Cannabis Use and Age at Onset of Psychosis: Further Evidence of Interaction with COMT Val158Met Polymorphism

IntroductionDifferent studies have confirmed the association between cannabis use and psychosis and, also, the relationship between age at first cannabis use and age at onset of psychosis (Henquet et al 2005, Barnes et al 2006). In a young psychiatric sample, we aimed to investigate the correlation between cannabis use and the age at onset of psychotic and non-psychotic symptoms and whether this relationship is modulated by the genetic variability at COMT, CNR1 and CHRNA7genes.MethodsThe sample comprised 157 Caucasian patients (mean age: 17.01 (3.6)) diagnosed following DSM-IV-TR criteria: 80 patients with schizophrenia-spectrum disorders, 77 patients with affective or conduct disorders. Cannabis use was assessed with UNICA-A and DIGS scales (Nurnberger 1994) and 49% individuals were classified as consumers. SNPs were genotyped using Taqman 5′-exonuclease assays.ResultsWe observed a positive relationship between age at first cannabis use and age at onset in, both, schizophrenia-spectrum (β = 1.44 p < 0.001) and other psychiatric disorders (β = 0.56 p < 0.002). An interaction was observed between COMT Val158Met polymorphism and cannabis use specifically within schizophrenia-spectrum disorders’ group (β = −2.72 p = 0.04), with Val/Val genotype carriers showing an earlier age of onset than Val/Met carriers, and these, lower than the Met/Met carriers. No modulation effect of CNR1 or CHRNA7 polymorphisms was observed.ConclusionsOur results seem to indicate the importance of maturation timing and brain development in which exposition to cannabis occurs. We provide new evidence about the COMT modulation effect on the association between cannabis use and age at onset of symptoms, specifically in individuals affected by schizophrenia-spectrum disorders.

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Premorbid cannabis use is associated with more symptoms and poorer functioning in schizophrenia spectrum disorder

Psychological Medicine ◽

10.1017/s0033291716001999 ◽

2016 ◽

Vol 46 (15) ◽

pp. 3127-3136 ◽

Cited By ~ 10

Author(s):

P. A. Ringen ◽

R. Nesvåg ◽

S. Helle ◽

T. V. Lagerberg ◽

E. H. Lange ◽

...

Keyword(s):

Substance Use ◽

Age At Onset ◽

Cannabis Use ◽

Spectrum Disorder ◽

Psychotic Symptoms ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum Disorder ◽

Schizophrenia Spectrum ◽

Premorbid Functioning ◽

Spectrum Disorders

BackgroundCannabis use disorder is associated with an earlier age at onset and a more severe outcome of schizophrenia spectrum disorders. The role of cannabis use before the onset of illness (premorbid cannabis use) has not been fully investigated. We here examined how amount and type of premorbid cannabis use was associated with the later course of illness including current substance use, symptoms and level of functioning in schizophrenia spectrum disorder.MethodWe used a naturalistic sample of patients with DSM-IV schizophrenia spectrum disorders with a comprehensive history of illness and substance use. Data on premorbid substance use was obtained from comprehensive self-report. The relationship to outcome was investigated using regression models that included current substance use and premorbid functioning.ResultsPre-schizophrenia cannabis use was significantly associated with more severe psychotic symptoms and impaired functioning. Higher levels of premorbid cannabis use were associated with higher levels of current psychotic symptoms. These associations were independent of current substance use and premorbid functioning. Early use of cannabis (age <17 years) was associated with earlier age at onset of psychosis, independently of potential confounders.ConclusionsPre-psychosis cannabis use affects illness outcome in schizophrenia spectrum disorders, and is associated with lower age at onset of psychosis. These findings of independent negative effects of premorbid cannabis use in schizophrenia suggest that a limitation of the general use of cannabis may have beneficial health effects.

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Cannabis use and clinical outcome in people with first-episode schizophrenia spectrum disorders over 24 months of treatment

Psychiatry Research ◽

10.1016/j.psychres.2021.114022 ◽

2021 ◽

pp. 114022

Author(s):

Freda Scheffler ◽

Lebogang Phahladira ◽

Hilmar Luckhoff ◽

Stefan du Plessis ◽

Laila Asmal ◽

...

Keyword(s):

Clinical Outcome ◽

Cannabis Use ◽

First Episode ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

First Episode Schizophrenia

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Acoustic speech markers for schizophrenia-spectrum disorders: a diagnostic and symptom-recognition tool

Psychological Medicine ◽

10.1017/s0033291721002804 ◽

2021 ◽

pp. 1-11

Author(s):

J. N. de Boer ◽

A. E. Voppel ◽

S. G. Brederoo ◽

H. G. Schnack ◽

K. P. Truong ◽

...

Keyword(s):

Negative Symptoms ◽

Structured Interview ◽

Diagnostic Value ◽

Spectrum Disorder ◽

Psychotic Symptoms ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum Disorder ◽

Speech Technology ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

Abstract Background Clinicians routinely use impressions of speech as an element of mental status examination. In schizophrenia-spectrum disorders, descriptions of speech are used to assess the severity of psychotic symptoms. In the current study, we assessed the diagnostic value of acoustic speech parameters in schizophrenia-spectrum disorders, as well as its value in recognizing positive and negative symptoms. Methods Speech was obtained from 142 patients with a schizophrenia-spectrum disorder and 142 matched controls during a semi-structured interview on neutral topics. Patients were categorized as having predominantly positive or negative symptoms using the Positive and Negative Syndrome Scale (PANSS). Acoustic parameters were extracted with OpenSMILE, employing the extended Geneva Acoustic Minimalistic Parameter Set, which includes standardized analyses of pitch (F0), speech quality and pauses. Speech parameters were fed into a random forest algorithm with leave-ten-out cross-validation to assess their value for a schizophrenia-spectrum diagnosis, and PANSS subtype recognition. Results The machine-learning speech classifier attained an accuracy of 86.2% in classifying patients with a schizophrenia-spectrum disorder and controls on speech parameters alone. Patients with predominantly positive v. negative symptoms could be classified with an accuracy of 74.2%. Conclusions Our results show that automatically extracted speech parameters can be used to accurately classify patients with a schizophrenia-spectrum disorder and healthy controls, as well as differentiate between patients with predominantly positive v. negatives symptoms. Thus, the field of speech technology has provided a standardized, powerful tool that has high potential for clinical applications in diagnosis and differentiation, given its ease of comparison and replication across samples.

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F128. THE AGE OF ONSET OF SCHIZOPHRENIA SPECTRUM DISORDERS

Schizophrenia Bulletin ◽

10.1093/schbul/sby017.659 ◽

2018 ◽

Vol 44 (suppl_1) ◽

pp. S270-S270 ◽

Cited By ~ 1

Author(s):

Jouko Miettunen ◽

Johanna Immonen ◽

John McGrath ◽

Matti Isohanni ◽

Erika Jääskeläinen

Keyword(s):

Age Of Onset ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

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Awareness of illness moderates self-assessment of psychotic symptoms

Australian & New Zealand Journal of Psychiatry ◽

10.1177/00048674211057480 ◽

2021 ◽

pp. 000486742110574

Author(s):

Luis Martinez Agulleiro ◽

Renato de Filippis ◽

Stella Rosson ◽

Bhagyashree Patil ◽

Lara Prizgint ◽

...

Keyword(s):

Mental Disorders ◽

Confidence Interval ◽

Rating Scale ◽

Psychotic Symptoms ◽

Schizophrenia Spectrum Disorders ◽

Brief Psychiatric Rating Scale ◽

Schizophrenia Spectrum ◽

Psychiatric Rating ◽

Spectrum Disorders ◽

Psychiatric Rating Scale

Objective: Self-reports or patient-reported outcome measures are seldom used in psychosis due to concerns about the ability of patients to accurately report their symptomatology, particularly in cases of low awareness of illness. The aim of this study was to assess the effect of insight on the accuracy of self-reported psychotic symptoms using a computerized adaptive testing tool (CAT-Psychosis). Methods: A secondary analysis of data drawn from the CAT-Psychosis development and validation study was performed. The Brief Psychiatric Rating Scale and the Scale of Unawareness of Mental Disorders were administered by clinicians. Patients completed the self-reported version of the CAT-Psychosis. Patients were median-split regarding their insight level to compare the correlation between the two psychosis severity measures. A subgroup sensitivity analysis was performed only on patients with schizophrenia spectrum disorders. Results: A total of 159 patients with a psychotic disorder who completed both CAT-Psychosis and Scale of Unawareness of Mental Disorders were included. For the whole sample, CAT-Psychosis scores showed convergent validity with Brief Psychiatric Rating Scale ratings ( r = 0.517, 95% confidence interval = [0.392, 0.622], p < 0.001). Insight was found to moderate this correlation (β = –0.511, p = 0.005), yet agreement between both measures remained statistically significant for both high ( r = 0.621, 95% confidence interval = [0.476, 0.733], p < 0.001) and low insight patients ( r = 0.408, 95% confidence interval = [0.187, 0.589], p < 0.001), while psychosis severity was comparable between these groups (for Brief Psychiatric Rating Scale: U = 3057, z = –0.129, p = 0.897; disorganization: U = 2986.5, z = –0.274, p = 0.784 and for CAT-Psychosis: U = 2800.5, z = –1.022, p = 0.307). Subgroup of patients with schizophrenia spectrum disorders showed very similar results. Conclusions: Insight moderates the correlation between self-reported and clinician-rated severity of psychosis, yet CAT-Psychosis remains valid in patients with both high and low awareness of illness.

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Admixture analysis of age at onset in older patients with schizophrenia spectrum disorders

International Psychogeriatrics ◽

10.1017/s104161022000085x ◽

2020 ◽

Vol 32 (6) ◽

pp. 781-785

Author(s):

Maureen M. J. Smeets-Janssen ◽

Idan M. Aderka ◽

Paul D. Meesters ◽

Sjors Lange ◽

Sigfried Schouws ◽

...

Keyword(s):

Late Onset ◽

Age At Onset ◽

Cross Sectional Study ◽

Data Driven ◽

Admixture Analysis ◽

Schizophrenia Spectrum Disorders ◽

Sectional Study ◽

Cross Sectional ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

ABSTRACTThe nature of schizophrenia spectrum disorders with an onset in middle or late adulthood remains controversial. The aim of our study was to determine in patients aged 60 and older if clinically relevant subtypes based on age at onset can be distinguished, using admixture analysis, a data-driven technique. We conducted a cross-sectional study in 94 patients aged 60 and older with a diagnosis of schizophrenia or schizoaffective disorder. Admixture analysis was used to determine if the distribution of age at onset in this cohort was consistent with one or more populations of origin and to determine cut-offs for age at onset groups, if more than one population could be identified. Results showed that admixture analysis based on age at onset demonstrated only one normally distributed population. Our results suggest that in older schizophrenia patients, early- and late-onset ages form a continuum.

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A review of autobiographical memory studies on patients with schizophrenia spectrum disorders

BMC Psychiatry ◽

10.1186/s12888-019-2346-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Yujia Zhang ◽

Sara K. Kuhn ◽

Laura Jobson ◽

Shamsul Haque

Keyword(s):

Autobiographical Memory ◽

Psychotic Symptoms ◽

Control Group ◽

Schizophrenia Spectrum Disorders ◽

Autobiographical Memories ◽

Memory Specificity ◽

Autobiographical Memory Specificity ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

The Relationship

Abstract Background Patients suffering from schizophrenia spectrum disorders demonstrate various cognitive deficiencies, the most pertinent one being impairment in autobiographical memory. This paper reviews quantitative research investigating deficits in the content, and characteristics, of autobiographical memories in individuals with schizophrenia. It also examines if the method used to activate autobiographical memories influenced the results and which theoretical accounts were proposed to explain the defective recall of autobiographical memories in patients with schizophrenia. Methods PsycINFO, Web of Science, and PubMed databases were searched for articles published between January 1998 and December 2018. Fifty-seven studies met the inclusion criteria. All studies implemented the generative retrieval strategy by inducing memories through cue words or pictures, the life-stage method, or open-ended retrieval method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines were followed for this review. Results Most studies reported that patients with schizophrenia retrieve less specific autobiographical memories when compared to a healthy control group, while only three studies indicated that both groups performed similarly on memory specificity. Patients with schizophrenia also exhibited earlier reminiscence bumps than those for healthy controls. The relationship between comorbid depression and autobiographical memory specificity appeared to be independent because patients’ memory specificity improved through intervention, but their level of depression remained unchanged. The U-shaped retrieval pattern for memory specificity was not consistent. Both the connection between the history of attempted suicide and autobiographical memory specificity, and the relationship between psychotic symptoms and autobiographical memory specificity, remain inconclusive. Patients’ memory specificity and coherence improved through cognitive training. Conclusions The overgeneral recall of autobiographical memory by patients with schizophrenia could be attributed to working memory, the disturbing concept of self, and the cuing method implemented. The earlier reminiscence bump for patients with schizophrenia may be explained by the premature closure of the identity formation process due to the emergence of psychotic symptoms during early adulthood. Protocol developed for this review was registered in PROSPERO (registration no: CRD42017062643).

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Hallucinations without delusions in patients with first-episode psychosis: Clinical correlates and implications for pathophysiological models

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.859 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S32-S32

Author(s):

I. Melle

Keyword(s):

Negative Symptoms ◽

Clinical Symptoms ◽

Age At Onset ◽

Diagnostic Interview ◽

Clinical Profile ◽

First Episode ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Competing Interest

IntroductionThe symptomatic distribution in schizophrenia spectrum disorder is heterogeneous. Patients may experience hallucinations, delusions and combinations thereof, in addition to disorganized and negative symptoms. We have previously found that patients with monosymptomatic hallucinations exhibited a different clinical profile than patients with monosymptomatic delusions or combinations of the two; with an earlier age at onset and more suicidal symptoms.AimsTo replicate findings in a new group of patients with schizophrenia spectrum disorders.MethodsA total of 421 consecutive patients with schizophrenia spectrum disorders were included into the study. They were comprehensively assessed by specifically trained psychiatrists or clinical psychologists; using the SCID for DSM-IV for diagnostic purposes, the PANSS to assess current clinical symptoms and CDSS to assess current depression. Lifetime presence of different symptom types was ascertained during the diagnostic interview.ResultsA total of 346 (82%) had experienced both hallucinations and delusion, 63 (15%) had experienced delusions without hallucinations, 10 (2.5%) had experienced hallucinations without delusions and 2 patients (0.5%) had neither but experienced negative and severely disorganized symptoms. Contrary to hypothesis, we did not find any statistically significant differences in age at onset and in clinical symptoms (including suicidality) between these groups. We also did not find any differences in the type of hallucinatory experiences between hallucinating groups.ConclusionsIn a new sample of patients, we did not replicate previous findings of a different clinical profile in patients with monosymptomatic hallucinations. This type of psychotic disorder is relatively rare, which might pose a problem concerning statistical strength.Disclosure of interestThe author has not supplied his declaration of competing interest.

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