bluuebunny/crossref_metadata_2025 huggingface dataset:
T72. COGNITIVE CLUSTERS IN FIRST-EPISODE PSYCHOSIS AND THEIR RELATIONSHIP TO SYMPTOMATOLOGY AND DEVELOPMENTAL SCHOLASTIC PERFORMANCE
Authors: Tan Eric , Rossell Susan , Subotnik Kenneth , Ventura Joseph , Nuechterlein Keith H
Published: May 2020

Background

Groups with differential levels of cognitive impairment are increasingly recognized among patients with schizophrenia spectrum disorders. Using cluster analytical techniques, this study sought to explore cognitive clusters in a sample of first-episode psychosis patients and compare levels of symptomatology as well as childhood and adolescent scholastic performance between the resultant groups.

Methods

Data from 105 first-episode psychosis patients (n=56 with schizophrenia, n=13 with schizoaffective disorder, depressed type, n=36 with schizophreniform disorder) (mean age=22.06, SD=3.79) in the UCLA Aftercare Research Program were used for this analysis. Cognition was assessed using a modified beta version of the MATRICS Consensus Cognitive Battery which consisted of 16 tasks across seven cognitive domains. Symptomatology and developmental scholastic performance were assessed using the Brief Psychiatric Rating Scale and the Cannon-Spoor Premorbid Adjustment Scale respectively. Hierarchical cluster analysis with Ward’s method and squared Euclidean distance was conducted, confirmed by discriminant function analysis and optimized with k-means clustering. Stability of the solution was evaluated through split-sample (random 80% and 70% samples) and alternate method (average linkage method) replication via Cohen’s κ analysis.

Results

Three clusters were identified: most impaired (n=27), moderately impaired (n=41) and good (n=37). Controlling for multiple comparisons, one-way ANOVAs revealed no significant differences in symptomatology between the groups (p>.008). Significant differences were observed for scholastic performance at three different developmental stages: childhood (p<.0001), early adolescence (p<.0001) and late adolescence (p<.0001), with the good group demonstrating significantly better scholastic performance than both the moderately impaired and most impaired groups (who did not significantly differ from each other) at all three stages.

Discussion

The findings add to growing evidence that cognitive clusters in FEP mirror that of later-stage schizophrenia. Cognitive clusters were not associated with differences in symptom severity, but reflected differing levels of premorbid scholastic performance during the developmental years. This suggests that performance at school may not just be a risk factor for developing schizophrenia, but also related to the severity of impairment and potentially prognosis.
T80. CARDIOMETABOLIC RISK PREDICTION ALGORITHMS AND THEIR APPLICABILITY FOR YOUNG PEOPLE WITH PSYCHOSIS: A SYSTEMATIC REVIEW AND ILLUSTRATIVE EXAMPLE USING ORIGINAL DATA FROM A POPULATION-BASED BIRTH COHORT
Authors: Jang Soomin , Crawford Owen , Perry Benjamin , Jones Peter B , Khandaker Golam
Published: May 2020

Background

Cardiometabolic risk prediction algorithms are used in clinical practice. Young people with psychosis are a high-risk group for developing cardiometabolic disorders, but it is unclear whether existing algorithms are suitable for this group.

Methods

We conducted a systematic review employing PRISMA criteria to identify studies reporting the development and/or validation of cardiometabolic risk prediction algorithms for general or psychiatric populations. A narrative synthesis was conducted to compare algorithms and consider their suitability for young people with psychosis. In addition, we used data from 3,470 young adults aged 18 years from the ALSPAC birth cohort to illustrate the impact of age on model performance of QDiabetes, an established algorithm.

Results

Having screened 6,609 studies, we included 57 risk algorithms designed for type 2 diabetes, cardiovascular disease or stroke, all of which were developed/validated in relatively older participants. Three algorithms featured psychiatric predictors and could be used for young people with psychosis. However, in all of three, age was weighted to a much greater extent than other risk factors. Furthermore, using ALSPAC data, we report that QDiabetes significantly under-predicted cardiometabolic risk in young people. Increasing the sample age to 50, leaving all other predictors unchanged, improved algorithm calibration markedly.

Discussion

Existing cardiometabolic risk prediction algorithms are heavily weighted on age and so under-predict risk in young people. A new or recalibrated algorithm is required for young people with psychosis that appropriately balances the weighting of relevant risk factors.
T91. THE POSITIVE AND NEGATIVE SYNDROME SCALE SUPERIOR TO A SELF-REPORT QUESTIONNAIRE IN THE PHARMACOTHERAPY MONITORING AND OUTCOME SURVEY
Authors: Bartels-Velthuis Annegien , Ties Koen , Visser Ellen , Arends Johan , Pijnenborg Marieke , Wunderink Lex , Jörg Frederike , Veling Wim , Castelein Stynke , Knegtering Henderikus , Bruggeman Richard
Published: May 2020

Background

Aiming to improve the quality of care for patients with a psychotic disorder, the ongoing Pharmacotherapy Monitoring Outcome Survey (PHAMOUS) started in 2006 in four large mental health care organizations in the Northern Netherlands, by adding it to the at that time mandatory Routine Outcome Monitoring program. However, since the cuts in the financial budgets for mental health care, research nurses are increasingly experiencing time-pressure in the assessments. The Positive and Negative Syndrome Scale (PANSS), part of the assessment, is a time-consuming interview, taking approximately 30 minutes. Therefore, we developed and validated a short self-report questionnaire assessing positive psychotic symptoms, the Brief Positive Symptoms Questionnaire (BPSQ).

Methods

The BPSQ was added to PHAMOUS and filled in once by patients in four mental health care institutions in 2017 and 2018. The BPSQ consists of nine items and takes about 2–3 minutes to complete. It was validated against the PANSS positive scale and two items of the Health of the Nations Outcome Scale (HoNOS), with item 6 assessing the problems that patients experience due to hallucinations and delusions and item 8 assessing further mental and behavioural problems.

Results

BPSQ data were obtained from n=287 patients (mean age 47.1 years, 67.6% male). The PANSS was assessed in n=244 and HoNOS data were available for n=156 patients. Scores of one patient were considered unreliable and thus removed from the data set. The BPSQ had a Cronbach’s alpha of .81. Spearman’s correlation coefficient of the BPSQ and the PANSS positive scale was significant (ρ(243) = .63, p < .05). Correlations between the BPSQ and HoNOS items 6 and 8 were significant (ρ(155) = .488, p < .05 and ρ(155) = .251, p < .05 respectively). Post hoc analysis showed that the more severely psychotic the patients were, the less the BPSQ and the PANSS positive scale were corresponding.

Discussion

Given the medium correlation of the BPSQ with the PANSS positive scale and the low concurrent validity with the two relevant HoNOS items, we argue that the widely used and validated PANSS is indispensable in the PHAMOUS assessment of positive symptoms in a chronic population with psychotic disorders. Replication of this study in first-episode psychotic patients is recommended.
T228. SOCIAL REWARD REACTIVITY AND SENSITIVITY IN SCHIZOPHRENIA SPECTRUM CONDITIONS
Authors: Aldridge-Waddon Luke , Vanova Martina , Munneke Jaap , Puzzo Ignazio , Kumari Veena
Published: May 2020

Background

Individuals with schizophrenia spectrum disorders often experience less pleasure during social interaction and frequently demonstrate reduced social motivation. This research examines the extent to which these behaviours may be linked to reduced social reward reactivity and sensitivity, and aims to clarify whether schizophrenia spectrum traits are associated with reduced behavioural and neural responsiveness to social rewards. It includes a systematic review and meta-analyses of social reward sensitivity research in schizophrenia, and also provides preliminary data (participant n = 50) on a novel avatar-based social incentive delay task that was created to further investigate the links between schizophrenia spectrum traits and social reward reactivity.

Methods

First, a systematic review and meta-analyses (literature database search conducted November 2019) found six studies that investigated social reward anticipation and consumption within the schizophrenia continuum (total participant n = 440). Four investigated social reward sensitivity in clinical samples with schizophrenia diagnoses, and two studied the links between social anhedonia traits and social reward responding in normative samples. The novel social incentive delay task presents participants with the opportunity to win animated avatar-based monetary or social rewards by responding to a cued target.

Results

The narrative review and meta-analyses of behavioural data from clinical and normative samples found that individuals with schizophrenia diagnoses or traits demonstrate significantly reduced behavioural anticipation of social rewards in comparison to healthy controls. Furthermore, this reduced reward reactivity was more pronounced for social rewards than for monetary rewards. This effect was also mirrored at neural levels, with individuals with schizophrenia demonstrating reduced social reward-related activation in areas such as the ventral striatum and anterior cingulate cortex. Preliminary behavioural data from the social incentive delay task suggest that, in normative samples, more pronounced negative schizotypal traits are associated with reduced anticipation and consumption of social rewards. Like in the reviewed studies, this reduced anticipation was more marked for social rewards than for monetary rewards.

Discussion

This research suggests that schizophrenia spectrum traits are associated with reduced reactivity and sensitivity to social rewards. It also highlights that this reduced reactivity is demonstrated at behavioural and neural levels, and is more marked for social rewards than for monetary rewards. We consider the implications of these findings for treatment programmes that target atypical social behaviour within schizophrenia spectrum conditions. A series of methodological recommendations for future work investigating social reward reactivity in schizophrenia are also included.
T231. QUALITY OF LIFE IN ANTIPSYCHOTIC-NAïVE YOUTH: EXPLORING THE INTERPLAY WITH METABOLIC SIDE-EFFECTS
Authors: Chintoh Araba , Agarwal Mahavir , Mackenzie Nicole , Remington Gary , Hahn Margaret
Published: May 2020

Background

This observational, exploratory pilot study aims to understand changes in clinical presentation and quality of life (QoL) in antipsychotic-naïve youth. Outcomes for these first-episode psychosis patients will be explored in the context metabolic changes during their first three months of treatment.

Methods

Participants (n = 10) aged 14–29 years were followed throughout their first three months of treatment with an antipsychotic medication (of physician’s/patient’s choice). Participants were evaluated on metabolic indices including weight, waist circumference, and BMI, as well as QoL [Pediatric Quality of Life Index (PedsQL) and PedsQL General Well-Being Scale] and clinical presentation [Clinical Global Impression (CGI) scale]. Descriptive statistics and nonparametric tests were conducted to compare significant changes across these variables.

Results

Significant changes in metabolic indices were observed over the first three months of treatment, as measured in weight gain (p = 0.02), increased waist circumference (p = 0.02) and increased BMI (p = 0.01). Physicians rated clinical improvement in participants, CGI score (p = 0.03). However, patient-rated QoL remained unchanged within all subcategories, including psychosocial (p = 0.52) and general well-being (p = 0.35).

Discussion

It appears that antipsychotic-related metabolic side effects may not impede upon early clinical improvement or impact QoL. In addition, there does not appear to be a relationship between clinical presentation and QoL as our small sample show QoL remains neutral or positive. Taken together, these findings suggest that clinical presentation and metabolic side effects may not be influential in early psychosis. From a clinical perspective, these early pilot data add to the literature highlighting the significant, early, antipsychotic-induced metabolic side effects in youth, and also encouraging clinicians to attend to the interplay between treatment and related QoL. This study is limited by its small sample size and naturalistic treatment allocation. These participants will be followed longitudinally to monitor development of adverse metabolic outcomes as well as changes in QoL in later stages of treatment/illness. The field must to understand how treatment and management of metabolic side effects can be augmented to promote clinical improvement and QoL, given the prevalence of adolescent patients who eventually wish to discontinue antipsychotic drugs because of metabolic side effects.
T234. MEASURING PERSONAL RECOVERY IN PEOPLE WITH A PSYCHOTIC DISORDER BASED ON CHIME: A COMPARISON OF RELIABILITY AND VALIDITY PROPERTIES ON THREE VALIDATED MEASURES
Authors: Sjoerd Vogel Jelle , Bruins Jojanneke , Halbersma Levi , Janine Lieben Rianne , de Jong Steven , Van der Gaag Mark , Castelein Stynke
Published: May 2020

Background

Living well in spite of residual symptoms of mental illness is measured with the construct of personal recovery. The CHIME framework might be suitable to evaluate personal recovery measures and guide instrument choice.

Methods

Three validated measures were evaluated in Dutch patients with a psychotic disorder (N=52). We compared the Recovery Assessment Scale [RAS], the Mental Health Recovery Measure [MHRM] and the Netherlands Empowerment List [NEL]. The measures were assessed on six criteria: content validity (based on CHIME), convergent validity with a social support measure, internal consistency, floor and ceiling effects, item interpretability and ease of administration.

Results

The MHRM scored high on content validity with a balanced distribution of items covering the CHIME framework. The MHRM and NEL showed moderate convergent validity with social support. In all three measures internal consistency was moderate and floor and ceiling effects were absent. The NEL scores demonstrated a high degree of item interpretability. Ease of administration was moderate for all three measures. Finally, the CHIME framework demonstrated good utility as a framework in guiding instrument choice and evaluation of personal recovery measures.

Discussion

The MHRM showed the best overall result. However, differences between measures were minimal. Generalization of the results is limited by cultural and linguistic factors in the assessment for the subjective measures (i.e. content validity and item interpretability). The broad and multi-dimensional construct of personal recovery might lead to ambiguous interpretations. Scientific consensus on a well-defined personal recovery construct is needed.
T237. PERSON-CENTERED PSYCHOSIS CARE –HOW INCREASING PERSON-CENTEREDNESS IN PSYCHOSIS INPATIENT CARE RELATE TO CARE CONSUMPTION AND WARD BURDEN
Authors: Allerby Katarina , Goulding Anneli , Ali Lilas , Gremyr Andreas , Waern Margda
Published: May 2020

Background

Since person-centered care (PCC) is widely embraced and internationally considered to increase effectiveness and quality of complex health care today this study sets out to investigate its relation to ward level outcomes such as length of hospital stay (LoS), involuntary treatments and ward burden. An educational intervention for staff, using a participatory approach, was created to increase the person-centeredness of the care delivered at four inpatient psychosis wards. 6 conference days spread over a 6 months period with practical work at home wards in-between let participants receive information on, discuss and test the principles of PCC, such as acknowledge patients resources, preferences and experiences, working in partnership with patients to co-create the care plan, and documenting agreements.

Methods

Data for all patients receiving care at the inpatient services during data collection periods before (n = 416) and after (n = 375) the intervention, including LoS, length of involuntary stay (LoIS) as well as number of episodes involving restraints, seclusions and forced injections, were extracted from the clinic registry. During the same data collection periods one staff member per day and ward filled out a VAS rating (1 = no burden – 10 =highest imaginable burden) capturing experienced ward burden (n = 505, 60% response rate vs n = 465, 45% response rate). Mean or median of each variable was used for comparative analysis.

Results

A longer LoS was found after implementation (Md = 21.1, n = 416 vs Md = 26.2, n = 375), U = 85894, p = .014, r = .09. LoIS was shorter after implementation (Md = 10.6 vs Md = 6.6), the difference was however not significant U = 74263, p = .231. Analysis of data on involuntary treatments are underway and will be presented. Ward burden was rated significantly lower after implementation (M = 5.4, SD = 1.94 vs M = 4.5, SD = 2.08), t = 7.5 (968), p <.0005.

Discussion

Although study design prevents conclusions on cause and effect, the results indicate a beneficial development for perceived care burden after implementation of PCC. The increased LoS could be interpreted as a result of more thorough attention to patient needs. It could also be due to differences between groups in terms of severity of symptom and functional ability at admission.
T238. RATES AND PREDICTORS OF RELAPSE IN AN AUSTRALIAN FIRST EPISODE PSYCHOSIS COHORT
Authors: Brown Ellie , O’Donoghue Brian
Published: May 2020

Background

Clinical and functional recovery is usually achieved after treatment for a first episode of psychosis (FEP). Unfortunately, subsequent relapse remains common, occurring within a year for approximately 30% of individuals and within five years for 80%. What makes someone more likely to relapse remains poorly understood.

Methods

This study is a naturalistic cohort study of young people (15–25 years old) accessing an early intervention in psychosis service in Melbourne, Australia between 1st January 2011 and 31st December 2016. Demographic and clinical predictors of relapse were collected from patient records and analysed using Cox regression analysis.

Results

A total of 1220 young people presented with a FEP during the study period and 37.7% (N=460) experienced at least one relapse during their episode of care. Over half of all relapses resulted in an admission to hospital. Non-adherence to medication, substance use and psychosocial stressors precipitated relapses. Significant predictors of relapse in this sample were a diagnosis of a schizophrenia spectrum disorder or an affective psychotic disorder, amphetamine use, and substance use during treatment.

Discussion

These findings suggest that relapse occurs frequently for young people who have experienced FEP. This is one of the first studies to find that amphetamine use increases the risk of relapse. Clinical services, especially in Australasia, need to consider how best to manage this co-morbidity in young people with FEP.
M17. PREDICTION OF NEUROLEPTIC AND ANTIDEPRESSANT TREATMENT RESPONSES VIA FMRI OF THE EXTENDED REWARD SYSTEM
Authors: Gruber Oliver , Rauer Lisa , Trost Sarah , Lückel Maximilian
Published: May 2020

Background

Neuroimaging techniques have been developed as important tools to assess brain dysfunctions that underlie mental disorders. In particular, modern functional magnetic resonance imaging (fMRI) holds the promise to provide neurofunctional biomarkers for improved differential diagnosis and optimized treatment of schizophrenic and affective disorders.

Methods

Neurofunctional connectivity MRI of the extended human reward system (Makris et al., 2008) was conducted in a large transnosological cohort of patients suffering from schizophrenia, bipolar disorder or major depressive disorder. Responses to neuroleptic treatments in patients with schizophrenic or bipolar disorder were determined retrospectively, while treatment responses to different antidepressants were directly assessed in a prospective naturalistic clinical study.

Results

Responders to neuroleptic treatment with aripiprazole showed significantly higher reward-related activation in a larger set of brain regions (including ventral striatum, hippocampus, amygdala, pregenual ACC and anteroventral PFC) in comparison to non-responders to aripiprazole. This finding proved to be specific for this neuroleptic treatment when compared to treatments with other atypical or typical neuroleptics. Pre-treatment reward-related activation of the nucleus accumbens, the ventral tegmental area and the amygdala showed a substance-class specific correlation with subsequent antidepressant treatment responses to SSRIs and/or agomelatine.

Discussion

These findings of ongoing studies exemplify the high potential of neuroimaging techniques to foster the development of precision medicine in psychiatry. The identification of neuroimaging markers associated with specific treatment responses may allow the development of “tailored”, i.e. stratified treatment approaches.
M19. NIGROSTRIATAL CONNECTIVITY AND THE PREDICTION OF THOUGHT DISTURBANCE IN EARLY PSYCHOSIS
Authors: Homan Philipp , Malhotra Anil , Lencz Todd , De Rosse Pamela
Published: May 2020

Background

Dopamine neurons are known to fire both tonically and phasically, resulting in tonic dopamine concentrations and spikes in those concentrations (often referred to as transients). Empirical evidence has shown elevated activity in the striatum in response to neutral stimuli which correlated with positive symptoms, in line with the proposed increased prediction errors. The increase of sponataneous phasic dopamine release in early psychosis should also be evident by altered resting state connectivity between the midbrain and its dopaminergic projections to the dorsal striatum. Given that all antipsychotics bind to striatal dopamine D2 receptors, we assumed that this altered functional connectivity would also relate to treatment efficacy of those antipsychotic agents. Using striatal seeds, and extending our own group’s prior work exploring striatal connectivity, we computed an index of nigrostriatal connectivity and estimated its relationship with improvement of positive symptoms under antipsychotic monotherapy.

Methods

We conducted a parcellation of subcortical midbrain structures including the substantia nigra and ventral tegmental area in two independent early phase psychosis cohorts. Early phase psychosis was defined as having an antipsychotic life time exposure of less than 52 weeks. Patients were between 15 and 40 years old and with a DSM-V-defined diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features and provided informed consent to participate in the study. Exclusion criteria were active alcohol or substance abuse disorders, serious medical conditions, and pregnancy. Preprocessing involved the state-of-the art Human Connectome Project pipeline and extensive correction for motion artifacts. After parcellation, we extracted the connectivity values of the striatal seeds with the substantia nigra and calculated an improved version of the striatal connectivity index with the R-package sci developed by the presenter and freely available online at http://github.com/philipphoman/sci.

Results

We found that nigrostriatal connectivity was predictive of treatment efficacy in a sample of 41 patients with early phase psychosis. Indeed, individual differences in this connectivity index explained 18% of the variance of positive symptom improvement under antipsychotic treatment. Importantly, we replicated this effect in an independent replication cohort of 40 early phase psychosis patients, where we found that the identical model explained 11% of the variance in symptom improvement.

Discussion

There is an urgent need for diagnostic and prognostic biomarkers in psychotic disorders, and our results suggest that nigrostriatal connectivity is a promising candidate for a prognostic biomarker for antipsychotic treatment.
M20. CYTOKINE LEVELS THROUGHOUT PREGNANCY AND RISK FOR PSYCHOSIS IN ADULT OFFSPRING: EARLY PREGNANCY MATTERS
Authors: Allswede Dana , Yolken Robert , Buka Stephen , Cannon Tyrone
Published: May 2020

Background

Schizophrenia has been associated with pregnancy and birth complications, and fetal exposure to inflammation is thought to be a common underlying mechanism. However, it is unclear whether the risk associated with inflammation is specific to particular phases of pregnancy, as no prior studies have examined maternal serum samples across multiple assessments from the first trimester onward. This study examined differences in longitudinal patterns of maternal serum levels of TNFa, IL-1b, IL-5, IL-6, IL-8, IL-10, and IL-17a across pregnancy for offspring who were later ascertained as having a psychotic disorder diagnosis, non-psychotic siblings of these cases, and unrelated, non-psychotic individuals who served as controls.

Methods

Participants included 90 offspring, 79 siblings, and 273 matched controls from the Philadelphia cohort of the National Collaborative Perinatal Project. Psychotic disorder diagnoses in adulthood were assessed with review of medical records and were confirmed with a validation study. Cytokine levels were assessed using a multiplex bead assay in archived maternal serum samples collected across prenatal visits and birth.

Results

Levels of pro-inflammatory TNFa, IL-1b, and IL-6 were significantly higher in maternal serum of offspring who later developed psychosis relative to maternal serum of non-psychotic siblings and matched controls. These differences were maximal in first half of pregnancy (7–20 weeks), tapering to non-significant during the second half of pregnancy.

Discussion

These findings elucidate the importance of exposure to elevated maternal pro-inflammatory cytokine levels in early pregnancy to the etiology of psychosis.
M29. SPECIFIC SYMPTOMS IN ADOLESCENCE PREDICT PSYCHOSIS IN THE NORTHERN FINLAND BIRTH COHORT 1986
Authors: Palomäki Johanna , Kerkelä Martta , Järvelin Marjo-Riitta , Jones Peter , Murray Graham , Nordström Tanja , Therman Sebastian , Veijola Juha
Published: May 2020

Background

A number of psychological symptoms have been found to predict psychosis. Many studies have found no specificity to separate symptoms predicting non-psychotic psychiatric disorders from those predicting psychotic disorders. Prodromal symptoms are non-specific problems often preceding frank psychosis. Previously prodromal symptoms have been studied mainly retrospectively or in high-risk clinical populations. We were able to conduct prospective study comparing adolescent symptoms predicting non-psychotic psychiatric disorders and psychotic psychiatric disorders.

Methods

Members of the Northern Finland Birth Cohort 1986 were asked to fill in PROD-screen questionnaire at age 15–16 years. PROD-screen includes 21 items both measuring positive prodromal symptoms, negative prodromal symptoms and general symptoms.

We were able to follow 5,368 participants using Finnish Hospital Discharge Register detecting new hospital treated mental disorders till 30 years.

Results

Subjects who developed psychosis had significantly more commonly positive and negative symptoms than subjects without psychiatric disorder or subjects who developed non-psychotic disorder.

When comparing separate symptoms in those having psychiatric hospital treatments, we found three positive symptoms and three negative symptoms predicting specifically psychotic disorders.

After adjusting for confounders, the symptoms predicting psychosis were: Difficulty in controlling one’s speech, behavior or facial expression while communicating, Difficulties in understanding written text or speech heard, Feelings, thoughts or behaviors that could be considered weird or peculiar. Three of the negative symptoms also predicted psychosis: Difficulty or uncertainty in making contact with other people, Lack of initiative or difficulty in completing tasks, Difficulties in carrying out ordinary routine activities (at least one week).

Discussion

In this large prospective population sample both positive and negative symptoms in adolescence associated specifically with development of first episode psychosis compared to hospital treated non-psychotic disorders. This finding is in line with the other prospective general population follow-up studies. The main contribution of our study to the literature is that we had the possibility to compare the subjects who developed clinically real hospital-treated psychosis not only to healthy comparison subjects but also to subjects who developed non-psychotic psychiatric disorder.
M33. ATTENTUATED POSITIVE SYMPOMS AND FACIAL AFFECT PROCESSING IN HIGH-RISK ADOLESCENTS WITH AND WITHOUT AUTISM
Authors: Maat Arija , Therman Sebastian , Swaab Hanna , Ziermans Tim
Published: May 2020

Background

Autism and schizophrenia spectrum disorders both represent severely disabling neurodevelopmental disorders with marked impairments in social functioning. Despite an increased incidence of psychosis in autism, and substantial overlap in symptoms and cognitive markers, it is unclear whether such phenotypes are specifically related to risk for psychosis or perhaps reflect more general, idiosyncratic autism traits. Attenuated positive symptoms (APS) currently constitute the best and most-replicated clinical predictors of schizophrenic psychosis, and are common in clinical youth with and without autism. The aims of this study were to test the hypothesis that facial affect processing is impaired in adolescents with APS and to explore whether such deficits are more indicative of psychotic or autistic phenotypes on a categorical and dimensional level.

Methods

Fifty-three adolescents with APS and 81 typically developing controls (aged 12–18) were included. The APS group consisted of adolescents with (n = 21) and without (n = 32) a diagnosis of autism spectrum disorder. Facial affect recognition and ‘lower-level’ cognitive skills, namely pattern and face recognition, were assessed with the Amsterdam Neuropsychological Tasks. For associations with schizotypal and autistic-like traits the Schizotypal Personality Questionnaire and Social Communication questionnaire were used and one-dimensional factor scores were generated with confirmatory factor analysis.

Results

Our preliminary findings suggest that APS in adolescents is not associated with impairments in pattern, face, or emotion recognition. However, the APS group with autism spectrum disorder generally showed slower reaction times for face/emotional stimuli and they were significantly worse in recognizing fearful expressions than APS participants without autism spectrum disorder and controls. There were no dimensional correlations with schizotypal traits and marginal correlations between autistic-like traits and speed of recognizing faces.

Discussion

Contrary to our expectations, APS demonstrated limited use in identifying cognitive deficits typical to schizophrenic psychosis. A more autistic-like profile may be characterized by slower reaction times to facial stimuli, suggesting that more complicated and dynamic social cognitive stimuli have a better chance of discerning between autistic and psychotic-like phenotypes.
M59. THE ASSOCIATIONS BETWEEN THEORY OF MIND AND NEUROCOGNITION IN RECENT ONSET PSYCHOSIS
Authors: Thibaudeau Élisabeth , Pothier William , Lavoie Andréanne , Turcotte Mélissa , Achim Amélie M , Vallières Chantal , Roy Marc-André , Cellard Caroline
Published: May 2020

Background

Deficits in theory of mind (ToM), the ability to infer the mental states of others, are common in psychotic disorders and are associated with functioning difficulties. While ToM is a social cognitive process, several neurocognitive processes are involved when inferring the mental states of others. A better understanding of the associations between ToM and neurocognitive domains could help better target treatment for ToM in schizophrenia. A recent meta-analysis has revealed that all neurocognitive domains are moderately associated with ToM in schizophrenia, but very few studies have looked at these associations in recent onset psychosis. These studies showed associations between ToM and speed of processing, episodic memory and executive functions although few neurocognitive domains have been assessed in each study. The aim of this study was to determine the associations between ToM and the key neurocognitive domains in recent onset psychosis.

Methods

These results are part of a larger study that aimed to determine the cognitive predictors of return to work or school in recent onset psychosis. Twenty-seven recent onset psychosis patients were recruited for this study, with a mean age of 24.9 years. The clinical assessment included the Combined Stories Test for ToM and the Matrics Consensus Cognitive Battery (MCCB) for neurocognition. The MCCB assesses the key cognitive domains relevant for schizophrenia, including attention/vigilance, speed of processing, working memory, verbal learning, visual learning, reasoning/problem solving and social cognition. Pearson correlations were conducted between the ToM scores of the Combined Stories Test and each neurocognitive domain of the MCCB.

Results

Correlations revealed a moderate to strong association between ToM and working memory (r = 0.443, p = 0.021), visual learning (r = 0.493, p = 0.009) and verbal learning (r = 0.443, p = 0.021). The correlations between ToM and attention/vigilance, speed of processing and reasoning/problem solving were not significant (p > 0.05).

Discussion

This is the first study that has assessed the associations between ToM and the neurocognitive domains of the MCCB in recent onset psychosis. This study did not show association between ToM and speed of processing nor executive functions, but rather with working memory and learning. These contradictory results could be explained by the large heterogeneity of tasks used across studies, particularly ToM tasks that often present with psychometric limitations such as ceiling effect. Learning processes highlighted here should be considered in the understanding of the therapeutic response following a cognitive remediation therapy for ToM in recent onset psychosis.
M62. PERIPHERAL INFLAMMATION MARKERS IDENTIFY SUBSET OF PATIENTS WITH SCHIZOPHRENIA AND RELATED PSYCHOSES WHO HAVE INTELLECTUAL DECLINE FROM PREMORBID LEVELS
Authors: Weickert Thomas , Ramanathan Seetha , Lenroot Rhoshel , Liu Dennis , Balzan Ryan , Galletly Cherrie , Shannon Weickert Cynthia
Published: May 2020

Background

Higher inflammation has been identified in a substantial subset of both high-risk and chronically ill patients with schizophrenia and related psychoses and this may account for some of the heterogeneity of the schizophrenia. There is also much heterogeneity in cognitive deficits related to schizophrenia with some patients showing a marked decline from premorbid intellectual levels while others show little change from either normal or low intellect. However, the relationship between intellectual change with the illness onset and inflammation in schizophrenia has not been established.

Methods

Here, we report the assessment of two common markers of inflammation from two independent samples of generally chronically ill patients with schizophrenia and related psychoses (one sample of 73 patients versus 70 healthy controls from Sydney, NSW, Australia and one sample of 297 patients from Syracuse, NY, USA). Peripheral venous blood samples were collected from all patients and blood markers of inflammation (C-Reactive Protein, CRP, and Neutrophil to Lymphocyte Ratio, NLR) were assayed using standard procedures. Assessment of premorbid and current intellectual abilities were obtained from the Sydney cohort of patients.

Results

Grouping the patients and controls from the Sydney sample into those with elevated (> 3 mg/L) versus normal (< 3 mg/L) CRP levels revealed 42% of the patients versus 20% of the healthy controls had elevated CRP (Chi Square = 9.16, p = .002) and further evidence of inflammation with an elevated mean NLR of 2.5. The frequency of peripheral inflammation was confirmed by the independent sample from Syracuse in which 39% of the patients (n= 115) had an elevated NLR above a cutoff score for normal of 2.2 which was consistent with the Sydney sample. Patients from the Sydney sample who had an elevated CRP also had a significant mean 15-point IQ decline from premorbid IQ levels, whereas the patients with CRP levels within normal limits did not show a statistically significant drop in IQ from premorbid levels (mean IQ decline 7.6 points). Healthy controls with normal CRP had no IQ change (0.0 points) and healthy controls with elevated CRP has a slight, non-significant IQ decline (mean 2.3 points).

Discussion

Thus, our study showed supportive evidence of elevated peripheral inflammation markers in subgroups of chronically ill patients with schizophrenia from two independent samples and a link between marked intellectual decline from premorbid levels and current peripheral inflammation in one chronically ill subgroup of patients with schizophrenia suggesting a role for inflammation in the cognitive impairment of a substantial proportion (40%) of patients with schizophrenia.
M63. TRANSDIAGNOSTIC NEUROCOGNITIVE DEFICITS IN PSYCHIATRY: A REVIEW OF META-ANALYSES
Authors: East-Richard Caroline , R-Mercier Alexandra , Nadeau Danielle , Cellard Caroline
Published: May 2020

Background

In recent decades, several meta-analyses have documented the severity of neurocognitive impairments in various domains and psychiatric disorders. There is also a growing body of literature on the common factors among psychiatric disorders (e.g., common psychological factors, neurobiological alterations or genetic variants). The first objective of this review was to investigate transdiagnostic neurocognitive impairments across several psychiatric disorders. The second objective was to document transdiagnostic neurocognitive impairments across the life span, to establish whether they are consistent across age.

Methods

A literature search was conducted in Pubmed, PsycINFO and Embase to identify all meta-analyses of neurocognitive deficits in psychiatry published prior to August, 2017. The following psychiatric disorders were considered: mood disorders, psychotic disorders, autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders. The R-AMSTAR (Revised Assessment of Multiple Systematic Reviews) was used to assess methodological quality of all retrieved meta-analyses. The final selection included only the most rigorous meta-analyses.

Results

A total of 36 meta-analyses were included. They documented neurocognitive impairments in schizophrenia, autism spectrum disorder, ADHD, bipolar disorder, depression, obsessive-compulsive disorder, and posttraumatic stress disorder. Neurocognitive impairments were observed in the majority of psychiatric disorders, regardless of age group (childhood/adolescence, first episode, adulthood, elderly). Across all disorders, deficits in executive functions and in episodic memory were the most severe and the most frequently reported. Moreover, severe deficits in executive functions were frequently reported across age groups. Neurocognitive deficits were consistently more severe in schizophrenia compared to other psychiatric disorders, across all age groups.

Discussion

Neurocognitive impairments were observed in almost all disorders, in all age groups. Some neurocognitive impairments were more frequently reported across all disorders. Indeed, executive functions and episodic memory were severely impaired in almost every age group and psychiatric disorder considered in this review. Deficits in these two domains appear to be transdiagnostic and they remain relatively stable across the life span. Transdiagnostic factors could be key targets for transdiagnostic cognitive interventions in psychiatric populations. Neurobiological, neuropsychological, and genetic hypotheses of transdiagnostic neurocognitive impairments are discussed.
M76. ATYPICAL RESPONSE INHIBITION IN 22Q11.2DS: DIMINISHED ERROR REGISTRATION AND AWARENESS
Authors: Alves Francisco Ana , Horsthuis Douwe J , Foxe John J , Molholm Sophie
Published: May 2020

Background

22q11.2 deletion syndrome (22q11.2DS; also known as DiGeorge syndrome or velo-cardio-facial syndrome) is characterized by increased vulnerability for neuropsychiatric symptoms, with approximately 30% of the individuals with the deletion developing schizophrenia. Clinically, deficits in executive function have been noted in this population, but the underlying neural processes are not well understood.

Methods

Using high-density electrophysiology (EEG), we investigated the neural dynamics of inhibition of a prepotent response (a critical component of executive function) in individuals with 22q11.2DS with and without psychotic symptoms. Twenty-seven individuals with 22q11.2DS (14–35 years old, 14 with at least one psychotic symptom) and 27 age-matched neurotypical controls participated in a go/no-go task while EEG was recorded. Analyses were focused on the P3 go/no-go response and error-related positivity (Pe).

Results

Behaviorally, individuals with 22q11.2DS were slower and unable to inhibit prepotent responses as the controls, with significantly more false alarms. Atypical inhibitory processing was confirmed by significantly reduced P3 no-go responses in the 22q11.2DS group. Such reductions were particularly marked in those with psychotic symptomatology. Pe was likewise significantly decreased (regardless of the presence of psychotic symptoms), suggesting impaired ability to register errors (i.e., false alarms) in 22q11.2DS. Both Pe and P3 correlated with clinical measures of inhibition (DKEFS and CPT).

Discussion

To our knowledge, this is the first study looking at electrophysiological measures of response inhibition in 22q11.2DS. P3 and Pe reductions, which have also been shown in schizophrenia, suggest diminished error registration and awareness in 22q11.2DS and, possibly, a consequent difficulty in adjusting response strategies.
M82. GROWING BURDEN OF DISEASE: THE PREVALENCE OF CHRONIC HEALTH CONDITIONS AFTER A FIRST EPISODE OF PSYCHOSIS
Authors: Rodrigues Myanca , Stranges Saverio , Ryan Bridget , Anderson Kelly
Published: May 2020

Background

Over 12% of Canadians live with two or more (2+) co-occurring chronic physical health conditions or multimorbidity. This proportion is expected to rise with increased exposure to risk factors for these diseases. People with psychotic disorders often have co-occurring chronic physical health conditions; however, to date there has been a paucity of research on the prevalence of multimorbidity among people with psychosis. The objective of our study was to examine the prevalence of multimorbidity ten years after a first episode of psychosis (FEP) utilizing data from a retrospective cohort study based on health administrative data.

Methods

The health administrative dataset has been linked to data from the Prevention and Early Intervention Program for Psychoses in London, Canada to enable identification of FEP patients (n=455). FEP patients were compared to a randomly selected comparison group from the general population (n=1,783), matched on age, gender, and neighbourhood. This cohort has been followed for a 10-year period in the health administrative data to ascertain the prevalence of physical comorbidities.

Results

Preliminary analyses on 2,238 patients (557 females, 1,681 males) at 10-year follow-up, reveals that 32.1% (95% CI 28.0%, 36.5%) of FEP patients have 2+ conditions, as compared to 15.1% (95% CI 13.6%, 16.9%) of people without psychosis. Full results on risk factors for multimorbidity will be presented.

Discussion

The findings from this study will facilitate increased surveillance and recognition of the common physical health conditions faced by people with psychosis, including those contributing to premature mortality of this patient population. This information aims to assist decision-makers in creating tailored intervention plans to improve the physical health of patients with psychotic disorders, and integrate care across multiple specialties to reduce the growing burden of disease to the Canadian health system.
M102. MEASURING PHYSIOLOGICAL RESPONSES ASSOCIATED WITH SOCIAL STRESS IN A VIRTUAL ENVIRONMENT AND ITS RELATIONSHIP WITH CHILDHOOD TRAUMA IN EARLY SCHIZOPHRENIA - A PILOT STUDY
Authors: Du Plessis Stéfan , Mckenzie Michelle , Crockart Ivan , Kilian Sanja , Scheffler Frederika , Rosenstein David , Van den Heever David , Andreatta Marta , Pauli Paul , Emsley Robin
Published: May 2020

Background

In lower to middle income countries (LMIC), the influences of environmental stress on neurobiological processes involved in the development of schizophrenia is of great importance. High levels of stress may contribute to an increased burden of schizophrenia, including profound functional impairment and disability, decreased productivity, and even elevated mortality. Stress in Schizophrenia has been associated with behavioral disturbances such as maladaptive coping styles as well as well-established physiological abnormalities in sensorimotor gating in the form of abnormal startle responses. In turn, childhood trauma exposure is known to affect physiological stress responses. Indeed, we have found childhood trauma to be associated with both white matter and hippocampal changes in schizophrenia. Few studies, however, have explored the relationship between Childhood trauma and stress responses in schizophrenia. In recent years Virtual Reality (VR) has undergone a resurgence as a viable method for studying fear related physiological stress responses in an ecologically valid manner. Here we aim to investigate the potential relationship between abnormal physiological stress responses in schizophrenia with early life adversity.

Methods

Physiological response data were collected while participants completed a VR paradigm based on the Trier stress test, a well-established social stressor that reliably elicits a stress response in participants in VR and HPA axis attenuation in schizophrenia. Data were also collected in a fear of heights environment, not associated with abnormalities in schizophrenia. Childhood trauma was assessed with the Childhood Trauma Questionnaire (CTQ). HPA axis stress responses during the course of the task were assessed using saliva cortisol samples collected at key points during the paradigms.

Results

Preliminary data of both the social anxiety and fear of heights scenario will be presented. We will focus specifically on the viability of using VR in a LMIC context.

Discussion

VR could prove to be a cost-effective tool to explore the relationship between childhood trauma, stress sensitivity and schizophrenia.