scholarly journals Increased Heschl’s Gyrus Duplication in Schizophrenia Spectrum Disorders: A Cross-Sectional MRI Study

2021 ◽  
Vol 11 (1) ◽  
pp. 40
Author(s):  
Tsutomu Takahashi ◽  
Daiki Sasabayashi ◽  
Yoichiro Takayanagi ◽  
Atsushi Furuichi ◽  
Mikio Kido ◽  
...  

Duplicated Heschl’s gyrus (HG) is prevalent in patients with schizophrenia and may reflect early neurodevelopmental anomalies. However, it currently remains unclear whether patients with schizotypal disorder, a prototypic disorder within the schizophrenia spectrum, exhibit a similar HG gyrification pattern. In this magnetic resonance imaging study, HG gyrification patterns were examined in 47 patients with schizotypal disorder, 111 with schizophrenia, and 88 age- and sex-matched healthy subjects. HG gyrification patterns were classified as single, common stem duplication (CSD), or complete posterior duplication (CPD). The prevalence of the duplicated HG patterns (CSD or CPD) bilaterally was higher in the schizophrenia and schizotypal groups than in healthy controls, whereas no significant difference was observed between the schizophrenia and schizotypal groups. Schizophrenia patients with the right CPD pattern had less severe positive symptoms, whereas the right single HG pattern was associated with higher doses of antipsychotic medication in schizotypal patients. The present study demonstrated shared HG gyrification patterns in schizophrenia spectrum disorders, which may reflect a common biological vulnerability factor. HG patterns may also be associated with susceptibility to psychopathology.

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S305-S305
Author(s):  
Andreas Rosén Rasmussen ◽  
Josef Parnas

Abstract Background Imagination is the formation of ideas or images of something known not to be present to the senses. Clinical psychopathology has few notions addressing this domain apart from obsession and rumination. Some classic psychopathological notions such as Jaspers’ concept of pseudohallucination or the pseudo-obsession are relevant to this area. In a recent research project, informed by contemporary philosophy of mind and phenomenology, we have developed novel concepts targeting subjective disturbances of imagination and fantasy life with a focus on the schizophrenia-spectrum. Patients describe a spatialization of images, i.e., stable imagery with an articulated spatial structure being liable to inspection ‘from afar in the mind’ and often undergoing an autonomous development independently of the will of the patient (‘like watching a movie in the head’). Other notions address tacit, non-psychotic erosions of the demarcation of fantasy life from perception and memory. A broad range of ideations (such as ‘daydreams’, ‘fears’, anticipations, intrusions, paranoid or suicidal ideation) may involve such structural disturbances of experience. Here, we present data from the first, cross-sectional study investigating the distribution of anomalies of imagination in different diagnostic groups and healthy controls as well as their association with positive symptoms, negative symptoms and disorders of basic selfhood. Methods The sample (N=81) included in- and outpatients with schizophrenia or another non-affective psychosis (N=32), outpatients with schizotypal disorder (N=15) or other mental illness (N=16) and healthy controls (N=18). The sample was 70% female with mean age 29.9 (SD 6.8; range 18–42) years. Anomalies of imagination were assessed with the Examination of anomalous fantasy and imagination (EAFI), which is an instrument recently developed in our group for a semi-structured interview exploring these experiences. The EAFI has shown very good reliability with average Kappa of 0.84. Disorders of basic self were assessed with the Examination of anomalous self experience (EASE) and positive, negative and general symptoms with the Positive and Negative Syndrome Scale (PANSS). Results Anomalies of imagination aggregated significantly (p < 0.000, Kruskall-Wallis test) in the schizophrenia-spectrum disorders compared to other mental illness with no significant difference between schizophrenia and schizotypal disorder. The group of healthy controls very rarely reported these anomalies and scored significantly lower (p < 0.000) than all diagnostic groups. In multivariate linear regression analysis (R2 = 0.66), EAFI score was significantly associated with EASE score (β = 0.62, p < 0.000), PANSS positive (β = 0.34, p = 0.01) and PANSS negative (β = 0.29, p = 0.02), but not PANSS general score (β = -0.29, p = 0.07). More than 79% of the schizophrenia-spectrum patients retrospectively reported the onset of these experiences to adolescence or earlier. Discussion The results of this cross-sectional study support that the subjective anomalies of imagination, targeted with the EAFI, are associated with the schizophrenia-spectrum. The association with disorders of basic self, which has been shown to have trait-like characteristics and to predict transition to schizophrenia-spectrum disorders, may reflect that the anomalies of imagination share a common experiential core-structure with self disorders. We suggest that the anomalies of imagination belong to an early onset level of psychopathology in the schizophrenia-spectrum and may have a relevance for differential diagnosis and early detection.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S182-S182
Author(s):  
Igor Filipčić ◽  
Ivona Šimunović Filipčić ◽  
Žarko Bajić

Abstract Background Patients with schizophrenia spectrum disorders (SSD) have higher prevalence of chronic physical illness (CPI) and a substantially reduced life expectancy compared with the general population. Despite the increasing amount of research in this area, the effect on psychiatric treatment outcome is still not clear. Some research reported significant associations between several CPIs and different SSD treatment outcomes, whereas the remaining study did not. The objective of the current study is to assess differences in the association of the number of CPI with the overall number of psychiatric rehospitalization in specific SSD diagnosis. Methods We conducted a cross-sectional study of 354 patients diagnosed with SSD (ICD10): 135 schizophrenia, 71 acute and transient psychotic disorder, 57 schizoaffective disorder, 68 unspecified unorganic psychosis, 23 other (persistent delusional disorder, schizotypal disorder). The primary outcome was the association of the number of CPI with the number of psychiatric rehospitalization since the diagnosis, as the surrogate outcome for the treatment success, adjusted for the time from diagnosis, age, and gender of participants. Results Mean number of CPI adjusted for the time from diagnosis, age, and gender was not significantly nor clinically relevantly different between particular SSD diagnosis (F(5,345)=0.70; p=0.620). It was 1.7 in schizophrenia, 1.5 in acute and transient psychotic disorder, 1.4 in schizoaffective disorder, 1.8 in unspecified unorganic psychosis, 1.0 in persistent delusional disorder and 1.9 in schizotypal disorder. The mean number of CPI adjusted for the same three potential confounders was significantly different between particular SSD diagnosis (F(5,345)=2.78; p=0.018). It was 6.7 in schizophrenia, 3.8 in acute and transient psychotic disorder, 7.3 in schizoaffective disorder, 4.8 in unspecified unorganic psychosis. However, the association of the number of CPI with the psychiatric rehospitalizations, adjusted for the previously stated three confounders, was significant and clinically relevant only in participants diagnosed with schizophrenia. In these participants, an increase of one CPI was associated with the 2.3 (95% CI 1.2 to 3.5) more psychiatric rehospitalizations (p<0.001). In participants diagnosed with other specific SSD the association of the number of CPI was not significantly associated with the number of psychiatric rehospitalizations. Moreover, on this particular sample level, it was negative, meaning that more CPI was associated with the lower number of psychiatric rehospitalization in all other SSD except in the case of unspecified nonorganic psychosis. Discussion In this cross-sectional study, we observed that the hypothesis of the effect of the number of CPI on the SSD treatment outcomes is valid only in the case of schizophrenia. Further research is needed to clarify whether additional psychological distress is related to the additional burden of multimorbidity.


2020 ◽  
Vol 32 (6) ◽  
pp. 781-785
Author(s):  
Maureen M. J. Smeets-Janssen ◽  
Idan M. Aderka ◽  
Paul D. Meesters ◽  
Sjors Lange ◽  
Sigfried Schouws ◽  
...  

ABSTRACTThe nature of schizophrenia spectrum disorders with an onset in middle or late adulthood remains controversial. The aim of our study was to determine in patients aged 60 and older if clinically relevant subtypes based on age at onset can be distinguished, using admixture analysis, a data-driven technique. We conducted a cross-sectional study in 94 patients aged 60 and older with a diagnosis of schizophrenia or schizoaffective disorder. Admixture analysis was used to determine if the distribution of age at onset in this cohort was consistent with one or more populations of origin and to determine cut-offs for age at onset groups, if more than one population could be identified. Results showed that admixture analysis based on age at onset demonstrated only one normally distributed population. Our results suggest that in older schizophrenia patients, early- and late-onset ages form a continuum.


2006 ◽  
Vol 12 (5) ◽  
pp. 750-754 ◽  
Author(s):  
MIÉ MATSUI ◽  
HIROMI YUUKI ◽  
KANADE KATO ◽  
MASAYOSHI KURACHI

Verbal learning and the organization of memory in patients with schizophrenia or schizotypal disorder were compared with normal subjects. Three indices of memory organization (semantic clustering, serial clustering, and subjective clustering) were calculated from participants' responses on the Japanese Verbal Learning Test. Schizophrenic and schizotypal patients showed similar decrements in semantic organization compared with normal subjects. Neither patient group showed any effect of learning on their use of semantic organization, although both groups recalled more items as the number of trials increased. These results suggest that impairment of memory organization is a common characteristic of schizophrenia spectrum disorders (JINS, 2006, 12, 750–754.)


2020 ◽  
Author(s):  
Maria S. Neumeier ◽  
Stephanie Homan ◽  
Stefan Vetter ◽  
Erich Seifritz ◽  
John M. Kane ◽  
...  

Background: Side effects of antipsychotic drugs play a key role in non-adherence and discontinuation of treatment in schizophrenia spectrum disorders (SSD). Precision medicine aims to minimize such side effects by selecting the right treatment for the right patient. However, to determine the extent of precision medicine that is required, we need to (1) show that there is indeed variation in side effects and (2) estimate the amount of variation in those side effects between patients. While clinical observations suggest that such variation may be considerable, a statistical comparison of side effect variation between active and control treatments is required to confirm this. Here, we hypothesized to find larger side effect variation in treatment compared with control in patients treated with first and second generation antipsychotics. Methods: We included double-blind, placebo-controlled, randomized controlled trials (RCTs) of adults with a diagnosis of SSD and prescription for licensed antipsychotic drugs. Standard deviations of the pre-post treatment differences of weight gain, prolactin levels,and corrected QT (QTc) times were extracted. Data quality and validity were ensured by following the PRISMA guidelines. The outcome measure was the overall variability ratio of treatment to control across RCTs. Individual variability ratios were weighted by the inverse-variance method and entered into a random-effects model. Results: We included N = 16578 patients for weight gain, N = 16633 patients for prolactin levels, and N = 10384 patients for QTc time. Variability ratios (VR) were significantly increased for weight gain (VR = 1.08; 95% CI: 1.02 - 1.14; P = 0.004) and prolactin levels (VR = 1.38; 95% CI: 1.17 - 1.62; P < 0.001) but did not reach significance for QTc time (VR = 1.05; 95% CI: 0.98 - 1.12; P = 0.135). Conclusion: We found increased variability in major side effects in patients with SSD under treatment with second generation antipsychotics, suggesting that subgroups of patients or even individual patients may benefit from improved treatment allocation through stratified or personalized medicine, respectively.


Author(s):  
L. Yu. Demidova ◽  
G. E. Vvedensky ◽  
T. E. Makarova ◽  
M. Yu. Kamenskov ◽  
L. N. Shtark

Te article is concerned with the study of disturbances in psychosexual sphere, which are specifc for schizophrenia spectrum disorders. Te results of a comparison of two groups are presented: 29 people were diagnosed with schizophrenia and schizotypal disorder and a comparison group of 34 people without endogenous pathology. Te study outcomes of their gender self-consciousness with methods «MF», «CTAT», «Coding» are shown that the presence of endogenous disorder changes the psychosexual profle of patients on a number of signs. Persons with schizophrenia and schizotypal disorder, regardless of their comorbide diagnosis of paraphilia are characterized by lower value of masculinity, high distinction with the male role, absence of intention to line up with the man-image, in some cases instability of identity, altered emotional attitudes to sex-role stereotypes, emotional ambivalence.


2017 ◽  
Vol 41 (S1) ◽  
pp. S356-S356
Author(s):  
M. Holubova ◽  
J. Prasko ◽  
S. Matousek ◽  
K. Latalova ◽  
M. Marackova ◽  
...  

BackgroundThe views of one's self-stigma and quality of life in patients with schizophrenia and depressive disorders are significant subjective notions, both being proven to affect patient's functioning in life. The objective of this research was to find out the quality of life and self-stigma in connection with demographic factors and compare the two groups of patients in those variables.MethodIn a cross-sectional study, the outpatients with the schizophrenia spectrum disorders and depressive disorders completed the quality of life satisfaction and enjoyment questionnaire, the internalized stigma of mental illness scale and a demographic questionnaire during a routine psychiatric control. Furthermore, both patients and their psychiatrists evaluated the severity of the disorder by clinical global impression-severity scale.ResultsThe quality of life of patients with depression or schizophrenia spectrum disorders did not significantly differ between the two groups. In both groups, unemployment was perceived to be a significant factor decreasing the quality of life. Self-stigma was detected to be higher in patients with schizophrenia as compared to the depressive patients. A strong correlation was found between the two scales, meaning that those with higher levels of self-stigmatization were less prone to see their life as fulfilling and joyful.ConclusionsThe present study shows that the degree of the internalized stigma can be an important aspect linked to the quality of life irrespective of the diagnostic category.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2020 ◽  
pp. 002076402096253
Author(s):  
Rui Barranha ◽  
Tânia Teixeira ◽  
João Quarenta ◽  
Orlando von Doellinger

Background: Schizophrenia spectrum disorders (SSD) are the most impairing psychiatric disorders and are a major cause of social exclusion. Despite that, there are only two studies published assessing the socioeconomic characteristics of SSD patients living in Portugal. Aims: The purpose of this study is to assess the degree of social and family support for SSD patients living in the region of ‘Tâmega e Sousa’, in northern Portugal. Method: We conducted a cross-sectional observational study using patients under home-based care provided by the Department of Psychiatry and Mental Health of Centro Hospitalar do Tâmega e Sousa. We retrieved sociodemographic data from clinical records. The study was approved by the Hospital Ethics Committee. Results: Our sample consists on 67 patients with SSD, mostly men (74.6%). Although the majority was single (69.2%) and childless (85.7%), only a minority lived alone (21.2%). In relation to their professional status, only 5.0% were employed and 78.3% got a disability pension. Among the patients that lived accompanied, 68% lived with their parents or grandparents, and a quarter lived with family members affected by psychiatric disorders. Conclusions: These findings highlight the dependence of SSD patients on their family’s support. Lack of labour market integration, economic dependence and difficulty establishing stable relationships further aggravate their social exclusion. Although our results are consistent with a previous observational study held in Portugal, our patients display a worse functional status. Even considering the possible patient selection bias, there is evidence supporting the need for more investment in psychosocial rehabilitation that should take into account the sociodemographic idiosyncrasies of this Portuguese region.


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