ABSTRACT
BACKGROUND: People with schizophrenia spectrum disorders (SSD) frequently present cognitive impairments. Here, we investigated whether the exposome score for schizophrenia (ES-SCZ) - a cumulative environmental exposure score - was associated with impairments of neurocognition, social cognition, and perception in patients with SSD, their unaffected siblings, and healthy controls. METHODS: This cross-sectional sample consisted of 1200 patients, 1371 siblings, and 1564 healthy controls. Neurocognition, social cognition, and perception were assesed using a short version of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), the Degraded Facial Affect Recognition Task (DFAR), and the Benton Facial Recognition Test (BFR), respectively. Regression models were used to analyze the association between ES-SCZ and cognitive domains in each group. RESULTS: There were no statistically significant associations between ES-SCZ and cognitive domains in SSD. ES-SCZ was negatively associated with T-score of cognition in siblings (B=-0.40, 95% CI -0.76 to -0.03) and healthy controls (B=-0.63, 95% CI -1.06 to -0.21). Additionally, ES-SCZ was positively associated with DFAR-total in siblings (B=0.83, 95% CI 0.26 to 1.40). Sensitivity analyses excluding cannabis use history from ES-SCZ largely confirmed the main findings. CONCLUSIONS: Longitudinal cohorts may elucidate how environmental exposures influence the onset and course of cognitive impairments in trans-syndromic psychosis spectrum.
Subject(s)
Cognition , Exposome , Schizophrenic Psychology , Adult , Humans , Cross-Sectional Studies , Schizophrenia/epidemiology , Siblings/psychology , Case-Control Studies , Cognition Disorders/epidemiology , Male , FemaleABSTRACT
BACKGROUND: Auditory hallucinations (AH) are a core symptom of psychosis. The brain abnormalities responsible for AH remain controversial due to inconsistent and conflicting findings across studies, with substantial confounding factors, such as chronicity. Few studies have examined the pathological changes that occur in the gray matter (GM) of patients with first-episode psychosis (FEP) and AH. The present study aims to validate the presence and characteristics of these structural abnormalities in relation to the intensity of psychotic symptoms and AH in a larger homogeneous sample than those of previous studies. METHODS: A magnetic resonance voxel-based morphometric analysis was applied to a group of 215 patients with FEP (93 patients with AH and 122 patients without AH) and 177 healthy controls. The patients were evaluated using the PANSS scale. RESULTS: Patients with FEP exhibited greater reductions in GM concentrations in the temporal, frontal, cingulate and insular areas than the healthy controls did. No specific differences were found between the patients with FEP and AH and the patients without AH. In addition, total scores on the PANSS were negatively correlated with GM reductions in the FEP group. No correlations were found between the severity of the AH and the GM volumes. CONCLUSIONS: As in previous studies, reductions in the GM concentrations in patients with FEP suggest that alterations are present in the early stages of psychosis, and these alterations are correlated with the severity of the illness. The GM reductions were not found to be related to the presence or severity of AH.
Subject(s)
Cerebral Cortex/diagnostic imaging , Gray Matter/diagnostic imaging , Hallucinations/diagnostic imaging , Psychotic Disorders/diagnostic imaging , Adolescent , Adult , Case-Control Studies , Cerebral Cortex/pathology , Female , Frontal Lobe/diagnostic imaging , Frontal Lobe/pathology , Gray Matter/pathology , Gyrus Cinguli/diagnostic imaging , Gyrus Cinguli/pathology , Hallucinations/pathology , Humans , Magnetic Resonance Imaging , Male , Organ Size , Psychotic Disorders/pathology , Temporal Lobe/diagnostic imaging , Temporal Lobe/pathology , Young AdultABSTRACT
Hay un creciente interés en las intervenciones mobile Health (m-Health) en pacientes con psicosis. El objetivo de este estudio es realizar una revisión sistemática para analizar el estado actual de la investigación en este ámbito. La búsqueda de publicaciones se llevó a cabo siguiendo los criterios PRISMA, centrándose en aquellos estudios que utilizan tecnologías móviles en pacientes con psicosis durante el periodo de 1990 a 2016. Se seleccionó un total de 20 artículos de los 431 estudios que se encontraron. Se diferencian 3 tipos de intervenciones: 1) análisis de calidad y usabilidad; 2) mejora de la adherencia, síntomas y reducción de hospitalizaciones, y 3) análisis de la sintomatología del paciente. Conclusión: Las intervenciones m-Health son viables y resultan fáciles de utilizar para los pacientes con psicosis. Evalúan de forma más eficiente la evolución de los síntomas psicóticos y mejoran la adherencia al tratamiento, los síntomas y las hospitalizaciones. No se puede destacar una estrategia sobre las demás debido a que las diferencias en la metodología las hace difícilmente comparables (AU)
There is a growing interest in mobile Health interventions (m-Health) in patients with psychosis. The aim of this study is to conduct a systematic review in order to analysethe current state of research in this area. The search of articles was carried out following the PRISMA criteria, focusing on those studies that used mobile technologies in patients with psychosis during the period from 1990 to 2016. A total of 20 articles were selected from the 431 studies found. Three types of studies are distinguished: 1) Analysis of quality and usability, 2) Improving treatment adherence and reducing hospital admissions, and 3) Analysisof patient symptoms. Conclusions: m-Health interventions are feasible, and are easy to use for patients with psychosis. They evaluate the evolution of psychotic symptoms more efficiently, and improve adherence to treatment, as well as symptoms and hospital admissions. However, a particular strategy does not stand out over the rest, because differences in methodology make them difficult to compare (AU)
Subject(s)
Humans , Cell Phone , Psychotic Disorders/psychology , Schizophrenic Psychology , Psychopathology/instrumentation , Medication Adherence/psychology , Mobile ApplicationsABSTRACT
There is a growing interest in mobile Health interventions (m-Health) in patients with psychosis. The aim of this study is to conduct a systematic review in order to analysethe current state of research in this area. The search of articles was carried out following the PRISMA criteria, focusing on those studies that used mobile technologies in patients with psychosis during the period from 1990 to 2016. A total of 20 articles were selected from the 431 studies found. Three types of studies are distinguished: 1) Analysis of quality and usability, 2) Improving treatment adherence and reducing hospital admissions, and 3) Analysisof patient symptoms. CONCLUSIONS: m-Health interventions are feasible, and are easy to use for patients with psychosis. They evaluate the evolution of psychotic symptoms more efficiently, and improve adherence to treatment, as well as symptoms and hospital admissions. However, a particular strategy does not stand out over the rest, because differences in methodology make them difficult to compare.
Subject(s)
Mobile Applications , Psychotic Disorders/therapy , Telemedicine/methods , Humans , Patient ComplianceABSTRACT
Auditory hallucinations (AH) are the most frequent positive symptoms in patients with schizophrenia. Hallucinations have been related to emotional processing disturbances, altered functional connectivity and effective connectivity deficits. Previously, we observed that, compared to healthy controls, the limbic network responses of patients with auditory hallucinations differed when the subjects were listening to emotionally charged words. We aimed to compare the synchrony patterns and effective connectivity of task-related networks between schizophrenia patients with and without AH and healthy controls. Schizophrenia patients with AH (n = 27) and without AH (n = 14) were compared with healthy participants (n = 31). We examined functional connectivity by analyzing correlations and cross-correlations among previously detected independent component analysis time courses. Granger causality was used to infer the information flow direction in the brain regions. The results demonstrate that the patterns of cortico-cortical functional synchrony differentiated the patients with AH from the patients without AH and from the healthy participants. Additionally, Granger-causal relationships between the networks clearly differentiated the groups. In the patients with AH, the principal causal source was an occipital-cerebellar component, versus a temporal component in the patients without AH and the healthy controls. These data indicate that an anomalous process of neural connectivity exists when patients with AH process emotional auditory stimuli. Additionally, a central role is suggested for the cerebellum in processing emotional stimuli in patients with persistent AH.
Subject(s)
Hallucinations/diagnosis , Hallucinations/physiopathology , Schizophrenia/diagnosis , Schizophrenia/physiopathology , Acoustic Stimulation/methods , Adult , Auditory Cortex/physiopathology , Cerebellum/physiopathology , Humans , Male , Middle Aged , Neural Pathways/physiopathology , Temporal Lobe/physiopathology , Young AdultABSTRACT
OBJECTIVE: Hallucinations in patients with schizophrenia have strong emotional connotations. Functional neuroimaging techniques have been widely used to study brain activity in patients with schizophrenia with hallucinations or emotional impairments. However, few of these studies have investigated the association between hallucinations and emotional dysfunctions using an emotional auditory paradigm. Independent component analysis (ICA) is an analysis method that is especially useful for decomposing activation during complex cognitive tasks in which multiple operations occur simultaneously. Our aim in this study is to analyze brain activation after the presentation of emotional auditory stimuli in patients with schizophrenia with and without chronic auditory hallucinations using ICA methodology. It was hypothesized that functional connectivity differences in limbic regions responsible for emotional processing would be demonstrated. METHODS: The present functional magnetic resonance imaging (fMRI) study compared neural activity in 41 patients with schizophrenia (27 with auditory hallucinations, 14 without auditory hallucinations) with 31 controls. Neural activity data was generated while participants were presented with an auditory paradigm containing emotional words. The comparison was performed using a multivariate approach, ICA. Differences in temporo-spatial aspects of limbic network were examined in three study groups. RESULTS: Limbic networks responded differently in patients with auditory hallucinations compared to healthy controls and patients without auditory hallucinations. Unlike control subjects and non-hallucinators, the group of hallucinatory patients showed an increase of activity in the parahippocampal gyrus and the amygdala during the emotional session. CONCLUSIONS: These findings may reflect an increase in parahippocampal gyrus and amygdala activity during passive listening of emotional words in patients with schizophrenia and auditory hallucinations.
Subject(s)
Amygdala/physiopathology , Hallucinations/complications , Hallucinations/physiopathology , Magnetic Resonance Imaging , Parahippocampal Gyrus/physiopathology , Schizophrenia/complications , Schizophrenia/physiopathology , Adult , Humans , Male , Severity of Illness IndexABSTRACT
La evolución ha dotado al ser humano de un sistema de detección de peligros cuyo adecuado funcionamiento facilita la adaptación al medio. Tanto en la psicosis como en los trastornos de ansiedad existe una disfunción de estos mecanismos de alarma. El objetivo de este estudio es comparar la respuesta ante estímulos visuales amenazantes entre estos grupos diagnósticos y sujetos sanos. Se estudiaron 24 pacientes con trastorno de ansiedad, 39 con psicosis y 39 controles, comparando las respuestas en percepción de amenaza y agradabilidad ante distintos tipos de estímulos visuales, humanos y no humanos, ya fueran amenazantes o no. Los resultados reflejan una diferente percepción de amenaza entre psicóticos y sanos, así como una valoración de las imágenes como más desagradables por parte del grupo ansioso. Todo ello sugeriría una diferente evaluación emocional de los distintos estímulos entre ambos trastornos (AU)
Evolution has provided humans with an alarm system that may facilitate adaptation. Both psychosis and anxiety disorders involve danger detection difficulties. Our main goal is to compare threat responses of these diagnostic groups and with those of healthy subjects. We studied 24 subjects with an anxiety disorder diagnosis, 39 with psychosis, and 39 healthy control subjects. We compared threat and pleasantness perception using visual stimuli (human and nonhuman stimuli, either threatening or nonthreatening). Regarding threat perception, significant differences were found between psychosis and control groups. Subjects with anxiety disorder diagnosis evaluated any kind of stimuli more negatively. These results suggest differential emotional processing of diverse visual stimuli in these diagnostic groups (AU)
