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Obstetric complications and cognition in schizophrenia: a systematic review and meta-analysis
- Silvia Amoretti, Francisco Diego Rabelo-da-Ponte, Marina Garriga, Maria Florencia Forte, Rafael Penadés, Eduard Vieta, Eduard Parellada, Josep Antoni Ramos-Quiroga, Clarissa S. Gama, Norma Verdolini, Byron Bitanihirwe, Clemente Garcia-Rizo
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- Journal:
- Psychological Medicine / Volume 52 / Issue 14 / October 2022
- Published online by Cambridge University Press:
- 18 August 2022, pp. 2874-2884
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Background
Schizophrenia (SZ) is a complex brain disorder linked to cognitive and neurostructural abnormalities that involves genetic and environmental factors with obstetric complications (OCs) at birth conferring a high risk for the disease. Indeed, current research in the general population describes the deleterious effect of OCs on cognitive performance in adulthood. With this rationale, we aim to review the relationship between OCs and cognition in SZ and related psychotic disorders.
MethodsA systematic review and meta-analysis describing cognitive function and OCs in patients with SZ and related disorders were conducted. PubMed, EmBase, SCOPUS, and the Cochrane Library were systematically searched to identify eligible studies up to January 2022. We calculated the effect sizes (Hedges' g) of cognitive domains within each study and quantified the proportion of between-study variability using the I2 statistic. Homogeneity was assessed using the Q-statistic (X2). The study was registered on PROSPERO (CRD42018094238).
ResultsA total of 4124 studies were retrieved, with 10 studies meeting inclusion criteria for the systematic review and eight for meta-analysis. SZ subjects with OCs showed poor verbal memory [Hedges' g = −0.89 (95% CI −1.41 to −0.37), p < 0.001] and working memory performance [Hedges' g = −1.47 (95% CI −2.89 to −0.06), p = 0.01] in a random-effect model compared to those without OCs.
ConclusionsOCs appear to have a moderate impact on specific cognitive such as working memory and verbal memory. Our findings suggest that OCs are associated with brain development and might underlie the cognitive abnormalities described at onset of psychosis.
Social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis
- I. González-Ortega, S. Alberich-Mesa, E. Echeburúa, M. Bernardo, B. Cabrera, S. Amoretti, A. Lobo, C. Arango, I. Corripio, E. Vieta, E. De La Serna, R. Rodriguez-Jimenez, R. Segarra, J.M. López-Ilundain, A. Sánchez-Torres, M. Cuesta, A. González-Pinto
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S163
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Introduction
Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear.
ObjectivesThe aim of the study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.
MethodsThe sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.
ResultsAt baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).
ConclusionsCognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.
DisclosureThis work was supported by the Carlos III Institute of Health and European Fund for Regional Development (PI08/1213, PI11/ 01977, PI14/01900, PI08/01026, PI11/02831, PI14/01621, PI08/1161, PI16/ 00359, PI16/01164, PI18/00805), the Basque Foundation for He
Examining the independent and joint effects of genomic and exposomic liabilities for schizophrenia across the psychosis spectrum
- L.-K. Pries, G. A. Dal Ferro, J. van Os, P. Delespaul, G. Kenis, B. D. Lin, J. J. Luykx, A. L. Richards, B. Akdede, T. Binbay, V. Altınyazar, B. Yalınçetin, G. Gümüş-Akay, B. Cihan, H. Soygür, H. Ulaş, E. Şahin Cankurtaran, S. Ulusoy Kaymak, M. M. Mihaljevic, S. Andric Petrovic, T. Mirjanic, M. Bernardo, G. Mezquida, S. Amoretti, J. Bobes, P. A. Saiz, M. Paz García-Portilla, J. Sanjuan, E. J. Aguilar, J. L. Santos, E. Jiménez-López, M. Arrojo, A. Carracedo, G. López, J. González-Peñas, M. Parellada, N. P. Maric, C. Atbaşoğlu, A. Ucok, K. Alptekin, M. Can Saka, Genetic Risk and Outcome of Psychosis (GROUP) investigators, C. Arango, M. O'Donovan, S. Tosato, B. P. F. Rutten, S. Guloksuz
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 29 / 2020
- Published online by Cambridge University Press:
- 17 November 2020, e182
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Aims
Psychosis spectrum disorder has a complex pathoetiology characterised by interacting environmental and genetic vulnerabilities. The present study aims to investigate the role of gene–environment interaction using aggregate scores of genetic (polygenic risk score for schizophrenia (PRS-SCZ)) and environment liability for schizophrenia (exposome score for schizophrenia (ES-SCZ)) across the psychosis continuum.
MethodsThe sample consisted of 1699 patients, 1753 unaffected siblings, and 1542 healthy comparison participants. The Structured Interview for Schizotypy-Revised (SIS-R) was administered to analyse scores of total, positive, and negative schizotypy in siblings and healthy comparison participants. The PRS-SCZ was trained using the Psychiatric Genomics Consortiums results and the ES-SCZ was calculated guided by the approach validated in a previous report in the current data set. Regression models were applied to test the independent and joint effects of PRS-SCZ and ES-SCZ (adjusted for age, sex, and ancestry using 10 principal components).
ResultsBoth genetic and environmental vulnerability were associated with case-control status. Furthermore, there was evidence for additive interaction between binary modes of PRS-SCZ and ES-SCZ (above 75% of the control distribution) increasing the odds for schizophrenia spectrum diagnosis (relative excess risk due to interaction = 6.79, [95% confidential interval (CI) 3.32, 10.26], p < 0.001). Sensitivity analyses using continuous PRS-SCZ and ES-SCZ confirmed gene–environment interaction (relative excess risk due to interaction = 1.80 [95% CI 1.01, 3.32], p = 0.004). In siblings and healthy comparison participants, PRS-SCZ and ES-SCZ were associated with all SIS-R dimensions and evidence was found for an interaction between PRS-SCZ and ES-SCZ on the total (B = 0.006 [95% CI 0.003, 0.009], p < 0.001), positive (B = 0.006 [95% CI, 0.002, 0.009], p = 0.002), and negative (B = 0.006, [95% CI 0.004, 0.009], p < 0.001) schizotypy dimensions.
ConclusionsThe interplay between exposome load and schizophrenia genetic liability contributing to psychosis across the spectrum of expression provide further empirical support to the notion of aetiological continuity underlying an extended psychosis phenotype.
A replication study of JTC bias, genetic liability for psychosis and delusional ideation
- Cécile Henquet, Jim van Os, Lotta K. Pries, Christian Rauschenberg, Philippe Delespaul, Gunter Kenis, Jurjen J. Luykx, Bochao D. Lin, Alexander L. Richards, Berna Akdede, Tolga Binbay, Vesile Altınyazar, Berna Yalınçetin, Güvem Gümüş-Akay, Burçin Cihan, Haldun Soygür, Halis Ulaş, Eylem S. Cankurtaran, Semra U. Kaymak, Marina M. Mihaljevic, Sanja S. Petrovic, Tijana Mirjanic, Miguel Bernardo, Gisela Mezquida, Silvia Amoretti, Julio Bobes, Pilar A. Saiz, Maria P. García-Portilla, Julio Sanjuan, Eduardo J. Aguilar, Jose L. Santos, Estela Jiménez-López, Manuel Arrojo, Angel Carracedo, Gonzalo López, Javier González-Peñas, Mara Parellada, Nadja P. Maric, Cem Atbaşoğlu, Alp Ucok, Köksal Alptekin, Meram C. Saka, Celso Arango, Michael O'Donovan, Bart P.F. Rutten, Sinan Gülöksüz
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- Journal:
- Psychological Medicine / Volume 52 / Issue 9 / July 2022
- Published online by Cambridge University Press:
- 13 October 2020, pp. 1777-1783
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Background
This study attempted to replicate whether a bias in probabilistic reasoning, or ‘jumping to conclusions’(JTC) bias is associated with being a sibling of a patient with schizophrenia spectrum disorder; and if so, whether this association is contingent on subthreshold delusional ideation.
MethodsData were derived from the EUGEI project, a 25-centre, 15-country effort to study psychosis spectrum disorder. The current analyses included 1261 patients with schizophrenia spectrum disorder, 1282 siblings of patients and 1525 healthy comparison subjects, recruited in Spain (five centres), Turkey (three centres) and Serbia (one centre). The beads task was used to assess JTC bias. Lifetime experience of delusional ideation and hallucinatory experiences was assessed using the Community Assessment of Psychic Experiences. General cognitive abilities were taken into account in the analyses.
ResultsJTC bias was positively associated not only with patient status but also with sibling status [adjusted relative risk (aRR) ratio : 4.23 CI 95% 3.46–5.17 for siblings and aRR: 5.07 CI 95% 4.13–6.23 for patients]. The association between JTC bias and sibling status was stronger in those with higher levels of delusional ideation (aRR interaction in siblings: 3.77 CI 95% 1.67–8.51, and in patients: 2.15 CI 95% 0.94–4.92). The association between JTC bias and sibling status was not stronger in those with higher levels of hallucinatory experiences.
ConclusionsThese findings replicate earlier findings that JTC bias is associated with familial liability for psychosis and that this is contingent on the degree of delusional ideation but not hallucinations.
Influence of social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis
- I González-Ortega, A González-Pinto, S Alberich, E Echeburúa, M Bernardo, B Cabrera, S Amoretti, A Lobo, C Arango, I Corripio, E Vieta, E de la Serna, R Rodriguez-Jimenez, R Segarra, JM López-Ilundain, AM Sánchez-Torres, MJ Cuesta, PEPs Group:, I Zorrilla, P López, M Bioque, G Mezquida, F Barcones, C De-la-Cámara, M Parellada, A Espliego, A Alonso-Solís, EM Grasa, C Varo, L Montejo, J Castro-Fornieles, I Baeza, M Dompablo, I Torio, A Zabala, JI Eguiluz, L Moreno-Izco, J Sanjuan, R Guirado, I Cáceres, P Garnier, F Contreras, J Bobes, S Al-Halabí, J Usall, A Butjosa, S Sarró, R Landin-Romero, A Ibáñez, G Selva
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- Journal:
- Psychological Medicine / Volume 50 / Issue 16 / December 2020
- Published online by Cambridge University Press:
- 22 October 2019, pp. 2702-2710
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Background
Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.
MethodsThe sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.
ResultsAt baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).
ConclusionsCognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.
12 - RELIGION IN THE TIMURID AND SAFAVID PERIODS
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- By B. S. Amoretti, Institute of Islamic Studies, University of Rome
- Edited by Peter Jackson, Keele University, Lawrence Lockhart
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- Book:
- The Cambridge History of Iran
- Published online:
- 28 March 2008
- Print publication:
- 06 February 1986, pp 610-655
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Summary
GENERAL CHARACTERISTICS OF THE TIMURID ERA
At the time of Tīmūr's death and under his immediate successors the religious situation in Iran was characterised by two complementary processes, which were the primary determinant of – or, minimally, ultimately resulted in - that particular form of religious reality known as Safavid Shi'ism.
The first factor is the great flexibility, bordering on prevarication, displayed by the religious world in fulfilling its cementing function between the political rulers and their subjects in the most disparate alliances between successive sovereigns and the local religious (and administrative) aristocracy, even when the diversity of madhhab professed by the two protagonists would lead one to expect an at least dual missionary activity rather than a day-to-day cooperation. It is true that there was a diversity of madhhab in a slightly broader and more equivocal sense, rather than in that usual connotation of the word which restricts it simply to the canonical schools. But it is indisputable that there was a rapprochement on the concrete plane which occurred at a time when, as all scholars admit, there was a “return” to the myth of the ideal sovereign, a “true Caliph”, and consequently to a renewal of the hope in the advent of a leader in spiritual affairs and so too in religious affairs. This eagerly awaited leader was the Mahdī, a figure who was variously delineated and characterised in the different areas and madhāhib proclaiming and anticipating his coming.
The other decisive factor is a gradual trend towards Shi'ism among the “aberrant” currents of orthodoxy, including sufism, allied with the presence of strong “Twelver” elements in the movements consciously aiming at a centralist outlook, which transcended the traditional divisions of Muslim religious society.
15 - SECTS AND HERESIES
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- By B. S. Amoretti, Rome University
- Edited by R. N. Frye
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- Book:
- The Cambridge History of Iran
- Published online:
- 28 March 2008
- Print publication:
- 26 June 1975, pp 481-519
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Summary
The religious evolution of Iran during the centuries from the Arab conquest to the rise of the Saljuqs was determined by a number of factors which, so far, have not been adequately isolated and analysed. This chapter identifies the politico-economical dimension of rebellions and heresies, and at the same time single out a few recurring and typical traits deserving the attention of the student of Iranian religious phenomena. It considers political and social developments of Iran by analysing their factual background before proceeding to a religious interpretation. The leader's wealth stressed by sources and the claim to Abū Muslim's treasure do not allow one to bracket this revolt together with other purely "protest" movements. The very term of Khurramdīn can in fact incorporate a number of meanings ranging from ambiguous though plausible identification with a reformed branch of new Mazdakism adjusted to Islamic pattern, to a vague sort of common denominator for a number of small sects mentioned by heresiographers.