Anastasia Theodoridou

Anastasia Theodoridou
Psychiatrische Universitätsklinik Zürich · Department of Psychiatry, Psychotherapie and Psychosomatics

PD Dr. med.

About

121
Publications
19,405
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1,653
Citations
Additional affiliations
February 2003 - present
Psychiatrische Universitätsklinik Zürich
Position
  • senior physician

Publications

Publications (121)
Article
Full-text available
Individuals at Clinical High Risk for Psychosis (CHR-P) demonstrate heterogeneity in clinical profiles and outcome features. However, the extent of neuroanatomical heterogeneity in the CHR-P state is largely undetermined. We aimed to quantify the neuroanatomical heterogeneity in structural magnetic resonance imaging measures of cortical surface are...
Article
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Background Widespread white matter abnormalities are a frequent finding in chronic schizophrenia patients. More inconsistent results have been provided by the sparser literature on at-risk states for psychosis, i.e., emerging subclinical symptoms. However, considering risk as a homogenous construct, as characteristic of earlier studies, may impede...
Article
Full-text available
As early detection of symptoms in the subclinical to clinical psychosis spectrum may improve health outcomes, knowing the probabilistic susceptibility of developing a disorder could guide mitigation measures and clinical intervention. In this context, polygenic risk scores (PRSs) quantifying the additive effects of multiple common genetic variants...
Article
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Psychiatric emergencies occur frequently in the community setting, e.g. the patient’s home or public places. Little is known about the characteristics and outcome of these situations. This study describes psychiatric emergencies in the canton of Zurich, Switzerland, and examines determinants of their outcome. We retrospectively analyzed 620 medical...
Preprint
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While hundreds of thousands of patients suffer from Long Covid/Post-Acute Covid-Syndrome, the condition still remains a medical conundrum. Patients’ experiences and symptoms cannot always be linked to a pathophysiological mechanism. We present a hypothesis that depicts Long Covid as a hybrid condition, which means that pathophysiology and patients’...
Article
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Background: Healthcare professionals can be a source of stigma and discrimination for people with mental illness, and anti-stigma programs are needed for this target group. However, there is no validated German language scale to assess attitudes of healthcare professionals towards people with mental illness. This study had the aim to validate the...
Article
Importance: The ENIGMA clinical high risk (CHR) for psychosis initiative, the largest pooled neuroimaging sample of individuals at CHR to date, aims to discover robust neurobiological markers of psychosis risk. Objective: To investigate baseline structural neuroimaging differences between individuals at CHR and healthy controls as well as betwee...
Article
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The COVID-19 pandemic has challenged the Swiss mental healthcare system. Many services were downsized or closed, and admission to treatment and care institutions was restricted during lockdown. These measures were necessary according to the general containment and mitigation strategies of federal and cantonal authorities, but this situation has had...
Preprint
Importance: The ENIGMA clinical high risk for psychosis (CHR) initiative, the largest pooled CHR-neuroimaging sample to date, aims to discover robust neurobiological markers of psychosis risk in a sample with known heterogeneous outcomes. Objective: We investigated baseline structural neuroimaging differences between CHR subjects and healthy contro...
Article
Die Idee, dass nach der klassischen Psychiatrie nun eine Postpsychiatrie folgt, die auf anderen Grundlagen und aus einer anderen Perspektive heraus tätig wird, wird seit einigen Jahren nicht nur im deutschsprachigen, sondern auch im englischsprachigen Raum diskutiert (Bracken, Thomas 2001). Der Artikel stellt die Hypothese auf, dass wir längst in d...
Preprint
Full-text available
Background: Healthcare professionals can be a source of stigma and discrimination for people with mental illness, and anti-stigma programs are needed for this target group. However, there is no validated German language scale to assess attitudes of healthcare professionals towards people with mental illness. This study had the aim to validate the G...
Article
Importance Diverse models have been developed to predict psychosis in patients with clinical high-risk (CHR) states. Whether prediction can be improved by efficiently combining clinical and biological models and by broadening the risk spectrum to young patients with depressive syndromes remains unclear. Objectives To evaluate whether psychosis tra...
Article
Full-text available
The Covid-19 pandemic has challenged the Swiss mental health care system. Many services were downsized or closed and admission to treatment and care institutions was restricted during lockdown. While these measures were necessary according to the general containment and mitigation strategies of federal and cantonal authorities, this situation has h...
Article
Objective: The Health of the Nation Outcome Scales was developed as an overall measure of mental health, applicable to the complete range of psychiatric disorders. Meanwhile, it is a benchmark tool for service providers and is also used for the allocation of costs and funding. The ability of the Health of the Nation Outcome Scales to assess and di...
Article
Zusammenfassung Psychopathologie, die wissenschaftliche Erfassung krankhaft veränderten bzw. gestörten Erlebens und Verhaltens, hat für mehr als ein Jahrhundert eine Gestalt für psychiatrische Störungsbilder und damit die Grundlage der psychiatrischen Nosologie gebildet. So schuf sie die Basis für den klinischen und wissenschaftlichen Fortschritt i...
Article
In subjects at risk for psychosis, the studies on gray matter volume (GMV) predominantly reported volume loss compared with healthy controls (CON). However, other important morphological measurements such as cortical surface area (CSA) and cortical thickness (CT) were not systematically compared. So far, samples mostly comprised subjects at genetic...
Article
Zusammenfassung Ziel der Studie Untersuchung der Haltung gegenüber somatischen und psychiatrischen Patientenverfügungen (PPV) in der deutschsprachigen Schweiz. Methodik Fragebogenerhebung bei Psychiatriepatienten, Psychiatern, Psychologen, Pflegefachpersonen und Peers anhand von drei Fallbeispielen. Ergebnisse Die Haltung gegenüber Patientenverfügu...
Article
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Objectives : The emotional Stroop effect is defined as increased reaction times to emotional stimuli compared to neutral ones. It has been often reported in the literature, on both behavioral and neurophysiological level. The goal was to investigate the frontal brain activation in individuals at risk for schizophrenic psychosis and bipolar disorder...
Article
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Emerging evidence has attributed altered network coordination between the default mode, central executive, and salience networks (DMN/CEN/SAL) to disturbances seen in schizophrenia, but little is known for at-risk psychosis stages. Moreover, pinpointing impairments in specific network-to-network interactions, although essential to resolve possibly...
Article
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Background: The therapeutic relationship and its importance for psychotherapy outcome have been the subject of extensive research over the last decades. An acute psychiatric inpatient setting is a unique environment where severely ill patients receive intensive treatment over a limited, relatively short, period of time. This renders establishing a...
Chapter
Subjective disturbances in mental processes are the focus of the concept of basic symptoms (BSs), which provides a biopsychosocial model of psychosis, as well as the concept of self-disorders or self-disturbances (SDs) that aims at providing a comprehensive model of schizophrenia centered around the philosophical notion of “self.” Irrespective of t...
Article
The use of coercion poses a key concern in terms of patients’ rights. To reduce coercive interventions, a change in the attitudes of mental health professionals toward coercion has been proposed. This study examined whether individual and workplace characteristics are associated with attitudes toward coercion. A sample of 110 staff members of a lar...
Article
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Introduction: Transient psychotic symptoms in patients with borderline personality disorder seem to be similar to those in patients with psychotic disorders. Especially in the field of early detection of psychosis, this might lead to individuals with borderline personality disorder being wrongly classified as subjects at risk for developing a manif...
Article
Schizophrenia is a complex and chronic neuropsychiatric disorder, with a heritability of around 60–80%. Large (>100 kb) rare (<1%) copy number variants (CNVs) occur more frequently in schizophrenia patients compared to controls. Currently, there are no studies reporting genome‐wide CNVs in clinical high risk for psychosis (CHR‐P) individuals. The a...
Article
Background Psychiatric advance directives (PAD) were shown to be effective in the reduction of coercion and strengthening of the patients` autonomy. Therefore, the Swiss legislation was revised and stipulates that PAD must be taken into account during involuntary hospitalization. This study aimed to analyze knowledge on and attitudes towards this i...
Article
Background Involuntary admissions can be detrimental for patients. Due to legal, ethical and clinical considerations, they are also challenging for referring physicians. Nevertheless, not much is known about the subjective perceptions of those who have to decide whether to conduct an involuntary admission or not. Aims This study aimed at answering...
Article
Seit den 1990er-Jahren fand im Rahmen der Deinstitutionalisierung und Schliessung von Langzeitabteilungen in der Psychiatrie eine Verlegung von Langzeitpatientinnen und -patien­ten in betreute Wohnformen statt. Im Bereich der Wohninstitutionen mit geschlossen geführten Abteilungen für Menschen mit einer psychischen Erkrankung übersteigt in der Deut...
Article
Background: Involuntary admission (IA) for psychiatric treatment has a history of controversial discussions. We aimed to describe characteristics of a cohort of involuntarily compared to voluntarily admitted patients regarding clinical and socio-demographic characteristics before and after implementation of the new legislation. Methods: In this...
Article
Background: Involuntary admission (IA) for psychiatric treatment is a massive restriction of human rights. Therefore, its execution is regulated by law. During executing IAs referring physicians find themselves in a dual role: support of patients in the recovery process but also safe-keeper of society. In Zurich, Switzerland the law stipulates tha...
Article
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Somatosensory evoked potentials (SEPs) enable the investigation of thalamocortical and early cortical processing. Previous studies reported alterations of SEPs in patients with schizophrenia as well as in individuals in the prodromal stage. Moreover, cannabis use as an environmental risk factor for the development of schizophrenia has been demonstr...
Article
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Introduction: Involuntary admissions to psychiatric hospitals, regardless of their beneficial effects, violate the patients' autonomy. To keep such measures at a minimum and develop less restricting and coercive alternatives, a better understanding of the psychiatric emergency situations which end up in involuntary admissions is needed. This descri...
Article
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Psychopathology is the scientific exploration of abnormal mental states that, for more than a century, has provided a Gestalt for psychiatric disorders and guided clinical as well as scientific progress in modern psychiatry. In the wake of the immense technical advances, however, psychopathology has been increasingly marginalized by neurobiological...
Article
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Introduction: Although knowledge about negative effects of coercive measures in psychiatry exists, its prevalence is still high in clinical routine. This study aimed at define risk factors and test machine learning algorithms for their accuracy in the prediction of the risk to being subjected to coercive measures. Methods: In a sample of involuntar...
Article
Early detection of psychosis: evidence and perspectives Abstract. Early detection of psychosis, in the sense of preventing psychosis, has become increasingly important in recent years. Especially psychopathological approaches are promising and are reflected in the attenuated and transient positive symptoms ("ultra high risk" criteria) and the basic...
Article
Little is known about valid predictive markers for functional outcomes in an at-risk for psychosis population. In a cohort of 185 individuals (age: 13-35 years) at high risk (HR) and ultra-high risk (UHR), we assessed pan-NRG1 mRNA levels across good functional status (GFS) and poor functional status (PFS) at baseline, and good functional outcome (...
Article
Little is known about valid predictive markers for functional outcomes in an at-risk for psychosis population. In a cohort of 185 individuals (age: 13-35 years) at high risk (HR) and ultra-high risk (UHR), we assessed pan-NRG1 mRNA levels across good functional status (GFS) and poor functional status (PFS) at baseline, and good functional outcome (...
Article
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Aims of the study: In daily clinical work, coercion continues to be highly prevalent, with rates differing between countries and sometimes even within countries or between wards of the same hospital. Previous research found inconsistent characteristics of individuals who underwent coercive measures during psychiatric treatment. Furthermore, there...
Article
Treatment pressure restricts patients' voluntary and autonomous decisions. Yet interventions involving treatment pressure are widely used in mental health and psychosocial services. This cross-sectional study explored whether mental health professionals' knowledge on five types of treatment pressure (no coercion, persuasion or conviction, leverage,...
Article
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Schizophrenia is characterized by positive and negative symptoms and cognitive dysfunction. The glutamate hypothesis of schizophrenia has been hypothesized to explain the negative symptoms and cognitive deficits better than the dopamine hypothesis alone. Therefore, we aimed to evaluate whether glutamatergic variants such as d-amino acid oxidase (DA...
Article
Aims: Informal coercion is a frequently used form of communication among mental health professionals to influence treatment outcomes. This study investigates the recognition, attitude, and application of different forms of informal coercion by mental health professionals. Methods: Mental health professionals of five psychiatric institutions in G...
Article
Background: The aim of this study was to critically examine the prognostic validity of various CHR criteria alone and in combination with additional clinical characteristics. Methods: A total of 188 CHR-positive persons from the region of Zurich, Switzerland (mean age 20.5 years; 60.2% male), meeting ultra high-risk (UHR) and/or basic symptoms (BS...
Article
Aim: Presentation of attenuated positive psychotic symptoms (APS) was reported to be modestly influenced by age, sex and education in a psychosis-risk sample. We re-examined the influence of demographic variables on APS in an independent psychosis-risk sample. Method: In a clinical high-risk-sample (N = 188; 13-35 years; 60.1% men), bivariate co...
Article
The aim of this study was to test the validity of the CHR state by focusing on the course of psychosis spectrum symptoms, depression and global functioning in converters and non-converters. A total of 188 CHR-positive subjects (60.2% men) aged between 13 and 35 years (mean = 20.5) at study outset were assessed five times (t0-t4) over a total observ...
Article
An important aim in schizophrenia research is to optimize the prediction of psychosis and to improve strategies for early intervention. The objectives of this study were to explore neurocognitive performance in individuals at risk for psychosis and to optimize predictions through a combination of neurocognitive and psychopathological variables. Inf...
Article
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Reduction in hippocampal volume is a hallmark of schizophrenia and already present in the clinical high-risk state. Nevertheless, other subcortical structures, such as the thalamus, amygdala and pallidum can differentiate schizophrenia patients from controls. We studied the role of hippocampal and subcortical structures in clinical high-risk indivi...
Article
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Background The goal was to investigate the quality in terms of formal and content-based comprehensiveness of the forms for involuntary admission before and after the introduction of the new law (KESR, “Kindes- und Erwachsenenschutzrecht”) for the regulation of involuntary admission. Moreover, the study aimed at assessing if the quality of the admis...
Article
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Suicidality is common among individuals at risk of psychosis. Emerging findings suggest that mental illness stigma contributes to suicidality. However, it is unclear whether stigma variables are associated with suicidality among young people at risk of psychosis. This longitudinal study assessed perceived public stigma and the cognitive appraisal o...
Article
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In its initial formulation, the concept of basic symptoms (BSs) integrated findings on the early symptomatic course of schizophrenia and first in vivo evidence of accompanying brain aberrations. It argued that the subtle subclinical disturbances in mental processes described as BSs were the most direct self-experienced expression of the underlying...
Chapter
Die psychiatrische Versorgung befindet sich im Umbruch. Immer mehr Menschen sind bereit, sich wegen psychischer Probleme behandeln zu lassen. Die meisten Betroffenen werden heute ambulant versorgt. Schwierigkeiten der Versorgung entstehen z. B. an den Schnittstellen zwischen ambulanter und stationärer Versorgung, wo Patienten gegen ihren Willen in...
Article
Background: The attenuated positive symptoms syndrome (APSS) is considered an at-risk indicator for psychosis. However, the characteristics and developmental aspects of the combined or enriched risk criteria of APSS and basic symptom (BS) criteria, including self-experienced cognitive disturbances (COGDIS) remain under-researched. Method: Based...
Article
Objectives: The Loudness Dependence of Auditory Evoked Potentials (LDAEP) is considered as an indicator of central serotonergic activity. Alteration of serotonergic neurotransmission was reported in bipolar disorders and schizophrenia. In line with previous reports on clinically manifest disorders, we expected a weaker LDAEP in subjects at risk fo...
Article
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Neurocognitive deficits are important aspects of schizophrenic disorder because they have a strong impact on social and vocational outcomes. Previously it was assumed that cognitive abilities progressively deteriorate with illness onset. However, recent research results have contradicted this with observations of continuous or even improved perform...
Article
Mental health service use is helpful but rare among young people at risk of psychosis. The label and stigma associated with mental illness may affect attitudes towards help-seeking. We examined 67 individuals at risk of psychosis over the course of 1 year. An increase of self-labelling as "mentally ill" predicted more positive attitudes towards psy...
Article
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There is growing evidence that reward processing is disturbed in schizophrenia. However, it is uncertain whether this dysfunction predates or is secondary to the onset of psychosis. Studying 21 unmedicated persons at risk for psychosis plus 24 healthy controls (HCs) we used a incentive delay paradigm with monetary rewards during functional magnetic...
Article
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Early detection of persons with first signs of emerging psychosis is regarded as a promising strategy to reduce the burden of the disease. In recent years, there has been increasing interest in early detection of psychosis and bipolar disorders, with a clear need for sufficient sample sizes in prospective research. The underlying brain network dist...
Article
Full-text available
Human cortical somatosensory evoked potentials (SEPs) allow an accurate investigation of thalamocortical and early cortical processing. SEPs reveal a burst of superimposed early (N20) high-frequency oscillations around 600 Hz. Previous studies reported alterations of SEPs in patients with schizophrenia. This study addresses the question whether tho...
Article
Full-text available
The present study evaluated a new integrated treatment concept offering inpatient care, acute psychiatric day hospital and outpatient treatment by the same therapeutic team. 178 patients participated in this randomized controlled trial. Data on psychopathology, global and social functioning, patient satisfaction, continuity of care and administrati...
Article
This pilot study aimed at investigating how mental health professionals on acute psychiatric wards recognize different levels of formal and informal coercions and treatment pressures as well as their attitude towards these interventions. An explorative cross-sectional survey among mental health professionals (N=39) was conducted using a questionnai...
Article
Stigma may undermine the well-being of young people at risk of psychosis. We therefore measured self-labeling, stigma variables and well-being at baseline and again one year later among 77 at-risk participants. An increase in self-labeling during this period predicted heightened stigma stress after one year and a decrease in stigma stress predicted...
Article
Full-text available
BACKGROUND: Neurocognitive deficits are important aspects of the schizophrenic disorders because they have a strong impact on social and vocational outcomes. We expanded on previous research by focusing on the neurocognitive profiles of persons at high risk (HR) or ultra-high risk (UHR) for schizophrenic and affective psychoses. Our main aim was to...