bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships between negative symptoms and abnormalities in the anticipatory component of reward
Authors: Schlagenhauf F. , Juckel G. , Heinz A. 
Published: May 2011

A dysfunction of the dopaminergic reward system has been postulated in the pathophysiology of schizophrenia. A subcortical hyperdopaminergic state in unmedicated schizophrenia patients has been associated with the pathogenesis of positive symptoms and a prefrontal hypodopaminergic state with cognitive and negative symptoms. But negative symptoms like anhedonia have also been hypothesized to be associated with a dysfunction of the mesolimbic dopaminergic system. However, preclinical studies indicate that the mesolimbic dopaminergic system mediates motivation and incentive salience of reward-indicating stimuli rather than the ability to experience pleasure.Recent neuroimaging findings in schizophrenia patients confirmed dysfunctional activation during reinforcement learning. We used functional magnetic resonance imaging (fMRI) to assess the BOLD response in the ventral striatum of unmedicated schizophrenia patients during presentation of reward-indicating stimuli and during reversal learning. Compared with healthy controls, unmedicated schizophrenics showed reduced ventral striatal activation during presentation of reward-indicating cues, which was negatively correlated with the severity of negative symptoms. During reversal learning unmedicated schizophrenia patients displayed behavioral impairments and reduced activation in the ventral striatum and the ventrolateral PFC. In unmedicated schizophrenic patients, a high striatal dopamine turnover may interfere with neuronal processing of reward-indicating stimuli by phasic dopamine release, thus contributing to negative symptoms as such as loss of drive and motivation.
Assessing functionality in Schizophrenia: The psychosocial remission in Schizophrenia scale (PSRS)
Authors: Barak Y. 
Published: May 2011

BackgroundRemission, both symptomatic and psychosocial, is now an achievable goal in a substantial proportion of schizophrenia patients.Objectiveto develop a brief, clinician rated scale for the assessment of psychosocial remission in schizophrenia (the PSRS). The scale is to match the quantification of symptomatic remission as delineated by the American Psychiatric Association (APA) task force.Methoda “bank” of 124 questions pertaining to psychosocial remission was derived from published scales reflecting two domains: quality of life (QoL) and activities of daily living (ADL). Psychiatrists, residents, psychiatric nurses and community nurses were presented with the questions. All were asked to choose the 8 items they considered as reflecting the essence of psychosocial remission. Inter-rater reliability of the final scale version was assessed amongst psychiatrists.Resultsthe questions' “bank” was reviewed by 429 mental health professionals. The four items found to be most frequently sanctioned in the QoL domain were: a. familial relations (endorsed by 78% of participants), b. understanding and self-awareness (46%), c. energy (58%) and d. interest in every-day life (38%). The four items sanctioned in the I-ADL domain were: a. self-care (86%), b. activism (65%), c. responsibility for medications (54%) and d. use of community services (32%). Inter-rater reliability amongst 70 psychiatrists ranged from 0.67 to 0.83.Conclusionthe PSRS is an 8-item scale quantifying psychosocial remission in schizophrenia in a manner that complements symptomatic assessment of remission. The PSRS may be useful for both research and clinical evaluation.
The Functional Recovery Scale in Schizophrenia (FRSS): Relationship to panss
Authors: Llorca P.-M. , Samalin L. , Blanc O. ,   EGOFORS Group
Published: May 2011

Schizophrenia is a severe and disabling disorder, which affects multiple functional domains adversely.Several factors like premorbid functioning and psychopathological symptoms can affect functional outcome. Residual psychopathology after an acute exacerbation has a variable influence, going from a weak correlation to positive symptoms to clear association of negative symptoms with reduced social functioning to widespread influence of cognitive symptoms.We performed a cross-sectional evaluation in a sample of 296 schizophrenic patients for demographic, functional characteristics (using different scales: Functional Recovery Scale in Schizophrenia (FRSS), Subjective Well-being Scale (SWN-K), Quality of Life Scale (QLS)) and symptomatic (using the Positive and Negative Syndrome Scale (PANSS)). Exploratory multivariate analyses were conducted and a model with “functioning” as a latent variable was proposed and tested. Results: Using the 5 clinical dimensions of the PANSS, negative, cognitive and excitation factors are significant predictors of functioning. The model was constructed with “functioning” defined as a latent variable; indicators are sub-scores on FRSS, SWN-K, QLS and exogenous variables included symptomatology, Duration of Untreated Psychosis and educational level. The negative and cognitive dimensions are highly correlated via the latent variable to the 3 dimensions of functioning evaluated by the FRSS: “daily life”, “social functioning” and “treatment” and the QLS sub-scores (“interpersonal”, “common object”, “instrumental role”). Educational level is significantly linked to functioning but not DUP. The model emphasizes the need for treatment strategies that have an effect on negative and cognitive factors, to improve functioning in schizophrenia.
Patient reported measures and functional remission
Authors: Naber D. 
Published: May 2011

Only recently success criteria became more ambitious and include a more thorough consideration of the patient's perspective. Recent data indicate that in addition to the positive influence of a good relationship between doctor and patient, the subjective experience of antipsychotic treatment is a major predictor of compliance.Among other scales, a self-report instrument has been constructed to evaluate “subjective well-being under neuroleptics” (SWN). Data indicate: a) schizophrenic patients, if no longer acutely psychotic or suffering from severe cognitive deficits, are able to reliably assess their subjective well-being, b) high SWN is correlated with high compliance, c) atypical antipsychotics increase SWN, d) individual improvements of SWN and of PANSS are not strongly related (r = -.30 - -.40), and e) dopamine D2 receptor blockade is highly correlated to reduced SWN (r = .66–.76).Recent trials reveal the relevance of early improvement of subjective well-being: In a 12-week trial 95% of those with early subjective response (within 4 weeks) showed later subjective and/or psychopathological improvement, but only 9% without early subjective response showed later improvement. In another 3-year trial again psychopathological response as well as symptomatic and functional remission were not only related to young age and treatment with atypical antipsychotics, but mostly to early (within the first 3 months) subjective improvement. Moreover in a five year trial of first episode patients, marked improvement of SWN within the first 6 weeks of antipsychotic treatment was found to be related to enduring remission, while early improvement of PANSS did not predict outcome.
Case presentation on a childhood homicide offender
Authors: Zalsman G. 
Published: May 2011

A case presentation of a young homicide offender from Israel will be presented. This young man murdered three adults and 500 cats claiming it was part of a Satanist ritual. Psychiatric assessment of him and his family will be presented.The neurobiology of aggression in the young will be briefly discussed. Aggression in adolescents has neurobiological, psychological and social roots. Greater aggression is reported in male KO mice which have increased levels of serotonin, dopamine and norepinephrine. A mutation in the MAO A gene is associated with impulsive-aggressive behaviour in males while higher MAO A expression appears to protect against the effects of childhood abuse on development of aggressive behaviors or impulsivity in adulthood in males but not females.
Juvenile sex offenders: Mental health and reoffending
Authors: Hart-Kerkhoffs L.’t , Vermeiren R. , Jansen L. , Doreleijers T. 
Published: May 2011

BackgroundJuvenile sex offending all too often is the reason of public commotion and concern. About 20% of all rapes and 20–50% of cases of child abuse are perpetrated by juveniles. However little is known on the psychiatric characteristics and recidivism rates of these youths. In the present study the prevalence of psychopathology in (subgroups of) juvenile sex offenders and its relation with criminal recidivism two to four years later were investigated.MethodsSemi-structured psychiatric interviews (K-SADS-PL) and a parent-report questionnaire (CSBQ) were carried out with 106 adolescent sex offenders (mean age 15.0 ± 1.5 years, 60 group offenders, 27 solo rapists, and 19 child molesters) referred to the Dutch child protection agency and juvenile justice institutions. Recidivism was ascertained from registration systems.ResultsThree quarters of juvenile sex offenders met criteria for at least one psychiatric disorder and comorbidity was found in more than half of the subjects. Child molesters showed the highest rates of internalizing disorders and showed most pronounced autism spectrum disorder core symptomatology. Forty percent of juvenile sex offenders had committed multiple sexual offenses, but none recidivated sexually within the 2–4 years after the study. Compared to one time sex offenders, multiple sex offenders were higher in DBD and anxiety disorder.ConclusionChild and adolescent psychiatric care should be given to juvenile sex offenders, with particular attention to multiple sex offenders and child molesters. However, the predictive value of psychopathology for sexual recidivism remains unclear and warrants further research.
The usefulness of mood stabilizers in the treatment of bipolar depression
Authors: Cruz N. , Nivoli A. , Vieta E. 
Published: May 2011

AimsConsidering bipolar depression a diagnostic and therapeutic challenge, distinct from unipolar depression and associated with significant morbidity and mortality, we aim to systematically review guidelines, consensus meetings and treatment algorithms on the acute treatment of bipolar depression to critically underline the role of mood-stabilizers.MethodThe MEDLINe/PubMed/Index Medicus, PsycINFO/PsycLIT, Excerpta Medica/EMBASE, databases were searched using “depression”, “bipolar”, “mood-stabilizers”, “manic-depressive” and “treatment guidelines” as key words since 2005 onward.ResultsAmong mood-stabilizers, the use of lamotrigine is overall recommended as first-line choice. Monotherapy is suggested on the basis of several positives clinical trials, however, pooled data analysis showed that lamotrigine was only modestly useful. Valproate monotherapy is suggested as first-line treatment option in the WFSBP and BAP guidelines, and in combination with lithium or antidepressants, but it is not mentioned among first-line choices neither in monotherapy nor as adjunctive treatment in two guidelines (ICG, NICE).Lithium monotherapy is suggested in three of all guidelines (ICG, BAP, CANMAT and ISBD) as first-line treatment on the basis of positive evidence, but it is not recommended as first-choice by WFSBP and NICE guidelines. Its combination with lamotrigine, valproate and other agents is instead recommended as first choice treatment.ConclusionsIn summary, mood-stabilizers are considered a key point in the management of bipolar depression, preferably in combination. Despite algorithms evidence-based could be helpful to guide clinicians, they always need the case by case pharmacotherapeutic consideration.
Antipsychotics in the treatment of bipolar depression
Authors: Pacchiarotti I. 
Published: May 2011

The Food and Drug Administration (FDA) has not approved any antidepressant for the treatment of bipolar depression. To date, the only antidepressant drug that showed evidence of efficacy in bipolar depression is fluoxetine but only when given combined with olanzapine, which allowed the FDA, but not the EMEA (European Medicines Agency), to approve a fixed dose olanzapine-fluoxetine combination for the treatment of acute bipolar I depression. Quetiapine monotherapy is at present the only both FDA- and EMEA-approved treatment for bipolar depression. In a recent metanalysis on treatment options for bipolar depression, quetiapine and the olanzapine-fluoxetine combination showed the greatest symptomatic improvements.Aripiprazole showed a 6-week limited superiority compared to placebo, decreasing its effect size at endpoint. The very early onset of action of all tested atypical antipsychotics in the treatment of bipolar depression, even as monotherapy, may highlight an overlapping mechanism of action of these drugs as a potential class effect with independence of the monoaminergic pathways. Results suggest some atypical antipsychotics (quetiapine and olanzapine) may be considered as first line management option in acute bipolar I and/or II depression, even for poor responders subgruoups such as rapid cyclers and patients with psychotic feature.
Functional consequences of genome wide risk variants for neuropsychiatric disordes in the human brain
Authors: Lancaster T. , Linden D. 
Published: May 2011

IntroductionRecent advances in DNA sequencing have allowed large neuropsychiatric populations to be screened for genetic variants that may influence the progression of mental disorders. Recent GWAS (Genome Wide Association Studies) have identified risk loci for schizophrenia (SZ), Bipolar disorder (BD) and Alzheimer's disease (AD). ObjectivesA major concern is to understand how these recently identified risk variants influence vulnerability to neuropsychiatric disorders.AimsCommon risk variants may contribute to intermediate phenotypes associated with neuropsychiatric disorders. A key aim is to investigate whether individuals expressing susceptibility loci demonstrate similar deficits to those of patients. This may help to elucidate new pharmacological pathways.MethodsA combination of neuroimaging (fMRI & EEG) and behavioural studies (emotional working memory task, visual encoding efficiency and decision-making ability) were used to probe risk carriers for GWAS validated risk loci associated with SZ, BD and AD. The paradigms were previously validated as methods that neuropsychiatric populations displayed deficits in.ResultsGWAS risk SNP carriers displayed patterns of behavioural/neurophysiology typically seen in their respective neuropsychiatric populations. The risk carrier populations display less overt phenotypes than patients or first-degree relatives, nevertheless displayed small but significant trait effects typically observed in individuals with high levels of genetic risk.ConclusionsGWAS risk carriers display small but significant effects that reflect a sub-clinical phenotype typically seen in individuals with high genetic risk. Imaging techniques such as fMRI are useful in measuring these subtle differences. Behavioural testing requires larger populations or more penetrant risk alleles for overt phenotypic effects to be witnessed.
Neurogenetics of emotion processing in major depression
Authors: Dannlowski U. 
Published: May 2011

Converging lines of research suggest that major depression is characterized by abnormalities in different stages of emotion processing (e.g., automatic emotion processing, emotion regulation, or reward processing). Using functional neuroimaging, the neurobiological correlates of these emotion processing biases have been intensively investigated during the last decade. Depressed patients appear to be characterized by a hyper-responsive amygdala to negative stimuli, dysfunctional prefrontal activity during emotion regulation and blunted activity of the ventral striatum in response to positive cues or reward.We present a series of studies investigating genetic underpinnings of these neurobiological abnormalities frequently observed in depression. We demonstrate a consistent pattern of serotonergic and neuropeptide genes that bias automatic amygdala responsiveness towards subliminally presented negative stimuli. Other genes were shown to impact prefrontal engagement during conscious emotion processing, e.g. genetic variants in the interleukin 1 beta gene. Further polymorphisms, e.g. in the endocannabinoid system rather seem to influence striatal responsiveness to positive social cues.We conclude that the neurobiological abnormalities in major depression which are linked to biased emotional processes are strongly under genetic influence. The investigation of neurogenetic pathways to different aspects of depression psychopathology might help to better characterize patients according to their neurobiological dysfunctions and might ultimately lead to individualized therapy plans.
Predictors of persistence of ultrahigh risk symptoms and predictors of transition into psychosis
Authors: van der Gaag M. , Rietdijk J. , Ising H. , Dragt S. , Klaassen R. , Nieman D. , Wunderink L. , Linszen D.H. 
Published: May 2011

AimsTo determine predictors of transition from ultrahigh risk into psychosis.MethodThe Dutch EDIE trial has included 201 people with an ultrahigh risk for psychosis. These were included with both a referral based strategy and a screening all help-seeking people strategy. The study had a 24 month inclusion period and an 18 mont follow-up period with each patient. The preliminary results are presented.ResultsA loogistic regression was performed over 164 cases. 29 patients developed a psychosis.Predictor variables were depression, social intercation anxiety, positive symptoms on the CAARMS, negative symptoms on the CAARMS, quality of life, social functioning, genetic risk, and the personal beliefs about illness.The backward logistice regression (likelyhood ratio) discarded four variables. Predictors of psychosis were depression, positive symptoms, genetic liability and beliefs about illness at basline.ConclusionsPeople with hihd scores on depression and positive symptoms are likely to develop a psychosis. Also those who have a psychotic parent and positive symptoms a more lekly to make a transition. Interestingly people that consider their condition as hopeless, feel entrapped by their condition, excluded by other pople and not in control of symptoms also have a heightened chance for developing psychosis in this sample.
The structure of the ultra high risk mental state for psychosis. A latent class cluster analysis study
Authors: Valmaggia L. , Stahl D. , Yung A. , Nelson B. , McGorry P. , McGuire P. 
Published: May 2011

IntroductionIndividuals at Ultra High Risk (UHR) for psychosis typically present with attenuated psychotic symptoms. However it is difficult to predict which individuals will later develop frank psychosis when their mental state is rated in terms of individual symptoms.The objective of the study was to examine the phenomenological structure of the UHR mental state and identify symptom profiles that predict later transition to psychosis.MethodPsychopathological data from a large sample of UHR subjects were analysed using latent class cluster analysis.A total of 318 individuals with a UHR for psychosis. Data were collected from two specialised community mental health services for people at UHR for psychosis: OASIS in London and PACE, in Melbourne.ResultsLatent class cluster analysis produced 4 classes: Class 1 - Mild was characterized by lower scores on all the CAARMS items. Subjects in Class 2 - Moderate scored moderately on all CAARMS items and was more likely to be in employment. Those in Class 3 - Moderate-Severe scored moderately-severe on negative symptoms, social isolation and impaired role functioning. Class 4 - Severe was the smallest group and was associated with the most impairment: subjects in this class scored highest on all items of the CAARMS, had the lowest GAF score and were more likely to be unemployed. This group was also characterized by the highest transition rate (41%).ConclusionsDifferent constellations of symptomatology are associates with varying levels of risk to of transition to psychosis.
Stress in people at high risk for psychosis
Authors: Day F. , Valmaggia L. , Pariante C. , Papadopoulos A. , Papadopoulos I. , McGuire P. 
Published: May 2011

BackgroundStress is a key feature of many aetiological models of psychosis and there is considerable empirical evidence implicating stress in the development of psychosis. This paper investigates the role of psychosocial stress in the onset of psychosis by examining the relationship between current and lifetime exposure to traumatic experiences and psychosocial stressors, HPA axis function, and psychopathology in people at high risk of developing psychosis.MethodsSixty ‘high risk’ (HR) participants were compared with 50 healthy control (HC) participants on measures of exposure to psychosocial stressors. Subgroups of HR and HC participants which provided saliva samples were compared regarding measures of HPA axis function.ResultsHR participants were exposed to greater levels of psychosocial stress than HC participants. Specifically, HR participants were more likely to have been separated from their parents (p = .003), report severe parental antipathy (p = .011), and have been bullied while growing up (p = .024). HR participants experienced greater levels of perceived stress than HC participants (p = .001) and were more likely to have had a negative life event in the previous 6 months (p < .001). Positive correlations were found between current stress and number of life events and attenuated psychotic symptoms (r = .585, p < .001, and r = .384, p = < .001, respectively) in the HR participants.DiscussionThis study shows that people at high risk of developing psychosis experience greater levels of psychosocial stress than matched healthy control participants throughout the lifetime, from early childhood to the present day, and that current stress is strongly associated with psychotic symptomatology.
Fatty acid metabolism and the onset of psychotic disorder
Authors: Amminger P. , Mossaheb N. , Schlögelhofer M. , Schäfer M. 
Published: May 2011

IntroductionPotentially chronic diseases often have a critical point in their course beyond which treatment becomes less effective. In support of this, early treatment in schizophrenia and other psychoses has been linked to better outcome.ObjectivesThe emergence of simultaneous brain volume changes in those ultra-high-risk individuals who develop psychosis indicate an active biological process, and underline the importance of pre-onset treatment. However, pre-psychotic intervention has also been questioned as, using current criteria, only 20–50% of individuals classified as prodromal develop a psychotic disorder within a 1–2 years period.AimsTreatment agents in the pre-psychotic phase should, therefore, not have major side effects. Bioactive lipids are molecules that have both intra- and intercellular roles, including mediation, modulation and control of neurobiological processes, such as ion channel and receptor activity, neurotransmitter release, synaptic plasticity, second messenger pathways and neuronal gene expression.MethodsLong-chain omega-3 polyunsaturated fatty acids (PUFAs) have been shown effective for both, mood and psychotic symptoms, and they have neuroprotective properties. Because of the controversy concerned with the extent to which an intervention may produce harm which outweighs its benefits, omega-3 PUFAs are prime candidates for evaluation in putatively prodromal individuals.ResultsWe report on the first randomized, placebo-controlled trial on the preventive use of omega-3 fatty acids in 81 ultra-high-risk individuals.ConclusionsSupplementation with long-chain omega-3 PUFAs reduces the risk of progression to psychotic disorder, and offers a safe and efficacious strategy for indicated prevention in individuals at ultra-high-risk of developing a psychotic illness.