; (ii) distributed brief purpose-built questionnaires to viewers at organized screenings to assess preliminary impact; and (iii) conducted focus groups with viewers to elicit further impressions of the videos and subsequent subjective impact. The three workgroups achieved high-fidelity to the action-plan. They successfully produced a total of 26 videos, over double the targeted number, during an 18-month period. Likewise, the workgroups organized 49 screenings at a range of venues attended by 1542 people, again exceeding the action-plan targets. Results from the viewer questionnaires (N = 1104, response rate 72%) indicated that viewers reported that their understandings had improved after watching the videos. Four themes emerged from six viewer focus groups (N = 30), with participants frequently noting that videos were (i) educational and informative; (ii) real and relatable; (iii) attention-grabbing; and (iv) change-inducing. To our knowledge, this study is the first large-scale multi-site project examining the feasibility and impact of a participatory video program for people with severe mental illness. The results indicate that participatory video is a feasible method in this population and gives preliminary evidence that resultant videos can reduce viewer stigma. Thus, participatory video should be considered a promising practice in the ongoing effort to reduce mental illness stigma.

    更新日期:2020-01-11
  • Gender differences in response to war-related trauma and posttraumatic stress disorder – a study among the Congolese refugees in Uganda
    BMC Psychiatry (IF 2.666) Pub Date : 2020-01-10
    Herbert E. Ainamani; Thomas Elbert; David Kani Olema; Tobias Hecker

    The wars in the Democratic Republic of Congo have left indelible marks on the mental health and functioning of the Congolese civilians that sought refuge in Uganda. Even though it is clear that civilians who are exposed to potentially traumatizing events in war and conflict areas develop trauma-related mental health problems, scholarly information on gender differences on exposure to different war-related traumatic events, their conditional risks to developing PTSD and whether the cumulative exposure to traumatic events affects men and women differently is still scanty. In total, 325 (n = 143 males, n = 182 females) Congolese refugees who lived in Nakivale, a refugee settlement in the Southwestern part of Uganda were interviewed within a year after their arrival. Assessment included exposure to war-related traumatic events, and DSM-IV PTSD symptom severity. Our main findings were that refugees were highly exposed to war-related traumatic events with experiencing dangerous flight as the most common event for both men (97%) and women (97%). The overall high prevalence of PTSD differed among women (94%) and men (84%). The highest conditional prevalence of PTSD in women was associated with experiencing rape. The dose-response effect differed significantly between men and women with women showing higher PTSD symptom severity when experiencing low and moderate levels of potentially traumatizing event types. In conflict areas, civilians are highly exposed to different types of war-related traumatic events that expose them to high levels of PTSD symptoms, particularly women. Interventions focused at reducing mental health problems resulting from war should take the context of gender into consideration.

    更新日期:2020-01-11
  • Protein expression of prenyltransferase subunits in postmortem schizophrenia dorsolateral prefrontal cortex
    Transl. Psychiaty (IF 5.182) Pub Date : 2020-01-10
    Anita L. Pinner; Toni M. Mueller; Khaled Alganem; Robert McCullumsmith; James H. Meador-Woodruff
    更新日期:2020-01-11
  • Magnitude and heterogeneity of brain structural abnormalities in 22q11.2 deletion syndrome: a meta-analysis
    Mol. Psychiatry (IF 11.973) Pub Date : 2020-01-10
    Maria Rogdaki; Maria Gudbrandsen; Robert A McCutcheon; Charlotte E Blackmore; Stefan Brugger; Christine Ecker; Michael C Craig; Eileen Daly; Declan G M Murphy; Oliver Howes
    更新日期:2020-01-10
  • Assessing the Causal Effects of Human Serum Metabolites on 5 Major Psychiatric Disorders
    Schizophr. Bull. (IF 7.289) Pub Date : 2020-01-10
    Yang J, Yan B, Zhao B, et al.

    Psychiatric disorders are the leading cause of disability worldwide while the pathogenesis remains unclear. Genome-wide association studies (GWASs) have made great achievements in detecting disease-related genetic variants. However, functional information on the underlying biological processes is often lacking. Current reports propose the use of metabolic traits as functional intermediate phenotypes (the so-called genetically determined metabotypes or GDMs) to reveal the biological mechanisms of genetics in human diseases. Here we conducted a two-sample Mendelian randomization analysis that uses GDMs to assess the causal effects of 486 human serum metabolites on 5 major psychiatric disorders, which respectively were schizophrenia (SCZ), major depression (MDD), bipolar disorder (BIP), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD). Using genetic variants as proxies, our study has identified 137 metabolites linked to the risk of psychiatric disorders, including 2-methoxyacetaminophen sulfate, which affects SCZ (P= 1.7 × 10–5) and 1-docosahexaenoylglycerophosphocholine, which affects ADHD (P = 5.6 × 10–5). Fourteen significant metabolic pathways involved in the 5 psychiatric disorders assessed were also detected, such as glycine, serine, and threonine metabolism for SCZ (P = .0238), Aminoacyl-tRNA biosynthesis for both MDD (P =.0144) and ADHD (P =.0029). Our study provided novel insights into integrating metabolomics with genomics in order to understand the mechanisms underlying the pathogenesis of human diseases.

    更新日期:2020-01-10
  • Low-dose Perampanel rescues cortical gamma dysregulation associated with parvalbumin interneuron GluA2 upregulation in epileptic Syngap1+/- mice
    Biol. Psychiatry (IF 11.501) Pub Date : 2020-01-10
    Brennan J. Sullivan; Simon Ammanuel; Pavel A. Kipnis; Yoichi Araki; Richard L. Huganir; Shilpa D. Kadam

    Background Loss-of-function SYNGAP1 mutations cause a neurodevelopmental disorder characterized by intellectual disability and epilepsy. SYNGAP1 is a Ras-GTPase-activating protein that underlies the formation and experience-dependent regulation of postsynaptic densities. The mechanisms that contribute to this proposed monogenic cause of intellectual disability and epilepsy remain unresolved. Methods Here, we establish the phenotype of the epileptogenesis in a Syngap1+/- mouse model using 24h video electroencephalogram/electromyogram (vEEG/EMG) recordings at advancing ages. We administered an acute low-dose of Perampanel, an FDA approved AMPAR antagonist, during a follow-on 24h vEEG to investigate the role of AMPARs in SYNGAP1 haploinsufficiency. To determine the region- and location-specific differences in the expression of the GluA2 AMPAR subunit, immunohistochemistry was performed. Results A progressive worsening of the epilepsy with emergence of multiple seizure phenotypes, interictal spike frequency, sleep dysfunction, and hyperactivity was identified in Syngap1+/- mice. Interictal spikes emerged predominantly during NREM in 24h vEEG of Syngap1+/- mice. Myoclonic seizures occurred at behavioral-state transitions both in Syngap1+/- mice and during an overnight EEG from a child with SYNGAP1 haploinsufficiency. In Syngap1+/- mice, EEG spectral power analyses identified a significant loss of gamma power modulation during behavioral-state transitions. A significant region-specific increase of GluA2 AMPAR subunit expression in the somas of parvalbumin-positive (PV+) interneurons was identified. Conclusions Acute dosing with Perampanel significantly rescued behavioral-state dependent cortical gamma homeostasis, identifying a novel mechanism implicating Ca2+ impermeable AMPARs on PV+ interneurons underlying circuit dysfunction in SYNGAP1 haploinsufficiency.

    更新日期:2020-01-10
  • Correction to Lancet Psychiatry 2019; 6: 1031–38
    Lancet Psychiatry (IF 18.329) Pub Date : 2020-01-09

    Steinberg JR, Laursen TM, Adler NE, Gasse C, Agerbo E, Munk-Olsen T. The association between first abortion and first-time non-fatal suicide attempt: a longitudinal cohort study of Danish population registries. Lancet Psychiatry 2019; 6: 1031–38—In this Article, the ATC code N03AE01 was missing a number. This correction has been made to the online version as of Jan 9, 2020.

    更新日期:2020-01-10
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