Maternal recall bias, obstetric history and schizophrenia

BackgroundThis study sought to clarify the role of obstetric complications (OCs) and maternal recall bias for patients with first episodes of schizophrenia and those at increased risk of the disorder.MethodSubjects at high risk of schizophrenia were compared with people with first-episode schizophrenia and with healthy volunteers. Consenting mothers of subjects were interviewed using a standardised questionnaire for the recall of OCs, and OCs were also measured from records collected at the time of pregnancy and delivery.ResultsHigh-risk subjects and first-episode patients had higher rates of OCs recalled by their mother than controls, but hospital records showed no differences in OCs between groups. The number of OCs recalled by mothers of the high-risk group was not related to whether the mother had schizophrenia or not, but was related to the maternally rated abnormal childhood behaviour as measured by the Child Behaviour Checklist.ConclusionsThese results suggest that studies that rely on maternal recall alone are susceptible to bias. The excess of OCs recalled by the mother could be related to abnormal behaviour in their child rather than maternal illness, family history or psychotic symptoms.

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Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.049536 ◽

2008 ◽

Vol 193 (5) ◽

pp. 378-382 ◽

Cited By ~ 155

Author(s):

Ian Kelleher ◽

Michelle Harley ◽

Fionnuala Lynch ◽

Louise Arseneault ◽

Carol Fitzpatrick ◽

...

Keyword(s):

Domestic Violence ◽

High Risk ◽

Childhood Trauma ◽

Psychotic Disorders ◽

Traumatic Events ◽

High Risk Group ◽

Traumatic Experiences ◽

Psychotic Symptoms ◽

High Risk Population ◽

Increased Risk

BackgroundChildren and adolescents who report psychotic symptoms appear to be at increased risk for psychotic disorders in adulthood – a putative ‘symptomatic’ high-risk group. However, little research has investigated whether those in this high-risk population have increased rates of exposure to traumatic events in childhood, as seen in patients who have a psychotic illness.AimsTo examine whether adolescents with psychotic symptoms have an increased rate of traumatic experiences.MethodPsychiatric interviews were carried out with 211 adolescents aged between 12 and 15 years and their parents as part of a population-based study. The interview enquired about a number of early traumatic events including physical and sexual abuse, exposure to domestic violence and bullying.ResultsFourteen adolescents (6.6% of those interviewed) reported experiencing at least one psychotic symptom. Adolescents who reported psychotic symptoms were significantly more likely to have been physically abused in childhood, to have been exposed to domestic violence and to be identified as a bully/victim (that is, both a perpetrator and victim of bullying) than those who did not report such symptoms. These findings were not confounded by comorbid psychiatric illness or family history of psychiatric history.ConclusionsOur findings suggest that childhood trauma may increase the risk of psychotic experiences. The characteristics of bully/victims deserve further study.

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Formal thought disorder in people at ultra-high risk of psychosis

BJPsych Open ◽

10.1192/bjpo.bp.116.004408 ◽

2017 ◽

Vol 3 (4) ◽

pp. 165-170 ◽

Cited By ~ 8

Author(s):

Arsime Demjaha ◽

Sara Weinstein ◽

Daniel Stahl ◽

Fern Day ◽

Lucia Valmaggia ◽

...

Keyword(s):

High Risk ◽

First Episode Psychosis ◽

High Risk Group ◽

Thought Disorder ◽

Psychotic Symptoms ◽

First Episode ◽

Control Group ◽

Formal Thought Disorder ◽

Episode Psychosis ◽

Ultra High Risk

BackgroundFormal thought disorder is a cardinal feature of psychosis. However, the extent to which formal thought disorder is evident in ultra-high-risk individuals and whether it is linked to the progression to psychosis remains unclear.AimsExamine the severity of formal thought disorder in ultra-high-risk participants and its association with future psychosis.MethodThe Thought and Language Index (TLI) was used to assess 24 ultra-high-risk participants, 16 people with first-episode psychosis and 13 healthy controls. Ultra-high-risk individuals were followed up for a mean duration of 7 years (s.d.=1.5) to determine the relationship between formal thought disorder at baseline and transition to psychosis.ResultsTLI scores were significantly greater in the ultra-high-risk group compared with the healthy control group (effect size (ES)=1.2), but lower than in people with first-episode psychosis (ES=0.8). Total and negative TLI scores were higher in ultra-high-risk individuals who developed psychosis, but this was not significant. Combining negative TLI scores with attenuated psychotic symptoms and basic symptoms predicted transition to psychosis (P=0.04; ES=1.04).ConclusionsTLI is beneficial in evaluating formal thought disorder in ultra-high-risk participants, and complements existing instruments for the evaluation of psychopathology in this group.

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Cannabis Use is Not Associated With the Development of Psychosis in an ‘Ultra’ High-Risk Group

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2002.01089.x ◽

2002 ◽

Vol 36 (6) ◽

pp. 800-806 ◽

Cited By ~ 83

Author(s):

Lisa J Phillips ◽

Christina Curry ◽

Alison R Yung ◽

Hok Pan Yuen ◽

Steven Adlard ◽

...

Keyword(s):

Risk Factor ◽

High Risk ◽

Psychotic Disorder ◽

Risk Group ◽

High Risk Group ◽

Cannabis Use ◽

Psychotic Symptoms ◽

First Episode ◽

Psychotic Episode ◽

Ultra High Risk

Background: The association between cannabis use and the development of a first psychotic episode was studied in a group of 100 young people identified as being at very high risk for the onset of psychosis. Method: The ‘ultra’ high risk cohort was identified by the presence of subthreshold psychotic symptoms, or a combination of first-degree relative with a psychotic disorder and recent functional decline. Thirty-two per cent of the cohort developed an acute psychotic episode over the 12-month period after recruitment. As a component of a larger research study, the level of cannabis use by participants in the year prior to enrolment in the study was assessed at intake. Results: Cannabis use or dependence in the year prior to recruitment to this study was not associated with a heightened risk of developing psychosis over the following 12-month period and therefore did not appear to contribute to the onset of a psychotic disorder. Conclusion: The results of this study suggest that cannabis use may not play an integral role in the development of psychosis in a high-risk group. While this study does not support a role for cannabis in the development of first-episode psychosis, we cannot conclude that cannabis use should be completely ignored as a candidate risk factor for onset of psychosis. A number of weaknesses of the study (the low level of cannabis use in the current sample, the lack of monitoring of cannabis use after intake) suggest that it may be premature to dismiss cannabis use as a risk factor for the development of psychosis and further research is urged in this area.

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Sustained attention in young people at high risk for schizophrenia

Psychological Medicine ◽

10.1017/s0033291701005050 ◽

2002 ◽

Vol 32 (2) ◽

pp. 277-286 ◽

Cited By ~ 37

Author(s):

R. COSWAY ◽

M. BYRNE ◽

R. CLAFFERTY ◽

A. HODGES ◽

E. GRANT ◽

...

Keyword(s):

High Risk ◽

Sustained Attention ◽

Performance Test ◽

Poor Performance ◽

Continuous Performance Test ◽

High Risk Group ◽

Psychotic Symptoms ◽

First Episode ◽

Attentional Capacity ◽

Close Relatives

Background. Sustained attention has been found to be impaired in individuals suffering from schizophrenia and their close relatives. This has led to the hypothesis that impaired sustained attention is an indicator of vulnerability to schizophrenia.Methods. The Edinburgh High Risk Study used the Continuous Performance Test-Identical Pairs version (CPT-IP) to assess sustained attention in 127 high risk participants, 30 controls and 15 first-episode schizophrenic patients. A second assessment was completed by 59 high risk and 18 control participants 18 months to 2 years after the first.Results. No differences in attentional capacity were found between the high risk and control groups and there was no association between genetic liability to schizophrenia and poor performance on the CPT-IP. Additionally, no association between occurrence of psychotic symptoms in the high risk group and impaired attentional capacity was found.Conclusions. The results suggest that deficits in sustained attention are not indicative of a genetic vulnerability to schizophrenia, and are not associated with the occurrence of psychotic symptoms.

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White matter microstructure in ultra-high risk and first episode schizophrenia: A prospective study

Psychiatry Research Neuroimaging ◽

10.1016/j.pscychresns.2015.11.003 ◽

2016 ◽

Vol 247 ◽

pp. 42-48 ◽

Cited By ~ 14

Author(s):

Silvia Rigucci ◽

Giulia Santi ◽

Valentina Corigliano ◽

Annamaria Imola ◽

Camilla Rossi-Espagnet ◽

...

Keyword(s):

White Matter ◽

High Risk ◽

Prospective Study ◽

First Episode ◽

White Matter Microstructure ◽

Ultra High Risk ◽

A Prospective Study ◽

First Episode Schizophrenia

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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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Mortality in offspring of mothers with psychotic disorder

Psychological Medicine ◽

10.1017/s0033291707002383 ◽

2007 ◽

Vol 38 (8) ◽

pp. 1203-1210 ◽

Cited By ~ 9

Author(s):

J. Suvisaari ◽

L. Häkkinen ◽

J. Haukka ◽

J. Lönnqvist

Keyword(s):

High Risk ◽

General Population ◽

Psychotic Disorder ◽

Psychotic Disorders ◽

Suicide Attempts ◽

Risk Group ◽

High Risk Group ◽

Suicide Mortality ◽

Increased Risk ◽

Maternal Suicide

BackgroundPrevious studies suggest that offspring of mothers with psychotic disorders have an almost two-fold higher mortality risk from birth until early adulthood. We investigated predictors of mortality from late adolescence until middle age in offspring of mothers with psychotic disorders.MethodThe Helsinki High-Risk Study follows up offspring (n=337) of women treated for schizophrenia spectrum disorders in mental hospitals in Helsinki before 1975. Factors related to mortality up to 2005 among offspring of these mothers was investigated with a survival model. Hazard rate ratios (HRR) were calculated using sex, diagnosis of psychotic disorder, childhood socio-economic status, maternal diagnosis, and maternal suicide attempts and aggressive symptoms as explanatory variables. The effect of family was investigated by including a frailty term in the model. We also compared mortality between the high-risk group and the Finnish general population.ResultsWithin the high-risk group, females had lower all-cause mortality (HRR 0.43, p=0.05) and mortality from unnatural causes (HRR 0.24, p=0.03) than males. Having themselves been diagnosed with a psychotic disorder was associated with higher mortality from unnatural causes (HRR 4.76, p=0.01), while maternal suicide attempts were associated with higher suicide mortality (HRR 8.64, p=0.03). Mortality in the high-risk group was over two-fold higher (HRR 2.44, p<0.0001) than in the general population, and remained significantly higher when high-risk offspring who later developed psychotic disorders were excluded from the study sample (HRR 2.30, p<0.0001).ConclusionsOffspring of mothers with psychotic disorder are at increased risk of several adverse outcomes, including premature death.

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T39. IMPAIRED SENSORIMOTOR GATING USING THE ACOUSTIC PREPULSE INHIBITION PARADIGM IN INDIVIDUALS AT A CLINICAL HIGH RISK FOR PSYCHOSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.599 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S246-S246

Author(s):

Qijing Bo ◽

Zhen Mao ◽

Qing Tian ◽

Weidi Li ◽

Lei Zhao ◽

...

Keyword(s):

High Risk ◽

Prepulse Inhibition ◽

Clinical Characteristics ◽

Sensorimotor Gating ◽

Spatial Separation ◽

Structured Interview ◽

First Episode ◽

Clinical High Risk ◽

Neurocognitive Functions ◽

First Episode Schizophrenia

Abstract Background Many robust studies on prepulse inhibition (PPI) were conducted in patients with schizophrenia, and, increasingly, evidence has indicated individuals who are at clinical high risk for psychosis (CHR). The specificity of the PPI is insufficient with the classic paradigm. The current study investigated an improved perceived spatial separation PPI (PSSPPI) paradigm in CHR individuals, compared with patients of first-episode schizophrenia (FES) and healthy controls (HC), and the relationship between PPI, demographics, clinical characteristics, and cognitive performance. Methods We included 53 FESs, 55 CHR individuals, and 53 HCs. CHRs were rated on the Structured Interview for Prodromal Syndromes (SIPS). The prepulse inhibition measures of perceived spatial co-location PPI (PSCPPI) and PSSPPI paradigms were applied using 60- and 120-ms lead intervals. The MATRICS Consensus Cognitive Battery (MCCB) was used to assess neurocognitive functions. Results Compared with HC, the CHR group had lower PSSPPI level (ISI=60 ms, P<0.001; ISI=120 ms, P<.001). PSSPPI showed a large effect size (ES) between CHR and HC (ISI=60 ms, ES=0.91; ISI=120 ms, ES=0.98); on PSSPPI using 60-ms lead interval, ES ranged from small to large from CHR to FES. PPI deficits in CHR were unrelated to demographics, clinical characteristics, and cognition. Discussion CHR individuals show a sensorimotor gating deficit similar to FES patients on PSSPPI of the startle response, with greater sensitivity than the classic PPI paradigm. PSSPPI appears a promising objective approach for identifying individuals at clinical high risk for psychosis related to a high risk of transition to schizophrenia.

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Small-world networks in individuals at ultra-high risk for psychosis and first-episode schizophrenia during a working memory task

Neuroscience Letters ◽

10.1016/j.neulet.2012.11.051 ◽

2013 ◽

Vol 535 ◽

pp. 35-39 ◽

Cited By ~ 17

Author(s):

Kyungun Jhung ◽

Sung-Hwan Cho ◽

Ji-Hyun Jang ◽

Jin Young Park ◽

Dongkwan Shin ◽

...

Keyword(s):

Working Memory ◽

High Risk ◽

Memory Task ◽

Small World ◽

First Episode ◽

Small World Networks ◽

Ultra High Risk ◽

First Episode Schizophrenia

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The relation between dopamine D2 receptor blockade and the brain reward system: a longitudinal study of first-episode schizophrenia patients

Psychological Medicine ◽

10.1017/s0033291718004099 ◽

2019 ◽

Vol 50 (2) ◽

pp. 220-228 ◽

Cited By ~ 6

Author(s):

Sanne Wulff ◽

Mette Ødegaard Nielsen ◽

Egill Rostrup ◽

Claus Svarer ◽

Lars Thorbjørn Jensen ◽

...

Keyword(s):

Longitudinal Study ◽

Reward System ◽

Reward Processing ◽

Psychotic Symptoms ◽

First Episode ◽

Receptor Blockade ◽

Fmri Signal ◽

Brain Reward ◽

First Episode Schizophrenia ◽

The Brain

AbstractBackgroundPsychotic symptoms have been linked to salience abnormalities in the brain reward system, perhaps caused by a dysfunction of the dopamine neurotransmission in striatal regions. Blocking dopamine D2 receptors dampens psychotic symptoms and normalises reward disturbances, but a direct relationship between D2 receptor blockade, normalisation of reward processing and symptom improvement has not yet been demonstrated. The current study examined the association between blockade of D2 receptors in the caudate nucleus, alterations in reward processing and the psychopathology in a longitudinal study of antipsychotic-naïve first-episode schizophrenia patients.MethodsTwenty-two antipsychotic-naïve first-episode schizophrenia patients (10 males, mean age 23.3) and 23 healthy controls (12 males, mean age 23.5) were examined with single-photon emission computed tomography using 123I-labelled iodobenzamide. Reward disturbances were measured with functional magnetic resonance imaging (fMRI) using a modified version of the monetary-incentive-delay task. Patients were assessed before and after 6 weeks of treatment with amisulpride.ResultsIn line with previous results, patients had a lower fMRI response at baseline (0.2 ± 0.5 v. 0.7 ± 0.6; p = 0.008), but not at follow-up (0.5 ± 0.6 v. 0.6 ± 0.7), and a change in the fMRI signal correlated with improvement in Positive and Negative Syndrome Scale positive symptoms (ρ = −0.435, p = 0.049). In patients responding to treatment, a correlation between improvement in the fMRI signal and receptor occupancy was found (ρ = 0.588; p = 0.035).ConclusionThe results indicate that salience abnormalities play a role in the reward system in schizophrenia. In patients responding to a treatment-induced blockade of dopamine D2 receptors, the psychotic symptoms may be ameliorated by normalising salience abnormalities in the reward system.

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