bluuebunny/crossref_metadata_2025_split huggingface dataset:
T99. HARNESSING DIGITAL TECHNOLOGIES TO ASSESS AND TREAT COGNITIVE SYMPTOMS IN SCHIZOPHRENIA
Authors: Shvetz Cecelia , Gu Feng , Drodge Jessica , Torous John , Guimond Synthia 
Published: May 2020

Abstract

Background
Cognitive impairments are a core feature of schizophrenia. Although cognitive impairments have consistently shown to have negative impacts on functional outcomes among individuals with schizophrenia, assessing and treating these symptoms in clinical settings remains a difficult challenge. Interestingly, the growing potential of new digital technologies, such as smartphone applications and virtual reality, hold great promise in alleviating these impairments.

Methods
This presentation will introduce results from two recent studies using digital technologies to assess and treat cognitive symptoms in schizophrenia. In the first study, smartphone versions of the pen-and-paper Trail Making Tests A and B were developed. These cognitive tests measure speed of processing and cognitive flexibility. We assessed the validity of the smartphone versions of both Trail Making Tests in measuring these cognitive domains in in 37 healthy controls and 26 individuals with schizophrenia. Following the initial assessment, participants were asked to complete the two smartphone cognitive tests once a week for three months. This served as a measure of cognitive performance over time

Results
Results showed that it was feasible to measure cognition using a smartphone application in schizophrenia. Performances on both smartphone cognitive tests were significantly and positively correlated with the pen-and-paper versions (Parts A: r = 0.65, p &lt; .001; Parts B: r= 0.44, p= .01). Additionally, significant differences were observed between controls and individuals with schizophrenia on both smartphone tests (Part A: t = -3.88, p = .004; Part B: t = -3.29, p = .002). Moreover, longitudinal results showed no significant effect of practice over time on the smartphone cognitive tests.

Discussion
Digital technologies have the potential to optimize cognitive assessments, monitoring, and care in schizophrenia. Our findings support the feasibility and efficacy of using digital technologies to measure and treat cognitive impairments in schizophrenia. Our research also highlights the importance of including scientists, clinicians, and content experts with schizophrenia in the development of these tools to ensure their validity and facilitate clinical implementation.
T103. THE EFFECT OF VIRTUAL REALITY COGNITIVE BEHAVIORAL THERAPY ON PARANOIA AND MOOD STATES
Authors: Geraets Chris , Snippe Evelien , Van Beilen Marije , Pot-Kolder Roos , Wichers Marieke , van der Gaag Mark , Veling Wim 
Published: May 2020

Abstract

Background
Recently, the efficacy of a novel virtual reality based cognitive behavior therapy (VR-CBT) for paranoia was demonstrated. Evidence is growing that the maintenance of psychosis may be influenced by affective processes. This study examined how treatment with VR-CBT influenced positive and negative affect states, and whether the interplay between mental states was affected.

Methods
The sample consisted of 91 patients with a psychotic disorder randomized either to 16-session individual VR-CBT or treatment as usual. The experience sampling method (ESM; a structured diary technique) was used to assess mental states at baseline, post-intervention and 6-month follow-up. Mixed model analyses were conducted to study treatment effects. Lagged associations between mental states were estimated at baseline and post-intervention, and were visualized with networks.

Results
VR-CBT, but not treatment as usual, resulted in reduced levels of paranoia and negative affect. At pre-intervention networks depicting the dynamic interplay between mental states over time had limited significant connections, with most stable connections being auto-relations. I.e., paranoia was best predicted by paranoia at the previous moment. The dynamic interplay between affective states did not change over time after VR-CBT.

Discussion
We found that VR-CBT specifically targets paranoia and there are indications that VR-CBT had an enduring effect on negative emotions. These beneficial treatment effects do not seem to transfer to positive affective states. Unexpectedly, we did not find evidence that negative mental states such as feeling down or lonely triggered paranoia in the next moment even at pre-intervention, and these temporal relations between mental states did not change over time in response to treatment.
M2. STRESS IS ASSOCIATED AND PREDICTS SCHIZOTYPIC AND PSYCHOTIC-LIKE EXPERIENCES IN THE FLOW OF DAILY LIFE IN NONCLINICAL AND INCIPIENT PSYCHOSIS INDIVIDUALS
Authors: Barrantes-Vidal Neus , Monsonet Manel , Racioppi Anna , Kwapil Thomas R 
Published: May 2020

Abstract

Background
Daily-life stressors, specially of a social nature, seem to play an important role in the origin and expression of the continuum of psychosis vulnerability. This study examined whether social stress and social positive appraisals in daily-life were associated, respectively, with the occurrence and the decrease of momentary psychotic-like and paranoid experiences and symptoms across the psychosis continuum.

Methods
Both social stressors and positive appraisals, as well as psychotic and paranoid experiences, were collected by means of Experience Sampling Methodology over a week. Schizotypy was assessed with the Wisconsin Schizotypy Scales. Participants were 206 nonclinical individuals oversampled for schizotypy scores (mean age=19.8) and 113 individuals with at-risk mental states for psychosis and first episode psychosis (74 and 39, respectively; mean age=22.5).

Results
In the nonclinical sample, appraisals of social stress (but no social contact per se) were associated with psychotic-like and paranoid experiences in daily-life, but not with diminished thoughts or emotions (negative-like symptoms). The association of stress with psychotic and paranoid experiences was moderated by positive, but not negative, schizotypy. In the clinical sample, the positive social appraisal of feeling cared for by others moderated the association between negative self-esteem and the experience of paranoia. Also, they predicted (time-lagged analyses) a decrease of these experiences at subsequent time points—although only feeling cared about did so when the previous level of paranoia was controlled for.

Discussion
Consistent with models postulating that stress-sensitivity is a potential mechanistic pathway of, specifically, the positive dimension of psychosis, situational and also social stress predicted psychotic-like and paranoid experiences only in participants with high positive schizotypy. Furthermore, positive social appraisals showed a critical role for buffering the expression of paranoia associated to poor self-esteem in clinical risk for and early psychosis and predicted its amelioration prospectively. Altogether, these findings support the notion that increased sensitivity to social cues is a critical aspect for both risk and resilience mechanisms in the continuum of psychosis. Additionally, they highlight the powerful relevance of positive social identification for dampening the deleterious effects of poor self-esteem and stress.
M13. INCREASED SAFETY SEEKING IN PATIENTS WITH SCHIZOPHRENIA AND PARANOID THREAT
Authors: Gangl Nicole , Conring Frauke , Walther Sebastian , Rüter Maximilian , Wüthrich Florian , Schäppi Lea , Stegmayer Katharina 
Published: May 2020

Abstract

Background
Schizophrenia is a disabling disorder with tremendous individual burden, reduced quality of life, leading to intense costs for society. Paranoia is a central feature of schizophrenia. In particular, paranoid experience is thought to be associated with aggressive behaviour, and poor social and functional outcome. Since paranoid threat is sometimes hard to detect in the clinical interview, a simple bedside test to identify patients suffering from paranoid experience was recently proposed: the interpersonal distance test.

Methods
For measuring interpersonal distance in patients with schizophrenia and age-, gender- and education-matched healthy controls, we performed a stop-distance paradigm. To accomplish the paradigm, we positioned experimenter and participant at opposite ends of the room with a distance of seven meters facing each other. The stop-distance paradigm contained four different conditions; two active conditions (i.e. participant is approaching experimenter) and two passive conditions (i.e. experimenter is approaching participant) both, with and without eye contact. Participants were instructed to stop or tell the experimenter to stop at a distance, at which they would start to feel less comfortable. Moreover, we assessed paranoid threat with the Bern Psychopathology Scale. We compared the interpersonal distance between patients with current experiences of paranoid threat, schizophrenic patients without paranoia and healthy controls.

Results
Patients with higher ratings in paranoid experience presented with higher interpersonal distance than patients without paranoid threat and matched healthy controls. This effect was most prominent in the passive conditions. Patients without paranoia did not differ from healthy controls in the interpersonal distance test.

Discussion
Interpersonal distance is a reliable indicator of current paranoid threat in patients with schizophrenia. In fact, interpersonal distance is not generally altered in schizophrenia. However, paranoid threat leads to impairments in interpersonal space regulation. This is of particular relevance as interpersonal distance might be predictive of social and functional outcome and aggressive behaviour in schizophrenia.
M31. THE ASSOCIATION BETWEEN BULLYING VICTIMIZATION AND PSYCHOSIS AND THE MEDIATING ROLE OF PEER AND FAMILY SOCIAL SUPPORT
Authors: Shannon Ciaran , Jordan Julie-Ann , Higgins Kathryn , Kelly Grace , Mulholland Ciaran 
Published: May 2020

Abstract

Background
The relationship between psychotic symptoms and bullying has received limited attention to date. A systematic review by Cunningham, Hoy, & Shannon (2016) identified only ten studies that met their inclusion criteria for examining the relationship between childhood bullying and psychosis via a prospective research design. A meta-analysis of these studies suggested that being bullied does predict the later development of psychotic symptoms. The authors went on to say that a better understanding of the factors that mediate the bullying/psychosis relationship is needed. It is possible that prolonged exposure to social adversity and exclusion can lead to a state of “social defeat” which has also been found to increase the risk of psychosis (Johnston et al., 2011; Selten et al., 2013; Selten and Cantor-Graae, 2005). Being bullied in childhood has also been linked to depression in adulthood (Bowes et al. 2014), and social support from family and friends may also mediate the bullying victimisation-depression relationship.

Methods
The present study is a secondary data analysis of a prospective cohort study; namely, the Belfast Youth Development Study (BYDS). The BYDS followed a group of children longitudinally from ages 12–21 years. The participants are 2,087 individuals who took part in the Belfast Youth Development Study (BYDS) in 2011 (Wave 7). This longitudinal survey started in 2001 (Wave 1) when the sample members were aged 11 years. The sample were then surveyed again annually up until age 15 years (Waves 2–5), and post-compulsory schooling follow ups were carried out at 17 and 21 years (Waves 6 & 7). The secondary analysis will involve conducting path models. The first of which will be a bullying victimisation-psychosis mediation model; this will include a predictor (bullied, age 12 years), outcome (Psychosis, age 21 years), mediators (e.g. peer attachment, age 13 years; parental attachment. age 14 years), and covariates (gender, free school meals, depression, and frequency of cannabis use in the past year; cannabis abuse screening test). A bullying victimisation-depression mediation model will also be examined; this will include the same mediator and covariate variables.

Results
The results will be reported in the poster submission (analysis in progress). These will include measures of direct and indirect effect, as well as model fit statistics.

Discussion
Clinical implications in terms of prevention, assessment, and intervention for young people at risk of psychotic disorders will be discussed.
M42. INDEPENDENT REVIEW & MONITORING IMPROVES QUALITY OF PANSS DATA IN GLOBAL CLINICAL TRIALS
Authors: Echevarria Barbara , Liu Cong , Negash Selam , Opler Mark , Molero Patricio , Capodilupo Gianna 
Published: May 2020

Abstract

Background
The Positive and Negative Syndrome Scale (PANSS) (1) is the most widely used endpoint for measuring change in schizophrenia clinical trials. A set of flags have been developed by ISCTM expert working group to identify potential scoring errors in PANSS assessments (2). Measures have been taken by sponsors (pharmaceutical industry) with the goal of increasing scoring reliability and data quality, such as the use of Independent Review (IRev). We evaluated changes in data quality when site raters stop being recorded and monitored via IRev by comparing two studies with the same cohort of raters, one with independent review and one without.

Methods
Data from PANSS assessments in two global multisite schizophrenia clinical trials were analyzed. We selected data from raters participating in both studies (which run concurrently for a significant period of time). Raters were rigorously trained on administration and scoring conventions and certified prior to the study through demonstration of adequate interrater reliability. In addition to these steps, raters in study A were required to audio record all PANSS assessments with a selected subset of visits being subject to IRev. PANSS assessments in study B were neither recorded nor monitored via IRev. Data quality after study completion was examined by calculating the frequency of anomalous data patterns identified as “high” (very probable or definite error) by the ISCTM Working Group in both studies. Additionally, we examined the percentage of assessments with lower than expected PANSS interview duration as captured via an eCOA platform.

Results
There were 9441 eCOA PANSS assessments in study A and 6178 in study B included in this analysis. The proportions of flags that represented highly probable/definite error differed significantly between the studies (9% vs 18% for Study A and B, respectively, p&lt;.01). The most significant differences in ISCTM flags were related to overly consistent scoring patterns (27 or more items scored identically to the prior visit) occurring with higher frequency in study B. Additionally, study B also had a significantly higher frequency of assessments flagged for low interview duration (&lt; 15 minutes) (1% vs 4% for Study A and B, respectively, p&lt;.01).

Discussion
Initial rater training is necessary but not sufficient to ensure adequate data quality in schizophrenia trials. Implementation of additional in-study oversight through Independent Review or similar methods reduces the probability of data error in PANSS assessments, including the appearance of improbable rating patterns and decreased time spent interviewing study subjects. One potential limitation is that study A is a double-blind study whereas study B is an open label extension of study A.
M74. FACIAL EMOTION RECOGNITION ABILITY IN PATIENTS WITH SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS
Authors: Kjellenberg Elin , Winblad Stefan 
Published: May 2020

Abstract

Background
Psychotic disorders are associated with impaired facial emotion recognition (FER) and poor functional outcome. Most studies regarding facial emotion recognition have focused on schizophrenia. The aim of this study was to explore FER in patients with different psychotic disorders at psychiatric outpatient facilities. The intention was also to examine if patients diagnosed with schizophrenia differed from patients diagnosed with other psychotic disorders in the ability to recognize facial emotions.

Methods
FER was examined in forty outpatients, evenly divided between schizophrenia and other psychotic disorders and 33 healthy control persons. The ability to recognize facial emotions was assessed with The Facially Expressed Emotion Labelling (FEEL). To assess the severity of psychotic symptoms in the patient group The Structured Clinical Interview for Symptoms of Remission (SCI-SR) was used.

Results
Patients performed significantly worse than healthy controls (p&lt;.001, r =-.28) in recognizing facial emotions in general, including expressions of fear, disgust and sadness. Subjects with a schizophrenia diagnosis performed poorer than healthy controls when depicting fear (p&lt;.01, r=.45) or anger (p=.026, r=.36). Compared to other psychotic disorders they were less accurate in recognizing anger (p=.036, r=-.040). We did not find any significant differences between patients with other psychotic disorders and healthy controls in FER. Furthermore, patients performed significantly slower on the FEEL test (p&lt;.001, r=0.44), including both patients with a schizophrenia diagnosis and other psychotic disorders as compared to healthy controls. Patients diagnosed with schizophrenia showed significantly more psychotic symptoms (p= .001, r= -.53). However, there were no significant differences between patients in remission (40 %) and patients with more severe psychotic symptoms regarding the FEEL measures.

Discussion
In this study, patients with psychotic disorders performed less accurately and slower on the FEEL task as compared to healthy control persons. Patients diagnosed with schizophrenia tended to exhibit more difficulties. The results from this between-group comparison should however be interpreted with caution due to limited statistical power. Since no significant difference in FEEL score was demonstrated between patients in remission and patients suffering from more severe psychotic symptoms, it could be suggested that deficits in FER are independent of current psychotic symptoms. Impaired facial emotion recognition ability may negatively influence social interaction and functional outcome and the results from this study indicate that FER should be further explored in larger cohorts of outpatients with different psychotic disorders.
M88. EVIDENCE FOR INFLAMMATION AS A PUTATIVE SHARED MECHANISM FOR INSULIN RESISTANCE AND SCHIZOPHRENIA
Authors: Perry Benjamin , Burgess Stephen , Jones Hannah , Zammit Stanley , Upthegrove Rachel , Mason Amy , Day Felix , Stewart Isobel , Langenberg Claudia , Wareham Nicholas , Jones Peter , Khandaker Golam 
Published: May 2020

Abstract

Background
Insulin Resistance (IR) predisposes to cardiometabolic disorders, which are common in schizophrenia and are associated with excess morbidity and mortality. The mechanisms of association remain unknown. We aimed 1) To use genetic data to examine the direction of association between IR and related cardiometabolic risk factors, and schizophrenia; 2) To examine whether inflammation could be a shared mechanism for IR and schizophrenia.

Methods
We used two-sample uni-variable Mendelian randomization (MR) to examine whether genetically-predicted IR-related cardiometabolic risk factors (Fasting insulin (FI), high-density lipoprotein (HDL), triglycerides (TG), low-density lipoprotein, fasting plasma glucose, glycated haemoglobin, leptin, body mass index, glucose tolerance and type 2 diabetes) may be causally associated with schizophrenia. We used the most recent summary statistics for genetic variants associated with schizophrenia and IR-related cardiometabolic risk factors from publicly-available large genome-wide association studies (GWAS). We used bi-directional MR to examine direction of association. To examine whether inflammation could be a shared mechanism for IR and schizophrenia, we first conducted a sensitivity analysis by performing MR using only cardiometabolic genetic variants that were also associated with inflammation, at genome-wide significance. Second, we used multi-variable MR (MVMR) to examine associations between cardiometabolic risk factors and schizophrenia after adjusting for genetically-predicted levels of C-reactive protein.

Results
In analyses using all associated genetic variants, genetically predicted levels of leptin were associated with risk of schizophrenia (OR=2.54 per SD increase in leptin; 95% CI, 1.02–6.31). In analyses using inflammation-related variants, genetically predicted levels of FI (OR=2.76 per SD increase in FI; 95% C.I., 1.31–6.17), TG (OR=2.90 per SD increase in TG; 95% C.I., 1.36–6.17), and HDL (OR=0.56 per SD increase in HDL; 95% C.I., 0.37–0.83) were associated with schizophrenia. The associations completely attenuated in MVMR analyses controlling for CRP. There was no evidence of an association between genetically-predicted schizophrenia liability and cardiometabolic factors.

Discussion
The IR phenotype of FI, TG and HDL could be associated with schizophrenia over and above common sociodemographic and lifestyle factors. This association is likely explained by a common inflammatory mechanism. Interventional studies are required to test whether inflammation could represent a putative therapeutic target for the treatment and prevention of cardiometabolic disorders in schizophrenia.
M93. BRAIN GENE EXPRESSION PROFILING OF INDIVIDUALS WITH DUAL DIAGNOSIS WHO DIED BY SUICIDE
Authors: Cabrera Brenda , Fresno Cristóbal , Monroy-Jaramillo Nancy , Walss-Bass Consuelo , Fries Gabriel , Glahn David , Ostrosky-Wegman Patricia , Delia Genis-Mendoza Alma , Martínez-Magaña Jaime , Enrique Díaz-Otañez Carlos , García-Dolores Fernando , González-Sáenz Eli Elier , Mendoza-Morales Roberto , Flores Gonzalo , Antonio Vázquez-Roque Rubén , Nicolini Humberto 
Published: May 2020

Abstract

Background
Dual diagnosis is the co-occurrence of at least one substance use disorder (SUD) and one or more mental disorders in a given individual. Despite this comorbidity is highly prevalent and associated with adverse clinical outcomes, its neurobiology remains unclear. Furthermore, patients with dual diagnosis are at higher risk for suicidal behavior in comparison with single disorder patients. Our objective was to evaluate brain gene expression patterns in individuals with dual diagnosis who died by suicide.

Methods
We compared the gene expression profile in the dorsolateral prefrontal cortex of suicides with DD (n= 10) to the transcriptome of suicides with SUD alone (n=10), suicides with mood disorders alone (n=13), and suicides without mental comorbidities (n=5). Gene expression profiles were assessed by microarrays. Microarray data quality control was performed. Then, microarray data were background corrected and quantile normalized. Differentially expressed genes among the conditions were identified by a linear model implemented in the limma package.

Results
When comparing the transcriptome of suicides with dual diagnosis to suicides with SUD alone and suicides with mood disorders alone, we identified 255 and 172 differentially expressed genes, respectively. When comparing suicides with DD to suicides without mental comorbidities, we identified 330 differentially expressed genes, mainly enriched in neurogenesis.

Discussion
Our results suggest that suicides with dual diagnosis present a gene expression profile distinct from that of suicides with a single disorder and suicides without mental disorders. Also, suicides with dual diagnosis, SUD and mood disorders exhibited alterations in the expression of synaptic genes. However, suicides with each condition (dual diagnosis, SUD or mood disorders) exhibited unique gene expression changes at different levels within synaptic signaling. These gene expression differences might contribute to the phenotypical and clinical discrepancies observed in patients with dual diagnosis and patients with a single disorder