the effect of ethnicity and immigration on treatment resistance in schizophrenia

Background: Treatment resistance is a common issue among schizophrenia patients undergoing antipsychotic treatment. According to the American Psychiatric Association (APA) guidelines, treatment-resistant status is defined as little or no symptom reduction to at least two antipsychotics at a therapeutic dose for a trial of at least six weeks. The aim of the current study is to determine whether ethnicity and migration are associated with treatment resistance. Methods: In a sample of 251 participants with schizophrenia spectrum disorders, we conducted cross-sectional assessments to collect information regarding self-identified ethnicity, immigration and treatment history. Ancestry was identified using 292 markers overlapping with the HapMap project. Using a regression analysis, we tested whether a history of migration, ethnicity or genetic ancestry were predictive of treatment resistance. Results: Our logistic regression model revealed no significant association between immigration (OR = 0.04; 95%CI = 0.35–3.07; p = 0.93) and treatment resistant schizophrenia. White Europeans did not show significant association with resistance status regardless of whether ethnicity was determined by self-report (OR = 1.89; 95%CI = 0.89–4.20; p = 0.105) or genetic analysis (OR = −0.73; 95%CI = −0.18–2.97; p = 0.667). Conclusion: Neither ethnicity nor migrant status was significantly associated with treatment resistance in this Canadian study. However, these conclusions are limited by the small sample size of our investigation. Keywords: Schizophrenia, Treatment resistance, Antipsychotics, Ethnicity, Migratio

Childhood Adversity Moderates the Effects of HTR2A Epigenetic Regulatory Polymorphisms on Rumination

The serotonin system has been suggested to moderate the association between childhood maltreatment and rumination, with the latter in its turn reported to be a mediator in the depressogenic effect of childhood maltreatment. Therefore, we investigated whether the associations of two epigenetic regulatory polymorphisms in the HTR2A serotonin receptor gene with Ruminative Responses Scale rumination and its two subtypes, brooding and reflection, are moderated by childhood adversity (derived from the Childhood Trauma Questionnaire) among 1,501 European white adults. We tested post hoc whether the significant associations are due to depression. We also tested the replicability of the significant results within the two subsamples of Budapest and Manchester. We revealed two significant models: both the association of methylation site rs6311 with rumination and that of miRNA binding site rs3125 (supposed to bind miR-1270, miR-1304, miR-202, miR-539 and miR-620) with brooding were a function of childhood adversity, and both interaction findings were significantly present both in the never-depressed and in the ever-depressed group. Moreover, the association of rs3125 with brooding could be replicated across the separate subsamples, and remained significant even when controlling for lifetime depression and the Brief Symptom Inventory depression score. These findings indicate the crucial importance of involving stress factors when considering endophenotypes and suggest that brooding is a more promising endophenotype than a broader measure of rumination. Transdiagnostic relevance of the brooding endophenotype and the potential of targeting epigenetic regulatory polymorphisms of HTR2A in primary and secondary prevention of depression and possibly of other disorders are also discussed

Neuroimaging the consciousness of self: Review, and conceptual-methodological framework

We review neuroimaging research investigating self-referential processing (SRP), that is, how we respond to stimuli that reference ourselves, prefaced by a lexical-thematic analysis of words indicative of “self-feelings”. We consider SRP as occurring verbally (V-SRP) and non-verbally (NV-SRP), both in the controlled, “top-down” form of introspective and interoceptive tasks, respectively, as well as in the “bottom-up” spontaneous or automatic form of “mind wandering” and “body wandering” that occurs during resting state. Our review leads us to outline a conceptual and methodological framework for future SRP research that we briefly apply toward understanding certain psychological and neurological disorders symptomatically associated with abnormal SRP. Our discussion is partly guided by William James’ original writings on the consciousness of self

Genetics and Epigenetics of Suicidal Behavior

According to the latest World Health Organization report (2012), suicide was the second leading cause of death among people. Approximately 90% of suicide victims or suicide attempters are diagnosed with a psychiatric disorder. Schizophrenia patients have been shown to be at an increased risk for suicide. Although many risk factors have been identified, few of these factors have a significant clinical impact on predicting suicide. Whether genetic and epigenetic alterations are potential risk factors for suicidal behavior in schizophrenia has yet to be investigated. A well-characterized sample of schizophrenia patients with a distinct suicide attempt history was recruited to evaluate the influence of genetic and epigenetic alterations as potential risk factors for suicidal behavior. Sociocultural and clinical variables were also examined. Selected genes were genotyped to test whether independently or combined, specific clinical variables and DNA variants can accurately predict suicidal behavior. Our study found no evidence that genetic or epigenetic factors have a significant influence on the risk for suicidal behavior in schizophrenia.Ph.D

Exploring the Impact of Labour Mobility on the Mental Health and Wellbeing of Skilled Trades Workers in Ontario, Canada

Labour mobility and subsequent workers migration is an increasing trend worldwide and can be a force that counteracts Canada’s shortage of skilled labour. Supercommuting allows workers facing economic challenges to pursue more financially advantageous work opportunities in other regions. This study aimed to evaluate the “supercommuting” labour mobility model and its impact on long-distance mobile workers’ mental health and wellbeing. We utilized a non-experimental research design using convenience sampling from workers who participated in Blue Branch Inc.’s (Hamilton, Canada) supercommuting labour mobility model. An online questionnaire collected demographic data, work-related data, occupational stress measures related to burnout, and job-related stress data. Data collection was started on 1 April 2021, and of the total 58 participants, the majority (44, 76%) were male, born outside Canada, and had an average age of 32.8 years. Workplace Safety (95%), full-time employment opportunity (95%), career advancement possibility (95%), and income and benefits (94.9%) were found to be the most crucial factors to keep study participants working in their current position. Of the 47 participants who experienced burnout, only one showed severe burnout in each domain (personal, work-related, and colleague-related). There is a great need for preventative burnout programs and supportive employer resources for those who engage in long-distance labour commuting. The study emphasizes the need to encourage policymakers to develop solutions for training future Ontario workers to support mobile employment and long-distance labour commuting

Ethnicity and suicide attempt: analysis in bipolar disorder and schizophrenia

Abstract Background Evidence is mixed as to whether White Europeans are at a higher risk for suicide attempts or completions compared to other ethnic groups. The present analysis assessed whether risk for suicide attempt was associated with White European ethnicity in 907 subjects with schizophrenia or bipolar disorder. Methods Subjects were diagnosed using the Structured Clinical Interview for DSM-IV, and ethnicity was determined by self-report. Subjects were recruited from psychiatric care centers in Toronto, Canada. Logistic regression correcting for clinical covariates like age, gender and diagnosis, was used in this study. Results We found no difference in suicide attempter status in white and non-white subjects who were diagnosed with schizophrenia and bipolar disorder. Conclusion Our study does not support the evidence that White-European patients in North America are at higher risk for suicide attempt compared to non-European descent subjects. However, this result has to be replicated in larger studies in patients with these disorders

Ethnicity and suicide attempt: analysis in bipolar disorder and schizophrenia

BACKGROUND: Evidence is mixed as to whether White Europeans are at a higher risk for suicide attempts or completions compared to other ethnic groups. The present analysis assessed whether risk for suicide attempt was associated with White European ethnicity in 907 subjects with schizophrenia or bipolar disorder. METHODS: Subjects were diagnosed using the Structured Clinical Interview for DSM-IV, and ethnicity was determined by self-report. Subjects were recruited from psychiatric care centers in Toronto, Canada. Logistic regression correcting for clinical covariates like age, gender and diagnosis, was used in this study. RESULTS: We found no difference in suicide attempter status in white and non-white subjects who were diagnosed with schizophrenia and bipolar disorder. CONCLUSION: Our study does not support the evidence that White-European patients in North America are at higher risk for suicide attempt compared to non-European descent subjects. However, this result has to be replicated in larger studies in patients with these disorders

Assessing the risk for suicide in schizophrenia according to migration, ethnicity and geographical ancestry

Abstract Background Suicide is a leading cause of mortality among those afflicted by schizophrenia. Previous studies demonstrated that the stressors associated with immigration may lead to an onset of schizophrenia and suicide separately in susceptible individuals. However, no studies have shown whether immigration may lead to suicidal behaviour for individuals with schizophrenia. Our study proposes that an individual’s geographical ancestry, ethnicity or migration status may be predictive of suicide risk in schizophrenia. Methods In a sample of 276 participants with schizophrenia spectrum disorders, we conducted cross-sectional assessments to collect clinical information. Self-identified ethnicity and suicide history were collected through self-report questionnaires and interview-based scales. Ancestry was identified using 292 genetic markers from HapMap. Migrants were classified as those who immigrated to Canada during their lifetime. Using a regression analysis, we tested whether a history of migration, ethnicity or geographical ancestry were predictive of a history of suicide attempts. Results Our analysis failed to demonstrate a significant relationship between suicide history and migration, ethnicity or ancestry. However, ethnicity appears to be significantly associated with the number of psychiatric hospitalizations in our sample. Conclusion Ethnicity and migration history are not predictive of previous suicide attempts. Ethnicity may be an important demographic factor affecting access to mental health resources and frequency of hospitalizations

Chromosome 22 Deletions and Suicidal Behavior in Schizophrenia

The final published version of this article is available at https://doi.org/10.1159/000513645Background: Studies have shown that the overall copy number variant (CNV) load is associated with schizophrenia. Schizophrenia is a mental disorder that is frequently associated with suicidal behavior. Methods: We recruited 263 patients with schizophrenia from the Centre for Addiction and Mental Health. The Columbia Suicide Severity Rating Scale was used to assess the presence of lifetime suicide attempt. Genotyping was completed using the Illumina Omni 2.5 chip. We tested the association between deletion events on chromosome 22 with suicide attempt in our schizophrenia sample. Results: There was no significant difference between suicide attempters and non-attempters considering the presence/absence of deletion events on chromosome 22. Conclusion: Although our results did not show a significant association between deletions on chromosome 22 and suicide attempt in schizophrenia, CNV studies may reveal important, novel insights and open further investigation for the treatment of neuropsychiatric diseases.This project was supported by the American Foundation for Suicide Prevention (A.B.F.) and by the Miner’s Lamp Award from the Department of Psychiatry at University of Toronto (V.D.L.). V.D.L. is recipient of a Scholar Award form the Department of Psychiatry, University of Toronto