Family History Of Schizophrenia Research Articles

Abstract C001: A pilot study of palliadelic treatment with psilocybin to reduce psychological distress and improve quality of life in patients with advanced pancreatic adenocarcinoma

Abstract Background: Psychological distress is a common reaction to a cancer diagnosis and its treatment. Distress impacts quality of life, adherence to treatment, decision making and survival. Patients with pancreatic adenocarcinoma (PDAC) experience exceptionally high rates of psychological distress, most commonly depression, anxiety and suicidality. Psilocybin, a serotonergic psychedelic which is the active component in “magic mushrooms,” is a promising treatment for several mental health disorders. Prior studies in patients with cancer have combined a single dose of psilocybin with preparation and integration counseling and have shown significant, rapid and sustained improvement in depression, anxiety and quality of life. These studies have primarily been conducted in psychiatry or neuroscience clinics in heterogenous groups of patients, many of whom had completed cancer treatment. This study will evaluate the feasibility and safety of psilocybin-assisted therapy delivered in the outpatient palliative care clinic in patients with advanced PDAC who are receiving chemotherapy. Methods: This is a single center, open label pilot study of a psilocybin-assisted therapy integrated with palliative care in patients with advanced PDAC. The primary endpoints are the feasibility and safety of this strategy when integrated into routine palliative care. Secondary endpoints include short term changes in depression, anxiety and demoralization and changes in neuronal activity by functional MRI (fMRI). After 2-4 outpatient preparation sessions with a palliative medicine physician (PMP), the subject will take psilocybin (25mg capsule) at an individual session supported by a PMP and a trained mental health professional. Up to 3 integration sessions with a PMP will follow. Patient-reported measures of psychological distress and quality of life will be assessed at baseline, after the psilocybin dose and periodically during follow-up. Neuronal changes will be measured using fMRI before and after the psilocybin dose. Eligible patients are adults (ECOG 0-3) with advanced PDAC with adequate organ function. Patients with psychiatric conditions which preclude safe cessation of psychotropic drugs or requires hospitalization, a personal or family history of schizophrenia, psychotic disorder or bipolar disorder, who have a high risk of suicide or have serious or uncontrolled hypertension or cardiovascular disease are ineligible. Given the exploratory nature of the study, a formal statistical assessment of the sample size was not conducted. Twelve evaluable subjects will provide sufficient power to detect large effect sizes (Cohen’s d1.0) in the secondary endpoints. Wilcoxon signed rank test will determine the reduction in distress scores before and after the psilocybin session. Enrollment began in June 2023; two subjects have enrolled. The study is funded by the Jim Young Pancreatic Cancer Research Memorial Fund. Psilocybin is provided by Usona. ClinicalTrials.gov Identifier: NCT05220046 Citation Format: Kelsey A. Klute, Lou Lukas, Soonjo Hwang, Yeongjin Gwon, Mridula Krishnan, Jean Grem, Sunil Hingorani, Jody Koenig Kellas. A pilot study of palliadelic treatment with psilocybin to reduce psychological distress and improve quality of life in patients with advanced pancreatic adenocarcinoma [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr C001.

Long-term diagnostic stability, predictors of diagnostic change, and time until diagnostic change of first-episode psychosis: a 21-year follow-up study.

Although diagnostic instability in first-episode psychosis (FEP) is of major concern, little is known about its determinants. This very long-term follow-up study aimed to examine the diagnostic stability of FEP diagnoses, the baseline predictors of diagnostic change and the timing of diagnostic change. This was a longitudinal and naturalistic study of 243 subjects with FEP who were assessed at baseline and reassessed after a mean follow-up of 21 years. The diagnostic stability of DSM-5 psychotic disorders was examined using prospective and retrospective consistencies, logistic regression was used to establish the predictors of diagnostic change, and survival analysis was used to compare time to diagnostic change across diagnostic categories. The overall diagnostic stability was 47.7%. Schizophrenia and bipolar disorder were the most stable diagnoses, with other categories having low stability. Predictors of diagnostic change to schizophrenia included a family history of schizophrenia, obstetric complications, developmental delay, poor premorbid functioning in several domains, long duration of untreated continuous psychosis, spontaneous dyskinesia, lack of psychosocial stressors, longer duration of index admission, and poor early treatment response. Most of these variables also predicted diagnostic change to bipolar disorder but in the opposite direction and with lesser effect sizes. There were no significant differences between specific diagnoses regarding time to diagnostic change. At 10-year follow-up, around 80% of the diagnoses had changed. FEP diagnoses other than schizophrenia or bipolar disorder should be considered as provisional. Considering baseline predictors of diagnostic change may help to enhance diagnostic accuracy and guide therapeutic interventions.

ISOTRETINOIN INDUCED PSYCHOTIC SYMPTOMS

Isotretinoin is an effective treatment for severe and resistant forms of acne. It has proven potential for inducing dose-dependent psychiatric side effects, especially in some vulnerable groups of patients. Objective: The aim of the present article is to report a case of a 22-year-old woman with a family history of schizophrenia who was diagnosed with acne. After unsuccessful antibiotic treatment of acne, a panic disorder accompanied by depressive symptoms manifested. Isotretinoin 20 mg/day was used as а second step of the dermatological treatment for a period of four months, along with psychotropic treatment for panic disorder – sertraline 50 mg/day and flupentixol 1,5 mg/day. When the dose of Isotretinoin was increased to 40 mg/day, paranoid delusions occurred. The manifestation of psychotic symptoms required discontinuation of all medications and initiation of antipsychotic therapy with quetiapine. The psychotic symptoms completely disappeared when the dose of quetiapine was increased to 300 mg/day. Conclusion: The presented case emphasizes the need for increased vigilance about the manifestation of psychiatric symptoms, especially in patients with a family history, current or past medical history of mental disorder. In such cases, consultation with a psychiatrist before starting treatment with Isotretinoin is recommended in order to better clarify the benefits and the risks of the treatment. The endogenous origin of the psychosis was discussed in the differential diagnostic plan, which requires long-term monitoring of the mental state.

Factors Contributing to Risk of Persistence of Positive and Negative Symptoms in Schizophrenia during Hospitalization

The aim of the study was to evaluate factors that may contribute to the persistence of positive, negative and other psychopathological symptoms of schizophrenia. All patients were treated in general psychiatric wards between January 2006 and December 2017. The initial study sample comprised of the medical reports of 600 patients. The main, specified inclusion criterion for the study was schizophrenia as a discharge diagnosis. Medical reports of 262 patients were excluded from the study due to no neuroimaging scans being available. The symptoms were categorised into three groups: positive, negative, and other psychopathological symptoms. The statistical analysis comprised modalities such as demographic data, clinical symptoms, as well as neuroimaging scans linking them to a potential impact of sustaining the mentioned groups of symptoms during the period of hospitalization. The analysis revealed that statistically significant risk factors of persistence of the three groups of symptoms are the elderly age, the increasing toll of hospitalizations, suicidal attempts in medical history, a family history of alcohol abuse, the presence of positive, negative and other psychopathological symptoms on admission to the hospital, as well as the absence of cavum septi pellucidi (CSP). The study showed that addiction to psychotropic drugs and a family history of schizophrenia were more frequent in patients with persistent CSP.

A case-control study of aggressiveness in adolescents with schizophrenia family history

IntroductionViolence is a common behavioral and health concern among adolescents, aged 12 to 18 years old. In fact, aggressiveness may result in severe outcome in a critical age characterised by biological, psychological, and social changes. Schizophrenia is a severe and chronic condition, with elevated level of aggressiveness. Since unaffected biological relatives of schizophrenia patients share similar though less severe neurocognitive and behavioral abnormalities seen in their affected relatives, they are at increased risk of violence mainly during adolescence. However, studies including adolescents with schizophrenia first degree history are scarce.ObjectivesThe aim of this survey was to evaluate the aggressiveness among unaffected adolescents with fist degree family history of schizophrenia and in a control group of adolescents with no family psychiatric history.MethodsIn this purpose wo conducted a case-control cross sectional study in Razi hospital during three months: from July to September 2022. Unaffected adolescents aged 12 to 18 whom first-degree relatives were diagnosed with schizophrenia according to DSM-5 criteria were included. Adolescents with psychiatric conditions or medical affections associated with psychiatric presentation were not included. Control group was selected amongst the population. Sociodemographic data were collected on a preestablished questionnaire and the following scales were used: The Life History of Aggression LHA, an 11 items self-reported tool, in the Arabic version, The Aggression Questionnaire AQ which is a 29 items self-reported scale in Arabic version. Written informed consent was obtained from the legal tutor of each adolescent.ResultsResults of this survey are ongoing.ConclusionsResults of this survey are ongoing.Disclosure of InterestNone Declared

Aggressiveness and emotion dysregulation among adolescents first degree relatives of schizophrenia patients

IntroductionSchizophrenia is a severe debilitating condition, with elevated level of aggressiveness reaching 33% in a large sample of patients. Unaffected biological relatives of schizophrenia patients share similar though less severe neurocognitive and behavioral abnormalities seen in their affected relatives. Recent findings demonstrates that first degree relatives of schizophrenia patients are at increased risk of violence and aggressive behavior, especially during adolescence, with poor outcome. Besides, adolescents aged from 12 to 18 years old, may experience aversive and overwhelming emotions difficult to regulate due to immaturity of neuronal networks. There are evidence of an association of emotion dysregulation and violent conduct among youth. However, to our knowledge, studies among first degree relatives of psychotic patients were not performed.ObjectivesThe aim of this study was to evaluate the aggressiveness and emotion dysregulation among unaffected adolescents with fist degree family history of schizophrenia and to investigate the association linking these two entities.MethodsIn this purpose wo conducted a cross sectional descriptive study in Razi hospital during three months: from July to September 2022. Unaffected adolescents aged 12 to 18 whom first-degree relatives were diagnosed with schizophrenia according to DSM-5 criteria were included. Adolescents with psychiatric conditions or medical affections associated with psychiatric presentation were not included. Sociodemographic data were collected on a preestablished questionnaire and the following scales were used: The Life History of Aggression LHA, an 11 items self-reported tool, in the Arabic version, The Aggression Questionnaire AQ which is a 29 items self-reported scale in Arabic version and the The Emotion Regulation Questionnaire (ERQ), a 10 items self-reported measure rated on a likert scale, in the validated Arabic version. Written informed consent was obtained from the legal tutor of each adolescent.ResultsResults of this survey are ongoing.ConclusionsResults of this survey are ongoing.Disclosure of InterestNone Declared

Attitudes towards schizophrenia and associated factors among community members in Hossana town: a mixed method study

BackgroundMental health disorders have been identified as being one of the public health issues throughout the world. More than 24 million people worldwide suffer from schizophrenia. However, there is little information about the attitude toward people with Schizophrenia in Ethiopia.ObjectiveThis study aimed to assess attitudes toward people with Schizophrenia and associated factors among residents of Hossana town, Southern Ethiopia.MethodsA community-based cross-sectional study was conducted with qualitative and quantitative data collection approaches among 417 households and three FGDs. The interviewer-administered standard tool was used to collect the data. Descriptive statistics like frequency, mean, and median are computed. A binary logistic regression model was used to identify factors affecting community perception and attitude toward people with schizophrenia.ResultsOf the study participants, 194 (46.5%) had positive attitudes toward people with schizophrenia. Eccentric behavior and wandering were the most commonly mentioned manifestation. Besides, Substance misuse, loss of loved ones, and conflict with family as the perceived cause, and spiritual or traditional methods as the preferred treatment for people with schizophrenia. Moreover, participants with no family history of schizophrenia were six times [6.3(2.55–15.77)] more likely to develop a negative attitude towards schizophrenia than those with a family history of schizophrenia.ConclusionIn this study, the findings of this study indicate more than half of the participants had a negative attitude toward people with schizophrenia.Eccentric behavior and wandering were the most commonly mentioned manifestation. Substance misuse, loss of loved ones, and conflict with family have been perceived causes of schizophrenia. Spiritual/traditional places were preferred places for the treatment. Having a family history of schizophrenia was the only factor associated with attitude towards schizophrenia. Therefore, due attention should be given to changing negative attitudes towards schizophrenia, reducing potential schizophrenia-predisposing factors, and enhancing community awareness to seek medical help as early as possible when such kinds of events occur.

Association of sociodemographic, proximal, and distal clinical factors with current suicidal ideation: Findings from a nonclinical sample of young adults.

Accumulating evidence indicates that a variety of distal and proximal factors might impact a risk of suicide. However, the association between both groups of factors remains unknown. Therefore, in the present study, we aimed to investigate the interplay between distal and proximal correlates of the current suicidal ideation. A total of 3,000 individuals (aged 18-35years, 41.7% males), who had reported a negative history of psychiatric treatment, were enrolled through an online computer-assisted web interview. Self-reports were administered to measure: (a) distal factors: a history of childhood trauma (CT), reading disabilities (RDs), symptoms of attention-deficit/hyperactivity disorder (ADHD), lifetime history of non-suicidal self-injury (NSSI), lifetime problematic substance use as well as family history of schizophrenia and mood disorders; (b) proximal factors: depressive symptoms, psychotic-like experiences (PLEs), and insomnia; and (c) sociodemographic characteristics. Suicidal ideation was directly associated with unemployment, being single, higher level of RD, lifetime history of NSSI as well as higher severity of PLEs, depression, and insomnia. The association of distal factors with suicidal ideation was fully (a history of CT and symptoms of ADHD) or partially (a history of NSSI and RD) mediated by proximal factors (PLEs, depression, and insomnia). Main findings from this study posit the role of distal factors related to neurodevelopmental disorders, CT and NSSI in shaping suicide risk. Their effects might be partially or fully mediated by depression, PLEs, and insomnia.

Diagnostic progression to schizophrenia: A nationwide cohort study of 11 170 adolescents and young adults with autism spectrum disorder.

Previous studies have suggested an increased risk of developing schizophrenia later in life in children with autism spectrum disorder (ASD). This study aims to investigate the diagnosis stability and the potential predictors for progression to schizophrenia in ASD. We recruited 11 170 adolescents (10-19 years) and young adults (20-29 years) with ASD between 2001 and 2010. They were followed up to the end of 2011 to identify newly diagnosed schizophrenia. The Kaplan-Meier method and Cox regression with age as a time scale were employed to estimate incidence rates and the significance of candidate predictors. The progression rate from ASD to schizophrenia was 10.26% for 10 years of follow-up. Among 860 progressors, 580 (67.44%) occurred within the first 3 years after a diagnosis of ASD. The identified predictors were age (reported as hazard ratio with 95% confidence interval: 1.13; 1.11-1.15), depressive disorder (1.36; 1.09-1.69), alcohol use disorder (3.05; 2.14-4.35), substance use disorder (1.91; 1.18-3.09), cluster A personality disorder (2.95; 1.79-4.84), cluster B personality disorder (1.86; 1.05-3.28), and a family history of schizophrenia (2.12; 1.65-2.74). More than two-thirds of the progressors developed schizophrenia within the first 3 years. Demographic characteristics, physical and psychiatric comorbidities, and psychiatric family history were significant predictors of progression.

Personalized approach to early diagnosis of acute schizophrenia: an observational comparative study

BACKGROUND: An acute schizophrenic episode often meets the diagnostic criteria for the ICD-10 category acute and transient psychotic disorders (ATPD, F23), which includes clinically similar conditions of diverse etiologies. The presence of schizophrenic negative symptoms in ATPD signifies their nosological affiliation and determines the therapeutic tactics. Early recognition of the schizophrenic etiology in the first episode of psychosis may contribute to the development of a personalized approach for the management of patients with acute psychotic disorders.
 AIM: To evaluate the relationship between the developmental characteristics of psychosis and identify the negative symptoms after its reduction in patients with ATPD with the symptoms of schizophrenia.
 MATERIALS AND METHODS: This observational single-center selective comparative study was conducted during 20182020. The clinical-psychopathological method was applied to examine patients hospitalized in a psychiatric hospital with ATPD presenting with the symptoms of schizophrenia (F23.1). In order to objectify the results of the study, the positive and negative syndrome scale was used.
 RESULTS: The study involved 60 patients (50 men, 10 women) aged 1846 years (mean age: 21.46.0 years). Depending on the presence of negative symptoms after the psychosis reduction at 4 weeks of therapy, the study sample was divided into two groups: 1) the group with negative symptoms (NS+; n=41); 2) the group without any negative symptoms (NS; n=19). Individuals presenting with negative symptoms were distinguished from those without it based on the more frequent presence of prodromal disorders, subpsychotic, and, particularly, mild negative disorders at the prodromal stage, prolonged development, and long-drawn course of psychosis. The likelihood of negative symptoms detection after the reduction of psychosis was associated with a family history of schizophrenia and other psychiatric disorders, low premorbid social adjustment, prodromal symptoms, and impaired functioning, as well as with a longer duration of psychotic symptoms and its slow development.
 CONCLUSION: The likelihood of negative symptoms after the reduction of ATPD with symptoms of schizophrenia was associated with hereditary and premorbid characteristics of patients, prodromal psychopathological and functional abnormalities, as well as the clinical and dynamic characteristics of psychosis. The data obtained from this study may contribute to the early recognition of schizophrenia-spectrum disorders and to the development of a personalized approach for the management of patients with ATPD.

Abnormal Brain Structure Morphology in Early-Onset Schizophrenia.

With less exposure to environmental and medication influences, individuals with early-onset schizophrenia (EOS) may provide valuable evidence to study the pathogenesis and phenotypic pattern of schizophrenia.T1-weighted magnetic resonance images were collected in 60 individuals with EOS and 40 healthy controls. Voxel-based morphometry and surface-based morphometry analyzes were performed. Gray matter volume, cortical thickness and cortical surface area were compared between the EOS and healthy controls and among schizophrenia subgroups (with or without family history of schizophrenia). Compared with healthy controls, the EOS group had reduced gray matter volume in the bilateral middle temporal gyrus and reduced cortical thickness in several brain regions. The sporadic early onset schizophrenia and the familial early onset schizophrenia showed different brain structure morphology. These findings suggest that abnormal brain structure morphology, especially in the temporal and frontal lobes, may be an important pathophysiological feature of EOS.

Neuromotor dysfunction as a major outcome domain of psychotic disorders: A 21-year follow-up study

BackgroundThe long-term stability of neuromotor domains assessed at the first episode of psychosis (FEP) and their ability for predicting a number of outcomes remains largely unknown, and this study addressed these issues. MethodsThis was a longitudinal study of 243 participants with FEP who were assessed at baseline for background variables and parkinsonism, dyskinesia, neurological soft signs (NSS) and catatonia, and reassessed 21 years later for the same neuromotor variables, psychopathology, functioning, personal recovery, cognitive performance and medical comorbidity. Stability of neuromotor ratings was assessed using the intraclass correlations coefficient and associations between the predictors and outcomes were examined using univariate and multivariate statistics. ResultsBaseline dyskinesia and NSS ratings showed excellent stability over time whereas that for parkinsonism and catatonia was relatively low. Neuromotor dysfunction at follow-up was independently predicted by a family history of schizophrenia, obstetric complications, neurodevelopmental delay, low premorbid IQ and baseline ratings of dyskinesia and NSS. Moreover, baseline dyskinesia and NSS ratings independently predicted more positive and negative symptoms, poor functioning and less personal recovery; catatonia predicted less personal recovery and more medical comorbidity. Baseline neuromotor ratings explained between 4% (for medical comorbidity) and 34% (for neuromotor dysfunction) of the variance in the outcomes. Lastly, neuromotor dysfunction at baseline highly predicted clinical staging at follow-up. ConclusionBaseline neuromotor domains show variable stability over time and relate distinctively to very long-term outcomes. Both baseline dyskinesia and NSS are trait markers of the disease process and robust predictors of the outcomes.

Clinical Indicators of Symptom Dimensions and Cognitive Ability in Schizophrenia

IntroductionSchizophrenia is a heterogeneous disorder and it is unknown what causes individual variability in symptoms and cognitive ability.Objectives To examine the association between nine clinical predictors measurable at the onset of schizophrenia and five phenotype dimensions: positive, negative (diminished expressivity), negative (motivation and pleasure), disorganised symptoms and cognitive ability.Methods852 participants (mean age 49 years old) with a diagnosis of schizophrenia or schizoaffective depression were included from the CardiffCOGS cross-sectional sample. Phenotype dimensions were created using confirmatory factor analysis and a 5-factor model. Associations were tested using linear regression, adjusting for age and sex. A Bonferroni correction was applied for (p<1.1x10-3) for multiple testing.ResultsAge of onset of psychosis was significantly associated with positive symptoms (β=-0.18, p=4.0 x10-6). Lower premorbid IQ was associated with diminished expressivity (β=-0.25, p= 7.0x10-13), reduced motivation and pleasure (β=-0.23, p= 4.3x10-11), disorganised symptoms (β=-0.14, p= 7.6x10-5) and reduced cognition (β=0.54, p= 4.8x10-77). Poor premorbid social adjustment held associations with all except positive. Developmental delay was associated with reduced cognition (β=-0.35, p= 4.3x10-5). Cannabis use (year before onset), psychosocial stressors (within 6 months), childhood abuse and family history of schizophrenia held no associations.ConclusionsClinical indicators measurable at schizophrenia onset are associated with lifetime symptom variability. A younger psychosis onset is associated with more severe positive symptoms, suggesting possible age-targeted management. Pre-established links of lower premorbid IQ with poor premorbid social adjustment and negative symptom severity with cognition are strengthened. Further investigation could potentially improve diagnosis and guide treatment choice for aspects of schizophrenia with poor outcomes.DisclosureNo significant relationships.

Association of FAAH p.Pro129Thr and COMT p.Ala72Ser with schizophrenia and comorbid substance use through next-generation sequencing: an exploratory analysis.

Objective:Individuals with schizophrenia and substance use disorders have a poor prognosis and increased psychiatric symptoms. The present study aimed to explore the association of 106 genes in individuals with schizophrenia and comorbid substance use through a next-generation sequencing (NGS) analysis and different in silico algorithms.Methods:We included 105 individuals diagnosed with schizophrenia and a family history of schizophrenia, of whom 49 (46.67%) presented comorbid substance use. Using NGS, we sequenced 106 genes previously associated with schizophrenia. Logistic regression models were used to assess differences in allele frequencies, and a generalized gene-set analysis was performed at the gene level. Functional annotations were performed using different algorithms and databases.Results:We identified a total of 3,109 variants, of which 25 were associated with schizophrenia and comorbid substance use and were located in regulatory and coding regions. We found low-frequency variants in COMT p.Ala72Ser, independently of p.Val158Met, that were associated with substance use. The endocannabinoid functional variant FAAH p.Pro129Thr was also associated with substance use.Conclusions:Genetic variants of genes related to dopaminergic and cannabinoid neurotransmitter systems were associated with comorbid substance use in schizophrenia. Nevertheless, more studies with larger sample sizes are needed to confirm our findings.

Diagnostic progression to schizophrenia in 35,255 patients with obsessive-compulsive disorder: a longitudinal follow-up study.

Evidence suggests a continuity between obsessive-compulsive disorder (OCD) and schizophrenia. However, the factors that may predict diagnostic progression from OCD to schizophrenia remain unclear. A total of 35,255 adolescents and adults with OCD (ICD-9-CM code: 300.3) were enrolled between 2001 and 2010 and followed up at the end of 2011 for the identification of de novo schizophrenia (ICD-9-CM code: 295). The Kaplan-Meier method was used to estimate incidence rates, and the Cox regression was used to determine the significance of candidate predictors. At the end of the 11-year follow-up period, the crude cumulative progression rate from OCD to schizophrenia was 6%, and the estimated progression rate totaled 7.80%. Male sex (hazard ratio: 1.23), obesity (1.77), autism spectrum disorder (1.69), bipolar disorder (1.69), posttraumatic stress disorder (1.65), cluster A personality disorder (2.50), and a family history of schizophrenia (2.57) also were related to an elevated likelihood of subsequent progression to schizophrenia in patients with OCD. Further study is necessary to elucidate the exact pathomechanisms underlying diagnostic progression to schizophrenia in patients with OCD.

Sex and gender associations with indicators of neurodevelopmental compromise in schizophrenia spectrum disorders

BackgroundIt has been proposed that sex and gender differences described in schizophrenia can be explained from a neurodevelopmental perspective. AimIn this study, we examined the associations of biological sex and gender role endorsement with putative indicators of neurodevelopmental compromise. MethodsWe used the Bem Sex Role Inventory to calculate masculinity scores in 77 patients with a first episode of a schizophrenia spectrum disorder, and selected the following indicators of neurodevelopmental compromise: family history of schizophrenia, obstetric complications, premorbid functioning, neurological soft signs, and cognitive function. Secondary objectives included the moderating effects of age of onset of illness, substance use and negative symptoms on these associations. ResultsThere were no significant sex differences across any of the indicators of neurodevelopmental compromise. However, lower masculinity scores correlated significantly with poorer premorbid adjustment, sensory integration deficits and worse overall cognitive performance. Stepwise linear regression identified poorer premorbid adjustment in early adolescence and lower verbal learning scores as independent predictors of lower masculinity scores. In contrast to sex, gender showed several associations with indicators of neurodevelopmental compromise. ConclusionsLower masculinity scores may represent part of a phenotype for a neurodevelopmental anomaly that places some individuals on a pathway to schizophrenia.

Network Association of Biochemical and Inflammatory Abnormalities With Psychiatric Symptoms in First-Episode Schizophrenia Patients.

BackgroundCardiovascular disease (CVD) risk factors such as dyslipidemia and systemic aberrant inflammatory processes may occur in patients with psychotic disorders, which may cause increased mortality. The interplay between immune and metabolic markers and its contribution to the clinical symptoms of schizophrenia (SCZ) remain unclear. This study aimed to examine the association of a series of inflammatory factors, plasma biochemical indicators, and SCZ clinical symptomatology with the severity of SCZ symptoms.MethodsA total of 115 participants, including 79 first-episode drug-naïve patients with SCZ and 36 healthy controls, were enrolled in this study. Semi-structured interviews were used to collect sociodemographic data, family history of SCZ, and medical and psychiatric history. The Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS) were administered by a clinical psychiatrist to evaluate the symptom severity of patients with SCZ. Plasma inflammatory cytokines were measured by a fully automated electrochemiluminescent immunoassay (Meso Scale Discovery).ResultsBlood routine, biochemical, and inflammation cytokine test results showed that the levels of white blood cell count, neutrophil count, natrium, CRP, IL-8, IL-6, IL-13, and IL-16 significantly increased in the case group than in the healthy controls (p < 0.05), whereas levels of red blood cell count, hemoglobin concentration, mean corpuscular hemoglobin concentration, total protein, albumin, total bile acid, high-density lipoprotein (HDL), apolipoprotein A1, blood urea nitrogen, kalium and IL-15 were lower than in the healthy controls (p < 0.05). Correlation network analysis results shown that the natrium, HDL and red blood cell count were the top 3 factors closely to with BPRS and PANSS related clinical symptoms among of correlation network (degree = 4). ROC curve analysis explored the IL-16, IL-8, IL-13, IL-15, natrium, and HDL had highly sensitivity and specificity to the predictive validity and effectiveness for SCZ symptoms.ConclusionOur study revealed a complex interactive network correlation among the cardiovascular risk factors, biological immunity profiles, and psychotic symptoms in first-episode patients. Abnormal inflammatory factors and CVD risk factors had high sensitivity and specificity for predicting SCZ symptoms. Generally, our study provided novel information on the immune-related mechanisms involved in early CVD risk in patients with psychotic disorders.

Recreational Marijuana Use, Adolescent Cognitive Development, and Schizophrenia Susceptibility

BackgroundWe investigated how low marijuana (MJ) use levels, the typical use pattern in most adolescent users, affect cognitive maturation and schizophrenia risk. MethodsIn two complementary adolescent samples where the majority reported minimal MJ use, we compared cognitive performances before and after MJ use initiation. The Iowa sample (40 first-degree relatives and 54 second-degree relatives of patients with schizophrenia and 117 control subjects with no schizophrenia family history) underwent a battery of standardized neuropsychological tests at 0, 18, and 36 months. Based on self-administered Timeline Followback interviews, 26.5% of adolescents had emergent MJ use (eMJ) during follow-up. The second sample (n = 3463), derived from a birth cohort, received substance use and sustained attention assessments between ages 10 and 15 years. Mixed linear models and regression analyses tested the effects of eMJ on longitudinal changes in cognitive performance. ResultsIn the Iowa sample, longitudinal changes in 5 of 8 cognitive domains were significantly associated with eMJ. On sustained attention, visuospatial working memory, and executive sequencing, adolescents with eMJ showed less age-expected improved performance. In addition, first-degree relatives with eMJ were less improved on processing speed and executive reasoning than first-degree relatives without eMJ. In the birth cohort, greater intraindividual variability in reaction times (indicative of poorer sustained attention) was significantly associated with more frequent MJ use and with recreational use levels. ConclusionsNonheavy MJ use disrupts normal adolescent maturation and compounds aberrant adolescent maturation associated with familial schizophrenia risk. These findings underscore the importance of reducing adolescent MJ access in the context of increased availability to high-potency MJ.

IMPACT OF FAMILIAL AND ENVIRONMENTAL RISK FACTORS ON AGE OF ONSET OF SCHIZOPHRENIA

ABSTRACT &#x0D; Objectives: 1.To determines impact of familial risk factor i.e. positive family history of schizophrenia on age of onset of schizophrenia.&#x0D; 2. To determine impact of environmental risk factor i.e. substance misuse on age of onset of schizophrenia.&#x0D; Materials and Methods: In this cross sectional analytical study, 430 patients were enrolled from OPD in Sarhad Hospital for Psychiatric Diseases Peshawar through convenience non probability sampling technique. First Data was dichotomized on the basis of positive and negative family history of schizophrenia. Later on data was again dichotomized on the basis of positive and negative history of substance misuse. Frequency and percentage were calculated for categorical variable while mean and standard deviation for continuous variables. Independent-samples T test was used while comparing categorical variable with continuous variable and Chi-square test was used while comparing two categorical variables in between them.&#x0D; Results: The mean age of onset of schizophrenia was 22.28 years with early onset in males than females. In those with familial schizophrenia, the mean ages of onset of schizophrenia in males and females were 22.35 and 22.05 years while in those with sporadic cases, the mean age of onset of schizophrenia in males and females were 21.83 and 25.43 years respectively. Moreover non-tobacco substances and cannabinoids were having statistically significant impact on age of onset of schizophrenia.&#x0D; Conclusion: There was significant gender difference in age at onset of schizophrenia and substance misuse. Family history of schizophrenia eliminates the gender difference in age at onset of schizophrenia. Moreover non-tobacco substances and cannabinoids misuse can cause early onset of schizophrenia.

A comparison of phenomenological, clinical and familial psychiatric features of pediatric OCD and trichotillomania

Objectives Although trichotillomania (TTM) is classified in the obsessive-compulsive disorders (OCD) chapter of the DSM-5, several studies showed that it has several differences. The aim of this study was to examine the phenomenology, comorbidity, and family psychiatric characteristisc of childhood TTM and OCD. Methods This study compared youth ages 6–17 years with a primary diagnosis of TTM (n = 63) to those with primary OCD (n = 65) on clinical and familial psychiatric characteristics. Results In our study, the findings showed that family history of schizophrenia (42.3%) was higher among patients with TTM than the OCD group, while the history of OCD (55.8%) in the family was significantly higher among the OCD group (p < 0.001). The behaviour of plucking eyebrows was significantly higher among patients with TTM comorbid OCD than patients with only trichotillomania. TTM patients with comorbid OCD had one-dimensional symptom distribution than the presence of the OCD-only group, and the severity of OCD was lower. The incidence of pathological doubting was higher among the TTM group with comorbid OCD, than those with only OCD diagnosis. Conclusions These findings support significant differences between OCD and TTM. Differences between OCD and TTM may reflect differences in underlying psychobiology, and may necessitate contrasting treatment approaches. KEYPOINTS We aimed to compare the trichotillomania in itself and in the presence of OCD with the OCD group. Even if OCD accompanied trichotillomania, OCD symptom dimensions and severity were found to be lower than in the OCD-only group. Trichotillomania is a heterogeneous disorder with different dimensions besides the OCD spectrum.