M134. MISMATCH NEGATIVITY IS REFLECTIVE OF DISEASE PROGRESSION RATHER THAN SYMPTOMATIC RECOVERY IN FIRST-EPISODE PSYCHOSIS

Abstract Background Whether mismatch negativity (MMN) is associated with clinical status or reflects the disease progression in first-episode psychosis (FEP) patients has not been established. We aimed to investigate whether the change in MMN impairment fluctuates with the change in clinical status during 1-year. Methods MMN and the clinical status of 25 patients with FEP were measured at baseline and reassessed after 1 year. MMN of 25 matched healthy controls (HCs) were measured at baseline. Repeated-measures analysis of variance (ANOVA) was used to compare MMN at baseline among the groups, and paired t-tests were utilized to compare baseline and 1-year MMN amplitude of FEP. To identify the association between MMN impairment change and symptomatic, cognitive or functional change during 1-year, this study used multiple regression analysis controlling possible confounders. Results MMN amplitudes at baseline were significantly attenuated in FEP patients compared to HC. One-year follow-up MMN amplitude decreased significantly at Fz electrode site in FEP group. Also, the change in MMN amplitudes significantly correlated with the worsened TMT-B but did not with the symptomatic or functional recovery. Discussion These results suggest that MMN impairment may be more closely related to cognitive deficits reflecting disease progression than the currently apparent symptoms and functional status during the beginning of a psychotic episode. Future studies are needed to elucidate the relationship with the disease pathophysiology of psychosis and MMN.

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Patterns and predictors of hospitalisation in first-episode psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.178.6.518 ◽

2001 ◽

Vol 178 (6) ◽

pp. 518-523 ◽

Cited By ~ 47

Author(s):

Attila Sipos ◽

Glynn Harrison ◽

David Gunnell ◽

Shazad Amin ◽

Swaran P. Singh

Keyword(s):

Negative Symptoms ◽

First Episode Psychosis ◽

Psychiatric Services ◽

First Episode ◽

Psychotic Episode ◽

Duration Of Untreated Illness ◽

Specialist Services ◽

Increased Risk ◽

Episode Psychosis

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.

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Aggressive incidents in first-episode psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.178.5.433 ◽

2001 ◽

Vol 178 (5) ◽

pp. 433-440 ◽

Cited By ~ 64

Author(s):

John Milton ◽

Shazad Amin ◽

Swaran P. Singh ◽

Glynn Harrison ◽

Peter Jones ◽

...

Keyword(s):

First Episode Psychosis ◽

Psychotic Symptoms ◽

First Episode ◽

Psychotic Episode ◽

Increased Risk ◽

Episode Psychosis ◽

Clinical Associations ◽

Independent Effects ◽

One Act ◽

Service Contact

BackgroundRecent research has reported increased risk of aggressive incidents by individuals with psychotic illness.AimsTo examine acts of aggression in first-episode psychosis.MethodSubjects with a first-episode psychosis were ascertained from a defined catchment area (Nottingham, UK) and reassessed at 3 years (n=166) using clinical interview, informants, health care and forensic records.ResultsOf the subjects, 9.6% demonstrated at least one act of serious aggression (defined as weapon use, sexual assault or victim injury) during at least one psychotic episode and 23.5% demonstrated lesser acts of aggression (defined as all other acts of aggression). For all aggressive subjects (33.1%), unemployment (OR=3.6, 95%CI 1.6–8.0), comorbid substance misuse (OR=3.1, CI 1.1–8.8) and symptoms of overactivity at service contact (OR=6.9, CI 2.7–17.8) had independent effects on risk of aggression.ConclusionsWe confirmed some previously reported demographic and clinical associations with aggression in first-episode psychosis but no relationship with specific psychotic symptoms or diagnostic groups was observed.

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White Matter Microstructural Abnormalities in the Broca’s-Wernicke’s-Putamen “Hoffman Hallucination Circuit” and Auditory Transcallosal Fibers in First-Episode Psychosis With Auditory Hallucinations

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa105 ◽

2020 ◽

Author(s):

Dean F Salisbury ◽

Yiming Wang ◽

Fang-Cheng Yeh ◽

Brian A Coffman

Keyword(s):

White Matter ◽

Left Hemisphere ◽

Structural Integrity ◽

Right Hemisphere ◽

First Episode Psychosis ◽

Auditory Hallucinations ◽

First Episode ◽

Psychotic Episode ◽

Arcuate Fasciculus ◽

Episode Psychosis

Abstract Background Functional connectivity abnormalities between Broca’s and Wernicke’s areas and the putamen revealed by functional magnetic resonance imaging (fMRI) are related to auditory hallucinations (AH). In long-term schizophrenia, reduced white matter structural integrity revealed by diffusion imaging in left arcuate fasciculus (connecting Broca’s and Wernicke’s areas) is likely related to AH. The structural integrity of connections with putamen and their relation to AH are unknown. Little is known about this relationship in first-episode psychosis (FEP), although auditory transcallosal connections were reported to play a role. White matter in the Broca’s-Wernicke’s-putamen language-related circuit and auditory transcallosal fibers was examined to investigate associations with AH in FEP. Methods White matter connectivity was measured in 40 FEP and 32 matched HC using generalized fractional anisotropy (gFA) derived from diffusion spectrum imaging (DSI). Results FEP and HC did not differ in gFA in any fiber bundle. In FEP, AH severity was significantly inversely related to gFA in auditory transcallosal fibers and left arcuate fasciculus. Although the right hemisphere arcuate fasciculus-AH association did not attain significance, the left and right arcuate fasciculus associations were not significantly different. Conclusions Despite overall normal gFA in FEP, AH severity was significantly related to gFA in transcallosal auditory fibers and the left hemisphere connection between Broca’s and Wernicke’s areas. Other bilateral tracts’ gFA were weakly associated with AH. At the first psychotic episode, AH are more robustly associated with left hemisphere arcuate fasciculus and interhemispheric auditory fibers microstructural deficits, likely reflecting mistiming of information flow between language-related cortical centers.

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S46. IMPAIRED ERROR-PROCESSING IN PATIENTS WITH FIRST-EPISODE PSYCHOSIS: AN EVENT-RELATED POTENTIAL STUDY

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.112 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S50-S50

Author(s):

Jihye Park ◽

Minah Kim ◽

Wu Jeong Hwang ◽

Jun Soo Kwon

Keyword(s):

Correct Response ◽

Event Related Potentials ◽

First Episode Psychosis ◽

Electrode Site ◽

Event Related Potential ◽

First Episode ◽

Conflict Monitoring ◽

Error Related Negativity ◽

Episode Psychosis ◽

Related Potentials

Abstract Background Impaired error/conflict monitoring as reflected in the event-related potentials (ERPs) has consistently reported in patients with schizophrenia. However, whether this impairment exist from the early phase of psychosis such as first-episode psychosis (FEP) is not yet been clearly reported. To investigate the presence of error/conflict monitoring deficit in early psychosis, we examined the error-related negativity (ERN), error-related positivity (Pe), and correct-response negativity (CRN) during the Go/Nogo task in the patients with FEP. Methods 25 patients with and 25 age, sex matched healthy controls (HCs) were participated in electroencephalographic recording during the Go/Nogo task. Trials with error response was analyzed to define ERN at Fz electrode site and Pe at Pz electrode site. Trials with correct response was used for CRN analysis at Fz electrode site. Independent samples t-test was used to compare the amplitudes of ERP components between FEP and HC groups. Pearson’s correlation analysis was performed to reveal the relationship of altered ERP component with symptomatic severity in patients with schizophrenia. Results FEP patients showed significantly smaller ERN amplitude at Fz electrode site compared to HCs (t=-3.294, p=0.002). However, there was no difference of CRN (t=0.017, p=0.986) and Pe (t=1.806, p=0.077) amplitudes between FEP and HC groups. There was no significant correlation of symptomatic severity and ERN amplitude at Fz electrode site in FEP patients. Discussion These findings suggest that impairments in error/conflict monitoring as reflected by ERN amplitude exist from the early course of psychotic disorder. Future study with larger sample size and subjects at earlier phase such as clinical high risk for psychosis would be needed to confirm the findings of current study.

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The pathways to mental health care of first-episode psychosis patients: a systematic review

Psychological Medicine ◽

10.1017/s0033291710000371 ◽

2010 ◽

Vol 40 (10) ◽

pp. 1585-1597 ◽

Cited By ~ 92

Author(s):

K. K. Anderson ◽

R. Fuhrer ◽

A. K. Malla

Keyword(s):

Mental Health ◽

First Episode Psychosis ◽

Pathways To Care ◽

First Episode ◽

Psychotic Episode ◽

First Psychotic Episode ◽

Episode Psychosis ◽

First Contact ◽

Pathway To Care ◽

Delay In Treatment

BackgroundAlthough there is agreement on the association between delay in treatment of psychosis and outcome, less is known regarding the pathways to care of patients suffering from a first psychotic episode. Pathways are complex, involve a diverse range of contacts, and are likely to influence delay in treatment. We conducted a systematic review on the nature and determinants of the pathway to care of patients experiencing a first psychotic episode.MethodWe searched four databases (Medline, HealthStar, EMBASE, PsycINFO) to identify articles published between 1985 and 2009. We manually searched reference lists and relevant journals and used forward citation searching to identify additional articles. Studies were included if they used an observational design to assess the pathways to care of patients with first-episode psychosis (FEP).ResultsIncluded studies (n=30) explored the first contact in the pathway and/or the referral source that led to treatment. In 13 of 21 studies, the first contact for the largest proportion of patients was a physician. However, in nine of 22 studies, the referral source for the greatest proportion of patients was emergency services. We did not find consistent results across the studies that explored the sex, socio-economic, and/or ethnic determinants of the pathway, or the impact of the pathway to care on treatment delay.ConclusionsAdditional research is needed to understand the help-seeking behavior of patients experiencing a first-episode of psychosis, service response to such contacts, and the determinants of the pathways to mental health care, to inform the provision of mental health services.

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Reduced Mismatch Negativity is Associated with Increased Plasma Level of Glutamate in First-episode Psychosis

Scientific Reports ◽

10.1038/s41598-017-02267-1 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 22

Author(s):

Tatsuya Nagai ◽

Kenji Kirihara ◽

Mariko Tada ◽

Daisuke Koshiyama ◽

Shinsuke Koike ◽

...

Keyword(s):

Plasma Level ◽

Mismatch Negativity ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis

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Neurological soft signs in first-episode psychosis: A systematic review

The British Journal of Psychiatry ◽

10.1192/bjp.181.43.s50 ◽

2002 ◽

Vol 181 (S43) ◽

pp. s50-s57 ◽

Cited By ~ 132

Author(s):

Paola Dazzan ◽

Robin M. Murray

Keyword(s):

Motor Coordination ◽

First Episode Psychosis ◽

The Body ◽

First Episode ◽

Psychotic Episode ◽

Neurological Soft Signs ◽

First Psychotic Episode ◽

Cerebral Dysfunction ◽

Episode Psychosis ◽

First Onset

BackgroundNeurological soft signs (NSS) are minor neurological signs indicating non-specific cerebral dysfunction. Their presence has been documented extensively in schizophrenia but not during the first psychotic episode.AimsTo review studies that have specifically investigated NSS at the time of the first psychotic episode.MethodA review of studies investigating neurological function in first-episode psychosis, using a clinical examination.ResultsPatients with first-episode psychosis show an excess of NSS, particularly in the areas of motor coordination and sequencing, sensory integration and in developmental reflexes. Furthermore, NSS may be associated with a specific laterality pattern.ConclusionsMore studies on first-onset schizophrenia are needed, evaluating both sensory and motor neurological domains (scoring separately for the two sides of the body), integrating this knowledge with neuroimaging findings and clarifying the role of NSS as markers of cognitive dysfunction.

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