Tobacco use and psychosis risk in persons at clinical high risk

Introduction: Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes. This perspective incorporating information regarding exposure at differing developmental periods is lacking in research surrounding individuals at Clinical High Risk (CHR) for developing a psychotic disorder. Methods: CHR individuals (n = 35) and healthy volunteers (n = 28) completed structured clinical interviews as well as our group’s newly developed Individual and Structural Exposure to Stress in Psychosis-risk-states (ISESP) interview. Lifetime cumulative scores were calculated, and severity of stress was reported for multiple developmental periods/ages. Group differences were tested, and associations with current symptom domains were examined. Results: Significant group differences were not observed for lifetime cumulative events, though CHR trended toward endorsing more events and greater stress severity. For stress severity across development, there were trending group differences for the 11–13 age range, and significant group differences for the 14–18 age range; notably, comparisons for earlier time points did not approach statistical significance. Associations between negative symptoms and cumulative severity of exposure were observed. Discussion: Results suggest exploring exposure to cumulative environmental risk factors/stressors and stress severity across developmental periods is generally informative and possibly specifically so for predictive models and diathesis-stress psychosis risk conceptualizations.

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S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.220 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S94-S95

Author(s):

Andrea De Micheli ◽

Albertine van Lawick van Pabst ◽

Enass Yossef ◽

Philip McGuire ◽

Paolo Fusar-Poli

Keyword(s):

Systematic Review ◽

High Risk ◽

Physical Health ◽

Tobacco Use ◽

Citation Index ◽

Meta Analysis ◽

Assessment Tools ◽

Clinical High Risk ◽

Increased Risk ◽

Russian Science Citation Index

Abstract Background There is converging evidence that youths at clinical high risk (CHR) are not only likely to develop the first episode of psychosis but also to develop poor physical outcomes. Some physical health risk factors - such as smoking - have been shown to increase the probability of a frank onset of psychosis in those at risk. A meta-analysis conducted in psychotic patients confirmed that daily tobacco use is associated with an increased risk of psychosis. A significant association between any attenuated psychotic symptoms (that characterize CHR state) and cigarette smoking has been recently shown in a study conducted in South London. Nowadays, it is not completely clear how these findings would translate to the CHR population but a better understanding of how physical health parameters could affect psychopathological outcomes could be beneficial for these vulnerable clinical populations. To shed light on the percentage of smokers in CHR populations, an updated systematic review and meta-analysis of the literature has been carried out. Our main aim was to test whether the probability of being a smoker was higher in the CHR subjects or in the control group. Methods The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We systematically scrutinized from literature inception to 2019 the following on-line databases: Web of Science Core Collection, BIOSIS Citation Index, KCL-Korean Journal Database, MEDLINE, Russian Science Citation Index, SCiELO Citation Index. We have considered all the relevant studies reporting the smoking status in CHR subjects and in control groups. We used the odds ratio (OR) as effect size measure and data were pooled using a random effect approach. Results Preliminary data show that CHR individuals were more likely to use tobacco that matched healthy controls. Specifically, the overall OR of 2.016 (p<.001 95%CI=1.476–2.749) indicated a higher likelihood that CHR individuals would use tobacco compared to controls. Heterogeneity was not significant (I²=30.193 p=0.11). The visual inspection of funnel plots did not reveal a clear suggestion for publication bias and the Egger’s test was non-significant (p=0.10). Discussion Our systematic review and meta-analysis suggest that is crucial to investigate physical health outcomes such as tobacco use as part of clinical practice in CHR services. Unfortunately, current CHR assessment tools are entirely based on the measurement of psychopathological features and do not include an assessment of these parameters on a regular basis.

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Automatic Auditory Processing Deficits in Schizophrenia and Clinical High-Risk Patients: Forecasting Psychosis Risk with Mismatch Negativity

Biological Psychiatry ◽

10.1016/j.biopsych.2013.07.038 ◽

2014 ◽

Vol 75 (6) ◽

pp. 459-469 ◽

Cited By ~ 126

Author(s):

Veronica B. Perez ◽

Scott W. Woods ◽

Brian J. Roach ◽

Judith M. Ford ◽

Thomas H. McGlashan ◽

...

Keyword(s):

High Risk ◽

Auditory Processing ◽

Mismatch Negativity ◽

Clinical High Risk ◽

High Risk Patients ◽

Psychosis Risk ◽

Risk Patients ◽

Processing Deficits

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T37. PREPULSE INHIBITION IN UNAFFECTED SIBLINGS OF SCHIZOPHRENIA AND CLINICAL-HIGH RISK WITHOUT FAMILY HISTORY OF PSYCHOSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.597 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S245-S246

Author(s):

Mao Zhen ◽

Qijing Bo ◽

Qing Tian ◽

Fang Dong ◽

Xianbin Li ◽

...

Keyword(s):

Family History ◽

High Risk ◽

Prepulse Inhibition ◽

Spatial Separation ◽

Structured Interview ◽

Clinical High Risk ◽

Priority Effect ◽

Stimulus Interval ◽

Psychosis Risk ◽

History Of

Abstract Background It is reported that prepulse inhibition (PPI) deficiency of startle reflex in schizophrenia is associated with positive symptoms and is hereditary. In this study, the perceived spatial separation (PSS) induced-prepulse inhibition paradigm based on the priority effect effectively was used to explore PPI levels of genetically high-risk (GHR) of schizophrenia and clinical high risk (CHR) without family history of psychosis Methods We examined startle magnitude and PPI in38 CHR (No family history of psychosis), 28 GHR (Siblings or children of schizophrenia), and 44 healthy controls (HC). Modified acoustic PPI paradigm included PSS-PPI and perceived spatial co-location PPI (PSC-PPI) with inter-stimulus interval (ISI) of 60 or 120ms. The Structured Interview for Psychosis risk Syndromes (SIPS) and MATRICS Consensus Cognitive Battery (MCCB) was used to measure psychotic symptom and neuropsychological state of individuals Results Using gender, age, and smoking as covariates, Covariance analysis for modified PPI level results revealed that there were significant differences in PSSPPI60 (F = 6.25, p = 0.03) and PSSPI120 (F = 6.57, p = 0.03) paradigm between the three groups. Compared with HC, PSSPPI paradigm detected PPI defects of CHR individuals at 60ms ISI (F = 14.25, p ＜0.001) and 120ms ISI (F = 14.01, p ＜0.001). PPI deficiency was not detected in GHR individuals. PPI level in both groups were unrelated to demographics, clinical characteristics, and cognition. Using GLM analysis, the interaction between grouping and experimental paradigm had no significant effect on PPI level at 60ms (F = 1.88, P = 0.16) and 120ms (Z = 1.66, P = 0.19). Discussion It seems that mere heritability of psychosis is not enough to produce PPI defects, which may be related to the progression of psychosis

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S105. VALIDATING THE PREDICTIVE ACCURACY OF THE NAPLS-2 PSYCHOSIS RISK CALCULATOR IN A CLINICAL HIGH-RISK SAMPLE FROM THE SHARP (SHANGHAI AT RISK FOR PSYCHOSIS) PROGRAM

Schizophrenia Bulletin ◽

10.1093/schbul/sby018.892 ◽

2018 ◽

Vol 44 (suppl_1) ◽

pp. S366-S366

Author(s):

TianHong Zhang ◽

HuiJun Li ◽

LiHua Xu ◽

YingYing Tang ◽

HuiRu Cui ◽

...

Keyword(s):

At Risk ◽

High Risk ◽

Predictive Accuracy ◽

Clinical High Risk ◽

Risk Calculator ◽

Psychosis Risk

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Heterogeneity of Psychosis Risk Within Individuals at Clinical High Risk

JAMA Psychiatry ◽

10.1001/jamapsychiatry.2015.2324 ◽

2016 ◽

Vol 73 (2) ◽

pp. 113 ◽

Cited By ~ 198

Author(s):

Paolo Fusar-Poli ◽

Marco Cappucciati ◽

Stefan Borgwardt ◽

Scott W. Woods ◽

Jean Addington ◽

...

Keyword(s):

High Risk ◽

Clinical High Risk ◽

Psychosis Risk

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Substance use in individuals at clinical high risk of psychosis

Psychological Medicine ◽

10.1017/s0033291715000227 ◽

2015 ◽

Vol 45 (11) ◽

pp. 2275-2284 ◽

Cited By ~ 23

Author(s):

L. Buchy ◽

K. S. Cadenhead ◽

T. D. Cannon ◽

B. A. Cornblatt ◽

T. H. McGlashan ◽

...

Keyword(s):

Substance Use ◽

High Risk ◽

Clinical Outcome ◽

Tobacco Use ◽

Cannabis Use ◽

Longitudinal Impact ◽

Clinical High Risk ◽

Alcohol And Drug Use ◽

Additional Information ◽

Lower Alcohol

BackgroundA series of research reports has indicated that the use of substances such as cannabis, alcohol and tobacco are higher in youth at clinical high risk (CHR) of developing psychosis than in controls. Little is known about the longitudinal trajectory of substance use, and findings on the relationship between substance use and later transition to psychosis in CHR individuals are mixed.MethodAt baseline and 6- and 12-month follow-ups, 735 CHR and 278 control participants completed the Alcohol and Drug Use Scale and a cannabis use questionnaire. The longitudinal trajectory of substance use was evaluated with linear mixed models.ResultsCHR participants endorsed significantly higher cannabis and tobacco use severity, and lower alcohol use severity, at baseline and over a 1-year period compared with controls. CHR youth had higher lifetime prevalence and frequency of cannabis, and were significantly younger upon first use, and were more likely to use alone and during the day. Baseline substance use did not differentiate participants who later transitioned to psychosis (n = 90) from those who did not transition (n = 272). Controls had lower tobacco use than CHR participants with a prodromal progression clinical outcome and lower cannabis use than those with a psychotic clinical outcome at the 2-year assessment.ConclusionsIn CHR individuals cannabis and tobacco use is higher than in controls and this pattern persists across 1 year. Evaluation of clinical outcome may provide additional information on the longitudinal impact of substance use that cannot be detected through evaluation of transition/non-transition to psychosis alone.

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Alterations in Emotional Diversity Correspond With Increased Severity of Attenuated Positive and Negative Symptoms in the Clinical High-Risk Syndrome

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.755027 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zachary Anderson ◽

Tina Gupta ◽

William Revelle ◽

Claudia M. Haase ◽

Vijay A. Mittal

Keyword(s):

High Risk ◽

Negative Symptoms ◽

Medication Use ◽

Structured Interview ◽

Clinical High Risk ◽

Future Studies ◽

Clinical Interviews ◽

Clinical Correlates ◽

Psychosis Risk ◽

Positive And Negative Symptoms

Background: Alterations in emotional functioning are a key feature of psychosis and are present in individuals with a clinical high-risk (CHR) syndrome. However, little is known about alterations in emotional diversity (i.e., the variety and relative abundance of emotions that humans experience) and clinical correlates in this population.Methods: Individuals meeting criteria for a CHR syndrome (N = 47) and matched healthy controls (HC) (N = 58) completed the modified Differential Emotions Scale (used to derive scores of total, positive, and negative emotional diversity) and clinical interviews (i.e., Structured Interview for Psychosis-Risk Syndromes).Results: Findings showed that the CHR group experienced lower levels of positive emotional diversity compared to HCs. Among the CHR individuals, lower levels of positive and higher levels of negative emotional diversity were associated with more severe attenuated positive and negative symptoms. Analyses controlled for mean levels of emotion and current antipsychotic medication use.Discussion: Results demonstrate that altered emotional diversity (in particular lower levels of positive and higher levels of negative emotional diversity) is a clinically relevant marker in CHR individuals, above and beyond alterations in mean levels of emotional experiences. Future studies may probe sources, downstream consequences, and potential modifiability of decreased emotional diversity in individuals at CHR.

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