bluuebunny/crossref_metadata_2025 huggingface dataset:
O1.4. HOW THE MOST CITED RESEARCH ARTICLES ABOUT SCHIZOPHRENIA IN 2018 DEPICT THE DISEASE?
Authors: Tonsig Gabriela , Dino Maria , Haguiara Bernardo , Fonseca Lais , Orsi José , Bressan Rodrigo , Gadelha Ary
Published: May 2020

Background

Despite the progress in treatment and clinical outcomes, schizophrenia remains a highly stigmatized disease and imposes a challenge to families and patients towards recovery. Stigma can debilitate individuals as much as the disease itself, representing one of the most relevant obstacles to overcome the illness: it hinders the pursuit of autonomy and achievement of life goals. Stigma is complex and multilayered and its research usually focus on patients and society, but a lower number of studies address health professionals stigma. Even fewer investigate stigma of researchers. Thus, our objective is to analyze how the most cited research papers published in 2018 addressing schizophrenia depict the disease to identify putative stigma among researchers.

Methods

In this exploratory study, we conducted a search using Web of Science (WoS) with the following terms: (“patients with schizophrenia”) OR (“schizophrenia patients”). We restricted the search to articles published in 2018 and selected the 20 studies with the highest total number of citations. We identified how the authors defined schizophrenia and then categorized the definition in three groups: (1) negative perspective, in which depreciative words were used to define the disease; (2) neutral definition, in which emphasis is given to the description of epidemiological data; and (3) neutral to positive definition, when negative outcomes were listed as possibilities, not certainties. Two independent authors (G.K. and M.M.) categorized each article and eventual conflicts were solved by a third author (A.G.)

Results

25% of the studies depicted a clearly negative perspective of schizophrenia. In these studies, the disease was described with words such as “devastating” and “highly disabling”. Most studies (60%) were coded as neutral, being mainly descriptive of current epidemiological data. Only 3 studies (15%) were identified as more favorable, since they acknowledged the possibility of better outcomes among patients with schizophrenia.

Discussion

In the current schizophrenia scientific literature, negative views of the disease are still largely common. Considering the role of highly cited papers as opinion formers, we suggest that as occurred in other fields, such as the change in address of suicide by the media, some orientation should be adopted to avoid further contributions to the schizophrenia stigma.
O6.2. A NETWORK FOR COGNITIVE, MOTOR, AND PSYCHOPATHOLOGICAL ALTERATIONS IN SCHIZOPHRENIA SPECTRUM DISORDERS
Authors: Moura Bernardo , van Rooijen Geeske , Schirmbeck Frederike , Wigman Johanna , Van Harten Peter , Madeira Luís , Roberto Bakker P , van Os Jim , Marcelis Machteld
Published: May 2020

Background

Schizophrenia spectrum disorders are complex syndromes involving multiple clinical manifestations. Besides psychopathological symptoms, cognitive and motor alterations are also highly relevant in the context of the comprehension, assessment, and treatment of these disorders. Moreover, these three domains of clinical manifestations display complex reciprocal interactions that require further characterization. This work aims to use network analysis to investigate the associations between cognitive, motor, and psychopathological alterations in schizophrenia spectrum disorders. This approach might prove to be advantageous in identifying key variables for the assessment and treatment of these disorders.

Methods

A sample of 732 patients with schizophrenia spectrum disorders from a multi-site cohort study was included in the analysis. We estimated a network using a regularized Gaussian Graphical Model and conducted network stability analyses. Twenty-six nodes were included, encompassing items from the Positive and Negative Syndrome Scale, multiple neuropsychological tests, and clinician-assessed extrapyramidal symptoms’ scores. The results were further explored with centrality analyses and network comparisons between subgroups defined according to illness duration and remission status.

Results

We found that the estimated network was densely interconnected. Furthermore, nodes representing symptoms of disorganization were very central and, therefore, pivotal in connecting other psychopathological symptoms to cognitive and motor alterations. The estimated network for the subgroup of patients in remission showed a more sparse density and a different structure from the network of non-remitted patients.

Discussion

In conclusion, in the context of a broader representation of schizophrenia spectrum disorders’ manifestations, our results of a network analysis confirm a close association between different symptom domains and unveil a highly influential role of disorganization symptoms. Moreover, structural differences in networks occur according to remission status. These results are relevant for research in nosology, clinical assessment, and treatment approaches.
O8.4. ENVIRONMENTAL RISK FACTORS IN BIPOLAR DISORDER AND PSYCHOTIC DEPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF PROSPECTIVE STUDIES
Authors: Rodriguez Victoria , Alameda Luis , Marino Paolo , Trotta Giulia , Spinazzola Edoardo , Matheson Sandra , Laurens Kristin , Murray Robin , Vassos Evangelos
Published: May 2020

Background

There is replicated evidence of a shared genetic load between affective and non-affective psychosis, but much less is known of whether affective psychosis is affected by the same environmental risk factors as well. The aim of this review and meta-analysis is to study the association between specific environmental risk factors of interest previously associated with schizophrenia and later affective psychoses (bipolar disorder and psychotic depression).

Methods

A systematic search of prospective studies was conducted in MEDLINE, EMBASE and PsycINFO databases, supplemented by hand searching. Selected exposures included: paternal age, maternal infection, obstetric and perinatal factors, childhood trauma, childhood infection, urbanicity, migration, stressful life events, head injury and cannabis or substance use. Relevant studies were selected systematically among those fulfilling inclusion criteria, and effect sizes were extracted. Pooled information was presented for those factors with enough number studies to combine extracted effect sizes, while the rest were presented in a narrative way.

Results

Approximately 60 studies addressing the associations between environmental risk factors of interest and later affective psychoses were identified. The compiled studies showed that paternal age, early gestational age, lifetime cannabis use, parental death during childhood and ethnic minority in UK are associated with future development of affective psychosis.

Discussion

These results show that, as per genetics, there may be some overlap in the environmental load between schizophrenia and affective psychosis, suggesting general risks for psychosis rather than diagnostic specific risks. Nonetheless, publish studies for some factors in this subgroup of patients are still scarce. More longitudinal studies addressing specific association between environmental risk factors and affective psychosis are warranted.
O9.6. SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EFFECTS OF CANNABIS USE IN ADOLESCENCE ON IQ IN LONGITUDINAL STUDIES ACCOUNTING PRE-EXPOSURE BASELINE PERFORMANCE
Authors: Power Emmet , Sabherwal Sophie , O’Neill Aisling , Healy Colm , Cotter David , Cannon Mary
Published: May 2020

Background

Cannabis use in adolescence is a known risk factor for developing schizophrenia. Decline in intellectual functioning is a well-studied phenomenon of schizophrenia. Schizophrenia in its first classification was conceptualized as a dementia - ‘Dementia Praecox’ indicating a dominance of effect of cognitive symptoms on functioning at that time. First episode psychosis patients with histories of cannabis use compared to those without cannabis use have superior cognitive functioning suggesting different disease phenotypes. Our aim was to investigate whether cannabis had an effect on full scale IQ in general population samples to further inform understanding of this disease pathway.

Methods

We developed a search strategy through an iterative approach with a qualified information specialist. We searched three databases: Medline, Embase and PsychInfo. We included conference abstracts and full text publications in English. We contacted authors for additional information in cases where an effect size was not calculable. We included longitudinal studies of non-help-seeking young people in the community with a pre-drug exposure standardized measure of IQ prior to the age of 18 and a comparable measure at subsequent follow up. We defined the case group as individuals with a history of heavy cannabis use (more than 25 lifetime uses, at least weekly use for 6 months and/or meeting criteria for a cannabis use disorder) and the control group as similar young people who had no or very minimal experimental exposure to cannabis (<5 lifetime uses). Two reviewers independently extracted the data and assessed for bias using the Newcastle-Ottawa risk of bias tool. We performed random effects meta-analysis in Stata version 14 given expected heterogeneity in measurement of cannabis use across studies.

Results

We identified 7 cohort studies detailed in 6 reports including over 650 subjects and 5600 controls. Study designs included twin cohorts, representative cluster sampled community cohorts and birth cohort studies. Range of follow up was between 2 and 23 years. All studies showed relative decline in IQ of which two were statistically significant. Our findings show that cannabis use in youth is associated with modest IQ differences that equate to approximately to a 2-point decrease in young cannabis users. Studies examining twin pairs showed that twins discordant for cannabis use did not have divergent cognitive trajectories, however these analyses were relatively underpowered to find an effect.

Discussion

Our findings demonstrate the harmful effects of cannabis use on brain development in young people. These findings are of public health importance and provide further evidence for the detrimental effects of early cannabis use on mental health and cognition.
O11.4. INTERACTOME OVERLAP BETWEEN SCHIZOPHRENIA AND COGNITION
Authors: Koch Elise , Rosenthale Brin , Lundquist Anders , Chen Chi-Hua , Kauppi Karolina
Published: May 2020

Background

Cognitive impairments constitute a core feature of schizophrenia, and a genetic overlap between schizophrenia and cognitive functioning in healthy individuals has been identified. However, due to the high polygenicity and complex genetic architecture of both traits, overlapping biological pathways have not yet been identified between schizophrenia and normal cognitive ability. Network medicine offers a framework to study biologically meaningful gene networks through protein-protein interactions among risk genes. Here, established network-based methods were used to further reveal the biological relatedness of schizophrenia and cognition.

Methods

The protein interactome was used to examine the genetic link between schizophrenia risk genes and genes associated with cognitive performance in healthy individuals. First, we used a method called network separation to examine if there is an overlap between schizophrenia and cognition in the interactome network space. Then, we used network propagation analyses to identify schizophrenia risk genes that are close to cognition-associated genes in the interactome network space. Gene ontology and pathway enrichment analysis was performed to describe the function of this gene set.

Results

Network separation analyses showed a profound interactome overlap between schizophrenia risk genes and genes associated with cognitive performance (SAB = -0.22, z-score = -6.80, p = 5.38e-12). We identified 140 schizophrenia risk genes that are close to cognition-associated genes in the interactome. Risk genes close to cognition were enriched for pathways including long-term potentiation and Alzheimer’s disease, and included genes with a role in neurotransmitter systems implemented in cognition, such as glutamate and dopamine, that were not part of the direct genetic overlap. Moreover, schizophrenia risk genes close to cognition included 45 druggable genes not yet used as drug targets.

Discussion

These results pinpoint schizophrenia risk genes of particular interest for further examination in schizophrenia patient groups to reveal the genetic architecture of cognitive impairments in schizophrenia, of which some are druggable genes with potential as candidate targets for cognitive enhancing drugs.
O11.5. INCREASED INFLAMMATION AND MACROPHAGE INFILTRATION IS ASSOCIATED WITH ALTERED SUBEPENDYMAL ZONE NEUROGENESIS IN SCHIZOPHRENIA BUT NOT BIPOLAR DISORDER
Authors: North Hayley , Weissleder Christin , Bitar Maina , Fullerton Janice M , Sager Rachel , Barry Guy , Webster Maree J , Shannon Weickert Cynthia
Published: May 2020

Background

Inflammation is implicated in the pathogenesis of schizophrenia and bipolar disorder. Inflammation regulates neurogenesis, and markers for stem cells and neuronal progenitors are reduced in schizophrenia and bipolar disorder in the subependymal zone (SEZ) – the brain’s largest region of neurogenesis. This research aimed to discover core differences in gene expression and cellular composition in the SEZ in psychiatric disorders that may contribute to dysregulated neurogenesis.

Methods

We performed total RNA sequencing in the SEZ of 20 post-mortem schizophrenia and 21 control brains. Quantitative PCR (qPCR) and immunohistochemistry were performed in 32 schizophrenia and 32 control overlapping cases and 29 bipolar disorder cases. Immunohistochemistry was used for quantification and localisation of CD163+ macrophages. Cluster-analysis of IL6, IL6R, IL1R1 and SERPINA3 expression defined low and high inflammation subgroups, which were used to compare neurogenesis marker expression.

Results

Out of >60,000 genes, the most significantly differentially expressed gene in schizophrenia was CD163, a macrophage marker, which was increased 3.3 times compared to controls and confirmed by qPCR. Abundant CD163+ macrophages were located surrounding blood vessels, in the parenchyma and seem to infiltrate throughout the SEZ where neural stem and progenitor cells typically reside. Macrophage cell density was increased in schizophrenia compared to controls and bipolar disorder (by 29% and 61%; p = 0.017 and p = 0.002 respectively). CD163 expression positively correlated with the quiescent neural stem cell marker GFAPδ (r = 0.56, p = 0.001), and negatively correlated with neuronal progenitor marker ASCL1 (r = - 0.40, p = 0.032) in schizophrenia but not bipolar disorder. Cluster analysis of inflammatory gene expression revealed 40% of schizophrenia but only 10% of control cases were highly inflamed. The high inflammation schizophrenia subgroup had increased CD163 and GFAPδ expression but decreased ASCL1 expression (all p < 0.026).

Discussion

Increased macrophages in the SEZ is a key difference in schizophrenia pathology and potentially drives heightened inflammation in a subgroup. Inflammation has varied effects on different stages of neurogenesis in schizophrenia but not bipolar disorder, implicating divergent mechanisms leading to reduced neurogenesis in each psychiatric condition. In schizophrenia, macrophages and high inflammation seem to reduce neuronal differentiation and sustain neural stem cell quiescence, likely blunting stem cell proliferation. Therefore, reduced SEZ neurogenesis across the lifespan in schizophrenia may contribute to the widely reported inhibitory interneuron deficits.
T12. THE RELATIONSHIP OF INTESTINAL PERMEABILITY FACTORS WITH SOCIODEMOGRAPHIC AND PHYSICAL HEALTH FACTORS AND PANSS SCORES IN SCHIZOPHRENIA PATIENTS AND HEALTHY CONTROLS
Authors: Borkent Jenny , Sommer Iris E C , Haarman Bartholomeus C M
Published: May 2020

Background

Recent studies have pointed to the gut-brain axis as a new venue for treatment of psychiatric disorders, with increased inflammation stemming from increased intestinal permeability to further affect brain functioning in a significant subset of patients. Yet, this line of research is still in its infancy, with multiple studies showing increased intestinal permeability in schizophrenia and bipolar disorders, demonstrated as translocation of food and bacterial antigens, as well as intestinal microbiome disturbances.

Methods

Therefore, we measured intestinal permeability markers soluble CD14 (sCD14) and lipopolysaccharide binding protein (LBP) in schizophrenia patients and healthy controls. Intestinal permeability markers were compared to several sociodemographic, including age, gender and BMI, and physical health variables, including CRP, glucose, cholesterol, triglycerides, HDL, LDL and non-HDL, and Positive and Negative Syndrome Scale (PANSS) scores. Of the control group (n = 43), 76.7% was male, with a mean age of 25.1 years. Of the schizophrenia group (n = 105) 75.2 % was male, with a mean age of 27.4 years and an average PANSS score of 57.2.

Results

Levels of LBP and sCD14 were not significantly different between schizophrenia patients and controls. LBP and sCD14 levels were neither correlated in the control group, nor in the schizophrenia group. In the control group Females had elevated LBP levels compared to males (p < 0.01), but not in the schizophrenia group. Quantitative levels of LBP, but not sCD14, correlated with triglycerides in the schizophrenia group (R2 = 0.049, p < 0.05). Furthermore, quantitative levels of sCD14, but not LBP, correlated with CRP in the schizophrenia group (R2 = 0.078, p < 0.05). Finally, LBP levels in patients correlated with PANSS negative scores (R2 = 0.055, p < 0.05). Neither a correlation of LBP and sCD14 with age, nor with BMI was observed in both the control and the schizophrenia group.

Discussion

In conclusion, these intestinal permeability markers showed few differences between the schizophrenia and the control group. We found weak, yet significant correlations with triglycerides, CRP and severity of negative symptoms, which may be caused by poor eating habits or metabolic syndrome leading to leaky gut in the more severely affected patients. These results are not in line with results of Severance et al. (2013), who performed a similar analysis and found differences in intestinal permeability markers between a control group and a schizophrenia group. Furthermore, they did observe a positive correlation between sCD14 and LBP in both the control and the schizophrenia group. The difference between that study and our current findings may stem from the different patients samples, as we assessed patients in their first five years after diagnosis, when metabolic syndrome was less abundant.
T15. MISMATCH NEGATIVITY INDICES AS A PROGNOSTIC FACTOR FOR REMISSION IN SCHIZOPHRENIA
Authors: Shim Se-Hoon , Lim Eunsung , Park Sung-Yong , Jang Seung-Ho , Bahk Won-Myong , Kwon Young-Joon , Yoon Bo-Hyun
Published: May 2020

Background

Mismatch negativity (MMN) is an event-related potential component when a sequence of relatively standard stimuli is interrupted by the infrequent presentation of deviant stimuli. MMN is known to be associated with neuro-cognition and functional outcomes. Also, abnormally decreased MMN has often been reported in schizophrenia. Remission and recovery rates are related to the neuro-cognition of patients with schizophrenia. The present study explored the relationship of MMN with remission in patients with schizophrenia.

Methods

Forty patients with schizophrenia were recruited and divided into two groups, with or without remission, according to the Remission in Schizophrenia Working Group criteria (RSWGcr). For assessments of symptom severity, cognitive function and functional outcome, scale such as Positive and Negative Syndrome Scale (PANSS), K-WAIS-IV, and Global Assessment of Functioning (GAF) were measured. MMN of the patients were evaluated at the frontocentral site. A regression analysis was used to identify the factors that significantly predicted symptom improvement and remission including MMN at frontal site assessed at baseline, and anticipated clinical variables as predictive factors.

Results

MMN amplitudes in frontal sites were further decreased in the groups without remission compared to the groups with remission. MMN amplitude was significantly correlated with measures of symptom change and functional outcome measurements in patients with schizophrenia. Regression analysis revealed that symptom severity and MMN significantly predicted remission in patients with schizophrenia. Symptom improvement significantly predicted PANSS at baseline, illness duration, and antipsychotic dose, as did MMN amplitude at frontal site.

Discussion

This study explored the relationship of MMN with remission in patients with schizophrenia. The remitted patients with schizophrenia showed larger MMN amplitude in frontal electrode site than those of non-remitted patients. MMN in frontal sites was correlated with symptom improvement and functional outcomes through PANSS and GAF scales. The present study found that MMN was significantly correlated with variables related to remission such as PANSS and GAF evaluated at 6 months later. MMN indexes appears to be a promising candidate for predicted factor of remission of schizophrenia.
T19. GLUTAMATE AND RESPONSE TO CLOZAPINE IN TREATMENT RESISTANT SCHIZOPHRENIA
Authors: Egerton Alice , McQueen Grant , Sendt Kyra-Verena , Gillespie Amy , Lally John , Borgan Faith , Howes Oliver , Barker Gareth J , Stone James , McGuire Philip , MacCabe James
Published: May 2020

Background

The mechanisms that underlie and may mediate the therapeutic response to clozapine in treatment resistant schizophrenia (TRS) are unclear. Basic science studies have indicated that clozapine may modulate brain glutamate, but this has not yet been investigated in man. The aim of this study was to determine whether clozapine alters brain glutamate levels in patients with TRS, and the associations with clinical outcome.

Methods

The study included patients with TRS who were about to start clozapine as part of their normal clinical care. Glutamate levels were measured in the anterior cingulate cortex (ACC) and right caudate nucleus using proton magnetic resonance spectroscopy (1H-MRS) before clozapine initiation (n=37) and again after 12-weeks of clozapine treatment (n=27). Symptoms were principally assessed using the PANSS. 1H-MRS scans were also acquired in a comparator group of healthy volunteers (n = 16).

Results

Over the 12 weeks of clozapine treatment there was a significant reduction in glutamate in the caudate (n = 22, F = 7.61 P < 0.05) but not in the ACC. The percentage reduction in caudate glutamate was positively associated with the percentage reduction in total PANSS score (n = 23, r = 0.42, P = 0.04). ACC Glx (glutamate plus glutamine) prior to clozapine initiation was higher in patients with TRS than in healthy volunteers (P=0.03).

Discussion

Improvements in symptoms following clozapine initiation in TRS may be related to reductions in glutamate in the caudate nucleus. In contrast, ACC glutamate levels appear to remain high during the first three months of clozapine treatment.
T24. CHANGES IN TELOMERE LENGTH IN YOUNG PEOPLE WITH FIRST EPISODE PSYCHOSIS: A 12-MONTHS FOLLOW-UP STUDY
Authors: Ayora Mirian , Fraguas David , Recio Sandra , Diaz-Caneja Covadonga M , Blasco Maria A , Arango Celso
Published: May 2020

Background

Cellular aging is associated with the appearance of several chronic organic diseases, and many neuropsychiatric disorders such as schizophrenia spectrum disorders, which include psychotic disorders. Telomeres are one of the biomarkers of this cellular aging. Researches have shown that shorter telomere length is a biomarker of oxidation and cellular aging. Recent studies have concluded that patients with a first psychotic episode (FEP) have shorter telomere length than healthy controls (HC). However, there is no published data on the change in telomere length in the first years of illness.

The purpose of this study is to evaluate the changes in telomere length measured in peripheral blood mononuclear cells (PBMCs) in a sample of patients with early-onset psychosis and healthy subjects.

Methods

This study included 10 young patients with FEP (50% female, mean age 18.4 years) and 10 young HC (60% female, mean age 16.4 years). PBMCs telomere length was determined using high-throughput quantitative fluorescence in situ hybridization (HT Q-FISH) at baseline and 12-month follow-up. We analysed in our sample of patients if there are significant differences according to the diagnosis and antipsychotic treatment.

Results

At baseline, we did not find significant differences in telomere length between FEP patients and HC. After one-year follow-up, it was found that telomere length is shorter in patients with FEP than in HC (p=0.007).

The diagnostics in the patients’ group were: 60% schizophrenia and 40% other diagnoses (20% psychosis not specified and 20% bipolar disorder). There was no significant difference between changes in telomeres length and diagnosis (p = 0.840).

The antipsychotic treatment in the patients’ group after 12 months was: 20% risperidone, 50% aripiprazole, 10% clozapine, 10% paliperidone and 10% quetiapine. We didn′t find a strong association between the shortening of telomeres and the cumulative dose of antipsychotics.

Discussion

This is one of the first studies where it has been analysed a longitudinal data of telomere length. It is shown that patients with the first episode of psychosis have significantly shorter telomere length than healthy controls. Changes in telomere length during the first years of illness can represent an early marker of accelerated cellular aging. Further studies are needed with a larger sample to know mechanisms responsible for accelerating aging and the role of oxidative stress in the pathogenesis of psychosis.
T29. CHILDHOOD PSYCHOPATHOLOGY ACROSS 12 YEARS PREDICTS ADULT PSYCHOTIC-LIKE EXPERIENCES: A PARALLEL TWO-PART PIECEWISE LATENT GROWTH CURVE MODEL
Authors: Ka-Yee Wong Keri , Francesconi Marta , Flouri Eirini
Published: May 2020

Background

The prevalence of childhood psychopathology fluctuates across the lifespan, yet studies often adopt linear growth curve models (LGM) of estimation that assumes constant linear growth and do not account for the comorbidity between internalizing and externalizing behaviors in predicting later psychosis. This study tests whether internalizing and externalizing behaviors in early childhood (4–9 years) and adolescence (11–16 years) are best modelled by a two-part parallel piecewise growth model (2-PGM) or a single LGM (4–16 years) and whether specific developmental periods better predict psychotic-like experiences (PLEs) in adulthood (18 years).

Methods

Parent-rated child’s psychopathology on the Strengths and Difficulties Questionnaire (Goodman, 2006) at ages 4, 6, 8, 9, 11, 13, and 16 years from the Avon Longitudinal Study of Parents and Children were first modelled by a parallel LGM, then a 2-PGM, to predict clinician-rated adult PLEs. Models were re-run controlling for confounds assessed prior to age 4 years (i.e., child’s gender, verbal IQ, socioeconomic status, maternal education, prior diagnosis of mental health issues, and stressful life experiences at 42 months).

Results

Considering internalizing and externalizing problem behaviors in tandem, a 2-PGM fit the data better than a LGM (CFI/TLI = .97/.96, 2(129) = 781.63, p < .001, RMSEA = .033, 90%CI[.031-.035], WRMR = 1.32, N = 4717). Controlling for confounds, internalizing symptoms at baseline (b = .130, p = .004) and changes (b = .196, p < .001) in early childhood best predicted adult PLEs, but not changes in adolescent internalizing/externalizing symptoms. Females were more likely than males to be in the definite/suspected PLEs group at 18 years (b = .078, p = .006). Findings suggest that maternal reports of internalizing problem behaviors, particularly in primary school years, provide predictive utility of clinician-assessed PLEs.

Discussion

Using a 2-PGM technique may better identify important developmental windows of assessment and intervention for PLEs than LGM. Findings have important theoretical and practical implications for mental health research.
T43. PREDNISOLONE VERSUS PLACEBO AS AUGMENTATION THERAPY IN PSYCHOTIC DISORDERS
Authors: Lyliana Nasib , Winter Inge , Kahn Rene , Sommer Iris
Published: May 2020

Background

An increasing body of evidence suggests that immune dysregulation is involved in the pathophysiology of psychotic disorders. Some, but not all, anti-inflammatory drugs have shown positive effects on symptom severity. Given the need for new treatment options in psychosis, anti-inflammatory medication should be explored as a potential treatment to improve outcome. Being a potent glucocorticosteroid that adequately passes through the blood-brain barrier, prednisolone qualifies as a potential candidate. This proof-of-concept study aims to explore the effect of prednisolone, compared to placebo, on symptom severity in patients with a psychotic disorder who are on a stable dose of antipsychotic medication.

Methods

The study was conducted from July 2015 until April 2019 in four centers in the Netherlands and Belgium. Patients with a psychotic disorder were randomized, double blind, 1:1 to prednisolone or placebo in addition to their antipsychotic treatment. Patients randomized to prednisolone started with 40 mg/day, tapered down to zero in six weeks. Several procedures were implemented to ensure patient safety during prednisolone exposure (e.g. regular safety labs). The primary objective was to compare change in symptom severity, measured through the Positive and Negative Syndrome Scale (PANSS), in patients treated with prednisolone versus placebo, in additional to a stable antipsychotic regimen. To this end, a mixed model repeated measures ANOVA was applied.

Results

42 participants were randomized, equally divided across the treatment arms. The six week treatment period was completed by 20 patients randomized to placebo and 19 patients randomized to prednisolone. There were no baseline differences in demographics, symptom severity, depression or global functioning between the treatment groups. There was no difference in symptom improvement between patients treated with prednisolone compared to placebo at the end of the six week treatment period (p=.304). Global functioning and depression were not significantly different between treatment arms end of treatment. No Serious Adverse Events (SAEs) occurred during the treatment phase.

Discussion

The results of this proof-of-concept study do not support the immune hypothesis of psychosis: there was no difference in symptom improvement after a six week treatment with prednisolone compared to placebo, in addition to a stable regimen of antipsychotics. The small sample size is the main limitation of this trial. Even though prednisolone did not show to be a potential candidate for augmentation therapy in psychosis, it is of interest to note that patients did not deteriorate when using prednisolone nor were there more SAE’s in the active treatment arm. This argues against the general safety concerns for prescribing prednisolone in patients with psychosis for the treatment of immune disorder, although additional research is needed.
T48. DEVIATIONS IN MICRO AND MACRO WHITE MATTER STRUCTURES IN PSYCHOSIS PRONENESS
Authors: Arslan Seda , Şahin Tuba , Şahin Didenur , Toulopoulou Timothea
Published: May 2020

Background

Psychotic disorders are characterized by neurobiological deviations, including in the macro and microstructure of white matter. White matter alterations are also seen in psychosis-proneness and in individuals who have a high risk of psychosis. For example, studies have indicated decreases in white matter integrity in the genu/forceps minor of corpus callosum (CC) in the latter populations. Anterior corona radiata (ACR) is one crucial white-matter tract connecting the anterior cingulate cortex to the striatum. Indeed, reductions in the white matter structure of anterior genu of CC significantly predict the transition from ultra-high risk to psychosis. However, there is a gap in the literature related to observing the psychosis-proneness by applying both micro and macrostructural brain analyses, and most of the microstructural white matter studies in psychosis focus on fractional anisotropy (FA) and not include mean diffusivity (MD). Thus, the current study aims to assess whether white matter deviations in CG, ACR, and CC, are associated with psychosis proneness by combining both tract-based spatial statistics (TBSS) and voxel-based morphometry (VBM) analyses in a sample of participants with psychosis proneness (PP) and without psychosis proneness (NPP).

Methods

The study included 53 participants (29 PP vs. 24 NPP) whose ages were between 17 and 24 years. Participants were split into two groups based on their scores on Structured Interview for Schizotypy assessment, a well-validated instrument of psychosis proneness. White matter integrity was analyzed via diffusion tensor imaging (DTI) and white matter volume (WMV) via VBM. Two sample t-test was used in GLM for both DTI and VBM analyses. FA, MD, and VMV were compared between two groups to observe micro and macro white matter structure alterations in the region of interest.

Results

DTI analysis revealed decreased FA values in the right ACR and right genu of the CC in the psychosis-proneness group (F(1,52)= 7.37, p= 0.009). Moreover, VBM showed a significant WMV decreases in the right CG, Brodmann areas 8, 9, and 32 in the PP group (F(1,52)= 50.85, uncorrected p<0.01). However, MD did not differ between the two groups (F(1,51)= 3.65, p=0.06)

Discussion

These findings suggest that PP associated with decreased white matter integrity in ACR, genu of CC, and also reduced white matter volumes in the right CG, Brodmann areas 8, 9, and 32. Significant FA decreases might result from alterations in radial or axial diffusivity since we did not observe significant MD differences between two groups. The current findings suggested that participants with PP had both macro and micro white matter structure disruptions, mostly in frontal parts of the right cerebrum, compared to no PP group.
T59. ACOUSTIC SPEECH MARKERS FOR SCHIZOPHRENIA
Authors: de Boer Janna , Voppel Alban , Wijnen Frank , Sommer Iris
Published: May 2020

Background

Clinicians routinely use impressions of speech as an element of mental status examination, including ‘pressured’ speech in mania and ‘monotone’ or ‘soft’ speech in depression or psychosis. In psychosis in particular, descriptions of speech are used to monitor (negative) symptom severity. Recent advances in computational linguistics have paved the way towards automated speech analyses as a biomarker for psychosis. In the present study, we assessed the diagnostic value of acoustic speech features in schizophrenia. We hypothesized that a classifier would be highly accurate (~ 80%) in classifying patients and healthy controls.

Methods

Natural speech samples were obtained from 86 patients with schizophrenia and 77 age and gender matched healthy controls through a semi-structured interview, using a set of neutral open-ended questions. Symptom severity was rated by consensus rating of two trained researchers, blinded to phonetic analysis, with the Positive And Negative Syndrome Scale (PANSS). Acoustic features were extracted with OpenSMILE, employing the Geneva Acoustic Minimalistic Parameter Set (GeMAPS), which comprises standardized analyses of pitch (F0), formants (F1, F2 and F3, i.e. acoustic resonance frequencies that indicate the position and movement of the articulatory muscles during speech production), speech quality, length of voiced and unvoiced regions. Speech features were fed into a linear kernel support vector machine (SVM) with leave-one-out cross-validation to assess their value for psychosis diagnosis.

Results

Demographic analyses revealed no differences between patients with schizophrenia and healthy controls in age or parental education. An automated machine-learning speech classifier reached an accuracy of 82.8% in classifying patients with schizophrenia and controls on speech features alone. Important features in the model were variation in loudness, spectral slope (i.e. the gradual decay in energy in high frequency speech sounds) and the amount of voiced regions (i.e. segments of the interview where the participant was speaking). PANSS positive, negative and general scores were significantly correlated with pitch, formant frequencies and length of voiced and unvoiced regions.

Discussion

This study demonstrates that an algorithm using quantified features of speech can objectively differentiate patients with schizophrenia from controls with high accuracy. Further validation in an independent sample is required. Employing standardized parameter sets ensures easy replication and comparison of analyses and can be used for cross linguistic studies. Although at an early stage, the field of clinical computational linguistics introduces a powerful tool for diagnosis and prognosis of psychosis and neuropsychiatric disorders in general. We consider this new diagnostic tool to be of high potential given its ease of acquirement, low costs and patient burden. For example, this tool could easily be implemented as a smartphone app to be used in treatment settings.
T63. TOO MUCH OR TOO LITTLE? EXPLORING EFFORT IN SCHIZOPHRENIA WITHIN THE FRAMEWORK OF MOTIVATIONAL INTENSITY THEORY
Authors: Décombe Amandine , Brunel Lionel , Capdevielle Delphine , Raffard Stéphane
Published: May 2020

Background

Motivation impairments have long been seen as a central feature of schizophrenia. Attention has focused on the reward system and effort-based decision-making deficits. However, according to motivational intensity theory (MIT), effort mobilization and perception are not directly – and not only – determined by reward but, fundamentally, by task difficulty. At the same time, the link between effort and difficulty has been poorly studied in schizophrenia.

Methods

Therefore, this cross-sectional study compared effort perception in an experimental schizophrenia group with healthy controls. Participants were asked to carry various quantities of objects from one point to another using their hands. Task difficulty was manipulated by increasing the number of objects and the distance covered. Perceived difficulty, perceived effort and walking speed were assessed for all levels of difficulty. Psychotic symptoms, depression, self-efficacy and bodyweight data were also recorded.

Results

The results are consistent with MIT, in that perceived effort increased with task difficulty in both groups. Effort and difficulty perceptions were higher in the schizophrenia group, and although this was positively correlated with bodyweight and depression, there was no association with negative symptoms. Importantly, although schizophrenia patients perceived the task as more effortful, walking speed was similar between the two groups, suggesting that the schizophrenia group mobilized more effort to overcome higher perceived effort and difficulty.

Discussion

Together, these results suggest that the schizophrenia group perceived the task as more difficult, but mobilized more effort to complete it. This observation could partly explain the chronic decrease in motivation to engage in physically demanding activities, leading to a decline in such activities in daily life among schizophrenia individuals.
T75. METABOLIC SYNDROME AND HEAR RATE VARIABILITY IN SCHIZOPHRENIC INPATIENTS
Authors: Yoon Bo-Hyun , Lee Kwanghun , Kim Moon-Doo , Nam Beomwoo , Shim Se-Hoon , Lim Eun-Sung , Park Sung-Yong
Published: May 2020

Background

The purpose of this study was to explore the relationships between metabolic syndrome and markers of heart rate variability (HRV) in chronic schizophrenic inpatients

Methods

A total of 99 schizophrenic inpatients was included in this study. Metabolic syndrome of patients was defined according to the revised NCEP-ATP III criteria. HRV was measured by SA-3000P (Medi-core, Seoul, Korea). Psychopathology, anxiety state of patients, psychosocial functional state and subjective well-being were examined by Positive and Negative Symptom Scale (PANSS), Hamilton Anxiety Inventory (HAM-A), Social and Occupational Functioning Assessment (SOFAS) and Satisfaction with Life Scale (SWLS), respectively. Comparisons of data were done between patients with metabolic syndrome and without metabolic syndrome.

Results

Fifty-four (54.5%) of 99 patients had satisfied the criteria of metabolic syndrome. Patients with metabolic syndrome showed significant higher negative symptoms scores in PANSS (p<0.05) and HAM-A scores (p<0.05) than patients without metabolic syndrome. Age, sex, smoking status, age at onset, duration of illness, scores of SOFAS and SWLS were not differed between two groups. Data of HRV were transformed to log values to satisfy the hypothesis of normal distribution of curve. SDNN of Time domain was significantly differed between two groups (p<0.05). Activation of autonomic nerve, resistance of stress, index of stress, rate of fatigue and heart stability were also significantly differed between groups (p<0.05, respectively). Multiple linear regression was done to explore which factors were associated with HRV and metabolic syndrome. Metabolic syndrome was negatively influenced to InTP, InVLF, InLF and InHF of HRV (frequency domain).

Discussion

This study suggested that metabolic syndrome was negatively influenced to the frequency domain of HRV in chronic schizophrenic patients.
T87. CHANGING RATES OF PAST-YEAR CANNABIS USE BY PEOPLE WITH A PSYCHOTIC DISORDER
Authors: Waterreus Anna , Di Prinzio Patsy , Badcock Johanna , Martin-Iverson Mat , Morgan Vera
Published: May 2020

Background

General population data show that cannabis use by younger people has been declining but increasing in older adults and overall, the gap between men and women appears to be narrowing. Despite rates of past-year cannabis use by people with a psychotic disorder being much higher than that of the general population, little has been documented about sex and age differences in patterns of cannabis use over time by people with a psychotic disorder.

Methods

To better understand trends in cannabis use by people with a psychotic illness, we examined sex and age differences in rates of past-year cannabis use using nationally representative data from two cross-sectional Australian national surveys of psychosis (1997, 2010). We then compared our findings to comparable general population data collected in the Australian National Drug Strategy Household Survey (1998, 2010).

Results

Prevalence of past-year cannabis use by people with psychotic illness dropped significantly from 38.2% to 33.7%. Both sexes showed a decline in use. The steeper decline in use by men aged 18–29 years (70.2% to 47.8%) contributed to a narrowing of the sex gap. Conversely, use by men aged 55–64 increased from 4.8% to 18.8%. In comparison, general population data showed a similar pattern of change across sex and age groups including a steeper decline in use by men aged 18–29 years, but only a very modest increase in use from 3% to 5%, by men aged 55 and over.

Discussion

Despite declining rates of past-year cannabis use in people with a psychotic illness, rates remain more than double that of the general population. Traditionally, men were more likely to use cannabis than women, but convergence in rates in younger people shows this is changing. Furthermore, cannabis use is not restricted to young people. Increasing use of cannabis by older men will place additional demands on drug and alcohol services.
T222. IMPAIRED COST-BENEFIT COMPUTATION IN SOCIAL CONTEXT IN PATIENTS WITH SCHIZOPHRENIA
Authors: Yan Chao , Shao Yu-xin , Wang Xuan , Chu Min-yi , Lv Qin-yu , Yi Zheng-hui
Published: May 2020

Background

Social withdrawal is one of core negative symptoms in schizophrenia, which dampens their social outcomes and prognosis. However, the underlying behavioral mechanisms of this symptom are poorly understood. In the present study, we aimed to explore the capacity of cost-benefit computation under social context in schizophrenia patients.

Methods

We recruited twenty-six patients, who met the criteria for diagnosis of schizophrenia, and thirty-one healthy controls matched for their age and gender ratio. All the participants were administrated to Effortful Job Interview Task, which is a novel behavioral paradigm where participants were asked to make an effort to get job offers. Before their taking effort, they were required to decide whether they would like to get involved in a less challenging job interview with no bonus point or a more challenging one with varied bonus points (i.e., 5, 15, 25 points, higher points indicate higher chance of getting a job offer).

Results

In healthy controls, there was a main effect of prize on the choice percentage of challenging job interview (F (2, 90) = 68.577, p <0.001), with higher percentage of picking challenging interview under large (25) and medium (15) bonus points than low bonus point (5). Schizophrenia patients, however, exhibited lower percentage of challenging interview choices under medium (p =.015) and large (p <.01) bonus points than healthy controls, as reflected by a significant Group x Prize interaction effect (F (2, 110) = 6.478, p <0.01). In addition, we observe significant negative correlations between percentage of challenging interview choices under large bonus and amotivation sub-score on the Scale for the Assessment of Negative Symptoms (r = -0.49, p = 0.01). Interestingly, patients with schizophrenia displayed spared experience of pleasantness when they received a job offer as compared with healthy controls (p = .09). But, they showed blunted aversive experience towards the outcomes of failure as compared to healthy controls (p < .01).

Discussion

These findings suggest that impaired social cost-benefit computation may play a central role in the symptoms of social withdrawal in schizophrenia, which may facilitate the clinical intervention of negative symptoms.