scholarly journals Risk Model Assessment in Early-Onset and Adult-Onset Schizophrenia Using Neurological Soft Signs

2019 ◽  
Vol 8 (9) ◽  
pp. 1443
Author(s):  
Chen ◽  
Tsai ◽  
Lin ◽  
Lu ◽  
Tan ◽  
...  

Age at onset is one of the most important clinical features of schizophrenia that could indicate greater genetic loadings. Neurological soft signs (NSS) are considered as a potential endophenotype for schizophrenia. However, the association between NSS and different age-onset schizophrenia still remains unclear. We aimed to compare risk model in patients with early-onset schizophrenia (EOS) and adult-onset schizophrenia (AOS) with NSS. This study included 262 schizophrenia patients, 177 unaffected first-degree relatives and 243 healthy controls. We estimated the discriminant abilities of NSS models for early-onset schizophrenia (onset age < 20) and adult-onset schizophrenia (onset age ≥ 20) using three data mining methods: artificial neural networks (ANN), decision trees (DT) and logistic regression (LR). We then assessed the magnitude of NSS performance in EOS and AOS families. For the four NSS subscales, the NSS performance were greater in EOS and AOS families compared with healthy individuals. More interestingly, there were significant differences found between patients’ families and control group in the four subscales of NSS. These findings support the potential for neurodevelopmental markers to be used as schizophrenia vulnerability indicators. The NSS models had higher discriminant abilities for EOS than for AOS. NSS were more accurate in distinguishing EOS patients from healthy controls compared to AOS patients. Our results support the neurodevelopmental hypothesis that EOS has poorer performance of NSS than AOS. Hence, poorer NSS performance may be imply trait-related NSS feature in EOS.

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S22-S22
Author(s):  
Felice Iasevoli ◽  
Eugenio Razzino ◽  
Benedetta Altavilla ◽  
Camilla Avagliano ◽  
Annarita Barone ◽  
...  

Abstract Background Earlier age at schizophrenia onset has been associated with worse prognosis, greater symptom severity, social withdrawal, poorer cognitive performances, however much heterogeneity and inconsistency in findings have been reported in these studies. Treatment Resistant Schizophrenia (TRS) is defined as the persistence of significant symptoms despite at least two adequate treatment trials, each for a minimum duration and dosage. Patients affected by TRS display worse cognitive functioning, social performances and a greater prevalence of Neurological Soft Signs compared to non-TRS. To date, no studies have explored whether early onset TRS patients differ in multiple clinical, cognitive, and social outcomes compared to early onset non-TRS patients and to adult onset patients. The objective of this study is to investigate the relationship of the condition of non-response to antipsychotic agents with age at onset of the first psychotic episode Methods We recruited 99 non-affective psychotic patients, that were referred to our academic outpatient unit for supposed resistance to antipsychotics. The diagnosis of TRS was made by a structured diagnostic flowchart, according to published guidelines. Patients underwent a wide set of clinical and cognitive evaluations by trained raters. According to the age of the first episode of psychosis, patients were subdivided in early onset (EO, &lt;20 years) and adult onset (AO, &gt;20 years). Clinical and demographic variables were compared by Student’s t and Chi square tests. Then, patients were subdivided in EO-TRS, EO-nonTRS, AO-TRS, AO-nonTRS and their clinical outcomes were compared by ANCOVA, using age as a covariate. The 2way ANOVA was used to assess whether significant differences among groups were attributable to Diagnosis (TRS vs. non-TRS), Age at Onset (EO vs. AO), or combined effects. Results Compared to AO schizophrenia patients, EO had more relevant cognitive impairments (although limited to discrete domains), more severe neurological soft signs, more severe psychotic symptoms, mostly in the disorganized and autistic trait domains, and exhibited more severe social and functional impairments. The rate of TRS patients was significantly higher in the EO group and the rate of non-TRS was significantly higher in the AO group (X=6.31, df=1, p=0.012). At the ANCOVA, EO-TRS patients had significantly longer duration of disease, more severe disease, and were under higher antipsychotic doses. Neurological soft signs were more relevant in the group of EO-TRS, while Visuospatial memory and verbal memory were more impaired in this group compared to the others. Also, this subgroup of patients exhibited the highest scores on PANSS total and subscales, and more impaired psychosocial functioning at the PSP, the UPSA, and the SLOF. Notably, in many cases, EO-TRS were more impaired than EO-nonTRS, while significant differences with AO-TRS were less consistent. 2way ANOVA demonstrated that in the majority of the investigated variables the significant differences among groups were attributable to a Diagnosis effect rather than to Age at Onset or combined effects. Discussion The study confirmed previous observations in patients subdivided into EO vs. AO ones. However, EO patients were more frequently TRS. The group of EO-TRS had the most severe and impaired outcomes. These results were mostly dependent on the condition of non-response to antipsychotic agents rather than to the earlier age at onset of psychotic symptoms. The neurobiology of TRS may cause both the most severe clinical course and the earlier age at onset of these patients. Heterogeneity in previous reports on EO schizophrenia may stem from fluctuating relative rates of TRS/non-TRS patients included in some studies compared to others.


2020 ◽  
Vol 88 (08) ◽  
pp. 488-489

Die wenigen Studien zum kognitiven Training bei Patienten mit früh beginnender Schizophrenie (Early-Onset-Schizophrenia, EOS) zeigten einen geringeren Behandlungserfolg als das kognitive Training bei Patienten, die als Erwachsene erkrankt sind (Adult-Onset-Schizophrenia, AOS). Eine Sekundäranalyse zweier Studien prüfte jetzt, ob ein auditorisches Training (AT) bei beiden Patientengruppen unterschiedlich wirksam ist.


2010 ◽  
Vol 4 (4) ◽  
pp. 283-290 ◽  
Author(s):  
María Mayoral ◽  
Jessica Merchán-Naranjo ◽  
Marta Rapado ◽  
Marta Leiva ◽  
Carmen Moreno ◽  
...  

1998 ◽  
Vol 28 (3) ◽  
pp. 645-653 ◽  
Author(s):  
G. N. SMITH ◽  
L. C. KOPALA ◽  
J. S. LAPOINTE ◽  
G. W. MacEWAN ◽  
S. ALTMAN ◽  
...  

Background. Substantial variability in age at onset of illness and course of illness exists between patients with schizophrenia. Recent studies suggest that age at illness onset may be useful in defining biologically and clinically distinct subgroups of patients.Methods. Two hundred and ten males with schizophrenia were classified as early-onset or adult-onset according to their age at first hospitalization. Birth history, clinical functioning and treatment response was assessed in a subgroup of patients. Brain anatomy was assessed from CT scans in all patients and in 32 non-psychiatric control subjects.Results. Patients with an early-onset were likely to have a history of obstetric complications, a poor response to neuroleptic treatment, and showed no relationship between ventricle size and duration of illness. Adult-onset patients were less likely to have obstetric complications, more likely to respond to treatment in the first years of illness, and showed an association between brain structure and duration of illness.Conclusions. The distinction between early- and adult-onset patients may have important aetiological and treatment implications.


2020 ◽  
Vol 10 (9) ◽  
pp. 131 ◽  
Author(s):  
Alessandro Frolli ◽  
Maria Carla Ricci ◽  
Francesco Alberto Tortorelli ◽  
Antonella Cavallaro ◽  
Luana Valenzano ◽  
...  

In this study, we aim to verify how emotional training can improve empathy and theory of mind (ToM) in patients diagnosed with early onset schizophrenia and Asperger’s syndrome. The study design includes 100 subjects divided into two experimental groups and two control groups. The two experimental groups followed a rational emotive behavior therapy (REBT) protocol. The two control groups instead underwent cognitive behavioral psychotherapy training. Analysis of Variance (ANOVA) was applied to analyze the difference between the Asperger’s syndrome (AS) and early onset schizophrenia (EOS) groups, pre and post training. Our analysis shows that the AS group improved post emotional training but only when emotions were internalized, as demonstrated by the improvement of the scores in the post-treatment eye test (ET) but not in the emotional quotient (EQ) test. The EOS group instead showed post-training improvement, not only concerning skills leading to internalizing emotions but also in empathy, as demonstrated by the improvement of EQ and Reflective Functioning Questionnaire (RFQ) test scores. These scores remained lower than in the control group. Finally, our findings reveal that the value of the treatment was more considerable for the EOS group than for the AS group due to the improvement in first- and second-order ToM skills and an improvement of empathic skills in the first group, followed by the group comprising AS subjects. In the AS group, the treatment only favored the enhancement of first-order ToM skills; however, this improved quality of life and social adaptation.


2020 ◽  
Vol 11 ◽  
Author(s):  
Ze-tian Li ◽  
Shu-bin Li ◽  
Jin-feng Wen ◽  
Xiao-yuan Zhang ◽  
Thomas Hummel ◽  
...  

2016 ◽  
Vol 74 (3) ◽  
pp. 189-194 ◽  
Author(s):  
Osman Özdemir ◽  
Vedat Cilingir ◽  
Pınar Güzel Özdemir ◽  
Aysel Milanlioglu ◽  
Mehmet Hamamci ◽  
...  

ABSTRACT A few studies have explored dissociative experiences in epilepsy patients. We investigated dissociative experiences in patients with epilepsy using the dissociative experiences scale (DES). Ninety-eight patients with epilepsy and sixty healthy controls were enrolled in this study. A sociodemographic questionnaire and the Dissociative Experiences Scale (DES), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were administered to the participants. The DES scores were significantly higher for the patients with epilepsy than the healthy individuals. The number of individuals with pathological dissociation (DES ≥ 30) was higher in the epilepsy group (n = 28) than in the control group (n = 8). Also, higher levels of dissociation were significantly associated with frequency of seizures, but were not associated with duration of epilepsy and age at onset of the disorder. These findings demonstrate that patients with epilepsy are more prone to dissociation than controls. The high rate of dissociative experiences among patients with epilepsy suggest that some epilepsy-related factors are present.


2001 ◽  
Vol 158 (8) ◽  
pp. 1299-1304 ◽  
Author(s):  
Hideo Matsumoto ◽  
Andrew Simmons ◽  
Steven Williams ◽  
Michael Hadjulis ◽  
Roderic Pipe ◽  
...  

2012 ◽  
Vol 39 (5) ◽  
pp. 1008-1012 ◽  
Author(s):  
CARLOS MONTILLA ◽  
JAVIER DEL PINO-MONTES ◽  
EDUARDO COLLANTES-ESTEVEZ ◽  
PILAR FONT ◽  
PEDRO ZARCO ◽  
...  

Objective.Ankylosing spondylitis (AS) is generally observed in young patients but can occur later in life or in persons ≥ 50 years of age. Our objective was to characterize the clinical features of late-onset AS in a large multicenter national cohort.Methods.We studied late-onset AS in the National Registry of Spondyloarthritis of the Spanish Society of Rheumatology (REGISPONSER database) cohort (n = 1257), of whom 3.5% had onset at age ≥ 50 years versus a control group with onset at < 50 years.Results.There were no differences between late-onset and early-onset AS according to sex and family history of spondyloarthropathies. Patients in the late-onset group more often showed involvement of the cervical spine (22.7% vs 9.7%; p = 0.03) and arthritis of the upper (13.6% vs 3.0%; p = 0.002) and lower limbs (27.3% vs 15.2%; p = 0.03) as first manifestations than did patients in the early-onset group. A higher percentage of mixed forms (axial and peripheral joint disease) during the course of the disease was also recorded in the late-onset group (50% vs 24%; p = 0.0001).Conclusion.Our study suggests that age at onset of AS affects the patients’ presenting clinical form. Arthritis of the upper limbs requires a differential diagnosis with other conditions frequent in patients over 50 years of age, such as rheumatoid arthritis or crystal-induced arthropathy.


2007 ◽  
Vol 64 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Gordana Djuric ◽  
Marina Svetel ◽  
Nikolaevic Illarioskin ◽  
Natasa Dragadjevic ◽  
Jelena Gavrilovic ◽  
...  

Background/Aim. The presence of Parkinson's disease (PD) among the members of a family is a clear indication of the significance of genetics in its development. In spite of that, the majority of patients with PD shows a sporadic form of the disease induced as a result of interaction of both environmental and genetic factors. The aim of this study was to examine the effects of polymorphisms in the genes of cytohrome P450 2D6(CYP2D6), paraoxonase 1 (PON 1) and apolipoprotein E (APOE), as risk factors for PD. Methods. We examined 106 patients with PD (65 men and 41 women) and 75 ethnically matched control subjects. The mean age at onset of PD in the patients was 46.9?9.4 years (ranging from 30 to 70 years). Genotyping was performed using standard PCR amplification and restriction endonuclease digestion protocols described for known polymorphism in the candidate genes under study. Results. The genotype A/A polymorphisms 2D6* gene of CYP2D6 and genotype M/M polymorphisms L54M gene of PON1 were significantly more frequent in the patients with PD than in the control group. The patients with genotypes A/A and M/M had 3.4 and 3.2 higher risk of PD, respectively than the control group (p = 0.01). The relation between genotypes A/A gene of CYP2D6 and M/M gene of PON1 was modified by the age at onset. The genotypes were associated with early onset of PD (p = 0.001, p = 0.004). The carriers of the A and M alleles in homozygote had 2.4 and 4.2 years respectively earlier onset of PD than carriers of other genotypes with these polymorphisms. The frequency allele ?4 gene of APOE was higher in the PD patients with early onset (20%) than in PD with later onset (7.4%), while the genotype ?3/?3 was associated with PD late onset (p = 0.024). Combined genotype I (carriers of the two risk allels in homozygote and one alleles risk in heterozygote) and combined genotype II (carriers of the three alleles risk in homozygote) caused early PD. Combined genotype II was detected in 12.7% of the patients in the group of early onset, and in 2.4% of the patients with the onset after 45 years. Conclusion. The results of our study suggest that the genotypes A/A and M/M genes of CYP2D6 and PON1, and allele ?4 gene are an important risk for the development of PD, causing its early onset. The cumulative effects of the risk genes cause an early onset of PD.


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