scholarly journals T25. THE RELATIONSHIP BETWEEN AGE AT FIRST-EPISODE AND LONGITUDINAL CORTICAL CHANGES IN FIRST-EPISODE PSYCHOSIS: A TWO-YEAR LONGITUDINAL STUDY IN AN ADOLESCENT AND ADULT-ONSET COHORT

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S240-S241
Author(s):  
Javier Santonja ◽  
Laura Pina-Camacho ◽  
Kenia Martínez ◽  
Covadonga Díaz-Caneja ◽  
Celso Arango ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Brain Magnetic Resonance Imaging ◽  
Imaging Study ◽  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Healthy Controls ◽  
Episode Psychosis ◽  
Occipital Lobes

Abstract Background In a unique deeply phenotyped longitudinal dataset consisting of first-episode psychosis (FEP) patients with a wide age at FEP onset (15 to 35 years) and healthy controls, we aimed to determine whether cortical abnormalities are already present at FEP, whether they progress further over the first two years of the illness, and, if so, whether change patterns are associated with age at first episode. Methods Multicenter (four-site) two-year follow-up case-control brain magnetic resonance imaging study; 74 patients with a FEP of less than 12 months’ duration, and 64 healthy controls (matched for age, sex, parental socioeconomic status and handedness) were scanned twice (median time between baseline and follow-up scan 24 months, range [16 – 32]). We computed percentage changes (PC) over follow-up in thickness/area/volume for frontal, temporal, parietal and occipital lobes. We included diagnosis (patient vs. control), age at baseline scan, sex, TBV and site as potential confounders. We conducted post-hoc comparisons for young (≤19y) and adult (>19y) diagnostic pairs (FEP vs healthy controls). Results A significant age-by-diagnosis interaction was only found for temporal lobe cortical thickness (CT)-PC (d = -.54, p = .002). Within this lobe, the largest effects for the age x diagnosis interaction were found in the middle (d = -.43, p = .01) and inferior (d = - .48, p = .007) temporal gyrus CT-PC. The younger the patient group, the greater temporal thinning relative to their age-matched control group. The most extreme patient vs. control PC difference (i.e. the largest effect size) was found at an age cut-off of 19 years (d=0.9, p= .01). Discussion In individuals with psychosis, the two-year cortical changes that follow the FEP are dependent of age at first episode, with those with an earlier onset showing more severe cortical thinning in the temporal lobe.

Volumetric and morphological characteristics of the hippocampus are associated with progression to schizophrenia in patients with first-episode psychosis

2017 ◽  
Vol 45 ◽  
pp. 1-5 ◽  
Author(s):  
R. Sauras ◽  
A. Keymer ◽  
A. Alonso-Solis ◽  
A. Díaz ◽  
C. Molins ◽  
...  
Keyword(s):  
Morphological Changes ◽  
Morphological Characteristics ◽  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Subcortical Structures ◽  
Episode Psychosis ◽  
Left Hippocampus ◽  
One Year

AbstractBackground:Abnormalities in the hippocampus have been implicated in the pathophysiology of psychosis. However, it is still unclear whether certain abnormalities are a pre-existing vulnerability factor, a sign of disease progression or a consequence of environmental factors. We hypothesized that first-episode psychosis patients who progress to schizophrenia after one year of follow up will display greater volumetric and morphological changes from the very beginning of the disorder.Methods:We studied the hippocampus of 41 patients with a first-episode psychosis and 41 matched healthy controls. MRI was performed at the time of the inclusion in the study. After one year, the whole sample was reevaluated and divided in two groups depending on the diagnoses (schizophrenia vs. non-schizophrenia).Results:Patients who progressed to schizophrenia showed a significantly smaller left hippocampus volume than control group and no-schizophrenia group (F = 3.54; df = 2, 77; P = 0.03). We also found significant differences in the morphology of the anterior hippocampus (CA1) of patients with first-episode psychosis who developed schizophrenia compared with patients who did not.Conclusions:These results are consistent with the assumption of hyperfunctioning dopaminergic cortico-subcortical circuits in schizophrenia, which might be related with an alteration of subcortical structures, such as the hippocampus, along the course of the disease. According with these results, hippocampus abnormalities may serve as a prognostic marker of clinical outcome in patients with a first-episode psychosis.

Neurological soft signs in adolescents with first episode psychosis

2006 ◽  
Vol 21 (5) ◽  
pp. 283-287 ◽  
Author(s):  
Arantzazu Zabala ◽  
Olalla Robles ◽  
Mara Parellada ◽  
Dolores Maria Moreno ◽  
Ana Ruiz-Sancho ◽  
...  
Keyword(s):  
Evolutionary Process ◽  
Significant Negative Correlation ◽  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Healthy Population ◽  
Healthy Controls ◽  
Neurological Soft Signs ◽  
Schizophrenia Group ◽  
Episode Psychosis

AbstractThe purpose of this study is to determine the decrease of neurological soft signs (NSS) during adolescence and to compare this evolutionary process in two groups of adolescents with first episode psychosis: a) schizophrenia and b) non-schizophrenia patients. The structured neurological evaluation scale (NES) was administered to 24 adolescents with first episode psychosis. The number of NSS, the total and subscales scores were correlated with age in patients and in 39 healthy controls. Adolescents with first-episode psychosis had a higher prevalence of NSS than healthy controls; the schizophrenia patients (N = 9) scored higher than non-schizophrenia patients (N = 15). The number of NSS, total score and the scores on three of the four NES subscales correlated inversely with age in the healthy control group. No correlation was found for the schizophrenia group. For the non-schizophrenia group, a significant negative correlation was found only in one subscale. The decrease of NSS during adolescence in the healthy population but not in the patient groups with psychosis may be an indicator of a disturbance of brain processes that occurs during development. We did not find a clear pattern of NSS that distinguished schizophrenia from other psychoses.

scholarly journals Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study

2020 ◽  
Vol 270 (6) ◽  
pp. 709-722 ◽  
Author(s):  
Siv Hege Lyngstad ◽  
Erlend Strand Gardsjord ◽  
Magnus Johan Engen ◽  
Beathe Haatveit ◽  
Henrik Myhre Ihler ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Healthy Controls ◽  
Follow Up Study ◽  
Early Predictors ◽  
Episode Psychosis

Resting-state functional brain networks in first-episode psychosis: A 12-month follow-up study

2018 ◽  
Vol 52 (9) ◽  
pp. 864-875 ◽  
Author(s):  
Eleni P Ganella ◽  
Caio Seguin ◽  
Christos Pantelis ◽  
Sarah Whittle ◽  
Bernhard T Baune ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Resting State ◽  
First Episode Psychosis ◽  
First Episode ◽  
Healthy Controls ◽  
Resting State Functional Connectivity ◽  
And Topology ◽  
Episode Psychosis ◽  
Network Properties

Introduction: Schizophrenia is increasingly conceived as a disorder of brain network connectivity and organization. However, reports of network abnormalities during the early illness stage of psychosis are mixed. This study adopted a data-driven whole-brain approach to investigate functional connectivity and network architecture in a first-episode psychosis cohort relative to healthy controls and whether functional network properties changed abnormally over a 12-month period in first-episode psychosis. Methods: Resting-state functional connectivity was performed at two time points. At baseline, 29 first-episode psychosis individuals and 30 healthy controls were assessed, and at 12 months, 14 first-episode psychosis individuals and 20 healthy controls completed follow-up. Whole-brain resting-state functional connectivity networks were mapped for each individual and analyzed using graph theory to investigate whether network abnormalities associated with first-episode psychosis were evident and whether functional network properties changed abnormally over 12 months relative to controls. Results: This study found no evidence of abnormal resting-state functional connectivity or topology in first-episode psychosis individuals relative to healthy controls at baseline or at 12-months follow-up. Furthermore, longitudinal changes in network properties over a 12-month period did not significantly differ between first-episode psychosis individuals and healthy control. Network measures did not significantly correlate with symptomatology, duration of illness or antipsychotic medication. Conclusions: This is the first study to show unaffected resting-state functional connectivity and topology in the early psychosis stage of illness. In light of previous literature, this suggests that a subgroup of first-episode psychosis individuals who have a neurotypical resting-state functional connectivity and topology may exist. Our preliminary longitudinal analyses indicate that there also does not appear to be deterioration in these network properties over a 12-month period. Future research in a larger sample is necessary to confirm our longitudinal findings.

scholarly journals No progressive brain changes during a 1-year follow-up of patients with first-episode psychosis

2015 ◽  
Vol 46 (3) ◽  
pp. 589-598 ◽  
Author(s):  
U. K. Haukvik ◽  
C. B. Hartberg ◽  
S. Nerland ◽  
K. N. Jørgensen ◽  
E. H. Lange ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
First Episode Psychosis ◽  
Longitudinal Change ◽  
First Episode ◽  
Cortical Region ◽  
Healthy Controls ◽  
Episode Psychosis ◽  
Wide Range ◽  
Brain Changes

BackgroundFirst-episode psychosis (FEP) patients show structural brain abnormalities. Whether the changes are progressive or not remain under debate, and the results from longitudinal magnetic resonance imaging (MRI) studies are mixed. We investigated if FEP patients showed a different pattern of regional brain structural change over a 1-year period compared with healthy controls, and if putative changes correlated with clinical characteristics and outcome.MethodMRIs of 79 FEP patients [SCID-I-verified diagnoses: schizophrenia, psychotic bipolar disorder, or other psychoses, mean age 27.6 (s.d. = 7.7) years, 66% male] and 82 healthy controls [age 29.3 (s.d. = 7.2) years, 66% male] were acquired from the same 1.5 T scanner at baseline and 1-year follow-up as part of the Thematically Organized Psychosis (TOP) study, Oslo, Norway. Scans were automatically processed with the longitudinal stream in FreeSurfer that creates an unbiased within-subject template image. General linear models were used to analyse longitudinal change in a wide range of subcortical volumes and detailed thickness and surface area estimates across the entire cortex, and associations with clinical characteristics.ResultsFEP patients and controls did not differ significantly in annual percentage change in cortical thickness or area in any cortical region, or in any of the subcortical structures after adjustment for multiple comparisons. Within the FEP group, duration of untreated psychosis, age at illness onset, antipsychotic medication use and remission at follow-up were not related to longitudinal brain change.ConclusionsWe found no significant longitudinal brain changes over a 1-year period in FEP patients. Our results do not support early progressive brain changes in psychotic disorders.

Cognitive clusters in first-episode psychosis: Overlap with healthy controls and relationship to concurrent and prospective symptoms and functioning.

2017 ◽  
Vol 31 (7) ◽  
pp. 787-797 ◽  
Author(s):  
Jacqueline Uren ◽  
Susan M. Cotton ◽  
Eoin Killackey ◽  
Michael M. Saling ◽  
Kelly Allott
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Healthy Controls ◽  
Episode Psychosis

Brief psycho-education for caregivers of persons with first episode psychosis

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Praful Prabhuappa Kapse ◽  
Manisha Kiran
Keyword(s):  
First Episode Psychosis ◽  
First Episode ◽  
Control Group ◽  
Episode Psychosis ◽  
Study Results ◽  
Before And After ◽  
Quasi Experimental ◽  
Expressed Emotions ◽  
Experimental Group ◽  
Group Family

Caring for the persons with first episode psychosis is challenging and demanding. It may lead to the increased burden, expressed emotions among the caregivers. The numerous studies have shown that high burden and negative expressed emotions among caregivers can lead to early relapse in the patients with first episode psychosis. To evaluate the effects of the brief psychoeducation on the caregivers burden and expressed emotions. A quasi experimental - before and after with control group research design was adopted for the study. A total of 60 caregivers have participated in the study, of which 30 caregivers in experimental group and 30 caregivers in the control group. Family Burden Interview Schedule (Pai and Kapoor, 1981) and Attitude Questionnaire (Sethi et al., 1981) was used to assess caregiver's burden and expressed emotions. At end of the psychoeducation intervention, burden among caregivers and negative expressed emotions of the caregivers have significantly reduced. The positive expressed emotions have been increased. Study results demonstrates the importance of psychoeducation intervention in reducing the burden and negative expressed emotions.

scholarly journals Implementation of NAVIGATE Coordinated Specialty Care for First Episode Psychosis: the Michigan Experience

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 177-178
Author(s):  
Eric D. Achtyes ◽  
Kari Kempema ◽  
Zhehui Luo ◽  
Katharine N. Thakkar ◽  
Catherine Adams ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Symptoms ◽  
The United States ◽  
First Episode Psychosis ◽  
Specialty Care ◽  
First Episode ◽  
Control Group ◽  
Evidence Based ◽  
Block Grant ◽  
Episode Psychosis

AbstractStudy ObjectivesCoordinated specialty care (CSC) is widely accepted as an evidence-based treatment for first episode psychosis (FEP). The NAVIGATE intervention from the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP) study is a CSC intervention which offers a suite of evidence-based treatments shown to improve engagement and clinical outcomes, especially in those with shorter duration of untreated psychosis (DUP). Coincident with the publication of this study, legislation was passed by the United States Congress in 2014–15 to fund CSC for FEP via a Substance Abuse and Mental Health Services Administration (SAMHSA) block grant set-aside for each state. In Michigan (MI) the management of this grant was delegated to Network180, the community mental health authority in Kent County, with the goal of making CSC more widely available to the 10 million people in MI. Limited research describes the outcomes of implementation of CSC into community practices with no published accounts evaluating the use of the NAVIGATE intervention in a naturalistic setting. We describe the outcomes of NAVIGATE implementation in the state of MI.MethodsIn 2014, 3 centers in MI were selected and trained to provide NAVIGATE CSC for FEP. In 2016 a 4th center was added, and 2 existing centers were expanded to provide additional access to NAVIGATE. Inclusion: age 18–31, served in 1 of 4 FEP centers in MI. Data collection began in 2015 for basic demographics, global illness (CGI q3 mo), hospital/ED use and work/school (SURF q3 mo) and was expanded in 2016 to include further demographics, diagnosis, DUP, vital signs; and in 2018 for clinical symptoms with the modified Colorado Symptom Inventory (mCSI q6 mo), reported via an online portal. This analysis used data until 12/31/19. Mixed effects models adjusted by age, sex and race were used to account for correlated data within patients.ResultsN=283 had useable demographic information and were included in the analysis. Age at enrollment was 21.6 ± 3.0 yrs; 74.2% male; 53.4% Caucasian, 34.6% African American; 12.9 ± 1.7 yrs of education (N=195). 18 mo retention was 67% with no difference by sex or race. CGI scores decreased 20% from baseline (BL) to 18 mo (BL=3.5, N=134; 15–18 mo=2.8, N=60). Service utilization via the SURF was measured at BL (N=172) and 18 mo (N=72): psychiatric hospitalizations occurred in 37% at BL and 6% at 18 mo (p<0.01); ER visits occurred in 40% at BL and 13% at 18 mo (p<0.01). 44% were working or in school at BL and 68% at 18 mo (p<0.01). 21% were on antipsychotics (AP) at BL (N=178) and 85% at 18 mo (N=13) with 8% and 54% on long acting injectable-AP at BL and 18 mo, respectively. Limitations include missing data and lack of a control group.ConclusionThe implementation of the NAVIGATE CSC program for FEP in MI resulted in meaningful clinical improvement for enrollees. Further support could make this evidence-based intervention available to more people with FEP.FundingSupported by funds from the SAMHSA Medicaid State Block Grant set-aside awarded to Network180 (Achtyes, Kempema). The funders had no role in the design of the study, the analysis or the decision to publish the results.

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