T27. COGNITIVE RESERVE IN CHILD AND ADOLESCENT OFFSPRING OF PATIENTS DIANOSED WITH SCHIZOPHRENIA OR BIPOLAR DISORDER

Abstract Background Cognitive Reserve (CR) is defined as the ability of the brain to cope and deal with physiological or pathological brain injuries. In the field of psychiatry, higher levels of CR have been associated with lower levels of psychotic symptoms, higher psycho-social functioning and higher cognitive performance, suggesting that CR should be considered as a protective factor (Barnett et al., 2006; Amoretti et al., 2016). This study aims to compare CR levels in a sample of adolescents and young adult offspring of patients with schizophrenia or bipolar disorder who are at high risk of developing these disorders (HR) and compared them with a group of healthy controls (HC). We also assess the utility of CR in predicting clinical and cognitive variables. Methods Participants were 85 HR and 45 HC. A CR proxy was calculated based on premorbid IQ, socio-occupational attainment and social activities. Clinical assessment included: the Structured Interview for Prodromal Symptoms (SOPS), the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HDRS). Neuropsychological assessment included: Working Memory, Processing Speed, Verbal Memory, attention and executive functioning. A factorial analysis was conducted in order to obtain a single CR measure. Differences between groups in CR were assessed via MANCOVA and linear regressions were conducted to check the effectiveness of CR in predicting clinical and neuropsychological variables. Results No significant differences were observed in age or gender between HR and HC groups. Socioeconomic status was lower in HR subjects (F=8.100, p=0.005).CR was significantly lower in the HR group than in the HC group (F=17.522; p<0.001). Moreover, the CR proxy was able to correctly classify 72.7% of the sample as either HR or HC. Our proxy was able to predict the following clinical variables in the HR group: negative (F=9.269; p=0.002), and total (F=7.290; p=0.009) prodromal symptoms, the YMRS (F=11.597; P<0.001) and the HDRS (F=12.761; p<0.001). In terms of neuropsychological variables, RC predicted WM (F=9.738; p=0.003), PS (F=4.557; p=0.037) and verbal memory [immediate (F=6.999; p=0.010) and delayed recall (F=10.990; P=0.002)] in the HR sample. Discussion HR subjects have lower CR than controls. CR is associated with clinical and neuropsychological variables. To our knowledge no previous studies have assessed CR in high risk samples. Nevertheless, studies conducted in adult first episode psychotic samples have shown an association between CR and the severity of symptoms.

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Cognitive reserve in neuropsychiatry

Psychological Medicine ◽

10.1017/s0033291706007501 ◽

2006 ◽

Vol 36 (8) ◽

pp. 1053-1064 ◽

Cited By ~ 159

Author(s):

J. H. BARNETT ◽

C. H. SALMOND ◽

P. B. JONES ◽

B. J. SAHAKIAN

Keyword(s):

Bipolar Disorder ◽

Cognitive Function ◽

Head Injury ◽

Cognitive Reserve ◽

Protective Factor ◽

Psychiatric Symptoms ◽

Neuropsychiatric Disorders ◽

Future Studies ◽

Cognitive Failure ◽

History Of

Background. The idea that superior cognitive function acts as a protective factor against dementia and the consequences of head injury is well established. Here we suggest the hypothesis that cognitive reserve is also important in neuropsychiatric disorders including schizophrenia, bipolar disorder and depression.Method. We review the history of passive and active models of reserve, and apply the concept to neuropsychiatric disorders. Schizophrenia is used as an exemplar because the effects of premorbid IQ and cognitive function in this disorder have been extensively studied.Results. Cognitive reserve may impact on neuropsychiatric disorders in three ways: by affecting the risk for developing the disorder, in the expression of symptoms within disorders, and in patients' functional outcome. Cognitive failure below a certain threshold may alone, or in combination with common psychiatric symptoms, produce neuropsychiatric syndromes.Conclusions. Consideration of cognitive reserve may considerably improve our understanding of individual differences in the causes and consequences of neuropsychiatric disorders. For these reasons, the concept of cognitive reserve should be incorporated in future studies of neuropsychiatric disorder. It may be possible to enhance cognitive reserve through pharmacological or non-pharmacological means, such as education, neurocognitive activation or other treatment programmes.

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Longitudinal study of premorbid adjustment in 22q11.2 deletion (velocardiofacial) syndrome and association with psychosis

Development and Psychopathology ◽

10.1017/s0954579416000018 ◽

2016 ◽

Vol 29 (1) ◽

pp. 93-106 ◽

Cited By ~ 5

Author(s):

Petya D. Radoeva ◽

Wanda Fremont ◽

Kevin M. Antshel ◽

Wendy R. Kates

Keyword(s):

Early Adolescence ◽

Velocardiofacial Syndrome ◽

Structured Interview ◽

School Age Children ◽

Deletion Syndrome ◽

Psychotic Symptoms ◽

22Q11.2 Deletion ◽

Prodromal Symptoms ◽

Premorbid Adjustment ◽

Increased Risk

AbstractVelocardiofacial syndrome, also known as 22q11.2 deletion syndrome (22q11DS), is associated with an increased risk of major psychiatric disorders, including schizophrenia. The emergence of psychotic symptoms in individuals with schizophrenia in the general population is often preceded by a premorbid period of poor or worsening social and/or academic functioning. Our current study evaluated premorbid adjustment (via the Cannon–Spoor Premorbid Adjustment Scale [PAS]) and psychotic symptoms (via the Structured Interview for Prodromal Symptoms and the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version) in youth with 22q11DS (N = 96), unaffected siblings (N = 40), and community controls (N = 50). The PAS scores indicated greater maladjustment during all developmental periods in individuals with 22q11DS compared to the controls. Many participants with 22q11DS had chronically poor (n = 33) or deteriorating (n = 6) PAS scores. In 22q11DS, chronically poor PAS trajectories and poor childhood and early adolescence academic domain and total PAS scores significantly increased the risk of prodromal symptoms or overt psychosis. Taking into account the catechol-O-methyltransferase (COMT) genotype, the best predictor of (prodromal) psychosis was the early adolescence academic domain score, which yielded higher sensitivity and specificity in the subgroup of youth with 22q11DS and the high-activity (valine) allele. PAS scores may help identify individuals at higher risk for psychosis.

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Disturbances of basic self and prodromal symptoms among non-psychotic help-seeking adolescents

Psychological Medicine ◽

10.1017/s0033291712002322 ◽

2012 ◽

Vol 43 (7) ◽

pp. 1365-1376 ◽

Cited By ~ 42

Author(s):

D. Koren ◽

N. Reznik ◽

M. Adres ◽

R. Scheyer ◽

A. Apter ◽

...

Keyword(s):

Psychosocial Functioning ◽

Help Seeking ◽

Structured Interview ◽

Psychotic Symptoms ◽

Risk Markers ◽

Prodromal Symptoms ◽

The Social ◽

Prodromal Syndrome ◽

The Relationship ◽

Subclinical Psychotic Symptoms

BackgroundThe goal of this study was to explore the notion that anomalies of self-experience (ASE) are a core, ‘not-yet-psychotic’ clinical phenotype of emerging schizophrenia and its spectrum.MethodTo accomplish this goal, we examined the relationship between ASE and commonly accepted risk markers in a sample of 87 help-seeking, non-psychotic adolescents (aged 14–18 years). ASE were assessed with the Examination of Anomalous Self-Experience (EASE), subclinical psychotic symptoms were assessed with the Prodromal Questionnaire and the Structured Interview for Prodromal Syndromes, deterioration in psychosocial functioning was assessed with the Social and Role Functioning Scales, and level of distress with the Mood and Anxiety Symptoms Questionnaire.ResultsAbout 82 participants completed the entire EASE interview. The number of participants who reported ASE at a clinically meaningful level (n = 18, 22%) was smaller than that who met diagnostic criteria for a prodromal syndrome (n = 28, 34%). The degree of overlap between the two conditions was moderate but statistically significant (χ2(1) = 7.01, p = 0.008). An exploratory factor analysis revealed that ASE load on a different factor than prodromal symptoms and deterioration in functioning, but that there is a moderate correlation between the three factors.ConclusionsThese results suggest that ASE are prevalent among non-psychotic help-seeking adolescents, yet at a considerably lower rate than prodromal symptoms. In addition, they suggest that ASE and prodromal symptoms constitute distinct but moderately related dimensions of potential risk. Taken together, they provide preliminary support for the clinical usefulness of supplementing and refining the methods of early detection of risk with assessment of ASE.

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Factor–structure of the Italian version of the Scale Of Prodromal Symptoms (SOPS): a comparison with the English version

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796011000114 ◽

2011 ◽

Vol 20 (1) ◽

pp. 45-54 ◽

Cited By ~ 19

Author(s):

A. Comparelli ◽

V. Savoja ◽

G. D. Kotzalidis ◽

S. W. Woods ◽

S. Mosticoni ◽

...

Keyword(s):

Psychometric Properties ◽

Factor Structure ◽

Convergent Validity ◽

Rating Scale ◽

Structured Interview ◽

Italian Version ◽

Prodromal Symptoms ◽

Early Intervention Services ◽

Psychiatric Rating ◽

Psychiatric Rating Scale

Aims.The 19-item ‘Scale Of Prodromal Symptoms’ (SOPS) and its semi-structured interview, the Structured Interview for Prodromal Symptoms (SIPS), have been developed to assess prodromes of psychosis. We assessed psychometric properties of the Italian version of the instrument.Methods.We collected socio-demographic and clinical data of 128 people seeking first-time psychiatric help in a large Roman area, either as outpatients at community facilities or as inpatients in psychiatric wards of two general hospitals. Participants were administered the Italian version of the SOPS and the 24-item Brief Psychiatric Rating Scale (BPRS). Data were analysed through Pearson's correlation and factorial analysis.Results.The English and Italian SOPS versions showed similar psychometric properties and factorial structure. The best-fit model was trifactorial, explaining 90% of total variance, and roughly corresponding to the positive, negative, and general dimensions, with disorganisation spreading over the other dimensions. Compared with the BPRS, the Italian version of the SOPS showed construct validity and convergent validity.Conclusions.The factor–structure of the Italian version of the SOPS is similar to those of the English and Spanish versions, in that the factors emerged are the same (positive, negative, and general symptoms). The scale could be used to assess at-risk people in early intervention services.

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Protective factors for social-emotional well-being of refugee children in the first three years of settlement in Australia

Archives of Disease in Childhood ◽

10.1136/archdischild-2016-312495 ◽

2017 ◽

Vol 103 (3) ◽

pp. 261-268 ◽

Cited By ~ 8

Author(s):

Karen Zwi ◽

Lisa Woodland ◽

Katrina Williams ◽

Pamela Palasanthiran ◽

Santuri Rungan ◽

...

Keyword(s):

Protective Factors ◽

Protective Factor ◽

Stressful Life Events ◽

Rating Scale ◽

Community Support ◽

Well Being ◽

Structured Interview ◽

Marital Stability ◽

Refugee Children ◽

Social Emotional

AimThis longitudinal study investigated protective factors for social-emotional well-being in refugee children in Australia.MethodsNewly arrived refugee children aged 4–15 years were recruited between 2009 and 2013 and assessments were conducted at two points, at years 2 and 3 postarrival. Social-emotional well-being was assessed using the Strengths and Difficulties Questionnaire (SDQ). Protective factors were assessed by structured interview and the Social Readjustment Rating Scale (SRRS); scores <150 reflect fewer stressful life events in the previous year.ResultsForty-three eligible refugee children were recruited. The SDQ was completed by parents in 90% and protective factor data in 80% at years 2 and 3 of follow-up. Protective factors for normal SDQ scores were: originating from Africa (p=0.01), father present on arrival (p=0.019) and family SRRS scores <150 at year 2 (p=0.045). The median number of protective factors was 4 (range 1–8). Better SDQ scores were associated with ≥4 protective factors (p<0.006). Furthermore, more protective factors increased the child’s likelihood of a stable or improved SDQ score over time (p<0.04). Modifiable protective factors likely to promote social-emotional well-being include stability in the child’s school and residence, parental employment, financial and marital stability, proximity to one’s own ethnic community and external community support.ConclusionsCumulative protective factors, some of which are potentially modifiable, can predict social-emotional well-being in newly arrived refugee children. Children with four or more protective factors are at low risk of poor social-emotional well-being.

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Autism Rating Scale: A New Tool for Characterizing the Schizophrenia Phenotype

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.622359 ◽

2021 ◽

Vol 12 ◽

Author(s):

Davide Palumbo ◽

Giovanni Stanghellini ◽

Armida Mucci ◽

Massimo Ballerini ◽

Giulia Maria Giordano ◽

...

Keyword(s):

Bipolar Disorder ◽

Internal Consistency ◽

Negative Symptoms ◽

Rating Scale ◽

Autistic Traits ◽

Structured Interview ◽

Autism Spectrum ◽

Divergent Validity ◽

Convergent And Divergent Validity ◽

Psychotic Features

Social dysfunctions (SD) are frequently observed in subjects with schizophrenia. Some of these dysfunctions are also observed in other neuropsychiatric disorders such as autism spectrum disorders (ASD), major depression, bipolar disorder, or Alzheimer disease. Recently, a characterization of a specific type of SD in schizophrenia has been proposed, with the concept of dis-sociality, which form the core aspect of “Schizophrenic Autism” (SA). The present study aimed to explore the presence in people with schizophrenia of SA, independent of other autistic traits, which can be often found in schizophrenia and other neurodevelopmental disorders. We used a structured interview—the Autism Rating Scale (ARS), an instrument devised to detect and measure SA. Fifty-one outpatients affected by schizophrenia (26 remitted, SCZ-r) and 28 affected by bipolar disorder type 1, with psychotic features, in the euthymic phase (BD-e) were recruited. Before assessing the specificity for schizophrenia of SA, we tested the internal consistency, the convergent and divergent validity of the ARS in the schizophrenia sample. Specificity was assessed by examining potential differences in ARS scores between SCZ-r and BD-e subjects. ARS showed good internal consistency, as well as convergent and divergent validity. ARS items were more frequently of moderate severity in SCZ-r than in BD-e subjects. This scale can contribute to establish more precise phenomenal boundaries between schizophrenia and bipolar disorder, and opens up the possibility of identifying a different type of SD in schizophrenia, independent of autistic traits and negative symptoms, which might benefit from different treatments.

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Temporal association of stress sensitivity and symptoms in individuals at clinical high risk for psychosis

Psychological Medicine ◽

10.1017/s0033291712001262 ◽

2012 ◽

Vol 43 (2) ◽

pp. 259-268 ◽

Cited By ~ 54

Author(s):

J. E. DeVylder ◽

S. Ben-David ◽

S. A. Schobel ◽

D. Kimhy ◽

D. Malaspina ◽

...

Keyword(s):

High Risk ◽

Stress Tolerance ◽

Life Events ◽

Longitudinal Design ◽

Stress Sensitivity ◽

Psychotic Symptoms ◽

Clinical High Risk ◽

Prodromal Symptoms ◽

Wide Range ◽

Over Time

BackgroundIncreased sensitivity and exposure to stress are associated with psychotic symptoms in schizophrenia and its risk states, but little is known about the co-evolution of stress sensitivity and exposure with positive and other symptoms in a clinical high-risk (CHR) cohort.MethodA combined cross-sectional and longitudinal design was used to examine the associations over time of stress sensitivity and exposure (i.e. life events) with ‘prodromal’ symptoms in a cohort of 65 CHR patients assessed quarterly for up to 4 years, and at baseline in 24 healthy controls similar in age and gender.ResultsImpaired stress tolerance was greater in patients, in whom it was associated over time with positive and negative symptoms, in addition to depression, anxiety and poor function. By contrast, life events were comparable in patients and controls, and bore no association with symptoms. In this treated cohort, there was a trajectory of improvement in stress tolerance, symptoms and function over time.ConclusionsImpaired stress tolerance was associated with a wide range of ‘prodromal’ symptoms, consistent with it being a core feature of the psychosis risk state. Self-reported life events were not relevant as a correlate of clinical status. As in other treated CHR cohorts, most patients improved over time across symptom domains.

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The Management of Prodromal Symptoms of Bipolar Disorder: Available Options and Future Perspectives

Medicina ◽

10.3390/medicina57060545 ◽

2021 ◽

Vol 57 (6) ◽

pp. 545

Author(s):

Elisa Del Favero ◽

Cristiana Montemagni ◽

Paola Bozzatello ◽

Claudio Brasso ◽

Cecilia Riccardi ◽

...

Keyword(s):

Bipolar Disorder ◽

High Risk ◽

Treatment Options ◽

Future Perspectives ◽

Prodromal Symptoms ◽

Clinical Risk ◽

Treatment Indications ◽

Risk Patients ◽

Important Means ◽

The Moment

The onset of prodromal symptoms in subjects who are at familial or clinical risk for bipolar disorder could be considered as an important alarm bell for the development of the disease and should be carefully detected. The management of prodromes in bipolar high-risk patients appears to be an important means of prevention; nevertheless, at the moment, there aren’t clear and widely shared treatment indications. The aim of this review is to summarize the available treatment options (pharmacological, psychosocial and nutraceutical) for the management of prodromal symptoms in subjects who are at familial or clinical risk for bipolar disorder.

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M26. CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT OFFSPRING OF PATIENTS DIAGNOSED WITH SCHIZOPHERNIA: A COMPARATIVE STUDY WITH ADHD CHILDREN

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.338 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S143-S144

Author(s):

Elena De la Serna ◽

Gisela Sugranyes ◽

Daniel Ilzarbe ◽

Patricia Camprodon ◽

Inmaculada Baeza ◽

...

Keyword(s):

Psychosocial Functioning ◽

Psychotic Disorders ◽

Rating Scale ◽

Child And Adolescent ◽

Psychotic Symptoms ◽

Adhd Group ◽

Mixed Effect ◽

Prodromal Symptoms ◽

Adolescent Offspring ◽

History Of

Abstract Background Recent studies have observed high rates of psychopathology in child and adolescent offspring of patients with schizophrenia (SZoff). Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent psychopathology in SZoff (Sanchez-Gistau, et al., 2015). The high prevalence of ADHD observed in SZoff can conceal the vulnerability characteristics specific to schizophrenia. The aim of this study is to analyze the clinical characteristics of a sample of child and adolescent SZoff diagnosed with ADHD (SZoff-ADHD) compared to a sample of children with ADHD without a family history of psychotic disorders and a sample of healthy controls. We hypothesize that SZoff-ADHD will show more psychopathology and more prodromal psychotic symptoms than the other two groups. Methods we studied a sample of 22 SZoff-ADHD children, 15 children with ADHD with no familiar history of psychotic disorders and 40 healthy controls (HC) between 6 and 17 years old and we conducted a complete clinical assessment which included: Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Structured interview for Prodromal Symptoms (SOPS) and Global Assessment Functioning (GAF). In order to detect significant differences between groups, multilevel mixed-effect logistic regression models (categorical variables) or multilevel mixed-effect linear regression models (continuous variables) were performed with group as the fixed factor and the fact of having a sibling in the same study (identified by the family number) as the random variable. Results significant differences between groups were found in socio-economic status which was lower in the SZoff-ADHD group than in the other two groups (F=15.886; p<0.001). Moreover the SZoff-ADHD also showed a higher percentage of males (90.9%) compared with the ADHD group (62.5%) and the HC (45%) (F=12.647; p=0.002). No significant age differences between groups were detected. Regarding clinical assessments, the SZoff-ADHD group showed a higher percentage of conduct disorders (F=3.720; p=0.039) than the ADHD group. No significant differences were observed in other psychopathological diagnoses. Furthermore the SZoff-ADHD group also obtained higher scores than the HC group on the following scales: YMRS, positive, negative, general and total sub-scales of the SOPS and lower scores in the GAF. The ADHD group obtained significantly higher scores than the HC group in the sub-scale of SOPS general prodromal symptoms and lower scores on the GAF. Significant differences were detected between SZoff-ADHD and ADHD in the YMRS and the positive and negative sub-scales of the SOPS where the SZoff-ADHD group showed higher scores than the ADHD group. Discussion Compared with the HC group, the SZoff-ADHD displayed more manic, prodromal psychotic symptoms and worse psychosocial functioning. The ADHD group showed an intermediate pattern between the SZoff-ADHD and the HC group, with more general prodromal symptoms and lower psychosocial functioning than the HC group but lower scores than the SZoff-ADHD in the psychotic prodromal symptoms interview.

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Schizotypal components in people at high risk of developing schizophrenia: early findings from the Edinburgh High-Risk Study

The British Journal of Psychiatry ◽

10.1192/bjp.180.2.179 ◽

2002 ◽

Vol 180 (2) ◽

pp. 179-184 ◽

Cited By ~ 64

Author(s):

Patrick Miller ◽

Majella Byrne ◽

Ann Hodges ◽

Stephen M. Lawrie ◽

David G. Cunningham Owens ◽

...

Keyword(s):

At Risk ◽

High Risk ◽

Principal Components ◽

Social Withdrawal ◽

Risk Groups ◽

Structured Interview ◽

Psychotic Symptoms ◽

Emotional Dysfunction ◽

State Examination

BackgroundThe study of high-risk groups and the development of schizophrenia.AimsTo investigate further schizotypy, measured by the Structured Interview for Schizotypy (SIS), and to examine relationships between schizotypal components, psychotic symptoms on the Present State Examination (PSE) and subsequent schizophrenia.MethodThe SIS and PSE were administered on entry. Schizophrenia onsets were recorded during follow-up.ResultsThe SIS yielded four principal components labelled social withdrawal, psychotic symptoms, socio-emotional dysfunction and odd behaviour. On entry, these differentiated between controls, subjects at risk for schizophrenia with and without symptoms and patients with schizophrenia. Seven of 78 subjects at risk developed schizophrenia within 39 months. This was best predicted by combining the four SIS components.ConclusionsSchizotypy is heterogeneous and may become psychosis, particularly if several of its components are present. As psychosis develops, odd behaviour gives way to psychotic symptoms and social function deteriorates.

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