Anthony Harris

Evoked response potentials and regional cerebral blood flow in somatization disorder

Publisher: S. Karger AG

Date: 1987

DOI: 10.1159/000288017

Abstract: Somatization disorder (SMD) is a chronic condition characterized by multiple complaints which are not due to any apparent organic illness but frequently involve pain. This study employs computer-aided imaging technologies to examine brain function in thousandths of a second (event-related brain potentials) and over a number of minutes (regional cerebral blood flow). Fourteen patients with SMD and 14 normal controls were investigated. Results from both studies suggest that patients with SMD have a dysfunction in the processes of attention, compared to normal controls.

A negative association between brainstem pontine grey-matter volume, well-being and resilience in healthy twins

Publisher: CMA Joule Inc.

Date: 11-2018

DOI: 10.1503/JPN.170125

Autobiographical and subjective memory with right unilateral high-dose 0.3-millisecond ultrabrief-pulse and 1-millisecond brief-pulse electroconvulsive therapy: A double-blind, randomized controlled trial

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 12-2013

DOI: 10.1097/YCT.0B013E3182941BAF

Predictors of outcome three years after diagnosis of first episode psychosis

Publisher: Elsevier BV

Date: 10-2008

DOI: 10.1016/J.PSYCHRES.2007.10.004

Abstract: This study aimed to determine which of demographic remorbid, psychiatric or neuropsychological factors best predict functional outcome at 3 years after a first episode of psychotic illness. This will, it is hoped, identify prognostic indicators of longer term outcomes, as well as targets for rehabilitation. The Western Sydney First Episode Psychosis Project collected data on young people (aged 13 to 25) presenting with newly diagnosed psychosis at baseline and 3-year follow-up (n=52). Outcome was measured using the Role Functioning Scale (RFS) and the Clinical Global Impression Scale--severity of illness measure (CGI-S). Multiple regression analyses were performed to identify baseline predictors of outcome. The Premorbid Social Adjustment Scale in Adolescence (PSAS-Adolescent) and the Verbal Comprehension Index from the WAIS-III were found to be the two significant predictors for RFS, with only the former (PSAS-Adolescent) predicting CGI-S. Demographic and neuropsychological measures relating to premorbid functioning were the best predictors of long-term outcome in first episode psychosis, with baseline psychiatric symptoms not contributing.

Reply to Ng: a closer look at late‐onset psychoses for the general internist

Publisher: Wiley

Date: 08-2023

DOI: 10.1111/IMJ.16195

“Motoring in idle”: The default mode and somatomotor networks are overactive in children and adolescents with functional neurological symptoms

Publisher: Elsevier BV

Date: 2018

DOI: 10.1016/J.NICL.2018.02.003

Web-Based Cognitive Remediation Improves Supported Employment Outcomes in Severe Mental Illness: Randomized Controlled Trial

Publisher: JMIR Publications Inc.

Date: 20-09-2017

DOI: 10.2196/MENTAL.6982

Abstract: Finding work is a top priority for most people however, this goal remains out of reach for the majority of in iduals with a severe mental illness (SMI) who remain on benefits or are unemployed. Supported employment (SE) programs aimed at returning people with a severe mental illness to work are successful however, they still leave a significant number of people with severe mental illness unemployed. Cognitive deficits are commonly found in SMI and are a powerful predictor of poor outcome. Fortunately, these deficits are amenable to treatment with cognitive remediation therapy (CRT) that significantly improves cognition in SMI. CRT combined with SE significantly increases the likelihood of in iduals with severe mental illness obtaining and staying in work. However, the availability of CRT is limited in many settings. The aim of this study was to examine whether Web-based CRT combined with a SE program can improve the rate return to work of people with severe mental illness. A total of 86 people with severe mental illness (mean age 39.6 years male: n=55) who were unemployed and who had joined a SE program were randomized to either a Web-based CRT program (CogRem) or an Internet-based control condition (WebInfo). Primary outcome measured was hours worked over 6 months post treatment. At 6 months, those participants randomized to CogRem had worked significantly more hours (P=.01) and had earned significantly more money (P=.03) than those participants randomized to the WebInfo control condition. No change was observed in cognition. This study corroborates other work that has found a synergistic effect of combining CRT with a SE program and extends this to the use of Web-based CRT. The lack of any improvement in cognition obscures the mechanism by which an improved wage outcome for participants randomized to the active treatment was achieved. However, the study substantially lowers the barrier to the deployment of CRT with other psychosocial interventions for severe mental illness. Australian and New Zealand Clinical Trials Registry (ANZCTR) 12611000849998 www.anzctr.org.au/TrialSearch.aspx?searchTxt=12611000849998& isBasic=True (Archived by WebCite at sMKwpeos)

An open clinical trial assessing a novel training program for social cognitive impairment in schizophrenia

Publisher: SAGE Publications

Date: 14-02-2013

DOI: 10.1177/1039856213475683

Abstract: Social cognition is profoundly impaired in patients with schizophrenia. This study describes ‘Mental-State Reasoning Training for Social Cognitive Impairment’ (SoCog-MSRT), a 5-week program developed to improve social cognition in patients with schizophrenia. We aimed to investigate the feasibility of implementing SoCog-MSRT in a rehabilitation setting and to evaluate whether our training methods produced improvements. The feasibility and benefits of SoCog-MSRT were evaluated in an open clinical trial with 14 participants with schizophrenia or schizoaffective disorder. Training comprised 10 twice-weekly sessions, for 5 weeks, with a pre- and post-training assessment. There were significant improvements on: (a) a classic false-belief test of Theory of Mind (ToM) (b) inferring complex mental states from the eyes and (c) a self-reported measure of social understanding. Some of these improvements were associated with baseline levels of working memory and premorbid Intelligence Quotient (IQ). SoCog-MSRT can improve ToM abilities and social understanding, but in iduals with poorer working memory and lower premorbid IQ may be less able to benefit from this type of training.

Clinical and cognitive associations with aggression in the first episode of psychosis

Publisher: SAGE Publications

Date: 2010

DOI: 10.3109/00048670903270423

Abstract: Objective: Although there may be an increased risk of aggression in first-episode psychosis, little is known about the clinical and cognitive associations of serious and less serious aggression during this phase of psychotic illness. Methods: Eighty-five patients in the first episode of psychosis under the age of 26 underwent comprehensive clinical assessment and cognitive testing. Aggression was assessed using a purpose-designed rating scale based on corroborative interviews to record 10 types of aggressive behaviour in the 3 months before presenting for treatment. Results: Thirty-seven of 85 patients (43.5%) exhibited physically aggressive behaviour and 23 patients (27.1%) had assaulted another person or used a weapon. Young age and elevated scores in the mania rating scale were associated with a history of any type of aggression. Serious aggression was associated with regular cannabis use and more errors of commission on a continuous performance task. Conclusions: The clinical features associated with less serious aggression were different to those associated with more serious forms of aggression. Serious aggression is associated with regular cannabis use and also reduced behavioural inhibition. Awareness of substance use and neurocognitive deficits may assist in the identification of potentially violent patients.

Community treatment orders increase community care and delay readmission while in force: Results from a large population-based study

Publisher: SAGE Publications

Date: 27-02-2019

DOI: 10.1177/0004867418758920

Abstract: There is debate about the effectiveness of community treatment orders in the management of people with a severe mental illness. While some case–control studies suggest community treatment orders reduce hospital readmissions, three randomised controlled trials find no effects. These randomised controlled trials measure outcomes over a longer period than the community treatment order duration and assess the combined effectiveness of community treatment orders both during and after the intervention. This study examines the effectiveness of community treatment orders in a large population-based s le, restricting observation to the period under a community treatment order. All persons ( n = 5548) receiving a community treatment order in New South Wales, Australia, over the period 2004–2009 were identified. Controls were matched using a propensity score based on demographic, clinical and prior care variables. A baseline period equal to each case’s duration of treatment was constructed. Treatment effects were compared using zero-inflated negative binomial regression, adjusting for demographics, clinical characteristics and pre-community treatment order care. Compared to matched controls, people on community treatment orders were less likely to be readmitted (odds ratio = 0.90, 95% confidence interval = [0.84, 0.97]) and had a significantly longer time to their first readmission (incidence rate ratio = 1.47, 95% confidence interval = [1.36, 1.58]), fewer hospital admissions (incidence rate ratio = 0.90, 95% confidence interval = [0.84, 0.96]) and more days of community care (incidence rate ratio = 1.55, 95% confidence interval = [1.51, 1.59]). Increased community care and delayed first admission were found for all durations of community treatment order care. Reduced odds of readmission were limited to people with 6 months or less of community treatment order care, and reduced number of admissions and days in hospital to people with prolonged ( months) community treatment order care. In this large population-based study, community treatment orders increase community care and delay rehospitalisation while they are in operation. Some negative findings in this field may reflect the use of observation periods longer than the period of active intervention.

Author response: Neurophysiological evidence of efference copies to inner speech

Publisher: eLife Sciences Publications, Ltd

Date: 10-10-2017

DOI: 10.7554/ELIFE.28197.022

NEUROPHYSIOLOGICALLY-BASED MEAN-FIELD MODELLING OF TONIC CORTICAL ACTIVITY IN POST-TRAUMATIC STRESS DISORDER (PTSD), SCHIZOPHRENIA, FIRST EPISODE SCHIZOPHRENIA AND ATTENTION DEFICIT HYPERACTIVITY DISO

Publisher: World Scientific Pub Co Pte Lt

Date: 12-2004

DOI: 10.1142/S0219635204000592

Abstract: A recently developed quantitative model of cortical activity is used that permits data comparison with experiment using a quantitative and standardized means. The model incorporates properties of neurophysiology including axonal transmission delays, synaptodendritic rates, range-dependent connectivities, excitatory and inhibitory neural populations, and intrathalamic, intracortical, corticocortical and corticothalamic pathways. This study tests the ability of the model to determine unique physiological properties in a number of different data sets varying in mean age and pathology. The model is used to fit in idual electroencephalographic (EEG) spectra from post-traumatic stress disorder (PTSD), schizophrenia, first episode schizophrenia (FESz), attention deficit hyperactivity disorder (ADHD), and their age/sex matched controls. The results demonstrate that the model is able to distinguish each group in terms of a unique cluster of abnormal parameter deviations. The abnormal physiology inferred from these parameters is also consistent with known theoretical and experimental findings from each disorder. The model is also found to be sensitive to the effects of medication in the schizophrenia and FESz group, further supporting the validity of the model.

Using a mobile health device to monitor physiological stress for serious mental illness: A qualitative analysis of patient and clinician-related acceptability.

Publisher: American Psychological Association (APA)

Date: 09-2022

DOI: 10.1037/PRJ0000514

Abstract: There is growing interest in using mobile health (mHealth) devices to monitor physiological stress associated with mental deterioration. Research is currently examining whether physiological information returned to in iduals with serious mental illness (SMI) and their clinicians enhances early intervention. The aim of this study was to explore patient and clinician-related acceptability of an mHealth device to monitor stress for SMI. In iduals with SMI and their clinicians at a community youth mental health service were shown how an mHealth device could be used to monitor stress. Focus groups and interviews regarding the acceptability of the mHealth device were then conducted with participants ( Six themes were identified. In iduals with SMI and clinicians identified two themes related to benefits of the mHealth device: (a) self-monitoring improves symptom insight and (b) clinician monitoring as a benefit to treatment. They identified one barrier theme: (c) privacy and data misuse concerns. They also identified three facilitators of uptake: (d) ease of use, (e) engaging design and (f) procedural guidelines. The perceived benefits of passive physiological monitoring afforded by an mHealth device come with concerns regarding its privacy and the potential for ambiguity in the patient-clinician relationship. Results suggest the importance of codesign to ensure that it is secure, easy to use and engaging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Continuity of mental health care during the transition from prison to the community following brief periods of imprisonment

Publisher: Frontiers Media SA

Date: 20-09-2022

DOI: 10.3389/FPSYT.2022.934837

Abstract: The prison-to-community transition period is one of high risk and need, particularly for those with mental illness. Some in iduals cycle in and out of prison for short periods with little opportunity for mental health stabilization or service planning either in prison or the community. This study describes the socio-demographic, clinical and criminal justice characteristics of in iduals with mental illness and frequent, brief periods of imprisonment, examines continuity of mental health care between prison and the community for this group, and reports on their post-release mental health and criminal justice outcomes. This study examined a s le of 275 men who had recently entered prison in New South Wales (NSW), Australia, who had been charged with relatively minor offenses and had been identified on reception screening as having significant mental health needs. Baseline demographic and mental health information was collected via interview and file review and contacts with the prison mental health service were recorded for the period of incarceration. Follow-up interviews were conducted 3 months post-release to determine level of health service contact and mental health symptoms. Information on criminal justice contact during the 3 month period was also collected. The majority (85.5%) of the s le had contact with a mental health professional during their period of incarceration. Mental health discharge planning was, however, lacking, with only one in 20 receiving a referral to a community mental health team (CMHT) and one in eight being referred for any kind of mental health follow-up on release. Of those followed up 3 months post-release ( n = 113), 14.2% had had contact with a CMHT. Of those released for at least 3 months ( n = 255), one in three had received new charges in this period and one in five had been reincarcerated. Continuity of mental health care for those exiting prison is poor, particularly for those with mental health needs experiencing brief periods of imprisonment, and rates of CMHT contact are low in the immediate post-release period. These findings suggest a need for early identification of in iduals in this group for timely commencement of intervention and release planning, and opportunities for ersion from prison should be utilized where possible.

Acute antidepressant effects of right unilateral ultra-brief ECT: A double-blind randomised controlled trial

Publisher: Elsevier BV

Date: 07-2013

DOI: 10.1016/J.JAD.2012.12.005

Abstract: Shortening the pulse width to 0.3 ms holds neurophysiological and clinical promise of making ECT safer by limiting cognitive side effects. However, the antidepressant effects of right ultra-brief unilateral ECT are under contention. In an acute ECT course, antidepressant equivalence of ultra-brief right unilateral ECT to the high-dose brief pulse right unilateral ECT was investigated. Severely depressed patients were randomised to 1 ms-brief pulse (n=18) or 0.3 ms ultra-brief pulse (n=17) right unilateral ECT, both at high-dose (6 times threshold stimulus dose) given thrice weekly. Depression severity was measured using the Montgomery Asberg Depression Rating Scale at baseline, after 8 treatments and after the acute course of ECT. Depression severity declined equally in both groups: F (1.27,41.97)=0.31, p=0.63. Median time in days to remission (95%CI) was in brief pulse ECT: 26 (18.6-33.4) and ultra-brief pulse ECT:28 (17.9-38.0). The small s le study in the study increases the likelihood of type 2 error. In severe depression, high-dose ultra-brief right unilateral ECT appears to show matching acute antidepressant response to an equally high-dose brief pulse right unilateral ECT.

A disturbance of nonlinear interdependence in scalp EEG of subjects with first episode schizophrenia

Publisher: Elsevier BV

Date: 09-2003

DOI: 10.1016/S1053-8119(03)00332-X

Abstract: It has been proposed that schizophrenia arises through a disturbance of coupling between large-scale cortical systems. This "disconnection hypothesis" is tested by applying a measure of dynamical interdependence to scalp EEG data. EEG data were collected from 40 subjects with a first episode of schizophrenia and 40 matched healthy controls. An algorithm for the detection of dynamical interdependence was applied to six pairs of bipolar electrodes in each subject. The topographic organization of the interdependence was calculated and served as the principle measure of cortical integration. The rate of occurrence of dynamical interdependence did not statistically differ between subject groups at any of the sites. However, the topography across the scalp was significantly different between the two groups. Specifically, nonlinear interdependence tended to occur in larger concurrent "clusters" across the scalp in schizophrenia than in the healthy subjects. This disturbance was reflected most strongly in left intrahemispheric coupling and did not differ significantly according to symptomatology. Medication dose and subject arousal were not observed to be confounding factors. The study of dynamical interdependence in scalp EEG data does not support a straightforward interpretation of the disconnection hypothesis-that there is a decrease in the strength of functional coupling between adjacent cortical regions. Rather, it suggests a dysregulation in the organization of dynamical interactions across supraregional brain systems.

RBANS neuropsychological profiles within schizophrenia samples recruited from non-clinical settings

Publisher: Elsevier BV

Date: 2007

DOI: 10.1016/J.SCHRES.2006.08.022

Abstract: This paper examines the potential impact of recruitment source differences in schizophrenia research by comparing the neuropsychological performance of volunteers from the NISAD Schizophrenia Research Register with recently published schizophrenia normative data for the Repeatable Battery for Neuropsychological Status (RBANS). The Register s le comprised 285 volunteers with schizophrenia or schizoaffective disorder. Their RBANS performance was compared with US data from 575 predominantly outpatient-recruited schizophrenia patients. The Register s le displayed impairments in immediate and delayed memory, but near-normal language, attention and visuospatial-constructional performance (mean RBANS total score=88.72, SD=16.35). By contrast, health service-recruited schizophrenia patients displayed impairments on all RBANS scales (mean RBANS total score=70.54, SD=14.80). Within the Register s le, volunteers with low levels of current functioning had immediate and delayed memory performance comparable to the US schizophrenia s le. Gender and school completion status were also associated with different RBANS profiles. These findings reinforce the notion that a severity/functioning gradient exists across schizophrenia recruitment sources, which has important implications for research design and generalizability. Memory impairments have emerged as a central feature of schizophrenia.

Dimensions of anxiety in Major depressive disorder and their use in predicting antidepressant treatment outcome: An iSPOT-D report

Publisher: Cambridge University Press (CUP)

Date: 26-04-2020

DOI: 10.1017/S0033291719000941

Abstract: Major depressive disorder (MDD) commonly co-occurs with clinically significant levels of anxiety. However, anxiety symptoms are varied and have been inconsistently associated with clinical, functional, and antidepressant treatment outcomes. We aimed to identify and characterise dimensions of anxiety in people with MDD and their use in predicting antidepressant treatment outcome. 1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic, MDD were assessed at baseline on clinical features and cognitive hysiological functioning. Participants were then randomised to one of three commonly prescribed antidepressants and reassessed at 8 weeks regarding symptom change, as well as remission and response, on the 17-item Hamilton Rating Scale Depression (HRSD 17 ) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR 16 ). Exploratory factor analysis was used on items from scales assessing anxiety symptoms, and resulting factors were assessed against clinical features and cognitive hysiological functioning. Factors were also assessed on their ability to predict treatment outcome. Three factors emerged relating to stress, cognitive anxiety, and somatic anxiety. All factors showed high internal consistency, minimal cross-loadings, and unique clinical and functional profiles. Furthermore, only higher somatic anxiety was associated with poorer QIDS-SR 16 remission, even after adjusting for covariates and multiple comparisons. Anxiety symptoms in people with MDD can be separated onto distinct factors that differentially respond to treatment outcome. Furthermore, these factors do not align with subscales of established measures of anxiety. Future research should consider cognitive and somatic symptoms of anxiety separately when assessing anxiety in MDD and their use in predicting treatment outcome.

Impact of depression heterogeneity on attention: An auditory oddball event related potential study

Publisher: Elsevier BV

Date: 06-2010

DOI: 10.1016/J.JAD.2009.08.010

Abstract: Major depressive disorder is associated with a reduced ability to attend and concentrate, however, the extent to which attentional impairment is dependent on subtype remains to be clarified. Event-related potentials (ERPs) associated with a well-validated auditory oddball, selective attention task, were recorded to determine the impact of melancholia (n=57) versus non-melancholia (n=48) relative to controls (n=116). The key findings were an exaggeration of the P200 to both non-target and target stimuli and a reduction in the P300 to targets in patients with melancholia, relative to patients with non-melancholia and controls. In addition, the N200/P300 complex was slowed in latency corresponding to the slowed behavioural responses to targets in melancholia. Stepwise regression analysis also revealed that depression severity, but not psychomotor slowing, contributed to increases in P200 litude. This study is cross-sectional and cannot determine whether the observed ERP changes are a state or trait marker, highlighting the need for a longitudinal study of ERP characteristics in different subgroups of depressed patients. Results point to a difficulty in differentiating significant stimuli in the environment in the depressed in idual. The combined disruption of early sensory processing (P200) and subsequent context processing (N200/P300 complex) may provide a potential mechanism for the attentional impairment that is frequently observed in depression, particularly in more severe depression.

Shared versus distinct genetic contributions of mental wellbeing with depression and anxiety symptoms in healthy twins

Publisher: Elsevier BV

Date: 10-2016

DOI: 10.1016/J.PSYCHRES.2016.07.016

Abstract: Mental wellbeing and mental illness symptoms are typically conceptualized as opposite ends of a continuum, despite only sharing about a quarter in common variance. We investigated the normative variation in measures of wellbeing and of depression and anxiety in 1486 twins who did not meet clinical criteria for an overt diagnosis. We quantified the shared versus distinct genetic and environmental variance between wellbeing and depression and anxiety symptoms. The majority of participants (93%) reported levels of depression and anxiety symptoms within the healthy range, yet only 23% reported a wellbeing score within the "flourishing" range: the remainder were within the ranges of "moderate" (67%) or "languishing" (10%). In twin models, measures of wellbeing and of depression and anxiety shared 50.09% of variance due to genetic factors and 18.27% due to environmental factors the rest of the variance was due to unique variation impacting wellbeing or depression and anxiety symptoms. These findings suggest that an absence of clinically-significant symptoms of depression and anxiety does not necessarily indicate that an in idual is flourishing. Both unique and shared genetic and environmental factors may determine why some in iduals flourish in the absence of symptoms while others do not.

Small‐world properties of nonlinear brain activity in schizophrenia

Publisher: Wiley

Date: 19-01-2009

DOI: 10.1002/HBM.20517

The impact of depression heterogeneity on cognitive control in major depressive disorder

Publisher: SAGE Publications

Date: 26-10-2012

DOI: 10.1177/0004867412461383

Abstract: Depressed patients display a variety of deficits in neuropsychological function, and contradictory findings in the literature may be due to disorder heterogeneity. The aim of this study was to examine the impact of severity, subtype and symptoms on cognitive control. Neuropsychological function across a range of cognitive control tasks was examined in melancholic ( n = 65) and non-melancholic depressed patients ( n = 59) relative to controls ( n = 124). The relationship between subtype (melancholia vs non-melancholia) and anxiety was also examined. Melancholia was characterised by attention and working memory deficits typically associated with the dorsolateral prefrontal cortex, while non-melancholia was characterised by verbal memory recall deficits indicative of left frontal lobe and medial temporal lobe function. The severity of anxious arousal and psychomotor disturbance contributed to cognitive impairment more than the severity of depression symptoms and anxious apprehension. Findings highlight a differential impact of depression subtype and severity, and suggest that anxious arousal and psychomotor disturbance may contribute to poorer performance on neuropsychological tasks associated with dorsolateral prefrontal cortex function.

Stop Using Stuff: Trial of a drug and alcohol intervention for young people with comorbid mental illness and drug and alcohol problems

Publisher: SAGE Publications

Date: 12-2007

DOI: 10.1080/10398560701439665

Abstract: Objective: Substance abuse is a significant problem in the treatment of young people with their first psychosis. This study reports a randomized trial of a brief manualized cognitive behavioural therapy for substance abuse in young people with psychosis. Method: Subjects were randomized between the study treatment and a group treated as usual. Treatment was a four to six session brief cognitive behavioural therapy (CBT) intervention developed specifically for this patient group – Stop Using Stuff (SUS). Results: Both groups improved across the trial. However, those exposed to the active treatment improved significantly on measures of the frequency of cannabis and alcohol abuse. Conclusions: Brief interventions in substance abuse in young people with psychosis can help moderate substance use in this difficult to treat group.

Clinical reasoning sessions: Back to the patient

Publisher: Wiley

Date: 16-02-2011

DOI: 10.1111/J.1743-498X.2010.00407.X

Neurophysiological evidence of efference copies to inner speech

Publisher: eLife Sciences Publications, Ltd

Date: 04-12-2017

DOI: 10.7554/ELIFE.28197

Abstract: Efference copies refer to internal duplicates of movement-producing neural signals. Their primary function is to predict, and often suppress, the sensory consequences of willed movements. Efference copies have been almost exclusively investigated in the context of overt movements. The current electrophysiological study employed a novel design to show that inner speech – the silent production of words in one’s mind – is also associated with an efference copy. Participants produced an inner phoneme at a precisely specified time, at which an audible phoneme was concurrently presented. The production of the inner phoneme resulted in electrophysiological suppression, but only if the content of the inner phoneme matched the content of the audible phoneme. These results demonstrate that inner speech – a purely mental action – is associated with an efference copy with detailed auditory properties. These findings suggest that inner speech may ultimately reflect a special type of overt speech.

A Brief Guide to Medications for Psychosis

Publisher: Elsevier

Date: 2019

DOI: 10.1016/B978-0-12-815012-2.00023-7

The impact of online brain training exercises on experiences of depression, anxiety and emotional wellbeing in a twin sample

Publisher: Elsevier BV

Date: 02-2021

DOI: 10.1016/J.JPSYCHIRES.2020.12.054

The effect of music on brain wave functioning during an acute psychotic episode

Publisher: Elsevier BV

Date: 07-2010

DOI: 10.1016/J.PSYCHRES.2010.04.020

Abstract: This pilot study compared the differences in the quantified electroencephalogram (qEEG) between two conditions eyes closed resting and eyes closed listening to music of 15 subjects currently experiencing an acute psychotic episode. The results showed a significant decrease in delta, alpha and beta waves when listening to music compared to resting condition.

Approach to schizophrenia

Publisher: Wiley

Date: 04-2023

DOI: 10.1111/IMJ.16068

Abstract: Schizophrenia is the most common of a group of psychotic disorders that occur in approximately 3% of the population over the lifespan. It has clear genetic antecedents, which are shared across the spectrum of psychotic disorders however, a range of other biological and social factors influence the onset and treatment of the disorder. Schizophrenia is diagnosed by a characteristic set of symptoms (positive, negative, disorganisation, cognitive and affective) accompanied by a functional decline. Investigations are used to exclude other organic causes of psychosis and to provide a baseline for the negative effects of pharmacological treatments. Treatment requires a combination of pharmacological and psychosocial interventions. Physical health is poor in this group of people and this is not helped by inconsistent care from health services. Although earlier intervention has improved the immediate outcomes, the longer‐term outcome has not significantly shifted.

Remediation of Facial Emotion Recognition in Schizophrenia: Functional Predictors, Generalizability, and Durability

Publisher: University of Nebraska Press

Date: 21-05-2010

DOI: 10.1080/15487761003757066

Origins of early intervention in first-episode psychosis

Publisher: SAGE Publications

Date: 06-2003

DOI: 10.1046/J.1039-8562.2003.00556.X

Abstract: Objective: To outline reasons contributing to the delayed introduction of early intervention strategies for first-episode psychosis, followed by a discussion of recent factors that have supported the increased use of these strategies. Conclusions: The reasons for this delay include pessimistic beliefs carried over from early in the 20th century about the prognosis of schizophrenia, the central role of the institution in psychiatric history, and the need for a working neurobiological model for psychosis. The discovery of the antipsychotic drugs, the process of deinstitutionalization, and new conceptualizations of schizophrenia have been necessary precursors to current best practice treatments. In recent years these factors have been complemented by the increasing influence of consumer and family advocacy groups, and government policy initiatives.

Neurofeedback as an adjunct therapy for treatment of chronic posttraumatic stress disorder related to refugee trauma and torture experiences: two case studies

Publisher: SAGE Publications

Date: 12-07-2017

DOI: 10.1177/1039856217715988

Abstract: The objective of this study was to describe the use of neurofeedback for refugee-related chronic posttraumatic stress disorder (PTSD) in two case studies. We describe the assessment and application of neurofeedback integrated into the treatment of two clients with chronic PTSD. We include details of our treatment schedule, symptoms and quantitative electrophysiological data for each case. All clients achieved significant reduction in symptoms of PTSD and improvement in daily functioning post-neurofeedback therapy. Quantitative electroencephalogric (EEG) measures indicate a normalisation of EEG markers relating to trauma, including overarousal at rest and working memory function. Neurofeedback as an adjunct to trauma-informed therapy may help to remediate chronic PTSD relating to refugee experiences. If replicated then improvements demonstrated in this population would be generalisable to all chronic PTSD.

General and social cognition in first episode schizophrenia: identification of separable factors and prediction of functional outcome using the IntegNeuro test battery.

Publisher: Elsevier BV

Date: 02-2008

DOI: 10.1016/J.SCHRES.2007.10.019

Abstract: It is increasingly recognized that cognitive assessments, unlike symptom ratings, provide a reliable predictor of functional outcome in schizophrenia. This study evaluated the utility of the 'IntegNeuro' computerized test battery for assessing cognition in first episode schizophrenia. We determined the presence of separable factors of general and social cognition, their equivalence to the consensus domains identified by the NIMH MATRICS project, and their effectiveness in predicting real world functional outcomes. Fifty six first episode schizophrenia (FES) patients and 112 matched healthy controls were assessed on the touchscreen-based 'IntegNeuro' cognitive test battery and FES patients for social functioning (SOFAS) and quality of life (WHOQOL-BREF). Principal components analysis identified i) six factors corresponding to MATRICS domains of general cognition ('Information Processing Speed', 'Verbal Recall', 'Working Memory Capacity', 'Sustained Attention/Vigilance', 'Verbal Processing', 'Executive Function'), ii) an 'Emotional Intelligence' factor corresponding to the MATRICS social cognition domain, and iii) an additional 'Sensori-Motor Function' factor of general cognition and 'Negativity' factor of social cognition. Patients showed impairments relative to controls across all factors, but especially for Working Memory Capacity, followed by Verbal Memory, Sustained Attention/Vigilance and Negativity. These factors strongly predicted poorer social functioning in FES, along with poorer quality of life in psychological, social, and health satisfaction facets. The IntegNeuro battery has utility for assessing separable domains of general and social cognition in FES, which are predictive of real world outcomes. Thus, it may be appropriate for clinical application, including in multi-center trials targeting new treatments for cognition in schizophrenia.

Frontal and rostral anterior cingulate (rACC) theta EEG in depression: Implications for treatment outcome?

Publisher: Elsevier BV

Date: 08-2015

DOI: 10.1016/J.EURONEURO.2015.03.007

Abstract: In major depressive disorder (MDD), elevated theta current density in the rostral anterior cingulate (rACC), as estimated by source localization of scalp-recorded electroencenphalogram (EEG), has been associated with response to antidepressant treatments, whereas elevated frontal theta has been linked to non-response. This study used source localization to attempt to integrate these apparently opposite results and test, whether antidepressant response is associated with elevated rACC theta and non-response with elevated frontal theta and whether theta activity is a differential predictor of response to different types of commonly used antidepressants. In the international Study to Predict Optimized Treatment in Depression (iSPOT-D), a multi-center, international, randomized, prospective practical trial, 1008 MDD participants were randomized to escitalopram, sertraline or venlafaxine-XR. The study also recruited 336 healthy controls. Treatment response and remission were established after eight weeks using the 17-item Hamilton Rating Scale for Depression (HRSD17). The resting-state EEG was assessed at baseline with eyes closed and source localization (eLORETA) was employed to extract theta from the rACC and frontal cortex. Patients with MDD had elevated theta in both frontal cortex and rACC, with small effect sizes. High frontal and rACC theta were associated with treatment non-response, but not with non-remission, and this effect was most pronounced in a subgroup with previous treatment failures. Low theta in frontal cortex and rACC are found in responders to antidepressant treatments with a small effect size. Future studies should investigate in more detail the role of previous treatment (failure) in the association between theta and treatment outcome.

Psychiatrists and GPs: Diagnostic decision making, personality profiles and attitudes toward depression and anxiety

Publisher: SAGE Publications

Date: 25-04-2013

DOI: 10.1177/1039856213486210

Abstract: The objective of this article is to explore diagnostic decision making around psychological symptoms presenting to general practitioners (GPs) and psychiatrists, identify attitudinal and personality factors of possible relevance in these decisions, and compare GPs and psychiatrists to help identify potential educational targets. GPs and psychiatrists attended separate peer-facilitated workshops in which two case presentations were discussed. Decision making was explored by structured questions embedded in the workshop, with responses recorded by electronic keypad technology. Participants completed demographic questionnaires and measures of personality and attitudes to depression. GPs and psychiatrists accorded emphasis to different elements of the history, and assigned different diagnoses based on the same set of symptoms. Both groups relied on non-pharmacological management for milder psychological symptoms GPs were less likely to make a diagnosis of bipolar disorder. Traits of Extraversion and Agreeableness were associated with greater ease in treating depression. Differences in diagnostic decision making likely reflect the different contexts of specialist and generalist practice. Educational targets may include information about key symptoms to assist in diagnostic precision, but further information is needed to determine the best match between diagnostic processes, context and outcome. An awareness of the role of personality factors may help when designing education and support programs.

The Five Symptom Dimensions and Depression in Schizophrenia

Publisher: S. Karger AG

Date: 2003

DOI: 10.1159/000073447

Abstract: The aim of this study was to investigate the relationship between the five-factor model of psychopathology and depression in schizophrenia. Symptoms were rated using the Positive and Negative Syndrome Scale (PANSS) and the Montgomery and Åsberg Depression Rating Scale (MADRS) in 105 chronic patients with schizophrenia. Principal-component analysis (PCA) produced a five-factor solution for the PANSS (psychomotor poverty, disorganisation, reality distortion, excitement, and depression), and a two-factor solution for the MADRS (psychological and behavioural depression). The PANSS depression factor was highly associated with the MADRS psychological depression factor but not with MADRS behavioural depression. By contrast, the PANSS excitement factor showed a strong positive correlation with the behavioural depression factor but not with psychological depression. These MADRS factors were not associated significantly with the core PANSS factors, including psychomotor poverty. It is suggested that depression exists as an independent domain, differentiated from negative symptoms, in the structure of schizophrenia symptomatology.

Factors associated with functional psychosocial status in first-episode psychosis

Publisher: Wiley

Date: 02-2009

DOI: 10.1111/J.1751-7893.2008.00099.X

Abstract: This study aimed to determine which of demographic remorbid, psychiatric or neuropsychological variables are most closely associated with functional status around the time of diagnosis of first-episode psychosis. This was with a view to determining factors that should be the focus of intervention in these early stages of illness. The Western Sydney First Episode Psychosis Project collected data on young persons (aged 13-25) with newly diagnosed psychosis (n=92). Psychosocial functional status was measured using the Role Functioning Scale (RFS). Multiple regression analyses were carried out to identify predictors of RFS score from a wide range of predictor variables. Psychiatric variables accounted for the most variance in RFS score. Positive and Negative Syndrome Scale (PANSS) Negative subscale and Young Mania Rating Scale score were found to be significant in idual predictors, with variables from the other domains failing to contribute to the overall model. In separate models, demographic remorbid and neuropsychological factors weakly related to functional status. Psychiatric factors were the main influence on psychosocial functioning in first-episode psychosis at baseline. Evidence suggests the relationships between symptoms, cognition and demographics with function might change over time, depending on the stage of illness being examined.

A comparison between Right Unilateral Ultrabrief electroconvulsive therapy and bilateral electroconvulsive therapy in the elderly: a pilot naturalistic observational study

Publisher: SAGE Publications

Date: 03-04-2018

DOI: 10.1177/1039856218765898

Abstract: To compare clinical outcomes and adverse effects between Bitemporal (BT) and Right Unilateral Ultrabrief (RUL(UB)) electroconvulsive therapy (ECT) in an elderly population. Patients over the age of 65 years admitted to a tertiary referral hospital over a seven month period requiring ECT received RUL(UB) ECT. They were compared with those who received BT ECT over these and the preceding seven months. Twenty-three patients entered the study. No significant differences was observed between the groups in demographic and clinical characteristics or clinical improvement. However, patients who received BT ECT were significantly more likely to be confused post treatment compared with the RUL(UB) group. This pilot study found RUL(UB) ECT to be an effective treatment in elderly patients. These patients also suffered significantly less confusion than patients who received BT ECT.

Why do we not use psychosocial interventions in the treatment of schizophrenia?

Publisher: SAGE Publications

Date: 29-05-2013

DOI: 10.1177/0004867413489173

Dysregulation of arousal and amygdala-prefrontal systems in paranoid schizophrenia.

Publisher: American Psychiatric Association Publishing

Date: 03-2004

DOI: 10.1176/APPI.AJP.161.3.480

Abstract: The authors investigated impaired differentiation of limbic-prefrontal systems by autonomic arousal in schizophrenia. It was predicted that paranoid patients would be distinguished by a disjunction of hyperarousal but reduced amygdala and medial prefrontal activity relative to both healthy comparison subjects and patients with nonparanoid schizophrenia. Pictures depicting facial expressions of fear were presented to 27 schizophrenia patients (13 paranoid, 14 nonparanoid) and 22 matched healthy comparison subjects in an implicit perception task to evoke limbic activity. Simultaneous functional magnetic resonance imaging and skin conductance arousal recordings were acquired during presentation of faces expressing fear or neutral emotion. Responses to fear stimuli were further examined by contrasting those that were associated with a skin conductance response ("with arousal") and those that were not ("without arousal"). In the comparison subjects, arousal dissociated amygdala/medial prefrontal ("visceral") networks and hippoc us/lateral prefrontal ("context") networks for fear perception. Excessive arousal responses were elicited in the schizophrenia subjects, but there was an associated reduction in amygdala/medial prefrontal activity. This disjunction was pronounced in paranoid patients relative to both healthy subjects and nonparanoid patients. Paranoid patients also showed a relatively greater prefrontal deficit for "without-arousal" responses. This is the first study to reveal a functional disconnection in autonomic and central systems for processing threat-related signals in patients with paranoid schizophrenia. Paranoid cognition may reflect an internally generated cycle of misattribution regarding incoming fear signals due to a breakdown in the regulation of these systems.

The shared and unique genetic relationship between mental well-being, depression and anxiety symptoms and cognitive function in healthy twins

Publisher: Informa UK Limited

Date: 30-09-2016

DOI: 10.1080/02699931.2016.1232242

Abstract: Alterations to cognitive function are often reported with depression and anxiety symptoms, yet few studies have examined the same associations with mental well-being. This study examined the association between mental well-being, depression and anxiety symptoms and cognitive function in 1502 healthy adult monozygotic (MZ) and dizygotic (DZ) twins, and the shared/unique contribution of genetic (G) and environmental (E) variance. Using linear mixed models, mental well-being was positively associated (p < .01) with sustained attention (β = 0.127), inhibition (β = 0.096), cognitive flexibility (β = 0.149), motor coordination (β = 0.114) and working memory (β = 0.156), whereas depression and anxiety symptoms were associated (p < .01) with poorer sustained attention (β = -0.134), inhibition (β = -0.139), cognitive flexibility (β = -0.116) and executive function (β = -0.139). Bivariate twin modelling showed well-being shared a small environmental correlation with motor coordination and a small genetic correlation with working memory. Trivariate twin modelling showed well-being shared a small genetic correlation with inhibition, whereas depression and anxiety symptoms shared a small environmental correlation with inhibition. The remaining variance was mostly driven by unique G and/or E variance. Overall, well-being and depression and anxiety symptoms show both independent and shared relationships with cognitive functions but this is largely attributable to unique G or E variance and small shared G/E variance between pairs of variables.

Investigating the neural basis of cognitive control dysfunction in mood disorders

Publisher: Wiley

Date: 22-10-2019

DOI: 10.1111/BDI.12844

Abstract: Dysfunction of cognitive control is a feature of both bipolar disorder (BP) and major depression (MDD) and persists through to remission. However, it is unknown whether these disorders are characterized by common or distinct disruptions of cognitive control function and its neural basis. We investigated this gap in knowledge in asymptomatic BP and MDD participants, interpreted within a framework of normative function. Participants underwent fMRI scans engaging cognitive control through a working memory task and completed a cognitive battery evaluating performance across multiple subdomains of cognitive control, including attention, impulsivity, processing speed, executive function, and memory. Analysis was performed in two stages: (i) cognitive control-related brain activation and deactivation were correlated with cognitive control performance in 115 healthy controls (HCs), then, (ii) significantly correlated regions from (i) were compared between 25 asymptomatic BP, 25 remitted MDD, and with 25 different HCs, matched for age and gender. Impulsivity and executive function performance were significantly worse in BP compared to both MDD and HCs. Both BP and MDD had significantly poorer memory performance compared to HCs. Greater deactivation of the medial prefrontal cortex (MPFC) during the fMRI task was associated with better executive function in healthy controls. Significantly less deactivation in this region was present in both BP and MDD compared to HCs. Failure to deactivate the MPFC, a key region of the default mode network, during working memory processing is a shared neural feature present in both bipolar and major depression and could be a source of common cognitive dysfunction.

Major depressive disorder with melancholia displays robust alterations in resting state heart rate and its variability: Implications for future morbidity and mortality

Publisher: Frontiers Media SA

Date: 27-11-2014

DOI: 10.3389/FPSYG.2014.01387

Integrating a Mobile Health Device Into a Community Youth Mental Health Team to Manage Severe Mental Illness: Protocol for a Randomized Controlled Trial

Publisher: JMIR Publications Inc.

Date: 02-11-2020

DOI: 10.2196/19510

Abstract: Symptoms of mental illness are often triggered by stress, and in iduals with mental illness are sensitive to these effects. The development of mobile health (mHealth) devices allows continuous recording of biometrics associated with activity, sleep, and arousal. Deviations in these measures could indicate a stressed state requiring early intervention. This paper describes a protocol for integrating an mHealth device into a community mental health team to enhance management of severe mental illness in young adults. The aim of this study is to examine (1) whether an mHealth device integrated into a community mental health team can improve outcomes for young adults with severe mental illness and (2) whether the device detects periods of mental health versus deterioration. This study examines whether physiological information from an mHealth device prevents mental deterioration when shared with the participant and clinical team versus with the participant alone. A randomized controlled trial (RCT) will allocate 126 young adults from community mental health services for 6 months to standard case management combined with an integrated mHealth device (ie, physiological information is viewed by both participant and case manager: unWIRED intervention) or an unintegrated mHealth device (ie, participant alone self-monitors: control). Participants will wear the Empatica Embrace2 device, which continuously records electrodermal activity and actigraphy (ie, rest and activity). The study also examines whether the Embrace2 can detect periods of mental health versus deterioration. A variety of measurements will be taken, including physiological data from the Embrace2 participant and case manager self-report regarding symptoms, functioning, and quality of life chart reviews and ecological momentary assessments of stress in real time. Changes in each participant’s Clinical Global Impression Scale scores will be assessed by blinded raters as the primary outcome. In addition, participants and case managers will provide qualitative data regarding their experience with the integrated mHealth device, which will be thematically analyzed. The study has received ethical approval from the Western Sydney Local Health District Human Research Ethics Committee. It is due to start in October 2020 and conclude in October 2022. The RCT will provide insight as to whether an integrated mHealth device enables case managers and participants to pre-emptively manage early warning signs and prevent relapse. We anticipate that unWIRED will enhance early intervention by improving detection of stress and allowing case managers and patients to better engage and respond to symptoms. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000642987 www.anzctr.org.au/ACTRN12620000642987.aspx PRR1-10.2196/19510

How Doctors View and Use Social Media: A National Survey

Publisher: JMIR Publications Inc.

Date: 02-12-2014

DOI: 10.2196/JMIR.3589

Intrinsic, task-evoked and absolute gamma synchrony during cognitive processing in first onset schizophrenia

Publisher: Elsevier BV

Date: 04-2018

DOI: 10.1016/J.JPSYCHIRES.2017.12.004

Abstract: Cognitive deficits present from the first onset of schizophrenia are thought to arise from a core problem in neural synchrony. This is the first study to characterize the profile of gamma (30-100 Hz) synchrony (rather than power) and behavioral performance during higher-order cognitive processing in schizophrenia. Gamma synchrony was acquired from the EEG, and elicited by a Continuous Performance Test (CPT). We quantitated synchrony for regions associated with the fronto-parietal attention and visual networks for 59 young people with First Onset Schizophrenia (FOS) and 59 matched controls, facilitated by the BRAINnet.net data sharing initiative. We compared groups on gamma synchrony for intrinsic (pre-stimulus), task-evoked change (relative to baseline) and absolute (not relative to baseline) measures. Relationships between synchrony and CPT accuracy, symptoms and functioning were also assessed. FOS showed a reduced ability to modulate task-evoked changes in gamma synchrony, in the context of generally higher intrinsic and absolute synchrony, particularly in frontal regions. These gamma synchrony abnormalities in FOS were associated with performance on the CPT, but not with symptoms or functioning. Task-relevant changes in synchrony may be constrained by an overall excess of intrinsic background synchrony that is unrelated to specific task demands and this relates to cognitive performance. Results are in line with theoretical accounts of gamma synchrony as a core abnormality in schizophrenia, affecting functional connectivity in central executive circuits and causing cognitive symptoms. This study is the first to demonstrate that these gamma synchrony abnormalities are not limited to perceptual or lower-order cognitive processing.

The contribution of BDNF and 5-HTT polymorphisms and early life stress to the heterogeneity of major depressive disorder: A preliminary study

Publisher: SAGE Publications

Date: 2012

DOI: 10.1177/0004867411430878

Abstract: Objective: Two reported genetic polymorphisms related to the production of brain-derived neurotrophic factor (BNDF) and reuptake by the serotonin transporter (5-HTT) appear to contribute to depression in combination with stressful life events. The aim of the current study was to investigate the contribution of early life stress (ELS), BDNF (Val versus Met alleles) and 5-HTT polymorphisms (L versus S alleles) to melancholic ( n = 65) and non-melancholic depression ( n = 59). Methods: A mediation approach ((G × G) × E mediation model) was employed to confirm the indirect effects of ELS on the relationship between 5-HTTPLR × BDNF polymorphism combinations and depression subtype. A series of binary logistic regressions were then conducted to determine whether genotype, ELS, and their interaction were able to predict depression subtype. Results: Key findings indicated that BDNF and 5-HTT polymorphisms in combination with ELS contributed to the development of non-melancholic depression. An interaction between BDNF and ELS increased the risk of non-melancholia by 3.327, whereas the interaction between 5-HTT and ELS increased risk by 2.406. Conclusion: The results support a role for genetic factors in the development of non-melancholia. The lack of findings in melancholia indicates that other mechanisms may underlie the subtype. Alternatively, null findings may reflect a Type II error associated with a small s le size. Future studies should consider further examination of differential gene–environment interactions for melancholia versus non-melancholia.

Declaring conflicting interests

Publisher: SAGE Publications

Date: 25-07-2013

DOI: 10.1177/0004867412456442

Visual scanpath dysfunction in first-degree relatives of schizophrenia probands: evidence for a vulnerability marker?

Publisher: Elsevier BV

Date: 03-2004

DOI: 10.1016/S0920-9964(03)00094-X

Abstract: Previous research demonstrates that people with schizophrenia have abnormally 'restricted' visual scanpaths to face and facial expression stimuli, which appear to be diagnostically specific to schizophrenia [Schizophr. Res. 55 (2002) 159 Biol. Psychiatry 52 (2002) 338]. This study examined the familial transmission of 'restricted' scanpaths in first-degree relatives of schizophrenia subjects. We recorded visual scanpaths for 65 schizophrenia subjects, 37 biological first-degree relatives and 61 nonrelated 'healthy' control subjects in two experiments: 'face recognition' and 'facial affect recognition'. Concurrent behavioral tasks were face matching and expression matching, each under two multiple-choice conditions (seven or three options). As predicted, first-degree relatives generally showed an attenuated form of the markedly 'restricted' scanpaths of schizophrenia subjects across all face stimuli. The notable exception to this pattern was the relatives' extreme avoidance of facial features (compared to both schizophrenia and healthy control groups). Our results offer the first evidence that some components of visual scanpath dysfunction may represent a trait marker in the familial transmission of schizophrenia, but that first-degree relatives may have additional disturbances in social cognition associated with the perception of facial features.

Grey matter deficits and symptom profile in first episode schizophrenia

Publisher: Elsevier BV

Date: 08-2005

DOI: 10.1016/J.PSCYCHRESNS.2005.05.010

Abstract: Several studies have investigated grey matter reductions in first episode schizophrenia (FES), but few have examined the relationship between grey matter reduction and clinical profile. A group of 31 patients with strictly defined FES and 30 healthy controls underwent T1-weighted magnetic resonance imaging (MRI) scan. Voxel-based morphometry in SPM99 was used to identify four distinct regions of grey matter reduction in the FES subjects. The regions of interest (ROIs) were in the left ventral prefrontal cortex (ROI 1), left parietal and temporal cortices (ROI 2), right cerebellum (ROI 3), and right frontal and parietal cortices (ROI 4). These regions of reduction were transformed into binary masks, which were convolved with patients' pre-processed grey matter images. Patients' grey matter volumes in these regions were correlated with their composite scores on the following three symptom dimensions: Psychomotor Poverty, Disorganization and Reality Distortion. The volumes of ROIs 1, 2 and 4 were found to be significantly correlated with the Reality Distortion syndrome score. Our findings indicate that distinct, widespread grey matter reductions are present very early in the course of schizophrenia. The results also suggest a possible structural underpinning for the abnormal brain activity typically associated with symptoms of Reality Distortion.

Efficacy, safety, and impact on hospitalizations of paliperidone palmitate in recent-onset schizophrenia

Publisher: Informa UK Limited

Date: 03-2015

DOI: 10.2147/NDT.S77778

Intrinsic functional connectivity of the default mode and cognitive control networks relate to change in behavioral performance over two years

Publisher: Elsevier BV

Date: 11-2020

DOI: 10.1016/J.CORTEX.2020.08.014

Verbal and visual learning ability in patients with treatment-resistant schizophrenia: A 1-year follow-up study

Publisher: Elsevier BV

Date: 09-2023

DOI: 10.1016/J.SCOG.2023.100283

Improvement of cognitive function in schizophrenia with N-acetylcysteine: A theoretical review

Publisher: Informa UK Limited

Date: 30-05-2020

DOI: 10.1080/1028415X.2018.1478766

A randomized controlled trial of cognitive remediation in schizophrenia

Publisher: Oxford University Press (OUP)

Date: 20-08-2010

DOI: 10.1093/SCHBUL/SBN102

The interdependence of subtype and severity: Contributions of clinical and neuropsychological features to melancholia and non-melancholia in an outpatient sample

Publisher: Cambridge University Press (CUP)

Date: 03-02-2012

DOI: 10.1017/S1355617711001858

Abstract: Major depressive disorder is often considered to be a homogenous disorder that changes in terms of severity however, the presence of distinct subtypes and a variety of presenting symptoms suggests much heterogeneity. Aiming to better understand the relationship between heterogeneity and diagnosis we used an exploratory approach to identify subtypes of depression on the basis of clinical symptoms and neuropsychological performance. Cluster analysis identified two groups of patients distinguished by level of cognitive dysfunction with the more severe cluster being associated with melancholic depression. While the relationship between cluster and subtype was significant, only 58% of melancholic patients were assigned to cluster 1 (the more severe cluster) and 66% of non-melancholic patients assigned to cluster 2. Subtypes also displayed a distinctive profile of impairment such that melancholic patients ( n = 65) displayed more variability in attention while non-melancholic patients ( n = 59) displayed memory recall impairment. While melancholia and non-melancholia are associated with a more severe and less severe form of depression respectively, findings indicate that differences between melancholia and non-melancholia are more than simple variation on severity. In summary, findings provide support for the heterogeneity of depression. ( JINS , 2012, 18 , 361–369)

Case reports: An opportunity for early intervention: Velo-cardio-facial syndrome and psychosis

Publisher: Wiley

Date: 23-10-2008

DOI: 10.1111/J.1751-7893.2008.00087.X

Abstract: Velo-cardio-facial syndrome is the most common micro deletion syndrome in man, with the typically deleted region in the 22q11area, an area that contains many genes with possible links to mental illnesses. The syndrome phenotype includes multiple physical abnormalities, learning disorders and a greatly increased risk of developing a psychotic disorder. A series of three cases is presented to describe some of the psychiatric manifestations of the velo-cardio-facial syndrome. The three young people presented here all had an illness of long duration that was difficult to treat, with significant side effects of treatment and varying degrees of recovery. As more children with genetic syndromes are identified early and monitored by genetic clinics and other paediatric services, there is an opportunity for psychiatric services to provide early intervention for a group of patients who are likely to have a poor response to treatment if they present with an advanced psychosis. Studying the deletions in the 22q11 area also has great potential for investigating possible causes of a genetic vulnerability to psychotic illness.

Delusions and reasoning: A study involving cognitive behavioural therapy

Publisher: Informa UK Limited

Date: 03-2008

DOI: 10.1080/13546800801900587

Abstract: Anomalies on probabilistic reasoning, theory of mind (ToM) tasks, and attributional biases have been found in delusional people. Delusions are also effectively modified by cognitive behavioural therapy (CBT). We sought to examine whether CBT reduces delusional conviction by changing such general reasoning anomalies. Sixteen patients commenced an 8-11 week CBT programme that targeted their delusions. Probabilistic reasoning, attributional biases, and ToM were assessed pre- and post-treatment. Delusional conviction, preoccupation, and distress were rated at each session. Pretreatment task performances were compared to norms. Repeated measures analyses compared pre- and posttreatment task performances and ratings of delusions. Correlational analyses were used to identify factors associated with reduced delusional conviction. At baseline, 11 patients showed some form of abnormal probabilistic reasoning, 13 excessive attributional biases, and 13 defective ToM compared to norms. Fourteen patients completed the CBT programme and showed significant reductions in delusional conviction and preoccupation. Despite some inconsistent evidence of improvement in verbal ToM tasks, reasoning styles in these 14 patients were largely unchanged by CBT. Reasoning anomalies associated with delusions in this s le mark a vulnerability that persists and is independent of the effectiveness of CBT.

N-Acetylcysteine (NAC) in Schizophrenia Resistant to Clozapine: A Double-Blind, Randomized, Placebo-Controlled Trial Targeting Negative Symptoms

Publisher: Oxford University Press (OUP)

Date: 20-07-2022

DOI: 10.1093/SCHBUL/SBAC065

Abstract: Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia, yet a significant proportion of in iduals on clozapine continue to experience disabling symptoms, despite being treated with an adequate dose. There is a need for adjunct treatments to augment clozapine, notably for negative and cognitive symptoms. One such potential agent is the glutathione precursor N-acetylcysteine (NAC). A randomized double-blind, multi-center, placebo-controlled trial for clozapine patients with enduring psychotic symptoms (n = 84) was undertaken to investigate the efficacy of adjunctive NAC (2 g daily) for negative symptoms, cognition and quality of life (QoL). Efficacy was assessed at 8, 24, and 52 weeks. NAC did not significantly improve negative symptoms (P = .62), overall cognition (P = .71) or quality of life (Manchester quality of life: P = .11 Assessment of quality of life: P = .57) at any time point over a 1-year period of treatment. There were no differences in reported side effects between the groups (P = .26). NAC did not significantly improve schizophrenia symptoms, cognition, or quality of life in treatment-resistant patients taking clozapine. This trial was registered with “Australian and New Zealand Clinical Trials” on the 30 May, 2016 (Registration Number: ACTRN12615001273572).

Investigating the neuropsychological and neuroanatomical changes that occur over the first 2–3 years of illness in patients with first-episode schizophrenia

Publisher: Elsevier BV

Date: 02-2008

DOI: 10.1016/J.PNPBP.2007.10.011

Abstract: This study explored the concurrent courses of the neuroanatomical and neuropsychological changes that occurred over the first 2-3 years of illness in patients with first-episode schizophrenia (FES). Fifty-two patients with FES underwent neuropsychological testing and a structural magnetic resonance imaging (sMRI) scan within three months of their first presentation to mental health services with psychotic symptoms (time1). Patients' cognitive performance was evaluated via an extensive neuropsychological test battery, which assessed 9 cognitive domains. Of the 52 patients at time1, 32 returned 2-3 years later (time2) for follow-up neuropsychological testing, and 20 of these also underwent follow-up sMRI. MR images were preprocessed in SPM99. Grey matter volumes of patients' whole-brain, frontal lobes and temporal lobes were calculated by convolving the preprocessed images with manually-drawn binary masks. Patients exhibited longitudinal improvements in full-scale IQ, performance IQ and visual memory. In contrast, concurrent reductions in grey matter were observed for the whole-brain (3% reduction) and the frontal lobe (3.65% reduction). Furthermore, the extent of patients' whole-brain and frontal-lobe grey matter changes were positively correlated with longitudinal changes in verbal learning and memory. The results of this study suggest that while the early stages of schizophrenia are associated with a mild improvement in patients' overall cognitive functioning, they are also associated with progressive grey matter atrophy.

Integrating objective gene-brain-behavior markers of psychiatric disorders

Publisher: World Scientific Pub Co Pte Lt

Date: 03-2007

DOI: 10.1142/S0219635207001465

Abstract: There is little consensus about which objective markers should be used to assess major psychiatric disorders, and predict/evaluate treatment response for these disorders. Clinical practice relies instead on subjective signs and symptoms, such that there is a "translational gap" between research findings and clinical practice. This gap arises from: a) a lack of integrative theoretical models which provide a basis for understanding links between gene-brain-behavior mechanisms and clinical entities b) the reliance on studying one measure at a time so that linkages between markers are their specificity are not established and c) the lack of a definitive understanding of what constitutes normative function. Here, we draw on a standardized methodology for acquiring multiple sources of genomic, brain and behavioral data in the same subjects, to propose candidate markers of selected psychiatric disorders: depression, post-traumatic stress disorder, schizophrenia, attention-deficit/hyperactivity disorder and dementia disorders. This methodology has been used to establish a standardized international database which provides a comprehensive framework and the basis for testing hypotheses derived from an integrative theoretical model of the brain. Using this normative base, we present preliminary findings for a number of disorders in relation to the proposed markers. Establishing these objective markers will be the first step towards determining their sensitivity, specificity and treatment prediction in in idual patients.

Evidence for Early Intervention in First-Episode Psychosis [3]

Publisher: SAGE Publications

Date: 04-2004

DOI: 10.1177/070674370404900412

Evaluation of Neurofeedback for Posttraumatic Stress Disorder Related to Refugee Experiences Using Self-Report and Cognitive ERP Measures

Publisher: SAGE Publications

Date: 27-05-2020

DOI: 10.1177/1550059419849170

Abstract: Background. Neurofeedback holds promise as an intervention for the psychophysiological dysfunction found in posttraumatic stress disorder (PTSD). Few empirical studies have assessed the efficacy of neurofeedback for PTSD, and none in in iduals with refugee trauma. A proposed mechanism for neurofeedback efficacy in PTSD is through remediating deficits in cognitive control. We assessed pre- and postchanges in symptoms and neurocognitive functioning of refugee clients participating in a neurofeedback intervention for PTSD. Methods. Clinical data for 13 adult refugees with chronic PTSD who participated in neurofeedback combined with trauma counseling (NFT) was compared with 13 adult refugees placed on a waitlist to receive neurofeedback. Waitlist clients continued to receive trauma counseling alone (TC). NFT was additionally assessed pre- and posttherapy for changes in event-related potentials (ERPs) and behavioral indices of cognitive control using a visual continuous performance task (VCPT). Comparison VCPT data from healthy controls (HC) was available from the Human Brain Index database. Results. Posttherapy, NFT had significantly lower symptoms of trauma, anxiety, and depression compared with TC. NFT demonstrated an increased P3 litude and improved behavioral performance suggesting a normalization of cognitive control. Conclusions. These preliminary observations are consistent with a possible benefit of neurofeedback for remediating PTSD. This may be achieved at least partially by an improvement in cognitive control. Further confirmation of the effectiveness of the treatment now requires a randomized controlled trial that considers issues such as placebo response, nonspecific therapist effects, and duration of treatment.

Monitoring for post-injection delirium/sedation syndrome with long-acting olanzapine during the COVID-19 pandemic

Publisher: SAGE Publications

Date: 14-05-2020

DOI: 10.1177/0004867420927465

Gamma activity in schizophrenia: evidence of impaired network binding?

Publisher: Elsevier BV

Date: 08-2000

DOI: 10.1016/S1388-2457(00)00347-3

Abstract: Gamma ('40 Hz') rhythms may play a role in the integration of sensory processing activity. Impaired temporal integration may be a key feature of the associated disturbances in schizophrenia. This is the first study to examine the time course of Gamma activity induced in response to stimuli in this disorder. Gamma activity induced in response to task-relevant and irrelevant auditory oddball stimuli was examined in 35 medicated schizophrenics and 35 age- and gender-matched normal controls. We employed a moving Welch window with short time FFT to examine the time course of Gamma litude. The litude spectrum for each time point was de-trended to eliminate any contribution of broad spectrum activity (EEG or EMG) to Gamma litude. For targets, schizophrenics showed a significant decrease in post-stimulus Gamma response litude in left hemisphere and frontal sites and an increase in right hemisphere and parieto-occipital sites (P<0.0009). The abnormalities correlated with PANSS general symptom scores. In the non-targets (at a different latency), schizophrenics showed a widespread Gamma decrease (P<0.0005). The Gamma findings in non-targets may reflect an abnormality in appropriately processing irrelevant stimuli. This could result in defective processing of the context (integration) of relevant target information.

Common and differential neural mechanisms underlying mood disorders

Publisher: Wiley

Date: 25-08-2022

DOI: 10.1111/BDI.13248

Abstract: Despite homogenous clinical presentations between bipolar and unipolar disorders, there are distinct neurobiological differences. Chronicity of illness may be a factor impacting and sustaining certain neural features. The goal of this study was to investigate common and shared neural mechanisms underlying mood disorders, and possible sustained neural changes relating to illness chronicity by investigating a cohort of euthymic patients with bipolar disorder (BD), unipolar depression who had responded to treatment (treatment‐sensitive depression, TSD), and a chronically treatment‐resistant depressed (TRD) group. One hundred and seventy‐two participants (40 BD, 39 TSD, 40 TRD, and 53 age–gender‐matched healthy controls) underwent resting‐state fMRI scans. Seed‐based and independent component analyses were performed to investigate group differences in resting‐state connectivity between the four groups. All three clinical groups had significantly lower connectivity within the frontoparietal network (FPN) relative to controls. TRD and BD were significantly different from TSD (TRD, BD TSD) but were not significantly different from each other. TRDs were also significantly different from both BD and TSD for salience network connectivity with the posterior cingulate (DMN) and the FPN with frontal pole (DMN). Additionally, the BD group exhibited greater DMN‐FPN (sgACC‐RDLPFC) connectivity relative to TRD, TSD, and controls, which was correlated with a previous number of depressive episodes, in the BD group only. BD demonstrated shared and differential connectivity features relative to symptomatic TRD and euthymic TSD groups. The increased sgACC‐RDLPFC connectivity in BD and its correlation with a number of depressive episodes could be a neural feature associated with illness chronicity.

Event-related potential correlates of depression, insight and negative symptoms in males with recent-onset psychosis

Publisher: Elsevier BV

Date: 08-2006

DOI: 10.1016/J.CLINPH.2006.04.017

Abstract: The neurobiology of clinical characteristics -in particular depression, insight and negative symptoms- in recent-onset psychosis (ROP) was studied using event-related potentials (ERPs). Twenty right-handed ROP men and 20 controls completed an auditory-oddball task. ROP men had minimum exposure to antipsychotic medication. N100, N200 and P300 were studied to ascertain the effects of (a) diagnosis (patients versus controls), and (b) clinical characteristics. ROP men had significantly lower anterior N100, enhanced N200 at T3, and lower P300 at Pz than controls. Lower right-anterior N100 and enhanced right-anterior N200 litude explained 47.7% of negative symptoms. Left-central N100 litude explained 30.28% of negative symptoms. Lower left-posterior and higher right-posterior P300 litude explained 65.99% of total symptoms. Lower left-central N100, enhanced left-central N200 and depression explained 78.8% of impairments in insight and judgement. Impaired insight/judgement correlated positively with right-anterior N200 and was identified as the most significant co-efficient for depression. Disturbed selective-attention and executive function indexed by N100 and N200, respectively, are associated with poor insight and negative symptoms. A complex interaction exists between insight and depression. The current results demonstrate a biological basis of insight and depression and a complex interaction between the two, perhaps mediated by executive function, in early psychosis.

Systematic meta-analysis of the risk factors for deliberate self-harm before and after treatment for first-episode psychosis

Publisher: Wiley

Date: 09-01-2013

DOI: 10.1111/ACPS.12074

Abstract: Attempted suicide and deliberate self-injury can occur before or after presentation with a first-episode of psychosis. The aim of the study is to identify the factors associated with suicide attempts or deliberate self-injury before and after treatment for first-episode psychosis. A systematic review and meta-analysis of controlled studies of factors associated with either suicide attempts or deliberate self-injury, referred to here as deliberate self-harm (DSH). The pooled proportion of patients who reported DSH prior to treatment for first-episode psychosis was 18.4% (95% Confidence Interval (CI) 14.4-23.3, N = 18 studies, I(2) = 93.8). The pooled proportion of patients with DSH during the period of untreated psychosis was 9.8%, (95% CI 6.7-14.2, N = 5 studies, I(2) = 58.9). The pooled proportion of patients committing DSH during periods of follow up of between 1 and 7 years was 11.4%, (95% CI, 8.3-15.5, N = 13 studies, I(2) = 89.2). Categorical factors associated with an increased risk of DSH were a prior history of DSH (OR = 3.94), expressed suicide ideation (OR = 2.34), greater insight (OR = 1.64), alcohol abuse (OR = 1.68) and substance use (OR = 1.46). Continuous variables associated with an increased risk of DSH were younger age of onset (Standardized Mean Difference (SMD) = -0.28), younger age at first treatment (SMD = -0.18), depressed mood (SMD = 0.49) and the duration of untreated psychosis (SMD = 0.20). Depressed mood and substance use were associated with DSH both before and after treatment, negative symptoms were associated with DSH after treatment but not before treatment. Positive symptoms and social and global functioning were not associated with DSH. Younger age and the duration of untreated psychosis were associated with DSH before treatment but not after treatment. Earlier treatment of first-episode psychosis and successful treatment of depression and substance use could prevent some episodes of DSH and might reduce suicide mortality in early psychosis.

Facial emotion identification in early-onset psychosis

Publisher: Elsevier BV

Date: 12-2014

DOI: 10.1016/J.SCHRES.2014.10.035

Abstract: Facial emotion identification (FEI) deficits are common in patients with chronic schizophrenia and are strongly related to impaired functioning. The objectives of this study were to determine whether FEI deficits are present and emotion specific in people experiencing early-onset psychosis (EOP), and related to current clinical symptoms and functioning. Patients with EOP (n=34, mean age=14.11, 53% female) and healthy controls (HC, n=42, mean age 13.80, 51% female) completed a task of FEI that measured accuracy, error pattern and response time. Relative to HC, patients with EOP (i) had lower accuracy for identifying facial expressions of emotions, especially fear, anger and disgust, (ii) were more likely to misattribute other emotional expressions as fear or disgust, and (iii) were slower at accurately identifying all facial expressions. FEI accuracy was not related to clinical symptoms or current functioning. Deficits in FEI (especially for fear, anger and disgust) are evident in EOP. Our findings suggest that while emotion identification deficits may reflect a trait susceptibility marker, functional deficits may represent a sequelae of illness.

Using multiple methods to characterize the phenotype of individuals with a family history of major depressive disorder

Publisher: Elsevier BV

Date: 09-2013

DOI: 10.1016/J.JAD.2013.04.042

Abstract: Unaffected relatives (URs) of in iduals with major depressive disorder (MDD) are biologically more vulnerable to depression. We compare healthy URs and controls at the level of phenotype (symptoms and functioning) and endophenotype (negative emotion bias), and further investigate the interrelation between these and the contribution of environmental early life stress. URs (n=101), identified using Family History Screen interview methods and matched controls completed written and interview questions assessing symptoms of depression and anxiety, negative cognitive style, life functioning and early life stress. Biases in emotion processing were measured using a facial expression of emotion identification paradigm. Compared to controls, URs reported higher levels of depression and anxiety, a stronger negative cognitive bias, and poorer functioning and lower satisfaction with life. URs were slower to correctly identify fear and sad facial expressions. A slower response time to identify sad faces was correlated with lower quality of life in the social domain. Early life stress (ELS) did not contribute significantly to any outcome. The methodology relies on accurate reporting of participants' own psychiatric history and that of their family members. The degree of vulnerability varies among URs. A family history of depression accounts for subtle differences in symptom levels and functioning without a necessary role of ELS. A negative emotion bias in processing emotion may be one vulnerability marker for MDD. Biological markers may affect functioning measures before symptoms at the level of experience.

Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report

Publisher: Springer Science and Business Media LLC

Date: 04-08-2021

DOI: 10.1038/S41398-021-01533-1

Abstract: Side effects to antidepressant medications are common and can impact the prognosis of successful treatment outcome in people with major depressive disorder (MDD). However, few studies have investigated the severity of side effects over the course of treatment and their association with treatment outcome. Here we assessed the severity of side effects and the impact of treatment type and anxiety symptoms over the course of treatment, as well as whether side effects were associated with treatment outcome. Participants were N = 1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic MDD. Participants were randomised to receive escitalopram, sertraline, or venlafaxine-extended release with equal probability and reassessed at 8 weeks regarding Hamilton Rating Scale Depression (HRSD 17 ) and Quick Inventory of Depressive Symptomatology (QIDS-SR 16 ) remission and response. Severity of side effects were assessed using the Frequency, Intensity, and Burden of Side Effects Rating (FIBSER) scale and assessed at day 4 and weeks 2, 4, 6, and 8. Frequency, intensity, and burden of side effects were greatest at week 2, then only frequency and intensity of side effects gradually decreased up to week 6. Treatment type and anxiety symptoms did not impact the severity of side effects. A greater burden—but not frequency or intensity—of side effects was associated with poorer treatment outcome and as early as 4 days post-treatment. Together, this work provides an informative mapping of the progression of side effects throughout the treatment course and their association with treatment outcome. Importantly, the burden of side effects that are present as early as 4 days post-treatment predicts poorer treatment outcome and should be monitored closely. iSPOT-D: Registry name: ClinicalTrials.gov. Registration number: NCT00693849.

Does giving up substance use work for patients with psychosis? A systematic meta-analysis

Publisher: SAGE Publications

Date: 24-02-2012

DOI: 10.1177/0004867412440192

Abstract: To assess the extent to which ceasing the use of cannabis or other substances reduces the symptoms and social disability associated with psychotic illness. The electronic databases CINAHL, EMBASE, MEDLINE and PsycINFO were searched for peer-reviewed publications in English that report data about the characteristics of current and former substance-using patients diagnosed with psychotic illnesses. The searches yielded 328 articles, of which 23 studies met the inclusion criteria. Four key outcome variables positive symptoms, negative symptoms, ratings of depression and global function, and five other measures of outcome that were reported in five or more studies were examined using meta-analysis. Current substance-using patients were significantly younger than former substance-using patients (standardised mean difference (SMD) = −0.38), but did not differ in age at onset of psychosis, sex, level of education or marital status. Current substance users had higher scores on rating scales of positive symptoms (SMD = 0.29) and depression (SMD = 0.36), and lower scores on global function (SMD = −0.26) when compared with former substance users. There was a significant improvement in the ratings of positive symptoms, mood and global function among patients who stopped using substances during the first episode of psychosis, while improvements in the symptoms of patients with a more established psychotic illness did not reach statistical significance. The results suggest that substance use contributes to both the symptoms and the burden of disability experienced by patients with psychosis. Patients in the early stages of psychotic illness should be informed about the benefits of giving up substances earlier, rather than later in the illness. Psychiatric services should regard the treatment of substance use as an integral part of the treatment of psychotic disorders.

Verbal memory predicts treatment outcome in syndromal anxious depression: An iSPOT-D report

Publisher: Elsevier BV

Date: 2020

DOI: 10.1016/J.JAD.2019.09.028

Abstract: Major Depressive Disorder (MDD), anxiety disorders, and high levels of anxious symptoms are associated with impaired cognitive functioning. However, little is known of how cognitive functioning is impaired in people with anxious depression. Here, we compared cognitive functioning between people with anxious depression, non-anxious depression, and healthy controls. We also tested whether anxious depression moderated the relationship between cognitive functioning and treatment outcome. 1008 adults with MDD and 336 healthy controls completed IntegNeuro: a computerized cognitive functioning test battery. Participants were then randomised to one of three antidepressants and reassessed at 8 weeks using the 17-item Hamilton Depression Rating Scale (HRSD Syndromal anxious depression was associated with better psychomotor functioning and poorer working memory, cognitive flexibility and information processing speed compared to their non-anxious counterparts. HRSD anxious depression was associated with better psychomotor functioning compared to their non-anxious counterparts. Syndromal anxious depression moderated the relationship between verbal memory and treatment outcome. In people with syndromal anxious depression, poorer baseline verbal memory predicted poorer treatment outcome. As DSM-IV criteria was used, the DSM-5 anxious distress specifier characterisation of anxious depression could not be assessed CONCLUSIONS: Syndromal anxious depression is characterised by impaired executive functions and moderates the relationship between verbal memory functioning and treatment outcome.

Sex Differences in Functional Connectivity in First-Episode and Chronic Schizophrenia Patients

Publisher: American Psychiatric Association Publishing

Date: 09-2004

DOI: 10.1176/APPI.AJP.161.9.1595

Meta-analysis of randomised controlled trials with N-acetylcysteine in the treatment of schizophrenia

Publisher: SAGE Publications

Date: 11-12-2020

DOI: 10.1177/0004867419893439

Abstract: There is accumulating evidence that adjunctive treatment with We systematically reviewed Medline, EmCare, PsycINFO, Embase, CINAHL Complete, China Knowledge Resource Integrated Database and the Cochrane Clinical Trials online registry for randomised control trials of Seven studies, including Evidence supports the notion that

500-mA ECT - A proof of concept report

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 06-2015

DOI: 10.1097/YCT.0000000000000214

Inner speech is accompanied by a temporally-precise and content-specific corollary discharge

Publisher: Elsevier BV

Date: 09-2019

DOI: 10.1016/J.NEUROIMAGE.2019.04.038

Abstract: When we move our articulator organs to produce overt speech, the brain generates a corollary discharge that acts to suppress the neural and perceptual responses to our speech sounds. Recent research suggests that inner speech - the silent production of words in one's mind - is also accompanied by a corollary discharge. Here, we show that this corollary discharge contains information about the temporal and physical properties of inner speech. In two experiments, participants produced an inner phoneme at a precisely-defined moment in time. An audible phoneme was presented 300 ms before, concurrently with, or 300 ms after participants produced the inner phoneme. We found that producing the inner phoneme attenuated the N1 component of the event-related potential - an index of auditory cortex processing - but only when the inner and audible phonemes occurred concurrently and matched on content. If the audible phoneme was presented before or after the production of the inner phoneme, or if the inner phoneme did not match the content of the audible phoneme, there was no attenuation of the N1. These results suggest that inner speech is accompanied by a temporally-precise and content-specific corollary discharge. We conclude that these results support the notion of a functional equivalence between the neural processes that underlie the production of inner and overt speech, and may provide a platform for identifying inner speech abnormalities in disorders in which they have been putatively associated, such as schizophrenia.

Intrinsic Functional Connectomes Characterize Neuroticism in Major Depressive Disorder and Predict Antidepressant Treatment Outcomes

Publisher: Elsevier BV

Date: 03-2022

DOI: 10.1016/J.BPSC.2021.07.010

Neurophysiological correlates of excitement in men with recent-onset psychosis

Publisher: Medicinska Naklada d.o.o.

Date: 15-03-2018

DOI: 10.24869/PSYD.2018.64

Abstract: Right frontal function, as indicated by the N200 component of the event-related potential during target detection, has previously been associated with excitement (excitement, impulsivity, hostility, uncooperativeness) in men with a long-term diagnosis of schizophrenia. The current study investigated excitement in relation to N200 in men who had recently experienced their first episode of psychosis. Twenty men who had recently suffered their first psychotic episode underwent a clinical interview and auditory oddball task. Multiple linear regression analysis showed that 58% of the variance in the excitement symptom cluster was explained by a positive association with frontal midline N200 litude and an inverse association with right frontal N200 litude. The latter was not apparent in the initial correlation, suggesting suppression by the midline activity. These associations were not explained by drug use, medication or negative symptoms. However, the correlation between excitement and midline N200 was stronger in drug users, and that between right frontal N200 and excitement was stronger in nonusers. Findings support the independent contributions to excitement of mechanisms reflected in midline and right frontal N200 litude respectively during the early stages of psychosis.

Increased absolute magnitude of gamma synchrony in first-episode psychosis

Publisher: Elsevier BV

Date: 10-2008

DOI: 10.1016/J.SCHRES.2008.05.029

Abstract: Recent studies have explored a model of the disconnection hypothesis of schizophrenia through the demonstration of abnormal stimulus induced gamma phase synchrony (GPS). These studies have principally examined synchrony in the 40 Hz band elicited in post-stimulus time periods, relative to a pre-stimulus baseline. In this study we examined the absolute magnitude of GPS elicited by a selective attention task, in first-episode psychosis (FEP). We hypothesized that FEP would be associated with abnormalities in absolute GPS, particularly when required to selectively attend to task-relevant stimuli. Fifty-five first-episode psychosis (FEP) subjects and one hundred and ten matched healthy control subjects underwent an auditory oddball selective attention task during EEG recording. The absolute magnitude of GPS was extracted for the range 35-45 Hz, and time-locked to stimulus onset. GPS averaged were computed for oddball 'target' (task-relevant) and 'non-target' (task-irrelevant) stimuli, for each subject. FEP subjects showed a significant elevation in absolute GPS relative to controls, apparent across the 35-45 Hz range. This elevation was most marked in the left centro-temporal region, across the 800 ms post-stimulus period. In FEP subjects, the elevation in GPS was also greater for target compared to non-target stimuli, while healthy controls did not show a stimulus effect. These findings complement previous evidence for reductions in peak gamma synchrony, calculated relative to a pre-stimulus baseline, in schizophrenia. The results an excess of absolute GPS in schizophrenia may contribute to an inability to effectively integrate task-relevant information, which underlie psychotic symptoms.

Cumulative childhood interpersonal trauma is associated with reduced cortical differentiation between threat and non-threat faces in posttraumatic stress disorder adults

Publisher: SAGE Publications

Date: 09-03-2019

DOI: 10.1177/0004867418761578

Abstract: Posttraumatic stress disorder and childhood trauma frequently co-occur. Both are associated with abnormal neural responses to salient emotion stimuli. As childhood trauma is a risk factor for posttraumatic stress disorder, differentiating between their neurophysiological effects is necessary to elucidate the neural pathways by which childhood trauma exposure contributes to increased posttraumatic stress disorder risks. Face-specific N170 evoked response potentials for backward-masked (non-conscious) and conscious threat (fear, angry) and non-threat (happy) faces were measured in 77 adults (18–64 years old, 64% women, 78% right-handed) symptomatic for posttraumatic stress disorder. Differences in N170 peak litudes for fear-versus-happy and angry-versus-happy faces at bilateral temporo-occipital (T5, T6) sites were computed. The effect of cumulative exposure to childhood interpersonal trauma, other childhood trauma, adult trauma, depression and posttraumatic stress disorder symptom severity on the N170 response was assessed using hierarchical multiple regression analyses. T5 N170 peak litudes for non-conscious fear-versus-happy faces were inversely related to cumulative childhood interpersonal trauma after accounting for socio-demographic, clinical symptom and other trauma factors. Posttraumatic stress disorder Avoidance was positively associated with N170 peak litudes for non-conscious fear-versus-happy faces, primarily due to reduced N170 responsivity to happy faces. Childhood interpersonal trauma exposure is associated with reduced discrimination between fear and happy faces, while avoidance symptom severity is associated with d ened responsivity to automatically processed happy faces in posttraumatic stress disorder adults. Results are discussed in terms of the likely contributions of impaired threat discrimination and deficient reward processing during neural processing of salient emotion stimuli, to increased risks of posttraumatic stress disorder onset and chronicity in childhood interpersonal trauma–exposed adults.

Psychiatry and online social media: Potential, pitfalls and ethical guidelines for psychiatrists and trainees

Publisher: SAGE Publications

Date: 06-2012

DOI: 10.1177/1039856212447881

Abstract: This paper proposes ethical guidelines for psychiatrists and psychiatry trainees when interacting with social media. A three-stage process was followed in the development of these guidelines. A literature review provided situations and possible broad rules as to how social media could be ethically engaged. A roundtable discussion by a panel of invited psychiatrists, psychiatry trainees, psychologists, e-health practitioners, lawyers and consumers was held to discuss the situations and to better formulate the ethical principles upon which psychiatrists could act. These vignettes and principles were then broadly discussed at a seminar held at the 2011 RANZCP Congress. Finally, this paper was circulated to the original invitees for final comment. A set of recommendations for working with social media were developed. The new social media provides important avenues for communication, education and treatment. These avenues pose ethical and practical dilemmas that can be resolved by the application of established ethical principles. Practical recommendations for navigating social media are proposed.

Different psychopathological models and quantified EEG in schizophrenia

Publisher: Cambridge University Press (CUP)

Date: 09-1999

DOI: 10.1017/S0033291799008855

Abstract: Background. This study compared the ability of two different models of psychopathology in schizophrenia to account for findings in the quantified electroencephalogram (qEEG) recorded from midline sites in a group of 40 subjects with schizophrenia. The first model was based on the positive and negative syndrome dichotomy, the second was a tripartite model that resembled Liddle's syndromes of psychomotor poverty, disorganization and reality distortion (Liddle, 1987 a ). Methods. A group of 40 subjects with predominantly chronic schizophrenia was assessed with the Positive and Negative Syndrome Scale (PANSS) prior to the acquisition of their quantified electroencephalogram. The relationship between EEG data and symptomatology was explored, initially with the PANSS positive and negative subscales and then with a tripartite model derived from a principal component analysis of the 14 positive and negative subscale items. Results. The tripartite syndrome model showed a greater concordance with the qEEG of the subjects than the dichotomous model. ‘Psychomotor poverty’ was significantly positively correlated with both delta and beta power and ‘reality distortion’ was significantly positively correlated with alpha-2 power. No significant correlations between the positive and negative syndrome dichotomy and the qEEG were observed. Conclusions. This study lends support to the factor analysis of psychopathology, and specifically the tripartite syndrome model of schizophrenia, as a step in explicating the biological dimensions of the disorder.

Comparison of ictal electroencephalogram between ultrabrief- and brief-pulse right unilateral electroconvulsive therapy: A multitaper Jackknife analysis

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 12-2012

DOI: 10.1097/YCT.0B013E318255A3B6

Brain imaging predictors and the international study to predict optimized treatment for depression: study protocol for a randomized controlled trial

Publisher: Springer Science and Business Media LLC

Date: 2013

DOI: 10.1186/1745-6215-14-224

Progressive grey matter atrophy over the first 2–3 years of illness in first-episode schizophrenia: A tensor-based morphometry study

Publisher: Elsevier BV

Date: 08-2006

DOI: 10.1016/J.NEUROIMAGE.2006.03.041

Abstract: Little is known about the structural brain changes that occur over the first few years of schizophrenia, or how these changes differ from those associated with healthy brain development in adolescence and early adulthood. In this study, we aimed to identify regional differences in grey matter (GM) volume between patients with first-episode schizophrenia (FES) and matched healthy controls, both at the time of the patients' first psychotic episode (baseline condition) and 2-3 years subsequently (follow-up condition). Forty-one patients with FES and 47 matched healthy controls underwent a T1-weighted structural MRI scan. Of these participants, 25 FES patients and 26 controls returned 2-3 years later for a follow-up scan. Voxel-based morphometry in SPM2 was used to identify the regions of GM difference between the groups in the baseline condition, while tensor-based morphometry was used to identify the longitudinal change within subject over the follow-up interval. The FES patients exhibited widespread GM reductions in the frontal, parietal, and temporal cortices and cerebellum in the baseline condition, as well as more circumscribed regions of GM increase, particularly in the occipital lobe. Furthermore, the FES subjects were observed to lose considerably more GM over the follow-up interval than the controls, especially in the parietal and temporal cortices. We argue that the progressive GM atrophy we have found to be associated with the onset of schizophrenia arises from a dysfunction in the dramatic period of healthy brain development typically associated with adolescence.

Diagnosis-Related Regional Gray Matter Loss Over Two Years in First Episode Schizophrenia and Bipolar Disorder

Publisher: Elsevier BV

Date: 11-2005

DOI: 10.1016/J.BIOPSYCH.2005.04.033

Abstract: We examined gray- and white-matter brain volumes in first episode psychosis (FEP) at initial presentation and at two-year follow-up. We predicted that FEP subjects would show longitudinal reductions in fronto-temporal gray- and white-matter volumes compared with controls. Furthermore, we expected groups to be differentiated by diagnosis-related reductions. Twenty-five schizophrenia and 8 bipolar disorder FEP patients underwent a structural MRI scan at first presentation and 2 years later. Matched healthy subjects (n = 22) underwent a single identical scan. At initial presentation FEP subjects had significantly less gray- and white-matter than healthy subjects. Diagnostic dissociations were revealed both at first presentation and at follow-up. In schizophrenia patients, gray-matter deficits were observed in lateral and medial frontal regions and in bilateral posterior temporal lobe regions, with additional extensive losses over time in lateral fronto-temporal regions and left anterior cingulate gyrus. By contrast, gray matter deficit in bipolar patients was localized to bilateral inferior temporal gyri with additional loss over time observed only in the anterior cingulate cortex. The results are consistent with a dual process model of psychosis, in which the diagnosis-related gray matter loss is determined by neurodevelopmental gray-matter volumetric differences which predate symptom onset, and diagnosis-related neurodegenerative gray-matter loss over time.

Early life trauma predicts self-reported levels of depressive and anxiety symptoms in nonclinical community adults: Relative contributions of early life stressor types and adult trauma exposure

Publisher: Elsevier BV

Date: 2013

DOI: 10.1016/J.JPSYCHIRES.2012.08.006

Abstract: Exposure to early life trauma is a known risk factor for depression and anxiety disorders in adulthood. This study aimed to evaluate the relative contributions of early life versus adult trauma in predicting levels of depressive and anxiety symptoms in nonclinical community adults. 1209 nonclinical community adults (18-70 years 45% male) were assessed for mental health status, early life stressors, lifetime trauma exposure, and self-reported levels of depressive and anxiety symptoms. A subset of the full s le subjected to group comparisons (n = 1088) indicated that early life stressor exposure primarily accounted for significantly higher depressive and anxiety symptom scores when compared against adults reporting to be free of childhood stressor or adult trauma exposure. Subsequent hierarchical multiple regression analyses of this subset using five distinct early life stressor types, namely 'Interpersonal violation', 'Family breakup', 'Disasters/war', 'Familial health trauma/death' and 'Personal health trauma' derived from principal component analysis of a wide range of self-reported early stressor events in the full s le, showed childhood 'Interpersonal violation' differentially predicted higher self-reported depressive and anxiety symptom scores in both males and females. Adult trauma exposure did not significantly predict these symptom scores. These findings underline the relative importance of exposure to 'interpersonal violation' relative to other types of early life stressors and adult trauma in the risk of depressive and anxiety symptoms in nonclinical community adults.

Recovery Assessment Scale-Domains and Stages: Measurement capacity, relevance, acceptability and feasibility of use with young people

Publisher: Wiley

Date: 05-07-2020

DOI: 10.1111/EIP.12842

Abstract: The Recovery Assessment Scale-Domains and Stages (RAS-DS) is a self-rated measure of mental health recovery. While this instrument has demonstrated good measurement properties and acceptability to clinicians and consumers in adult mental health services, it has not been evaluated in the context of youth-focused mental health services. This study was established to evaluate the measurement properties, feasibility and acceptability of the RAS-DS in a youth mental health service context. Young people accessing a youth mental health service were invited to complete the RAS-DS and both young people and clinicians provided feedback about its usefulness. Analyses of the measurement properties of the RAS-DS were completed using Rasch analysis. Usability feedback was analysed using descriptive statistics and constant comparative analysis. Fifty-eight consumer-clinician dyads participated. Analyses revealed that items on the RAS-DS generally demonstrated good fit with the expectations of the Rasch model and clinician and consumer feedback was generally positive. Ninety-one percent of young people completed the RAS-DS in less than 15 minutes. Thirty-four percent of young people had measure scores above the level of the "hardest" item on the RAS-DS, suggesting that measurement precision is lower for in iduals at more advanced stages of recovery. This study demonstrates that the RAS-DS has acceptable measurement properties and was acceptable to young people and clinicians. Future research should explore the use of the RAS-DS by young people in other contexts as well as explore whether additional items could be added to capture the later stages of recovery for young people.

Quantum analysis of P3a and P3b from auditory single trial ERPs differentiates borderline personality disorder from schizophrenia

Publisher: Cold Spring Harbor Laboratory

Date: 23-09-2022

DOI: 10.1101/2022.09.23.509191

Abstract: Traditional approaches to EEG modelling use the methods of classical physics to reconstruct scalp potentials i n terms of explicit physical models of cortical neuron ensembles. The principal difficulty is that the multiplicity of cellular processes with an intricate array of deterministic and random factors prevents creation of consistent biophysical parameter sets. An original, empirically-testable solution has been recently achieved in our previous studies by a radical departure from the deterministic equations of classical physics to the probabilistic reasoning of quantum mechanics. This crucial step relocates elementary bioelectric sources of EEG signals from the cellular to the molecular level where positively and negatively ions are considered as elementary sources of electricity. The rationale is that despite dramatic differences in cellular machineries, statistical factors governed by the rules of central limit theorem produce EEG waveforms as a statistical aggregate of the synchronized activity of multiple closely-located microscale sources. Using the formalism of nonhomogeneous birth-and-death processes (BDP) the quantum models of microscale events are deduced and linked to the dynamics of macroscale EEG waveforms. This study expands these methods with new features for comprehensive analysis of event related potentials directly from single trials, i.e. the EEG segments which are closely related in timing to cognitive events. We derive a universal model of the components of single trial ERPs both in frequency and time domains. This, for the first time, enables us to quantify all significant cognitive components in single trial ERPs, providing an alternative to the traditional method of averaging. Given P300 as an important objective marker of psychiatric disorders, a methodology which reliably discloses the component compositions of this potential, may have specific diagnostic importance. In this study, reliable identification of the P3a and P3b components from an auditory oddball paradigm provided a means of differentiating borderline personality disorder from schizophrenia.

Functional disconnections in the direct and indirect amygdala pathways for fear processing in schizophrenia.

Publisher: Elsevier BV

Date: 02-2007

DOI: 10.1016/J.SCHRES.2006.11.023

Abstract: Schizophrenia patients show reduced neural activity, relative to controls, in the amygdala and its projection to the medial prefrontal cortex (MPFC) in response to fear perception. In this study we tested the hypothesis that schizophrenia is characterized by abnormal functional connectivity in the amygdala network underlying fear perception. Functional MRI images were acquired from 14 schizophrenia patients and 14 matched healthy control subjects during an emotion perception task, in which fearful and neutral facial expression stimuli were presented pseudorandomly under nonconscious (using masking) and conscious conditions. Both subtraction and functional connectivity analyses were undertaken using a region of interest approach. In response to fearful facial expressions, schizophrenia patients displayed reduced amygdala activity, compared to controls, in both the conscious and nonconscious conditions. The amygdala displayed a reversal of the normal pattern of connectivity with the brainstem, visual cortex, and also with the dorsal and ventral isions of the MPFC in the schizophrenia patients. The presence of functional disconnections in amygdala pathways suggests that schizophrenia patients have a failure in coordinating their automatic orienting to salient signals and the associated prefrontal monitoring of these signals.

Using a mobile health device to manage severe mental illness in the community: What is the potential and what are the challenges?

Publisher: SAGE Publications

Date: 08-08-2020

DOI: 10.1177/0004867420945782

Abstract: There has been a revolution in the use of mobile health devices for monitoring physical health. There is more recent interest in whether these devices can also be used for monitoring symptoms of mental illness. This paper considers how stress increases risk of mental deterioration and in iduals with mental illness are sensitive to the effects of stress. It discusses how an inexpensive mobile health device could be used for detecting physiological signs of stress: deviations in biometrics such as sleep, activity and arousal may reflect a stress response and increased risk of relapse. These biometrics can allow patients to self-monitor and clinicians to detect early warning signs. This paper reviews the measurement of electrodermal activity, actigraphy and heart rate to predict mental deterioration. It considers the advantages of continuous measurement and reviews studies using mobile health devices to monitor stress and psychosis. It describes the potential for using a mobile health device to manage and monitor severe mental illness in young adults. Finally, this paper considers challenges associated with this approach, particularly with regard to correctly interpreting the physiological data and integrating the mobile health device into clinical practice. This paper concludes a mobile health device has the potential to enhance care by improving detection of early warning signs and increasing the connection between clinicians and their patients.

Measurement and reporting of the duration of untreated psychosis

Publisher: Wiley

Date: 23-10-2008

DOI: 10.1111/J.1751-7893.2008.00080.X

Abstract: The aim of this study was to investigate the demographic, illness and methodological factors associated with mean and median duration of untreated psychosis (DUP). A systematic review and meta-analysis of the published studies of DUP and an examination of available DUP distributions. DUP was longer in s les with a higher proportion of patients with schizophrenia and was shorter in s les that included affective psychosis. Sex, age, and the methods of measuring the onset and end-point of DUP and the type of service in which the studies were performed did not contribute to the heterogeneity of the mean or median DUP values. Mean DUP is significantly prolonged by a small number of patients, and the median DUP is a poor indicator of the rate at which patients present. The DUP of patients with affective and non-affective psychosis should be examined separately in order to make measures of DUP more meaningful and comparable, and DUP should be reported using more comprehensive measures. We suggest a method of reporting DUP based on the rate of presentation of first-episode psychosis patients rather than the length of DUP.

Emotion circuits differentiate symptoms of psychosis versus mania in adolescents

Publisher: Informa UK Limited

Date: 29-09-2015

DOI: 10.1080/13554794.2014.960426

Abstract: The diagnostic boundary between schizophrenia and bipolar disorder can be unclear, particularly with early onset. We assessed if emotion brain circuits differentiate psychosis versus mania symptoms in a series of six early onset patients. Symptoms were dissociated by direction, awareness condition, and brain regions. Greater psychosis symptoms were correlated with greater prefrontal, anterior cingulate, amygdala, and fusiform face area activation during masked fear processing. By contrast, greater mania symptoms were correlated with less amygdala activation during unmasked fear and happy processing. This suggests emotion dysfunction in schizophrenia versus bipolar disorder may arise from partially distinct neural mechanisms of susceptibility.

Neurofeedback for post-traumatic stress disorder: systematic review and meta-analysis of clinical and neurophysiological outcomes

Publisher: Informa UK Limited

Date: 21-09-2023

DOI: 10.1080/20008066.2023.2257435

Neural processing of facial expressions of emotion in first onset psychosis

Publisher: Elsevier BV

Date: 11-2014

DOI: 10.1016/J.PSYCHRES.2014.06.017

Abstract: Schizophrenia is characterized by deficits in face and facial emotion processing. This is the first study using event-related potentials (ERPs) to investigate the corresponding neural activation in first onset psychosis. ERPs for 108 first onset psychosis participants and 108 matched healthy controls were recorded while they viewed facial expressions. Group differences on general (neutral) face processing and emotional valence were examined under both unmasked (conscious) and backward-masked (nonconscious implicit) conditions over frontal and temporo-occipital regions. Clinical significance was assessed by comparing diagnoses and correlating ERPs with symptoms. During general face processing, patients showed reduced activation within 70 ms and exaggerated later processing from 160 ms over the frontal region, with a negative shift in voltage over left temporal and occipital regions across the time course. In addition, from 70 ms onwards, patients showed a positive shift in voltage for disgust whereas controls showed a negative shift in voltage for fear and anger (both compared to happy) over temporo-occipital regions. Effects were related to disorganization and depression symptoms and (preliminarily) were apparent across psychotic diagnoses. These results suggest that first onset psychosis is characterized by general as well as emotion-specific face processing impairments from the earliest, automatic processing period.

The differential diagnosis of dementia using P300 latency

Publisher: Elsevier BV

Date: 10-1986

DOI: 10.1016/0006-3223(86)90220-9

Abstract: The P300 component was elicited by an auditory oddball paradigm in 55 normal adults from a wide age range: 19 patients with dementia, 17 patients with depression, and 15 patients with schizophrenia. Normal P300 latency at a given age was predicted by using an age regression equation that had been calculated on the basis of the entire normal s le. Using this procedure, an abnormal delay in latency (greater than 2 SD) was found in approximately 80% of the dementia patients. However, when normal latency was predicted with a slightly greater degree of reliability according to separate equations for adults younger and older than 63 years, an abnormal delay in P300 was found to be less sensitive and specific to dementia. Suggestions for enhancing the diagnostic utility of the P300 component are proposed.

Neuropsychological correlates of symptom profiles in first episode schizophrenia

Publisher: Elsevier BV

Date: 12-2004

DOI: 10.1016/J.SCHRES.2004.03.006

Abstract: This paper aimed to examine the relationship between the trichotomous symptom structure of psychopathology and neuropsychological functioning in young people with first episode schizophrenia (FES), most of whom were receiving atypical antipsychotic medication. This was with a view to providing insight into the underlying pathophysiology of the clinical symptoms of schizophrenia. Fifty-three young people (aged 13-25 years) with FES participated in the study. Subjects completed a comprehensive clinical and neuropsychological examination. Cognitive domain scores were correlated with composite scores relating to Disorganisation, Psychomotor Poverty and Reality Distortion. A significant association was identified between Disorganisation and Verbal Acquisition, Verbal Recall and Cognitive Flexibility. There were no significant associations between cognitive domains and either Reality Distortion or Psychomotor Poverty, nor with measures of depressive symptomatology. The present study provides preliminary evidence that symptoms associated with the Disorganisation factor are significantly associated with cognitive deficits suggesting impaired frontal-temporal functioning. Differences between the current findings and those of similar research may reflect the effects of different medication regimes, as well as the absence of illness chronicity.

Electrodermal responsivity distinguishes ERP activity and symptom profile in schizophrenia

Publisher: Elsevier BV

Date: 02-2003

DOI: 10.1016/S0920-9964(01)00368-1

Facial emotion identification in early-onset and first-episode psychosis: A systematic review with meta-analysis

Publisher: Elsevier BV

Date: 10-2014

DOI: 10.1016/J.SCHRES.2014.07.049

Abstract: Patients with chronic schizophrenia are characterized by deficits in identifying facial expressions of emotion, and these deficits relate to impaired social and occupational function. It is not yet known if these deficits are trait-like and present at the onset of psychosis, preceding a subsequent diagnosis of schizophrenia. Our objective was to systematically review and analyze the extant literature to assess if there is a consistent profile of emotion identification problems in early-onset and first-episode psychosis. We conducted a systematic review and meta-analysis of 12 peer-reviewed studies of facial emotion identification in early-onset and first-episode psychosis, published between 1980 and March 2013. We examined the average mean difference between patients and controls on measures of facial emotion identification. Findings suggest that patients with early-onset and first-episode psychosis have impairment in identifying facial expressions of biologically salient emotion. Across the 12 studies, the onset of psychosis was distinguished by a generalized effect of significantly poorer accuracy for identifying facial expressions of emotion than healthy controls, and this difference had a substantial effect size (d=-0.88, N=378, 95% CI=-1.42 to -0.32). Within this general effect some emotions were also harder for patients to identify than others, with the magnitude of impairment found to be (i) large for disgust, fear and surprise, and (ii) medium for sadness, and happiness. No between groups mean differences were found for anger or neutral facial expressions. Deficits in facial emotion identification are evident at first onset of a psychotic episode. The findings suggest that, over and above a generalized deficit in identifying facial emotion, patients may find some emotions harder to identifying than others. This reflects findings with chronic schizophrenia populations and suggests that emotion identification impairment represents a trait susceptibility marker, rather than a sequeale of illness. They signal the urgent need to treat emotion identification deficits at the onset of illness, which could improve functional outcomes.

Amygdala Reactivity to Emotional Faces in the Prediction of General and Medication-Specific Responses to Antidepressant Treatment in the Randomized iSPOT-D Trial

Publisher: Springer Science and Business Media LLC

Date: 31-03-2015

DOI: 10.1038/NPP.2015.89

Dynamic spectral analysis findings in first episode and chronic schizophrenia

Publisher: Informa UK Limited

Date: 2006

DOI: 10.1080/00207450500402977

Abstract: The quantified analysis of the electroencephalogram (qEEG) has enabled the extraction of additional psychophysiological information from the raw EEG, but in turn has introduced a number of distortions. This study compared Dynamic Spectral Analysis (DSA), a novel and mathematically stringent technique for the evaluation of qEEG activity with conventional power spectral analysis in subjects with both first episode and chronic schizophrenia and matched controls. Advantages of the technique in the automated processing of data, rejection of artefact, avoidance of artefact introduced by the mathematical trans-formation of the data and the identification of irregular low frequency artefactual activity "pi" are discussed in detail. Using this method, the study has confirmed past observations of increased slow wave activity in schizophrenia, and identified a decrease in peak frequency in the alpha band in the subjects with chronic schizophrenia. The two clinical groups differed in mean peak frequency in the delta band with the first episode schizophrenia subjects having a raised mean peak frequency and the subjects with chronic schizophrenia having a lowered mean peak frequency. The results suggest continued change in the EEG with illness chronicity in schizophrenia. These changes were most evident in the frequency domain emphasizing the importance of routine measurement of mean band frequencies in qEEG studies.

A retrospective matched case–control comparison of non-fatal hanging to non-fatal self-poisoning in a sample of Australian men and women

Publisher: SAGE Publications

Date: 09-03-2023

DOI: 10.1177/10398562231162240

Abstract: Our study examined the characteristics of in iduals who survived attempted hanging and compared this group to a randomly selected comparison group of patients with non-fatal self-poisoning. Non-fatal hanging cases were identified from case files from an Australian public hospital. They were matched by age, sex, and month of presentation with double the number of non-fatal self-poisoning cases. Patients were compared on demographic and clinical characteristics, as well as length of stay in hospital and discharge plan. Most non-fatal hanging patients were males with medium suicidal intent, and a significant proportion misused alcohol. In this group, women were more likely than men to have past psychiatric care, and men were more likely to misuse alcohol and stimulants. In comparison to the self-poisoning group, the non-fatal hanging group had higher suicidal intent but proportionally lower history of self-harm and psychiatric care, or benzodiazepine misuse. People who self-harm by hanging have higher suicidal intent, misuse alcohol more often, and are less likely to be in psychiatric care. They may benefit from a general community intervention, rather than one based upon interventions with people already in psychiatric care.

Neurophysiological markers of attention distinguish bipolar disorder and unipolar depression

Publisher: Elsevier BV

Date: 09-2020

DOI: 10.1016/J.JAD.2020.05.048

Corrigendum to “Failure to differentiate between threat-related and positive emotion cues in healthy adults with childhood interpersonal or adult trauma” (J. Psychiatr. Res. (2016) 78 (31–41) (S0022395616300449) (10.1016/j.jpsychires.2016.03.006))

Publisher: Elsevier BV

Date: 11-2017

DOI: 10.1016/J.JPSYCHIRES.2017.07.017

Impulsivity and Its Relationship With Lisdexamfetamine Dimesylate Treatment in Binge Eating Disorder

Publisher: Frontiers Media SA

Date: 31-08-2021

DOI: 10.3389/FPSYG.2021.716010

Abstract: High trait impulsivity is thought to contribute to the sense of loss of control over eating and impulses to binge eat experienced by those with binge eating disorder (BED). Lisdexamfetamine dimesylate (LDX), a drug approved for treatment of moderate to severe BED, has been shown to decrease impulsive features of BED. However, the relationship between LDX-related reductions of binge eating (BE) episodes and impulsivity has not yet been explored. Forty-one adults aged 18–40years with moderate to severe BED completed questionnaires and tasks assessing impulsivity at baseline and after 8weeks of 50–70mg of LDX. Twenty age-matched healthy controls were also assessed at two timepoints for normative comparison. Data were analysed using linear mixed models. BED participants exhibited increased self-reported motor, non-planning, cognitive and food-related impulsivity relative to controls but no differences in objective task-based measures of impulsivity. Food-related and non-planning impulsivity was significantly reduced by LDX, but not to normative levels. In iduals with higher baseline levels of motor and non-planning impulsivity, and loss of control over eating scores experienced the greatest reduction in BE frequency after 8weeks of LDX. Further, there were significant associations between the degree to which subjective loss of control over eating, non-planning impulsivity and BE frequency reduced after 8weeks of LDX. These data suggest that specific subjective measures of impulsivity may be able to predict who will have the greatest benefit from LDX treatment and that reductions in BE frequency may be moderated by concurrent reductions in non-planning impulsivity.

Fronto-limbic and autonomic disjunctions to negative emotion distinguish schizophrenia subtypes.

Publisher: Elsevier BV

Date: 05-2007

DOI: 10.1016/J.PSCYCHRESNS.2006.12.018

Abstract: Schizophrenia patients show a disconnection in amygdala-medial prefrontal cortex and autonomic arousal systems for processing fear. Concurrent functional magnetic resonance imaging [fMRI] and skin conductance recording were used to determine whether these disturbances are specific to fear, or present in response to other signals of danger. We also examined whether these disturbances distinguish a specific symptom profile. During scanning, 27 schizophrenia (13 paranoid, 14 nonparanoid) and 22 matched healthy control subjects viewed standardized facial expressions of fear, anger and disgust (versus neutral). Skin conductance responses [SCRs]were acquired simultaneously to assess phasic increases in arousal. 'With-arousal' versus 'without-arousal' responses were analysed using non-parametric methods. For controls, 'with-arousal' responses were associated with emotion-specific activity for fear (amygdala), disgust (insula) and anger (anterior cingulate), together with common medial prefrontal cortex [MPFC] engagement, as predicted. Schizophrenia patients displayed abnormally increased phasic arousal, with concomitant reductions in emotion-specific regions and MPFC. These findings may reflect a general disconnection between central and autonomic systems for processing signals of danger. This disjunction was most apparent in patients with a profile of paranoia, coupled with poor social function and insight. Heightened autonomic sensitivity to signals of fear, threat or contamination, without effective neural mechanisms for appraisal, may underlie paranoid delusions which concern threat and contamination, and associated social and interpersonal difficulties.

The TWIN-E Project in Emotional Wellbeing: Study Protocol and Preliminary Heritability Results Across Four MRI and DTI Measures

Publisher: Cambridge University Press (CUP)

Date: 06-2012

DOI: 10.1017/THG.2012.12

Abstract: Despite the significant advancements being made in the neurogenetics for mental health, the identification and validation of potential endophenotype markers of risk and resilience remain to be confirmed. The TWIN-E study (The Twin study in Wellbeing using Integrative Neuroscience of Emotion) aims to validate endophenotype markers of mental health across cognitive, brain, and autonomic measures by testing the heritability, clinical plausibility, and reliability of each of these measures in a large adult twin cohort. The specific gene and environmental mechanisms that moderate prospective links between endophenotype-phenotype markers and the final outcome of wellbeing will also be identified. TWIN-E is a national prospective study with three phases: I) baseline testing on a battery of online questionnaires and cognitive tasks, and EEG, MRI, and autonomic testing II) 12-month follow-up testing on the online assessments and III) randomized controlled trial of brain training. Minimum target numbers include 1,500 male/female twins (18–65 years) for the online assessments (Phase I and II), 300 twins for the EEG testing component, and 244 twins for the MRI testing component. For Phase III, each twin out of the pair will be randomized to either the treatment or waitlist control group to test the effects of brain training on mental health over a 30-day period, and to confirm the gene–environment and endophenotype contributions to treatment response. Preliminary heritability results are provided for the first 50% of the MRI subgroup ( n = 142) for the grey matter volume, thickness, and surface area measures, and white matter diffuse tensor imaging fractional anisotropy.

Profiling risk for depressive disorder by circuit, behavior and self-report measures of emotion function

Publisher: Elsevier BV

Date: 02-2017

DOI: 10.1016/J.JAD.2017.11.067

Abstract: Major depressive disorder (MDD) is characterized by maladaptions in affective brain circuitry and in emotion regulation. It remains unknown whether these maladaptions characterize first-degree relatives of probands who are unaffected yet have a higher risk of developing MDD. Participants were 72 unaffected first-degree relatives of probands with MDD and 66 matched non-relative controls. We investigated brain circuit function and self-reported emotion regulation strategies for reappraisal and suppression. During functional magnetic resonance imaging, we probed circuitry relevant to both negative and positive valence systems using facial expressions signaling potential threat, sadness and happiness, presented under both conscious and subliminal viewing conditions. We compared groups using a statistically controlled region of interest (ROI) approach including the amygdala, insula, anterior cingulate cortex (ACC), ventromedial prefrontal cortex and dorsolateral prefrontal cortex. We also used a data-driven cluster analytic approach for characterizing the relatives by their brain function profiles. As a group, relatives were distinguished by hyper-reactivity of the pregenual ACC during subliminal viewing of threat-related expressions but hypo-activation of the amygdala, insula and dorsal ACC during explicit viewing of the same threat-related expressions and sadness. When considered in idually, this brain function profile characterized two-thirds of relatives, and these relatives were also less likely to use reappraisal to regulate negative emotion. The design was cross-sectional and therefore does not provide direct evidence as to the trait- (versus state-) like profile observed in relatives. Familial risk for MDD may involve a disruption to the normal recruitment of neural circuits for appraising salient emotions, both implicit and explicit. Interventions targeting reappraisal strategies for regulating negative emotion may serve to buffer this risk.

Integrating a Mobile Health Device Into a Community Youth Mental Health Team to Manage Severe Mental Illness: Protocol for a Randomized Controlled Trial (Preprint)

Publisher: JMIR Publications Inc.

Date: 12-06-2020

DOI: 10.2196/PREPRINTS.19510

Abstract: ymptoms of mental illness are often triggered by stress, and in iduals with mental illness are sensitive to these effects. The development of mobile health (mHealth) devices allows continuous recording of biometrics associated with activity, sleep, and arousal. Deviations in these measures could indicate a stressed state requiring early intervention. This paper describes a protocol for integrating an mHealth device into a community mental health team to enhance management of severe mental illness in young adults. he aim of this study is to examine (1) whether an mHealth device integrated into a community mental health team can improve outcomes for young adults with severe mental illness and (2) whether the device detects periods of mental health versus deterioration. his study examines whether physiological information from an mHealth device prevents mental deterioration when shared with the participant and clinical team versus with the participant alone. A randomized controlled trial (RCT) will allocate 126 young adults from community mental health services for 6 months to standard case management combined with an integrated mHealth device (ie, physiological information is viewed by both participant and case manager: unWIRED intervention) or an unintegrated mHealth device (ie, participant alone self-monitors: control). Participants will wear the Empatica Embrace2 device, which continuously records electrodermal activity and actigraphy (ie, rest and activity). The study also examines whether the Embrace2 can detect periods of mental health versus deterioration. A variety of measurements will be taken, including physiological data from the Embrace2 participant and case manager self-report regarding symptoms, functioning, and quality of life chart reviews and ecological momentary assessments of stress in real time. Changes in each participant’s Clinical Global Impression Scale scores will be assessed by blinded raters as the primary outcome. In addition, participants and case managers will provide qualitative data regarding their experience with the integrated mHealth device, which will be thematically analyzed. he study has received ethical approval from the Western Sydney Local Health District Human Research Ethics Committee. It is due to start in October 2020 and conclude in October 2022. he RCT will provide insight as to whether an integrated mHealth device enables case managers and participants to pre-emptively manage early warning signs and prevent relapse. We anticipate that unWIRED will enhance early intervention by improving detection of stress and allowing case managers and patients to better engage and respond to symptoms. ustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000642987 www.anzctr.org.au/ACTRN12620000642987.aspx RR1-10.2196/19510

Electrocortical reactivity to negative and positive facial expressions in individuals with a family history of major depression

Publisher: Elsevier BV

Date: 07-2018

DOI: 10.1016/J.BIOPSYCHO.2018.05.015

Abstract: Facial expressions signaling threat and mood-congruent loss have been used to probe abnormal neural reactivity in major depressive disorder (MDD) and may be implicated in genetic vulnerability to MDD. This study investigated electro-cortical reactivity to facial expressions in 101 unaffected, adult first-degree relatives of probands with MDD and non-relative controls (n = 101). We investigated event-related potentials (ERPs) to five facial expressions of basic emotion: fear, anger, disgust, sadness and happiness under both subliminal (masked) and conscious (unmasked) presentation conditions, and the source localization of group differences. In the conscious condition, controls showed a distinctly positive-going shift in responsive to negative versus happy faces, reflected in a greater positivity for the VPP frontally and the P300 parietally, and less negativity for the N200. By contrast, relatives showed less differentiation of emotions, reflected in less VPP and P300 positivity, particularly for anger and disgust, which produced an enhanced N200 for sadness. These group differences were consistently source localized to the anterior cingulate cortex. The findings contribute new evidence for neural disruptions underlying the differentiation of salient emotions in familial risk for depression. These disruptions occur to the appraisal (∼200 ms post-stimulus) through to the context evaluation (∼300 ms+ post-stimulus) phases of emotion processing, consistent with theories that risk for depression involves biased or attenuated processing of emotion.

Do former substance users with psychosis differ in their symptoms or function from non-substance users? A systematic meta-analysis

Publisher: SAGE Publications

Date: 22-01-2013

DOI: 10.1177/0004867412474071

Abstract: To compare the symptoms and function of patients with psychosis who have ceased using substances to those who have psychosis but do not have a history of substance use. The databases EMBASE, MEDLINE and PsycINFO were searched for peer-reviewed publications in English reporting the characteristics of patients with psychotic illness who had stopped using substances and those who had never used substances. The searches yielded 20 articles that met the inclusion criteria. Four key outcome variables – positive symptoms, negative symptoms, depression and global function – and four other outcome measures reported in five or more studies were examined using meta-analysis. Former substance-using patients were significantly younger than non-substance-using patients and were more likely to be male, but did not differ in age at onset of psychosis or in their level of education. There were no significant differences between former substance users and non-substance users in ratings of positive symptoms, negative symptoms, depression or global function. Among first-episode patients there was a trend towards former substance users having less severe depressive symptoms than non-substance users. In contrast, among non-first-episode patients, former substance users had significantly more depressive symptoms than non-substance users. In studies rated as being of higher quality, former substance users had significantly less severe positive symptoms than non-substance users. The absence of significant differences between the two groups suggests that a history of substance use is not a poor prognostic indicator for patients who are able to stop using substances.

Misattribution of sensory input reflected in dysfunctional target[ratio ]non-target ERPs in schizophrenia

Publisher: Cambridge University Press (CUP)

Date: 11-2000

DOI: 10.1017/S0033291799002858

Abstract: Background. While numerous studies have found disturbances in the Event-Related Potentials (ERPs) of patients with schizophrenia linked to task relevant target stimuli (most notably a reduction in P300 litude), few have examined ERPs to task irrelevant non-targets. We hypothesize, from current models of dysfunction in information processing in schizophrenia, that there will be less difference between ERPs to targets and non-targets in patients with schizophrenia than in controls. Methods. EEGs were recorded for 40 subjects with schizophrenia and 40 age and sex matched controls during an auditory oddball reaction time task. ERPs to the targets and non-targets immediately preceding the targets were averaged separately. Results. There was a disturbance in ERPs to targets but also to non-targets (reduced N100 litude and earlier P200 latency) and the difference between target and non-target ERP components (N100 and P200 litude and P200 latency), was significantly reduced in the schizophrenic group compared with controls. Conclusions. These findings suggest a disturbance in processing task relevant and irrelevant stimuli, consistent with Gray's (1998) hypothesis of misattributions in the ‘match[ratio ]mismatch’ of novel (target) and familiar (non-target) sensory input compared with stored information.

The impact of melancholia versus non-melancholia on resting-state, EEG alpha asymmetry: Electrophysiological evidence for depression heterogeneity

Publisher: Elsevier BV

Date: 03-2014

DOI: 10.1016/J.PSYCHRES.2013.12.049

Abstract: While depression has been associated with relatively greater right than left frontal cortical activity - a neurophysiological marker reflecting greater activation of the withdrawal system - contradictory findings have been reported. It was hypothesised that melancholia would be associated with relative right frontal activation, in comparison to non-melancholia and controls. We collected 2-min of resting-state, eyes closed, electroencephalographic activity from a total of 237 participants including 117 patients with major depressive disorder (57 with melancholia, 60 with non-melancholia) and 120 healthy controls. In contrast to hypotheses, patients with non-melancholia displayed relative left frontal activation in comparison to controls and those with melancholia. These findings were associated with a small to moderate effect size (Cohen's d=0.30-0.34). Critically, patients with melancholic subtype did not differ from controls despite increased severity - relative to those with non-melancholia - on clinical measures. These results may reflect an increase in approach tendencies in patients with non-melancholia including reassurance seeking, anger or irritable aggression. Findings highlight the need for further research on the heterogeneity MDD.

Does the clozapine/norclozapine ratio predict cognitive performance in patients with clozapine-resistant schizophrenia?

Publisher: SAGE Publications

Date: 07-12-2022

DOI: 10.1177/00048674211062828

Selection of cognitive tests for trials of therapeutic agents - Authors' reply

Publisher: Elsevier BV

Date: 06-2016

DOI: 10.1016/S2215-0366(16)30097-9

Expectation maximisation classification and Laplacian based thickness measurement for cerebral cortex thickness estimation

Publisher: SPIE

Date: 08-03-2007

DOI: 10.1117/12.710510

Body integrity identity disorder: Response to Patrone

Publisher: BMJ

Date: 03-2010

DOI: 10.1136/JME.2009.033175

Gamma synchrony in first-episode schizophrenia: A disorder of temporal connectivity?

Publisher: American Psychiatric Association Publishing

Date: 03-2005

DOI: 10.1176/APPI.AJP.162.3.459

Abstract: There has been a convergence of models describing schizophrenia as a disconnection syndrome, with a focus on the temporal connectivity of neural activity. Synchronous gamma-band (40-Hz) activity has been implicated as a candidate mechanism for the binding of distributed neural activity. To the authors' knowledge, this is the first study to investigate "gamma synchrony" in first-episode schizophrenia. Forty medicated first-episode schizophrenia patients and 40 age- and sex-matched healthy comparison subjects participated in a conventional auditory oddball paradigm. Gamma synchrony, time-locked to target stimuli, was extracted from an ongoing EEG. The magnitude and latency of both early (gamma 1: -150 msec to 150 msec poststimulus) and late (gamma 2: 200 to 550 msec poststimulus) synchrony were analyzed with multiple analysis of variance. First-episode schizophrenia patients showed a decreased magnitude and delayed latency for global gamma 1 synchrony in relation to healthy comparison subjects. By contrast, there were no group differences in gamma 2 synchrony. These findings suggest that first-episode schizophrenia patients have a global decrease and delay of temporal connectivity of neural activity in early sensory response to task-relevant stimuli. This is consistent with cognitive evidence of perceptual integration deficits in this disorder and raises the possibility that a breakdown in the early synchrony of distributed neural networks is a marker for the onset of schizophrenia.

Childhood adversity, trauma and abuse: Context and consequences

Publisher: SAGE Publications

Date: 08-2011

DOI: 10.3109/00048674.2011.602209

Genetic correlations between wellbeing, depression and anxiety symptoms and behavioral responses to the emotional faces task in healthy twins

Publisher: Elsevier BV

Date: 06-2018

DOI: 10.1016/J.PSYCHRES.2018.03.042

Abstract: Currently there is a very limited understanding of how mental wellbeing versus anxiety and depression symptoms are associated with emotion processing behaviour. For the first time, we examined these associations using a behavioural emotion task of positive and negative facial expressions in 1668 healthy adult twins. Linear mixed model results suggested faster reaction times to happy facial expressions was associated with higher wellbeing scores, and slower reaction times with higher depression and anxiety scores. Multivariate twin modelling identified a significant genetic correlation between depression and anxiety symptoms and reaction time to happy facial expressions, in the absence of any significant correlations with wellbeing. We also found a significant negative phenotypic relationship between depression and anxiety symptoms and accuracy for identifying neutral emotions, although the genetic or environment correlations were not significant in the multivariate model. Overall, the phenotypic relationships between speed of identifying happy facial expressions and wellbeing on the one hand, versus depression and anxiety symptoms on the other, were in opposing directions. Twin modelling revealed a small common genetic correlation between response to happy faces and depression and anxiety symptoms alone, suggesting that wellbeing and depression and anxiety symptoms show largely independent relationships with emotion processing at the behavioral level.

A quasi-randomized feasibility pilot study of specific treatments to improve emotion recognition and mental-state reasoning impairments in schizophrenia

Publisher: Springer Science and Business Media LLC

Date: 24-10-2016

DOI: 10.1186/S12888-016-1064-6

Systematic meta-analysis of outcomes associated with psychosis and co-morbid substance use

Publisher: SAGE Publications

Date: 03-03-2014

DOI: 10.1177/0004867414525838

Abstract: To compare the symptoms and social function of patients with psychosis and current substance use to those with psychosis and no history of substance use. The databases EMBASE, MEDLINE and PsycINFO were searched for peer-reviewed publications in English that reported the characteristics of patients with psychotic illness who were current substance users and those who had never used substances. The searches yielded 22 articles that met the inclusion criteria. Meta-analysis was used to compare four key outcome variables: positive symptoms, negative symptoms, depression and social function – and three secondary outcomes: violence, self-harm and hospital admissions. Current substance-using patients were significantly younger than non-substance-using patients and were more likely to be male, but did not differ in age at onset of psychosis or in their level of education. Current substance users had higher ratings of positive symptoms and were more likely to have a history of violence. Older studies reported a stronger association between current substance use and positive symptoms than more recently published studies. Current substance users did not differ from non-users on measurements of negative symptoms, depressive symptoms, social function, self-harm, or the number of hospital admissions. Current substance users with psychosis may have more severe positive symptoms than patients who have never used substances, but this result should be interpreted with caution because of demographic differences between substance users and non-substance users.

Effect of antidepressant treatment on cognitive impairments associated with depression: A randomised longitudinal study

Publisher: Elsevier BV

Date: 05-2016

DOI: 10.1016/S2215-0366(16)00012-2

Amygdala Activation and Connectivity to Emotional Processing Distinguishes Asymptomatic Patients With Bipolar Disorders and Unipolar Depression

Publisher: Elsevier BV

Date: 04-2019

DOI: 10.1016/J.BPSC.2018.08.012

Abstract: Mechanistically based neural markers, such as amygdala reactivity, offer one approach to addressing the challenges of differentiating bipolar and unipolar depressive disorders independently from mood state and acute symptoms. Although emotion-elicited amygdala reactivity has been found to distinguish patients with bipolar depression from patients with unipolar depression, it remains unknown whether this distinction is traitlike and present in the absence of an acutely depressed mood. We addressed this gap by investigating patients with bipolar disorder (BP) and unipolar major depressive disorder (MDD) in remission. Supraliminal and subliminal processing of faces exhibiting threat, sad, happy, and neutral emotions during functional magnetic resonance imaging was completed by 73 participants (23 BP patients and 25 MDD patients matched for age and gender, number of depressive episodes and severity 25 age- and gender-matched healthy control subjects). We compared groups for activation and connectivity for the amygdala. BP patients had lower left amygdala activation than MDD patients during supraliminal and subliminal threat, sad, and neutral emotion processing and for subliminal happy faces. BP patients also exhibited lower amygdala connectivity to the insula and hippoc us for threat and to medial orbitofrontal cortex for happy supraliminal and subliminal processing. BP patients also demonstrated greater amygdala-insula connectivity for sad supraliminal and subliminal face processing. Both patient groups were distinct from control subjects across several measures for activation and connectivity. Independent of valence or level of emotional awareness, amygdala activation and connectivity during facial emotion processing can distinguish BP patients and MDD patients. These findings provide evidence that this neural substrate could be a potential trait marker to differentiate these two disorders largely independent of illness state.

The case for social-cognitive remediation in schizophrenia: A life well lived is more than remission from psychosis

Publisher: SAGE Publications

Date: 19-02-2013

DOI: 10.1177/0004867413479066

Failure to differentiate between threat-related and positive emotion cues in healthy adults with childhood interpersonal or adult trauma

Publisher: Elsevier BV

Date: 07-2016

DOI: 10.1016/J.JPSYCHIRES.2016.03.006

Abstract: Enhanced threat-related processing is associated with both elevated anxiety and childhood exposure to trauma. Given the paucity of evidence regarding the effects of childhood and adult trauma exposure on subsequent psychophysiological processes in the absence of psychopathology, we investigated the relative impacts of childhood interpersonal and non-interpersonal trauma, as well as adult trauma exposure on neural processing of threat in healthy adults. We measured peak litudes of the N170 face-sensitive visual ERP component response to non-conscious and conscious Angry (threat) versus Happy (non-threat, positive) and Neutral (non-threat baseline) faces at temporo-occipital sites (right-T6 left-T5) in 489 psychiatrically asymptomatic adults (aged 18-70 years, 54% women, 94% right-handed). N170 peak litude differences between Angry vs Happy or Neutral faces were calculated and subjected to hierarchical multiple regression analysis, with trauma types (childhood interpersonal, childhood non-interpersonal and adult trauma) entered as predictors of interest. After controlling for sociodemographic and health factors, N170 peak litudes for non-conscious Angry vs Happy faces were inversely associated with childhood interpersonal trauma at T6 and adult trauma exposure at T5. Post-hoc repeated measures ANOVA indicated that unlike adults without trauma exposure, trauma-exposed adults failed to show significantly reduced N170 responses to Happy relative to Angry faces during non-conscious processing. This suggests that childhood interpersonal and adult trauma exposure are associated with a failure to differentiate between non-threat or positive and threat-related emotion cues. This is consistent with generalised hypervigilance seen in PTSD, and suggests trauma exposure is associated with a generalized heightened responsivity to non-conscious non-threat or positive as well as threat-related emotion cues in psychiatrically healthy adults.

Emotion perception in schizophrenia: An eye movement study comparing the effectiveness of risperidone vs. haloperidol

Publisher: Elsevier BV

Date: 08-2003

DOI: 10.1016/S0165-1781(03)00166-5

Abstract: We used a psychophysiological marker of visual attention (the visual scanpath) to investigate the effects of atypical (risperidone) vs. typical (haloperidol) antipsychotic medication on facial emotion perception in schizophrenia (n=28) and healthy control (n=28) groups. Of the schizophrenia subjects, 15 were prescribed risperidone. Visual scanpaths to 'happy', 'sad' and 'neutral' faces were recorded using video-oculography, and concurrent emotion-recognition accuracy was assessed using multiple-option tasks. Compared to control subjects, both schizophrenia subgroups showed a restriction in visual scanning (reduced total fixation number and decreased scanpath length). Haloperidol-treated schizophrenia subjects exhibited an additional and consistent pattern of reduced attention (fixation) to salient features for neutral and happy. By contrast, risperidone-treated subjects showed a relatively greater attention to salient features for these expressions, in which they did not differ from controls. Recognition accuracy for happy and neutral showed a similar lack of impairment. These findings suggest that risperidone may play a specific role in schizophrenia in the ability to attend to salient features, and to integrate this information into an accurate percept for neutral and positive expressions in particular.

Electrodermal activity in schizophrenia: a quantitative study using a short interstimulus paradigm

Publisher: Elsevier BV

Date: 1999

DOI: 10.1016/S0006-3223(98)00056-0

Abstract: Electrodermal activity in response to short interstimulus interval (ISI) stimulation allows aspects of information processing to be examined, but such paradigms cause skin conductance responses (SCRs) to overlap. A signal decomposition method was developed and employed to score the overlapped SCRs. This is the first application of the method to the study of schizophrenia. Electrodermal activity of 30 medicated patients with schizophrenia and 50 normal controls was obtained using a conventional auditory oddball paradigm with an ISI of 1.3 sec. Tonic skin conductance level (SCL), phasic SCRs, SCR temporal dynamics, and a range of SCR variables in response to target tones were examined. The schizophrenic group showed reduced response rate, proportion of responders, SCR litude, rise time, peak latency, and steady-state response litude, over the trial compared with controls. There were no between-group differences in SCL or SCR onset time. The combined use of a conventional short ISI paradigm and the new SCR scoring method demonstrated new facets of electrodermal hyporeactivity in medicated patients with schizophrenia. The hyporeactivity could not be attributed to changes in tonic arousal or dysfunctions in peripheral sympathetic nerve conductance.

Default-mode and fronto-parietal network connectivity during rest distinguishes asymptomatic patients with bipolar disorder and major depressive disorder

Publisher: Springer Science and Business Media LLC

Date: 23-10-2021

DOI: 10.1038/S41398-021-01660-9

Abstract: Bipolar disorder (BD) is commonly misdiagnosed as major depressive disorder (MDD). This is understandable, as depression often precedes mania and is otherwise indistinguishable in both. It is therefore imperative to identify neural mechanisms that can differentiate the two disorders. Interrogating resting brain neural activity may reveal core distinguishing abnormalities. We adopted an a priori approach, examining three key networks documented in previous mood disorder literature subserving executive function, salience and rumination that may differentiate euthymic BD and MDD patients. Thirty-eight patients with BD, 39 patients with MDD matched for depression severity, and 39 age-gender matched healthy controls, completed resting-state fMRI scans. Seed-based and data-driven Independent Component analyses (ICA) were implemented to examine group differences in resting-state connectivity ( p FDR 0.05). Seed analysis masks were target regions identified from the fronto-parietal (FPN), salience (SN) and default-mode (DMN) networks. Seed-based analyses identified significantly greater connectivity between the subgenual cingulate cortex (DMN) and right dorsolateral prefrontal cortex (FPN) in BD relative to MDD and controls. The ICA analyses also found greater connectivity between the DMN and inferior frontal gyrus, an FPN region in BD relative to MDD. There were also significant group differences across the three networks in both clinical groups relative to controls. Altered DMN–FPN functional connectivity is thought to underlie deficits in the processing, management and regulation of affective stimuli. Our results suggest that connectivity between these networks could potentially distinguish the two disorders and could be a possible trait mechanism in BD persisting even in the absence of symptoms.

The impact of depression heterogeneity on inhibitory control

Publisher: SAGE Publications

Date: 05-01-2012

DOI: 10.1177/0004867411432073

Abstract: Objective: Major depressive disorder (MDD) is associated with deficits in executive cognitive function, including inhibitory control. However, inconsistencies have been found across studies. Depression is a heterogeneous disorder and these inconsistencies may therefore relate to heterogeneity in relatively small s les. Method: Here we sought to examine event-related potentials (ERPs) during a cognitive Go/No-Go task in melancholic ( n = 60) and non-melancholic depressed patients ( n = 54) relative to controls ( n = 114). Results: Behavioural responses indicate that inhibitory control processes are differentially affected by subtypes of depression such that melancholic patients exhibit a greater number of commission errors and more variable response rates in comparison to non-melancholic patients and controls respectively. However, ERPs do not differ during a cognitive Go/No-Go task when ERPs associated with correct responses are examined. Conclusions: These findings indicate that while patients with melancholia differ from patients without melancholia and controls, no neurophysiological differences are observed when controlling for observable behavioural impairment.

Delusions and dorso-medial frontal cortex volume in first-episode schizophrenia: A voxel-based morphometry study

Publisher: Elsevier BV

Date: 06-2009

DOI: 10.1016/J.PSCYCHRESNS.2008.07.011

Abstract: Of the few studies that have directly investigated the neuroanatomical correlates of delusions in patients with recent-onset schizophrenia, a number have paradoxically reported a positive correlation between delusion severity and regional grey matter volume. In order to explore this relationship, 31 patients with first-episode schizophrenia (FES) underwent a clinical interview and a T1-weighted structural MRI scan. Patients' scores on the Delusions subscale of the Positive and Negative Syndrome Scale were correlated with the volume of every voxel in their grey matter images in SPM99. Patients' delusion scores were found to correlate with the volume of a cluster of voxels located in the dorso-medial frontal cortex, centred on the medial frontal gyrus. Post-hoc analysis revealed that this 'region-of-correlation' was volumetrically reduced in the FES patients relative to a group of 21 matched healthy controls. The results of this study support the hypothesis that while a certain level of structural brain atrophy is necessary for delusion formation in patients with FES, excessive structural atrophy may in fact preclude the formation of highly systematized delusions.

The presentation of early-onset psychotic disorders

Publisher: SAGE Publications

Date: 09-10-2013

DOI: 10.1177/0004867412463615

Abstract: This study aims to describe the clinical course of psychotic disorders, including the premorbid history, symptoms and level of functioning in a group of children and adolescents treated by paediatric mental health services, mainly as inpatients. A s le of 45 children and adolescents with a psychotic disorder (mean age 13.2 years) was assessed using questionnaires, semi-structured interviews, parent interviews and file audit. The symptoms of those with a schizophrenia spectrum disorder (SSD) were compared to those with a mood disorder (MD). This population showed a high level of premorbid impairment, including previous treatment for other psychiatric disorders. As well as hallucinations and delusions, high levels of self-harm, aggression, anxiety and depression were reported. The SSD and MD groups differed mainly in their levels of premorbid functioning. While it is well known that childhood-onset schizophrenia is a severe disorder with a poor outcome, this study found that young people diagnosed with other psychotic disorders also have significant impairment and are likely to require high levels of care to maximize their functional recovery.

Comparison of antidepressant effects between brief and ultrabrief pulse unilateral electroconvulsive therapy: Brief report of a randomized double-blind trial

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 12-2011

DOI: 10.1097/YCT.0B013E318218945E

Functional dysconnectivity in schizophrenia and its relationship to neural synchrony

Publisher: Informa UK Limited

Date: 07-2013

DOI: 10.1586/14737175.2013.811899

Abstract: Schizophrenia is a debilitating disorder of unknown cause. There is increasing momentum to consider functional dysconnectivity as an endophenotype of schizophrenia, and in particular, how it relates to cognition as a core feature of the disorder. Here, the authors review the conceptual models of functional dysconnectivity in schizophrenia to date, the evidence they are based on and some of the limitations of these models. The authors then propose 'neural synchrony' as a potential mechanism for functional dysconnectivity and review the current state of evidence for a link between neural synchrony and cognition in schizophrenia across behavioral, physiological, brain imaging, neurochemical and neurogenetic units of enquiry. The authors conclude by outlining the unmet needs in this field and give an outlook on how to fill these gaps.

Cognitive remediation: The foundation of psychosocial treatment of schizophrenia

Publisher: SAGE Publications

Date: 08-04-2013

DOI: 10.1177/0004867413484524

Characterising anxiety in major depressive disorder and its use in predicting antidepressant treatment outcome: An iSPOT-D report

Publisher: SAGE Publications

Date: 18-03-2019

DOI: 10.1177/0004867419835933

Abstract: Major depressive disorder commonly co-occurs with one or more anxiety disorders or with clinically significant levels of anxiety symptoms. Although evidence suggests that anxious forms of depression are prognostic of poorer antidepressant outcomes, there is no clear definition of anxious depression, and inferences about clinical outcomes are thus limited. Our objective was to compare and evaluate definitions of anxious depression and anxiety-related scales according to clinical and antidepressant outcome criteria. A total of 1008 adults with a current diagnosis of single-episode or recurrent, nonpsychotic, major depressive disorder were assessed at baseline on clinical features. Participants were then randomised to one of three antidepressants and reassessed at 8 weeks regarding remission and response of the 17-item Hamilton Rating Scale Depression (HRSD 17 ) and the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR 16 ). Anxious depression was defined as major depressive disorder with one or more anxiety disorders or major depressive disorder with a HRSD 17 anxiety/somatisation factor score ⩾7. Anxiety-related scales included the HRSD 17 anxiety/somatisation factor and the 42-item Depression Anxiety Stress Scales (DASS 42 ) anxiety and stress subscales. Anxious depression definitions showed poor agreement (κ = 0.15) and the HRSD 17 anxiety/somatisation factor was weakly correlated with both DASS 42 anxiety ( r = 0.24) and stress subscales ( r = 0.20). Anxious depression definitions were also associated with few impairments on clinical features and did not predict poorer antidepressant treatment outcome. However, higher DASS 42 anxiety predicted poorer HRSD 17 and QIDS-SR 16 remission, and item-level analysis found higher scores on items 9 (situational anxiety) and 23 (somatic anxiety) of the DASS 42 predicted poorer treatment outcome, even after adjusting for covariates and multiple comparisons. Common definitions of anxious depression show poor agreement and do not predict poorer treatment outcome. Anxiety symptoms may be better characterised dimensionally using DASS 42 when predicting treatment outcome.

Erratum: Synchronous gamma oscillations in first episode psychosis (Australian and New Zealand Journal of Psychiatry (2005) vol. 39 (2) (A15))

Publisher: SAGE Publications

Date: 08-2006

DOI: 10.1111/J.1440-1614.2006.01856.X

Characterizing neurocognitive markers of familial risk for depression using multi-modal imaging, behavioral and self-report measures

Publisher: Elsevier BV

Date: 06-2019

DOI: 10.1016/J.JAD.2019.04.078

Abstract: Major depressive disorder (MDD) is associated with poorer behavioral performance in domains of working memory and associated cognitive systems for cognitive control and attention. Functional neuroimaging studies show altered functioning in MDD in frontal executive control circuits implicated in these cognitive processes. It is not yet known whether poor cognitive performance involving these circuits is part of the familial risk for MDD, and we addressed this issue using a multi-modal imaging, behavioral and self-report approach in unaffected first-degree relatives of parent probands with MDD. 72 unaffected adult first-degree relatives of probands with MDD (mean age 30.5 ± 13.4 years) with and 66 case-wise matched non-relative controls underwent functional magnetic resonance imaging during performance of 'n-back' working memory task, a Go/No-go task assessing cognitive control and an Auditory Oddball test of selective attention. Groups were compared on imaging data analyzed voxel wise with a focus on dorsolateral prefrontal cortex, anterior cingulate cortex and insula regions of interest, and on corresponding behavioral accuracy and reaction time data. Symptoms were assessed using self-report scales. Relatives were distinguished by comparatively decreased activation in the left dorsolateral prefrontal cortex (DLPFC) during updating of working memory. Behaviorally, relatives also showed more errors of omission during working memory updating. DLPFC hypo-activation was associated with greater depressive symptom severity. Deficits in cognitive processing may be part of the profile of familial risk for depression, preceding illness onset, specifically in the domain of working memory.

N-acetylcysteine (NAC) in schizophrenia resistant to clozapine: a double blind randomised placebo controlled trial targeting negative symptoms.

Publisher: Springer Science and Business Media LLC

Date: 15-09-2016

DOI: 10.1186/S12888-016-1030-3

Target and non-target ERP disturbances in first episode vs. chronic schizophrenia

Publisher: Elsevier BV

Date: 11-2002

DOI: 10.1016/S1388-2457(02)00290-0

Abstract: Event-related potential (ERP) abnormalities to target stimuli are reliably found in schizophrenia. However, as people with schizophrenia are thought to have difficulty discerning the relevance of incoming sensory stimuli it is also important to examine ERPs to non-targets. To differentiate between potential trait markers of the disease and deficits that might be associated with the consequence of illness chronicity, this study investigated ERPs to both target and non-target stimuli in groups of people with either first episode or chronic schizophrenia (CSz). Using an auditory oddball paradigm, ERPs to target, non-target before target (Nt before) and non-target after target (Nt after) stimuli were analysed for 40 patients with CSz, 40 patients with first episode schizophrenia (FESz) and two groups of normal controls matched for age and sex with their patient counterparts. The FESz group showed the same pattern of litude disturbance as the CSz group to both targets (reduced N100, N200, P300 and increased P200) and non-targets (reduced N100) compared to controls. Both CSz and FESz groups also failed to show the changes to the P200-N200 component between targets and non-target stimuli that was exhibited by controls (smaller earlier P200 to targets vs. increased delayed P200 to non-targets) or the reduction in N100 litude of ERPs to the Nt after stimuli compared with ERPs to the Nt before stimuli. Previous literature has focussed on the sensitivity of P300 deficits in classifying persons into schizophrenia and non-schizophrenia groups. This study demonstrated improved accuracy in the classification of patients with schizophrenia from controls using discriminant analysis of target and non-target N100 and P200 components. The results suggest that ERP disturbances are evident at the time of first referral to mental health services and may be a potential trait (rather than secondary effect) of the illness. It is important to include both target and non-target stimuli processing, and their interrelationship in future research.

Investigating neural circuits of emotion regulation to distinguish euthymic patients with bipolar disorder and major depressive disorder

Publisher: Wiley

Date: 09-01-2021

DOI: 10.1111/BDI.13042

Abstract: Up to 40% of patients with bipolar disorder (BD) are initially diagnosed as having major depressive disorder (MDD), and emotional lability is a key aspect of both sets of mood disorders. However, it remains unknown whether differences in the regulation of emotions through cognitive reappraisal may serve to distinguish BD and MDD. Therefore, we examined this question in euthymic BD and MDD patients. Thirty‐eight euthymic BD, 33 euthymic MDD and 37 healthy control (HC) participants, matched for age, gender and depression severity, engaged in an emotion regulation (ER) cognitive reappraisal task during an fMRI scan were examined. Participants either reappraised (Think condition) or passively watched negative (Watch condition) or neutral (Neutral condition) pictures and rated their affect. Activation and connectivity analyses were used to examine group differences in reappraisal (Think vs Watch) and reactivity (Watch vs Neutral) conditions in ER‐specific neural circuits. Irrespective of group, participants rated most negatively the images during the Watch condition relative to Think and Neutral conditions, and more negatively to Think relative to Neutral. Notably, BD participants exhibited reduced subgenual anterior cingulate activation (sgACC) relative to MDD during reappraisal, but exhibited greater sgACC activation relative to MDD during reactivity, whereas MDD participants elicited greater activation in right amygdala relative to BD during reactivity. We found no group differences in task‐related connectivity. Euthymic BD and MDD patients engage differential brain regions to process and regulate emotional information. These differences could serve to distinguish the clinical groups and provide novel insights into the underlying pathophysiology of BD.

Does Adding Social Cognitive Remediation Therapy to Neurocognitive Remediation Therapy Improve Outcomes in Young People With a Severe Mental Illness?—The Advantage Trial

Publisher: Frontiers Media SA

Date: 14-03-2022

DOI: 10.3389/FPSYT.2021.789628

Abstract: Cognitive impairments are a common and significant issue for young people with a severe mental illness. Young people with schizophrenia, bipolar disorder and major depression all experience significant cognitive problems that impede their ability to return to work or study. These neurocognitive problems are frequently exacerbated by social cognitive deficits that interfere with their ability to integrate into the community and understand the social and emotional nuances about them. This study aimed to assess if the addition of a social cognitive remediation treatment to a neurocognitive remediation therapy improved functional outcome. Five youth mental health services were trained in both the Neuropsychological Educational Approach to Remediation (NEAR) and the Social Cognition and Interaction Training (SCIT) treatments. Participants were randomised between receiving either NEAR + SCIT or NEAR + treatment as usual (TAU) over a 20-week period, with all participants receiving the NEAR treatment first. Symptoms, neurocognition, social cognition and functioning were examined at baseline, end of treatment and at 3 months follow-up and compared between the two arms of the study. The primary outcome was function. Thirty-nine participants were randomised to treatment (Schizophrenia spectrum = 28, Bipolar disorder = 7, Major Depression = 2). The trial was curtailed by Covid-related service restrictions. There was an overall significant improvement in function over time with a trend towards a greater improvement in the NEAR + SCIT arm. No changes in symptoms, neurocognitive or social cognitive measures were seen. While 74% completed treatment only 49% agreed to follow up at 3 months affecting our ability to interpret the findings. Attrition did not differ by arm. In a pragmatic, service-based research project, treatment aimed at improving cognition enhanced functional outcome in young people with a range of severe mental illnesses. There was a trend towards improved function in young people who had a combined NEAR + SCIT approach. Identifier: ACTRN12622000192785.

Sex differences in the shared genetics of dimensions of self-reported depression and anxiety

Publisher: Elsevier BV

Date: 12-2015

DOI: 10.1016/J.JAD.2015.08.053

Abstract: The prevalence of depression and anxiety symptoms and their comorbidity varies between males and females for reasons still unknown. This study aims to test whether differences between males and females in self-reported symptoms and their covariation are caused by variations in the magnitude of genetic and environmental factors. 750 monozygotic and dizygotic healthy twin pairs (18-60 years M=39.77 years) participated in the TWIN-E project. Univariate and multivariate genetic modelling was undertaken using the Depression Anxiety Stress Scale (DASS-42). Additive genetics and unique environment contributed to self-reported depression (heritability, h(2): 34%), anxiety (h(2): 30%) and stress (h(2): 34%) scores in univariate models, and to the common latent factor (h(2): 39%) in the multivariate model. No sex differences in magnitude of estimates for DASS-42 scores were found in the univariate model. However when considering correlated depression and anxiety symptomatology only shared genetic factors between depression and anxiety contributed to depression scores in males, but both specific and shared genetic factors contributed to depression scores in females. The results are limited to the s le of healthy, community, adult, same sex twin pairs who participated in the study. Differences in males and females in genetic aetiology of self-reported dimensions of depression are only apparent when taking into consideration the covariation with self-reported anxiety. This difference is highlighted by the finding that both common and specific genetic factors contribute to self-reported depression in females but not males. This novel finding may help explain the increased incidence of depression symptoms in females.

Longitudinal changes in neuroanatomy and neural activity in early schizophrenia

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 03-2007

DOI: 10.1097/WNR.0B013E3280119D31

Spatio-temporal EEG waves in first episode schizophrenia

Publisher: Elsevier BV

Date: 09-2009

DOI: 10.1016/J.CLINPH.2009.06.020

Abstract: Schizophrenia is characterized by a deficit in context processing, with physiological correlates of hypofrontality and reduced litude P3b event-related potentials. We hypothesized an additional physiological correlate: differences in the spatio-temporal dynamics of cortical activity along the anterior-posterior axis of the scalp. This study assessed latency topographies of spatio-temporal waves under task conditions that elicit the P3b. EEG was recorded during separate auditory and visual tasks. Event-related spatio-temporal waves were quantified from scalp EEG of subjects with first episode schizophrenia (FES) and matched controls. The P3b-related task conditions elicited a peak in spatio-temporal waves in the delta band at a similar latency to the P3b event-related potential. Subjects with FES had fewer episodes of anterior to posterior waves in the 2-4 Hz band compared to controls. Within the FES group, a tendency for fewer episodes of anterior to posterior waves was associated with high Psychomotor Poverty symptom factor scores. Subjects with FES had altered global EEG dynamics along the anterior-posterior axis during task conditions involving context update. The directional nature of this finding and its association with Psychomotor Poverty suggest this result is related to findings of hypofrontality in schizophrenia.

Impairment and distress patterns distinguishing the melancholic depression subtype: An iSPOT-D report

Publisher: Elsevier BV

Date: 03-2015

DOI: 10.1016/J.JAD.2014.10.046

Abstract: This study seeks to provide a comprehensive and systematic evaluation of baseline clinical and psychological features and treatment response characteristics that differentiate Major Depressive Disorder (MDD) outpatients with and without melancholic features. Reflecting the emphasis in DSM-5, we also include impairment and distress. Participants were assessed pre-treatment on clinical features (severity, risk factors, comorbid conditions, illness course), psychological profile (personality, emotion regulation), functional capacity (social and occupational function, quality of life) and distress/coping (negativity bias, emotional resilience, social skills, satisfaction with life). Participants were randomized to sertraline, escitalopram or venlafaxine extended-release and re-assessed post-treatment at 8 weeks regarding remission, response, and change in impairment and distress. Patients with melancholic features (n=339 33.7%) were distinguished clinically from non-melancholics by more severe depressive symptoms and greater exposure to abuse in childhood. Psychologically, melancholic patients were defined by introversion, and a greater use of suppression to regulate negative emotion. Melancholics also had poorer capacity for social and occupational function, and physical and psychological quality of life, along with poorer coping, reflected in less emotional resilience and capacity for social skills. Post-treatment, melancholic patients had lower remission and response, but some of this effect was due to the more severe symptoms pre-treatment. The distress/coping outcome measure of capacity for social skills remained significantly lower for melancholic participants. Due to the cross-sectional nature of this study, causal pathways cannot be concluded. Findings provide new insights into a melancholic profile of reduced ability to function interpersonally or effectively deal with one׳s emotions. This distinctly poorer capacity for social skills remained post-treatment. The pre-treatment profile may account for some of the difficulty in achieving remission or response with treatment.

Westmead Institute For Medical Research

Location: Australia

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University Of Sydney

Location: Australia

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The Development Of Australian Community Psychiatry

Start Date: 2020

End Date: 2023

Funder: Australian Research Council

The Electrophysiological Signature Of Inner Speech

Start Date: 2017

End Date: 2019

Funder: Australian Research Council

Gene-brain Pathways In Emotional Brain Stability And Instability

Start Date: 2008

End Date: 2011

Funder: Australian Research Council

Brain Connectivity Imaging Markers To Confirm Diagnosis For Bipolar Vs. Unipolar Depression  A Connectome Approach.

Start Date: 2015

End Date: 2018

Funder: National Health and Medical Research Council

N-Acetyl Cysteine In Schizophrenia Resistant To Clozapine: A Double-Blind Randomised Placebo-Controlled Trial Targeting Negative Symptoms

Start Date: 2016

End Date: 2019

Funder: National Health and Medical Research Council

GEM Study: General And Emotional Cognition In First Onset Psychosis

Start Date: 2011

End Date: 2015

Funder: National Health and Medical Research Council

BRAINnet: Brain Research And Integrative Neuroscience Network

Start Date: 2003

End Date: 2003

Funder: Australian Research Council

Discovery Projects - Grant ID: DP190103655

Start Date: 02-2020

End Date: 12-2022

Amount: $233,000.00

Funder: Australian Research Council

Special Research Initiatives - Grant ID: SR0354494

Start Date: 2004

End Date: 02-2004

Amount: $10,000.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP0883621

Start Date: 05-2009

End Date: 05-2013

Amount: $670,000.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP170103094

Start Date: 2017

End Date: 06-2020

Amount: $304,000.00

Funder: Australian Research Council