FC19-02 - Electrocardiographic signs of autonomic imbalance in first-episode schizophrenia spectrum disorders— relations to first treatment discontinuation and five-year remission status

2011 ◽  
Vol 26 (S2) ◽  
pp. 1916-1916 ◽  
Author(s):  
R. Bodén ◽  
L. Lindström ◽  
P. Rautaharju ◽  
J. Sundström
Keyword(s):  
Heart Rate ◽  
Left Ventricular ◽  
First Episode ◽  
Healthy Controls ◽  
Autonomic Balance ◽  
Schizophrenia Spectrum Disorders ◽  
Remission Status ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

IntroductionSchizophrenia has since over a hundred years been associated with autonomic dysregulation, but the prognostic importance of this phenomenon is unclear.Objectives/aimsTo explore measures in electrocardiograms (ECG) reflecting autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent outcome. Three aspects of routine ECG measures were investigated:1)differences between patients with first-episode schizophrenia spectrum disorders and healthy controls,2)relations to early discontinuation of first antipsychotic medication and finally3)associations to symptomatic remission status five years later.MethodsTwelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization and left ventricular hypertrophy. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.ResultsPatients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy (hazard ratios 1.3–2.4) and with non-remission five years later (odds ratios 2.9–6.4).ConclusionIn this longitudinal cohort study, simple ECG measures reflecting autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. However, as this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.

Electrocardiographic signs of autonomic imbalance in medicated patients with first-episode schizophrenia spectrum disorders – relations to first treatment discontinuation and five-year remission status

2012 ◽  
Vol 27 (3) ◽  
pp. 213-218 ◽  
Author(s):  
Robert Bodén ◽  
Leif Lindström ◽  
Pentti Rautaharju ◽  
Johan Sundström
Keyword(s):  
Heart Rate ◽  
Small Sample ◽  
First Episode ◽  
Autonomic Balance ◽  
Schizophrenia Spectrum Disorders ◽  
Prognostic Information ◽  
Remission Status ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

AbstractPurposeTo explore measures in electrocardiograms (ECG) influenced by autonomic balance in early schizophrenia spectrum disorders and to examine their relation to subsequent first antipsychotic pharmacotherapy discontinuation and five-year remission status.Subjects and methodsTwelve-lead ECGs were recorded at baseline in 58 patients with first-episode schizophrenia spectrum disorders and in 47 healthy controls of similar age. Selected ECG variables included heart rate and measures of repolarization. Pharmacotherapy data were extracted from medical records. At a five-year follow-up the patients were interviewed and assessed with the Positive and Negative Syndrome Scale.ResultsPatients had higher heart rate and a different ST-T pattern than the controls. High T-wave amplitudes in the leads aVF and V5 and ST-elevations in V5 were associated both with higher risk of an earlier discontinuation of first antipsychotic pharmacotherapy and with non-remission five years later.Discussion and conclusionIn this longitudinal cohort study, simple ECG measures influenced by autonomic balance in the early phase of schizophrenia spectrum disorders contained prognostic information. As this is the first report of this association and is based on a relatively small sample, the results should be interpreted with caution.

scholarly journals T158. NO ALTERATION OF PITUTARY VOLUME IN PATIENTS WITH FIRST-EPISODE SCHIZPHRENIA BUT A TREND OF ENLARGEMENT IN NON-PSYCHOTIC FIRST-DEGREE RELATIVES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S291-S291
Author(s):  
Min-yi Chu ◽  
Simon S Y Lui ◽  
Karen S Y Hung ◽  
P C Sham ◽  
Henry K F Mak ◽  
...  
Keyword(s):  
High Risk ◽  
Intraclass Correlation ◽  
First Episode ◽  
Healthy Controls ◽  
Schizophrenia Spectrum Disorders ◽  
Duration Of Treatment ◽  
First Degree Relatives ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

Abstract Background There is growing evidence suggesting that the abnormal pituitary volume (PV) may be an essential deficit in schizophrenia spectrum disorders, and PV may change depending on the stage of the illness. However, previous studies assessing PV in schizophrenia spectrum disorders, especially in ultra-high risk individuals, were confounding. The present study aimed to assess whether there would be alteration of the PV in patients with first-episode schizophrenia and their non-affected first-degree relatives. Methods This study recruited 147 subjects, including subjects with 62 first-episode schizophrenia (31 man, 31 female), 25 non-psychotic first-degree relatives (11 male, 14 female), and 60 healthy controls (30 male, 30 female). All of them underwent a T1 weighted image magnetic resonance imaging using 3T MRI Scanner (Siemens, Germany). All volumes were examined with the 3D-Slicer 4.10.1 (Surgical Planning Laboratory, Brigham and Women’s Hospital, USA; http://www. slicer.org/). The PV was traced in all coronal slices with well-defied boundaries (such as diaphragma sellae (superiorly), the sphenoid sinus (inferiorly), the cavernous sinuses(bilaterally)). The infundibular stalk was excluded while the bright posterior pituitary was included. All images were tranced manually by a trained rater who was blind to the participants’ group assignment. In a random subset of 24 cases, both the inter-rater reliability (intraclass correlation coefficient r=0.916, p<0.001) and the intra-rater reliability (intraclass correlation coefficient r=0.924 p<0.001) were high. We conducted MANCOVA with gender, and whole brain volumes (WBV) as covariates to compare the PV among the groups. Results We found no significant differences in gender ratio, age, and WBV (p>0.05) among the three groups, but patients with first-episode schizophrenia showed shorter length of education than healthy controls (p<0.001). As expected, we found that male participants in general (Mean ± SD: 486.85 ± 100.24) exhibited a prominently smaller PV than female participants (Mean ± SD: 562.13 ± 102.90) after controlling for WBV (t=25.087, p<0.001). Findings from MANCOVA analysis showed that although first-episode schizophrenia patients (Mean ± SD: 523.81 ± 116.41) and healthy controls (Mean ± SD: 513.17 ± 103.57) showed no significant difference in PV (F=0.581, p=0.447), there was a trend of statistical significance in their non-psychotic first-degree relatives (Mean ± SD: 557.85 ± 93.58) compared with healthy controls (F=3.334, p=0.072). We also found a negative correlation between the duration of treatment and PV in female schizophrenia patients (r=-0.398, p=0.029), whose mean duration of treatment was 4.71 months (SD=2.18 months). No significant correlation was observed in in male patients. Discussion Our findings found no alteration of PV in first-episode schizophrenia patients but a trend of enlargement was observed in their non-psychotic first-degree relatives. Moreover, female schizophrenia patients with longer duration of treatment exhibited smaller PV. These findings suggested that the enlarged PV might be an early detection signal for individuals with potentially high risk of developing into schizophrenia, and such an enlargement of PV might be responsive to antipsychotic medications.

scholarly journals S201. HIPPOCAMPAL SUBFIELD VOLUMES AND CHANGE IN BODY MASS OVER 12 MONTHS OF TREATMENT IN FIRST-EPISODE SCHIZOPHRENIA SPECTRUM DISORDERS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S114-S115
Author(s):  
Stéfan Du Plessis ◽  
Hilmar Luckhoff ◽  
Sanja Kilian ◽  
Laila Asmal ◽  
Frederika Scheffler ◽  
...  
Keyword(s):  
Substance Use ◽  
Weight Gain ◽  
Body Mass ◽  
Interactive Effect ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Hippocampal Subfields ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

Abstract Background In this study, we explored the relationship between hippocampal subfield volumes and change in body mass over 12 months of treatment in 90 first-episode schizophrenia spectrum disorder patients (66 males, 24 females; mean age= 24.7±6.8 years). Methods Body mass index was assessed in patients at baseline, and at months 3, 6, 9 and 12. Hippocampal subfields of interest were assessed using a segmentation algorithm included in the FreeSurfer 6.0 software program. Results Linear regression analysis showed a significant interactive effect between sex and anterior hippocampus size as a predictor of change in body mass over 12 months, adjusting for age, substance use, treatment duration, and posterior hippocampal volumes. In an exploratory sub-analysis, partial correlations revealed a significant association between weight gain and smaller CA1, CA3 and subiculum volumes in females, but not males, adjusting for age and substance use, with similar trends evident for the CA4 and presubiculum subfields. Discussion In conclusion, our findings suggest that smaller anterior hippocampal subfields are associated with the development of weight gain over the course of treatment in first-episode schizophrenia spectrum disorders in a sex-specific fashion, and may partly explain the more severe and ongoing increase in body mass evident for female patients.

Depressive psychopathology in first-episode schizophrenia spectrum disorders: a systematic review, meta-analysis and meta-regression

2019 ◽  
Vol 49 (15) ◽  
pp. 2463-2474 ◽  
Author(s):  
Sarah E. Herniman ◽  
Kelly Allott ◽  
Lisa J. Phillips ◽  
Stephen J. Wood ◽  
Jacqueline Uren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Pooled Prevalence ◽  
Meta Regression ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

AbstractBackgroundDespite knowing for many decades that depressive psychopathology is common in first-episode schizophrenia spectrum disorders (FES), there is limited knowledge regarding the extent and nature of such psychopathology (degree of comorbidity, caseness, severity) and its demographic, clinical, functional and treatment correlates. This study aimed to determine the pooled prevalence of depressive disorder and caseness, and the pooled mean severity of depressive symptoms, as well as the demographic, illness, functional and treatment correlates of depressive psychopathology in FES.MethodsThis systematic review, meta-analysis and meta-regression was prospectively registered (CRD42018084856) and conducted in accordance with PRISMA and MOOSE guidelines.ResultsForty studies comprising 4041 participants were included. The pooled prevalence of depressive disorder and caseness was 26.0% (seven samples, N = 855, 95% CI 22.1–30.3) and 43.9% (11 samples, N = 1312, 95% CI 30.3–58.4), respectively. The pooled mean percentage of maximum depressive symptom severity was 25.1 (38 samples, N = 3180, 95% CI 21.49–28.68). Correlates of depressive psychopathology were also found.ConclusionsAt least one-quarter of individuals with FES will experience, and therefore require treatment for, a full-threshold depressive disorder. Nearly half will experience levels of depressive symptoms that are severe enough to warrant diagnostic investigation and therefore clinical intervention – regardless of whether they actually fulfil diagnostic criteria for a depressive disorder. Depressive psychopathology is prominent in FES, manifesting not only as superimposed comorbidity, but also as an inextricable symptom domain.

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