Symptom Dimensions Of Schizophrenia Research Articles

Positive and general psychopathology associated with specific gray matter reductions in inferior temporal regions in patients with schizophrenia

Schizophrenia is a complex disorder that affects perception, cognition, and emotion causing symptoms such as delusions, hallucinations, and suspiciousness. Schizophrenia is also associated with structural cortical abnormalities including lower gray matter (GM) concentration, GM volume, and cortical thickness relative to healthy control individuals. However, the association between GM measures and symptom dimensions in schizophrenia is still not well understood.Here, we applied parallel independent component analysis (pICA), a higher-order statistical approach that identifies covarying patterns within two (or more) data modalities simultaneously, to link covarying brain networks of GM concentration with covarying linear combinations of the positive and negative syndrome scale (PANSS). In a large sample of patients with schizophrenia (n = 337) the association between these two data modalities was investigated.The pICA revealed a distinct PANSS profile characterized by increased delusional symptoms, suspiciousness, hallucinations, and anxiety, that was associated with a pattern of lower GM concentration in inferior temporal gyri and fusiform gyri and higher GM concentration in the sensorimotor cortex. GM alterations replicate previous findings; additionally, applying a multivariate technique, we were able to map a very specific symptom profile onto these GM alterations extending our understanding of cortical abnormalities associated with schizophrenia.Techniques like parallel ICA can reveal linked patterns of alterations across different data modalities that can help to identify biologically-informed phenotypes which might help to improve future treatment targets.

The "Obsessive Paradox": The Complex Relationship Between Cognitive and Obsessive Dimensions in Schizophrenia.

The objective of the study was to investigate the relationship between cognitive functions and obsessive-compulsive dimension in schizophrenia and a possible moderating effect of schizophrenia symptom dimensions on this association. Sixty-one schizophrenia patients were administered the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and the Matrics Consensus Cognitive Battery. A U-shaped curve described a gradual transition from an inverse association to a positive relationship between YBOCS and processing speed scores, along a severity gradient of obsessive dimension. This effect ("the obsessive paradox") was not moderated by other symptom dimensions. The present study suggests that severe obsessive-compulsive symptoms may participate to counterbalance processing speed impairment independently from other symptom dimensions. These results highlight the complexity of the relationship between cognitive and obsessive dimensions in schizophrenia.

Schizophrenia symptom dimensions in correlation to patients’ demographic and clinical characteristics

Background Schizophrenia symptom dimensions could vary with clinical and demographic variables. Materials and methods A total of 100 patients with schizophrenia were diagnosed based on the Diagnostic and statistical manual criteria of the American Psychiatric association. Positive and negative symptom scale was used to assess schizophrenia symptoms. The search for possible correlations between dimensions and demographic and clinical variables was done by Pearson correlation coefficient. Results and conclusion Symptom dimensions showed a correlation with age, onset, duration, hospitalization, compliance to medication, duration without treatment, and family history of schizophrenia.

S248. Resting State Functional Connectivity From Hippocampus and Nucleus Accumbens Correlates With Symptom Dimensions in Schizophrenia

Cerebral dysconnectivity is thought to contribute to the schizophrenia syndrome phenotype. Reward system dysfunction was reported in schizophrenia. Here we test, whether resting state connectivity from the reward system would be linked to reward-related schizophrenia symptoms, such as delusions or avolition.

S115. SYMPTOM DOMAINS IN SCHIZOPHRENIA AND GENE POLYMORPHISMS

BackgroundDopamine and serotonin neurotransmission relies mostly on the action of four factors: serotonin and dopamine transporters (SERT and DAT) and enzymes monoaminooxidase A (MAO-A) and catechol-O-mehtyltransferase (COMT). The goal of this research was to closely examine schizophrenia symptom domains in relation to the investigated polymorphisms.MethodsStudy group was composed of 300 schizophrenic patients. Severity of schizophrenia was assessed by the Positive and negative syndrome scale (PANSS), depressive symptoms were assessed with Calgary depression scale for schizophrenia (CDSS). SERT (5-HTTLPR), DAT (VNTR), COMT (Val158Met) and MAO-A (VNTR) gene polymorphisms were analyzed. Schizophrenia symptom dimensions were determined with multivariate statistical methods, while logistic regression and ANOVA were used to investigate the influence of a genotype on a symptom domain.ResultsFactor analysis of PANSS scale retained all 30 items and identified 5 separate factors (aggressive/impulsive, affective/depressive, cognitive, negative and positive symptoms). Analysis of CDSS scale revealed 2 separate factors (depression and suicidality).Statistically significant PANSS variables were those of aggressive/impulsive and negative symptoms, while suicidality was the only significant CDSS variable.DiscussionOur PANSS scale factor analysis established 5 distinct factors. Previous factor analyses provided from 3, up to 7 different factors, but mostly 5 distinct ones: negative symptoms, positive symptoms, depressive symptoms, excitement and disorganization. That factor distribution corresponds to our findings in terms of identified number of factors, but seems to differ in terms of item distribution within those factors.When testing the influence of investigated gene polymorphisms on the variable of total PANSS score and five distinct factors we did not establish significant findings regarding four variables: total PANSS score, positive, cognitive and affective/depressive symptoms. While that is in line with majority of other investigations, SERT promoter polymorphism and COMT Val158Met gene polymorphism have been previously associated with depressive and positive symptoms. SERT and MAO-A polymorphisms separately had a significant effect on the variable of aggressive/impulsive symptoms, which has not been reported earlier. Furthermore, significant influence of COMT gene polymorphism was established for the variable of negative symptoms, which is a confirmation of some earlier reports, although there have been contrary findings.Previous reports of CDSS scale factor structure are limited to data from its initial validation to the few recent findings of its three-factor structure (depression, cognition and melancholy). We identified 2 separate factors using factor analysis, “depression” (which included seven out of nine items) and “suicidality”. To the best of our knowledge this is the first investigation of the putative association between any of the four investigated polymorphisms and depressive symptoms of schizophrenia measured by the CDSS scale. Ultimately, we did not establish a significant association of investigated gene polymorphisms and total CDSS score, as well as the “depression” factor. However, there was a significant association between the “suicidality” factor and SERT and MAO-A gene polymorphisms, as well as their interaction. The fact that the significant association was established for only one of the two obtained CDSS factors suggests that the association is subtle and, at least partially, explains rarely reported associations between investigated gene polymorphisms and schizophrenia symptom domains, which is especially true for depressive symptomatology.

T167. ABERRANT MYELINATION OF THE CINGULUM BUNDLE IN PATIENTS WITH SCHIZOPHRENIA: A 7T MTI/DTI STUDY

BackgroundThe structural integrity of the anterior cingulum has been repeatedly observed to be abnormal in patients with schizophrenia. Reduced glutathione levels, indicating oxidative stress, is associated with reduced structural integrity of cingulum bundle in patients with schizophrenia. Variations in neuregulin-1, a well-established candidate marker for schizophrenia, results in oligodendrocyte dysfunction and defective myelination, and is shown to affect the structural integrity of the anterior cingulum in patients with schizophrenia. While the evidence to date has been obtained using diffusion tensor imaging, abnormal tract-specific changes in myelin content can be more directly inferred by combining multiple modalities of WM imaging such as diffusion tensor (DTI) and magnetization transfer imaging (MTI) in parallel.MethodsWe used ultra-high resolution (7 Tesla) MTI in 17 patients with schizophrenia and 20 controls, to evaluate the macromolecular (predominantly myelin) content of the brain. Immediately after the 7T scanning, we also obtained a 3T diffusion tensor image (DTI) and undertook probabilistic tractography using FSL software (AutoPtx, ProbTrackX) to delineate anterior cingulum bilaterally. Unpaired t tests were used for group comparisons along with estimates of Cohen’s d or Hedge’s g for effect sizes.ResultsPatients had a significant reduction in magnetization transfer ratio (MTR) in right (Cohen’s d=0.91, p=0.007) but not left (d=0.03, p=0.92) cingulum bundle. There was also a trend level reduction in fractional anisotropy of right (d=0.60, p=0.07) but not left (d=0.47, p=0.17) cingulum bundle. We did not find any significant relationship between the 3 major symptom dimensions of schizophrenia (Reality Distortion, Disorganization, Psychomotor Poverty) and Cingulum MTR. Patients with Schneiderian delusions (n=5) showed a significantly reduced MTR of left cingulum compared to patients (n=12) with no Schneiderian delusions (Hedges’ g=1.36, p=0.02).DiscussionOur findings suggest that MTR changes in anterior cingulum, resulting from either dysmyelination or neuroinflammation, is present in clinically stable patients with schizophrenia despite their medicated status. We lacked sufficient power to detect association between MTR changes of cingulum and symptom dimensions. Nevertheless, our results suggest that MTR changes are of higher magnitude than changes in fractional anisotropy, indicating the sensitivity of measuring myelination as a biological marker of white matter aberrations in schizophrenia.

Efficacy of non-invasive brain stimulation on the symptom dimensions of schizophrenia: A meta-analysis of randomized controlled trials

BackgroundTranscranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) have shown promise in the treatment of schizophrenia. ObjectiveTo quantify the efficacy of double-blind randomized controlled trials (RCT) of tDCS and rTMS for the positive and negative symptoms of schizophrenia and identify significant moderators relating to patient-related features and stimulation parameters. MethodsSystemic review and meta-analyses of the relevant literature published until February 1st, 2017 to assess treatment efficacy and quantify the contribution of potential moderator variables. ResultsWe identified 7 RCTs on tDCS (involving 105 participants) and 30 RCTs on rTMS (involving 768 participants). Compared to sham, tDCS improved all symptom dimensions but the effect reached significance for negative symptoms (Hedge’s g = −0.63, p = 0.02). Efficacy for positive but not negative symptoms was linearly associated with cumulative tDCS stimulation. Compared to sham, rTMS improved hallucinations (Hedge’s g = −0.51, p < 0.001) and negative symptoms (Hedge’s g = −0.49, p = 0.01) but was associated with modest, non-significant worsening of positive symptoms (Hedge’s g = 0.28, p = 0.13). Higher pulse frequency (>10 Hz), motor threshold intensity of 110%, left prefrontal cortical treatment site and trial duration over 3 weeks were associated with improvement in negative symptoms and worsening in positive symptoms (all p < 0.03). ConclusionsThe symptom dimensions in schizophrenia may respond differently to brain stimulation interventions in a way that may reflect the interaction between disease- and treatment-related mechanisms. Our findings underscore the need for further research into patient selection prior to treatment assignment and greater refinement of stimulation protocols.

Factor analysis of symptom dimensions (psychotic, affective and obsessive compulsive symptoms) in schizophrenia

To carryout factor analysis of symptom profile of patients with schizophrenia assessed by using positive and negative syndrome scale (PANSS), Calgary depression rating scale (CDSS), Young mania rating scale (YMRS) and YBOCS checklist. 181 patients of schizophrenia were assessed on PANSS, CDSS, YMRS and YBOCS checklist. Factor analysis of PANSS yielded 3 factor structure (positive, negative, anxiety). When the items of CDSS were added to the PANSS items, total number of factors increased to 4 with depression emerging as a separate factor. Addition of YMRS to PANSS and CDSS led to emergence of 5 factor model. Further addition of YBOCS checklist led to emergence of a 7 factor model (positive, depressive, obsessive compulsive, negative, manic, anxiety and obsessive compulsive-2), which explained 49.85% variance of the data. Positive symptoms emerged as the factor-1. Depressive symptoms loaded on the factor-2, negative symptoms loaded on to factor-4, manic symptoms loaded onto factor-5 and anxiety symptoms loaded onto factor-6. OC symptoms loaded onto factor 3 and 7. Present study suggests that when multiple scales are used for assessment of various symptoms of schizophrenia, the symptoms separate out into 7 factors. This finding suggests that clinical assessment of schizophrenia should not be limited to core psychotic symptoms only and structured instruments must be used to elicit other symptoms too while monitoring the clinical picture of patients with schizophrenia.

Depressive, anxiety and hypomanic symptoms in schizophrenia may be driven by tryptophan catabolite (TRYCAT) patterning of IgA and IgM responses directed to TRYCATs

The aim of this study was to delineate the associations between the tryptophan catabolite (TRYCAT) pathway and affective symptoms in schizophrenia. Towards this end we measured immunoglobulin (Ig)A and IgM responses to relatively noxious TRYCATs, namely quinolinic (QA), xanthurenic (XA), picolinic (PA) acid and 3-OH-kynurenine (3HK), and generally protective TRYCATs, namely anthranilic (AA) and kynurenic (KA) acid in 80 patients with schizophrenia and 40 healthy controls. The Hamilton Rating Scale for Depression (HDRS) and anxiety (HAMA), Young Mania Rating Scale (YMRS) as well as the Positive and Negative Symptoms Scale of Schizophrenia (PANSS) were measured.Depression, anxiety and hypomanic as well as negative and positive symptoms were associated with increased IgA responses to PA. Increased IgA responses to XA were associated with anxiety, hypomanic and negative symptoms. Moreover, depressive, anxiety, hypomanic and negative symptoms were characterized by increased IgA responses to the noxious (XA+3HK+QA+PA)/protective (AA+KA) TRYCAT ratio. All symptom dimensions were associated with increased IgM responses to QA, while depressive, anxiety, positive and negative symptoms were accompanied by lowered IgM responses to 3HK. Hypomanic symptoms were additionally accompanied by lowered IgM responses to AA, and negative symptoms by increased IgM responses to KA.In conclusion, both shared and distinct alterations in the activity of the TRYCAT pathway, as well as its regulatory factors and consequences, may underpin affective and classical psychotic symptoms of schizophrenia. Increased mucosa-generated production of noxious TRYCATs, especially PA, and specific changes in IgM-mediated regulatory activities may be associated with the different symptom dimensions of schizophrenia.

“Pseudoneurotic Schizophrenia” Revisited: The role of obsessive-compulsive symptoms in low-level disorganization psychosishosiser

ObjectiveRecent research has suggested a dual impact of obsessive-compulsive dimension on functioning in schizophrenia with a gradual transition from an improving to a worsening effect depending on obsessive-compulsive symptom (OCS) severity (from mild to moderate-severe). Aim of the present study was to investigate whether this varying effect of OCS on functioning might be mediated or moderated by schizophrenia symptom dimensions or occur independently.MethodSeventy-five patients affected by schizophrenia were administered the SCID-IV, the PANSS, the YBOCS and the SOFAS.The sample was divided into two groups according to the severity of OCS (absent/mild and moderate/high).ResultsIn both groups, a significant interaction between OCS and disorganization dimension was found: the dual effect of OCS on functioning occurred only among patients with low disorganization symptoms while it was no more apparent at higher levels of disorganization (Figure 1).ConclusionData suggest that in patients with schizophrenia, functioning at least in part depends on the interaction between disorganization and OCS. Particularly, mild OCS contributes to higher levels of functioning in patients with psychosis at low levels of disorganization. In keeping with the historical concept of “pseudoneurotic schizophrenia”, we speculate that obsessive dimension might have a pathoplastic influence in milder forms of schizophrenia spectrum disorders, balancing the effect of underlying low disorganization symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Specific cerebral perfusion patterns in three schizophrenia symptom dimensions

Dimensional concepts such as the Research Domain Criteria initiative have been proposed to disentangle the heterogeneity of schizophrenia. One model introduced three neurobiologically informed behavioral dimensions: language, affectivity and motor behavior. To study the brain-behavior associations of these three dimensions, we investigated whether current behavioral alterations were linked to resting state perfusion in distinct brain circuits in schizophrenia.In total, 47 patients with schizophrenia spectrum disorders and 44 healthy controls were included. Psychopathology was assessed with the Positive And Negative Syndrome Scale and the Bern Psychopathology scale (BPS). The BPS provides severity ratings of three behavioral dimensions (language, affectivity and motor). Patients were classified according to the severity of alterations (severe, mild, no) in each dimension. Whole brain resting state cerebral blood flow (CBF) was compared between patient subgroups and controls.Two symptom dimensions were associated with distinct CBF changes. Behavioral alterations in the language dimension were linked to increased CBF in Heschl's gyrus. Altered affectivity was related to increased CBF in amygdala. The ratings of motor behavior instead were not specifically associated with CBF.Investigating behavioral alterations in three schizophrenia symptom dimensions identified distinct regional CBF changes in the language and limbic brain circuits. The results demonstrate a hitherto unknown segregation of pathophysiological pathways underlying a limited number of specific symptom dimensions in schizophrenia.

White matter integrity and symptom dimensions of schizophrenia: A diffusion tensor imaging study

Impaired fiber bundle connectivity between brain regions is a key neuropathological finding in schizophrenia. Symptom dimensions in schizophrenia can be clustered into factor models. Single syndromes have been related to grey and white matter brain structure alterations. We associated all core syndromes of schizophrenia in a single patient group with changes in white matter integrity.Diffusion weighted images (3T MRI) and SAPS/SANS scores were measured in 26 male patients and 26 healthy controls. First, group differences in fractional anisotropy (FA) were calculated with TBSS. Second, core symptom dimensions of schizophrenia were correlated with FA within these altered tracts.We found differences between groups in nine white matter tracts. Hallucinations were positively correlated with FA in the left uncinate fasciculus and left corticospinal tract. Ego-disturbances (passivity phenomena) showed a positive correlation with FA in the right anterior thalamic radiation. Positive formal thought disorders (FTD) corresponded negatively with FA in the right cingulum bundle. Negative symptoms were positively associated with the right anterior thalamic radiation and negatively with the right ventral cingulum bundle.For the first time, we analyzed the whole range of psychopathological factors in one schizophrenia patient group. We could validate our novel results for positive FTD and passivity phenomena by replicating findings for hallucinations and negative symptoms. Only those brain circuits which are most vulnerable at a given time during neurodevelopment are affected by a particular pathological impact (genetic, environmental). This scenario could explain the predominance of particular psychopathological syndromes related to specific white matter anomalies.

Ventral Striatal Dysfunction and Symptom Expression in Individuals With Schizotypal Personality Traits and Early Psychosis.

Striatal abnormalities play a crucial role in the pathophysiology of schizophrenia. Growing evidence suggests an association between aberrant striatal activity during reward anticipation and symptom dimensions in schizophrenia. However, it is not clear whether this holds across the psychosis continuum. The aim of the present study was to investigate alterations of ventral striatal activation during reward anticipation and its relationship to symptom expression in persons with schizotypal personality traits (SPT) and first-episode psychosis. Twenty-six individuals with high SPT, 26 patients with non-affective first-episode psychosis (including 13 with brief psychotic disorder (FEP-BPD) and 13 with first-episode schizophrenia [FEP-SZ]) and 25 healthy controls underwent event-related functional magnetic resonance imaging while performing a variant of the Monetary Incentive Delay task. Ventral striatal activation was positively correlated with total symptom severity, in particular with levels of positive symptoms. This association was observed across the psychosis continuum and within each subgroup. Patients with FEP-SZ showed the strongest elevation of striatal activation during reward anticipation, although symptom levels did not differ between groups in the psychosis continuum. While our results provide evidence that variance in striatal activation is mainly explained by dimensional symptom expression, patients with schizophrenia show an additional dysregulation of striatal activation. Trans-diagnostic approaches are promising in order to disentangle dimensional and categorical neural mechanisms in the psychosis continuum.

Improving Current Treatments for Schizophrenia.

Preclinical Research After the identification of the schizophrenia as an illness over a century ago, treatment of affected individuals included unspecific, mostly very robust methods including deep insulin coma and lobectomy/leucotomy. The first relatively specific treatment of schizophrenia started about 60 years ago with the antipsychotic chlorpromazine. All currently approved antipsychotic drugs block dopamine receptors, indicating that manipulation of dopaminergic function is fundamental to a therapeutic response in psychosis. Despite refinements in their mechanism of action, the therapeutic effects of subsequent generations of antipsychotics are insufficient in claiming superiority over the first generation, with the possible exception of clozapine. Dopamine receptor blockade is necessary but not always sufficient for antipsychotic response and improvements have been reported with molecules acting on other receptors (glutamate, glycine, cannabidiol, estrogen), intracellular signaling proteins, or products of identified risk genes. Here, we review the current status of drugs under investigation. In addition, we emphasize that the development of the novel compounds to target the underlying cognitive dysfunction and negative symptom dimension of full blown schizophrenia, or attenuated psychosis syndrome and specific endophenotypes related to the increased risk of psychosis in the general population, alongside efforts to deconstruct the concept of schizophrenia(s), represent the best way to meet patient needs for better therapies and more favorable outcomes. Drug Dev Res 77 : 357-367, 2016. © 2016 Wiley Periodicals, Inc.

PM514. DRD2, 5-HT1A, and 5-HT2A gene polymorphisms and clinical factors modulate aripiprazole efficacy in different symptom dimensions of schizophrenia

PM514. DRD2, 5-HT1A, and 5-HT2A gene polymorphisms and clinical factors modulate aripiprazole efficacy in different symptom dimensions of schizophrenia

Obsessive-compulsive symptoms interact with disorganization in influencing social functioning in schizophrenia

Objective Recent research has suggested a dual impact of obsessive-compulsive dimension on functioning in schizophrenia with a gradual transition from an improving to a worsening effect depending on obsessive-compulsive symptoms (OCS) severity (from mild to moderate-severe). Aim of the present study was to investigate whether this varying effect of OCS on functioning might be mediated or moderated by schizophrenia symptom dimensions or occur independently. Method Seventy-five patients affected by schizophrenia were administered the Structured Clinical Interview for DSM-IV Disorders, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale and the Social and Occupational Functioning Assessment. The sample was divided into two groups according to the severity of OCS (absent/mild and moderate/high OCS group). Results In both groups, the effect of OCS on functioning was not mediated by their effect on positive, negative or disorganization symptoms. Conversely, a significant interaction between OCS and disorganization dimension was found: the dual effect of OCS on functioning occurred only among patients with low disorganization symptoms while it was no more apparent at high levels of disorganization. Conclusion Data suggest that in patients with functioning at least in part depends on the interaction between disorganization and OCS. Particularly, since mild OCS contribute to lesser functional decline in patients with low disorganized psychosis, they may favor the constitution of a subtype of schizophrenia with a better functioning. In keeping with the historical concept of pseudoneurotic schizophrenia, we speculate that obsessive dimension might have a pathoplastic influence, balancing the effect of low disorganization symptoms.

Cerebral white matter structure is associated with DSM-5 schizophrenia symptom dimensions.

Diffusion tensor imaging (DTI) studies have provided evidence of widespread white matter (WM) abnormalities in schizophrenia. Although these abnormalities appear clinically significant, the relationship to specific clinical symptoms is limited and heterogeneous. This study examined the association between WM microstructure and the severity of the five main DSM-5 schizophrenia symptom dimensions. DTI was measured in forty patients with schizophrenia spectrum disorders. Using Tract-Based Spatial Statistics controlling for age, gender and antipsychotic dosage, our analyses revealed significant negative relationships between WM microstructure and two DSM-5 symptom dimensions: Whereas abnormal psychomotor behavior was particularly related to WM of motor tracts, negative symptoms were associated with WM microstructure of the prefrontal and right temporal lobes. However, we found no associations between WM microstructure and delusions, hallucinations or disorganized speech. These data highlight the relevance of characteristic WM disconnectivity patterns as markers for negative symptoms and abnormal psychomotor behavior in schizophrenia and provide evidence for relevant associations between brain structure and aberrant behavior.

Obsessive–compulsive symptoms interact with disorganization in influencing social functioning in schizophrenia

ObjectiveRecent research has suggested a dual impact of obsessive–compulsive dimension on functioning in schizophrenia with a gradual transition from an improving to a worsening effect depending on obsessive–compulsive symptoms (OCS) severity (from mild to moderate–severe). Aim of the present study was to investigate whether this varying effect of OCS on functioning might be mediated or moderated by schizophrenia symptom dimensions or occur independently. MethodSeventy-five patients affected by schizophrenia were administered the Structured Clinical Interview for DSM-IV Disorders, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive–Compulsive Scale and the Social and Occupational Functioning Assessment.The sample was divided into two groups according to the severity of OCS (absent/mild and moderate/high OCS group). ResultsIn both groups, the effect of OCS on functioning was not mediated by their effect on positive, negative or disorganization symptoms. Conversely, a significant interaction between OCS and disorganization dimension was found: the dual effect of OCS on functioning occurred only among patients with low disorganization symptoms while it was no more apparent at high levels of disorganization. ConclusionData suggest that in patients with schizophrenia, functioning at least in part depends on the interaction between disorganization and OCS.

Altered intra- and inter-network dynamics reflect symptom dimensions in childhood-onset schizophrenia.

This scientific commentary refers to ‘Disrupted sensorimotor and social–cognitive networks underlie symptoms in childhood-onset schizophrenia’, by Berman et al. . (doi:10.1093/brain/awv306). Schizophrenia is a highly heritable, heterogeneous and complex brain disorder characterized by positive symptoms (e.g. hallucinations, delusions) and negative symptoms (e.g. impoverished speech, flattened affect). The clinical symptoms that feature in schizophrenia frequently present during adolescence. Considerable evidence supports the hypothesis that a component of the aetiology of schizophrenia is neurodevelopmental. The study of patients with rare childhood-onset schizophrenia (COS) provides a unique opportunity to explore this facet of schizophrenia, without the correlates of an extended disease course (e.g. years of medication, institutionalization) and comorbidity (e.g. major depressive disorder, substance abuse) that confound studies of adult patients. In this issue of Brain , Berman et al. provide compelling evidence that childhood-onset schizophrenia (and its composite symptoms) is associated with reduced functional coupling (that is, correlations between brain regions over time) within and between independent neural networks (Berman et al. , 2015). Schizophrenia is generally thought to be a whole-brain disorder, characterized by patterns of disconnectivity (Buckholtz and Meyer-Lindenberg, 2012). Connections between brain regions can be assessed using neuroimaging techniques such as MRI, which can reveal schizophrenia-related alterations in brain macrostructure, microstructure and haemodynamic activity. While techniques such as …

Can Psychological, Social and Demographical Factors Predict Clinical Characteristics Symptomatology of Bipolar Affective Disorder and Schizophrenia?

Schizophrenia (SCH) is a complex, psychiatric disorder affecting 1 % of population. Its clinical phenotype is heterogeneous with delusions, hallucinations, depression, disorganized behaviour and negative symptoms. Bipolar affective disorder (BD) refers to periodic changes in mood and activity from depression to mania. It affects 0.5–1.5 % of population. Two types of disorder (type I and type II) are distinguished by severity of mania episodes. In our analysis, we aimed to check if clinical and demographical characteristics of the sample are predictors of symptom dimensions occurrence in BD and SCH cases. We included total sample of 443 bipolar and 439 schizophrenia patients. Diagnosis was based on DSM-IV criteria using Structured Clinical Interview for DSM-IV. We applied regression models to analyse associations between clinical and demographical traits from OPCRIT and symptom dimensions. We used previously computed dimensions of schizophrenia and bipolar affective disorder as quantitative traits for regression models. Male gender seemed protective factor for depression dimension in schizophrenia and bipolar disorder sample. Presence of definite psychosocial stressor prior disease seemed risk factor for depressive and suicidal domain in BD and SCH. OPCRIT items describing premorbid functioning seemed related with depression, positive and disorganised dimensions in schizophrenia and psychotic in BD. We proved clinical and demographical characteristics of the sample are predictors of symptom dimensions of schizophrenia and bipolar disorder. We also saw relation between clinical dimensions and course of disorder and impairment during disorder.