Clinically Meaningful Gaps Between Clinical Trials and Patient Treatment
In this editorial, we note issues in the psychopharmacological treatment of persons with psychosis, which are usually ignored in regulatory clinical trials and are inadequately addressed in subsequent studies. Virtually all the data to date relate to antipsychotic medications, which have their initiating action at the D2 dopamine receptor. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - May 12, 2018 Category: Psychiatry Source Type: research

Corrigendum
“Understanding the Association Between Negative Symptoms and Performance on Effort-Based Decision-Making Tasks: The Importance of Defeatist Performance Beliefs” by L. Felice Reddy et al. Schizophr Bull. 2017; doi:10.1093/schbul/sbx156. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - May 11, 2018 Category: Psychiatry Source Type: research

Erratum
“Studying Developmental Psychopathology Related to Psychotic Disorders—Challenges and Paradigms in Human Studies” by Andreas Meyer-Lindenberg. Schizophr Bull. 2017; 43(6):1169–1171. doi:10.1093/schbul/sbx129. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - May 9, 2018 Category: Psychiatry Source Type: research

Corrigendum
“Diagnostic and Prognostic Significance of DSM-5 Attenuated Psychosis Syndrome in Services for Individuals at Ultra High Risk for Psychosis” by Paolo Fusar-Poli et al. Schizophr Bull. 2017; doi:10.1093/schbul/sbx055. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - May 8, 2018 Category: Psychiatry Source Type: research

Erratum
to: Webb JR, Addington J, Perkins DO, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Heinssen RK, Seidman LJ, Tarbox SI, Tsuang M, Walker E, McGlashan TH, Woods SW. Specificity of incident diagnostic outcomes in patients at clinical high risk for psychosis.Schizophr. Bull. 2015;41:1066 –1075. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 26, 2018 Category: Psychiatry Source Type: research

Evidence That Environmental and Familial Risks for Psychosis Additively Impact a Multidimensional Subthreshold Psychosis Syndrome
ConclusionsRisk factors may not be directly associated with PE but additively give rise to a multidimensional subthreshold state anticipating the multidimensional clinical syndrome. Early motivational and cognitive impairments in the context of PE may be reducible to affective dysregulation. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 25, 2018 Category: Psychiatry Source Type: research

Corrigendum
to “Actissist: Proof-of-Concept Trial of a Theory-Driven Digital Intervention for Psychosis” by Sandra Bucci et al. Schizophrenia Bulletin, 2018. doi:10.1093/schbul/sby032. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 25, 2018 Category: Psychiatry Source Type: research

Grip Strength Is Associated With Cognitive Performance in Schizophrenia and the General Population: A UK Biobank Study of 476559 Participants
AbstractBackgroundHandgrip strength may provide an easily-administered marker of cognitive functional status. However, further population-scale research examining relationships between grip strength and cognitive performance across multiple domains is needed. Additionally, relationships between grip strength and cognitive functioning in people with schizophrenia, who frequently experience cognitive deficits, has yet to be explored.MethodsBaseline data from the UK Biobank (2007 –2010) was analyzed; including 475397 individuals from the general population, and 1162 individuals with schizophrenia. Linear mixed models an...
Source: Schizophrenia Bulletin - April 19, 2018 Category: Psychiatry Source Type: research

Author Index
Aarts, Henk, S77, S242 (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O9.1. cannabis and other substance use disorders predict conversion from schizotypal disorder to schizophrenia
DiscussionSubstance use disorders, in particular cannabis, amphetamines, and opioids, are important predictors of conversion from schizotypal disorder to schizophrenia. However, conversion rates are high even in those without substance use disorders, indicating a need for both universal and substance-targeted prevention in people with schizotypal disorder. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O8.8. neurocognition in ultra-highrisk individuals and relationship to transition to psychosis, depressive disorder, and functioning: findings from the neurapro trial
AbstractBackgroundNeurocognitive impairments are a core feature of psychosis and major depressive disorder (MDD) and are associated with poorer functioning outcomes in these illnesses. Individuals at ultra-high risk (UHR) for psychosis have been shown to experience mild but significant cognitive impairments relative to healthy controls. Evidence suggests neurocognitive deficits are useful predictors of transition to psychotic disorder, although there is inconsistency regarding the specific domains implicated. Furthermore, depression is common in the UHR population, but the relationship between neurocognitive impairment and...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O8.7. cognitive subtypes in first-episode psychosis and association to treatment response
DiscussionDistinct patterns of cognitive impairments exist within FEP that might be characterized by different response to treatment. Clinical presentation at the onset of the illness is not useful in predicting response to treatment later on in the course of the illness, while cognitive functioning might be a more valid indicator. Cognitive stratification could represent a promising way forward to elucidate pathophysiology of psychosis and to provide tailored interventions. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O8.6. the relationship between cognition and functional improvement in the context of a psychosocial intervention targeting social disability in first episode psychosis
This study ran alongside a multi-site proof of concept trial of SRCBT, for individuals with FEP experiencing social disability. Participants (M age = 25 years) had less than 30 hours a week of structured activity before entering the trial. At baseline, 123 participants completed a battery of SC and NC assessments. 59 participants were randomly allocated to the therapy group (SRCBT + EIS), and 64 were randomly allocated to the standard care group (care from an EIS alone). Participants completed a follow-up assessment at 9 months on the same cognitive battery, and a further assessment of their structured activity. The assess...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O8.5. schizophrenia and bipolar disorder diagnosis patterns: real-world evidence from us claims databases
This study explored diagnosis patterns of patients with schizophrenia and/or type I bipolar disorder (BD-I) diagnoses in a real-world setting.MethodsThis was a retrospective cohort study using Truven MarketScan ® Commercial, Medicaid, and Medicare Supplemental databases from the study period 01/01/2012 and 06/30/2016. Patients were considered to have a diagnosis of schizophrenia if 1 inpatient claim or 2 outpatient claims for schizophrenia were identified within a selected identification period (01/01/201 3 and 06/30/2015). BD-I was defined in an analogous way, and the following five mutually exclusive cohorts were def...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O8.4. the effect of early medication discontinuation on long-term clinical outcome in first episode psychosis
We examined the long-term effect of early medication discontinuation in year 2 following first-episode remission for patients with no residual psychotic symptoms.MethodsWe followed-up 178 first-episode psychosis patients who participated in a 1-year randomized controlled trial (RCT) on medication discontinuation. Patients were randomized into receiving either a medication maintenance group or a placebo discontinuation group. After the RCT, all patients received usual psychiatric care. Poor long-term clinical outcome was defined as a composite of persistent psychotic symptoms, a requirement for clozapine, or suicide.Results...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O8.3. clinical and functional outcomes in young adulthood of children with psychotic symptoms: a longitudinal twin cohort study
DiscussionIn our genetically sensitive cohort, we showed strong evidence of continuity between early psychotic symptoms in childhood and persistence of psychotic phenomena to young adulthood. Psychotic symptoms in childhood are also important risk markers for a wide range of non-psychotic disorders and poor functional outcomes and therefore should be carefully assessed and treated to prevent adverse consequences in adulthood. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O8.2. duration of untreated psychosis (dup) is associated with worse response to treatment in antipsychotic na ïve first episode psychosis
DiscussionOur findings support that DUP does not affect the severity of illness at baseline, but modifies the response to treatment and clinical severity after 10 weeks. This finding suggests that longer exposition to psychosis might be involved in biological abnormalities that modulate the response to antipsychotics, which could mediate poor response to treatment. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O8.1. examining relationships between psychotic experiences and suicidal ideation in adolescents using a network approach
DiscussionThrough a network analytic approach, our results add new insights to previous findings concerning the associations between psychotic experiences and suicidal ideation, suggesting that perceptual anomalies (mainly auditory experiences), social anxiety (being distant to people), and bizarre experiences (paranoid beliefs) are connected in a meaningful way to suicidal ideation in a network of symptoms in a sample of non-help-seeking adolescents. Given the potential advantages of the network analysis to study psychopathology and suicidal behavior, its usage can contribute to a better understanding of the nature of the...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O7.7. cognitive functioning following discontinuation of antipsychotic medication: a sub-group analysis from the opus ii trial
AbstractBackgroundThe presence of cognitive defects in patients suffering from schizophrenia is well established. While the earlier “Kraepelinian” view was one of deteriorating cognitive functioning, more recent studies have found that cognitive deficits tend to be stable or improving over time. Cognitive impairments are associated with poorer functional outcomes and understanding the factors that influence cognitive functio ning is critical for understanding how to improve cognitive and functional outcomes in patients. The effect of antipsychotics medication on cognitive functioning in patients diagnosed with ...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O7.6. meta-analysis of efficacy of cognitive enhancers for patients with schizophrenia-spectrum disorders
DiscussionThe current meta-analysis showed very few favorable effects of cognitive enhancers for patients with schizophrenia spectrum disorders. The overall analysis showed small difference between cognitive enhancers and placebo. Most studies were on agents acting on the glutamatergic and the cholinergic system. There is some evidence of positive effects on cognitive functioning for agents acting on glutamatergic system and acetylcholinesterase inhibitors within cholinergic system. There is still a major lack of studies involving agents acting on other systems. Important issues such as dose, treatment duration, including ...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O7.5. long-term safety and tolerability of brexpiprazole in patients with schizophrenia
DiscussionTreatment with open-label brexpiprazole 1 –4 mg/day was generally well tolerated for up to 52 weeks in patients with schizophrenia. Further, long-term treatment with brexpiprazole was associated with continued improvement in efficacy measures and functional outcomes.References1. Hasan A et al., World J Biol Psychiatry. 2013;14(1):2 ‒44.2. Lehman AF et al., Am J Psychiatry. 2004;161(2 Suppl):1–56.3. Marder SR et al., Acta Neuropsychiatr. 2016; 16:1–13. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O7.4. systematic review, meta-analysis and meta-regression of predictors of placebo response in acute schizophrenia
DiscussionThis meta-regression included approximately two times more studies than previous attempts to resolve this issue and it is therefore the to date by far largest analysis of this kind. Multiple potential moderators of placebo response were identified. Importantly, these moderators of placebo response were not identical with those identified in a previous analysis1 as significant moderators of drug-placebo differences in the same dataset. Thus, different factors appear to play a role in this complex area.References1. Leucht S, Leucht C, Huhn M, Chaimani A, Mavridis D, Helfer B, Samara M,Rabaioli M, B ächer S, Ci...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O7.3. dose-response meta-analysis to identify the optimum and equivalent doses of antipsychotic drugs for schizophrenia
DiscussionFrom a conceptual point of view, dose-response meta-analysis is the most appropriate method to identify maximally effective doses and equivalent doses. The results of this meta-analysis will be compared with other published methods to define dose-response, in particular the minimum-effective dose method, the classical mean dose method, the daily-defined-doses (DDD) method and expert consensus methods. The results of this analysis are likely to provide information with impact for treatment decisions. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O7.2. breakthrough on antipsychotic maintenance medication in a clinical cohort
DiscussionIn a clinical cohort, a meaningful proportion of patients with a psychotic disorder treated with LAIs were hospitalized, despite confirmed continuous treatment. The median time to this event occurred about 7 months after onset of LAI treatment, suggesting that these patients had been stable and had reached steady state antipsychotic levels prior to hospitalization. Patients with a more active illness at the time of initiation of LAI treatment were more likely to relapse. These data suggest that more comprehensive investigation of BAMM is feasible; and therefore research focused on this unique group of individuals...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O7.1. midbrain dopamine neuron activity controls the effects of repeated ketamine on striatal dopaminergic function
AbstractBackgroundSchizophrenia is a chronic debilitating disorder which affects about 21 million people worldwide (WHO 2017). Elevated pre-synaptic striatal dopamine synthesis capacity is a robust neurochemical alteration seen in patients with schizophrenia compared to controls, with a large effect size Cohen ’s d=0.79 (Howes et al., 2012). Ketamine, a non-competitive N-methyl-D-aspartate receptor (NMDAR) antagonist induces psychotomimetic effects in healthy human (Krystal et al., 1994, Stone et al., 2007) and exacerbates psychotic symptoms in patients with schizophrenia (Lahti et al., 1991). For these reasons, it h...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O6.8. glutamatergic dysfuction and treatment response in minimally treated and chronic schizophrenia patients
AbstractBackgroundGlutamatergic dysfunction as a result of NMDA receptor hypofunction has been implicated in antipsychotic treatment-resistant schizophrenia, however its nature in very early stages and chronic stages of the disease is still unknown. Data on glutamate and treatment response are currently limited in two separate studies, one in first-episode patients (Egerton et al., 2012) and one in chronic patients (Mouchlianitis et al., 2016). Here we acquired proton magnetic resonance spectroscopy measures from a large sample of minimally treated first episode and chronic schizophrenia patients, and a group of matched he...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O6.7. common neuroanatomical abnormalities in first episode psychosis across several independent samples
This study aimed to overcome these issues by testing for neuroanatomical abnormalities in individuals with FEP relative to healthy controls that are expressed consistently across five independent datasets.MethodsStructural Magnetic Resonance Imaging data were acquired from a total of 572 patients with FEP and 502 age and gender comparable healthy controls (HC) at five sites - London (UK), Utrecht (Netherlands), Chengdu (China) and two independent sites at Santander (Spain). Voxel-based morphometry (VBM) as implemented in Statistical Parametric Mapping software (SPM12) was used to investigate differences in gray matter volu...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O6.6. lack of antipsychotic medication effects on white matter microstructure in schizophrenia
DiscussionWith state of the art data-processing methods we only found small areas of white matter integrity deficits in our predominantly medication-na ïve patients. This is consistent with prior reports of limited white matter alterations at disease onset that may progress with illness duration. Our data suggests that a short-term course of antipsychotic medication may not alter white matter microstructure, but studies with longer follow up durat ions will be important to determine long term effects of antipsychotic medications. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O6.5. linking cortical and connectional pathology in schizophrenia
AbstractBackgroundSchizophrenia is associated with cortical thinning and breakdown in white matter microstructure. Whether these pathological processes are related remains unclear. We used multimodal neuroimaging to investigate the relation between regional cortical thinning and breakdown in adjacent infracortical white matter as a function of age and illness duration.MethodsStructural magnetic resonance and diffusion images were acquired in 218 schizophrenia patients and 167 age-matched healthy controls to map cortical thickness (CT) and fractional anisotropy (FA) in regionally adjacent infracortical white matter at vario...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O6.4. auditory and language areas distinguish converters from non –converters at baseline in sharp clinical high-risk subjects for psychosis study
AbstractBackgroundFrontal and temporal lobes abnormalities are often reported in schizophrenia. In the present study, we tested whether or not these abnormalities exist in individuals at clinical high risk for psychosis (CHR), and whether they distinguish between those CHR who convert to psychosis versus those who do not convert to psychosis at one year. We analyzed both cortical thickness (CT) and surface area (SA) given the fact that CT and SA develop along different developmental genetically mediated pathways. Since CHR individuals also experience a deterioration of cognitive functions and sub-threshold psychotic sympto...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O6.3. patterns of gray matter abnormalities in patients with first-episode and treatment-na ïve schizophrenia
DiscussionThese findings delineate a common pattern of gray matter changes in schizophrenia, and a subgroup of patients with robust cortical reorganization suggestive of compensatory plasticity after first episode. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

6.4 brain functional connectomics based on resting state fmri: from nodes to networks
DiscussionResting state fMRI provides a novel network-sensitive, immediately repeatable, non-invasive tool to examine human functional connectome. Future directions such as dynamic or time-varying functional connectivity which captures neural dynamics at a finer time scale will be briefly discussed. Further developed and integrated with brain structural connectivity measures, brain network functional connectomics may help us better understand heterogeneity in psychosis, reveal disease mechanism, predict and track disease progression, and monitor treatment response. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

6.3 eeg as a tool for psychosis research: challenges, pitfalls and new opportunities
DiscussionSimultaneous EEG-fMRI offers the best from both modalities, that is high temporal and high spatial resolution, but here, too, methodological challenges have to be addressed. Finally, the development of new noninvasive tools for brain stimulation such as transcranial alternating current stimulation (tACS) with the opportunity of frequency-specific modulation of neuronal oscillations ( “entrainment”) for both brain research and therapy makes detailed information about disturbed oscillations patterns in psychosis even more relevant. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

6.2 microstructural imaging with advanced diffusion mri methods – what is gained and what is lost?
DiscussionThe emerging results present dependency on the stage of the psychosis (e.g., first episode, chronic) as well as on the age and gender of the subjects, suggesting that care must be taken in the study design, as well as in the statistical analyses performed. The findings also promote the use of multi-modal acquisitions, as well as the collection of biological, clinical and cognitive parameters. The combined information of these different domains is more likely to truly characterize the underlying abnormalities. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O6.2. neurobiology of psychometric schizotypy: insights from multimodal imaging research
AbstractBackgroundThe continuum approach to psychosis proposes a dimensional continuity between the neurobiology of subclinical psychotic-like experiences in healthy individuals (or schizotypy) and psychotic symptoms in clinically relevant psychosis (Linscott and van Os, 2013, Nelson et al., 2013). Preclinical models propose that cortical glutamate dysfunction related to cortico-limbic-striatal hyper-responsivity to stress may underlie both hippocampal and striatal overdrive as well as gray matter loss associated with schizophrenia-like behaviors (Berretta et al., 2001, Lodge and Grace, 2011). Our recent studies investigat...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O6.1. hippocampal volume in adolescents with persistent psychotic experiences: a longitudinal population-based mri study
DiscussionThe differences identified in our study suggest that early hippocampal reductions, may play a role in increasing vulnerability to psychosis.References1. van Erp TG, Hibar DP, Rasmussen JM, et al. Subcortical brain volume abnormalities in 2028 individuals with schizophrenia and 2540 healthy controls via the ENIGMA consortium. Mol Psychiatry. 2016;21(4):585.2. Wright IC, Rabe-Hesketh S, Woodruff PW, David AS, Murray RM, Bullmore ET. Meta-analysis of regional brain volumes in schizophrenia. Am J Psychiatry. 2000;157(1):16 –25.3. Nelson MD, Saykin AJ, Flashman LA, Riordan HJ. Hippocampal volume reduction in sch...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O5.7. risk of diabetic complications and subsequent mortality among individuals with schizophrenia and diabetes mellitus: a nationwide population-based register study
AbstractBackgroundSchizophrenia constitutes a high risk of morbidity and mortality from physical illness. Individuals with comorbid schizophrenia and diabetes mellitus have been found to have a three- to four-fold higher rate of death than the general population, which may be explained by a higher rate of diabetic complications. We aimed to study incidence of diabetic complications diagnosed in hospitals following a diabetes diagnosis and subsequent mortality in individuals with schizophrenia compared to individuals without.MethodsThe entire Danish population was followed in 1997 –2016 using population-based registri...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O5.6. Submission Withdrawn
(Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O5.5. sleep in major psychiatric disorders: results from nationwide super finland study
DiscussionSleep disorders seem to be prominent in persons with major psychiatric disorders. Tiredness was common in all diagnosis groups. Long sleep was most common in schizophrenia and difficulties in getting sleep and early morning or night awakenings in affective psychoses. More research is needed on possibilities to prevent and treat sleep disorders in major psychiatric disorders. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O5.4. natural cause mortality in persons with schizophrenia and bipolar disorder
AbstractBackgroundIt is now well established that persons with schizophrenia and with bipolar disorder have a reduced life expectancy but the reasons for this premature mortality are not known with certainty. The aim of the current investigation was to identify the determinants of natural-cause mortality in a cohort of individuals with schizophrenia or bipolar disorder. To our knowledge, our investigation is unique in studying patients who were assessed at baseline with an in-person clinical assessment and blood sample and then subsequently evaluated regarding their mortality status and cause of death.MethodsPersons with s...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O5.3. a comprehensive nationwide study of comorbidity within treated mental disorders – a danish register-based study
We examined associations between all pairs of mental disorders. Hazard ratios (HR) were estimated using Cox Proportional Hazards models with age as time scale, and adjusting for sex, calendar time and other psychiatric comorbidity. Finally, we estimated the absolute risk of being diagnosed with other mental disorders after being diagnosed with a specific disorder.ResultsAll mental disorders were associated between them, with HR ranging from 1.1 to 19.5. There were 21,909 men and 20,106 women who were diagnosed with schizophrenia spectrum disorder (SSD) for the first time between 2000 and 2016. After onset of SSD, the rate ...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O5.2. predictors of cardiometabolic risk in the year after onset of psychosis: a prospective cohort study
DiscussionCardiometabolic risk factors and unhealthy lifestyle behavior are already prevalent in those with early psychosis and worsen in the year following first presentation, making this an important time for preventative strategies. We found no evidence however that such strategies should be preferentially directed towards those reporting less healthy lifestyle habits. Patterns of emergence of cardiometabolic risk over the first year of psychosis varied by ethnicity. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O5.1. clozapine and long-term mortality risk in patients with schizophrenia: preliminary results from a meta-analysis
The objectives of the current study were to determine in i) all-cause long-term mortality rates and ii) specific-cause mortality rates and ratios in patients with schizophrenia with and without clozapine treatment.MethodsWe systematically searched EMBASE, MEDLINE and PsycINFO and included studies that used a long-term follow-up design (i.e., ≥52 weeks) and reported on mortality in adults diagnosed with schizophrenia-spectrum disorders receiving clozapine treatment.ResultsAltogether, 23 studies fulfilled our criteria, reporting on 1,166 deaths during 203,231 patient years for patients treated with clozapine. Pooling five...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O4.8. vulnerable periods for cognitive development in individuals at high genomic risk of schizophrenia
AbstractBackground22q11.2 Deletion Syndrome (22q11.2DS) is caused by the deletion of approximately 60 genes on chromosome 22 and represents one of the strongest known genetic risk factors for schizophrenia. Approximately 1 in 4 adults with 22q11.2DS are diagnosed with schizophrenia spectrum disorders, presenting with psychotic symptomatology analogous to that exhibited in idiopathic schizophrenia.Cognitive deficits are a core feature of schizophrenia. 22q11.2DS presents a valuable model for understanding vulnerable periods of cognitive development which may be associated with psychosis development. Most previous studies re...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O4.7. placental gene expression, obstetrical history and polygenic risk for schizophrenia
AbstractBackgroundEarly life events influence later susceptibility to many adult diseases and may contribute to define the environmental context in which genes enhance risk for complex disorder like schizophrenia. Here we analyze the role of intrauterine and perinatal environment in modulating the association of schizophrenia with genomic risk.MethodsWe evaluated whether genomic risk for schizophrenia interacts with intrauterine and perinatal complications (Early Life Complications, ELCs) on case-control status, in three independent samples of healthy subjects and patients with schizophrenia from USA (n=501), Italy (n=273)...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O4.6. genome-wide association study, heritability estimation and polygenic risk analysis of susceptibility to infections in 65,534 individuals with severe mental disorders and population controls
DiscussionOur findings will illuminate the genetic architecture of acquiring infections, and the genetic associations with mental disorders exploring the possible genetic component of the known association between infections and severe mental disorders, such as schizophrenia. Furthermore, we will for the first time in a large population based study explore the associations with HLA alleles to infections and severe mental disorders. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O4.5. investigating genetic profiles associated with ‘real world’ clinical outcomes in psychosis: a retrospective cohort study
DiscussionThe results of this discovery phase may provide a rationale for subsequent multi-modal investigations whose aims will be to further enrich the biomarker signature and to also understand the molecular mechanisms that sustain them. (Source: Schizophrenia Bulletin)
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O4.4. does polygenic risk score for schizophrenia moderate the momentary affective and psychotic reactions to daily-life stressors?
AbstractBackgroundStudies using the event sampling method (ESM), a structured diary technique measuring subjective experiences and emotional fluctuations in daily life, have consistently shown that individuals reporting psychotic experiences display a heightened emotional reactivity to minor stressors —a neuropsychological mechanism that likely contributes to the development and perpetuation of psychotic experiences. Except a few undersized non-replicated candidate-gene studies showing an association between genetic variations and elevated momentary stress reactivity, genetic underpinnings of e motion reactivity to m...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O4.3. increased cerebral blood flow after single dose of antipsychotics in healthy subjects depends on dopamine d2 receptor density profiles evaluated with pet and mrna expression data.
AbstractBackgroundPrevious studies measuring cerebral blood flow (CBF) with magnetic resonance sequences like Arterial Spin Labelling (ASL) showed that patients with schizophrenia (SCZ) have increased CBF in basal ganglia and reduced blood flow in cortical areas like the prefrontal cortex. It is still not clear whether these abnormalities are related to antipsychotic treatment or rather they reflect a disease trait independent from medication. Interestingly, administration of single dose of antipsychotics in healthy volunteers produce marked functional effects that are in the same region reported as altered in SCZ. These e...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research

O4.2. heritability and correlation to schizophrenia spectrum disorder of glutamate and other neurometabolite levels in anterior cingulate and left thalamus: a register based magnetic resonance twin study
DiscussionIn this the first study to estimate heritability of glutamate levels in the brain, the primary findings are that glutamate levels in both the ACC and the left thalamus are heritable, and in the left thalamus also correlated to disease with a significant genetic overlap. This emphasizes glutamate levels in the left thalamus as a potential endophenotypic marker for schizophrenia. NAA and Cr were negatively correlated to disease in the ACC, which could point to disturbances of neuronal health and metabolism. For Cr an overlap of genes influencing both metabolite levels and disease suggests Cr as a possible candidate...
Source: Schizophrenia Bulletin - April 1, 2018 Category: Psychiatry Source Type: research