- Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. [Review]
- NRNeuropsychol Rev 2018 Oct 20
- Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated wit...
Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with poorer functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.
- Probiotic Treatment in Individuals with Euthymic Bipolar Disorder: A Pilot-Study on Clinical Changes and Compliance. [Journal Article]
- NNeuropsychobiology 2018 Oct 19; :1-9
- The importance of the microbiome for psychological well-being has gained rising interest in the last decade. A strategy to examine the role of the microbiome in different diseases is the intake of su...
The importance of the microbiome for psychological well-being has gained rising interest in the last decade. A strategy to examine the role of the microbiome in different diseases is the intake of supplements that modulate the gut microbiome. Despite promising results in animal studies, research in humans is sparse to date and especially in individuals with psychiatric disorders almost missing. The current report of the ProbioBIP-one pilot study aims at describing general effects of the intake of the probiotic OMNi-BiOTiC Stress repair® on psychological parameters as well as gastrointestinal symptoms and general compliance in a cohort of euthymic individuals with bipolar disorder (BD), receiving daily probiotic treatment over a time period of 3 months. Twenty-seven individuals with BD took part in the present study (mean age = 50.7 years, SD = 12.2; females 40.7%). In sum, there was a high compliance rate with 81.5% of the study participants completing all 3 study visits and 85% of planned probiotic ingestions taken. Gastrointestinal problems were prevalent in more than half of the patients at the time of inclusion (t1). Expectedly, in the whole cohort, a high proportion of study participants experienced changes concerning digestion during probiotic treatment, around one third reported positive changes (reduced flatulence and easier and more frequent bowel movements) after 1 month (t2) and further after 3 months (t3). In contrast, a smaller part of study participants reported gastrointestinal discomfort after 1 and after 3 months (mainly flatulence and obstipation). We found a significantly reduced cognitive reactivity to sad mood between t2 and t3 indicating that participants under probiotic supplementation perceived themselves to be less distracted by ruminative thoughts. Further changes in psychiatric symptoms were small due to the euthymic state and already low scoring at the time of inclusion. Nevertheless, we found a significant symptom reduction in the rating scales measuring manic symptoms. From a clinical point of view, probiotic supplementation might provide a well-tolerated tool to positively influence gastrointestinal quality of life as well as mental and somatic health, cognition and immune response and potentially have effects on psychiatric symptoms.
- Attitudes about smoking cessation treatment, intention to quit, and cessation treatment utilization among young adult smokers with severe mental illnesses. [Journal Article]
- ABAddict Behav 2018 Sep 25; 89:248-255
- CONCLUSIONS: Young adults with schizophrenia, bipolar disorder and other severe mental illnesses (SMI) have high rates of smoking, but little research has evaluated predictors of cessation activity and treatment utilization in this group.Perceptions of traditional cessation treatments improved somewhat after brief interventions, but most young adult smokers with SMI did not use cessation treatment. Instead, interventions led to quit attempts without treatment.
- Amygdala Activation and Connectivity to Emotional Processing Distinguishes Asymptomatic Patients With Bipolar Disorders and Unipolar Depression. [Journal Article]
- BPBiol Psychiatry Cogn Neurosci Neuroimaging 2018 Aug 31
- CONCLUSIONS: 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.
- Effects of childhood trauma on adult moral decision-making: Clinical correlates and insights from bipolar disorder. [Journal Article]
- JAJ Affect Disord 2018 Oct 05; 244:180-186
- CONCLUSIONS: The present study is limited by the self-reported nature of the CTQ and by the small number of trials of moral dilemmas. In addition, practical and clinical implications of the moral dilemmas paradigm are limited due to its abstract nature.Our results indicate that certain clinical features as well as childhood maltreatment (in particular neglect) may significantly impact moral decision making in adult life. Surprisingly, childhood trauma was associated with a more utilitarian style, which is in the opposite direction from previous effects shown in PTSD. Although speculative, our results suggest that there may be a protective quality associated with utilitarian moral decision-making tendencies.
- Differential clinical characteristics and possible predictors of bipolarity in a sample of unipolar and bipolar inpatients. [Journal Article]
- PRPsychiatry Res 2018 Jun 20
- Major affective conditions including both unipolar (UD) and bipolar disorders (BD) are associated with significant disability throughout the life course. We aimed to investigate the most relevant soc...
Major affective conditions including both unipolar (UD) and bipolar disorders (BD) are associated with significant disability throughout the life course. We aimed to investigate the most relevant socio-demographic/clinical differences between UD and BD subjects. Our sample included 180 inpatients, of which 82 (45.5%) participants were diagnosed with UD and 98 (54.5%) with BD. Relative to UD patients, BD individuals were more likely to report prior psychoactive medications, lifetime psychotic symptoms, nicotine abuse, a reduced ability to provide to their needs, gambling behavior, and fewer nonsuicidal self-harm episodes. Moreover, BD patients were more likely to report severe side effects related to medications, a younger age at illness onset and first hospitalization, higher illness episodes, and longer illness duration in years than UD subjects. In a multivariate logistic analysis accounting for age, gender, and socio-demographic characteristics, a significant positive contribution to bipolarity was found only for higher lifetime psychotic symptoms (β = 1.178; p ≤ .05) and number of illness episodes (β = .155; p ≤ .05). The present findings suggest that specific clinical factors may be used in order to better distinguish between UD and BD subgroups. Further studies are required to replicate these findings in larger samples.
- Rapid methods including network meta-analysis to produce evidence in clinical decision support: a decision analysis. [Journal Article]
- SRSyst Rev 2018 Oct 20; 7(1):168
- CONCLUSIONS: The transfer of knowledge to practice could benefit from faster systematic reviewing methods. The results in this preliminary assessment suggest that an improved rapid NMA approach might replace gold standard NMAs. Decision analysis could be used to compare evidence summarisation methods.
- Pattern and correlates of tobacco smoking among mentally ill male patients in El-Mamoura Psychiatric Hospital, Alexandria, Egypt. [Journal Article]
- JEJ Egypt Public Health Assoc 2017 Sep 01; 92(3):167-176
- CONCLUSIONS: Professionals working with people with mental disorders should be trained in raising awareness of smoking health outcomes and provision of counseling quit services.
- A nationwide study on concordance with multimodal treatment guidelines in bipolar disorder. [Journal Article]
- IJInt J Bipolar Disord 2018 Oct 20; 6(1):22
- CONCLUSIONS: In contrast to pharmacotherapy, psychosocial treatments are only implemented to a limited extend in everyday clinical practice in bipolar disorder. More effort is needed to implement non-pharmacological guideline recommendations for bipolar disorder.
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- Associations between polygenic risk scores for four psychiatric illnesses and brain structure using multivariate pattern recognition. [Journal Article]
- NCNeuroimage Clin 2018 Oct 09; 20:1026-1036
- Psychiatric illnesses are complex and polygenic. They are associated with widespread alterations in the brain, which are partly influenced by genetic factors. There have been some attempts to relate ...
Psychiatric illnesses are complex and polygenic. They are associated with widespread alterations in the brain, which are partly influenced by genetic factors. There have been some attempts to relate polygenic risk scores (PRS) - a measure of the overall genetic risk an individual carries for a disorder - to brain structure using univariate methods. However, PRS are likely associated with distributed and covarying effects across the brain. We therefore used multivariate machine learning in this proof-of-principle study to investigate associations between brain structure and PRS for four psychiatric disorders; attention deficit-hyperactivity disorder (ADHD), autism, bipolar disorder and schizophrenia. The sample included 213 individuals comprising patients with depression (69), bipolar disorder (33), and healthy controls (111). The five psychiatric PRSs were calculated based on summary data from the Psychiatric Genomics Consortium. T1-weighted magnetic resonance images were obtained and voxel-based morphometry was implemented in SPM12. Multivariate relevance vector regression was implemented in the Pattern Recognition for Neuroimaging Toolbox (PRoNTo). Across the whole sample, a multivariate pattern of grey matter significantly predicted the PRS for autism (r = 0.20, pFDR = 0.03; MSE = 4.20 × 10-5, pFDR = 0.02). For the schizophrenia PRS, the MSE was significant (MSE = 1.30 × 10-5, pFDR = 0.02) although the correlation was not (r = 0.15, pFDR = 0.06). These results lend support to the hypothesis that polygenic liability for autism and schizophrenia is associated with widespread changes in grey matter concentrations. These associations were seen in individuals not affected by these disorders, indicating that this is not driven by the expression of the disease, but by the genetic risk captured by the PRSs.