Schizophrenia Bulletin (SCHIZOPHRENIA BULL )

Publisher: United States. Alcohol, Drug Abuse, and Mental Health Administration; Center for Studies of Schizophrenia (U.S.); National Clearinghouse for Mental Health Information (U.S.); National Institute of Mental Health (U.S.); National Institute of Mental Health (U.S.). Office of Communications and Public Liaison, Oxford University Press


Covers current developments relating to all aspects of schizophrenia research.

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    Schizophrenia Bulletin website
  • Other titles
    Schizophrenia bulletin
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    Government publication, National government publication, Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

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Oxford University Press

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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: * The first and second author contributed equally to this work Background: Schizophrenia is a multi-faceted mental disorder characterized by cognitive, perceptual and affective symptom dimensions. This heterogeneity at the phenomenological level may be subserved by complex and heterogeneous patterns of structural abnormalities. Thus, delineating such patterns may improve the insight into the variability of disease and facilitate future MRI-based diagnosis. Methods: We aimed to identify structurally complex signatures that directly differentiate patients with predominantly negative (pNEG), positive (pPOS) and disorganized (pDIS) symptoms using Optimally-Discriminative Voxel-Based Analysis (ODVBA). ODVBA is a new analytical framework for group analysis, which showed to have superior sensitivity and specificity over conventional voxel-based morphometric approaches, thus facilitating the identification of subtle neuroanatomical signatures delineating different subgroups. Results: pPOS were characterized by pronounced gray matter (GM) volume reductions in the ventromedial prefrontal cortex (vmPFC), which herein is defined to include the orbitofrontal cortex, and in occipito-temporal GM and parts of the lingual gyrus. pNEG was found to have vmPFC reduction but to a lesser degree than pPOS and with a relative sparing of the more medial vmPFC regions, compared to pDIS; it also had significantly less cerebellar GM. pDIS showed relatively highest GM volume preservation among three subtypes. Conclusions: Although a common prefronto-perisylvian GM reduction pattern was present at the whole-group level, marked morphometric differences emerged between the three subgroups, including reduced cerebellar GM in pNEG, and reduced vmPFC and occipito-temporal GM in pPOS. Besides deepening our insight into the neurobiological underpinnings of clinical heterogeneity, these results also identify important imaging biomarkers that may aid patient stratification.
    Schizophrenia Bulletin 10/2014;
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    ABSTRACT: In recent years, virtual reality (VR) research on psychotic disorders has been initiated. Several studies showed that VR can elicit paranoid thoughts about virtual characters (avatars), both in patients with psychotic disorders and healthy individuals. Real life symptoms and VR experiences were correlated, lending further support to its validity. Neurocognitive deficits and difficulties in social behavior were found in schizophrenia patients, not only in abstract tasks but also using naturalistic virtual environments that are more relevant to daily life, such as a city or encounters with avatars. VR treatments are conceivable for most dimensions of psychotic disorders. There is a small but expanding literature on interventions for delusions, hallucinations, neurocognition, social cognition, and social skills; preliminary results are promising. VR applications for assessment and treatment of psychotic disorders are in their infancy, but appear to have a great potential for increasing our understanding of psychosis and expanding the therapeutic toolbox.
    Schizophrenia Bulletin 09/2014;
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    ABSTRACT: People living in densely populated and socially disorganized areas have higher rates of psychiatric morbidity but the potential causal status of such factors is uncertain. We used nationwide Swedish longitudinal registry data to identify all children born 1967-1989 (n=2,361,585), including separate datasets for all cousins (n=1,715,059) and siblings (n=1,667,894). The nature of the associations between population density and neighborhood deprivation and individual risk for a schizophrenia diagnosis were investigated while adjusting for unobserved familial risk factors (through cousin and sibling-comparisons), and then compared with similar associations for depression. We generated familial pedigree structures using the Multi-Generation Registry and identified study participants with schizophrenia and depression using the National Patient Registry. Fixed-effects logistic regression models were used to study within-family estimates. Population density, measured as ln(population size/km^2), at age 15 predicted subsequent schizophrenia in the population (OR=1.10; 95% CI 1.09-1.11). Unobserved familial risk factors shared by cousins within extended families attenuated the association (1.06; 1.03-1.10) and the link disappeared entirely within nuclear families (1.02; 0.97-1.08). Similar results were found for neighborhood deprivation as predictor and for depression as outcome. Sensitivity tests demonstrated that timing and accumulation effects of the exposures (mean scores across birth, ages 1-5, 6-10 and 11- 15 years) did not alter the findings. Excess risks of psychiatric morbidity, particularly schizophrenia, in densely populated and socioeconomically deprived Swedish neighborhoods appear therefore to result primarily from unobserved familial selection factors. Previous studies may have overemphasized the etiological importance of these environmental factors.
    Schizophrenia Bulletin 06/2014; Advance Access.
  • Schizophrenia Bulletin 05/2014;
  • Schizophrenia Bulletin 05/2014;
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    ABSTRACT: Recent studies suggest that people with schizophrenia (PSZ) have difficulty distributing their attention broadly. Other research suggests that PSZ have reduced working memory (WM) capacity. This study tested whether these findings reflect a common underlying deficit. We measured the ability to distribute attention by means of the Useful Field of View (UFOV) task, in which participants must distribute attention so that they can discriminate a foveal target and simultaneously localize a peripheral target. Participants included 50 PSZ and 52 healthy control subjects. We found that PSZ exhibited severe impairments in UFOV performance, that UFOV performance was highly correlated with WM capacity in PSZ (r = -.61), and that UFOV impairments could not be explained by either impaired low-level processing or a generalized deficit. These results suggest that a common mechanism explains deficits in the ability to distribute attention broadly, reduced WM capacity, and other aspects of impaired cognition in schizophrenia. We hypothesize that this mechanism may involve abnormal local circuit dynamics that cause a hyperfocusing of resources onto a small number of internal representations.
    Schizophrenia Bulletin 04/2014;
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    ABSTRACT: Schizophrenia (SZ) is a devastating mental condition with onset in young adulthood. The identification of molecular biomarkers that reflect illness pathology is crucial. Recent evidence suggested immune and inflammatory cascades in conjunction with infection may play a role in the pathology. To address this question, we investigated molecular changes in cerebrospinal fluid (CSF) from antipsychotic-naïve patients with SZ and at risk mental status for psychosis (ARMS), in comparison with healthy controls (HCs). We measured 90 analytes using a broad multiplex platform focusing on immune and inflammatory cascades then selected 35 with our quality reporting criteria for further analysis. We also examined Toxoplasma gondii (TG) and herpes simplex virus 1 antibody levels in CSF. We report that expression of 15 molecules was significantly altered in the patient groups (SZ and ARMS) compared with HCs. The majority of these molecular changes (alpha-2-macroglobulin [α2M], fibrinogen, interleukin-6 receptor [IL-6R], stem cell factor [SCF], transforming growth factor alpha [TGFα], tumor necrosis factor receptor 2 [TNFR2], IL-8, monocyte chemotactic protein 2 [MCP-2/CCL8], testosterone [for males], angiotensin converting enzyme [ACE], and epidermal growth factor receptor) were consistent between SZ and ARMS patients, suggesting these may represent trait changes associated with psychotic conditions in general. Interestingly, many of these analytes (α2M, fibrinogen, IL-6R, SCF, TGFα, TNFR2, IL-8, MCP-2/CCL8, and testosterone [for males]) were exacerbated in subjects with ARMS compared with subjects with SZ. Although further studies are needed, we optimistically propose that these molecules may be good candidates for predictive markers for psychosis from an early stage. Lastly, reduction of IL-6R, TGFα, and ACE was correlated with positivity of TG antibody in the CSF, suggesting possible involvement of TG infection in the pathology.
    Schizophrenia Bulletin 04/2014;
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    ABSTRACT: This study aimed to establish consensus about the meaning of recovery among individuals with experience of psychosis. A Delphi approach was utilized to allow a large sample of service users to be anonymously consulted about their views on recovery. Service users were invited to take part in a 3-stage consultation process. A total of 381 participants gave their views on recovery in the main stage of this study, with 100 of these taking part in the final review stage. The final list of statements about recovery included 94 items, which were rated as essential or important by >80% of respondents. These statements covered items which define recovery, factors which help recovery, factors which hinder recovery, and factors which show that someone is recovering. As far as we are aware, it is the first study to identify areas of consensus in relation to definitions of recovery from a service user perspective, which are typically reported to be an idiosyncratic process. Implications and recommendations for clinical practice and future research are discussed.
    Schizophrenia Bulletin 04/2014;
  • Schizophrenia Bulletin 04/2014;
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    ABSTRACT: Numerous studies have reported a reduced risk of rheumatoid arthritis (RA) in schizophrenia. The mechanisms are unknown, but recent genome-wide association studies of schizophrenia have shown strong associations with markers spanning the major histocompatibility complex region, indicating a possible role for adaptive immunity also in schizophrenia. In this population-based cohort study, we assess the associations between RA and schizophrenia and the extent to which any observed associations are specific to RA/schizophrenia. We then extend the assessments per RA subtype and to risks in first-degree relatives. The study population included every individual identified in the Swedish Population Register born in Sweden between 1932 and 1989. The risk for RA in schizophrenia was significantly decreased (hazard ratio [HR] = 0.69, 95% CI = 0.59-0.80), but similar reductions were noted for osteoarthritis (a noninflammatory joint disorder) and ankylosing spondylitis (a non-RA inflammatory disorder). Comparable associations were seen in schizoaffective subjects while no significant associations were observed in bipolar disorder. Overall, first-degree relatives of schizophrenia patients were not at reduced risk of RA, but the risk for seronegative RA was significantly decreased in children and siblings of schizophrenia probands (HR = 0.13, 95% CI = 0.02-0.95 and HR = 0.67, 95% CI = 049-0.92, respectively). In conclusion, our intraindividual analyses suggest that differential misclassification bias is an important factor for the observed inverse association and emphasize the need of optimized care-provision for nonpsychiatric symptoms in schizophrenia patients. Our familial analyses indicted the possibility of an inverse coinheritance of schizophrenia and seronegative RA.
    Schizophrenia Bulletin 04/2014;
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    ABSTRACT: Background: Associations between self-control in adolescence and adult mental health are unclear in the general population; to our knowledge, no study has investigated self-control in relation to psychotic-like symptoms. Aims: To investigate the relationship between adolescent self-control and the midlife mental health outcomes of anxiety and depression symptoms and psychotic-like experiences (PLEs), controlling for the effect of adolescent conduct and emotional problems and for parental occupational social class and childhood cognition. Methods: A population-based sample, the MRC National Survey of Health and Development (the British 1946 birth cohort) was contacted 23 times between ages 6 weeks and 53 years. Teachers completed rating scales to assess emotional adjustment and behaviors, from which factors measuring self-control, behavioral, and emotional problems were extracted. At age 53 years, PLEs were self-reported by 2918 participants using 4 items from the Psychosis Screening Questionnaire; symptoms of anxiety and depression were assessed using the scaled version of the General Health Questionnaire (GHQ-28). Results: After adjustment for the above covariates, poor adolescent self-control was associated with the presence of PLEs in adulthood, specifically hallucinatory experiences at age 53 years, even after adjustment for GHQ-28 scores. Conclusions: Lower self-control in adolescence is a risk factor for hallucinatory experiences in adulthood.
    Schizophrenia Bulletin 04/2014;

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