6 results
Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia: an international multicenter study
- Konstantinos N. Fountoulakis, Elena Dragioti, Antonis T. Theofilidis, Tobias Wiklund, Xenofon Atmatzidis, Ioannis Nimatoudis, Erik Thys, Martien Wampers, Luchezar Hranov, Trayana Hristova, Daniil Aptalidis, Roumen Milev, Felicia Iftene, Filip Spaniel, Pavel Knytl, Petra Furstova, Tiina From, Henry Karlsson, Maija Walta, Raimo K. R. Salokangas, Jean-Michel Azorin, Justine Bouniard, Julie Montant, Georg Juckel, Ida S. Haussleiter, Athanasios Douzenis, Ioannis Michopoulos, Panagiotis Ferentinos, Nikolaos Smyrnis, Leonidas Mantonakis, Zsófia Nemes, Xenia Gonda, Dora Vajda, Anita Juhasz, Amresh Shrivastava, John Waddington, Maurizio Pompili, Anna Comparelli, Valentina Corigliano, Elmars Rancans, Alvydas Navickas, Jan Hilbig, Laurynas Bukelskis, Lidija I. Stevovic, Sanja Vodopic, Oluyomi Esan, Oluremi Oladele, Christopher Osunbote, Janusz K. Rybakowski, Pawel Wojciak, Klaudia Domowicz, Maria L. Figueira, Ludgero Linhares, Joana Crawford, Anca-Livia Panfil, Daria Smirnova, Olga Izmailova, Dusica Lecic-Tosevski, Henk Temmingh, Fleur Howells, Julio Bobes, Maria P. Garcia-Portilla, Leticia García-Alvarez, Gamze Erzin, Hasan Karadağ, Avinash De Sousa, Anuja Bendre, Cyril Hoschl, Cristina Bredicean, Ion Papava, Olivera Vukovic, Bojana Pejuskovic, Vincent Russell, Loukas Athanasiadis, Anastasia Konsta, Nikolaos K. Fountoulakis, Dan Stein, Michael Berk, Olivia Dean, Rajiv Tandon, Siegfried Kasper, Marc De Hert
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- Journal:
- CNS Spectrums / Volume 27 / Issue 6 / December 2022
- Published online by Cambridge University Press:
- 09 August 2021, pp. 716-723
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Background
The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia.
MethodsTwenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects.
ResultsThere was a 3-year later age at onset for females (P < .001) and lower rates of negative symptoms (P < .01) and higher depression/anxiety measures (P < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages (P = .001). No significant effects were found concerning duration of illness.
DiscussionOur results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.
Motor activity patterns can distinguish between interepisode bipolar disorder patients and healthy controls
- Jakub Schneider, Eduard Bakštein, Marian Kolenič, Pavel Vostatek, Christoph U. Correll, Daniel Novák, Filip Španiel
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- Journal:
- CNS Spectrums / Volume 27 / Issue 1 / February 2022
- Published online by Cambridge University Press:
- 04 September 2020, pp. 82-92
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Background
Bipolar disorder (BD) is linked to circadian rhythm disruptions resulting in aberrant motor activity patterns. We aimed to explore whether motor activity alone, as assessed by longitudinal actigraphy, can be used to classify accurately BD patients and healthy controls (HCs) into their respective groups.
MethodsNinety-day actigraphy records from 25 interepisode BD patients (ie, Montgomery–Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) < 15) and 25 sex- and age-matched HCs were used in order to identify latent actigraphic biomarkers capable of discriminating between BD patients and HCs. Mean values and time variations of a set of standard actigraphy features were analyzed and further validated using the random forest classifier.
ResultsUsing all actigraphy features, this method correctly assigned 88% (sensitivity = 85%, specificity = 91%) of BD patients and HCs to their respective group. The classification success may be confounded by differences in employment between BD patients and HCs. When motor activity features resistant to the employment status were used (the strongest feature being time variation of intradaily variability, Cohen’s d = 1.33), 79% of the subjects (sensitivity = 76%, specificity = 81%) were correctly classified.
ConclusionA machine-learning actigraphy-based model was capable of distinguishing between interepisode BD patients and HCs solely on the basis of motor activity. The classification remained valid even when features influenced by employment status were omitted. The findings suggest that temporal variability of actigraphic parameters may provide discriminative power for differentiating between BD patients and HCs while being less affected by employment status.
Language lateralization in monozygotic twins discordant and concordant for schizophrenia. A functional MRI pilot study
- Filip Spaniel, Jaroslav Tintera, Tomas Hajek, Jiri Horacek, Monika Dezortova, Milan Hajek, Colleen Dockery, Jiri Kozeny, Cyril Höschl
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- Journal:
- European Psychiatry / Volume 22 / Issue 5 / July 2007
- Published online by Cambridge University Press:
- 16 April 2020, pp. 319-322
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Aim
Previous studies have suggested altered structural and functional asymmetry of the brain in schizophrenia.
MethodsFunctional MRI was used to assess differences in cortical activation during a verbal task in Broca's area and its contralateral homologue in four pairs of right-handed monozygotic (MZ) twins discordant and concordant for schizophrenia with low and high familial loading for the illness and four healthy control MZ twin pairs.
ResultsPooled data from all subjects with schizophrenia showed increased activation in the right homologue of Broca's area in contrast to healthy individuals. Concordant twins (i.e. high familial loading group) showed prominent between co-twin differences in lateralization index within given region of interest. Intra-pair differences in lateralization index were significantly higher in concordant twins compared to the controls (0.69 ± 0.4 vs. 0.13 ± 0.13, P < 0.03), albeit no significant differences in the variable were shown between the discordant and control groups.
ConclusionThis study provides evidence of reduced cerebral dominance for language processing in patients with schizophrenia. The findings further suggest the need for additional research on relative proportion of genetic and environmental factors underlying deviations of functional asymmetry in schizophrenia.
Magnetic resonance relaxometry in monozygotic twins discordant and concordant for schizophrenia
- Filip Spaniel, Vit Herynek, Tomas Hajek, Monika Dezortova, Jiri Horacek, Milan Hajek, Jiri Kozeny, Colleen Dockery, Cyril Höschl
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- Journal:
- European Psychiatry / Volume 20 / Issue 1 / January 2005
- Published online by Cambridge University Press:
- 16 April 2020, pp. 41-44
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T1 and T2 relaxation times were examined in four pairs of monozygotic (MZ) twins discordant and concordant for schizophrenia with low and high genetic loading for the illness and five healthy control MZ twin pairs. Patients with schizophrenia (n = 11) showed significant prolongation in T1 relaxation times in the globus pallidus (GP) bilaterally (P < 0.005, Bonferroni corrected) when compared to 14 healthy MZ twins.
Modeling psychological function in patients with schizophrenia with the PANSS: an international multi-center study
- Konstantinos N. Fountoulakis, Elena Dragioti, Antonis T. Theofilidis, Tobias Wiklund, Xenofon Atmatzidis, Ioannis Nimatoudis, Erik Thys, Martien Wampers, Luchezar Hranov, Trayana Hristova, Daniil Aptalidis, Roumen Milev, Felicia Iftene, Filip Spaniel, Pavel Knytl, Petra Furstova, Tiina From, Henry Karlsson, Maija Walta, Raimo K.R. Salokangas, Jean-Michel Azorin, Justine Bouniard, Julie Montant, Georg Juckel, Ida S. Haussleiter, Athanasios Douzenis, Ioannis Michopoulos, Panagiotis Ferentinos, Nikolaos Smyrnis, Leonidas Mantonakis, Zsófia Nemes, Xenia Gonda, Dora Vajda, Anita Juhasz, Amresh Shrivastava, John Waddington, Maurizio Pompili, Anna Comparelli, Valentina Corigliano, Elmars Rancans, Alvydas Navickas, Jan Hilbig, Laurynas Bukelskis, Lidija I. Stevovic, Sanja Vodopic, Oluyomi Esan, Oluremi Oladele, Christopher Osunbote, Janusz K. Rybakowski, Pawel Wojciak, Klaudia Domowicz, Maria L. Figueira, Ludgero Linhares, Joana Crawford, Anca-Livia Panfil, Daria Smirnova, Olga Izmailova, Dusica Lecic-Tosevski, Henk Temmingh, Fleur Howells, Julio Bobes, Maria P. Garcia-Portilla, Leticia García-Alvarez, Gamze Erzin, Hasan Karadağ, Avinash De Sousa, Anuja Bendre, Cyril Hoschl, Cristina Bredicean, Ion Papava, Olivera Vukovic, Bojana Pejuskovic, Vincent Russell, Loukas Athanasiadis, Anastasia Konsta, Dan Stein, Michael Berk, Olivia Dean, Rajiv Tandon, Siegfried Kasper, Marc De Hert
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- Journal:
- CNS Spectrums / Volume 26 / Issue 3 / June 2021
- Published online by Cambridge University Press:
- 15 April 2020, pp. 290-298
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Background
The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model.
MethodsTwenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed.
ResultsThe results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage.
ConclusionsThe current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.
An overlapping pattern of cerebral cortical thinning is associated with both positive symptoms and aggression in schizophrenia via the ENIGMA consortium
- Ting Yat Wong, Joaquim Radua, Edith Pomarol-Clotet, Raymond Salvador, Anton Albajes-Eizagirre, Aleix Solanes, Erick J. Canales-Rodriguez, Amalia Guerrero-Pedraza, Salvador Sarro, Tilo Kircher, Igor Nenadic, Axel Krug, Dominik Grotegerd, Udo Dannlowski, Stefan Borgwardt, Anita Riecher-Rössler, Andre Schmidt, Christina Andreou, Christian G. Huber, Jessica Turner, Vince Calhoun, Wenhao Jiang, Sarah Clark, Esther Walton, Gianfranco Spalletta, Nerisa Banaj, Fabrizio Piras, Valentina Ciullo, Daniela Vecchio, Irina Lebedeva, Alexander S. Tomyshev, Vasily Kaleda, Tatyana Klushnik, Geraldo Busatto Filho, Marcus Vinicius Zanetti, Mauricio Henriques Serpa, Pedro Gomes Penteado Rosa, Ryota Hashimoto, Masaki Fukunaga, Anja Richter, Bernd Krämer, Oliver Gruber, Aristotle N. Voineskos, Erin W. Dickie, David Tomecek, Antonin Skoch, Filip Spaniel, Cyril Hoschl, Alessandro Bertolino, Aurora Bonvino, Annabella Di Giorgio, Laurena Holleran, Simone Ciufolini, Tiago Reis Marques, Paola Dazzan, Robin Murray, Jelle Lamsma, Wiepke Cahn, Neeltje van Haren, Ana M. Díaz-Zuluaga, Julián A. Pineda-Zapata, Cristian Vargas, Carlos López-Jaramillo, Theo G. M. van Erp, Ruben C. Gur, Thomas Nickl-Jockschat
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- Journal:
- Psychological Medicine / Volume 50 / Issue 12 / September 2020
- Published online by Cambridge University Press:
- 16 October 2019, pp. 2034-2045
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Background
Positive symptoms are a useful predictor of aggression in schizophrenia. Although a similar pattern of abnormal brain structures related to both positive symptoms and aggression has been reported, this observation has not yet been confirmed in a single sample.
MethodTo study the association between positive symptoms and aggression in schizophrenia on a neurobiological level, a prospective meta-analytic approach was employed to analyze harmonized structural neuroimaging data from 10 research centers worldwide. We analyzed brain MRI scans from 902 individuals with a primary diagnosis of schizophrenia and 952 healthy controls.
ResultsThe result identified a widespread cortical thickness reduction in schizophrenia compared to their controls. Two separate meta-regression analyses revealed that a common pattern of reduced cortical gray matter thickness within the left lateral temporal lobe and right midcingulate cortex was significantly associated with both positive symptoms and aggression.
ConclusionThese findings suggested that positive symptoms such as formal thought disorder and auditory misperception, combined with cognitive impairments reflecting difficulties in deploying an adaptive control toward perceived threats, could escalate the likelihood of aggression in schizophrenia.