Faith Dickerson

Johns Hopkins University, Baltimore, Maryland, United States

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Publications (193)847.45 Total impact

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    ABSTRACT: Objective Immunologic abnormalities have been found in bipolar disorder and acute mania. However, there have been fewer studies of patients with acute bipolar depression.Method Blood samples were obtained from individuals with acute bipolar depression, acute mania, and controls. These samples were evaluated for antibodies to human herpesviruses, gliadin, Toxoplasma gondii, and endogenous retroviruses as well as for C-reactive protein (CRP) and pentraxin-3 using immunoassay methods. Linear regression models were used to compare the levels of the markers controlling for demographic and clinical variables. A subset of the bipolar depressed group was evaluated at a 6-month follow-up.ResultsThe sample consisted of 82 individuals with acute bipolar depression, 147 with acute mania, and 280 controls. The levels of CRP and IgG antibodies to an endogenous retrovirus, Mason-Pfizer monkey virus (MPMV), were significantly elevated in the bipolar depressed group. Levels of pentraxin-3 were reduced in both psychiatric groups. An evaluation of 32 individuals 6 months after hospitalization for bipolar depression showed a significant decrease in the levels of MPMV antibodies, but not a change in the other markers.Conclusion Individuals with acute bipolar depression show immune alterations. Some of the alterations are similar to those found in acute mania.
    Acta Psychiatrica Scandinavica 06/2015; DOI:10.1111/acps.12451 · 5.55 Impact Factor
  • Rachel Walsh, Lucy Schweinfurth, Faith Dickerson
    Psychiatric services (Washington, D.C.) 04/2015; 66(4):442-3. DOI:10.1176/ · 1.99 Impact Factor
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    ABSTRACT: Cognitive deficits are present in a large majority of Bipolar Disorder (BD) patients and known to be a marker of bad prognosis. Because, these deficits encompass several domains and no specific medical treatment seems to be effective, it is important to better understand the mechanisms underlying cognitive deterioration. As Toxoplasma gondii is known to induce the synthesis of pro-inflammatory cytokines such as IL-6, we will explore here the possible role of T. gondii in the cognitive decline observed in BD. 42 euthymic BD patients and 36 controls were assessed for episodic verbal memory using the CVLT and for working memory and verbal ability using the WAIS III. Patients and controls were also screened for seropositivity to T. gondii and evaluated for the levels of IL-6 transcripts. The seropositivity for T. gondii was significantly higher in BD patients as compared to controls (p=0.005). The cognitive deterioration index (DI) was higher in BD patients (p=5.10(-6)) and correlated to high IL-6 mRNA expression only among those infected by T. gondii (rho=0.43, p=0.01). Among deteriorated patients (defined by scores above 0.10 according to Weschler׳s definition), the IL-6 mRNA expression was twice greater (p=0.01). Our results are to be interpreted with caution because of our small sample size and the cross-sectional design. A long-term exposure to inflammation, measured here with IL-6 mRNA expression in T. gondii infected BD may alter cognitive functioning. IL-6 could thus be a useful predictive marker of cognitive deterioration in BD and may help to design personalized treatment. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 04/2015; 179:161-166. DOI:10.1016/j.jad.2015.03.038 · 3.71 Impact Factor
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    ABSTRACT: Consumers with serious mental illness smoke more and are at higher risk for smoking-related illness. We examined provider and consumer factors influencing the implementation of the evidence-based "5 A's" (ask, advise, assess, assist, arrange) in six community mental health centers in greater Baltimore. Data collected as part of a larger study examining the effectiveness of delivery of the 5 A's at patient visits. First, we examined responses to a survey administered to 49 clinicians on barriers and attitudes toward delivering the 5 A's. Second, we used multilevel models to examine variance between patients (n = 228), patient factors, and variance between their psychiatrists (n = 28) in the delivery of the 5 A's (and first 3 A's). The most strongly endorsed barrier was perceived lack of patient interest in smoking cessation. Psychiatrists and patients both accounted for significant variance in the delivery of the 5 A's and 3 A's. Patient "readiness to change" predicted delivery of the full 5 A's, while smoking severity predicted delivery of the first 3 A's. There is a critical need for creative and collaborative solutions, policies, and clinician training to address actual and perceived obstacles to the delivery of evidence-based smoking cessation treatment in the mental health care setting.
    Journal of Dual Diagnosis 04/2015; 11(2):145-150. DOI:10.1080/15504263.2015.1025025 · 0.80 Impact Factor
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    ABSTRACT: The association between Toxoplasma gondii seropositivity and respectively Bipolar Disorder (BD) and Schizophrenia/Schizoaffective disorder (SZ) is one of the most studied link between one pathogen and psychiatric disorders. The aim of the present study was thus to retrospectively determine if the administration of an antipsychotic and/or a mood stabilizer having known in vitro Anti-Toxoplasmic Activity (TATA+) was associated with a better clinical outcome in a population of 152 BD or 114 SZ patients and seropositive for T. gondii infection compared to patients receiving a treatment without anti-toxoplasmic activity (TATA-).
    Journal of Psychiatric Research 02/2015; 63. DOI:10.1016/j.jpsychires.2015.02.011 · 4.09 Impact Factor
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    ABSTRACT: Mucosal sites such as the oropharynx contain a wide range of microorganisms, collectively designated as the microbiome. The microbiome can affect behavior through a number of neurobiological and immunological mechanisms. Most previous studies have focused on the bacterial components of the microbiome. However, the microbiome also includes viruses such as bacteriophages, which are viruses that infect bacteria and alter their metabolism and replication. We employed metagenomic analysis to characterize bacteriophage genomes in the oral pharynx of 41 individuals with schizophrenia and 33 control individuals without a psychiatric disorder. This analysis was performed by the generation of more than 100000000 sequence reads from each sample and the mapping of these reads to databases. We identified 79 distinct bacteriophage sequences in the oropharyngeal samples. Of these, one bacteriophage genome, Lactobacillus phage phiadh, was found to be significantly different in individuals with schizophrenia (P < .00037, q < 0.03 adjusted for multiple comparisons). The differential levels of Lactobacillus phage phiadh remained significant when controlling for age, gender, race, socioeconomic status, or cigarette smoking (P < .006). Within the group of individuals with schizophrenia, the level of Lactobacillus phage phiadh correlated with the prevalence of immunological disorders as well as with the administration of valproate, which has been shown in animal models to alter the microbiome. The bacteriophage composition of the oropharynx in individuals with schizophrenia differs from that of controls. The biological consequences of this difference and the potential effects of altering bacteriophage levels through therapeutic interventions are worthy of further investigation. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email:
    Schizophrenia Bulletin 02/2015; DOI:10.1093/schbul/sbu197 · 8.61 Impact Factor
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    Proceedings of the National Academy of Sciences 02/2015; 112(9). DOI:10.1073/pnas.1424665112 · 9.81 Impact Factor
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    ABSTRACT: African Americans with serious mental illness (SMI) continue to experience inadequate representation in clinical trials. Persons with SMI, regardless of race, have an increased burden of all cardiovascular disease (CVD) risk factors including obesity, hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome and tobacco smoking. Having SMI and being African American, however, is each associated with an increased risk of CVD mortality compared to the general population. There is a critical need, therefore, to adapt health promotion interventions for African Americans with SMI. We sought to examine overall recruitment into a randomized clinical trial of CVD prevention among persons with SMI, and to examine racial differences in interest, enrollment, and potential barriers to participation. Although similar levels of interest in participation were seen between African Americans and Caucasians in signing screening consent, 9.6% fewer African Americans enrolled due to inability to complete initial data collection. Further work is needed to better understand the nature of the barriers encountered by African Americans with SMI who otherwise may be interested in participating within clinical trials.
    Ethnicity & disease 01/2015; 25(1):72-7. · 0.92 Impact Factor
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    ABSTRACT: Although peripheral immune system abnormalities have been linked to schizophrenia pathophysiology, standard antipsychotic drugs show limited immunological effects. Thus, more effective treatment approaches are required. Probiotics are microorganisms that modulate the immune response of the host and, therefore, may be beneficial to schizophrenia patients. The aim of this study was to examine the possible immunomodulatory effects of probiotic supplementation in chronic schizophrenia patients. The concentrations of 47 immune-related serum proteins were measured using multiplexed immunoassays in samples collected from patients before and after 14 weeks of adjuvant treatment with probiotics (Lactobacillus rhamnosus strain GG and Bifidobacterium animalis subsp. lactis strain Bb12; n = 31) or placebo (n = 27). Probiotic add-on treatment significantly reduced levels of von Willebrand factor (vWF) and increased levels of monocyte chemotactic protein-1 (MCP-1), brain-derived neurotrophic factor (BDNF), RANTES, and macrophage inflammatory protein-1 beta (MIP-1) beta with borderline significance (P ≤ 0.08). In silico pathway analysis revealed that probiotic-induced alterations are related to regulation of immune and intestinal epithelial cells through the IL-17 family of cytokines. We hypothesize that supplementation of probiotics to schizophrenia patients may improve control of gastrointestinal leakage.
    Biomarker insights 01/2015; 10:47-54. DOI:10.4137/BMI.S22007
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    ABSTRACT: The gut microbiota is increasingly considered as a symbiotic partner in the maintenance of good health. Metagenomic approaches could help to discover how the complex gut microbial ecosystem participates in the control of the host's brain development and function, and could be relevant for future therapeutic developments, such as probiotics, prebiotics and nutritional approaches for psychiatric disorders. Previous reviews focused on the effects of microbiota on the central nervous system in in vitro and animal studies. The aim of the present review is to synthetize the current data on the association between microbiota dysbiosis and onset and/or maintenance of major psychiatric disorders, and to explore potential therapeutic opportunities targeting microbiota dysbiosis in psychiatric patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
    Pathologie Biologie 11/2014; 63(1). DOI:10.1016/j.patbio.2014.10.003 · 1.07 Impact Factor
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    ABSTRACT: Objective Immunologic abnormalities have been found in bipolar disorder but pentraxin 3, a marker of innate immunity, has not been studied in this population.Methods Levels of pentraxin 3 were measured in individuals with bipolar disorder, schizophrenia, and non-psychiatric controls. Linear regression models were used to compare the pentraxin 3 levels in each of the psychiatric groups to that in the control group, adjusting for demographic and clinical variables. Logistic regression models were used to calculate the odds ratios associated with levels of pentraxin 3 which differed from specified levels of the control group.ResultsThe sample consisted of 831 individuals: 256 with bipolar disorder, 309 with schizophrenia, and 266 without a psychiatric disorder. The levels of pentraxin 3 in the bipolar disorder, but not in the schizophrenia, group were significantly lower than those of controls, adjusting for age, gender, race, maternal education, smoking status, and body mass index (t = −3.78, p < 0.001). The individuals with bipolar disorder also had significantly increased odds of having low levels of pentraxin 3 relative to both the 10th and 25th percentile level of the controls and significantly decreased odds of having a level greater than the 75th and the 90th percentile level of the controls, adjusting for the same covariates.Conclusions Individuals with bipolar disorder have low levels of pentraxin 3 which may reflect impaired innate immunity. An increased understanding of the role of innate immunity in the etiopathogenesis of bipolar disorder might lead to new modalities for the diagnosis and treatment of this disorder.
    Bipolar Disorders 11/2014; 17(4). DOI:10.1111/bdi.12281 · 4.89 Impact Factor
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    ABSTRACT: Chloroviruses (family Phycodnaviridae) are large DNA viruses known to infect certain eukaryotic green algae and have not been previously shown to infect humans or to be part of the human virome. We unexpectedly found sequences homologous to the chlorovirus Acanthocystis turfacea chlorella virus 1 (ATCV-1) in a metagenomic analysis of DNA extracted from human oropharyngeal samples. These samples were obtained by throat swabs of adults without a psychiatric disorder or serious physical illness who were participating in a study that included measures of cognitive functioning. The presence of ATCV-1 DNA was confirmed by quantitative PCR with ATCV-1 DNA being documented in oropharyngeal samples obtained from 40 (43.5%) of 92 individuals. The presence of ATCV-1 DNA was not associated with demographic variables but was associated with a modest but statistically significant decrease in the performance on cognitive assessments of visual processing and visual motor speed. We further explored the effects of ATCV-
    Proceedings of the National Academy of Sciences 10/2014; 111(45). DOI:10.1073/pnas.1418895111 · 9.81 Impact Factor
  • F. Dickerson, R. Yolken
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    ABSTRACT: A number of infectious and inflammatory markers have been associated with schizophrenia but previous investigations have not yielded definitive conclusions. We examined multiple antibodies to infectious agents and food antigens as well as protein markers of inflammation in well-characterized individuals with a recent onset of psychosis (N = 106), persistent schizophrenia (N = 261), and controls (N = 233). Linear regression methods were used to calculate the association between the markers in both patient groups in comparison with controls adjusting for demographic factors. For the recent onset group, significant associations were found for IgG antibodies to measles (t = 8.31, p < .001), gliadin (t = 5.90, p < .001), bovine casein (t = 4.74, p < .001), human coronavirus (t = 2.89, p = .004), Toxoplasma gondii (t = 2.20, p = .029), and the group D retroviruses, Mason-Pfizer monkey virus (t = 3.97, p < .001) and murine leukemia virus (t = 3.27, p = .001). For the persistent schizophrenia group, significant associations were found for C-reactive protein (t = 7.47, p ⩽ .001); IgG antibodies to wheat gliadin (t = 2.58, p = .010), Saccharomyces cerevisiae (t = −2.78, p < .006), measles (t = 2.37, p = .018), Herpes simplex virus (HSV) type 2 (t = 2.56, p = .011), and human coronavirus (t = 2.67, p = .008). No significant case-control differences were found for antibodies to cytomegalovirus, HSV-1, Epstein-Barr Virus, varicella-zoster virus, or influenza viruses. These results indicate overlap between the markers found in recent onset psychosis and in persistent schizophrenia. Future studies that assess patients throughout the course of the illness may further identify the infectious and inflammatory factors that contribute to disease pathogenesis.
    Brain Behavior and Immunity 09/2014; 40:e6. DOI:10.1016/j.bbi.2014.06.039 · 6.13 Impact Factor
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    ABSTRACT: Increased rates of exposure to Toxoplasma gondii have been found in individuals with schizophrenia and bipolar disorder, but the association between Toxoplasma and cognitive functioning has not previously been examined. We measured IgG and IgM class antibodies to Toxoplasma in 408 nonelderly individuals with schizophrenia, 347 with bipolar disorder, and 352 nonpsychiatric controls. Cognitive functioning was measured with the Repeatable Battery for the Assessment of Neuropsychological Status. Multivariate linear and regression analyses showed significant associations between Toxoplasma IgM antibody level and cognitive scores within the control group and the bipolar disorder group but not the schizophrenia group. Within the control group, having an elevated Toxoplasma IgM antibody level, greater than or equal to the 50th and 75th levels of the control group, was associated with significantly elevated odds of a low total cognitive score. Exposure to Toxoplasma may confer risk for lower cognitive functioning in persons without a psychiatric disorder and those with bipolar disorder.
    Journal of Nervous & Mental Disease 07/2014; 202(8). DOI:10.1097/NMD.0000000000000166 · 1.81 Impact Factor
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    ABSTRACT: Background Cognitive deficits are a central feature of schizophrenia but it is not certain how cognitive functioning changes over time. The purpose of this prospective longitudinal study was to determine the temporal change of cognitive functioning and the predictors of cognitive performance from among demographic, clinical, and biological variables. Methods Participants were individuals with schizophrenia or schizoaffective disorder whose cognitive functioning was assessed at multiple time points with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). At the baseline visit participants had a blood sample drawn from which C-reactive protein, antibodies to Herpes Simplex Virus type 1, and selected genetic polymorphisms were measured. Repeated measures linear regression was used to determine whether cognitive measures changed over time and which variables predicted cognitive performance. Results The sample consisted of 132 participants, mean age 43.7 years at baseline, who received a median of 3 cognitive assessments over a period averaging 2.8 years. The RBANS Total score and Language index showed no statistically significant temporal change; performance on two indices, Immediate Memory and Attention, showed modest but statistically significant improvements (gains of 0.89 ± 0.33 and 0.76 ± 0.29 points per year, respectively); Visuospatial/Constructional performance showed a modest but statistically significant decline (of 0.80 ± 0.25 points per year). Few variables predicted cognitive performance; however greater psychiatric symptom severity was associated with worse cognitive performance for most cognitive measures. Conclusions Cognitive functioning in middle-aged persons with schizophrenia showed an absence of decline for most measures and modest gains in some measures.
    Schizophrenia Research 07/2014; DOI:10.1016/j.schres.2014.04.019 · 4.43 Impact Factor
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    ABSTRACT: Background / Purpose: Many studies have found that viral infections like Herpes Simplex Virus 1 (HSV-1) are associated with cognitive impairment in schizophrenia as well as healthy controls. It has also been shown that daily functioning is affected by our cogniton level. The present study looked at whether HSV-1 infection affects daily living skills in schizophrenia. Main conclusion: Some domains of daily living skills were impaired in HSV-1 exposed persons with schizophrenia.
    69th Society of Biological Psychiatry Annual Meeting 2014; 06/2014
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    ABSTRACT: The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) and Treatment Units for Research on Neurocognition and Schizophrenia projects were designed to facilitate the development of new drugs for the treatment of cognitive impairments in people with schizophrenia. The MATRICS project identified three drug mechanisms of particular interest: dopaminergic, cholinergic, and glutamatergic. As a group, while people with schizophrenia have moderate cognitive impairment, it is the best predictor of long-term outcome. Unfortunately, there are no approved medications for cognitive impairment in this population. Hence, the development of new pharmacological approaches is critical for reducing illness-related disability. The combination of an acetylcholinesterase inhibitor (AChEI) and memantine is more effective than either medication alone to improve cognition in Alzheimer's dementia. Galantamine is not only an AChEI, but also a positive allosteric modulator of the α4β2 and α7 nicotinic receptors. Hypofunction of N-methyl-d-aspartate (NMDA) receptors has been implicated in the pathophysiology of cognitive symptoms in schizophrenia and hence memantine may positively impact cognition. Memantine decreases the tonic NMDA current and galantamine enhances the action potential mediated by a postsynaptic NMDA current. This results in an increased signal transmission; therefore, a greater signal-to-noise ratio occurs with the combination than memantine alone. Galantamine improves the α-amino-3-hydroxy-5-methyl-4-isoxazol-propionate (AMPA)-mediated signaling which could be neuroprotective and may improve memory coding. The combination of galantamine and memantine may be particularly effective in schizophrenia in order to increase the selective cognition enhancement produced by either medication alone. In the future, multitarget-directed ligands may play a role in the treatment of complex diseases like schizophrenia.
    Schizophrenia Research 05/2014; 157(1-3). DOI:10.1016/j.schres.2014.04.037 · 4.43 Impact Factor
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    ABSTRACT: Elevated levels of antibodies to Cytomegalovirus (CMV) have been associated with cognitive impairment, but the quantitative relationship between CMV antibody levels and domains of cognitive functioning in younger adults has not been established.
    PLoS ONE 05/2014; 9(5):e95510. DOI:10.1371/journal.pone.0095510 · 3.53 Impact Factor
  • F. Dickerson, R.H. Yolken
    Neurology Psychiatry and Brain Research 04/2014; 20(1):10. DOI:10.1016/S0920-9964(14)70051-9 · 0.10 Impact Factor
  • R. Yolken, F. Dickerson
    Neurology Psychiatry and Brain Research 04/2014; 20(1):26–27. DOI:10.1016/S0920-9964(14)70050-7 · 0.10 Impact Factor

Publication Stats

5k Citations
847.45 Total Impact Points


  • 2004–2015
    • Johns Hopkins University
      • • Department of Pediatrics
      • • Department of Medicine
      Baltimore, Maryland, United States
  • 2010–2014
    • Johns Hopkins Medicine
      • Department of Pediatrics
      Baltimore, Maryland, United States
  • 2005–2014
    • University of Maryland, Baltimore
      • Department of Psychiatry
      Baltimore, Maryland, United States
  • 1991–2014
    • Sheppard and Enoch Pratt Hospital
      Baltimore, Maryland, United States
  • 2013
    • Towson University
      تاوسن، مریلند, Maryland, United States
  • 2012
    • Capital Medical University
      Peping, Beijing, China
    • University of Notre Dame Australia
      Fremantle, Western Australia, Australia
    • University of Pittsburgh
      • Department of Human Genetics
      Pittsburgh, PA, United States
  • 2008
    • Loyola University Maryland
      Baltimore, Maryland, United States
  • 1996
    • University of Baltimore
      Baltimore, Maryland, United States