bluuebunny/crossref_metadata_2025 huggingface dataset:
M86. CAN WEIGHT GAIN CAUSE METABOLIC SYNDROME A DECADE LATER IN PATIENTS WITH SCHIZOPHRENIA SPECTRUM DISORDER?
Authors: Hawar Moradi , Helldin Lars , Olsson Anna-Karin , Anna Pontén
Published: May 2020

Background

Patients with schizophrenia spectrum disorder have a reduced life time expectancy with up to 20 years. Obesity and metabolic syndrome is highly prevalent and cardio vascular disease, CVD, remain the most common cause of the excess mortality. Despite studies showing the reduced life time expectancy and its causes the patients with schizophrenia spectrum disorder yet remain to benefit of the development of the healthcare. In this study we aim to focus on how the weight changes in different age groups and when do the cluster of conditions of metabolic syndrome start to occur.

Methods

In this naturalistic study we follow 71 patients, 47 man and 24 women diagnosed with schizophrenia spectrum disorder. We divided the patients into 5 different groups based on age. Group 1 aged 20–30 years, Group 2 aged 31–40 years, Group 3 aged 41–50 years, group 4 aged 51–60 years and Group 5 aged 61 years and elder. The longest time of observation was 18 years. Data on weight (kg) and disorders such as diabetes, hypertension and dyslipidemia were collected at baseline and then yearly thereafter. Data from baseline and the last yearly follow up were included in this study. Weight and the presence of the cluster of conditions that make up metabolic syndrome in the above-mentioned groups were analyzed.

Results

Patients in group 1 make the highest gain of weight with 0, 9 kg per year and group 2 with the least gain of weight only 0, 01 kg per year. Patients in group 3 have a weight loss of 0, 2 kg per year. At endpoint 9 out 19 patients in group 3 and 11 out of 21 patients in group 4 were treated for one, two or three conditions of the metabolic syndrome.

Discussion

In our study we show that weight gain appears at least 10 years before the development of metabolic syndrome. Despite the loss of weight that appear in group 3 the negative effects of the weight gained a decade earlier may be a factor that make patients aged 41 years and older to be at risk of developing metabolic syndrome.
M121. CLINICAL PREDICTION MODELS FOR TRANSITION TO PSYCHOSIS: AN EXTERNAL VALIDATION STUDY IN THE PRONIA SAMPLE
Authors: Rosen Marlene , Betz Linda , Bertolino Alessandro , Borgwardt Stefan , Brambilla Paolo , Chisholm Katharine , Kambeitz-Ilankovic Lana , Haidl Theresa , Lencer Rebekka , Meisenzahl Eva , Ruhrmann Stephan , Salokangas Raimo K R , Schultze-Lutter Frauke , Upthegrove Rachel , Wood Stephen J , Koutsouleris Nikolaos , Kambeitz Joseph
Published: May 2020

Background

A multitude of clinical models to predict transition to psychosis in individuals at clinical high risk (CHR) have been proposed. However, only limited efforts have been made to systematically compare these models and to validate their performance in independent samples.

Therefore, in this study we identified psychosis risk models based on information readily obtainable in general clinical settings, such as clinical and neuropsychological data, and compared their performance in the PRONIA study (Personalised Prognostic Tools for Early Psychosis Management, www.pronia.eu) as an independent sample.

Methods

Of the 278 CHR participants in the PRONIA sample, 150 had available data until month 18 and were included in the validation of eleven psychosis prediction models identified through systematic literature search. Discrimination performance was assessed with the area under the receiver operating characteristic curve (AUC), and compared to the performance of the prognosis of clinical raters. Psychosocial functioning was explored as an alternative outcome.

Results

Discrimination performance varied considerably across models (AUC ranging from 0.42 to 0.79). High model performance was associated with the inclusion of neurocognitive variables as predictors. Low model performance was associated with predictors based on dichotomized variables. Clinical raters performed comparable to the best data-driven models (AUC = 0.75). Combining raters’ prognosis and model-based predictions improved discrimination performance (AUC = 0.84), particularly for less experienced raters. One of the tested models predicted transition to psychosis and psychosocial outcomes comparably well.

Discussion

The present external validation study highlights the benefit of enriching clinical information with neuropsychological data in predicting transition to psychosis satisfactorily and with good generalizability across samples. Integration of data-driven risk models and clinical expertise may improve clinical decision-making in CHR for psychosis, particularly for less experienced raters. This external validation study provides an important step toward early intervention and the personalized treatment of psychotic disorders.
M122. DEPRESSION IN SCHIZOPHRENIA SPECTRUM DISORDERS: LONGITUDINAL COURSE AND THE RELATIONSHIP WITH OTHER CLINICAL PARAMETERS AND QUALITY OF LIFE
Authors: Phahladira Lebogang , Asmal Laila , Chiliza Bonginkosi , Luckhoff Hilmar , du Plessis Stefan , Kilian Sanja , Scheffler Freda , Emsley Robin
Published: May 2020

Background

The relationship between schizophrenia and depression is complex. Longitudinal studies on the course of depression in first episode schizophrenia populations are scarce and there are conflicting results on the predictive value of some baseline measures.

Methods

We conducted an open label longitudinal cohort study which included 126 patients with first-episode schizophrenia spectrum disorders treated with long-acting antipsychotic medication over 24 months. Depression was assessed at three monthly intervals using the Calgary Depression Scale for Schizophrenia. Changes in depression over time were assessed using the linear mixed-effect models for continuous repeated measures. The relationship between depression and other clinical parameters was assessed with regression models.

Results

Depressive symptoms were most prominent at baseline and showed highly significant reductions in the first three months (p<0.0001). Majority of the patients with depression improved with antipsychotic medication alone and we found associations between depressive symptoms with insight and poorer quality of life, however only illness awareness (p=0.0035) was the only significant predictor on depression in our regression analysis. There were a few differences between patients who experienced depression during the acute phase of treatment and those in the post-acute phase.

Discussion

Our findings suggest that depression in schizophrenia is common and generally responds well to treatment. The relationship between depression and insight has implications for further treatment considerations
M129. PATTERNS OF CHILDHOOD TEMPERAMENT ARE ASSOCIATED WITH ADULT PSYCHOTIC DISORDER IN A PROSPECTIVE COHORT STUDY
Authors: Clarke Mary , Brannigan Ross , Tanskanen Antti , Huttunen Matti , Leacy Finbarr , Cannon Mary
Published: May 2020

Background

Childhood temperament has previously been shown to be associated with mood and anxiety disorders later in life. Studies have also suggested possible links between childhood temperament and later psychosis.

Aim

To investigate the association between childhood temperament and its individual component factors, measured at age 5, and later psychiatric disorders including psychosis.

Methods

Using a sample from a Finnish birth cohort (N=1014), we used logistic regression models to examine associations between maternal reported childhood temperament at age 5, and later psychiatric diagnoses, ascertained through linkage with the Finnish Hospital Discharge Register.

Results

Individuals with a childhood temperament rated as difficult at age 5 had almost 5-times the odds of developing a psychotic disorder in adulthood compared to those with a temperament rated as average by their mothers (OR = 4.91, 95% CI = 1.51 – 15.91). The individual temperament factors of approach withdrawal, adaptability and quality of mood were each independently associated with later psychotic disorder while different temperament components were associated with increased risk of mood disorders.

Discussion

Early childhood temperament could be used in combination with other early life indicators to identify those at greatest risk for the development of psychosis later in life, and to inform the implementation of early interventions such as parent-training programs and school-based interventions to support children in developing more adaptive behavioural and self-regulatory strategies. Additionally, intervening early in a child’s life to support more optimal temperament development, such as better adaptability to new stressful situations through specific skills training, could be a viable target for early intervention to reduce psychosis risk.
M136. PSYCHOSIS POLYRISK SCORE (PPS): IMPROVING DETECTION OF INDIVIDUALS AT-RISK AND PREDICTION OF CLINICAL OUTCOMES
Authors: Oliver Dominic , Spada Giulia , Radua Joaquim , McGuire Philip , Fusar-Poli Paolo
Published: May 2020

Background

Primary prevention in Clinical High Risk for psychosis (CHR-P) can ameliorate the course of psychotic disorders. Further advancements of knowledge have been slowed by the standstill of the field, which is mostly attributed to its epidemiological weakness. This underlies the limited identification power for at-risk individuals and the relatively modest ability of CHR-P interviews to rule-in a state of risk for psychosis. One potential avenue for improving identification of individuals at risk for psychosis is a Psychosis Polyrisk Score (PPS) integrating genetic and non-genetic risk and protective factors for psychosis. The PPS hinges on recent findings that risk enrichment in CHR-P samples is accounted for by the accumulation of non-genetic factors e.g. parental and sociodemographic risk factors, perinatal risk factors, later risk factors, and antecedents.

Methods

A prototype of the PPS has been developed encompassing 26 non-genetic risk and protective factors, utilising Relative Risks (RR) from an umbrella review of risk and protective factors for psychosis onset in the general population. This was combined with prevalence data to ensure positive scores indicated increased psychosis risk and negative scores indicated decreased psychosis risk. To pilot this, patients referred for a CHR-P assessment (n=15) and healthy controls (n=66) were recruited and assessed with the PPS. Additionally, to investigate the range and distribution of these scores in the general population, 10,000,000 permutations were run utilising prevalence data to produce a simulated dataset.

Results

In the simulated general population data, scores ranged from -15 (least risk, equivalent RR = 0.03) to 39.5 (highest risk, RR = 8912.51). 50% of individuals had an RR < 1 (PPS < 0), 26.7% of individuals had an RR > 3 (PPS > 5), and 2.7% RR > 30 (PPS > 15). Patients referred for a CHR-P assessment had higher PPS scores (median=9, IQR=12.75) than healthy controls (median=-1.75, IQR=8.875). PPS scores in the simulated general population dataset (median=0, IQR=9.5) were similarly lower than patients.

Discussion

The PPS has potential for improving identification of individuals at risk for psychosis. Its distribution in a simulated general population is reflective of expected psychosis risk, with the vast majority of people not being at-risk and very few being at high risk. In addition to supplementing current assessments for CHR-P, this could be implemented at an earlier stage to stratify individuals based on psychosis risk and inform prognoses and clinical decision-making. This promise warrants further research to ascertain its prognostic accuracy and optimal thresholds for clinical intervention.
M145. ALTERED SUBCORTICAL EMOTIONAL SALIENCE PROCESSING AND A ‘JUMPING TO CONCLUSIONS’ BIAS IN PARKINSON’S PATIENTS WITH PSYCHOTIC SYMPTOMS
Authors: Knolle Franziska , Garofalo Sara , Viviani Roberto , Ermakova Anna , Murray Graham
Published: May 2020

Background

Current research does not provide a clear explanation for why some patients with Parkinson’s Disease (PD) develop psychotic symptoms. In schizophrenia research the ‘aberrant salience hypothesis’ of psychosis has been influential in explaining the development of psychotic symptoms. The theory proposes that dopaminergic dysregulation leads to inappropriate attribution of salience to otherwise irrelevant or non-informative stimuli, facilitating the formation of hallucinations and delusions, by providing irrational explanations. However, this theory has received very limited attention in the context of PD-psychosis.

Methods

In the study, we investigated salience processing in 14 PD-patients with psychotic symptoms, 23 PD-patients without psychotic symptoms and 19 healthy controls. All patients received dopaminergic medication. There was no difference in the medication dose between the two patient groups. We examined emotional salience using a visual oddball fMRI paradigm that has been used to investigate early stages of schizophrenia spectrum psychosis, controlling for resting cerebral blood flow (arterial spin labelling fMRI). Furthermore, a subgroup of the two patient groups complete a behavioural ‘jumping to conclusions’ task.

Results

We found significant differences in brain responses to emotional salience between the two patient groups. PD-patients with psychotic symptoms revealed enhanced brain responses in the striatum, the hippocampus and the amygdala compared to patients without psychotic symptoms. PD-patients with psychotic symptoms showed significant correlations between the levels of dopaminergic drugs they were taking and BOLD signalling, as well as psychotic symptom scores. Furthermore, our data provide first indications for dysfunctional top-down processes, measured in a ‘jumping to conclusions’ bias.

Discussion

Our study suggests that enhanced signalling in the striatum, hippocampus and amygdala together with deficient top-down cognitive regulations is associated with the development of psychotic symptoms in PD, similarly to that proposed in the ‘aberrant salience hypothesis’ of psychosis in schizophrenia.
M147. ABERRANT TIMING AND ODDBALL DETECTION IN SCHIZOPHRENIA: FINDINGS FROM A TIME DISCRIMINATION / ODDBALL FMRI STUDY
Authors: Goena Javier , Sol Garcés María , Alústiza Irene , Fernández-Martínez Miguel , Fernández-Seara María , García-Eulate Reyes , Ortuño Felipe
Published: May 2020

Background

Schizophrenia (SZ) is associated with deficits in both temporal and salience processing. The underlying neurological dysfunctions in both processes, which are interrelated and share neuroanatomical bases, remain poorly understood. Our main objective is to examine the hypothesis that the dysfunction of the brain circuits involved in time and salience processing underlies the cognitive deficit of schizophrenia and, to a lesser extent, in bipolar disorder (BD).

Methods

10 schizophrenia patients, 7 bipolar depression patients and 10 healthy volunteers carried out an original experimental test of TD/OD during fMRI brain scanning. All participants performed the MATRICS Consensus Cognitive Battery to assess their cognitive profile.

Results

We found that SZ patients showed hypoactivation in cortical and subcortical areas related both with time processing and Salience Network. The dysfunction observed during timing tasks partially coincided with deficiencies in Oddball tasks.

Discussion

A dysfunctional timing/salience detection network underlies the cognitive impairment observed in SZ but not in BD patients.
M175. BRAIN STRUCTURAL CORRELATES OF FUNCTIONAL CAPACITY IN FIRST-EPISODE PSYCHOSIS
Authors: Alkan Erkan , Davies Geoff , Evans Simon
Published: May 2020

Background

Impaired functional capacity is a core feature of schizophrenia and present even in first episode psychosis (FEP) patients. Impairments in daily functioning tend to persist despite antipsychotic therapy but their neural basis is not clear. Previous studies suggest that volume loss in frontal cortex might be an important contributor but findings are inconsistent. We aimed to comprehensively investigate the brain structural correlates of functional capacity in first episode psychosis using MRI and a reliable objective measure of functioning (University of California, San Diego Performance-Based Skills Assessment (UPSA))

Methods

In FEP and a well-matched control group, we measured cortical thickness, gray matter volume, and white matter tract integrity (fractional anisotropy, FA) in specific regions implicated by previous work. Between-group differences in these parameters were assessed first. We then examined correlations between MRI measures and UPSA scores in the FEP group while controlling for negative symptomology and medication use.

Results

The FEP group had thinner cortex in various frontal regions, fusiform, and insula, and reduced FA in inferior longitudinal fasciculus. In FEP, poorer functioning (UPSA) correlated with reduced superior frontal volume and lower FA in inferior longitudinal fasciculus.

Discussion

In accordance with previous findings, FEP exhibited widespread brain structural differences compared to controls. Importantly, frontal brain volumes and integrity of the inferior longitudinal fasciculus were identified as the structural correlates of functional capacity in FEP, after controlling for other relevant factors. These findings enhance mechanistic understanding of functional capacity deficits in schizophrenia by specifying the underlying neural correlates. In future, this could help inform intervention strategies.
M183. SINGLE-SESSION DANCE/MOVEMENT THERAPY FOR THOUGHT AND BEHAVIORAL DYSFUNCTION ASSOCIATED WITH ACUTE SCHIZOPHRENIA: A MIXED METHODS FEASIBILITY STUDY
Authors: Biondo Jacelyn
Published: May 2020

Background

Dance/movement therapy (DMT) interventions have been used to support people with schizophrenia; however, these typically include lengthier interventions. Current inpatient hospitalization lengths of stay do not offer the time needed to implement such interventions. The current treatment protocol for people in acute phases of schizophrenia is psychopharmacological; however, high rates of medication nonadherence and limited effects on negative symptomatology suggest the need for complementary psychosocial treatment options. The purpose of this study was to determine: feasibility of protocol completion, feasibility of measurement sensitivity, and the effects of a single-session DMT intervention compared to a single-session verbal treatment as usual (TAU) intervention.

Methods

This mixed methods feasibility study utilized a convergent mixed methods feasibility design. Qualitative and quantitative data were collected simultaneously in a single phase from the experimental and control groups. In this study, the quantitative strand was prioritized and constituted most of the data collection. A qualitative strand was added to enhance the understanding of participants’ experiences of the intervention and control conditions.

Thirty-two participants were randomized to a 45-minute DMT session or a 45-minute verbal TAU session. Quantitative data were collected using the Brief Psychiatric Rating Scale, and qualitative data through semi-structured interviews.

Results

indicated that participants in the DMT intervention group had statistically significant symptom reduction versus those in the TAU group in overall BPRS scores (p < 0.001), Psychological Discomfort (p < 0.001), Negative Symptoms (p = 0.007), and Positive Symptoms (p = 0.003). No statistical significance was shown for Resistance. Qualitative findings substantiate the quantitative findings, however, show divergence regarding Resistance. Participants in the DMT group expressed feeling more in control, less angry, and motivated for continued treatment.

Discussion

These findings suggest that a single-session DMT intervention can alleviate symptoms associated with acute schizophrenia including affective regulation, and positive and negative symptomatology such as isolation, spontaneity, interpersonal skills, paranoia, and auditory hallucinations. Psychosocial interventions may be used in tandem with psychopharmacological interventions to support increased stabilization for patients experiencing acute phases of schizophrenia.
M199. COPY NUMBER VARIANCE (CNV) ANALYSIS TO DETERMINE OPTIMAL ANTIPSYCHOTIC DOSAGE IN SCHIZOPHRENIA: A PILOT STUDY
Authors: Adanty Christopher , Wang Kevin , Dada Oluwagbenga , Wun Janice , Bani-Fatemi Ali , De Luca Vincenzo
Published: May 2020

Background

The relationship between genetic polymorphisms of antipsychotic drug-metabolizing agents and drug response has been thoroughly investigated and analyzed. However, from a pharmacokinetic standpoint, few studies have explored the relationship between Copy number variants (CNV) and antipsychotic dosage. The aim of the present study is to test the association between antipsychotic dosage and CNV in schizophrenia (SCZ) patients.

Methods

The current dosage of antipsychotic medications was collected from 263 schizophrenia patients. The dosage was standardized using three different methods: chlorpromazine equivalent(CPZe), defined daily dose (DDD), and percentage of maximum dose (PM %). The patients were then genotyped using the Illumina HumanOmni2.5–8 BeadChip Kit.

Results

The CNV analysis did not show that CNVs are associated with dosage variation for CPZe, PM %, and DDD.

Discussion

In this pilot sample, we investigated for the first time CNVs and standardized antipsychotic dosage. The relationship between CNV and optimal antipsychotic dosage has far reaching clinical implications. Further analysis is required that utilitze large prescription databases to build on the results presented in this pilot study.
S87. IDEAL CARDIOVASCULAR HEALTH IN RACIALLY AND ETHNICALLY DIVERSE PEOPLE WITH SERIOUS MENTAL ILLNESS
Authors: Hawes Mark , Roth Kimberly , Wang Xiaoyan , Stefancic Ana , Weatherly Christopher , Cabassa Leopoldo
Published: May 2020

Background

Cardiovascular disease (CVD) is a primary contributor to premature death among people with serious mental illness (SMI). This study examined the prevalence and correlates of the American Heart Association (AHA) metric of ideal cardiovascular health (ICVH) in racially and ethnically diverse people with serious mental illness living in supportive housing.

Methods

Our study used baseline data from an NIMH-funded trial testing the effectiveness of a peer-led healthy lifestyle intervention, for overweight/obese participants with SMI in three supportive housing agencies. A total of 314 participants were enrolled in the trial and included in these analyses. Five ICVH metrics (BMI, smoking, diet, physical activity, and blood pressure [BP]) were measured and summed to create a composite ICVH score. Correlates were informed by findings from systematic literature reviews examining ICVH in the general population and studies examining correlates of CVD in people with SMI. Hierarchal regression analysis was used to examine the associations of sample correlates with the composite ICVH score.

Results

The mean age of participants was 48.7 and 57.3% were male. The most common lifetime mental health diagnoses were depression (75.2%), schizophrenia/schizoaffective disorder (56.7%), and bipolar disorder (46.5%). Approximately 38.5% of participants reported lifetime substance abuse/dependence. The majority (62.7%) were taking an antipsychotic medication. Lifetime physical health diagnoses were high cholesterol (36.3%), diabetes (32.5%), cardiovascular disease (17.2%), and cancer (4.5%). Participants walked on average 318.4 meters during the six-minute walking test (6MWT), a measure of cardiorespiratory fitness (CRF). The prevalence of smoking (64.7%) and obesity (64%) were high, while the prevalence of ideal physical activity (37.6%), healthy diet status (2.2%), and ideal BP (23.6%) were low. The mean ICVH composite score was 3.15 (range 0 – 8). After controlling for all covariates, women, racial/ethnic minorities, use of antipsychotic medications, lifetime cancer diagnosis, and poor CRF were significantly (p < .05) related to low ICVH scores.

Discussion

In our racially/ethnically diverse sample of people with SMI in supportive housing, the prevalence of ICVH was low. Our findings suggest that there are specific subgroups that may benefit from targeted screening and interventions to improve cardiovascular health. The association between CRF and ICVH scores highlights the importance of increasing physical activity and reducing sedentary behavior. The AHA ICVH metric can be a useful tool for tracking and improving the cardiovascular health of people with SMI.
S122. TEN-YEAR FOLLOW-UP AFTER FIRST EPISODE PSYCHOSIS: FOCUSED ON LOW DOSE ANTIPSYCHOTIC MAINTENANCE AND FUNCTIONING
Authors: Liu Chen-Chung , Liu Chih-Min , Chien Yi-Ling , Lin Yi-Ting , Hsieh Ming H , Hwang Tzung-Jeng , Hwu Hai-Gwo
Published: May 2020

Background

Patients’ long-term phenomenology and outcomes after first episode psychosis are of great interest to patients, their caregivers and care providers. Contradictory messages regarding the necessity of long-term antipsychotic treatment and the factors affecting outcomes warrant careful examination.

Methods

We conducted a retrospective observational study by reviewing medical records at the study hospital of a cohort of patients since their participation in an early psychosis study starting from 2006, with special focus on patients maintaining very low dose antipsychotics and their functioning.

Results

Of the 81 patients with first episode psychosis, 55 patients (67.9%) had follow-up information for longer than 5 years. The majority (n=46, 83.6%) had non-affective psychosis, 20 patients (36.4%) had full-time employment/education by the time of their latest visit and 10 patients (18.2%) received very low dose antipsychotics (chlorpromazine equivalent [CPZE] dose < 50 mg/d) during maintenance, which was significantly correlated to good functioning. Being male, having a history of hospitalization and being on clozapine therapy were correlated to poorer functioning. Fifteen of the 20 good-functioning patients received dosage of antipsychotics no more than the reported minimum effective dose (CPZE 200 mg/d). Antipsychotic-free status was achieved only in two non-psychotic patients.

Discussion

A substantial proportion of patients could achieve good functioning under low-dose antipsychotic maintenance after first episode psychosis, even if they cannot successfully discontinue antipsychotic treatment in the long run. Optimizing the balance between preventing relapse and preserving functioning by fine-tuning antipsychotic dosage during maintenance is a challenge warranting more clinical attention.
S141. REWARD PROCESSING IN CHILDREN WITH PSYCHOTIC-LIKE EXPERIENCES
Authors: Harju-Seppänen Jasmine , Mason Liam , Bramon Elvira , Bell Vaughan
Published: May 2020

Background

Individuals with psychosis display an attenuated response to reward. However, it has not yet been established whether individuals with psychotic-like experiences (PLEs) also exhibit alterations in reward anticipation.

Methods

The present study examined whether non-distressing and distressing PLEs were associated with functional activity in the nucleus accumbens during reward anticipation. The sample consisted of 10313 children from the ABCD study aged 9–10 who had participated in the Monetary Incentive Delay task. PLEs were measured using the Prodromal Questionnaire Brief Child version and functional activity was measured using regional fMRI summary statistics for reward anticipation activation (data release 2.0, contrast of expected large reward versus neutral expectation). Linear mixed-effects models were used to investigate the relationship between reward anticipation and PLEs (distressing and non-distressing), whilst controlling for gender, household income, ethnicity, BMI and affective symptoms. The analyses were weighted by the average standard error of the mean activation in the accumbens. Separate linear mixed-effects models were conducted for the right and left hemisphere.

Results

6169 (59.8%) of the children did not report any PLEs, compared to 2270 (22.0%) with non-distressing PLEs and 1874 (18.2%) with distressing PLEs. We ran a regression to examine the association between reward anticipation and PLEs (distressing or non-distressing) and found that non-distressing PLEs were related to reduced reward anticipation in the right nucleus accumbens (P = 0.009). However, there was no significant association between reward anticipation and PLEs when adjusting for potential confounders.

Discussion

In the present study of 9–10 year olds, reward anticipation was not associated with PLEs. As previous research has found reductions in reward anticipation in individuals with schizophrenia, further follow-up studies of the ABCD cohort are needed to explore whether these associations emerge during adolescence.
S158. URBANICITY INDEX AND CORTICAL GYRIFICATION IN SCHIZOPHRENIA
Authors: Korann Vittal , Thonse Umesh , Jacob Arpitha , Patil Vaishnavi A , Shiri Sahana , Devi Priyanka , Nagendra Bhargavi , Kunte Mugdha , Shukla Ayushi , Padmanabha Anantha , Vijay Kumar K G , Varambally Shivaram , Venkatasubramanian Ganesan , Rao Naren P
Published: May 2020

Background

Urban birth and upbringing are considered to be risk factors for schizophrenia, but recent studies do not support the same. While several hypotheses are suggested, the pathogenic mechanisms are not known. Notably, no study has examined brain changes, if any, associated with an urban upbringing in schizophrenia. Hence, in this study, we examined the effect of urban upbringing on the cortical gyrification in schizophrenic patients.

Methods

We recruited 108 persons with DSM-IV schizophrenia and 74 healthy volunteers. Study participants underwent clinical assessments using Positive and negative syndrome scale, Calgary depression scale to measure severity of clinical symptoms. All participants were scanned using 3T MRI scanner and a high resolution T1 structural scan was obtained. Cortical gyrification measurements were conducted on these images using Freesurfer software. Statistical maps were generated in Query, design, Estimate, Contrast (QDEC) interface. A Monte Carlo Simulation (MCS) was run for FWE correction with the threshold 1.3 (p<0.05) in QDEC. Participants upbringing place was noted with respect to the place where they lived for the first 15 years of life. Based on Census India of 2011, the places were categorized into 1) rural 2) statutory town and 3) census town. These 3 groups and assigned values 1,2 and 3, respectively, which were then rated for each year of life (1–15) and urbanicity index was calculated using a previously used method (range from 15 to 45). A regression analysis was implemented in QDEC with age, sex, education and demean ICV as covariates to examine the relation between Urban upbringing and cortical gyrification index.

Results

In the overall population, HV had higher gyrification index in the left superior parietal cortex (p<0.008) than SCZ. There was a significant negative correlations between gyrification index and urbanicity index in left postcentral (p<0.0001), left insula (p<0.0001), left fusiform (p<0.0005), left rostral middle frontal (p<0.01), right supramarginal (p<0.0001), right fusiform (p<0.0001), and right superior temporal (p<0.005) cortices.

Discussion

The results indicate a significant effect of urbanicity on cortical gyrification in patients with SCZ as well as HV. The presence of deficits in frontal areas indicate the likely effect of urban upbringing on growth and maturation of the frontal cortex. Interestingly, the presence of difference in areas implicated in schizophrenia provides support to the possible increased risk of urban upbringing on schizophrenia. The preliminary evidence from this analysis provides the necessary rationale to further examine the impact of urban upbringing on brain structure/ function and the risk of developing schizophrenia.
S186. THE EFFECTS OF CHILDHOOD TRAUMA ON HIPPOCAMPAL VOLUME IN FIRST EPISODE PSYCHOSIS: DOES CORTISOL PLAY A ROLE?
Authors: Ciufolini Simone , Kempton Matthew , Gayer-Anderson Charlotte , Taylor Heather , Reis Marques Tiago , Fisher Helen , Di Forti Marta , Murray Robin , Zunszain Patricia , Morgan Craig , Pariante Carmine , Mondelli Valeria , Dazzan Paola
Published: May 2020

Background

Childhood trauma is one of the most important risk factors in psychosis. Mounting evidence is associating early trauma exposure with alterations in stress sensitive areas, like the hippocampus, and abnormal concentrations of the main stress hormone, cortisol. As hippocampus is a pivotal brain region in the hypothalamus–pituitary–adrenal (HPA) axis regulation of cortisol, better understanding the relationship between childhood trauma, hippocampus structure and cortisol concentration would help clarify how childhood trauma exposure can increase the risk of developing psychosis later on in life.

Methods

Brain structure was evaluated with a 3T MRI scan in 86 first episode psychosis patients (FEP) (49 of which positive for severe childhood trauma) (mean age: 27.8 SD ± 9.1 years). Hippocampal volume and the segmentation of the hippocampal subfields was obtained using FreeSurfer 6. Salivary cortisol samples were collected to measure cortisol levels at awakening (CAR). Initially two separate linear regression models were ran: 1) to predict hippocampal volume changes with childhood trauma as the independent variable and 2) to predict hippocampal volume changes with CAR as independent variable. Finally, we introduced CAR as moderator in the linear model 1 to explore whether it changed the relationship between childhood abuse and hippocampal volume.

Results

Individuals with psychosis and severe childhood abuse presented smaller volume of the right hippocampal head (β = -108.9, p = 0.027), particularly in subfields CA1, CA3, CA4 and in the right GC-ML-DG head (all significant at p < 0.05 with βs between – 110 and -90) (linear model 1). CAR did not predict changes in hippocampal volumes (linear model 2). However, when CAR was introduced the relationship between childhood abuse and hippocampal volume (linear model 1) it showed a moderator role. Indeed low levels of CAR were associated with an even further reduction in hippocampal volume in the right hippocampal head and particularly in subfields CA1, CA3 and CA4 (all significant at p < 0.05 and βs between – 150 and -180).

Discussion

These results suggest that exposure to childhood trauma has a long-term effect on the adult brain particularly in hippocampal areas related to the encoding and retrieval of memories. Importantly, low levels of CAR are associated with even smaller hippocampal head in patients who childhood trauma This is particularly important, because an abnormal hippocampal structure could alter the hippocampal feedback on the HPA axis leading to dysfunctional (lower) cortisol production, which in turn would amplify the impact on brain stress sensitive regions of further stress exposure.
S188. VISUAL ATTENTION IN EARLY-ONSET SCHIZOPHRENIA AND OTHER NEURODEVELOPMENTAL DISORDERS: THE IMPACT OF SPEAKING WHILE LOOKING AT PICTURES OF SOCIAL INTERACTIONS – EVIDENCE FROM EYE TRACKING DATA
Authors: Ioannou Chara , Canu Daniela , Müller Katarina , Martin Matthias , Bender Stefan , Smyrnis Nikos , Biscaldi Monica , Fleischhaker Christian , Klein Christoph
Published: May 2020

Background

Visual attention in Schizophrenia (SZ) differs from that of neuro-typical controls, and scan-path abnormalities have been proposed as a robust marker of the disorder (Nishiura et al., 2007). In free viewing paradigms, a restricted area of visual exploration has been reported as a robust atypical finding in SZ participants across a variety of depicted contents (Beedie et al., 2011), and has been shown to be a highly efficient discriminator between SZ and healthy controls (Benson et al., 2012). Moreover, speaking about what one sees during the act of looking has been shown to impact visual exploration behavior (Klein et al., 2014). Finally, despite clinical and genetic-biological relationships between schizophrenia, autism and ADHD (Owen & O’Donovan, 2017) there is, to our knowledge, yet no direct comparison between these neurodevelopmental disorders using eye tracking. The “head-to-head” comparison is the primary objective of this study.

Methods

We tested four groups of adolescent and young adults, namely early-onset Schizophrenia (SZ, N=21, 15 males, mean age ± 1 standard deviation 19.7±1.7 years), Attention Deficit Hyperactivity Disorder (ADHD, N=28, 15 males, 19.9±1.4 years), Autism (ASD, N=26, 25 males, 19.7±1.9 years), and typical controls (TD, N= 29, 12 males, 19.8±1.6 years). The ocular-motor task battery comprised of different free viewing tasks including free viewing of different kinds of social interactions in static pictures whilst solely viewing versus viewing-plus speaking (in counterbalanced order). Eye movements were recorded with 1.000Hz using the EyeLink 1000+ system and analyzed with Data Viewer Eyelink Software and MATLAB (Version R2017a, Mathworks, USA). Statistical Analysis was performed in SPSS Statistics 2.3 (IBM, USA).

Results

Visual attention of SZ patients manifested significant less gaze scatter than TD whilst merely looking at the images. During looking and speaking, however, the two groups had a similar spatial scatter of fixations. Preliminary analyses indicate that participants with ADHD and ASD did not differ from TD in this measure.

Discussion

Constraint gaze scatter in visual exploration is a robust and discriminating finding in schizophrenia that has been associated with the negative symptomatology of the disorder. The present results confirm our previous findings (Klein et al., 2014) and suggest that the act of speaking may partially counteract and compensate the restricted visual scanning performed by SZ participants, thus contributing to a better understanding of Visual Attention in SZ and its differentiation from other neurodevelopmental disorders.
S196. TRANSCRANIAL MAGNETIC STIMULATION IN SCHIZOPHRENIA WITH PROMINENT NEGATIVE SYMPTOMS- A REVIEW OF THE LITERATURE
Authors: Vasiliu Octavian
Published: May 2020

Background

Negative symptoms in schizophrenia are associated with lower quality of life, worse functional prognosis and poorer response to the psychopharmacological treatment [1]. Many efforts have been made to find new approaches for negative symptoms, and neuromodulation techniques may represent a solution for these patients when antipsychotics have reached their limits of efficacy [2]. Transcranial magnetic stimulation (TMS) is based on the use of alternating magnetic fields to induce electrical current in the cortical areas, being mainly used for patients with treatment-resistant depression and it is considered safe and well tolerated [3].

Methods

A narrative review of data regarding the efficacy of transcranial magnetic stimulation for patients with schizophrenia with prominent negative symptoms was performed. Papers published between January 2000 and July 2019 in the main electronic databases (PubMed, Cochrane, EMBASE, CINAHL) were included in this review. The keywords used for database search were “schizophrenia” and “negative symptoms” and “transcranial magnetic stimulation” or “repetitive transcranial magnetic stimulation”.

Results

The treatment of negative symptoms in schizophrenia with high frequency TMS has been associated with favorable results in clinical trials. The targeted zones were dorsolateral prefrontal cortex, either bilaterally or only on the left side. The results varied upon the stimulation regimen, including duration, frequency, uni- versus bilaterally application etc. Two meta-analyses were identified and their results supported an effect size from 0.58 to 0.63 [2,3]. However, negative results derived from well designed clinical trials exist, which show no difference in the Positive and Negative Syndromes Scale (PANSS) - negative symptom score between rTMS and sham rTMS [4,5]. An exploratory analysis of a large-scale trial showed the impact of rTMS on different negative symptom domains confirmed no additional beneficial effect of the actove comparative to sham rTMS [5]. Also, data exist about the potential of rTMS for increasing task-related in frontal areas in patients with schizophrenia with negative predominant symptoms, which may grant further exploration of the mechanisms underlying the effects of rTMS.

Discussion

Data about the efficacy of TMS in schizophrenia with negative symptoms are controversial, because both evidence to support its efficacy and its lack of efficacy exist in clinical trials. However, meta-analyses support an important size effect which may be comparable to that of the pharmacological treatment.

References
S199. HOW TO COLLECT FREE SPEECH TO SPEECH GRAPH ANALYSIS: STANDARDIZED TIME-LIMITED PROTOCOL
Authors: Simabucuru Gabriela , Copelli Mauro , Ribeiro Sidarta , Mota Natália
Published: May 2020

Background

SpeechGraphs is a computational tool successfully applied to the differential diagnosis of psychosis based on the non-semantic structural analysis of speech graphs. This approach provides quantitative, fast, and low-cost measurements of clinical interest based on free speech, but its replicability needs to understand how different ways to collect speech data can impact such measurements. Stimuli or interruption on a patient’s speech can have a direct impact, especially on SpeechGraphs analysis. We developed a standard for data collection, controlling the time in order to keep the subject talking for a minimum of 30 seconds, and only stimuli the patient’s speech with general instructions. We aim to investigate specifically the impact of considering interviewers interferences marked as paragraphs in transcriptions, and the impact of a time-limited standardized protocol to avoid this bias.

Methods

Two different speech samples from a previous study were compared: 1) using free speech (N = 60, Mota 2014) or 2) using the proposed time-limited protocol (sub-sample of N = 31, Mota 2017). For both samples, we calculated connectedness attributes (such as LSC) in two in two different transcribing conditions: with and without paragraphs. The paragraphs represented the interviewer’s stimuli, and when paragraphs were deleted, we connected the subject’s speech in a unique line.

Results

Interviewer’s interferences marked by line-breaks or paragraphs had an impact on connectedness results for the freely speaking protocol (LSC Schizophrenia x Non-Schizophrenia: p = 0.0051 and without paragraph, LSC Schizophrenia x Non-Schizophrenia: p = 0.7764). The standardized protocol with a time limit was sufficient to avoid this bias: we found that there are no differences in considering or not paragraphs, with reports of 30 seconds (LSC Schizophrenia x Non-Schizophrenia: p = 0.0017 and without paragraph, LSC Schizophrenia x Non-Schizophrenia: p=0.0003)

Discussion

The standardized data collection protocol seems to be robust in comparison to not controlled methods to collect free speech, allowing the automatization of data gathering and transcriptions, preventing methodological errors in future SpeechGraphs applications.
Perspectives and reflections on teaching linear algebra
Authors: Rensaa Ragnhild Johanne , Hogstad Ninni Marie , Monaghan John
Published: May 2020

This paper presents ‘expert opinions’ on what should be taught in a first-year linear algebra course at university; the aim is to gain a generic picture and general guiding principles for such a course. Drawing on a Delphi method, 14 university professors—called ‘experts’ in this study—addressed the following questions: What should be on a first-year linear algebra undergraduate course for engineering and/or mathematics students? How could such courses be taught? What tools (if any) are essential to these two groups of students? The results of the investigation, these experts’ opinions, mainly concern what should be in a linear algebra course (e.g. problem-solving and applications) and what students should be able to do. The experts also emphasized that certain theoretical aspects (e.g. proofs, abstract structures, definitions and relationships) were more important to mathematics students. There was no real consensus among the experts on teaching methods or the use of digital tools, but this lack of consensus is interesting in itself. The results are discussed in relation to extant research.
Safety reassessment of cinobufotalin injection: new findings into cardiotoxicity
Authors: Li Min , Wang Xijie , Qiu Yunliang , Zhang Yizhe , Pan Xueying , Tang Naping , Chen Tao , Ruan Bing , Shao Shuming , He Liang , Li Hua , Ma Jing
Published: May 2020

Cinobufotalin injection, a traditional Chinese medicine preparation, successfully used for several years, might induce cardiotoxicity. The aim of the study was to evaluate the cardiotoxicity of cinobufotalin injection and the cardiotoxicity-preventive effect of sodium phenytoin in vivo. According to the 4 × 4 Latin square design, four Beagle dogs were allocated into four dose levels of 0, 0.3, 1, and 3 g/kg in treatment phases I–IV (cinobufotalin injection) and 3 g/kg in treatment phase V (cardiotoxicity antidote). The following parameters and endpoints were assessed: clinical observations, body weight, indicators of myocardial injury, and electrocardiogram (ECG) parameters. The cinobufotalin injection-related changes were observed in clinical observations (rapid breathing pattern), indicators of myocardial injury (increased cardiac troponin I, creatine kinase isoenzymes, and aspartate aminotransferase), and ECG graphics (arrhythmia) at 3 g/kg concentration in treatment phases I–IV. The cardiotoxicity of cinobufotalin injection was attenuated by sodium phenytoin in treatment phase V. The results confirmed the cardiotoxicity of cinobufotalin injection, and they might bring information about the appropriate monitoring time points and cardiotoxicity parameters in clinical practices and shed light on the treatment of cardiovascular adverse reactions.
Bloody Diarrhea Caused by Intestinal Myiasis in an Infant: A Case Report and Review of Pediatric Literature
Authors: Chen Xiu-Qi , Zhang Kang-Ling , Shan Qing-Wen
Published: May 2020

Intestinal myiasis caused by fly larvae parasitic in gastrointestinal tract was rare reported in children. We reported an infant with bloody diarrhea caused by intestinal myiasis. A 1 year and 7 months old boy presented with the only symptom of bloody diarrhea of unknown origin. In the second week of onset, numerous moving worms were observed in the bloody stool after bowel preparation with polyethylene glycol for colonoscopy. The bloody diarrhea disappeared after 1 week of combined therapy with albendazole and metronidazole. On follow-up after 6 months, the patient remained well without bloody diarrhea. In conclusion, intestinal myiasis being a rare disease that is very challenging to diagnose, physicians should remember it when they receive cases of bloody diarrhea with non-specific symptoms without any apparent cause.
Reducing Pediatric Tracheostomy Wound Complications: An Evidence-Based Literature Review
Authors: Baker Lindsay R. , Chorney Stephen R.
Published: May 2020

OBJECTIVE

To discuss prevention strategies that can mitigate the frequency of tracheostomy-related wound complications.

DATA SOURCES

A systematic literature review of PubMed between 2010 and 2019.

STUDY SELECTION

Full-text articles written in English language and studying human participants younger than 18 years.

DATA EXTRACTION

The primary outcome was the rate of tracheostomy-related skin complications after implementation of a given intervention. Secondary outcomes included rates of accidental decannulation or other complications.

DATA SYNTHESIS

A total of 348 studies were identified and 6 met inclusion criteria. There were 1,607 children included with interventions designed to reduce peristomal and cervical wound complications in 1,174 (73.1%). Strategies considered safe and effective included protective skin barriers, reducing prolonged pressure, and early wound identification protocols.

CONCLUSIONS

Wound complications after pediatric tracheostomy can be reduced using a multifaceted approach by providers committed to making skin care a priority.