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Wu, Sally, Kristoffer J. Panganiban, Jiwon Lee, et al. "Peripheral Lipid Signatures, Metabolic Dysfunction, and Pathophysiology in Schizophrenia Spectrum Disorders." Metabolites 14, no. 9 (2024): 475. http://dx.doi.org/10.3390/metabo14090475.
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Metabolic dysfunction is commonly observed in schizophrenia spectrum disorders (SSDs). The causes of metabolic comorbidity in SSDs are complex and include intrinsic or biological factors linked to the disorder, which are compounded by antipsychotic (AP) medications. The exact mechanisms underlying SSD pathophysiology and AP-induced metabolic dysfunction are unknown, but dysregulated lipid metabolism may play a role. Lipidomics, which detects lipid metabolites in a biological sample, represents an analytical tool to examine lipid metabolism. This systematic review aims to determine peripheral lipid signatures that are dysregulated among individuals with SSDs (1) with minimal exposure to APs and (2) during AP treatment. To accomplish this goal, we searched MEDLINE, Embase, and PsychINFO databases in February 2024 to identify all full-text articles written in English where the authors conducted lipidomics in SSDs. Lipid signatures reported to significantly differ in SSDs compared to controls or in relation to AP treatment and the direction of dysregulation were extracted as outcomes. We identified 46 studies that met our inclusion criteria. Most of the lipid metabolites that significantly differed in minimally AP-treated patients vs. controls comprised glycerophospholipids, which were mostly downregulated. In the AP-treated group vs. controls, the significantly different metabolites were primarily fatty acyls, which were dysregulated in conflicting directions between studies. In the pre-to-post AP-treated patients, the most impacted metabolites were glycerophospholipids and fatty acyls, which were found to be primarily upregulated and conflicting, respectively. These lipid metabolites may contribute to SSD pathophysiology and metabolic dysfunction through various mechanisms, including the modulation of inflammation, cellular membrane permeability, and metabolic signaling pathways.
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Ousley, O. Y., E. Smearman, S. Fernandez-Carriba, et al. "Axis I psychiatric diagnoses in adolescents and young adults with 22q11 deletion syndrome." European Psychiatry 28, no. 7 (2013): 417–22. http://dx.doi.org/10.1016/j.eurpsy.2013.06.002.
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AbstractBackground22q11.2 deletion syndrome (22q11DS) associates with schizophrenia spectrum disorders (SSDs), autism spectrum disorders (ASDs), and other psychiatric disorders, but co-occurrence of diagnoses are not well described.MethodsWe evaluated the co-occurrence of SSDs, ASDs and other axis I psychiatric diagnoses in 31 adolescents and adults with 22q11DS, assessing ASDs using either stringent Collaborative Program for Excellence in Autism (ASD-CPEA) criteria, or less stringent DSM-IV criteria alone (ASD-DSM-IV).ResultsTen (32%) individuals met criteria for an SSD, five (16%) for ASD-CPEA, and five others (16%) for ASD-DSM-IV. Of those with ASD-CPEA, one (20%) met SSD criteria. Of those with ASD-DSM-IV, four (80%) met SSD criteria. Depressive disorders (8 individuals; 26%) and anxiety disorders (7; 23%) sometimes co-occurred with SSDs and ASDs. SSDs, ASDs, and anxiety occurred predominantly among males and depression predominantly among females.ConclusionsIndividuals with 22q11DS can manifest SSDs in the presence or absence of ASDs and other axis I diagnoses. The results suggest that standard clinical care should include childhood screening for ASDs, and later periodic screening for all axis I diagnoses.
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Oliver, Lindsay, Iska Moxon-Emre, Aristotle Voineskos, and Stephanie Ameis. "M49. BEHAVIOURAL SOCIAL COGNITION IN SCHIZOPHRENIA SPECTRUM DISORDERS IN COMPARISON TO AUTISM SPECTRUM DISORDER: A SYSTEMATIC REVIEW AND META-ANALYSIS." Schizophrenia Bulletin 46, Supplement_1 (2020): S152—S153. http://dx.doi.org/10.1093/schbul/sbaa030.361.
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Abstract Background Schizophrenia spectrum disorders (SSDs) and autism spectrum disorder (ASD) both feature social cognitive deficits, which are highly debilitating. These include lower-level processes (e.g. emotion recognition), thought to be subserved by a frontoparietal mirroring network, and higher-level mentalizing processes (e.g. theory of mind), involving cortical midline and lateral temporal brain regions. Across both disorders, impairments in social cognition persist over time, drive disability, and predict functional outcome. Overlapping symptoms in SSDs and ASD have long been recognized, particularly in the realm of social deficits. However, despite some studies including both individuals with SSDs and ASD showing similar levels of social cognitive impairment, including lower-level and higher-level deficits, results are mixed. Thus, our objective was to determine based on the extant literature how deficits in social cognition diverge or overlap between individuals with SSDs and ASD by conducting a systematic review and meta-analysis of studies directly comparing these groups on behavioural social cognitive measures. Methods Literature searches were conducted in MEDLINE, Embase, PsycINFO, and Web of Science to identify articles that utilized behavioural measures to assess social cognition in both SSD and ASD samples. Of 3682 articles identified, 28 met all inclusion criteria. Across the accepted articles, lower-level (e.g. facial and/or context-embedded emotion recognition) and higher-level (e.g. intention understanding, perspective taking) social cognitive measures were identified, and random-effects meta-analyses were conducted for each category. A separate meta-analysis was also conducted for the Reading the Mind in the Eyes test given that it was the most commonly used social cognitive metric. Effect sizes were estimated using Hedges’ g. Homogeneity of effects and publication bias were also assessed for each meta-analysis. Results A significant difference in lower-level social cognitive performance was found between individuals with SSDs and ASD, with the SSD group performing better than the ASD group (Hedges’ g = 0.30, 95% CI [0.05, 0.56], p = .018). In contrast, there was no significant difference in higher-level social cognitive performance between SSD and ASD groups (Hedges’ g = -0.14, 95% CI [-0.52, 0.24], p = .46). Similarly, the Reading the Mind in the Eyes test meta-analysis revealed no significant difference in effect sizes between disorders (Hedges’ g = 0.24, 95% CI [-0.07, 0.55], p = .14). Effect size distributions were significantly heterogeneous in all three cases (all p < .001). Discussion Based on meta-analyses of the extant literature, both shared and differential social cognitive deficits may be present between individuals with SSDs and ASD. Though no differences were detected between SSD and ASD groups on higher-level social cognitive tasks or the Reading the Mind in the Eyes test, lower-level social cognitive deficits were found to be more severe in individuals with ASD than SSDs. Notably, the majority of studies included in the meta-analyses had small sample sizes, and heterogeneity of effect sizes was apparent. Thus, studies including larger sample sizes and validated measures of social cognition in conjunction with other methodologies are needed to substantiate these results, and better understand the shared and unique behavioural underpinnings and associated neural circuit abnormalities underlying social cognitive deficits in SSDs and ASD.
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Agarwal, Sri Mahavir, Joel Dissanayake, Ofer Agid, et al. "Characterization and prediction of individual functional outcome trajectories in schizophrenia spectrum disorders (PREDICTS study): Study protocol." PLOS ONE 18, no. 9 (2023): e0288354. http://dx.doi.org/10.1371/journal.pone.0288354.
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Schizophrenia spectrum disorders (SSDs) are associated with significant functional impairments, disability, and low rates of personal recovery, along with tremendous economic costs linked primarily to lost productivity and premature mortality. Efforts to delineate the contributors to disability in SSDs have highlighted prominent roles for a diverse range of symptoms, physical health conditions, substance use disorders, neurobiological changes, and social factors. These findings have provided valuable advances in knowledge and helped define broad patterns of illness and outcomes across SSDs. Unsurprisingly, there have also been conflicting findings for many of these determinants that reflect the heterogeneous population of individuals with SSDs and the challenges of conceptualizing and treating SSDs as a unitary categorical construct. Presently it is not possible to identify the functional course on an individual level that would enable a personalized approach to treatment to alter the individual’s functional trajectory and mitigate the ensuing disability they would otherwise experience. To address this ongoing challenge, this study aims to conduct a longitudinal multimodal investigation of a large cohort of individuals with SSDs in order to establish discrete trajectories of personal recovery, disability, and community functioning, as well as the antecedents and predictors of these trajectories. This investigation will also provide the foundation for the co-design and testing of personalized interventions that alter these functional trajectories and improve outcomes for people with SSDs.
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Pushko, Ye. "PHENOMENOLOGICAL RESEARCH OF IMAGINATION IN SCHIZOPHRENIA SPECTRUM DISORDERS AS A CONCEPTUAL FRAMEWORK FOR UNDERSTANDING PSYCHOTHERAPEUTIC PROCESSES AND RECOVERY STRATEGIES." Psychology and Personality, no. 1 (March 13, 2023): 178–97. http://dx.doi.org/10.33989/2226-4078.2023.1.274746.
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Although imagination abnormalities are frequent and handicapping in schizophrenia spectrum disorders (SSDs), psychopathology lacks a conceptual framework for modeling imagination disorders. Recently, in connection with the “imaginary turn” in phenomenology, translational approaches between philosophy and psychopathology have been sought. The purpose of the article is the presentation and analysis of modern foreign phenomenological studies of imagination in SSDs by a group of researchers headed by A. Rasmussen and J. Parnas, for the possible implementation of the results in domestic practice. The author first examines the features of anomalous fantasy and imagination in SSDs from the phenomenological point of view and then presents an overview of the EAFI instrument for a semistructured, phenomenological study of anomalous fantasy and imagination through interviews. Then the author analyzes the theoretical and practical implications of such research for understanding psychotherapeutic processes and recovery strategies. The studied disorders of imagination are characterized by three phenomenological dimensions: 1) perceptualization of imagery: the experience acquires certain quasi-perceptual qualities, such as spatialization, spatiotemporal constancy and explorabilty; 2) autonomization of imagery with a quasi-involuntary flow and a sense of empirical distance between the conscious image and the sense of agency; and 3) erosion of irreality: whereas the imagination is normally lived with an ever-present character of unreality, people with SSDs can experience vivid imagery without a clear separation with the real world. Rasmussen et al. not only describe clinical experience, they also offer a conceptual model of imagination disorders as expressions of minimal self-disorders (disorders of ipseity). The researchers hypothesize that impaired ipseity itself is the core generative disorder of schizophrenia, and positive/negative symptoms derive from this core phenotype. Thus, imagination is understood as a mental domain that affects the underlying disorder, meaning that imagination has the same status as all other modes of intentional consciousness (such as perception or memory). T. Gozé and I. Fazakas go further and suggest a phenomenological distinction between fantasy and imagination, which resembles the distinction between body schema and body image.
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Springfield, Cassi, Lillian Hammer, Amy Pinkham, et al. "0692 Relationships Between Sleep and Social Cognitive Biases in Schizophrenia-Spectrum and Bipolar Disorders." SLEEP 46, Supplement_1 (2023): A304. http://dx.doi.org/10.1093/sleep/zsad077.0692.
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Abstract Introduction People with schizophrenia-spectrum disorders (SSDs) and bipolar disorders (BDs) experience difficulty with social cognition, or the mental processes that underlie social interactions, but determinants of social cognitive impairment are still under investigation. Research suggests that poor sleep quality is related to reduced social cognitive ability in BDs, but it is unclear if sleep quality is related to social cognition in SSDs and if sleep may be related to different types of social cognition (e.g., emotion recognition, biases) in different ways. This study aimed to examine relationships between sleep and different types of social cognition in SSDs and BDs. Given known relationships between blaming and untrustworthiness biases and paranoia in these populations, paranoia was also examined as potential mediator of these relationships. Methods Participants (SSDs n=91; BDs with psychotic features n=87) completed tasks of social cognitive ability (e.g., facial and multi-modal emotion recognition, attributional bias, untrustworthiness bias). Participants self-reported their sleep quality. Paranoia was assessed via clinical interview. Results In the BD group, poor sleep quality (r=-.23, p=.04) and shorter sleep duration (r=-.25, p=.02) were associated with a bias towards untrustworthiness. For those with SSDs, increased use of sleep medication was associated with poorer multi-modal emotion recognition (r=-.22, p=.04). Additionally, poor sleep quality and overall poor sleep were associated with increased blaming (r=.22, p=.03; r=.21, p=.04) and untrustworthiness biases (r=-.24, p=.03; r=-.24, p=.03) in this group. Higher daytime tiredness was also associated with untrustworthiness bias (r=-.23, p=.03) in SSDs. Regarding mediation results, paranoia did serve as a mediator in the relationships between sleep and blaming and untrustworthiness biases across the sample. Conclusion Results suggest that poor sleep quality is linked to increased attributional and untrustworthiness biases, and that these relationships may be at least partially explained by paranoia symptoms. Of note, however, is that indirect effect sizes in mediation models were small. Contrary to expectations, poor sleep quality was not consistently associated with reduced social cognitive ability in the current sample. Findings from the current study require further exploration and replication. Support (if any) This work was supported by the National Institute of Mental Health (grant number R01 MH116902-04 awarded to C.A.D).
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Snethen, PhD, LRT/CTRS, Gretchen, Bryan P. McCormick, PhD, CTRS, and Marieke Van Puymbroeck, PhD, CTRS. "Independence through Community Access and Navigation in adults with schizophrenia spectrum disorders Part 1: Theoretical and practical foundations." American Journal of Recreation Therapy 10, no. 1 (2011): 25–33. http://dx.doi.org/10.5055/ajrt.2011.0004.
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Negative symptoms and cognitive dysfunction are two symptomatic categories of schizophrenia spectrum disorders (SSDs) that significantly impair functioning. Treatment for adults with SSDs continues to focus primarily on medication adherence and positive symptom reduction, despite the fact that medication has little impact on negative and cognitive symptoms within this population and, thus, little impact on improving community functioning. This two-part series presents an intervention developed to increase community participation in adults with SSDs. This article presents a comprehensive description of the functional impairments experienced by this population, framed within the World Health Organization’s International Classification of Functioning, Disability, and Health. This article will also apply Self-Determination Theory to this population of adults with SSDs as a foundation to help this population increase community participation and successful integration.
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Bartoli, F., A. Calabrese, F. Moretti, et al. "The relationship between depression and overall, general psychopathology, positive, and negative symptoms in people with schizophrenia spectrum disorders: a cross-sectional study." European Psychiatry 67, S1 (2024): S387—S388. http://dx.doi.org/10.1192/j.eurpsy.2024.797.
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IntroductionDepressive symptoms are a common occurrence in people suffering from schizophrenia spectrum disorders (SSDs), representing a separate domain that interacts in peculiar ways with positive and negative symptoms. Nonetheless, available evidence on the relationship between depression and key clinical dimensions of SSDs is limited.ObjectivesTo increase the knowledge regarding depression in SSDs, we performed a cross-sectional study aimed to investigate the association of depressive symptoms with overall, general psychopathology, positive, and negative symptoms in individuals with SSDs.MethodsAdult people with SSDs were recruited from two psychiatric inpatient units in the northern area of the Metropolitan City of Milan from May 2020 to March 2023. Study participants with a Calgary Depression Scale for Schizophrenia score >6 were rated as depressed. Symptom severity was assessed by using the Positive and Negative Syndrome Scale (PANSS). Variables associated with depression at the univariate level were included into two multiple logistic regression models to analyse the association between depression and PANSS overall score as well as General Psychopathology, Positive, and Negative sub-scores.ResultsA total of 231 subjects with SSDs were included. Among them, approximately one third (N=78; 33.8%) reported depressive symptoms. Multiple logistic regression models suggested that depression in individiuals with SSDs was associated with higher overall (p<0.001) and General Psychopathology (p<0.001) PANSS scores. Conversely, an inverse relationship between depression and positive symptoms was found (p=0.002). Negative symptoms were not associated with depression (p=0.210).ConclusionsOur findings suggest that people affected by comorbid SSDs and depression have more severe overall and General Psychopathology symptoms according to PANSS scores, as well as lower levels of positive symptoms. Further investigations are needed to evaluate the generalisability of these findings and to improve the clinical management of people with SSDs and depression.Disclosure of InterestNone Declared
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Gozé, Tudi, and Istvan Fazakas. "Imagination and Self Disorders in Schizophrenia: A Review." Psychopathology 53, no. 5-6 (2020): 264–73. http://dx.doi.org/10.1159/000509488.
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Anomalies of imagination are frequent and handicapping in schizophrenia spectrum disorders (SSDs) but neglected in psychopathology due to the lack of a conceptual framework to model disorders of imagination. Recently, the link between minimal self disorders and pathology of imagination has been emphasized. The aim of the present article is to discuss this initiative by stressing their paradigm drawing on the recent imaginary turn in phenomenological research. Although this field of research is currently very active in philosophy, there are very few translational approaches in psychopathology or cognitive sciences. In this paper, we examine how contemporary research concerning fantasy and imagination can lead to the elaboration of an epistemological and phenomenological framework for schizophrenia research. We first examine the psychopathological literature on anomalous fantasy and imagination in SSDs. Then we propose an exhaustive overview of the imaginary turn of philosophical phenomenology. Further, we examine the theoretical and practical implications of such a recasting of phenomenological research. We show how fantasy and imagination are involved in the embodiment process, and how identity and imagination are interlinked. Finally, we propose an overview of the possible implications for the understanding of psychotherapeutic processes and recovery strategies.
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Fantozzi, Pamela, Claudia Del Grande, Stefano Berloffa, et al. "Neurodevelopmental Disorders, Schizophrenia Spectrum Disorders and Catatonia: The “Iron Triangle” Rediscovered in a Case Report." Children 10, no. 1 (2022): 77. http://dx.doi.org/10.3390/children10010077.
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Catatonia is a complex neuropsychiatric syndrome, occurring in the context of different psychiatric and neurodevelopmental disorders, in neurological and medical disorders, and after substance abuse or withdrawal. The relationship between Autism Spectrum Disorder (ASD), Schizophrenia Spectrum Disorders (SSDs) and catatonia has been previously discussed, with the three disorders interpreted as different manifestations of the same underlying brain disorder (the “Iron Triangle”). We discuss in this paper the diagnostic, clinical and therapeutic implications of this complex relationship in an adolescent with ASD, who presented an acute psychotic onset with catatonia, associated with mixed mood symptoms. Second-generation antipsychotics were used to manage psychotic, behavioral and affective symptoms, with worsening of the catatonic symptoms. In this clinical condition, antipsychotics may be useful at the lowest dosages, with increases only in the acute phases, especially when benzodiazepines are ineffective. Mood stabilizers with higher GABAergic effects (such as Valproate and Gabapentin) and Lithium salts may be more useful and well tolerated, given the frequent association of depressive and manic symptoms with mixed features.
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Bassilios, Bridget, Fiona Judd, and Philippa Pattison. "Why don’t people diagnosed with schizophrenia spectrum disorders (SSDs) get enough exercise?" Australasian Psychiatry 22, no. 1 (2013): 71–77. http://dx.doi.org/10.1177/1039856213510575.
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Oliver, Lindsay D., John D. Haltigan, James M. Gold, et al. "Lower- and Higher-Level Social Cognitive Factors Across Individuals With Schizophrenia Spectrum Disorders and Healthy Controls: Relationship With Neurocognition and Functional Outcome." Schizophrenia Bulletin 45, no. 3 (2018): 629–38. http://dx.doi.org/10.1093/schbul/sby114.
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Abstract Background Schizophrenia spectrum disorders (SSDs) often feature social cognitive deficits. However, little work has focused on the factor structure of social cognition, and results have been inconsistent in schizophrenia. This study aimed to elucidate the factor structure of social cognition across people with SSDs and healthy controls. It was hypothesized that a 2-factor model, including lower-level “simulation” and higher-level “mentalizing” factors, would demonstrate the best fit across participants. Methods Participants with SSDs (N = 164) and healthy controls (N = 102) completed social cognitive tasks ranging from emotion recognition to complex mental state inference, as well as clinical and functional outcome, and neurocognitive measures. Structural equation modeling was used to test social cognitive models, models of social cognition and neurocognition, measurement invariance between cases and controls, and relationships with outcome measures. Results A 2-factor (simulation and mentalizing) model fit the social cognitive data best across participants and showed adequate measurement invariance in both SSD and control groups. Patients showed lower simulation and mentalizing scores than controls, but only mentalizing was significantly associated with negative symptoms and functional outcome. Social cognition also mediated the relationship between neurocognition and both negative symptoms and functional outcome. Conclusions These results uniquely indicate that distinct lower- and higher-level aspects of social cognition exist across SSDs and healthy controls. Further, mentalizing may be particularly linked to negative symptoms and functional outcome. This informs future studies of the neural circuitry underlying social cognition and the development of targeted treatment options for improving functional outcome.
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Brand, Bodyl A., Yudith R. A. Haveman, Franciska de Beer, Janna N. de Boer, Paola Dazzan, and Iris E. C. Sommer. "Antipsychotic medication for women with schizophrenia spectrum disorders." Psychological Medicine 52, no. 4 (2021): 649–63. http://dx.doi.org/10.1017/s0033291721004591.
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AbstractThere are significant differences between men and women in the efficacy and tolerability of antipsychotic drugs. Here, we provide a comprehensive overview of what is currently known about the pharmacokinetics and pharmacodynamics of antipsychotics in women with schizophrenia spectrum disorders (SSDs) and translate these insights into considerations for clinical practice. Slower drug absorption, metabolism and excretion in women all lead to higher plasma levels, which increase the risk for side-effects. Moreover, women reach higher dopamine receptor occupancy compared to men at similar serum levels, since oestrogens increase dopamine sensitivity. As current treatment guidelines are based on studies predominantly conducted in men, women are likely to be overmedicated by default. The risk of overmedicating generally increases when sex hormone levels are high (e.g. during ovulation and gestation), whereas higher doses may be required during low-hormonal phases (e.g. during menstruation and menopause). For premenopausal women, with the exceptions of quetiapine and lurasidone, doses of antipsychotics should be lower with largest adjustments required for olanzapine. Clinicians should be wary of side-effects that are particularly harmful in women, such as hyperprolactinaemia which can cause oestrogen deficiency and metabolic symptoms that may cause cardiovascular diseases. Given the protective effects of oestrogens on the course of SSD, oestrogen replacement therapy should be considered for postmenopausal patients, who are more vulnerable to side-effects and yet require higher dosages of most antipsychotics to reach similar efficacy. In conclusion, there is a need for tailored, female-specific prescription guidelines, which take into account adjustments required across different phases of life.
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Matheson, S. L., M. Kariuki, M. J. Green, et al. "Effects of maltreatment and parental schizophrenia spectrum disorders on early childhood social-emotional functioning: a population record linkage study." Epidemiology and Psychiatric Sciences 26, no. 6 (2016): 612–23. http://dx.doi.org/10.1017/s204579601600055x.
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Aims.Childhood maltreatment and a family history of a schizophrenia spectrum disorder (SSD) are each associated with social-emotional dysfunction in childhood. Both are also strong risk factors for adult SSDs, and social-emotional dysfunction in childhood may be an antecedent of these disorders. We used data from a large Australian population cohort to determine the independent and moderating effects of maltreatment and parental SSDs on early childhood social-emotional functioning.Methods.The New South Wales Child Development Study combines intergenerational multi-agency data using record linkage methods. Multiple measures of social-emotional functioning (social competency, prosocial/helping behaviour, anxious/fearful behaviour; aggressive behaviour, and hyperactivity/inattention) on 69 116 kindergarten children (age ~5 years) were linked with government records of child maltreatment and parental presentations to health services for SSD. Multivariable analyses investigated the association between maltreatment and social-emotional functioning, adjusting for demographic variables and parental SSD history, in the population sample and in sub-cohorts exposed and not exposed to parental SSD history. We also examined the association of parental SSD history and social-emotional functioning, adjusting for demographic variables and maltreatment.Results.Medium-sized associations were identified between maltreatment and poor social competency, aggressive behaviour and hyperactivity/inattention; small associations were revealed between maltreatment and poor prosocial/helping and anxious/fearful behaviours. These associations did not differ greatly when adjusted for parental SSD, and were greater in magnitude among children with no history of parental SSD. Small associations between parental SSD and poor social-emotional functioning remained after adjusting for demographic variables and maltreatment.Conclusions.Childhood maltreatment and history of parental SSD are associated independently with poor early childhood social-emotional functioning, with the impact of exposure to maltreatment on social-emotional functioning in early childhood of greater magnitude than that observed for parental SSDs. The impact of maltreatment was reduced in the context of parental SSDs. The influence of parental SSDs on later outcomes of maltreated children may become more apparent during adolescence and young adulthood when overt symptoms of SSD are likely to emerge. Early intervention to strengthen childhood social-emotional functioning might mitigate the impact of maltreatment, and potentially also avert future psychopathology.
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Endres, Dominique, Miriam Matysik, Bernd Feige, et al. "Diagnosing Organic Causes of Schizophrenia Spectrum Disorders: Findings from a One-Year Cohort of the Freiburg Diagnostic Protocol in Psychosis (FDPP)." Diagnostics 10, no. 9 (2020): 691. http://dx.doi.org/10.3390/diagnostics10090691.
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Introduction: Secondary schizophrenia spectrum disorders (SSDs) have clearly identifiable causes. The Department for Psychiatry and Psychotherapy at the University Hospital Freiburg has continued to expand its screening practices to clarify the organic causes of SSDs. This retrospective analysis was carried out to analyze whether a comprehensive organic diagnostic procedure could be informative in patients with SSDs. Methods and Participants: The “Freiburg Diagnostic Protocol in Psychosis” (FDPP) included basic laboratory analyses (e.g., thyroid hormones), metabolic markers, pathogens, vitamin status, different serological autoantibodies, rheumatic/immunological markers (e.g., complement factors), cerebrospinal fluid (CSF) basic and antineuronal antibody analyses, as well as cranial magnetic resonance imaging (cMRI) and electroencephalography (EEG). The findings of 76 consecutive patients with SSDs (55 with paranoid–hallucinatory; 14 with schizoaffective; 4 with hebephrenic; and 1 each with catatonic, acute polymorphic psychotic, and substance-induced psychotic syndromes) were analyzed. Results: Overall, vitamin and trace element deficiency was identified in 92%. Complement factor analyses detected reduced C3 levels in 11%. Immunological laboratory alterations were detected in 76%. CSF analysis revealed general alterations in 54% of the patients, mostly with signs of blood–brain barrier dysfunction. cMRI analyses showed chronic inflammatory lesions in 4%. Combination of EEG, cMRI, and CSF revealed alterations in 76% of the patients. In three patients, autoimmune psychosis was suspected (4%). Discussion: On the basis of these findings, we conclude that a comprehensive diagnostic procedure according to the FDPP in patients with SSD is worthwhile, considering the detection of secondary, organic forms of SSDs, as well as alterations in “modulating factors” of the disease course, such as vitamin deficiency. Larger studies using comprehensive diagnostic protocols are warranted to further validate this approach.
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Adams, MS, CTRS, C-IAYT, Emilie V., and Jasmine Townsend, PhD, CTRS. "A systematic review of yoga and schizophrenia spectrum disorders: Implications for recreational therapy practitioners." American Journal of Recreation Therapy 17, no. 2 (2018): 37. http://dx.doi.org/10.5055/ajrt.2018.0160.
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Schizophrenia spectrum disorders (SSDs) are a group of mental illnesses characterized by hallucinations, delusions, disorganized thought; they are often accompanied by cognitive dysfunction, social skills deficits, and low volition. This article reviews the extant literature on the efficacy of using yoga as an adjunct therapy to supplement standard pharmacotherapy and psychotherapy in the treatment and management of SSD. The 16 studies reviewed indicate yoga may be an effective intervention for increasing global cognitive functioning, decreasing psychotic symptoms, and improving quality of life for clients with SSD. Recommendations for integration of yoga into a Recreation Therapy program are outlined.
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Malliaris, P., and K. Bonotis. "Correlation between alterations in cognitive function and mean severity of psychotic symptoms in patients diagnosed with schizophrenia spectrum disorders and its clinical application." European Psychiatry 64, S1 (2021): S811. http://dx.doi.org/10.1192/j.eurpsy.2021.2143.
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IntroductionSchizophrenia spectrum disorders (SSD) are characterized by heterogeneity. Cognitive decline, due to recent research results, appears to be a core symptom of schizophrenia. Dimensional approach of SSDs allows the separate assessment of each psychotic symptom, as well as cognitive functioning. Thus, correlations among them and their alterations, between baseline and follow up examination, can be estimated.ObjectivesThe objective of this study is to correlate observed alterations in cognitive performance in patients diagnosed with schizophrenia spectrum disorders, compared with baseline measurement, with alterations in severity of psychotic symptoms.Methods85 Patients diagnosed with schizophrenia spectrum disorders, attended in the Outpatient Department of Early Intervention in Psychosis of University of Thessaly, Greece and its affiliated psychiatric clinics, were evaluated the last 24 months, using the CRDPSS (Clinician-Rated Dimensions of Psychosis Symptoms Severity) measure and the validated greek version of the MoCA test. 37 of them had a follow up evaluation. The relationship between the two new categorical variables [dMoCA (positive- negative) and dmCRDPSS7 (positive-negative)] was assessed with x² test.ResultsAlterations in cognitive function, as assessed with MoCA scale and dMoCA variable, were inversely correlated with the alteration in mean severity of other dimensions of psychosis symptoms (dmCRDPSS7), x²(1, N = 37) = 9.4891, p = .0021.Conclusions Our data suggest that alterations in cognitive performance may predict an inverse effect in the severity of psychotic symptoms. Periodic follow up of cognitive functioning in patients diagnosed with schizophrenia spectrum disorders is suggested, since it can be interpreted in clinically useful information considering relapse.DisclosureNo significant relationships.
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Martin, James C., Scott R. Clark, and K. Oliver Schubert. "Towards a Neurophenomenological Understanding of Self-Disorder in Schizophrenia Spectrum Disorders: A Systematic Review and Synthesis of Anatomical, Physiological, and Neurocognitive Findings." Brain Sciences 13, no. 6 (2023): 845. http://dx.doi.org/10.3390/brainsci13060845.
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The concept of anomalous self-experience, also termed Self-Disorder, has attracted both clinical and research interest, as empirical studies suggest such experiences specifically aggregate in and are a core feature of schizophrenia spectrum disorders. A comprehensive neurophenomenological understanding of Self-Disorder may improve diagnostic and therapeutic practice. This systematic review aims to evaluate anatomical, physiological, and neurocognitive correlates of Self-Disorder (SD), considered a core feature of Schizophrenia Spectrum Disorders (SSDs), towards developing a neurophenomenological understanding. A search of the PubMed database retrieved 285 articles, which were evaluated for inclusion using PRISMA guidelines. Non-experimental studies, studies with no validated measure of Self-Disorder, or those with no physiological variable were excluded. In total, 21 articles were included in the review. Findings may be interpreted in the context of triple-network theory and support a core dysfunction of signal integration within two anatomical components of the Salience Network (SN), the anterior insula and dorsal anterior cingulate cortex, which may mediate connectivity across both the Default Mode Network (DMN) and Fronto-Parietal Network (FPN). We propose a theoretical Triple-Network Model of Self-Disorder characterized by increased connectivity between the Salience Network (SN) and the DMN, increased connectivity between the SN and FPN, decreased connectivity between the DMN and FPN, and increased connectivity within both the DMN and FPN. We go on to describe translational opportunities for clinical practice and provide suggestions for future research.
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Dobrodeeva, Vera S., Natalia A. Shnayder, Maxim A. Novitsky, et al. "Association of a Single-Nucleotide Variant rs11100494 of the NPY5R Gene with Antipsychotic-Induced Metabolic Disorders." Pharmaceutics 14, no. 2 (2022): 222. http://dx.doi.org/10.3390/pharmaceutics14020222.
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Background: The usage of antipsychotics (APs) is the most robust and scientifically based approach in the treatment of schizophrenia spectrum disorders (SSDs). The efficiency of APs is based on a range of target receptors of the central nervous system (CNS): serotoninergic, dopaminergic, adrenergic, histaminergic and cholinergic. Metabolic disorders are the most severe adverse drug reactions (ADRs) and lead to cardiovascular diseases with a high rate of mortality in patients with SSDs. Neuropeptide Y receptor Y5 (NPY5R) is known in the chain of interaction to target receptors for APs, agouti-related peptide receptors and proopiomelanocortin receptors. We studied the association of the single-nucleotide variants (SNVs) rs11100494 and rs6837793 of the NPY5R gene, and rs16147, rs5573, rs5574 of the NPY gene, with metabolic disorders in Russian patients with SSDs. Methods: We examined 99 patients with SSDs (mean age—24.56 years old). The mean duration of APs monotherapy was 8 weeks. The biochemical blood test included levels of glucose, cholesterol, lipoproteins, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein and albumin. Anthropometry included weight, height, waist circumference and hip circumference. We used real-time PCR to study the carriage of major and minor alleles of the SNV rs11100494 (1164C>A) of the NPY5R gene (chromosome localization—4q32.2). Group 1 comprised 25 patients with SSDs taking APs with a change in body weight of more than 6% since the start of APs therapy. Group 2 comprised 74 patients with SSDs taking APs with a change in body weight of less than 6% since the start of APs therapy. Results: We show the significance of genetic risk factors (carriage of major allele C of SNV rs11100494 of the NPY5R gene) for the development of AP-induced weight gain in Russian patients with SSDs. The allele C predisposes to AP-induced weight gain (OR = 33.48 [95% CI: 12.62; 88.82], p-value < 0.001). Additionally, the results of our study demonstrate that first-generation APs (FGAs) are more likely to cause an increase in serum transaminase levels but are less likely to increase body weight. Second-generation APs (SGAs) are more likely to cause weight gain and changes in serum glucose levels. Conclusion: Our study shows the predictive role of the allele C of SNV rs11100494 of the NPY5R gene in the development of AP-induced weight gain. However, we did not find a significant association between biochemical markers and this SNV in Russian patients with SSDs.
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Forastiere, A., S. Cascini, E. Calandrini, N. Agabiti, M. Davoli, and A. Bargagli. "Prevalence of schizophrenia spectrum disorders among adults in the Lazio region, Italy: use of an algorithm based on health information systems." European Psychiatry 65, S1 (2022): S208—S209. http://dx.doi.org/10.1192/j.eurpsy.2022.545.
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Introduction Mental healthcare provision is undergoing substantial reconfiguration in many regions of the world. Such changes require a broad evidence-based approach incorporating epidemiological data and information of local needs. Objectives To estimate the prevalence of schizophrenia spectrum disorders (SSDs) in the Lazio region and its geographical distribution using the regional health information systems (HIS). Methods Cases of SSDs (15-64-year-old) were identified using an algorithm based on data from the hospital discharge registry [ICD IX CM: 295, 297, 298 (excl. 298.0)] and the ticket exemption database [code 044], between 2006 and 2019. Crude, and age- and gender-specific prevalence estimates on December 31, 2019, were calculated. To compare prevalence between different areas within the region, we calculated age- and gender-adjusted prevalence rates Results A total of 18,371 cases were identified. Crude prevalence rate was 4.29/1,000 (95% CI 4.29-4.30) and 5.93/1,000 (95% CI 5.92-5.949 for women and men, respectively. An increase in the prevalence rate by age was observed in both genders. The age- and gender-adjusted prevalence rate was 5.03/1,000 (95 % CI 4.96-5.10), with significant differences within the region, ranging from 4.25/1,000 in the province of Viterbo to 5.42/1,000 in the city of Rome and 6.02/1000 in the province of Frosinone. Conclusions Our results showed that the overall prevalence of SSDs among adults in the Lazio region is similar to estimates published in prior reviews, but an uneven regional geographical distribution was observed. While possible underestimation must be considered, HIS represents a valuable source of information useful for epidemiological surveillance and healthcare planning. Disclosure No significant relationships.
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Moura, Bernardo Melo, Geeske van Rooijen, Frederike Schirmbeck, et al. "A Network of Psychopathological, Cognitive, and Motor Symptoms in Schizophrenia Spectrum Disorders." Schizophrenia Bulletin 47, no. 4 (2021): 915–26. http://dx.doi.org/10.1093/schbul/sbab002.
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Abstract Schizophrenia spectrum disorders (SSDs) are complex syndromes involving psychopathological, cognitive, and also motor symptoms as core features. A better understanding of how these symptoms mutually impact each other could translate into diagnostic, prognostic, and, eventually, treatment advancements. The present study aimed to: (1) estimate a network model of psychopathological, cognitive, and motor symptoms in SSD; (2) detect communities and explore the connectivity and relative importance of variables within the network; and (3) explore differences in subsample networks according to remission status. A sample of 1007 patients from a multisite cohort study was included in the analysis. We estimated a network of 43 nodes, including all the items from the Positive and Negative Syndrome Scale, a cognitive assessment battery and clinical ratings of extrapyramidal symptoms. Methodologies specific to network analysis were employed to address the study’s aims. The estimated network for the total sample was densely interconnected and organized into 7 communities. Nodes related to insight, abstraction capacity, attention, and suspiciousness were the main bridges between network communities. The estimated network for the subgroup of patients in remission showed a sparser density and a different structure compared to the network of nonremitted patients. In conclusion, the present study conveys a detailed characterization of the interrelations between a set of core clinical elements of SSD. These results provide potential novel clues for clinical assessment and intervention.
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Murillo-Garcia, N., S. Papiol, S. Barrio-Martínez, et al. "The use of Polygenic Scores in a family design of First Episode Psychosis." European Psychiatry 66, S1 (2023): S631. http://dx.doi.org/10.1192/j.eurpsy.2023.1312.
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IntroductionA wide variety of traits is heritable and has genetic loading, including schizophrenia spectrum disorders (SSDs) and its associated neurocognitive features. The genetic architecture of SSDs is polygenic, with the contribution of thousands of single nucleotide polymorphisms of small effect with an estimated SNP-heritability of 24%. The same occurs with neurocognitive phenotypes such as intelligence or educational attainment. Therefore, the method of polygenic risk scores (PRS) is useful in estimating the genetic burden of such traits. Moreover, the use of PRS in a sample of genetically related individuals would allow analyzing the contribution of genetic and environmental factors involved in the development of the disorder and its candidate endophenotypes.ObjectivesTo estimate PRS for schizophrenia, and polygenic scores for intelligence and educational attainment in patients with First Episode Psychosis (FEP), their first-degree relatives (siblings and parents), and a group of healthy controls.MethodsThe sample is comprised of 579 participants of the PAFIP-FAMILIAS project in Santander, Spain (133 FEP patients, their 244 first-degree relatives, and 202 healthy controls). All provided sociodemographic information and completed the same neuropsychological battery. Participants’ DNA was extracted from venous blood samples, and genotyping was performed at the Centro Nacional de Investigaciones Oncológicas (CeGen) by the Global Screening Array v.3.0 panel (Illumina). Data quality control, imputation, calculation of PRS, and genetic association analysis are being performed using PLINK, SHAPEIT, IMPUTE2, SPSS and R.ResultsData analysis is currently in progress, at the quality analysis stage, in collaboration with the Institute of Psychiatric Phenomics and Genomics (IPPG) in Munich, Germany. We expect to find higher PRS for schizophrenia in FEP patients, while their first-degree relatives will potentially show intermediate risk scores between patients and healthy controls. A similar finding is expected regarding intelligence and educational attainment, as FEP patients may show more genetic burden for low intelligence and education.ConclusionsThe estimation of PRS has demonstrated to be valuable in studying complex traits such as schizophrenia. We believe that by applying this method in a family design can provide interesting insights on the development of SSDs and its potential endophenotypes, and potentially useful in their prevention.Disclosure of InterestNone Declared
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Bondrescu, Mariana, Liana Dehelean, Simona Sorina Farcas, et al. "Cognitive Impairments Related to COMT and Neuregulin 1 Phenotypes as Transdiagnostic Markers in Schizophrenia Spectrum Patients." Journal of Clinical Medicine 13, no. 21 (2024): 6405. http://dx.doi.org/10.3390/jcm13216405.
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Background: Research on the interaction between antipsychotic treatment and cognitive dysfunction in schizophrenia spectrum disorders (SSDs) is extensive, yet the role of genetic polymorphisms in catechol-O-methyltransferase (COMT) and neuregulin 1 (NRG1) remains underexplored. Methods: This study evaluates the impact of COMT (rs4680) and NRG1 (rs3924999 and rs35753505) polymorphisms on cognitive functions in SSD patients. A cross-sectional study was conducted with fifty-four patients, assessed using the Positive and Negative Syndrome Scale (PANSS) and the CNS Vital Signs battery. Results: Significant cognitive function differences were observed across SSD diagnostic categories (p < 0.001). The NRG1 rs35753505 TT genotype was significantly associated with better verbal memory performance compared to the CC genotype (p = 0.03), while no significant differences were observed for other genotypes. The NRG1 rs3924999 AA genotype showed superior reasoning performance compared to AG and GG genotypes (p = 0.01), with AG and GG associated with lower scores (p = 0.01 and p = 0.02, respectively). Additionally, the COMT Val158Met genotype significantly influenced processing speed, with patients at the first episode of psychosis showing higher scores than chronic patients (p = 0.01). Conclusions: These findings suggest that NRG1 and COMT polymorphisms may influence cognitive domains in schizophrenia spectrum disorders, potentially informing personalized treatment and cognitive rehabilitation strategies.
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Beebe, Lora Humphrey, Kathlene D. Smith, Marian W. Roman, et al. "A Pilot Study Describing Physical Activity in Persons with Schizophrenia Spectrum Disorders (SSDS) after an Exercise Program." Issues in Mental Health Nursing 34, no. 4 (2013): 214–19. http://dx.doi.org/10.3109/01612840.2012.746411.
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Beebe, Lora Humphrey, Kathleen Smith, and Chad Phillips. "Descriptions and Correlates of Medication Adherence, Attitudes, and Self-Efficacy in Outpatients With Schizophrenia Spectrum Disorders (SSDs)." Archives of Psychiatric Nursing 30, no. 3 (2016): 400–405. http://dx.doi.org/10.1016/j.apnu.2016.01.010.
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Browne, Julia, Philip D. Harvey, Robert W. Buchanan, et al. "A Longitudinal Examination of Real-World Sedentary Behavior in Adults with Schizophrenia-Spectrum Disorders in a Clinical Trial of Combined Oxytocin and Cognitive Behavioral Social Skills Training." Behavioral Sciences 12, no. 3 (2022): 60. http://dx.doi.org/10.3390/bs12030060.
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Sedentary behavior contributes to a shortened life expectancy in individuals with schizophrenia-spectrum disorders (SSDs), highlighting the need for effective interventions to improve health. This study examined whether reduced ecological momentary assessment (EMA) measures of sedentary activities were observed in individuals with SSDs who participated in a 24-week randomized trial of cognitive behavioral social skills training (CBSST) and either intranasal oxytocin or placebo (NCT01752712). Participants (n = 57) were prompted with EMA surveys seven times per day for seven days during the baseline, 12-week, and 24-week timepoints to sample sedentary behavior ratings, positive and negative affect, interpersonal interactions, and interpersonal interaction appraisals. Results revealed that sedentary behavior and social interactions did not significantly change over the 24-week clinical trial; however, positive and negative affect and defeatist interaction appraisals improved with treatment, and oxytocin produced modest additional improvements in these EMA outcomes. Greater momentary positive affect was significantly associated with greater activity and greater frequency of interactions. Overall, CBSST was effective at improving functioning, momentary affect, and defeatist interaction appraisals, although it did not reduce sedentary behavior; therefore, targeting these factors is not sufficient to reduce sedentary behavior, and adjunct interventions are needed.
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Filipcic, I., I. Simunovic Filipcic, E. Ivezic, et al. "Chronic physical illnesses in patients with schizophrenia spectrum disorders are independently associated with higher rates of psychiatric rehospitalization; a cross-sectional study in Croatia." European Psychiatry 43 (June 2017): 73–80. http://dx.doi.org/10.1016/j.eurpsy.2017.02.484.
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AbstractBackground:Increased physical morbidity in patients with schizophrenia spectrum disorders (SSDs) is well documented. However, much less is known about the association between somatic comorbidities and psychosis treatment outcomes.Subjects and methods:This cross-sectional study, nested within the larger frame of a prospective cohort study, was done in 2016 at Psychiatric Hospital Sveti Ivan, Zagreb, Croatia. Data were collected on a consecutive sample of 301 patients diagnosed with schizophrenia spectrum disorders who achieved a stable therapeutic dosage. Key outcome was the number of psychiatric rehospitalizations since diagnosis of the primary psychiatric illness. Predictors were number of physical and psychiatric comorbidities. By robust regression, we controlled different clinical, sociodemographic, and lifestyle confounding factors.Results:The number of chronic somatic comorbidities was statistically significantly associated with a larger number of psychiatric rehospitalizations, even after the adjustment for number of psychiatric comorbidities and large number of other clinical, sociodemographic, and lifestyle variables.Conclusions:Chronic somatic comorbidities are associated with higher rates of psychiatric rehospitalization independently of psychiatric comorbidities and other clinical, sociodemographic, and lifestyle factors. Therefore, to treat psychosis effectively, it may be necessary to treat chronic somatic comorbidities promptly and adequately. Chronic somatic comorbidities should be considered equally important as the SSD, and should be brought to the forefront of psychiatric treatment and research with the SSD as one entity. The integrative approach should be the imperative in clinical practice.
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Jeon, Eun-Jin, Shi-Hyun Kang, Yan-Hong Piao, et al. "Development of the Korea-Polyenvironmental Risk Score for Psychosis." Psychiatry Investigation 19, no. 3 (2022): 197–206. http://dx.doi.org/10.30773/pi.2021.0328.
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Objective Comprehensive understanding of polyenvironmental risk factors for the development of psychosis is important. Based on a review of related evidence, we developed the Korea Polyenvironmental Risk Score (K-PERS) for psychosis. We investigated whether the K-PERS can differentiate patients with schizophrenia spectrum disorders (SSDs) from healthy controls (HCs).Methods We reviewed existing tools for measuring polyenvironmental risk factors for psychosis, including the Maudsley Environmental Risk Score (ERS), polyenviromic risk score (PERS), and Psychosis Polyrisk Score (PPS). Using odds ratios and relative risks for Western studies and the “population proportion” (PP) of risk factors for Korean data, we developed the K-PERS, and compared the scores thereon between patients with SSDs and HCs. In addition, correlation was performed between the K-PERS and Positive and Negative Syndrome Scale (PANSS).Results We first constructed the “K-PERS-I,” comprising five factors based on the PPS, and then the “K-PERS-II” comprising six factors based on the ERS. The instruments accurately predicted participants’ status (case vs. control). In addition, the K-PERS-I and -II scores exhibited significant negative correlations with the negative symptom factor score of the PANSS.Conclusion The K-PERS is the first comprehensive tool developed based on PP data obtained from Korean studies that measures polyenvironmental risk factors for psychosis. Using pilot data, the K-PERS predicted patient status (SSD vs. HC). Further research is warranted to examine the relationship of K-PERS scores with clinical outcomes of psychosis and schizophrenia.
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Shen, Jie, Guangfan Shen, Woo-Sung Kim, et al. "Neuronal Signatures of Negative and Positive Schemas towards the Self and Others in Patients with Early Stage Schizophrenia." Psychiatry Investigation 18, no. 4 (2021): 284–94. http://dx.doi.org/10.30773/pi.2020.0335.
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Objective The present study investigated the functional neuroanatomy underlying negative and positive schemas towards the self and others in patients with early stage schizophrenia spectrum disorders (SSDs) using a task-based fMRI procedure.Methods This study included 50 patients with SSDs and 52 controls. The schema-evoking task consisted of four active conditions and neutral condition. Differences in brain activation were compared between the two groups. Correlation analysis was performed between task-related activation and psychopathology.Results The SSD patients exhibited higher activity of the left middle and inferior frontal gyri under the negative-others minus neutral contrast as well as greater activation of the left superior and middle frontal gyri and right medial superior frontal gyrus under the positive- self minus neutral and positive-others minus neutral contrasts. Under the positive-others minus neutral contrast, negative correlation was observed between activity of the right inferior parietal gyrus and right angular and total score of the Positive and Negative Syndrome Scale (PANSS), whereas positive correlation between activity of the left middle cingulate gyrus and left/right precuneus and positive-others score of the Brief Core Schema Scales (BCSS).Conclusion The present findings suggest that the frontal brain regions of SSD patients are more sensitive to negative and positive schemas towards the self and/or others compared to those of controls.
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Bondrescu, Mariana, Liana Dehelean, Simona Sorina Farcas, et al. "COMT and Neuregulin 1 Markers for Personalized Treatment of Schizophrenia Spectrum Disorders Treated with Risperidone Monotherapy." Biomolecules 14, no. 7 (2024): 777. http://dx.doi.org/10.3390/biom14070777.
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Pharmacogenetic markers are current targets for the personalized treatment of psychosis. Limited data exist on COMT and NRG1 polymorphisms in relation to risperidone treatment. This study focuses on the impact of COMT rs4680 and NRG1 (rs35753505, rs3924999) polymorphisms on risperidone treatment in schizophrenia spectrum disorders (SSDs). This study included 103 subjects with SSD treated with risperidone monotherapy. COMT rs4680, NRG1 rs35753505, and rs3924999 were analyzed by RT-PCR. Participants were evaluated via the Positive and Negative Syndrome Scale (PANSS) after six weeks. Socio-demographic and clinical characteristics were collected. COMT rs4680 genotypes significantly differed in PANSS N scores at admission: AG>AA genotypes (p = 0.03). After six weeks of risperidone, PANSS G improvement was AA>GG (p = 0.05). The PANSS total score was as follows: AA>AG (p = 0.04), AA>GG (p = 0.02). NRG1 rs35753504 genotypes significantly differed across educational levels, with CC>CT (p = 0.02), and regarding the number of episodes, TT>CC, CT>CC (p = 0.01). The PANSS total score after six weeks of treatment showed a better improvement for TT<CT genotypes (p = 0.01). NRG1 rs3924999 genotypes revealed GG<AG (p = 0.02) for PANSS G scores after six weeks, with AG and GG requiring higher doses (p = 0.007, p = 0.02). Overall, our study suggests that the genetic polymorphisms COMT rs4680, NRG1 rs35753505, and rs3924999 significantly impact the treatment response to risperidone in patients with SSD.
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Dodell-Feder, David, Laura M. Tully, Emily Dudek, and Christine I. Hooker. "The representation of mental state information in schizophrenia and first-degree relatives: a multivariate pattern analysis of fMRI data." Social Cognitive and Affective Neuroscience 16, no. 6 (2021): 608–20. http://dx.doi.org/10.1093/scan/nsab028.
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Abstract Individuals with a schizophrenia-spectrum disorder (SSD) and those at familial high risk (FHR) for SSDs experience social difficulties that are related to neural abnormalities in the network of brain regions recruited during theory of mind (ToM). Prior work with these groups has focused almost exclusively on characterizing the involvement of these regions in ToM. Here, we examine the representational content of these regions using multivariate pattern analysis. We analyzed two previously collected datasets of SSD, FHR and control participants who, while undergoing functional magnetic resonance imaging, completed the false-belief task in which they read stories describing beliefs or physical representations (e.g. photographs). Univariate and multivariate analyses were performed in regions of interest to evaluate group differences in task-based activation and representational content, respectively. Compared to non-SSDs, SSDs showed reduced decoding accuracy for the category of mental states in the right temporo-parietal junction—which was related to false-belief accuracy—and the dorsal medial prefrontal cortex (DMPFC) and reduced involvement of DMPFC for mental state understanding. FHR showed no differences in decoding accuracy or involvement compared to non-FHR. Given prior studies of disrupted neural involvement in FHR and the lack of decoding differences observed here, the onset of illness may involve processes that corrupt how mental state information is represented.
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Beebe, Lora Humphrey, Kathlene Smith, and Chad Phillips. "Effect of a Telephone Intervention Upon Self-Reported Medication Adherence and Self-Efficacy in Outpatients With Schizophrenia Spectrum Disorders (SSDs)." Issues in Mental Health Nursing 37, no. 10 (2016): 708–14. http://dx.doi.org/10.1080/01612840.2016.1214855.
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De Juan Viladegut, O., M. Llobet Farré, H. Andreu Gracia, et al. "Psychotic disorders in young patients with Prader-Willi syndrome: A case report and literature review." European Psychiatry 66, S1 (2023): S395. http://dx.doi.org/10.1192/j.eurpsy.2023.853.
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IntroductionPrader-Willi syndrome (PWS) is a genetic disorder with an estimated prevalence of 1:25,000. PWS results from defective gene expression on the paternal copy of chromosome 15. In 70% of the cases it is a deletion that means that part of the paternal chromosome 15 is missing. Maternal uniparental disomy (mUPD) is present in 25% of cases. Typical clinical features of PWS are dysmorphism, hypotonia, hyperphagia, hypogonadism and developmental delay. In addition, the syndrome is accompanied by various psychiatric symptoms that are often insufficiently known within the psychiatric field. Regarding the relationship between PWS and schizophrenia spectrum disorders (SSDs), individuals with mUPD appear to have a 3 to 4 times higher risk of psychotic symptoms than those with the deletion subtype. Psychotic episodes have an atypical presentation with recurrent episodes of confusion and rapidly fluctuating psychotic and mood symptoms.ObjectivesTo describe an unusual clinical case in order to determine the management regarding clinical approach, and provide an overview of psychotic episodes in patients with PWS for the general practitioner with the most up-to-date information on workup and management.MethodsWe report a case involving a 13-year-old woman with PWS (mUPD of chromosome 15) and mild intellectual disability (IQs 59), who presented psychotic symptomatology in the form of disorganized behavior, delusional ideation, auditory hallucinations, self-referentiality and suspicion. Parents reported that these symptoms started two days prior the day of consultation. No environmentals stressors were identified and no recent treatment changes were made. Patient’s medication consists in 150 mg sertraline per day due to anxiety control and aid in emotional and behavioral regulation.ResultsGiven the diagnostic approach of a psychotic episode (PE) in a patient with PWS, it was decided to offer 0.5mg risperidone per day, in an increasing pattern until reaching a final dose of 1.25 mg per day, presenting a global remission of the psychotic symptomatology.Recommendations for patients with PWS presenting PE are based upon systematic reviews. Patients with PWS, especially mUPD subjects, are at risk for SSDs and mood disorders. Antipsychotics (APs) are the gold standard in the treatment of SSDs, and some authors have suggested that APs protect patients with previous psychotic symptoms from relapse. It is unknown whether there is a protective effect of APs in mUPD patients who have not previously exhibited psychotic signs.ConclusionsPWS represents a good example of a genetic disease with behavioral and psychiatric symptoms that may be challenging to treat with psychotropic medications. For a better understanding of psychiatric problems in adults with PWS, longitudinal studies with careful and standardized follow-up of psychiatric symptoms in PWS are necessary.Disclosure of InterestNone Declared
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Beebe, Lora H., Kathlene Smith, Chad Phillips, Dawn Velligan, and Abbas Tavakoli. "The Long-Term Effects of Cellular Telephone-Delivered Telephone Intervention Problem Solving (TIPS) for Schizophrenia Spectrum Disorders (SSDs): Rationale and Design." Clinical Schizophrenia & Related Psychoses 11, no. 3 (2017): 164–71. http://dx.doi.org/10.3371/csrp.besm.103114.
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Hofmann, Lena A., Steffen Lau, and Johannes Kirchebner. "Advantages of Machine Learning in Forensic Psychiatric Research—Uncovering the Complexities of Aggressive Behavior in Schizophrenia." Applied Sciences 12, no. 2 (2022): 819. http://dx.doi.org/10.3390/app12020819.
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Linear statistical methods may not be suited to the understanding of psychiatric phenomena such as aggression due to their complexity and multifactorial origins. Here, the application of machine learning (ML) algorithms offers the possibility of analyzing a large number of influencing factors and their interactions. This study aimed to explore inpatient aggression in offender patients with schizophrenia spectrum disorders (SSDs) using a suitable ML model on a dataset of 370 patients. With a balanced accuracy of 77.6% and an AUC of 0.87, support vector machines (SVM) outperformed all the other ML algorithms. Negative behavior toward other patients, the breaking of ward rules, the PANSS score at admission as well as poor impulse control and impulsivity emerged as the most predictive variables in distinguishing aggressive from non-aggressive patients. The present study serves as an example of the practical use of ML in forensic psychiatric research regarding the complex interplay between the factors contributing to aggressive behavior in SSD. Through its application, it could be shown that mental illness and the antisocial behavior associated with it outweighed other predictors. The fact that SSD is also highly associated with antisocial behavior emphasizes the importance of early detection and sufficient treatment.
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Adler, Daniel A., Dror Ben-Zeev, Vincent W.-S. Tseng, et al. "Predicting Early Warning Signs of Psychotic Relapse From Passive Sensing Data: An Approach Using Encoder-Decoder Neural Networks." JMIR mHealth and uHealth 8, no. 8 (2020): e19962. http://dx.doi.org/10.2196/19962.
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Background Schizophrenia spectrum disorders (SSDs) are chronic conditions, but the severity of symptomatic experiences and functional impairments vacillate over the course of illness. Developing unobtrusive remote monitoring systems to detect early warning signs of impending symptomatic relapses would allow clinicians to intervene before the patient’s condition worsens. Objective In this study, we aim to create the first models, exclusively using passive sensing data from a smartphone, to predict behavioral anomalies that could indicate early warning signs of a psychotic relapse. Methods Data used to train and test the models were collected during the CrossCheck study. Hourly features derived from smartphone passive sensing data were extracted from 60 patients with SSDs (42 nonrelapse and 18 relapse >1 time throughout the study) and used to train models and test performance. We trained 2 types of encoder-decoder neural network models and a clustering-based local outlier factor model to predict behavioral anomalies that occurred within the 30-day period before a participant's date of relapse (the near relapse period). Models were trained to recreate participant behavior on days of relative health (DRH, outside of the near relapse period), following which a threshold to the recreation error was applied to predict anomalies. The neural network model architecture and the percentage of relapse participant data used to train all models were varied. Results A total of 20,137 days of collected data were analyzed, with 726 days of data (0.037%) within any 30-day near relapse period. The best performing model used a fully connected neural network autoencoder architecture and achieved a median sensitivity of 0.25 (IQR 0.15-1.00) and specificity of 0.88 (IQR 0.14-0.96; a median 108% increase in behavioral anomalies near relapse). We conducted a post hoc analysis using the best performing model to identify behavioral features that had a medium-to-large effect (Cohen d>0.5) in distinguishing anomalies near relapse from DRH among 4 participants who relapsed multiple times throughout the study. Qualitative validation using clinical notes collected during the original CrossCheck study showed that the identified features from our analysis were presented to clinicians during relapse events. Conclusions Our proposed method predicted a higher rate of anomalies in patients with SSDs within the 30-day near relapse period and can be used to uncover individual-level behaviors that change before relapse. This approach will enable technologists and clinicians to build unobtrusive digital mental health tools that can predict incipient relapse in SSDs.
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Escobedo-Aedo, Paula Jhoana, Ana Forjan-González, Adela Sánchez-Escribano Martínez, et al. "Investigating the Role of Insight, Decision-Making and Mentalizing in Functional Outcome in Schizophrenia: A Cross-Sectional Study." Behavioral Sciences 12, no. 2 (2022): 28. http://dx.doi.org/10.3390/bs12020028.
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Background: Recovery has become a priority in schizophrenia spectrum disorders (SSDs). This study aimed to investigate predictors of objective—general functioning and disability—and subjective—quality of life (QoL)—measures of functional outcomes in SSD. Methods: Sample: n = 77 SSD outpatients (age 18–64, IQ > 70) participating in a randomised controlled trial. Baseline data were used to build three multivariable linear regression models on: (i) general functioning—General Assessment of Functioning (GAF); (ii) disability—the World Health Organization Disability Assessment Schedule (WHODAS-2.0); and (iii) QoL—Satisfaction Life Domains Scale (SLDS). Results: Young age and being employed (R2 change = 0.211; p = 0.001), late adolescence premorbid adjustment (R2 change = 0.049; p = 0.0050), negative symptoms and disorganization (R2 change = 0.087; p = 0.025) and Theory of Mind (R2 change = 0.066, p = 0.053) predicted general functioning. Previous suicidal behaviour (R2 change = 0.068; p = 0.023) and negative and depressive symptoms (R2 change = 0.167; p = 0.001) were linked with disability. Previous suicidal behaviour (R2 change = 0.070, p = 0.026), depressive symptoms (R2 change = 0.157; p < 0.001) and illness recognition (R2 change = 0.046, p = 0.044) predicted QoL. Conclusions: Negative, disorganization and depressive symptoms, older age, unemployment, poor premorbid adjustment, previous suicide attempts and illness awareness appear to underlie a poor global functional outcome in SSD. Achieving recovery in SSD appears to require both symptomatic remission (e.g., through antipsychotics) and measures to improve mastery and relieve low mood.
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Laine, Anna, Minna Anttila, Heli Hirvonen, and Maritta Välimäki. "Feasibility of a Web-Based Psychoeducation Course and Experiences of Caregivers Living With a Person With Schizophrenia Spectrum Disorder: Mixed Methods Study." Journal of Medical Internet Research 23, no. 4 (2021): e25480. http://dx.doi.org/10.2196/25480.
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Background Schizophrenia is a severe mental illness that burdens both patients and caregivers. Objective The aim of this study is to examine the feasibility of a web-based psychoeducation course targeted at caregivers of persons with schizophrenia spectrum disorders (SSDs) and to describe their experiences of living with a person with SSD based on the material caregivers produced during the web-based course. Methods A convergent, parallel, mixed methods study design was used. First, caregivers’ engagement in the course was evaluated quantitatively. Second, the overview of the course feedback was evaluated using quantitative and qualitative methods. Third, the experiences of being a caregiver to a person with SSD were analyzed qualitatively with the thematic analysis of the writings caregivers produced during the web-based course. Results A total of 30 caregivers participated in the study and a web-based psychoeducation course. Less than two-thirds (18/30, 60%) completed the course. Content was most often logged for the first module, Orientation (3465 log-ins), and the lowest number of log-ins was recorded for the Daily life module (1061 log-ins). Feedback on the course varied; over half (10/17, 59%) of the caregivers considered the content to be very good or good, about half (9/17, 53%) considered the website layout to be good, only 6% (1/17) felt that the usability of the website was poor, and no one felt that it was very poor. From the reported experiences of being a caregiver to a person with SSD, 3 themes were formed: the caregiver’s own well-being, relationship with the person with SSD, and experience of health care services. Conclusions The web-based psychoeducation course for caregivers living with a person with SSD seems to be especially suitable for those who have little experience as a caregiver. In the future, more planning and the consideration of aspects related to the needs of specific target groups, course content, practical arrangements, and scheduling should be taken into account. In addition, although caregivers can improve their own well-being in different ways, they need regular support and cooperation from health care professionals.
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Jung, Yoon-Sun, Young-Eun Kim, Dun-Sol Go, and Seok-Jun Yoon. "The prevalence, incidence, and admission rate of diagnosed schizophrenia spectrum disorders in Korea, 2008–2017: A nationwide population-based study using claims big data analysis." PLOS ONE 16, no. 8 (2021): e0256221. http://dx.doi.org/10.1371/journal.pone.0256221.
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This study estimated the prevalence and incidence rate of schizophrenia, schizotypal, and delusional disorders (SSDD) in Korea from 2008 to 2017 and analyzed the hospital admission rate, re-admission rate, and hospitalization period. It used the Korean nationwide National Health Insurance Service claims database. SSDD patients who had at least one visit to Korea’s primary, secondary, or tertiary referral hospitals with a diagnosis of SSDD, according to the International Classification of Diseases, 10th Revision (ICD-10), were identified as SSDD cases if coded as F20-F29. Data were analyzed using frequency statistics. Results showed that the 12-month prevalence rate of SSDD increased steadily from 0.40% in 2008 to 0.45% in 2017. Analysis of the three-year cumulative prevalence rate of SSDD showed an increase from 0.51% in 2011 to 0.54% in 2017. In 2017, the five-year cumulative prevalence rate was 0.61%, and the 10-year cumulative prevalence rate was 0.75%. The hospital admission rate among SSDD patients decreased from 2008 (30.04%) to 2017 (28.53%). The incidence of SSDD was 0.05% and no yearly change was observed. The proportion of SSDD inpatients whose first hospital visit resulted in immediate hospitalization was 22.4% in 2017. Epidemiological indicators such as prevalence, incidence, and hospitalization rate play an important role in planning social and financial resource allocation. Therefore, efforts to produce more accurate epidemiological indicators are very important and this study’s findings could have a significant social impact.
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Nasyrova, Regina F., Natalia A. Shnayder, Sofia M. Osipova, et al. "Genetic Predictors of Antipsychotic Efflux Impairment via Blood-Brain Barrier: Role of Transport Proteins." Genes 14, no. 5 (2023): 1085. http://dx.doi.org/10.3390/genes14051085.
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Antipsychotic (AP)—induced adverse drug reactions (ADRs) are a current problem of biological and clinical psychiatry. Despite the development of new generations of APs, the problem of AP-induced ADRs has not been solved and continues to be actively studied. One of the important mechanisms for the development of AP-induced ADRs is a genetically-determined impairment of AP efflux across the blood-brain barrier (BBB). We present a narrative review of publications in databases (PubMed, Springer, Scopus, Web of Science E-Library) and online resources: The Human Protein Atlas; GeneCards: The Human Gene Database; US National Library of Medicine; SNPedia; OMIM Online Mendelian Inheritance in Man; The PharmGKB. The role of 15 transport proteins involved in the efflux of drugs and other xenobiotics across cell membranes (P-gp, TAP1, TAP2, MDR3, BSEP, MRP1, MRP2, MRP3, MRP4, MRP5, MRP6, MRP7, MRP8, MRP9, BCRP) was analyzed. The important role of three transporter proteins (P-gp, BCRP, MRP1) in the efflux of APs through the BBB was shown, as well as the association of the functional activity and expression of these transport proteins with low-functional and non-functional single nucleotide variants (SNVs)/polymorphisms of the ABCB1, ABCG2, ABCC1 genes, encoding these transport proteins, respectively, in patients with schizophrenia spectrum disorders (SSDs). The authors propose a new pharmacogenetic panel “Transporter protein (PT)—Antipsychotic (AP) Pharmacogenetic test (PGx)” (PTAP-PGx), which allows the evaluation of the cumulative contribution of the studied genetic biomarkers of the impairment of AP efflux through the BBB. The authors also propose a riskometer for PTAP-PGx and a decision-making algorithm for psychiatrists. Conclusions: Understanding the role of the transportation of impaired APs across the BBB and the use of genetic biomarkers for its disruption may make it possible to reduce the frequency and severity of AP-induced ADRs, since this risk can be partially modified by the personalized selection of APs and their dosing rates, taking into account the genetic predisposition of the patient with SSD.
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Mandarelli, G., F. Carabellese, G. Parmigiani, et al. "Treatment decision-making capacity in non-consensual psychiatric treatment: a multicentre study." Epidemiology and Psychiatric Sciences 27, no. 5 (2017): 492–99. http://dx.doi.org/10.1017/s2045796017000063.
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Aims.To evaluate treatment decision-making capacity (DMC) to consent to psychiatric treatment in involuntarily committed patients and to further investigate possible associations with clinical and socio-demographic characteristics of patients.Methods.131 involuntarily hospitalised patients were recruited in three university hospitals. Mental capacity to consent to treatment was measured with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T); psychiatric symptoms severity (Brief Psychiatric Rating Scale, BPRS-E) and cognitive functioning (Mini Mental State Examination, MMSE) were also assessed.Results.Mental capacity ratings for the 131 involuntarily hospitalised patients showed that patients affected by bipolar disorders (BD) scored generally better than those affected by schizophrenia spectrum disorders (SSD) in MacCAT-T appreciation (p< 0.05) and reasoning (p< 0.01). Positive symptoms were associated with poorer capacity to appreciate (r= −0.24;p< 0.01) and reason (r= −0.27;p< 0.01) about one's own treatment. Negative symptoms were associated with poorer understanding of treatment (r= −0.23;p< 0.01). Poorer cognitive functioning, as measured by MMSE, negatively affected MacCAT-T understanding in patients affected by SSD, but not in those affected by BD (SSDr= 0.37;p< 0.01; BDr= −0.01;p= 0.9). Poorer MacCAT-T reasoning was associated with more manic symptoms in the BD group of patients but not in the SSD group (BDr= −0.32;p< 0.05; SSDr= 0.03;p= 0.8). Twenty-two per cent (n= 29) of the 131 recruited patients showed high treatment DMC as defined by having scored higher than 75% ofunderstanding, appreciating and reasoningMacCAT-T subscales maximum sores and 2 atexpressing a choice. The remaining involuntarily hospitalised patients where considered to have low treatment DMC. Chi-squared disclosed that 32% of BD patients had high treatment DMC compared with 9% of SSD patients (p< 0.001).Conclusions.Treatment DMC can be routinely assessed in non-consensual psychiatric settings by the MacCAT-T, as is the case of other clinical variables. Such approach can lead to the identification of patients with high treatment DMC, thus drawing attention to possible dichotomy between legal and clinical status.
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Widiger, T. A., A. J. Frances, and M. Sweeney. "Schizophrenia spectrum disorders." Current Opinion in Psychiatry 1, no. 1 (1988): 13–18. http://dx.doi.org/10.1097/00001504-198801000-00004.
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Wright, Matthew. "Schizophrenia and schizophrenia spectrum disorders." Journal of the American Academy of Physician Assistants 33, no. 6 (2020): 46–47. http://dx.doi.org/10.1097/01.jaa.0000662412.51169.bf.
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KAHRAMAN, Nilay, and K. KARAMUSTAFALIOGLU. "SCHIZOPHRENIA SPECTRUM PERSONALITY DISORDERS." Journal of Neurobehavioral Sciences 1, no. 1 (2012): 38. http://dx.doi.org/10.5455/npakademi.20120106.
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Suetani, S., D. Siskind, J. G. Scott, and J. J. McGrath. "Disentangling schizophrenia spectrum disorders." Acta Psychiatrica Scandinavica 137, no. 4 (2018): 365–66. http://dx.doi.org/10.1111/acps.12865.
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Kim, Hyun Jung, and Emily Carol. "Autism Spectrum Disorder and Schizophrenia Spectrum Disorders." Psychiatric Annals 53, no. 5 (2023): 209–15. http://dx.doi.org/10.3928/00485713-20230424-01.
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Autism spectrum disorder (ASD) and schizophrenia spectrum disorders (SSD) are currently conceptualized as distinct illnesses. However, there has been considerable debate over the association between these two disorders. Research findings over the last decade suggest a number of overlapping domains between ASD and SSD: shared environmental risk factors, genetics, neurobiological features, brain imaging, clinical features, and comorbidities. These commonalities lead to significant challenges in differentiating between the core symptoms of ASD and SSD. Misinterpretation of symptoms is common in clinical practice, particularly while working with young people at the early stage of these neurodevelopmental conditions, such as first-episode psychosis or clinical high risk. It is essential for mental health professionals to know about research-informed clinical guidelines on how to differentiate ASD and SSD in the clinical setting. [ Psychiatr Ann . 2023;53(5):209–215.]
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Donovan, Abigail L., Julia Browne, Oliver Freudenreich, and Cori Cather. "Suicide in Schizophrenia Spectrum Disorders." Psychiatric Annals 50, no. 4 (2020): 146–51. http://dx.doi.org/10.3928/00485713-20200309-01.
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Yalçin, Nadir, Sertaç Ak, Şeref Can Gürel, and Ayçe Çeliker. "Compliance in schizophrenia spectrum disorders." International Clinical Psychopharmacology 34, no. 6 (2019): 298–304. http://dx.doi.org/10.1097/yic.0000000000000280.
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Heckers, Stephan. "Neurobiology of Schizophrenia Spectrum Disorders." Annals of the Academy of Medicine, Singapore 38, no. 5 (2009): 431–32. http://dx.doi.org/10.47102/annals-acadmedsg.v38n5p431.
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Kalin, Ned H. "Schizophrenia Spectrum Disorders and Psychosis." American Journal of Psychiatry 181, no. 10 (2024): 847–50. http://dx.doi.org/10.1176/appi.ajp.20240733.
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