Increased Risk Of Psychosis Research Articles

Postnatal risk environments, epigenetics, and psychosis: putting the pieces together.

Postnatal environmental factors, such as early life adversity, cannabis use, and social stressors are associated with increased risk for psychotic disorders. Understanding mechanisms that underlie increased psychosis risk is of great importance for the development of novel preventive approaches and early interventions. In a timely review article, Pishva et al. discuss available evidence suggesting that postnatal environmental risk factors contribute to psychotic disorders via epigenetic mechanisms. While the evidence supporting this hypothesis is limited and primarily based on the epigenetic profiling of psychotic patients and animal models, further investigation in this area is warranted and may bring exciting results.

Identifying a Treatable Psychosis-Risk Cohort

Identifying a Treatable Psychosis-Risk Cohort

Prediction of psychosis onset in Alzheimer disease: The role of depression symptom severity and the HTR2A T102C polymorphism

Psychotic symptoms in Alzheimer disease (AD + P) identify a heritable phenotype associated with a more severe course. We recently found an association of AD + P with depression symptom severity. Reports have shown an association of a serotonin-2A receptor (HTR2A) gene T102C polymorphism with AD + P and with depression during AD. We examined the interaction of this common genetic polymorphism with depression and increased psychosis risk. Subjects with possible or probable AD or mild cognitive impairment (MCI) without psychosis at study entry were genotyped for the HTR2A T102C polymorphism and reassessed every 6 months until psychosis onset. Psychotic and depressive symptoms were rated using the CERAD behavioral rating scale (CBRS). Cox proportional hazard models with time-dependent covariates were used to examine associations with psychosis onset. A total of 324 Caucasian subjects completed at least one follow-up exam. Depressive symptom severity was a strong predictor of psychosis onset. Neither psychosis onset nor depression severity was associated with the HTR2A genotype. Genotype interacted with depression severity to moderate the risk of AD + P onset. This did not result from an interaction of HTR2A genotype with antidepressant use. Psychosis onset in AD is strongly associated with severity of depressive symptoms, an association that may be modified by HTR2A genotype.

Postpartum Psychiatric Disorders — in Men, Too?

During the postpartum period, women, especially primiparous women, are at increased risk for depression and psychosis. Few researchers, however, have studied psychiatric disorders in fathers during the postpartum period. Now, researchers have used Danish registries to examine rates of first psychiatric hospitalization or outpatient contact in 630,373 women and 547,431 men during their first year of parenthood. …

Cumulative exposure to estrogen and psychosis: a peak bone mass, case-control study in first-episode psychosis

The organizational structural effects of estrogen may be cumulative and permanent by impacting on neurodevelopment, giving rise to “neuroprotective” effects and eventually reduction of psychosis risk. Reduction in bone mineral density (BMD, in g/cm 2), as a biological marker of reduced cumulative exposure to estrogen, may be a marker of increased psychosis risk. A sample of 19 first-episode female psychosis patients with minimal previous antipsychotic exposure (mean 10 weeks) and 20 female controls underwent advanced fan-beam dual X-ray absorptiometry (DXA) to assess lumbal spine BMD of the region of L1–L4. Mean BMD was around one standard deviation lower in patients (1.13, S.D.=0.10) than in controls (1.25, S.D.=0.12; p=0.0021), and 84% of patients scored below the median value of the controls (OR=5.3, 95% CI: 1.2, 24.2). The results are compatible with the hypothesis that psychosis in women may be associated causally with a reduced protective effect of estrogen over the course of development.

Reliability of best-estimate diagnosis in genetic linkage studies of major psychoses: results from the Quebec pedigree studies.

Diagnostic classification and reliability are critical in genetic linkage studies of schizophrenia and bipolar disorder. To establish an optimal diagnostic procedure, the authors drew 13 methodological elements from 38 major linkage studies and workshop reports. They determined reliability for a consensus best-estimate diagnostic method based on these 13 features. Each of 59 subjects from several large multiplex pedigrees, densely affected by either schizophrenia or bipolar disorder, received a best-estimate diagnosis from unblind diagnosticians in the field and also from a panel of four research psychiatrists who were blind to the proband's and relatives' clinical status. The best estimate was based on personal diagnostic interviews, all available medical records, and family history data. The diagnostic concordance between the field team and the blind psychiatric board yielded 78% to 90% agreement for the whole sample (kappa = 0.83-0.88) and 71% to 87% agreement for the subjects given field diagnoses (kappa = 0.76-0.83). The diagnoses made by the unblind field diagnosticians were biased toward a greater severity (or certainty) level in the diagnostic hierarchy (schizophrenic or bipolar) and more consistency with the most prevalent diagnosis affecting the pedigree. Since several previous linkage studies used diagnoses made by diagnosticians who were not blind to the status of the probands and the relatives or did not use a consensus best-estimate diagnosis, further reliability studies of different aspects of the best-estimate method and of its effect on linkage studies are needed. Such research is imperative given the serious impact of diagnostic misclassifications on genetic linkage results.