A. H. Schene

Radboud University Medical Centre (Radboudumc), Nymegen, Gelderland, Netherlands

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Publications (234)500.94 Total impact

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    ABSTRACT: Childhood adversity (CA) has been associated with long-term structural brain alterations and an increased risk for psychiatric disorders. Evidence is emerging that subtypes of CA, varying in the dimensions of threat and deprivation, lead to distinct neural and behavioral outcomes. However, these specific associations have yet to be established without potential confounders such as psychopathology. Moreover, differences in neural development and psychopathology necessitate the exploration of sexual dimorphism. Young healthy adult subjects were selected based on history of childhood adversity from a large database to assess gray matter (GM) differences associated with specific subtypes of adversity. We compared voxel-based morphometry data of subjects reporting specific childhood exposure to abuse (n=127) or deprivation (n=126) and a similar sized group of controls (n=129) without reported childhood adversity. Subjects were matched on age, gender and educational level. Differences between CA-subtypes were found in the fusiform gyrus and middle occipital gyrus, where subjects with a history of deprivation showed reduced GM compared to subjects with a history of abuse. An interaction between sex and CA-subtype was found. Women showed less GM in the visual posterior precuneal region after both subtypes of CA than controls. Men had less GM in the postcentral gyrus after childhood deprivation compared to abuse. Our results suggest that even in a healthy population CA subtypes are related to specific alterations in brain structure, which are modulated by sex. These findings may help understand neurodevelopmental consequences related to childhood adversity.Neuropsychopharmacology accepted article preview online, 18 November 2015. doi:10.1038/npp.2015.344.
    No preview · Article · Nov 2015 · Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology

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  • No preview · Article · Sep 2015
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    ABSTRACT: Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. Our aim was to investigate whether the addition of MBCT to mADM is a more effective prevention strategy than mADM alone. This study is one of two multicenter randomised trials comparing the combination of MBCT and mADM to either intervention on its own. In the current trial, recurrently depressed patients in remission who had been using mADM for 6 months or longer (n=68), were randomly allocated to either MBCT+mADM (n=33) or mADM alone (n=35). Primary outcome was depressive relapse/recurrence within 15 months. Key secondary outcomes were time to relapse/recurrence and depression severity. Analyses were based on intention-to-treat. There were no significant differences between the groups on any of the outcome measures. The current study included patients who had recovered from depression with mADM and who preferred the certainty of continuing medication to the possibility of participating in MBCT. Lower expectations of mindfulness in the current trial, compared with the parallel trial, may have caused selection bias. In addition, recruitment was hampered by the increasing availability of MBCT in the Netherlands, and even about a quarter of participants included in the trial who were allocated to the control group chose to get MBCT elsewhere. For this selection of recurrently depressed patients in remission and using mADM for 6 months or longer, MBCT did not further reduce their risk for relapse/recurrence or their (residual) depressive symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.
    No preview · Article · Aug 2015 · Journal of Affective Disorders
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    ABSTRACT: Major depressive disorder (MDD) affects multiple large-scale functional networks in the brain, which has initiated a large number of studies on resting-state functional connectivity in depression. We review these recent studies using either seed-based correlation or independent component analysis and propose a model that incorporates changes in functional connectivity within current hypotheses of network-dysfunction in MDD. Although findings differ between studies, consistent findings include: 1) increased connectivity within the anterior default mode network, 2) increased connectivity between the salience network and the anterior default mode network, 3) changed connectivity between the anterior and posterior default mode network and 4) decreased connectivity between the posterior default mode network and the central executive network. These findings correspond to the current understanding of depression as a network-based disorder. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Jul 2015 · Neuroscience & Biobehavioral Reviews
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    ABSTRACT: The tendency to recall more negative and less positive information has been frequently related to the genetic susceptibility to depression. This memory bias may be associated with depression candidate genes especially in individuals who experienced stressful childhood events. The serotonin transporter gene, SLC6A4/5-HTT, regulates the reuptake of serotonin. The 5-HTTLPR polymorphism in the gene's promoter region has a short (S) and a long (L) allele, of which L contains a further SNP (rs25531), resulting in a triallelic polymorphism: La, Lg, and S. Both S and Lg result in increased serotonin signaling (to simplify, we refer to both alleles as 'S'), which in turn appears associated with depression vulnerability, specifically in individuals with stressful events. In non-depressed individuals (N=1083), we examined the interaction between the 5-HTTLPR genotype (LaLa, SLa, and SS) and stressful childhood events in association with explicit verbal memory bias (positive, negative). Two types of stressful childhood events were studied, namely childhood adverse events (e.g. parental loss) and interpersonal traumatic childhood events (e.g. abuse). Less positive memory bias was found for individuals with the SS genotype who had experienced interpersonal childhood traumatic events. No general association of genotype with memory bias was found, nor was there a significant interaction between genotype and childhood adverse events. Our results suggest that the depression-susceptibility genotype of the 5-HTTLPR is associated with depressive information processing styles when occurring in combination with traumatic childhood events. Tailoring treatment to specific risk profiles based on genetic susceptibility and childhood stress could be promising. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Jul 2015 · Journal of Affective Disorders
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    ABSTRACT: To determine the contribution of perceived ethnic discrimination to depression in various ethnic minority groups in Amsterdam. Cross-sectional study. We included participants aged 18-70 years of Dutch (n = 1,744), Asian Surinamese (n = 1,126), Creole Surinamese (n = 1,770), Ghanaian (n = 1,072), and Turkish origin (n = 834) on the basis of baseline data from the HELIUS study, collected from January 2011to June 2013 in Amsterdam. Perceived discrimination was determined using the Everyday Discrimination Scale, and the severity of depressive symptoms was assessed using the Patient Health Questionnaire-9. We used logistic regression to investigate the association between discrimination and depression, and quantified the contribution of perceived discrimination to depressive symptoms and disorder using the population attributable fraction (PAF). Results were corrected for sex, age, civil status, migration generation, level of education and employment status. Both depressive symptoms and disorder were most common among participants of Turkish (24% and 14%, respectively) and Asian Surinamese origin (19% and 10%), and least common among participants of Dutch origin (6% and 2%). Participants from ethnic minority groups who had experienced higher rates of discrimination more often suffered depressive symptoms, with odds ratios varying from 1.66 to 2.98. The PAF of perceived discrimination to depression was 18-28% among participants of Asian Surinamese, Creole Surinamese and Turkish origin, and from 13- 16% among participants of Ghanaian origin. Perceived discrimination contributes substantially to the prevalence of depression in ethnic minority groups in Amsterdam. Differences in the prevalence of depression in ethnic minority groups may originate partially from perceived discrimination.
    No preview · Article · May 2015 · Nederlands tijdschrift voor geneeskunde
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    ABSTRACT: Attention-deficit/hyperactivity disorder (ADHD) in childhood is characterized by gray and white matter abnormalities in several brain areas. Considerably less is known about white matter microstructure in adults with ADHD and its relation with clinical symptoms and cognitive performance. In 107 adult ADHD patients and 109 gender-, age- and IQ-matched controls, we used diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS) to investigate whole-skeleton changes of fractional anisotropy (FA) and mean, axial, and radial diffusivity (MD, AD, RD). Additionally, we studied the relation of FA and MD values with symptom severity and cognitive performance on tasks measuring working memory, attention, inhibition, and delay discounting. In comparison to controls, participants with ADHD showed reduced FA in corpus callosum, bilateral corona radiata, and thalamic radiation. Higher MD and RD were found in overlapping and even more widespread areas in both hemispheres, also encompassing internal and external capsule, saggital stratum, fornix, and superior lateral fasciculus. Values of FA and MD were not associated with symptom severity. However, within some white matter clusters that distinguished patients from controls, worse inhibition performance was associated with reduced FA and more impulsive decision making was associated with increased MD. This study shows widespread differences in white matter integrity between adults with persistent ADHD and healthy individuals. Changes in RD suggest aberrant myelination as a pathophysiological factor in persistent ADHD. The microstructural differences in adult ADHD may contribute to poor inhibition and greater impulsivity but appear to be independent of disease severity. Copyright © 2015. Published by Elsevier Inc.
    Full-text · Article · May 2015 · Progress in Neuro-Psychopharmacology and Biological Psychiatry

  • No preview · Conference Paper · May 2015
  • Gabe de Vries · Aart H. Schene
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    ABSTRACT: Employees suffering from depression have a high risk of becoming unemployed. A combination of treatment focused on depression and on work rehabilitation is effective. Occupational therapy and the Program for Mood Disorders at the Department of Psychiatry of the Academic Medical Centre in Amsterdam, the Netherlands, have developed two modules focused on work reintegration for patients suffering from depression. The modules have been investigated in a ran-domised controlled trial and seem to be effective in work reintegration.
    No preview · Article · Jan 2015
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    ABSTRACT: European research on the association between perceived ethnic discrimination (PED) and health is importantly lacking. It is also unknown how much PED contributes to disease prevalence. In this study, we quantified the contribution of PED to depression in five ethnic groups in a middle-size European city. We used cross-sectional data from the HELIUS study (Healthy Life in an Urban Setting), collected from January 2011 to June 2013 in Amsterdam, The Netherlands. We included a random sample of 1753 ethnic Dutch, 1143 South-Asian Surinamese, 1794 African Surinamese, 1098 Ghanaians and 850 Turks, aged 18-70 years. PED was assessed using the Everyday Discrimination Scale. Patient Health Questionnaire-9 was used for assessing depressive symptoms and major depressive disorder (MDD). We used logistic regression and calculated the contribution of PED to depressive symptoms and MDD using the population attributable fractions. Depressive symptoms and MDD were most common in Turks and South-Asian Surinamese, and lowest in ethnic Dutch. PED had a positive association with depressive symptoms and MDD in only the ethnic minority groups. The contributions of PED to depressive symptoms and MDD were around 25% in both the Surinamese groups, and Turks, and ∼15% in Ghanaians. We conclude that PED contributes considerably to depression in ethnic minority groups in a European context. As such, ethnic inequalities in depression could be reduced substantially if ethnic minority groups would not perceive any ethnic discrimination. We encourage more European research on the health impact of PED. © The Author 2012. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
    Full-text · Article · Nov 2014 · The European Journal of Public Health

  • No preview · Article · Oct 2014 · European Neuropsychopharmacology
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    Full-text · Dataset · Sep 2013
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    Full-text · Dataset · Sep 2013
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    ABSTRACT: Childhood trauma is associated with the onset and recurrence of major depressive disorder (MDD). The thermolabile T variant of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism (rs1801133) is associated with a limited (oxidative) stress defense. Therefore, C677T MTHFR could be a potential predictor for depressive symptomatology and MDD recurrence in the context of traumatic stress during early life. We investigated the interaction between the C677T MTHFR variant and exposure to traumatic childhood events (TCEs) on MDD recurrence during a 5.5-year follow-up in a discovery sample of 124 patients with recurrent MDD and, in an independent replication sample, on depressive symptomatology in 665 healthy individuals from the general population. In the discovery sample, Cox regression analysis revealed a significant interaction between MTHFR genotype and TCEs on MDD recurrence (P=0.017). Over the 5.5-year follow-up period, median time to recurrence was 191 days for T-allele carrying patients who experienced TCEs (T+ and TCE+); 461 days for T- and TCE+ patients; 773 days for T+ and TCE- patients and 866 days for T- and TCE- patients. In the replication sample, a significant interaction was present between the MTHFR genotype and TCEs on depressive symptomatology (P=0.002). Our results show that the effects of TCEs on the prospectively assessed recurrence of MDD and self-reported depressive symptoms in the general population depend on the MTHFR genotype. In conclusion, T-allele carriers may be at an increased risk for depressive symptoms or MDD recurrence after exposure to childhood trauma.
    Full-text · Article · Jul 2013 · Translational Psychiatry
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    ABSTRACT: BackgroundNon-adherence to anti-psychotics is common, expensive and affects recovery. We therefore examine the cost-effectiveness of adherence therapy for people with schizophrenia by multi-centre randomised trial in Amsterdam, London, Leipzig and Verona.MethodsParticipants received 8 sessions of adherence therapy or health education. We measured lost productivity and use of health/social care, criminal justice system and informal care at baseline and one year to estimate and compare mean total costs from health/social care and societal perspectives. Outcomes were the Short Form 36 (SF-36) mental component score (MCS) and quality-adjusted life years (QALYs) gained (SF-36 and EuroQoL 5 dimension (EQ5D)). Cost-effectiveness was examined for all cost and outcome combinations using cost-effectiveness acceptability curves (CEACs).Results409 participants were recruited. There were no cost or outcome differences between adherence therapy and health education. The probability of adherence therapy being cost-effective compared to health education was between 0.3 and 0.6 for the six cost-outcome combinations at the willingness to pay thresholds we examined.ConclusionsAdherence therapy appears equivalent to health education. It is unclear whether it would have performed differently against a treatment as usual control, whether such an intervention can impact on quality of life in the short-term, or whether it is likely to be cost-effective in some sites but not others.Trial registrationTrial registration: Current Controlled Trials ISRCTN01816159
    Full-text · Article · May 2013 · Cost Effectiveness and Resource Allocation
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    ABSTRACT: Background Populations in Europe are becoming increasingly ethnically diverse, and health risks differ between ethnic groups. The aim of the HELIUS (HEalthy LIfe in an Urban Setting) study is to unravel the mechanisms underlying the impact of ethnicity on communicable and non-communicable diseases. Methods/design HELIUS is a large-scale prospective cohort study being carried out in Amsterdam, the Netherlands. The sample is made up of Amsterdam residents of Surinamese (with Afro-Caribbean Surinamese and South Asian-Surinamese as the main ethnic groups), Turkish, Moroccan, Ghanaian, and ethnic Dutch origin. HELIUS focuses on three disease categories: cardiovascular disease (including diabetes), mental health (depressive disorders and substance use disorders), and infectious diseases. The explanatory mechanisms being studied include genetic profile, culture, migration history, ethnic identity, socio-economic factors and discrimination. These might affect disease risks through specific risk factors including health-related behaviour and living and working conditions. Every five years, participants complete a standardized questionnaire and undergo a medical examination. Biological samples are obtained for diagnostic tests and storage. Participants’ data are linked to morbidity and mortality registries. The aim is to recruit a minimum of 5,000 respondents per ethnic group, to a total of 30,000 participants. Discussion This paper describes the rationale, conceptual framework, and design and methods of the HELIUS study. HELIUS will contribute to an understanding of inequalities in health between ethnic groups and the mechanisms that link ethnicity to health in Europe.
    Preview · Article · Apr 2013 · BMC Public Health
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    ABSTRACT: Aims. For people with schizophrenia, non-adherence to antipsychotic medications may result in high use of health and other services. The objective of our research was to examine the economic consequences of non-adherence in patients with schizophrenia taking antipsychotic medication. Methods. Data were taken from QUATRO, a randomized controlled trial that drew a sample of adults with schizophrenia receiving psychiatric services in four European cities: Amsterdam, Leipzig, London and Verona. Trial inclusion criteria were a clinical diagnosis of schizophrenia, requiring on-going antipsychotic medication for at least 1-year following baseline assessment, and exhibiting evidence of clinical instability in the year prior to baseline. The patient-completed Medication Adherence Questionnaire (MAQ) was used to calculate the 5-point Morisky index of adherence. Generalized linear models (GLM) were developed to determine the effect of adherence on (i) health and social care and (ii) societal costs before and after treatment, taking into account other potential cost-influencing factors. Results. The effect of non-adherence on costs was mixed. For different groups of services, and according to treatment group assignment, non-adherence was both negatively and positively associated with costs. Conclusions. The impact of non-adherence on costs varies across the types of services used by individuals with schizophrenia.
    Full-text · Article · Apr 2013 · Epidemiology and Psychiatric Sciences

Publication Stats

4k Citations
500.94 Total Impact Points

Institutions

  • 2015
    • Radboud University Medical Centre (Radboudumc)
      • Department of Psychiatry
      Nymegen, Gelderland, Netherlands
  • 2014-2015
    • Radboud University Nijmegen
      • • Department of Psychiatry
      • • Donders Institute for Brain, Cognition, and Behaviour
      Nymegen, Gelderland, Netherlands
  • 1993-2013
    • University of Amsterdam
      • Department of Psychiatry
      Amsterdamo, North Holland, Netherlands
  • 1992-2012
    • Academisch Medisch Centrum Universiteit van Amsterdam
      • Department of Psychiatry
      Amsterdamo, North Holland, Netherlands
  • 2000-2003
    • University of Verona
      • Department of Medicine and Public Health
      Verona, Veneto, Italy
    • Copenhagen University Hospital
      København, Capital Region, Denmark
  • 2002
    • The Kings College
      Overland Park, Kansas, United States
    • Universidad de Cantabria
      Santander, Cantabria, Spain
  • 2000-2002
    • University of Leipzig
      Leipzig, Saxony, Germany
    • King's College London
      • Institute of Psychiatry
      London, ENG, United Kingdom
  • 1986-1990
    • Utrecht University
      • Department of Psychiatry
      Utrecht, Utrecht, Netherlands