|
1
|
Díaz-Cutraro L, Verdaguer-Rodríguez M, García-Mieres H, Ferrer-Quintero M, López-Carrilero R, Palma-Sevillano C, Lamarca M, Espinosa V, Barrigón ML, González-Higueras F, Pousa E, Grasa E, Lorente-Rovira E, Gutiérrez-Zotes A, Barajas A, Ruiz-Delgado I, Cid J, Moritz S, Rico J, Sevilla-Llewellyn-Jones J, Haro JM, Ochoa S. Sex-based differences in Jumping to Conclusions: a multidimensional analysis of first-episode psychosis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2025; 11:60. [PMID: 40221473 PMCID: PMC11993601 DOI: 10.1038/s41537-025-00579-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2024] [Accepted: 02/04/2025] [Indexed: 04/14/2025]
Abstract
Jumping to conclusions (JTC) bias is a hallmark cognitive bias in psychosis that involves hasty decision-making with limited evidence. Previous research has shown links between JTC and neurocognitive (NC), social cognitive (SC), metacognitive (MC), and clinical (CV) variables, but sex-based differences in these relationships remain understudied. This multicenter cross-sectional study included 121 first-episode psychosis (FEP) patients from nine Spanish mental health centers. Participants underwent comprehensive assessments of JTC, SC, NC, MC, and CV, and the interaction between JTC and sex was analysed. JTC-women attributed negative causes of events to themselves more often than non-JTC women and men, while JTC-men displayed more cognitive rigidity, slower processing speed, and better self-esteem compared to their non-JTC counterparts. Non-JTC-women showed better verbal memory recall. Logistic regression revealed distinct predictors for JTC by sex: women were influenced by negative internalization of events and visuospatial speed, while men's JTC was linked to errors in executive functions and memory. These results highlight the importance of sex-specific patterns in JTC and suggest that women might benefit from interventions targeting reflective thinking and social cognition, whereas men may need neurocognitive rehabilitation strategies.
Collapse
Affiliation(s)
- Luciana Díaz-Cutraro
- Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
- Unitat de Recerca-RISE center, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Grup MERITT, Institut de Recerca Sant Joan de Déu, Sant boi de Llobregat, Spain
- Grup COMSAL, FPCEE-Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Marina Verdaguer-Rodríguez
- Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
- Unitat de Recerca-RISE center, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Grup MERITT, Institut de Recerca Sant Joan de Déu, Sant boi de Llobregat, Spain
- Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Cerdanyola, Spain
| | | | - Marta Ferrer-Quintero
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Raquel López-Carrilero
- Unitat de Recerca-RISE center, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Grup MERITT, Institut de Recerca Sant Joan de Déu, Sant boi de Llobregat, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Spanish Metacognition Study Group, Barcelona, Spain
| | - Carol Palma-Sevillano
- Grup COMSAL, FPCEE-Blanquerna, Universitat Ramon Llull, Barcelona, Spain
- Mataró's Hospital, Consorci Sanitari del Maresme, Mataro, Spain
| | - Maria Lamarca
- Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
- Unitat de Recerca-RISE center, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Grup MERITT, Institut de Recerca Sant Joan de Déu, Sant boi de Llobregat, Spain
- Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Cerdanyola, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
| | - Victoria Espinosa
- Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
- Unitat de Recerca-RISE center, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Grup MERITT, Institut de Recerca Sant Joan de Déu, Sant boi de Llobregat, Spain
| | - Mara Luisa Barrigón
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | | | - Esther Pousa
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Spanish Metacognition Study Group, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Eva Grasa
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Spanish Metacognition Study Group, Barcelona, Spain
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - Ester Lorente-Rovira
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Spanish Metacognition Study Group, Barcelona, Spain
- Psychiatry Service, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Alfonso Gutiérrez-Zotes
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
- Hospital Universitari Institut Pere Mata, Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
| | - Ana Barajas
- Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Cerdanyola, Spain
- Spanish Metacognition Study Group, Barcelona, Spain
| | - Isabel Ruiz-Delgado
- Spanish Metacognition Study Group, Barcelona, Spain
- Unidad de Salud Mental Comunitaria Málaga Norte, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Jordi Cid
- Spanish Metacognition Study Group, Barcelona, Spain
- Mental Health & Addiction Research Group, IdiBGi, Institut d'Assistència Sanitària, Girona, Girona, Spain
| | - Steffen Moritz
- Spanish Metacognition Study Group, Barcelona, Spain
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Rico
- Grup COMSAL, FPCEE-Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Julia Sevilla-Llewellyn-Jones
- Institute of Psychiatry and Mental Health, Health Research Institute (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - Josep Maria Haro
- Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain
- Unitat de Recerca-RISE center, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain
| | - Susana Ochoa
- Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain.
- Unitat de Recerca-RISE center, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.
- Grup MERITT, Institut de Recerca Sant Joan de Déu, Sant boi de Llobregat, Spain.
- Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Madrid, Spain.
- Spanish Metacognition Study Group, Barcelona, Spain.
| |
Collapse
|
|
2
|
Hoeksema L, Bruins J, Timmerman ME, Castelein S. Sex differences and age of onset in well-being and recovery in people with psychotic disorders. A PHAMOUS study. Schizophr Res 2025; 277:86-92. [PMID: 40023944 DOI: 10.1016/j.schres.2025.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 12/20/2024] [Accepted: 01/31/2025] [Indexed: 03/04/2025]
Abstract
PURPOSE Women generally have a later age of onset, and may therefore have a more favourable course of psychotic illness than men regarding psychopathology. Little is known about a broader range of outcomes, including well-being and recovery, and about the influence of age of onset. This study examines longitudinal sex-related and age of onset-related differences in well-being and recovery of people with a psychotic disorder with long illness durations. METHODS Routine outcome monitoring data (2012-2021) of n = 3843 patients were used. Well-being (quality of life and personal recovery) and recovery (clinical and societal recovery and psychosocial functioning) were assessed. Latent class growth analysis (LCGA) was performed to assess whether classes with different trajectories of well-being and recovery could be identified. Classes were related to sex and (early/late) age of onset of psychosis (EOP/LOP). RESULTS LCGA identified five classes with varying combinations in levels of well-being and recovery, which were stable over time. Sex, age of onset and the combination of these two were significantly related to class membership. Women and individuals with LOP were more prevalent in better functioning classes than men and individuals with EOP. CONCLUSION This study showed sex differences in long-term recovery patterns of psychosis. Not only women but also individuals with LOP had a higher chance of better well-being and recovery, while men with EOP were at risk for worse outcomes. Taking these sex differences into account when deciding on policy and treatment protocols for individual patients might provide better mental health care to people with psychosis.
Collapse
Affiliation(s)
- Linda Hoeksema
- Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands.
| | - Jojanneke Bruins
- Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Marieke E Timmerman
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Psychometrics & Statistics, Groningen, the Netherlands
| | - Stynke Castelein
- Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| |
Collapse
|
|
3
|
Salvadé A, Golay P, Abrahamyan L, Bonnarel V, Solida A, Alameda L, Ramain J, Conus P. Gender differences in first episode psychosis: Some arguments to develop gender specific treatment strategies. Schizophr Res 2024; 271:300-308. [PMID: 39084105 DOI: 10.1016/j.schres.2024.07.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/20/2024] [Accepted: 07/24/2024] [Indexed: 08/02/2024]
Abstract
INTRODUCTION Some aspects of gender differences in patients with schizophrenia spectrum disorders (SSD) have been studied, especially in cross-sectional designs and with a short-term follow-up. However, only a few studies have considered the evolution during the follow-up of SSD patients according to their gender. In this study, we explore gender differences from the time of entry in an early intervention program for psychosis, up to three years follow-up. METHODS We conducted a prospective study including a cohort of 474 patients treated at the Treatment and Early Intervention in Psychosis (TIPP) program, 319 men and 155 women, having presented a first episode of psychosis (FEP). Data regarding premorbid and baseline sociodemographic, psychopathological and patient functioning, were collected. These data were reassessed longitudinally after 2, 6, 12, 18, 24, 30 and 36 months after entry in TIPP. RESULTS Regarding premorbid and baseline characteristics, woman developed threshold symptoms of a FEP 1 year later than men on average. Women were more likely to be married, men were more likely to live in pension or care home facility or to be homeless. Women displayed a higher rate of history of suicide attempts and exposure to childhood trauma, while men were more likely to have a forensic history, a history of abuse of alcohol and cannabis as well as a dependency to cannabis at the time of entry in TIPP. Regarding evolution, men were more prone to violent acts and were less likely to decrease their usage of substances. The longitudinal analysis highlighted that men displayed greater negative symptoms over the entire treatment period, lower functioning after 6 months and on all assessment points after. Both genders displayed similar rate of improvement in these 3 dimensions over time. CONCLUSION Our study confirms that there are some gender differences in the early phase of psychosis that may require differentiation of assessment and treatment to improve recovery.
Collapse
Affiliation(s)
- Aude Salvadé
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Philippe Golay
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Av. Vinet 30, Lausanne, Switzerland
| | - Lilith Abrahamyan
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Vincent Bonnarel
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alessandra Solida
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Département de psychiatrie de l'adulte II, Centre Neuchâtelois de Psychiatrie, Neuchâtel, Switzerland
| | - Luis Alameda
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK; Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Julie Ramain
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Training and Research Institute in Mental Health (IFRSM), Neuchâtel Centre of Psychiatry, Neuchâtel, Switzerland
| | - Philippe Conus
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
|
4
|
Li W, Cao X, Liang Q, Li Y, Zhou C, Du J, Xie S. Gender differences in cognitive improvements after two months of atypical antipsychotic treatment in first episode schizophrenia. Front Psychiatry 2024; 15:1369532. [PMID: 38742135 PMCID: PMC11089100 DOI: 10.3389/fpsyt.2024.1369532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Aims This study aims to explore the gender differences in cognitive improvements after two months of atypical antipsychotic treatment in first episode schizophrenia (FES). Methods 82 patients with FES, including 50 male patients and 32 female patients, were enrolled in the present study. Positive and Negative Syndrome Scale (PANSS) and MATRICS Consensus Cognitive Battery (MCCB) were respectively conducted to evaluate the clinical symptoms and cognitive function of patients with FES at baseline and after treatment. Repeated measure ANOVA was performed to compare gender differences in cognitive domains scores between baseline and 2-month follow-up. Stepwise liner regression model was performed to explore the effect factors of cognitive improvements in patients. Results There was no significant difference in age of onset, education years, PANSS scores, duration of untreated psychosis and Olanzapine equivalent doses between male and female patients (all p > 0.05). In the comparisons of cognition function, male patients exhibited better performance in social cognition compared with female patients at baseline (t = 3.20, p < 0.05). After treatment, improvements of attention/vigilance and working memory were both found in male patients and female patients (attention/vigilance, F = 11.867, p < 0.05; working memory, F = 18.265, p < 0.05). In addition, improvement of speed of information processing was only found in female patients (F = 11.65, p < 0.01). Significant interaction between time and gender was found in speed information of processing (F = 4.140, p = 0.045). Stepwise liner regression model revealed that improvements of negative symptoms promote improvements of cognitive function in female patients (all p < 0.05). Conclusions Our findings revealed gender differences of cognitive improvements in patients with FES after 2-month treatment. It provides new evidence for gender differences in cognitive symptoms of schizophrenia, and also provides preliminary clues for further individualized cognitive intervention strategies.
Collapse
Affiliation(s)
| | | | | | | | | | - Jinglun Du
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shiping Xie
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
|
5
|
Hjelmervik H, Hausmann M, Bless JJ, Harkestad N, Hugdahl K, Laloyaux J. Estradiol driven change in hallucination proneness across the menstrual cycle as studied with a white noise paradigm. Psychoneuroendocrinology 2024; 159:106410. [PMID: 37832212 DOI: 10.1016/j.psyneuen.2023.106410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/23/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023]
Abstract
The estrogen hypothesis for schizophrenia suggests neuroprotective effects of estrogen for the development of the disorder and for symptom severity, including auditory hallucinations. Furthermore, estrogen has shown enhancing effects on cognitive control, a function that is also implicated in auditory hallucinations. Whether estrogen affects the tendency to hallucinate in healthy participants, and the potential mediating role of cognitive control, has not yet been studied. Therefore, the current study aimed to test these relationships by using a white noise paradigm in combination with a N-back working memory task in which cognitive load could be manipulated. The paradigm used simulates a hallucinatory state by induction of negative emotions and drainage of cognitive resources. The simultaneous exposure to white noise elicit experiences of hearing voices (false alarms). In a between-subject design, forty-two participants were tested during the menstrual cycle in either the early follicular phase (low estradiol) or late follicular phase (high estradiol). A 2(Cycle Phase) x2(N-back task) ANOVA showed a main-effect of cycle phase on number of experienced hallucinations in the white noise task, with a significantly higher number of reported hallucinations in the early follicular phase. Furthermore, estradiol was found to predict number of hallucinations. No interaction effect of cycle phase and available cognitive resources was found. The results suggest an estradiol-related change in hallucination proneness across the menstrual cycle, but the idea that cognitive functioning mediates this relationship was not supported. Overall, the study supports protective effects of estradiol on hallucination proneness in line with the estrogen-hypothesis of schizophrenia, and that such effects are not specific to the disease.
Collapse
Affiliation(s)
- Helene Hjelmervik
- School of Health Sciences, Kristiania University college, Bergen, Norway.
| | | | - Josef J Bless
- Institute of Medical Psychology, LMU Munich, Munich, Germany
| | - Nina Harkestad
- Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | | |
Collapse
|
|
6
|
Hofer A, Biedermann F, Kaufmann A, Kemmler G, Pfaffenberger NM, Yalcin-Siedentopf N. Self-esteem in stabilized individuals with chronic schizophrenia: association with residual symptoms and cognitive functioning. Eur Arch Psychiatry Clin Neurosci 2023; 273:1737-1746. [PMID: 36602648 PMCID: PMC10713693 DOI: 10.1007/s00406-022-01538-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023]
Abstract
Low self-esteem is regarded as a barrier to recovery from schizophrenia and the identification of factors affecting this psychological characteristic may help to implement effective therapeutic interventions. To this end, the present study aimed to assess whether residual symptoms of the disorder and performance on a comprehensive neuropsychological test battery might differently impact self-esteem among 70 stabilized outpatients with chronic schizophrenia from public outpatient mental health services. Self-esteem inter-correlated with the severity of overall symptomatology, affective and negative symptoms, with premorbid intelligence, and with performance in the domains of verbal learning and memory, visual memory, working memory, and verbal fluency. Residual affective symptoms, premorbid intelligence, and female sex predicted poorer self-esteem in multiple linear regression analysis. The findings of this study implicate that next to psychological interventions therapeutic strategies that specifically target affective symptoms of schizophrenia may have a beneficial impact on patients' self-esteem.
Collapse
Affiliation(s)
- Alex Hofer
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
| | - Falko Biedermann
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Alexandra Kaufmann
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Georg Kemmler
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Nicole M Pfaffenberger
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Nursen Yalcin-Siedentopf
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| |
Collapse
|
|
7
|
Spinazzola E, Meyer Z, Gray ZI, Azlan A, Wratten C, Rayat M, Hiscott L, Kyriakou L, Cottrell D, Pritchard M, Pinto da Costa M, Quattrone A, Stewart R, Di Forti M, Murray RM, Quattrone D. The effect of the COVID-19 pandemic on the treated incidence of psychotic disorders in South London. Psychiatry Res 2023; 329:115483. [PMID: 37783096 DOI: 10.1016/j.psychres.2023.115483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
Evidence on the impact of the COVID-19 pandemic on psychotic disorders is so far scarce. We conducted an incidence study to ascertain rates of first-episode psychosis (FEP) before and during the COVID-19 pandemic in South London. We screened clinical records of individuals living in the London boroughs of Southwark and Lambeth who were referred to the early intervention services before (from 1/3/2019 to 28/2/2020) and during (from 1/3/2020 to 28/2/2021) the COVID-19 pandemic. We used the Office for National Statistics to determine the population at risk. We computed crude and sex-age standardised FEP incidence per 100,000 person-years. We used Poisson regression to calculate the incidence rate ratio (IRR) across the COVID-19 pandemic. A total of 321 incident cases of FEP were identified during the COVID-19 pandemic, accounting for a crude rate of 69.8 (95% CI 62.1-77.4) per 100,000 person-years. The crude rate for the year before was 47.5 (95% CI 41.2-53.8). The incidence variation between the two years accounted for an adjusted IRR of 1.45 (95% CI 1.22-1.72). The pandemic was accompanied by a 45% spike in the rates of first-episode psychosis. This finding should inform public health research and demonstrate the need for adequate resources for secondary care.
Collapse
Affiliation(s)
- Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Zeryab Meyer
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Zoë Isabella Gray
- Avon and Wiltshire Mental Health Partnership NHS Trust, United Kingdom
| | - Aryn Azlan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Camille Wratten
- South West London and Saint George's Mental Health NHS Trust, United Kingdom
| | - Mandeep Rayat
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Lauren Hiscott
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Loui Kyriakou
- Hertfordshire Partnership University NHS Foundation Trust, United Kingdom
| | | | - Megan Pritchard
- South London and Maudsley NHS Foundation Trust, United Kingdom
| | - Mariana Pinto da Costa
- South London and Maudsley NHS Foundation Trust, United Kingdom; University of Porto, Institute of Biomedical Sciences Abel Salazar, Porto, Portugal; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Andrea Quattrone
- South London and Maudsley NHS Foundation Trust, United Kingdom; University of Porto, Institute of Biomedical Sciences Abel Salazar, Porto, Portugal
| | - Robert Stewart
- South London and Maudsley NHS Foundation Trust, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
| | - Marta Di Forti
- South London and Maudsley NHS Foundation Trust, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom
| | - Robin MacGregor Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
| | - Diego Quattrone
- South London and Maudsley NHS Foundation Trust, United Kingdom; National Institute for Health and Care Research, Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience. King's College of London, London, United Kingdom.
| |
Collapse
|
|
8
|
Ventura J, Subotnik KL, Han S, Hellemann GS, Green MF, Nuechterlein KH. The relationship between sex and functional outcome in first-episode schizophrenia: the role of premorbid adjustment and insight. Psychol Med 2023; 53:6878-6887. [PMID: 38314778 PMCID: PMC10600815 DOI: 10.1017/s0033291723000442] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 01/23/2023] [Accepted: 02/08/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Studies that examined sex differences in first-episode patients consistently show that males compared to females have poor premorbid adjustment, earlier age of onset, worse clinical characteristics, and poorer outcomes. However, little is known about potential mediators that could explain these sex differences. METHODS Our sample consisted of 137 individuals with first episode schizophrenia (males, n = 105; 77%) with a mean age of 22.1(s.d. = 4.1) years and mean education of 12.5(s.d. = 1.7) years. At entry, patients were within 2 years of their first psychotic episode onset. Baseline assessments were conducted for premorbid adjustment, symptoms, cognitive functioning, insight, and at 6-months for role and social functioning. RESULTS Males as compared to females had poorer premorbid adjustment across several key developmental periods (p < 0.01), an earlier age of onset [M = 20.3(3.3) v. 22.8(5.6), p = 0.002], more negative symptoms (p = 0.044), poorer insight (p = 0.031), and poorer baseline and 6-month role (p = 0.002) and social functioning (p = 0.034). Several of these variables in which males showed impairment were significant predictors of 6-month role and social functioning. Premorbid adjustment and insight mediated the relationship between sex and role and social functioning at 6-months, but not negative symptoms. DISCUSSION Males compared to females were at lower levels across several key premorbid and clinical domains which are strongly associated with functional outcome supporting the hypothesis that males might have a more disabling form of schizophrenia. The relationship between sex with role and social functioning was mediated through premorbid adjustment and insight suggesting pathways for understanding why females might have a less disabling form of schizophrenia.
Collapse
Affiliation(s)
- Joseph Ventura
- UCLA Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, University of California, Los Angeles, California, USA
| | - Kenneth L. Subotnik
- UCLA Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, University of California, Los Angeles, California, USA
| | - Sam Han
- Graduate School of Education and Psychology, Pepperdine University, Malibu, California, USA
| | - Gerhard S. Hellemann
- School of Public Health, Biostatistics Department, University of Alabama, Tuscaloosa, Alabama, USA
| | - Michael F. Green
- UCLA Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, University of California, Los Angeles, California, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Keith H. Nuechterlein
- UCLA Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, University of California, Los Angeles, California, USA
- UCLA Department of Psychology, University of California, Los Angeles, California, USA
| |
Collapse
|
|
9
|
Cloutier B, Lecomte T, Diotte F, Lamontagne J, Abdel-Baki A, Daneault JG, Gélineau Rabbath ME, de Connor A, Perrine C. Improving Romantic Relationship Functioning Among Young Men With First-Episode Psychosis: Impact of a Novel Group Intervention. Behav Modif 2023; 47:1170-1192. [PMID: 37496322 PMCID: PMC10403962 DOI: 10.1177/01454455231186586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Previous research has highlighted many of the challenges faced by individuals with psychosis in romantic relationships. The present study aimed to evaluate the impact of a novel group intervention for men with first-episode psychosis (FEP) on dating success, romantic and sexual functioning, self-esteem, self-stigma, mentalizing skills, and symptomatology, while using a repeated single-case experimental design and comparing results across two treatment modalities (i.e., in-person or online). Twenty-seven participants from five treatment sites completed a 12-week group intervention. Qualitative data was also collected to assess participants' subjective experiences with the program. In both modalities, significant improvements were observed for romantic functioning, mentalizing skills, and symptomatology, with effect sizes ranging from small to large. Several participants also attended more dates and entered committed relationships after the intervention. Most participants were satisfied with the program and many felt that they had learned new skills and gained confidence in dating. Future research should replicate these findings in larger and more inclusive samples.
Collapse
Affiliation(s)
| | | | | | | | - Amal Abdel-Baki
- Centre hospitalier de l’Université de Montréal, Clinique JAP, QC, Canada
| | | | | | - Alexandre de Connor
- Centre hospitalier universitaire de Montpellier, Centre de rétablissement et de réhabilitation Jean-Minvieille, Montpellier, France
| | - Cécile Perrine
- Établissement public de santé mentale Caen, Unité de réhabilitation psychosociale Ariane, Caen, France
| |
Collapse
|
|
10
|
MacDonald K, Mohan G, Pawliuk N, Joober R, Padmavati R, Rangaswamy T, Malla A, Iyer SN. Comparing treatment delays and pathways to early intervention services for psychosis in urban settings in India and Canada. Soc Psychiatry Psychiatr Epidemiol 2023; 58:547-558. [PMID: 36571623 PMCID: PMC10088896 DOI: 10.1007/s00127-022-02414-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/21/2022] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Although extensively studied in high-income countries (HICs) and less so in low- and middle-income countries (LMICs), pathways to care and treatment delays in early psychosis have not been compared across contexts. We compared pathways to early intervention for psychosis in an HIC (Montreal, Canada) and an LMIC (Chennai, India). We hypothesised that the duration of untreated psychosis (DUP) would be longer in Chennai. METHODS The number of contacts preceding early intervention, referral sources, first contacts, and DUP and its referral and help-seeking components of first-episode psychosis patients at both sites were similarly measured and compared using chi-square analyses and t tests/one-way ANOVAs. RESULTS Overall and help-seeking DUPs of Chennai (N = 168) and Montreal (N = 165) participants were not significantly different. However, Chennai patients had shorter referral DUPs [mean = 12.0 ± 34.1 weeks vs. Montreal mean = 13.2 ± 28.7 weeks; t(302.57) = 4.40; p < 0.001] as the early intervention service was the first contact for 44% of them (vs. 5% in Montreal). Faith healers comprised 25% of first contacts in Chennai. Those seeing faith healers had significantly shorter help-seeking but longer referral DUPs. As predicted, most (93%) Montreal referrals came from medical sources. Those seeing psychologists/counsellors/social workers as their first contact had longer DUPs. CONCLUSION Differences in cultural views about mental illnesses and organizational structures shape pathways to care and their associations with treatment delays across contexts. Both formal and informal sources need to be targeted to reduce delays. Early intervention services being the first portal where help is sought can reduce DUP especially if accessed early on in the illness course.
Collapse
Affiliation(s)
- Kathleen MacDonald
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Wilson Pavilion, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada
| | - Greeshma Mohan
- Schizophrenia Research Foundation (SCARF), R-7A North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600 101, India
| | - Nicole Pawliuk
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Wilson Pavilion, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Wilson Pavilion, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada
| | - Ramachandran Padmavati
- Schizophrenia Research Foundation (SCARF), R-7A North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600 101, India
| | - Thara Rangaswamy
- Schizophrenia Research Foundation (SCARF), R-7A North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu, 600 101, India
| | - Ashok Malla
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Wilson Pavilion, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada
| | - Srividya N Iyer
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Wilson Pavilion, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
| |
Collapse
|
|
11
|
Cuñat O, Del Hoyo-Buxo B, Vila-Badia R, Serra-Arumí C, Butjosa A, Del Cacho N, Colomer-Salvans A, Dolz M, Cuevas-Esteban J, Iglesias-González M, Usall J, Profep Group. Negative symptoms in drug-naive patients with a first-episode psychosis (FEP). Asian J Psychiatr 2023; 81:103448. [PMID: 36652842 DOI: 10.1016/j.ajp.2023.103448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/02/2023] [Accepted: 01/02/2023] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Negative symptoms are nuclear features of schizophrenia that may be present from the onset of the disease. In recent years, it has been described 2 subdomains of negative symptoms: experiential and expressive deficits. The aim of the study is to examine the relationship between negative symptoms and demographic and clinical variables in patients with first-episode psychosis. Also, to explore whether there are differences in the association among these variables and negative symptoms when divided into both subdomains. MATERIAL AND METHODS A cross-sectional study was performed in 160 patients (52 females and 108 males) with a diagnosis of a first episode psychosis. A questionnaire was administered to collect demographic and clinical variables. RESULTS A backward stepwise linear regressions analysis was performed in order to observe potential associations between demographic and clinical variables and the presence of negative symptoms. All three models are predicted by worse PSP score, a higher CDSS, a higher disorganized factor score and a lower excited factor score. A longer duration of untreated psychosis (DUP) is associated to a higher score in the experiential deficit subdomain only. CONCLUSIONS Our work highlights some clinical and phenomenological differences between experiential and expressive deficits. We think that taking into account both subdomains in future studies may lead to more accurate clinical assessment and interventions.
Collapse
Affiliation(s)
- O Cuñat
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain.
| | - B Del Hoyo-Buxo
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - R Vila-Badia
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - C Serra-Arumí
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - A Butjosa
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Hospital Infanto-juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, CIBERSAM, Esplugues de Llobregat, Spain
| | - N Del Cacho
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - A Colomer-Salvans
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - M Dolz
- Hospital Infanto-juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, CIBERSAM, Esplugues de Llobregat, Spain
| | - J Cuevas-Esteban
- Hospital Universitari Germans Trias i Pujol, CIBERSAM, Badalona, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - M Iglesias-González
- Hospital Universitari Germans Trias i Pujol, CIBERSAM, Badalona, Spain; Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - J Usall
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Profep Group
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| |
Collapse
|
|
12
|
Watson M, Filia K, Stevens A, Cotton S, Nelson B, Ratheesh A. A systematic review and meta-analysis of global and social functioning among people at risk of bipolar disorder. J Affect Disord 2023; 321:290-303. [PMID: 36306929 DOI: 10.1016/j.jad.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/04/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Functional status could predict development of bipolar disorder (BD) or have clinical significance. The relationship between BD risk and functioning is poorly understood. We undertook a systematic review examining the global and social functioning of those at risk for BD. METHODS We examined observational studies comparing a risk sample with healthy controls or full-threshold BD participants, using measures of global or social functioning. Risk status included family history of BD, meeting risk criteria, or having prodromal symptomatology, or premorbid functioning of persons with BD. Medline, PsycINFO, and Embase were searched. The Newcastle-Ottawa Scale for Cross-Sectional Studies was used to assess quality. Meta-analyses were performed where possible. RESULTS 7215 studies were screened and 40 studies were included (8474 participants). Risk samples had poorer functioning than controls, and superior functioning to participants with BD. Meta-analysis indicated poorer global functioning among persons with familial risk compared to healthy controls (mean global functional difference: 5.92; 95 % confidence interval: 7.90, 3.95; mean premorbid functioning difference: 2.31; 95 % confidence interval: 0.70, 3.92). Studies with higher proportions of female participants had slightly poorer global functioning. High heterogeneity was attributable functional measures and potentially functionally differential subgroups within the risk samples. LIMITATIONS Broader measures of functioning, such as neurocognition and behavioural measures, were excluded. Measures of global functioning are limited by conflating functioning and symptoms. CONCLUSIONS Functioning in the BD risk populations is intermediate to that of healthy controls and persons with BD, indicating their value in definitions of BD risk, in itself a likely heterogeneous state.
Collapse
Affiliation(s)
- M Watson
- The University of Melbourne, Centre for Youth Mental Health, Parkville 3052, Australia; The University of Melbourne, Melbourne Medical School, Parkville 3052, Australia
| | - K Filia
- Orygen, Parkville 3052, Australia
| | | | - S Cotton
- Orygen, Parkville 3052, Australia
| | - B Nelson
- Orygen, Parkville 3052, Australia
| | - A Ratheesh
- Orygen, Parkville 3052, Australia; The University of Melbourne, Centre for Youth Mental Health, Parkville 3052, Australia.
| |
Collapse
|
|
13
|
Kwakernaak S, Cahn W, Janssen R. Is change over time in psychotic symptoms related to social functioning? Int J Soc Psychiatry 2022; 68:1571-1579. [PMID: 34387531 DOI: 10.1177/00207640211039248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In psychosis, treatment often focuses on symptom reduction whereas social functioning is also essential. In this study, we investigate positive psychotic symptoms and medication use in relation to social functioning over a 3-year time-period in 531 patients diagnosed with psychosis. Furthermore, relations of positive symptoms with needs for care and quality of life were also investigated. METHOD Using repeated measures analysis, changes were measured over time. Hereafter, mixed model analyses were performed to determine the associations of social functioning, needs for care, and quality of life with psychotic symptoms and patient characteristics. Finally, we assessed differences in symptoms and medication dose between those with an increase and those with a decrease in social functioning. RESULTS Patients significantly improved in social functioning, while psychotic symptoms increased. Improvement in social functioning was associated with younger age, higher IQ, and lower social functioning at T1, but not with positive symptoms. Also, improvement in social functioning was found to be related to a decrease in the dose of clozapine. Improvement in social functioning occurs despite worsening of positive symptoms. CONCLUSIONS The findings suggest the need to further explore the relation between symptomatology, social functioning, and medication use. In the treatment of psychotic disorders, one should reconsider the strong focus on reducing psychotic symptoms. The current focus needs to shift much more toward improving functional outcome, especially when the patient expresses a desire for change in this respect.
Collapse
Affiliation(s)
- Sascha Kwakernaak
- Altrecht Mental Health Care, Utrecht, The Netherlands.,Department of Tranzo Scientific Center for Care and Welfare, Tilburg University, The Netherlands
| | | | - Wiepke Cahn
- Altrecht Mental Health Care, Utrecht, The Netherlands.,Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands
| | - Richard Janssen
- Department of Tranzo Scientific Center for Care and Welfare, Tilburg University, The Netherlands.,Department of Health Care Governance, Erasmus University Rotterdam, The Netherlands
| |
Collapse
|
|
14
|
Vázquez-Reyes A, Ángeles Pérez-San-Gregorio M, Martín-Rodríguez A, Vázquez-Morejón AJ. Ten-year follow-up of social functioning and behaviour problems in people with schizophrenia and related disorders. Int J Soc Psychiatry 2022; 68:1324-1335. [PMID: 34096361 DOI: 10.1177/00207640211023083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In recent years, several variables in the course of schizophrenia and related psychotic disorders have been studied. However, an instrumental analysis of the evolution of social functioning and behaviour problems has scarcely been explored. AIM To analyse the evolution of social functioning and behaviour problems and find any diagnosis or gender differences. METHOD The Social Functioning Scale (SFS) and the Behaviour Problems Inventory (BPI) were administered in Stages I (2003-2007) and II (2014-2017) to 100 close relatives of patients under treatment at a Community Mental Health Unit. A related samples t-test, analysis of variance and multivariate analysis of variance were performed to study the evolution and differences in social functioning and behaviour problems. Then a stepwise multiple linear regression analysis was done to predict the evolution of social functioning. RESULTS No deterioration in the evolution of social functioning or behaviour problems was observed, and schizophrenia patient scores were lower. Women scored higher in withdrawal/social engagement, interpersonal behaviour, independence-performance, independence-competence and total social functioning, with no significant differences in behaviour problems. Previous social functioning, underactivity/social withdrawal and education are predictive factors in the evolution of social functioning. Conclusion: The results show the need for implementing psychosocial intervention programs that promote functional recovery and keep problems from becoming chronic.
Collapse
Affiliation(s)
| | - María Ángeles Pérez-San-Gregorio
- Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatment, University of Seville, Seville, Spain
| | - Agustín Martín-Rodríguez
- Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatment, University of Seville, Seville, Spain
| | - Antonio J Vázquez-Morejón
- Mental Health Service, University Hospital Virgen del Rocío, Seville, Spain.,Faculty of Psychology, Department of Personality, Assessment, and Psychological Treatment, University of Seville, Seville, Spain
| |
Collapse
|
|
15
|
Serra-Navarro M, Amoretti S, Verdolini N, Forte MF, Sánchez-Torres AM, Vieta E, Clougher D, Lobo A, González-Pinto A, Panadero R, Roldán A, Carvalho AF, de la Serna E, Toll A, Ramos-Quiroga JA, Torrent C, Cuesta MJ, Bernardo M. Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: Differences between males and females. Front Psychiatry 2022; 13:982583. [PMID: 36339856 PMCID: PMC9632657 DOI: 10.3389/fpsyt.2022.982583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/28/2022] [Indexed: 01/10/2023] Open
Abstract
Background Deficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset. Materials and methods The initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up. Results FEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = -0.307, p = 0.012) were significantly associated with functioning. Conclusion Our data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended.
Collapse
Affiliation(s)
- Maria Serra-Navarro
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Silvia Amoretti
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, Italy
| | - María Florencia Forte
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Ana M. Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Derek Clougher
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Medicine and Psychiatry, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza University, Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain
- Department of Psychiatry, University of the Basque Country (UPV-EHU), Vitoria-Gasteiz, Spain
| | - Rocío Panadero
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Institute of Psychiatry and Mental Health, Universidad Complutense, IiSGM, Madrid, Spain
| | - Alexandra Roldán
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - André F. Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT), School of Medicine, Barwon Health, The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR881, Institut Clínic de Neurociències, Hospital Clínic Universitari, CIBERSAM, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Alba Toll
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J. A. Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d’Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
- Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Catalonia, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Carla Torrent
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| |
Collapse
|
|
16
|
Sex and gender differences in symptoms of early psychosis: a systematic review and meta-analysis. Arch Womens Ment Health 2022; 25:679-691. [PMID: 35748930 DOI: 10.1007/s00737-022-01247-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/12/2022] [Indexed: 11/02/2022]
Abstract
First-episode psychosis (FEP) can be quite variable in clinical presentation, and both sex and gender may account for some of this variability. Prior literature on sex or gender differences in symptoms of psychosis have been inconclusive, and a comprehensive summary of evidence on the early course of illness is lacking. The objective of this study was to conduct a systematic review and meta-analysis of the literature to summarize prior evidence on the sex and gender differences in the symptoms of early psychosis. We conducted an electronic database search (MEDLINE, Scopus, PsycINFO, and CINAHL) from 1990 to present to identify quantitative studies focused on sex or gender differences in the symptoms of early psychosis. We used random effects models to compute pooled standardized mean differences (SMD) and risk ratios (RR), with 95% confidence intervals (CI), for a range of symptoms. Thirty-five studies met the inclusion criteria for the systematic review, and 30 studies were included in the meta-analysis. All studies examined sex differences. Men experienced more severe negative symptoms (SMD = - 0.15, 95%CI = - 0.21, - 0.09), whereas women experienced more severe depressive symptoms (SMD = 0.21, 95%CI = 0.14, 0.27) and had higher functioning (SMD = 0.16, 95%CI = 0.10, 0.23). Women also had a lower prevalence of substance use issues (RR = 0.65, 95%CI = 0.61, 0.69). Symptoms of early psychosis varied between men and women; however, we were limited in our ability to differentiate between biological sex and gender factors. These findings may help to inform early detection and intervention efforts to better account for sex and gender differences in early psychosis presentation.
Collapse
|
|
17
|
Giordano GM, Caporusso E, Pezzella P, Galderisi S. Updated perspectives on the clinical significance of negative symptoms in patients with schizophrenia. Expert Rev Neurother 2022; 22:541-555. [PMID: 35758871 DOI: 10.1080/14737175.2022.2092402] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Negative symptoms in schizophrenia are associated with poor response to available treatments, poor quality of life, and functional outcome. Therefore, they represent a substantial burden for people with schizophrenia, their families, and health-care systems. AREAS COVERED In this manuscript, we will provide an update on the conceptualization, assessment, and treatment of this complex psychopathological dimension of schizophrenia. EXPERT OPINION Despite the progress in the conceptualization of negative symptoms and in the development of state-of-the-art assessment instruments made in the last decades, these symptoms are still poorly recognized, and not always assessed in line with current conceptualization. Every effort should be made to disseminate the current knowledge on negative symptoms, on their assessment instruments and available treatments whose efficacy is supported by research evidence. Longitudinal studies should be promoted to evaluate the natural course of negative symptoms, improve our ability to identify the different sources of secondary negative symptoms, provide effective interventions, and target primary and persistent negative symptoms with innovative treatment strategies. Further research is needed to identify pathophysiological mechanisms of primary negative symptoms and foster the development of new treatments.
Collapse
|
|
18
|
Abstract
Most psychiatric illnesses, such as schizophrenia, show profound sex differences in incidence, clinical presentation, course, and outcome. Fortunately, more recently the literature on sex differences and (to a lesser extent) effects of sex steroid hormones is expanding, and in this review we have focused on such studies in psychosis, both from a clinical/epidemiological and preclinical/animal model perspective. We begin by briefly describing the clinical evidence for sex differences in schizophrenia epidemiology, symptomatology, and pathophysiology. We then detail sex differences and sex hormone effects in behavioral animal models of psychosis, specifically psychotropic drug-induced locomotor hyperactivity and disruption of prepulse inhibition. We expand on the preclinical data to include developmental and genetic models of psychosis, such as the maternal immune activation model and neuregulin transgenic animals, respectively. Finally, we suggest several recommendations for future studies, in order to facilitate a better understanding of sex differences in the development of psychosis.
Collapse
|
|
19
|
Vila‐Badia R, Kaplan M, Butjosa A, Del Cacho N, Serra‐Arumí C, Colomer Salvans A, Esteban‐Sanjusto M, Iglesias‐González M, Cuñat O, Hoyo‐Buxo B, Profep G, Usall J. Suicidal behavior in First‐Episode Psychosis: the relevance of age, perceived stress and depressive symptoms. Clin Psychol Psychother 2022; 29:1364-1373. [DOI: 10.1002/cpp.2716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/06/2022]
Affiliation(s)
- R. Vila‐Badia
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
- Universitat de Barcelona, Facultat de Medicina i Ciències de la Salut Barcelona Spain
| | - M. Kaplan
- Hospital Neuropsiquiátrico B.A.Moyano Buenos Aires Argentina
| | - A. Butjosa
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Hospital Infanto‐juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, CIBERSAM Barcelona España
| | - N. Del Cacho
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
| | - C. Serra‐Arumí
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
- Universitat de Barcelona, Facultat de Medicina i Ciències de la Salut Barcelona Spain
| | - A. Colomer Salvans
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
| | - M. Esteban‐Sanjusto
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
| | | | - O. Cuñat
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
| | - B. Hoyo‐Buxo
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
| | - G. Profep
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
| | - J. Usall
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu Santa Rosa Esplugues de Llobregat
- Parc Sanitari Sant Joan de Déu, CIBERSAM Sant Boi de Llobregat
| |
Collapse
|
|
20
|
Firmin RL, Zalzala AB, Hamm JA, Luther L, Lysaker PH. How psychosis interrupts the lives of women and men differently: a qualitative comparison. Psychol Psychother 2021; 94:704-720. [PMID: 33215851 DOI: 10.1111/papt.12317] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 07/15/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Psychosis disrupts how persons experience themselves and their lives. Despite knowledge that gender differences have been noted in presentation and course of psychosis symptoms, little is known about differences in how men and women experience these disruptions. METHOD The narratives of 26 men and 27 women diagnosed with psychosis, matched on age, education, and race, of the impact of psychosis on one's life, were compared. Using secondary data from semi-structured interviews, themes were identified using inductive, phenomenological qualitative analyses. RESULTS Women and men discussed psychosis-related interruptions to the roles and relationships that shape their identity. Both genders discussed the impact of psychosis on their sense of self, work, and relationships. Nuanced gender differences emerged, informing unique areas of challenge related to (1) parenting and loss of parenting roles, (2) work and loss or changes in work trajectories, (3) isolation and strain on interpersonal relationships, and (4) manifestations of stigma. CONCLUSIONS Psychosis may disrupt distinct aspects of life for men and women. Each gender faces the intersection of socially informed expectations that impact one's experiences of stigma, expectations of others, and manifestations of losses felt in one's role and sense of identity. Findings inform important considerations for therapy and other services. PRACTITIONER POINTS Gender-based socialized expectations, losses, and challenges that accompany psychosis are important areas for therapeutic consideration. Current treatments may neglect challenges that are more commonly experienced by women with psychosis.
Collapse
Affiliation(s)
- Ruth L Firmin
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, Rhode Island, USA.,Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
| | - Aieyat B Zalzala
- Department of Psychiatry, The Institute of the Living at Hartford Hospital, Hartford, Connecticut, USA
| | - Jay A Hamm
- Midtown Community Mental Health Center, Eskenazi Hospital, Indianapolis, Indiana, USA
| | - Lauren Luther
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul H Lysaker
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Roudebush VA Medical Center, Indianapolis, Indiana, USA
| |
Collapse
|
|
21
|
Jerotic S, Lalovic N, Pejovic S, Mihaljevic M, Pavlovic Z, Britvic D, Risimic D, Soldatovic I, Silverstein SM, Maric NP. Sex differences in macular thickness of the retina in patients with psychosis spectrum disorders. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110280. [PMID: 33567332 DOI: 10.1016/j.pnpbp.2021.110280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/26/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Imaging of retinal structure in psychosis spectrum disorders (PSD) is a novel approach to studying effect of this illness class on CNS structure. Studies of optical coherence tomography (OCT) have revealed significant reductions in regarding: retinal nerve fiber layer (RNFL), macular thickness (MT), ganglion cell-inner plexiform layer (GC-IPL) and macular volume (MV). Sex differences in retinal structure in PSD have not been previously explored. METHODS This cross-sectional pilot study included 81 participant of age matched patients and controls. There were no differences between genders regarding illness duration and antipsychotic daily dose in the patient group. SD-OCT assessed RNFL, GC-IPL, MT, MV, and optic nerve cup-to-disc (C/D) ratio. In order to assess the main effects of illness, sex, and illness × sex interaction on the retinal parameters, general linear model was performed. RESULTS Patients demonstrated abnormalities on all OCT indices. Effects of sex were observed for central subfield MT and C/D ratio, which were lower in females. An illness × sex interaction effect was observed for the left MT, indicating greater thinning in female patients. CONCLUSION Sex differences in OCT findings in PSD appear to be most prominent considering macular parameters. These preliminary data may have important implications for the valid interpretation of OCT findings as potential biomarkers for PSD.
Collapse
Affiliation(s)
- Stefan Jerotic
- Clinic for Psychiatry, University Clinical Centre of Serbia, Belgrade, Serbia.
| | - Nikola Lalovic
- Clinic for Psychiatry, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Slobodanka Pejovic
- Clinic for Psychiatry, University Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marina Mihaljevic
- Clinic for Psychiatry, University Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zorana Pavlovic
- Clinic for Psychiatry, University Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dubravka Britvic
- Clinic for Psychiatry, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Dijana Risimic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Ophthalmology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Ivan Soldatovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Steven M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Nadja P Maric
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Institute of Mental Health, Belgrade, Serbia
| |
Collapse
|
|
22
|
Prat G, Marquez-Arrico JE, Río-Martínez L, Navarro JF, Adan A. Premorbid functioning in schizophrenia spectrum disorders with comorbid substance use: A systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110310. [PMID: 33775743 DOI: 10.1016/j.pnpbp.2021.110310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/03/2021] [Accepted: 03/23/2021] [Indexed: 11/26/2022]
Abstract
Premorbid functioning has been related with several clinical features and prognosis of schizophrenia spectrum disorders. Comorbidity with substance use is highly prevalent and usually hinders clinical improvement in this kind of psychiatric disorders. This systematic review analyzes the differences in the premorbid functioning of subjects with a schizophrenia spectrum disorder with substance use (SSD+, dual psychosis) or without it (SSD-). A systematic review (PRISMA guidelines), including search in electronic databases (MEDLINE, Web of Science, and Cochrane Library), was performed. 118 published works were considered of which only 20 met our inclusion criteria. Although there is a great variability in methodologies, diagnoses included, and substances used, studies using the Premorbid Functioning Scale to assess the academic and/or social domains found that SSD+ subjects had a poorer academic but better social premorbid functioning than those with SSD-. Current evidence is not conclusive, so additional studies are required to integrate intervening factors in order to clarify the clinical implications of premorbid functioning to improve the course and therapeutic response of patients.
Collapse
Affiliation(s)
- Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Julia E Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Laura Río-Martínez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - José Francisco Navarro
- Department of Psychobiology, School of Psychology, University of Málaga, Campus Teatinos s/n, 29071 Málaga, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain.
| |
Collapse
|
|
23
|
Breach MR, Dye CN, Joshi A, Platko S, Gilfarb RA, Krug AR, Franceschelli DV, Galan A, Dodson CM, Lenz KM. Maternal allergic inflammation in rats impacts the offspring perinatal neuroimmune milieu and the development of social play, locomotor behavior, and cognitive flexibility. Brain Behav Immun 2021; 95:269-286. [PMID: 33798637 PMCID: PMC8187275 DOI: 10.1016/j.bbi.2021.03.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/22/2021] [Accepted: 03/27/2021] [Indexed: 01/07/2023] Open
Abstract
Maternal systemic inflammation increases risk for neurodevelopmental disorders like autism, ADHD, and schizophrenia in offspring. Notably, these disorders are male-biased. Studies have implicated immune system dysfunction in the etiology of these disorders, and rodent models of maternal immune activation provide useful tools to examine mechanisms of sex-dependent effects on brain development, immunity, and behavior. Here, we employed an allergen-induced model of maternal inflammation in rats to characterize levels of mast cells and microglia in the perinatal period in male and female offspring, as well as social, emotional, and cognitive behaviors throughout the lifespan. Adult female rats were sensitized to ovalbumin (OVA), bred, and challenged intranasally on gestational day 15 of pregnancy with OVA or saline. Allergic inflammation upregulated microglia in the fetal brain, increased mast cell number in the hippocampus on the day of birth, and conferred region-, time- and sex- specific changes in microglia measures. Additionally, offspring of OVA-exposed mothers subsequently exhibited abnormal social behavior, hyperlocomotion, and reduced cognitive flexibility. These data demonstrate the long-term effects of maternal allergic challenge on offspring development and provide a basis for understanding neurodevelopmental disorders linked to maternal systemic inflammation in humans.
Collapse
Affiliation(s)
- Michaela R. Breach
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA,Neuroscience Graduate Program, The Ohio State University, Columbus, OH, USA
| | - Courtney N. Dye
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA,Neuroscience Graduate Program, The Ohio State University, Columbus, OH, USA
| | - Aarohi Joshi
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Steven Platko
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Rachel A. Gilfarb
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA,Neuroscience Graduate Program, The Ohio State University, Columbus, OH, USA
| | - Annemarie R. Krug
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | | | - Anabel Galan
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Claire M. Dodson
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Kathryn M. Lenz
- Department of Psychology, The Ohio State University, Columbus, OH, USA,Department of Neuroscience, The Ohio State University, Columbus, OH, USA,Institute for Behavioral Medicine Research, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
|
24
|
Peng X, Wang S, Bi J, You L, Zhou Z, Tan W, Xie H, Hu C, Ng CH, Liu T. Gender differences in socio-demographics, clinical characteristic and quality of life in patients with schizophrenia: A community-based study in Shenzhen. Asia Pac Psychiatry 2021; 13:e12446. [PMID: 33327044 DOI: 10.1111/appy.12446] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/28/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The objective of this study was to explore the gender differences of community-dwelling patients with schizophrenia in terms of socio-demographics, clinical characteristic and quality of life (QOL). METHODS A total of 433 community-dwelling patients with schizophrenia were recruited in Shenzhen city, China. Data were obtained from a face-to-face interview with standard research questionnaire. The QOL and insight were assessed using the WHOQOL-BREF and the Chinese version of the insight and treatment attitude questionnaire, respectively. RESULTS This cross-sectional study included 206 male and 227 female patients. Male patients were more likely to be educated, employed, smoking cigarettes and drinking alcohol, and have an early age of illness onset. In contrast, female patients were more likely to be married/cohabitating and have drug side effects. There was no significant difference between genders across all QOL domain. Multiple regression analyzes showed that mental symptoms were negatively associated with all QOL domains, whereas frequency of exercise in the past year was positively associated with all QOL domains. Higher education levels, household per capita annual income in past year (≥100 000 RMB), employment status, IATQ score, drug side effects, marital status, and number of hospitalization were also significantly associated with specific QOL domains. DISCUSSION There was significant gender difference in socio-demographics and clinical characteristics among community schizophrenia patients in Shenzhen city. Gender-specific intervention measures are needed to improve the functioning and QOL in patients with schizophrenia.
Collapse
Affiliation(s)
- Xiaodong Peng
- Department of Public health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Shibin Wang
- Department of Public health, Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jianqiang Bi
- Department of Public health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Liqin You
- Department of Public health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Zhijian Zhou
- Department of Public health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Wenyan Tan
- Department of Public health, Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haiyan Xie
- Department of Public health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Chiyi Hu
- Department of Public health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St. Vincent's Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Tiebang Liu
- Department of Public health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| |
Collapse
|
|
25
|
Irving J, Colling C, Shetty H, Pritchard M, Stewart R, Fusar-Poli P, McGuire P, Patel R. Gender differences in clinical presentation and illicit substance use during first episode psychosis: a natural language processing, electronic case register study. BMJ Open 2021; 11:e042949. [PMID: 33879482 PMCID: PMC8061860 DOI: 10.1136/bmjopen-2020-042949] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To determine whether gender differences in symptom presentation at first episode psychosis (FEP) remain even when controlling for substance use, age and ethnicity, using natural language processing applied to electronic health records (EHRs). DESIGN, SETTING AND PARTICIPANTS Data were extracted from EHRs of 3350 people (62% male patients) who had presented to the South London and Maudsley NHS Trust with a FEP between 1 April 2007 and 31 March 2017. Logistic regression was used to examine gender differences in the presentation of positive, negative, depressive, mania and disorganisation symptoms. EXPOSURES FOR OBSERVATIONAL STUDIES Gender (male vs female). MAIN OUTCOMES AND MEASURES Presence of positive, negative, depressive, mania and disorganisation symptoms at initial clinical presentation. RESULTS Eight symptoms were significantly more prevalent in men (poverty of thought, negative symptoms, social withdrawal, poverty of speech, aggression, grandiosity, paranoia and agitation). Conversely, tearfulness, low energy, reduced appetite, low mood, pressured speech, mood instability, flight of ideas, guilt, mutism, insomnia, poor concentration, tangentiality and elation were more prevalent in women than men. Negative symptoms were more common among men (OR 1.85, 95% CI 1.33 to 2.62) and depressive and manic symptoms more common among women (OR 0.30, 95% CI 0.26 to 0.35). After adjustment for illicit substance use, the strength of associations between gender and negative, manic and depression symptoms increased, whereas gender differences in aggression, agitation, paranoia and grandiosity became insignificant. CONCLUSIONS There are clear gender differences in the clinical presentation of FEP. Our findings suggest that gender can have a substantial influence on the nature of clinical presentation in people with psychosis, and that this is only partly explained by exposure to illicit substance use.
Collapse
Affiliation(s)
- Jessica Irving
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Craig Colling
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Hitesh Shetty
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Megan Pritchard
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Robert Stewart
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, London, UK
| | - Paolo Fusar-Poli
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, London, UK
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Rashmi Patel
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, London, UK
- Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
|
26
|
Register-based metrics of years lived with disability associated with mental and substance use disorders: a register-based cohort study in Denmark. Lancet Psychiatry 2021; 8:310-319. [PMID: 33743882 DOI: 10.1016/s2215-0366(21)00029-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mental disorders account for a substantial proportion of the years lived with disability (YLDs) globally. These estimates have generally been calculated top down based on summary statistics. The aim for this study was to calculate YLDs and a novel related measure, Health Loss Proportion (HeLP), for 18 mental and substance use disorders, based on person-level register data (bottom up). METHODS A cohort of 6 989 627 Danish residents (5·9% had a diagnosis of a mental or substance use disorder registered in the Danish Psychiatric Central Research Register) was investigated. YLDs (the duration of disease multiplied by a disability weight) were calculated for the disorder of interest and for comorbid mental and substance use disorders. HeLPs were estimated as YLDs associated with an index disorder and comorbid mental and substance use disorders divided by person-years at risk in persons with the index disorder. All analyses were adjusted for mental and substance use comorbidity using a multiplicative model of disability weights. FINDINGS Major depressive disorder was the most prevalent disorder, although schizophrenia was the leading cause of YLDs in both sexes combined (YLDs 273·3 [95 % CI 232·3-313·6] per 100 000 person-years). People diagnosed with schizophrenia lost the equivalent of 73% (63-83%) of healthy life per year due to mental and substance use disorders, the largest HeLP of all mental and substance use disorders. Comorbidity of mental and substance use disorders accounted for 69-83% of HeLPs in people with either cannabis use disorders, other drug use disorder and ADHD. By contrast, comorbidity explained 11-23% of the HeLPs in people with autism spectrum disorders, conduct disorder, and schizophrenia. INTERPRETATION Substantial variation in disability was observed across age, sex, and disorders. The new HeLP metric provides novel details of the contribution of comorbidity to the disability associated with mental and substance use disorders. FUNDING The Danish National Research Foundation, Queensland Government Department of Health, European Union's Horizon 2020, Lundbeck Foundation, Stanley Medical Research Institute. TRANSLATION For the Danish translation of the abstract see Supplementary Materials section.
Collapse
|
|
27
|
Shi H, Guan XN, Liu DY, Zhu L, Wu ZW, Luo GZ, Wang J, Xiu MH, Zhang XY. Sex-specific Association of Antipsychotic-induced Weight Gain and Treatment Response for Antipsychotic-Naive First Episode Schizophrenia Patients: A Prospective 8-week Longitudinal Study. PHARMACOPSYCHIATRY 2021; 54:68-74. [PMID: 33626593 DOI: 10.1055/a-1353-6544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patients with antipsychotic-naïve first-episode (ANFE) schizophrenia (SZ) can help clarify many confounding factors in determining sex differences in antipsychotic drug induced weight gain and its association with symptom improvement. METHODS This 8-week longitudinal trial of ANFE patients with SZ enrolled 526 patients and 313 healthy controls. We evaluated bodyweight and the efficacy of antipsychotics on the Positive and Negative Syndrome Scale (PANSS) at baseline and at the end of week 8. RESULTS Males and females after treatment showed no sex difference in weight gain, BMI increase, and percentage of weight gain. However, at baseline, male patients had more positive symptoms than female patients, and decreases in positive symptoms, general psychopathology, and total PANSS scores were less in male than female patients. Adjusting for confounding factors using multiple linear regression confirmed that weight gain was significantly associated with these decreases in PANSS symptoms only in men not women. CONCLUSIONS The relationship between weight gain and symptom reduction after 8 weeks of antipsychotic treatment exists only in male patients with ANFE SZ and not in female patients.
Collapse
Affiliation(s)
- Hui Shi
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiao Ni Guan
- Peking University Hui Long Guan Clinical Medical School, Beijing Hui Long Guan Hospital, Beijing, China
| | - Dian Ying Liu
- Department of Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Lin Zhu
- Department of Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Zhi Wei Wu
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.,Shenzhen Mental Health center. Shenzhen, Guangdong, China
| | - Guo Zhi Luo
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.,Shenzhen Mental Health center. Shenzhen, Guangdong, China
| | - Jun Wang
- Peking University Hui Long Guan Clinical Medical School, Beijing Hui Long Guan Hospital, Beijing, China
| | - Mei Hong Xiu
- Peking University Hui Long Guan Clinical Medical School, Beijing Hui Long Guan Hospital, Beijing, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
|
28
|
Berry C, Newcombe H, Strauss C, Rammou A, Schlier B, Lincoln T, Hayward M. Validation of the Hamilton Program for Schizophrenia Voices Questionnaire: Associations with emotional distress and wellbeing, and invariance across diagnosis and sex. Schizophr Res 2021; 228:336-343. [PMID: 33540145 DOI: 10.1016/j.schres.2020.12.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/02/2020] [Accepted: 12/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Voice-hearing is a transdiagnostic experience with evident negative effects on patients. Good quality measurement is needed to further elucidate the nature, impact and treatment of voice-hearing experiences across patient groups. The Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ) is a brief self-report measure which requires further psychometric evaluation. METHODS Using data from a transdiagnostic sample of 401 adult UK patients, the fit of a conceptual HPSVQ measurement model, proposing a separation between physical and emotional voice-hearing characteristics, was tested. A structural model was examined to test associations between voice-hearing, general emotional distress (depression, anxiety, stress) and wellbeing. The invariance of model parameters was examined across diagnosis and sex. RESULTS The final measurement model comprised two factors named 'voice severity' and 'voice-related distress'. The former comprised mainly physical voice characteristics and the latter mainly distress and other negative impacts. Structural model results supported voice-related distress as mediating the associations between voice severity and emotional distress and wellbeing. Model parameters were invariant across psychosis versus non-psychosis diagnosis and partially invariant across sex. Females experienced more severe and distressing voices and a more direct association between voice severity and general anxiety was evident. CONCLUSIONS The HPSVQ is a useful self-report measure of voice-hearing with some scope for further exploration and refinement. Voice-related distress appears a key mechanism by which voice severity predicts general distress and wellbeing. Whilst our data broadly support interventions targeting voice-related distress for all patients, females may benefit especially from interventions targeting voice severity and strategies for responding.
Collapse
Affiliation(s)
- C Berry
- Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, BN1 9PH, United Kingdom of Great Britain and Northern Ireland; School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland.
| | - H Newcombe
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland
| | - C Strauss
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland; Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HZ, United Kingdom of Great Britain and Northern Ireland
| | - A Rammou
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland
| | - B Schlier
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - T Lincoln
- Klinische Psychologie und Psychotherapie, Institut für Psychologie, Fakultät für Psychologie und Bewegungswissenschaft, Universität Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - M Hayward
- School of Psychology, University of Sussex, Falmer, Brighton, BN1 9QH, United Kingdom of Great Britain and Northern Ireland; Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HZ, United Kingdom of Great Britain and Northern Ireland
| |
Collapse
|
|
29
|
Huang W, Chen M, Lyu G, Tang X. A Deformation-Based Shape Study of the Corpus Callosum in First Episode Schizophrenia. Front Psychiatry 2021; 12:621515. [PMID: 34149469 PMCID: PMC8211893 DOI: 10.3389/fpsyt.2021.621515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 05/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Previous first-episode schizophrenia (FES) studies have reported abnormalities in the volume and mid-sagittal size of the corpus callosum (CC), but findings have been inconsistent. Besides, the CC shape has rarely been analyzed in FES. Therefore, in this study, we investigated FES-related CC shape abnormalities using 198 participants [92 FES patients and 106 healthy controls (HCs)]. Methods: We conducted statistical shape analysis of the mid-sagittal CC curve in a large deformation diffeomorphic metric mapping framework. The CC was divided into the genu, body, and splenium (gCC, bCC, and sCC) to target the key CC sub-regions affected by the FES pathology. Gender effects have been investigated. Results: There were significant area differences between FES and HC in the entire CC and gCC but not in bCC nor sCC. In terms of the localized shape morphometrics, significant region-specific shape inward-deformations were detected in the superior portion of gCC and the anterosuperior portion of bCC in FES. These global area and local shape morphometric abnormalities were restricted to female FES but not male FES. Conclusions: gCC was significantly affected in the neuropathology of FES and this finding was specific to female FES. This study suggests that gCC may be a key sub-region that is vulnerable to the neuropathology of FES, specifically in female patients. The morphometrics of gCC may serve as novel and efficient biomarkers for screening female FES patients.
Collapse
Affiliation(s)
- Weikai Huang
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Minhua Chen
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Guiwen Lyu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xiaoying Tang
- Department of Electrical and Electronic Engineering, Southern University of Science and Technology, Shenzhen, China
| |
Collapse
|
|
30
|
Giordano GM, Bucci P, Mucci A, Pezzella P, Galderisi S. Gender Differences in Clinical and Psychosocial Features Among Persons With Schizophrenia: A Mini Review. Front Psychiatry 2021; 12:789179. [PMID: 35002807 PMCID: PMC8727372 DOI: 10.3389/fpsyt.2021.789179] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/03/2021] [Indexed: 01/10/2023] Open
Abstract
An extensive literature regarding gender differences relevant to several aspects of schizophrenia is nowadays available. It includes some robust findings as well as some inconsistencies. In the present review, we summarize the literature on gender differences in schizophrenia relevant to clinical and social outcome as well as their determinants, focusing on clinical variables, while gender differences on biological factors which may have an impact on the outcome of the disorder were not included herewith. Consistent findings include, in male with respect to female patients, an earlier age of illness onset limited to early- and middle-onset schizophrenia, a worse premorbid functioning, a greater severity of negative symptoms, a lower severity of affective symptoms and a higher rate of comorbid alcohol/substance abuse. Discrepant findings have been reported on gender differences in positive symptoms and in social and non-social cognition, as well as in functional outcome and rates of recovery. In fact, despite the overall finding of a more severe clinical picture in males, this does not seem to translate into a worse outcome. From the recent literature emerges that, although some findings on gender differences in schizophrenia are consistent, there are still aspects of clinical and functional outcome which need clarification by means of further studies taking into account several methodological issues.
Collapse
Affiliation(s)
| | - Paola Bucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
|
31
|
Pu C, Huang B, Zhou T, Cheng Z, Wang Y, Shi C, Yu X. Gender Differences in the First-Year Antipsychotic Treatment for Chinese First-Episode Schizophrenia. Neuropsychiatr Dis Treat 2020; 16:3145-3152. [PMID: 33364771 PMCID: PMC7751687 DOI: 10.2147/ndt.s280719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/04/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To investigate the gender differences in the efficacy and side effects of three frequently used antipsychotic medicines (risperidone, olanzapine, aripiprazole) for patients with first-episode schizophrenia during the first year of treatment. METHODS A total of 569 patients with first-episode schizophrenia were randomly assigned to risperidone, olanzapine, and aripiprazole groups. All patients were treated according to their actual clinical needs. Clinical efficacies were assessed by the Positive and Negative Symptom Scale (PANSS) and side effects were assessed by the Udvalg for Kliniske Undersogelser Side-Effect scale (UKU). All assessments were completed at baseline and at 1, 2, 3, 6, 9, and 12 months. RESULTS Males had higher baseline PANSS total scores and PANSS negative and general pathological scores. No significant interactions were found between treatment time and gender in psychopathology improvements in all three groups. In the end of the first year, female patients receiving risperidone reported more dermatological symptoms (rashes) than males, female patients receiving olanzapine reported more autonomic side effects and dermatological symptoms than males, and female patients receiving aripiprazole reported more psychotic side effects than males. CONCLUSION Gender differences exhibited in response to antipsychotic treatments for Chinese patients with first-episode schizophrenia. After the first year of antipsychotic treatment, drug-related side effects were more likely presented in female patients than male patients.
Collapse
Affiliation(s)
- Chengcheng Pu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China
| | - Bingjie Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China
| | - Tianhang Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China
| | - Zhang Cheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Department of Psychology, University of Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Chuan Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China
| |
Collapse
|
|
32
|
Rosen M, Haidl TK, Ruhrmann S, Vogeley K, Schultze-Lutter F. Sex differences in symptomatology of psychosis-risk patients and in prediction of psychosis. Arch Womens Ment Health 2020; 23:339-349. [PMID: 31485796 DOI: 10.1007/s00737-019-01000-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 08/12/2019] [Indexed: 02/06/2023]
Abstract
Sex differences may be important for understanding underlying pathophysiological mechanisms and developing effective preventions and treatments of mental disorders. Despite sex differences in the onset of psychosis, patients at clinical high risk for psychosis (CHR) are underinvestigated for sex effects, especially with respect to models for prediction of conversion to psychosis. We studied psychopathological sex differences in referrals to a German early detection service and in its subgroup of converters and examined sex-specific psychopathological prediction models. In 152 male and 90 female referrals (88% at CHR; 35% converters), symptoms assessed with the Structured Interview for Psychosis-Risk Syndromes were investigated for sex differences using effect sizes. Sex-specific prediction models of psychosis were separately generated using Cox regressions with a LASSO operator. We found different small sex effects (0.10 < Rosenthal's r < 0.30) in the referral and in the converter sample. In the referral sample, exclusively, males showed more pronounced symptoms (all negative symptoms incl. reduced stress tolerance, grandiosity, and disorganized communication); in converters, females experienced more pronounced perceptual abnormalities, bizarre thinking, and odd behaviors, while males expressed and experienced emotions to a lower degree. Furthermore, sexes differed in psychosis-predictive symptoms: "suspiciousness" and "disorganized communication" were prominent in prediction of psychosis in males, whereas "trouble with focus and attention" was so in females. While most sex differences in patients attending an early detection service seem to reflect general differences that are not specifically related to psychosis, others might be psychosis-specific. These results can inform the development of more individualized and effective interventions for CHR patients based on more precise sex-specific prediction models.
Collapse
Affiliation(s)
- Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Theresa Katharina Haidl
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Bergische Landstraße 2, 40629, Düsseldorf, Germany
| |
Collapse
|
|
33
|
Solmi M, Campeol M, Gentili F, Favaro A, Cremonese C. Clinical presentation and need for treatment of a cohort of subjects accessing to a mental illness prevention service. RESEARCH IN PSYCHOTHERAPY 2020; 23:434. [PMID: 32913825 PMCID: PMC7451370 DOI: 10.4081/ripppo.2020.434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 03/04/2020] [Indexed: 11/23/2022]
Abstract
Outreaching activities decrease prognostic accuracy of at-risk mental state defining tools, over-attracting subjects who are not at increased risk of mental illness. The setting was a mental illness primary indicated prevention outpatients service embedded within the Psychiatry Unit of Padua University Hospital, Italy. Help-seeking patients accessing the service between January 2018 and December 2018 were evaluated with validated tools assessing functioning, at-risk mental state, schizotypal personality features, depressive and anxious symptoms, together with medical and family history collection. The primary outcome was the prevalence of drop in functioning at presentation according to the Social and Occupational Functioning Assessment Scale (SOFAS). Secondary outcomes were diagnoses according to DSM-5 criteria and meeting criteria for at-risk mental state. Fifty-nine patients accessed the service, mean age was 18.8 (2.12) years old, 54.2% were females. Virtually all subjects (97.7%) had a drop in functioning. Baseline primary diagnoses were depressive episode in 33%, anxiety disorder in 21%, personality disorder in 17%, adjustment disorder 9%, conduct disorder 7%, schizophrenia spectrum disorder 5%, bipolar disorder 5%, eating disorder in 1.7%, dissociative disorder 1.7%. Overall, 59.1% met at-risk mental state criteria. Lower functioning was associated with anxious symptoms (p=0.031), a family history of mental illness (p=0.045) and of suicide (p=0.042), and schizotypal personality traits (p=0.036). Subjects accessing a prevention service embedded within the mental health department already present a trans-diagnostic drop in functioning, mainly due to a non-psychotic mental disorder, with at-risk mental state in one patient out of two, and schizophrenia or bipolar disorder already present in only 10% of subjects. Prevention service within mental health facility setting appears to properly detect subjects in need of treatment with a drop in functioning, at risk of developing severe mental illness, without any outreaching activity in the general population.
Collapse
Affiliation(s)
- Marco Solmi
- Neurosciences Department, University of Padua.,Neuroscience Center, University of Padua.,Padua University Hospital, Psychiatry Unit, Padua, Italy
| | - Mara Campeol
- Neurosciences Department, University of Padua.,Padua University Hospital, Psychiatry Unit, Padua, Italy
| | | | - Angela Favaro
- Neurosciences Department, University of Padua.,Neuroscience Center, University of Padua.,Padua University Hospital, Psychiatry Unit, Padua, Italy
| | | |
Collapse
|
|
34
|
Schultze-Lutter F, Schimmelmann BG, Flückiger R, Michel C. Effects of age and sex on clinical high-risk for psychosis in the community. World J Psychiatry 2020; 10:101-124. [PMID: 32477906 PMCID: PMC7243619 DOI: 10.5498/wjp.v10.i5.101] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recent reports of both heightened prevalence rates and limited clinical relevance of clinical high-risk (CHR) criteria and their relevant symptoms in children and adolescents indicate an important role of neurodevelopment in the early detection of psychoses. Furthermore, sex effects in CHR symptoms have been reported, though studies were inconclusive. As sex also impacts on neurodevelopment, we expected that sex might have an additional contribution to age in the prevalence and clinical relevance of CHR symptoms and criteria.
AIM To investigate age and sex effects on CHR criteria and symptoms and their association with psychosocial impairment and mental disorder.
METHODS In this cross-sectional cohort study, n = 2916 8- to 40-year-olds, randomly drawn from the population register of the Swiss canton Bern, were assessed in semi-structured interviews by phone or face-to-face for CHR symptoms and criteria using the Structured Interview for Psychosis-Risk Syndromes and the Schizophrenia Proneness Instrument in its child and youth, and adult version, respectively. Furthermore, social and occupational functioning and DSM-IV axis I disorders were assessed. Simple and interaction effects of age and sex on CHR symptoms and criteria, and interaction effects of age, sex, and CHR symptoms and criteria on presentation of functional impairment and of non-psychotic disorder were investigated using logistic regression analyses.
RESULTS Altogether, 542 (18.6%) participants reported any CHR symptom; of these, 261 (9.0%) participants reported any one of the 11 criteria relevant cognitive and perceptual basic symptoms, and 381 (13.1%) any one of the five attenuated or transient psychotic symptoms (attenuated psychotic symptoms/brief intermittent psychotic symptoms). Fewer participants met any one of the CHR criteria (n = 82, 2.8%) or any one of the three recently recommended CHR criteria (n = 38, 1.3%). Both age and sex were significantly (P < 0.05) associated with CHR symptoms and criteria, mostly by younger age and female sex. Though slightly differing between symptom groups, age thresholds were detected around the turn from adolescence to adulthood; they were highest for cognitive basic symptoms and CHR criteria. With the exception of the infrequent speech disorganization attenuated psychotic symptom, the interaction of age with CHR symptoms and criteria predicted functional impairment; whereas, independent of each other, sex and CHR symptoms mostly predicted mental disorders.
CONCLUSION Age and sex differentially impact on CHR symptoms and criteria; these differences may support better understanding of causal pathways. Thus, future CHR studies should consider effects of sex and age.
Collapse
Affiliation(s)
- Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf 40692, Germany
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 3000, Switzerland
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Rahel Flückiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 3000, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 3000, Switzerland
| |
Collapse
|
|
35
|
Thorup A, Albert N, Bertelsen M, Petersen L, Jeppesen P, Le Quack P, Krarup G, Jørgensen P, Nordentoft M. Gender differences in first-episode psychosis at 5-year follow-up – two different courses of disease? Results from the OPUS study at 5-year follow-up. Eur Psychiatry 2020; 29:44-51. [DOI: 10.1016/j.eurpsy.2012.11.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 11/14/2012] [Accepted: 11/23/2012] [Indexed: 10/27/2022] Open
Abstract
AbstractObjectiveGender differences in psychosis have been investigated, and the results have contributed to a better understanding of the disease, but many questions are unanswered. In clinical terms, women and men with psychosis differ in terms of access to social support, tendency of substance abuse, level of functioning and symptom patterns. We aimed to investigate how gender differences at onset of psychosis develop during the first 5 years of treatment.MethodA total of 578 patients with a first-episode psychosis in the schizophrenia spectrum were included in the Danish OPUS trial – a randomized clinical trial comparing 2 years of intensive early-intervention programme with standard treatment. All patients were assessed with validated instruments at inclusion, and after 2 and 5 years. Data were analysed for significant gender differences.ResultsMales have significantly higher levels of negative symptoms at all times, and are more likely to live alone and suffer from substance abuse. Females reach higher levels of social functioning at follow-up, and show a greater tendency to be employed or in education than males. Markedly more women than men live with children. More women than men reach a state of recovery and are more compliant with medication.ConclusionThere are significant gender differences at 2- and 5-year follow-up in this large cohort of first-episode psychotic patients. Males and females show different symptomatology and different levels of social functioning.
Collapse
|
|
36
|
Comacchio C, Lasalvia A, Bonetto C, Cristofalo D, Miglietta E, Petterlini S, De Santi K, Tosato S, Riolo R, Cremonese C, Ceccato E, Zanatta G, Ruggeri M. Gender and 5-years course of psychosis patients: focus on clinical and social variables. Arch Womens Ment Health 2020; 23:63-70. [PMID: 30719573 DOI: 10.1007/s00737-019-0945-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/24/2019] [Indexed: 11/29/2022]
Abstract
Most studies on gender and psychosis have focused on gender differences at illness onset or on the long-term outcome, whereas little is known about the impact of gender on the first years after psychosis onset. A total of 185 first episode psychosis (FEP) patients were followed for 5 years after psychosis onset, and gender differences were explored in psychopathology (PANSS), needs for care (CAN), and insight (SAI-E). Male patients showed more negative symptoms than females over time, whereas female patients showed higher levels of depressive symptoms than males throughout the study period. In addition, female patients presented more functioning unmet needs for care, but higher levels of insight into illness than males. Therapy and rehabilitative programs for FEP patients should be gender-targeted, as gender has proved to impact on psychopathology, needs for care, and insight in the very first years following psychosis onset.
Collapse
Affiliation(s)
- Carla Comacchio
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Antonio Lasalvia
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Bonetto
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Doriana Cristofalo
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elisabetta Miglietta
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sara Petterlini
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - K De Santi
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - S Tosato
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - R Riolo
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - C Cremonese
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - E Ceccato
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - G Zanatta
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Mirella Ruggeri
- Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | |
Collapse
|
|
37
|
Wei CW, Chen YQ, Ma M, Xiu MH, Zhang XY. Sex differences in the association of body mass index with symptoms and cognitive deficits in Chinese patients with chronic schizophrenia. Transl Psychiatry 2020; 10:18. [PMID: 32066717 PMCID: PMC7026182 DOI: 10.1038/s41398-020-0717-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/19/2019] [Accepted: 11/28/2019] [Indexed: 12/17/2022] Open
Abstract
Accumulating studies have revealed gender differences in many aspects of schizophrenia (SZ), including obesity and cognitive function. The relationship between obesity and cognitive impairment in SZ has been studied before; however, the results are inconsistent. This study was designed to examine the sex differences in the relationship between body mass index (BMI) and cognitive deficits in Chinese patients with chronic SZ, which have not been investigated yet. 176 chronic patients with SZ (male/female = 108/68) and 200 controls (male/female = 120/80) were enrolled to compare the sex differences in cognitive functions measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), BMI, and their associations. The clinical symptoms were evaluated using the positive and negative syndrome scales (PANSS). Our results showed that male patients had lower BMI and more negative symptoms but fewer positive symptoms than female patients (all p < 0.05). However, there was no significant sex difference in RBANS scores. In male patients, BMI was correlated with age of onset, PANSS general psychopathology, total score, negative symptom, together with RBANS language, visuospatial/construction, and attention. Further regression analysis showed that in male patients, BMI was significantly associated with RBANS language, PANSS general psychopathology, PANSS total score, and age of onset, with adjusted R2 = 0.22. These findings revealed significant sex differences in BMI, cognitive dysfunctions and their association in SZ. Nonetheless, these results should only be considered as preliminary because of the cross-sectional design, which will deserve further replication in first-episode patients using a prospective longitudinal design.
Collapse
Affiliation(s)
- Chang Wei Wei
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, P. R. China
| | - Ying Qi Chen
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, P. R. China
| | - Mi Ma
- grid.452792.fQingdao Mental Health Center, Qingdao, P. R. China
| | - Mei Hong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, P. R. China.
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P. R. China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, P. R. China.
| |
Collapse
|
|
38
|
Stanton KJ, Denietolis B, Goodwin BJ, Dvir Y. Childhood Trauma and Psychosis: An Updated Review. Child Adolesc Psychiatr Clin N Am 2020; 29:115-129. [PMID: 31708041 DOI: 10.1016/j.chc.2019.08.004] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is growing evidence to support the link between childhood trauma and psychosis. Childhood trauma increases the risk for psychosis and affects severity and type of psychotic symptoms, and frequency of comorbid conditions, including depression and substance use. Childhood trauma is linked to more severe functional impairment in individuals with psychosis. There is evidence to support gender differences in the influence of childhood trauma on the course of psychotic illnesses, appearing to be more profound in girls and women. Other biological markers that may explain the link between childhood trauma and psychosis include brain-derived neurotrophic factor and other inflammatory markers.
Collapse
Affiliation(s)
- Kate J Stanton
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Brian Denietolis
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Brien J Goodwin
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way/Tobin Hall, Amherst, MA 01003, USA
| | - Yael Dvir
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| |
Collapse
|
|
39
|
Pu C, Qiu Y, Zhou T, Yang F, Lu Z, Wang C, Deng H, Zhao J, Shi C, Yu X. Gender differences of neurocognitive functioning in patients with first-episode schizophrenia in China. Compr Psychiatry 2019; 95:152132. [PMID: 31669790 DOI: 10.1016/j.comppsych.2019.152132] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/16/2019] [Accepted: 09/23/2019] [Indexed: 02/05/2023] Open
Abstract
AIMS To investigate the gender differences in neurocognitive functioning in patients with first-episode schizophrenia (FES) in China. METHODS A total of 449 Chinese patients with FES (210 males, 239 females) were included in this study. Participants' psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). Neurocognitive functioning was assessed by 10 neuropsychological tests from a battery. Neurocognitive test scores were converted to scale scores and t-scores using normative data from Chinese populations. RESULTS Males were younger and less likely to be married, had an earlier age of illness onset and a longer duration of untreated psychosis (DUP), and scored higher on the PANSS negative, general and total scales than females. After controlling for potential confounders, females performed better than males in the verbal learning and memory domain (p=0.016). While most neurocognitive domains were correlated with PANSS negative scores for male patients with FES, for female patients with FES, negative associations were found between scores on the PANSS general subscales and neurocognitive domains. We also performed a case-control comparison with a group of patients with clinically stable schizophrenia (CSS) (n=60) who were matched by age, sex and education years with patients with FES (n=58). After controlling for potential confounders, no significant differences were found between patients with FES and patients with CSS in all neurocognitive domains. Female patients still performed better in the verbal learning and memory domain (t=2.14, p=0.034). No interaction effects of gender and disease were found. CONCLUSIONS Gender was an independent influence factor for the verbal learning and memory domain. Both female patients with first-episode schizophrenia and female patients with clinically stable schizophrenia performed better than male patients.
Collapse
Affiliation(s)
- Chengcheng Pu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China
| | - Yujia Qiu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China
| | - Tianhang Zhou
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China
| | - Fude Yang
- Beijing Hui-Long-Guan Hospital, Beijing, China
| | - Zheng Lu
- Tongji Hospital of Tongji University, Shanghai, China
| | - Chuanyue Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Hong Deng
- West China Hospital, Sichuan University, Chengdu, China
| | - Jingping Zhao
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Chuan Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China.
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Centerfor Mental Disorders (Peking University Sixth Hospital), China.
| |
Collapse
|
|
40
|
Gogos A, Ney LJ, Seymour N, Van Rheenen TE, Felmingham KL. Sex differences in schizophrenia, bipolar disorder, and post-traumatic stress disorder: Are gonadal hormones the link? Br J Pharmacol 2019; 176:4119-4135. [PMID: 30658014 PMCID: PMC6877792 DOI: 10.1111/bph.14584] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/13/2018] [Accepted: 11/25/2018] [Indexed: 12/30/2022] Open
Abstract
In this review, we describe the sex differences in prevalence, onset, symptom profiles, and disease outcome that are evident in schizophrenia, bipolar disorder, and post-traumatic stress disorder. Women with schizophrenia tend to exhibit less disease impairment than men. By contrast, women with post-traumatic stress disorder are more affected than men. The most likely candidates to explain these sex differences are gonadal hormones. This review details the clinical evidence that oestradiol and progesterone are dysregulated in these psychiatric disorders. Notably, existing data on oestradiol, and to a lesser extent, progesterone, suggest that low levels of these hormones may increase the risk of disease development and worsen symptom severity. We argue that future studies require a more inclusive, considered analysis of gonadal steroid hormones and the intricacies of the interactions between them, with methodological rigour applied, to enhance our understanding of the roles of steroid hormones in psychiatric disorders. LINKED ARTICLES: This article is part of a themed section on The Importance of Sex Differences in Pharmacology Research. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc.
Collapse
Affiliation(s)
- Andrea Gogos
- Hormones in Psychiatry LaboratoryFlorey Institute of Neuroscience and Mental HealthParkvilleVictoriaAustralia
| | - Luke J. Ney
- School of Medicine (Psychology)University of TasmaniaSandy BayTasmaniaAustralia
| | - Natasha Seymour
- Hormones in Psychiatry LaboratoryFlorey Institute of Neuroscience and Mental HealthParkvilleVictoriaAustralia
- Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | - Tamsyn E. Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of PsychiatryUniversity of MelbourneParkvilleVictoriaAustralia
- Centre for Mental Health, School of Health Sciences, Faculty of Health, Arts and DesignSwinburne UniversityMelbourneVictoriaAustralia
| | - Kim L. Felmingham
- School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| |
Collapse
|
|
41
|
Alberich S, Fernández-Sevillano J, González-Ortega I, Usall J, Sáenz M, González-Fraile E, González-Pinto A. A systematic review of sex-based differences in effectiveness and adverse effects of clozapine. Psychiatry Res 2019; 280:112506. [PMID: 31401291 DOI: 10.1016/j.psychres.2019.112506] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 12/17/2022]
Abstract
Clozapine is one of the most widely used antipsychotics for treating psychiatric illnesses such as schizophrenia and bipolar disorder. This drug, however, is associated with adverse effects such as weight gain, metabolic syndrome, and blood dyscrasias. The manifestations of mental illness may differ between men and women. Yet, there is little evidence on the influence of sex on treatment response or the occurrence of AEs. To fill this gap of knowledge, we carried out a systematic review of the literature on sex differences in the effectiveness and adverse effects of clozapine. Scant evidence has been published on differences in effectiveness of clozapine between men and women. Indeed, to the best of our knowledge, this issue has only been addressed in a published study. Regarding adverse effects, males have been reported to be more likely to develop metabolic abnormalities such as cholesterol or triglycerides, hypertension, and cardiovascular risk, while females are at a higher risk for gaining weight, developing diabetes, and needing laxatives. Nevertheless, given the scarcity of sex-based studies on this drug, further studies are needed to explore sex-based differences, as the results obtained may be crucial to clinical practice and help improve the quality of life of patients.
Collapse
Affiliation(s)
- Susana Alberich
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Department of Psychiatry, Olaguibel Street 29, 01004, Vitoria, Spain; National Distance Education University Spain (UNED), Vitoria, Spain.
| | - Jessica Fernández-Sevillano
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Department of Psychiatry, Olaguibel Street 29, 01004, Vitoria, Spain; University of the Basque Country (EHU/UPV), Spain
| | - Itxaso González-Ortega
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Department of Psychiatry, Olaguibel Street 29, 01004, Vitoria, Spain; National Distance Education University Spain (UNED), Vitoria, Spain
| | - Judith Usall
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), University of Barcelona, Research Unit Parc Sanitari Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Marga Sáenz
- University of the Basque Country (EHU/UPV), Spain; Hospital Universitario Cruces, Biocruces, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Bilbao, España
| | | | - Ana González-Pinto
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), BioAraba Research Institute, OSI Araba-University Hospital, Department of Psychiatry, Olaguibel Street 29, 01004, Vitoria, Spain; University of the Basque Country (EHU/UPV), Spain
| |
Collapse
|
|
42
|
Dama M, Veru F, Schmitz N, Shah J, Iyer S, Joober R, Malla A. Sex Differences in Clinical and Functional Outcomes among Patients Treated in an Early Intervention Service for Psychotic Disorders: An Observational Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:708-717. [PMID: 31189340 PMCID: PMC6783666 DOI: 10.1177/0706743719854069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE It has been shown that men with a longstanding psychotic disorder have worse clinical and functional outcomes than women. Our objectives were to examine whether these sex differences are also present among patients treated in an early intervention service (EIS) for psychosis and to determine if these differences are related to risk factors other than sex. METHOD Patients (N = 569) were assessed for demographic/clinical characteristics at entry and for symptoms/functioning over 2 years of treatment. Clinical outcomes included remission of positive, negative, and total symptoms. Functional outcomes included good functioning and functional remission. Logistic regression models examined the relationship between sex and outcomes after 1 and 2 years of treatment while controlling for the influence of other risk factors. RESULTS Men reported to be less educated and have a longer duration of untreated psychosis, poorer childhood and early adolescent premorbid functioning, higher rates of substance abuse/dependence disorders, greater severity of baseline negative symptoms, and poorer baseline social/occupational functioning than women. Women were more likely to achieve symptom remission than men after 2 years of treatment (negative odds ratio [OR], 1.69; 95% confidence interval [CI], 1.02 to 2.78; total OR, 1.79; 95% CI, 1.08 to 2.98). Women were also more likely than men to exhibit good functioning (OR, 1.61; 95% CI, 1.04 to 2.49) after 1 but not after 2 years of treatment. These results did not persist after controlling for other risk factors that could confound these associations (i.e., childhood premorbid functioning and age at onset of psychosis). CONCLUSIONS Sex differences seen in outcomes among patients treated in an EIS for psychosis may be largely influenced by the disparity of other risk factors that exist between the 2 sexes.
Collapse
Affiliation(s)
- Manish Dama
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec
| | - Franz Veru
- Department of Psychiatry, McGill University, Montreal, Quebec
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Quebec
| | - Jai Shah
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec.,Department of Psychiatry, McGill University, Montreal, Quebec
| | - Srividya Iyer
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec.,Department of Psychiatry, McGill University, Montreal, Quebec
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec.,Department of Psychiatry, McGill University, Montreal, Quebec
| | - Ashok Malla
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Quebec.,Department of Psychiatry, McGill University, Montreal, Quebec
| |
Collapse
|
|
43
|
Nemoto T, Uchino T, Aikawa S, Saito J, Matsumoto H, Funatogawa T, Yamaguchi T, Katagiri N, Tsujino N, Mizuno M. Social anxiety and negative symptoms as the characteristics of patients with schizophrenia who show competence-performance discrepancy in social functioning. Psychiatry Clin Neurosci 2019; 73:394-399. [PMID: 30968478 DOI: 10.1111/pcn.12848] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/20/2019] [Accepted: 04/03/2019] [Indexed: 11/30/2022]
Abstract
AIM Although competence and performance in relation to social functioning usually go hand in hand, it is not uncommon to observe a discrepancy between the two in patients with schizophrenia. The present study was aimed at examining the characteristics of patient groups showing such discrepancy. METHODS A total of 205 outpatients with schizophrenia aged ≤40 years old were enrolled. The symptomatology and social functioning were widely assessed. The patients were divided into four groups by the cut-off scores for competence and performance in relation to social functioning calculated using a comprehensive dataset. RESULTS The subjects were divided according to their level of competence and performance as follows: high competence and high performance (CP) group, 108 (52.7%) patients; high competence, but low performance (Cp) group, 40 (19.5%) patients; low competence, but high performance (cP) group, 13 (6.3%) patients; low competence and low performance (cp) group, 44 (21.5%) patients. One-way analysis of variance and post-hoc comparisons revealed significantly worse negative symptoms, general psychopathology scores, global functioning, and quality of life in the Cp group than in the CP group, and significantly better social anxiety symptoms, global functioning, and quality of life in the cP group than in the cp group. CONCLUSION In patients who are capable, but do not perform well, negative symptoms may be involved in the discrepancy. Patients who are able to maintain themselves well despite low social competence appear to have milder social anxiety symptoms as compared to patients who are neither competent nor perform well.
Collapse
Affiliation(s)
- Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Takashi Uchino
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Sayaka Aikawa
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Junichi Saito
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Hiroshi Matsumoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Tomoyuki Funatogawa
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| |
Collapse
|
|
44
|
Rammou A, Fisher HL, Johnson S, Major B, Rahaman N, Chamberlain-Kent N, Stone JM. Negative symptoms in first-episode psychosis: Clinical correlates and 1-year follow-up outcomes in London Early Intervention Services. Early Interv Psychiatry 2019; 13:443-452. [PMID: 29148264 DOI: 10.1111/eip.12502] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/31/2017] [Accepted: 08/29/2017] [Indexed: 12/13/2022]
Abstract
AIM Negative symptoms (NS) have been associated with poor outcome and remain difficult to treat in patients with psychosis. This study examined the association of NS with clinical features at first presentation to mental health services for psychosis and with outcomes at 1-year follow-up. METHODS Clinical data were utilized from five London Early Intervention Services (EIS) included in the MiData audit database. The sample comprised 484 first-episode psychosis patients with complete Positive and Negative Syndrome Scale data at baseline and 1-year follow-up. Multiple imputation (N = 50) was conducted to account for missing follow-up data. RESULTS Baseline NS were associated with male gender (B = -1.63, P < .05), younger age at onset (B = -.15, P <. 05), a higher level of impairment on the Global Assessment of Functioning (disability) Scale at baseline (B = -.19, P <. 010), an absence of reported substance misuse prior to baseline assessment (B = -3.05, P <. 001) and unemployment at baseline (B = -.93, P <. 01). At 1-year follow-up, NS at presentation were associated with worse Global Assessment of Functioning Scale for symptom (B = -.28, P < .01) and disability (B = -.27, P <. 05) and with hospital admission (OR = 1.06, P < .01). CONCLUSIONS Negative symptoms at presentation to EIS were associated with worse functioning at entry and poorer outcomes 1 year later. Future research is required to better understand the aetiology and trajectories of NS in early psychosis and propose novel targeted interventions.
Collapse
Affiliation(s)
- Aikaterini Rammou
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,School of Psychology, University of Sussex, Brighton, UK
| | - Helen L Fisher
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
| | - Barnaby Major
- EQUIP, Hackney, East London NHS Foundation Trust, London, UK.,Herefordshire Early Intervention Service, 2gether NHS Foundation Trust, Hereford, UK
| | - Nikola Rahaman
- Kensington, Chelsea, Westminster and Brent Early Intervention Service, Central & North West London NHS Foundation Trust, London, UK
| | - Nick Chamberlain-Kent
- Wandsworth Early Intervention Service, South West London & St Georges' Mental Health NHS Trust, London, UK
| | - James M Stone
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
|
45
|
Heitz U, Studerus E, Menghini-Müller S, Papmeyer M, Egloff L, Ittig S, Navarra A, Andreou C, Riecher-Rössler A. Gender differences in first self-perceived signs and symptoms in patients with an at-risk mental state and first-episode psychosis. Early Interv Psychiatry 2019; 13:582-588. [PMID: 29235240 DOI: 10.1111/eip.12528] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 08/22/2017] [Accepted: 11/08/2017] [Indexed: 12/28/2022]
Abstract
AIM Gender differences in the current symptomatology of patients with psychotic disorders have previously been described in the literature. However, it has not yet been investigated whether gender differences exist in the very first self-perceived signs or symptoms of illness onset. The aim of this study was to investigate this aspect in at-risk mental state (ARMS) and first-episode psychosis (FEP) patients. METHODS ARMS and FEP were recruited via the early detection of psychosis (FePsy) clinic Basel, Switzerland. The Basel Interview for Psychosis (BIP) was used to retrospectively assess the first 3 self-perceived signs and symptoms at illness onset. Differences between gender and patient groups on single item and symptom cluster levels were analysed using logistic regression models. RESULTS One-hundred-thirty six ARMS (91 men, 45 women) and 89 FEP patients (63 men, 26 women) could be recruited for this study. On a single item level, women more frequently reported "unusual anxiety, fears" and men (at a trend level) "social withdrawal" as being among their 3 first self-perceived symptoms, independent of diagnostic group. On the symptom cluster level, women more frequently reported "increased worrying/anxiety" and (sub-threshold) "hallucinations", independent of diagnostic group. Problems with "thinking, concentration" were reported more frequently by men in the ARMS group only. CONCLUSION Our results suggest that only few and relatively small gender differences exist in the first self-perceived signs and symptoms. While men initially mainly notice negative/cognitive symptoms, women first notice (sub-threshold) positive and affective symptoms.
Collapse
Affiliation(s)
- Ulrike Heitz
- Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland
| | - Erich Studerus
- Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland
| | - Stephanie Menghini-Müller
- Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland
| | - Martina Papmeyer
- Rehabilitation Services and Care Unit, Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland
| | - Laura Egloff
- Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland
| | - Sarah Ittig
- Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland
| | - Astrid Navarra
- Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland
| | - Christina Andreou
- Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland
| | - Anita Riecher-Rössler
- Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland
| |
Collapse
|
|
46
|
Akün E, Batıgün AD. Negative symptoms and recollections of parental rejection: The moderating roles of psychological maladjustment and gender. Psychiatry Res 2019; 275:332-337. [PMID: 30954843 DOI: 10.1016/j.psychres.2019.03.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 03/24/2019] [Accepted: 03/24/2019] [Indexed: 01/19/2023]
Abstract
The aim of the study was to investigate the moderating roles of the current self-reported psychological maladjustment and gender in the relationship between perceived parental rejection in childhood and negative symptoms of schizophrenia patients. The study sample consisted of 52 outpatients (20 females and 32 males between the ages of 19 and 61), diagnosed with schizophrenia at Ankara University and Ege University Faculty of Medicine Department of Psychiatry in Turkey. Participants' negative symptoms, recollections of parental rejection, and psychological maladjustment were assessed by Scale for the Assessment of Negative Symptoms, Adult Parental Acceptance-Rejection Questionnaire, and Personality Assessment Questionnaire, respectively. The findings revealed that negative symptoms were not directly linked to maternal and paternal rejection. However, negative symptoms significantly associated with psychological maladjustment. Three-way interaction (moderated moderation) analyses showed that the effects of perceived maternal and paternal rejection in childhood on negative symptoms were significantly moderated by the current self-reported psychological maladjustment for female patients with schizophrenia, but not for males. The study highlighted the importance of applying trauma or attachment-focused interventions and a gender-specific psychiatric treatment in schizophrenia.
Collapse
Affiliation(s)
- Ebru Akün
- Department of Psychology, Ankara University, Turkey.
| | | |
Collapse
|
|
47
|
Ju J, Liu L, Zhang Y, Zhou Q. Effect of age onset on schizophrenia-like phenotypes and underlying mechanisms in model mice. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:465-474. [PMID: 30025793 DOI: 10.1016/j.pnpbp.2018.07.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/13/2018] [Accepted: 07/15/2018] [Indexed: 10/28/2022]
Abstract
In humans, schizophrenia with onset in adolescence or adult has distinct features. To understand whether schizophrenia with either adolescence- or adult-onset have distinct phenotypes and cellular mechanisms in schizophrenia model mice, we altered Nrg1 signaling during either adolescence or adult mice via injection of anti-Nrg1 antibodies. We found that in either early-onset schizophrenia (EOS)- or late-onset schizophrenia (LOS)-like mice, certain behavior phenotypes are shared including hyperlocomotion, impaired working memory and impaired fear conditioning. Anxiety appears to be largely unaffected. In vitro electrophysiology in brain slices showed altered excitation/inhibition balance in EOS-like mice towards enhanced synaptic excitation, but intrinsic excitability of the fast-spiking GABAergic neurons was elevated in the LOS-like mice. Thus, although schizophrenia-like main phenotypes appear to be preserved in both age onset model mice, there are distinct differences in cellular mechanisms between them. We suggest that these differences are important for more precise diagnosis and more effective treatment of schizophrenia.
Collapse
Affiliation(s)
- Jun Ju
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Luping Liu
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Yujie Zhang
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Qiang Zhou
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China.
| |
Collapse
|
|
48
|
Theodoridou A, Hengartner MP, Heekeren K, Dvorsky D, Schultze-Lutter F, Gerstenberg M, Walitza S, Rössler W. Influence of demographic characteristics on attenuated positive psychotic symptoms in a young, help-seeking, at-risk population. Early Interv Psychiatry 2019; 13:53-56. [PMID: 28417595 DOI: 10.1111/eip.12444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 01/20/2017] [Accepted: 02/05/2017] [Indexed: 01/15/2023]
Abstract
AIM Presentation of attenuated positive psychotic symptoms (APS) was reported to be modestly influenced by age, sex and education in a psychosis-risk sample. We re-examined the influence of demographic variables on APS in an independent psychosis-risk sample. METHOD In a clinical high-risk-sample (N = 188; 13-35 years; 60.1% men), bivariate correlations were examined with Spearman correlations. All other associations were computed with generalized linear models. RESULTS Inter-correlations between positive symptoms were statistically significant for all but the smallest coefficient (range: r = 0.12-0.49). Age was negatively related to APS (range: OR = 0.53-0.78, all P < .01). Male sex was uniquely related to disorganized communication (OR = 1.46) and a high education-level related negatively to suspiciousness/persecutory ideas (OR = 0.64), perceptual abnormalities/hallucinations (OR = 0.57) and disorganized communication (OR = 0.54). The variance explained by age ranged from R 2 = 0.044 for unusual thought content to R 2 = 0.144 for perceptual abnormalities. CONCLUSION Our results highlighted the role of age and, thereby, neurodevelopment in psychosis-risk assessment.
Collapse
Affiliation(s)
- Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Karsten Heekeren
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Diane Dvorsky
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
| | - Miriam Gerstenberg
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zürich, Zürich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zürich, Zürich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland.,Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
|
49
|
Madsen HK, Nordholm D, Krakauer K, Randers L, Nordentoft M. Psychopathology and social functioning of 42 subjects from a Danish ultra high-risk cohort. Early Interv Psychiatry 2018; 12:1181-1187. [PMID: 28422422 DOI: 10.1111/eip.12438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 01/04/2017] [Accepted: 01/19/2017] [Indexed: 11/30/2022]
Abstract
AIM To make a thorough characterization of the co-morbidity, psychopathology and demographics in the first Danish ultra high-risk (UHR) sample. METHOD Forty-two UHR subjects went through comprehensive interviews assessing their psychopathology, psychiatric disorders, substance use and family history of psychiatric disorders. RESULTS All UHR subjects met the criteria of at least 1 axis I diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and met on average four diagnoses (both axis I and II), mostly within the areas of depression, anxiety and substance abuse. A total of 48% had schizotypal personality disorder and 19% had borderline personality disorder. Level of functioning was low with a mean score on the Social and Occupational Functioning Assessment Scale corresponding to "major impairment in several areas," and mean scores in the Global Functioning: Social and Role scales between "moderate impairment in social functioning" and "very serious impairment independently." Forty-seven percent were unemployed and 29% on sick leave. Fifty-five percent relied financially on public support. CONCLUSION As seen in previous UHR populations, Danish UHR subjects had low function socio-economically and met criteria of several psychiatric diagnoses, suggesting that they require pharmacological and non-pharmacological psychiatric treatment as well as vocational and educational guidance and support.
Collapse
Affiliation(s)
- Helle Karkov Madsen
- Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dorte Nordholm
- Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS); Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Copenhagen, Denmark
| | - Kristine Krakauer
- Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS); Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Copenhagen, Denmark
| | - Lasse Randers
- Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS); Mental Health Center Glostrup, Copenhagen University Hospital, Glostrup, Copenhagen, Denmark
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| |
Collapse
|
|
50
|
Riecher-Rössler A, Butler S, Kulkarni J. Sex and gender differences in schizophrenic psychoses-a critical review. Arch Womens Ment Health 2018; 21:627-648. [PMID: 29766281 DOI: 10.1007/s00737-018-0847-9] [Citation(s) in RCA: 145] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many sex and gender differences in schizophrenic psychoses have been reported, but few have been soundly replicated. A stable finding is the later age of onset in women compared to men. Gender differences in symptomatology, comorbidity, and neurocognition seem to reflect findings in the general population. There is increasing evidence for estrogens being psychoprotective in women and for hypothalamic-pituitary-gonadal dysfunction in both sexes.More methodologically sound, longitudinal, multi-domain, interdisciplinary research investigating both sex (biological) and gender (psychosocial) factors is required to better understand the different pathogenesis and etiologies of schizophrenic psychoses in women and men, thereby leading to better tailored treatments and improved outcomes.
Collapse
Affiliation(s)
- Anita Riecher-Rössler
- Center of Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
| | - Surina Butler
- Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre (MAPrc), Melbourne, VIC, 3004, Australia
| |
Collapse
|