The role of schizotypal traits and the OXTR gene in theory of mind in schizophrenia: A family-based study

Background. There is consistent evidence that theory of mind (ToM) is impaired in schizophrenia (SZ); however, it remains unclear whether such deficits are trait- or state-dependent. We evaluated ToM in patients with schizophrenia spectrum disorders (SSDs), their healthy first-degree relatives, and controls to test its suitability as an endophenotypic marker. We also studied the modifying effect of markers of clinical and genetic liability to SZ (schizotypy and genetic variability in the oxytocin receptor gene: OXTR) on ToM in healthy individuals. Methods. The sample included 38 stable SSD patients, 80 unaffected first-degree relatives, and 81 controls. ToM was assessed using the Hinting Task (HT) and schizotypy via the Schizotypal Personality Questionnaire-Brief (SPQ-B), which generates interpersonal (SPQ-IP), cognitive-perceptual (SPQ-CP), and disorganization (SPQ-D) scores. The polymorphism rs53576 of OXTR was genotyped. Results. Patients presented poorer HT performance than relatives and controls (p = 0.003 and p < 0.001). High SPQ-IP and SPQ-CP scores correlated with poorer ToM performance in relatives (p = 0.010 and p = 0.030), but not in controls. OXTR was not associated with HT scores, but it showed a modifying effect within controls; high SPQ-CP was related to HT poorer performance conditional to GG genotype (p = 0.007). Conclusions. ToM deficits were present in patients but not in unaffected relatives or controls. However, our data indicate the usefulness of clinical and genetic liability markers to characterize differences in ToM abilities within healthy individuals. Then, the observed link between ToM and SZ liability suggests the putative role of ToM as an endophenotypic marker. Nevertheless, new analyses in larger samples are needed

Monoamine oxidase A (MAOA) interaction with parenting practices on callous-unemotional traits in preschoolers

Background and Objectives: From a gene-by-environment perspective, parenting in interaction with the polymorphism in the Monoamine oxidase A (MAOA) gene (MAOA-uVNTR) might also be associated with increased callous-unemotional traits (CU) in preschoolers. MAOA-uVNTR results in differential enzyme activity, so that high-activity alleles (MAOA-H) are linked to reduced dopamine, serotonin, and norepinephrine availability in comparison to low-activity allele (MAOA-L). As MAOA-uVNTR has been previously described to moderate the relationship between childhood parental maltreatment and aggressive and antisocial behavior, it may also play a role in CU traits etiology

Childhood abuse in the etiological continuum underlying psychosis from first-episode psychosis to psychotic experiences

GOAL: The present study aimed to examine the prevalence of child abuse across the continuum of psychosis. PATIENTS AND METHODS: The sample consisted of 198 individuals divided in three groups: (1) 48 FEP patients, (2) 77 individuals scoring high in Community Assessment of Psychic Experiences (CAPE), classified as 'High CAPE' group and (3) 73 individuals scoring low, classified as 'Low CAPE' group. Childhood abuse was assessed using self-report instruments. Chi(2) tests and logistic regression models controlling by sex, age and cannabis were used to perform three comparisons: (i) FEP vs. Low CAPE; (ii) FEP vs. High CAPE and (iii) High CAPE vs. Low CAPE. RESULTS: The frequency of individuals exposed to childhood abuse for FEP, High CAPE and Low CAPE groups were 52.1%, 41.6% and 11%, respectively. FEP and High CAPE group presented significantly higher rates of childhood abuse compared to Low CAPE group, however, no significant differences were found between FEP and High CAPE groups regarding the frequency of childhood abuse. CONCLUSION: There is an increasing frequency of childhood abuse from low subclinical psychosis to FEP patients. However, childhood abuse is equally common in FEP and at risk individuals

Psychosis-inducing effects of cannabis are related to both childhood abuse and COMT genotypes.

Evidence suggests that childhood trauma and cannabis use sinergistically impact on psychosis risk, although a non-replication of this environment-environment interaction was recently published. Gene-environment interaction mechanisms may partially account for this discrepancy. The aim of the current study was to test whether the association between childhood abuse, cannabis use and psychotic experiences (PEs) was moderated by the COMT gene. PEs, childhood abuse, cannabis use and COMT Val158Met genotypes were assessed in 533 individuals from the general population. Childhood abuse was shown to have a significant main effect on PEs (B=.08; SE=.04; p=.047). Furthermore, a significant three-way interaction among childhood abuse, cannabis use and the COMT gene was found (B=-.23; SE=.11; p=.006). This indicates that COMT genotypes and cannabis use only influenced PE scores among individuals exposed to childhood abuse. Exposure to childhood abuse and cannabis use increased PE scores in Val carriers. However, in individuals exposed to childhood abuse but who do not use cannabis, PEs increased as a function of the Met allele copies of the COMT gene. Our findings suggest that the psychosis-inducing effects of childhood abuse and cannabis use are moderated by the Val158Met polymorphism of the COMT gene, which supports a gene-environment-environment interaction. Cannabis use after exposure to childhood abuse may have opposite effects on the risk of PEs, depending on the COMT genotypes. Val carriers are vulnerable to the psychosis-inducing effects of cannabis

Facial Biomarkers Detect Gender-Specific Traits for Bipolar Disorder

Bipolar disorder (BD) is a psychiatric disorder associated with brain and neurodevelopmental alterations. As in other disorders, patients with BD present minor Physical Anomalies (MPAs) in higher frequency than healthy subjects. MPAs are subtle signs of developmental deviation that appear in body regions that share the ectodermal origin of the brain and are likely triggered by the same insults altering early brain development in mental disorders. MPAs are thus considered potential biomarkers for neurodevelopmental disorders. In this study, we compared facial shape variation between patients with BD and healthy controls using 3D facial reconstructions from magnetic resonance images (MRI) to test the potential of MPAs as a biomarker of BD diagnosis. Moreover, we assessed sex-specific facial shape variation to test whether the disorder affects differently male and female patients. We collected the 3D coordinates of 20 anatomical facial landmarks in a sample of 174 subjects (87 patients with BD and 87 healthy controls) and analyzed global and local patterns of facial shape using Geometric Morphometrics and multivariate statistical techniques. Although Procrustes-ANOVA analysis revealed that diagnosis accounted for a low but significant effect (1.1% of total facial shape variance, P-value=0.016), global facial shape did not significantly discriminate between patients with BD and healthy controls (P-value=0.19). However, Euclidean Distance Matrix Analysis (EDMA) based on local distances of the face revealed that 16.8% of facial traits were significantly different between patients with BD and healthy controls. Remarkably, the patterns of facial differences were sex-specific, suggesting that BD has a different effect on male and female patients. These findings show that local facial differences could be used as biomarkers for an improved diagnosis of BD and raise awareness on the importance of studying sex differences on neurodevelopmental disorders to develop more specific and efficient treatments

High Potential of Facial Biomarkers to Diagnose Psychotic Disorders

Schizophrenia (SCZ) and Bipolar Disorder (BP) are severe psychiatric disorders (PD) that affect more than 3% of the world's population and are among the leading causes of disability worldwide. Current diagnostic systems represent these PD as independent categorical entities. However, recent studies propose that both disorders would be two different manifestations of the same psychotic spectrum continuum. Differential diagnosis is mainly based on their clinical presentation, and reliable biomarkers remain an unmet clinical need. Since the brain and the face are derived from the same ectodermal origins and their development is intimately integrated through common genetic signaling, facial biomarkers emerge as one of the most promising biological risk factors for PD. Here, we assessed the potential of facial anatomy in predicting the diagnosis of SCZ and BP. Analyses were performed in a sample of 180 adults distributed in three groups of BP patients (n=46), SCZ patients (n=67), and CNT (n=67) matched by age and premorbid IQ. Faces were manually annotated from reconstructions of magnetic resonance scans. Facial shape correctly discriminated patients with BP and SCZ, even when facial differences between patients and CNT were so subtle that are not recognizable to the untrained eye or by exploratory multivariate statistical techniques. After cross-validation, 62-65% of patients were correctly diagnosed based on face shape. This percentage is similar to the discriminatory power of other genetic and brain biomarkers. Using Artificial Neural Networks, we tested a machine learning algorithm based on facial morphology to diagnose SCZ. The overall accuracy in diagnostic classification was greater than 90%, whereas the precision ranged between 70-95% depending on the model. We also trained a Support Vector Machine classification algorithm to diagnose BP. Results showed that BP is harder to diagnose from facial biomarkers than SCZ, achieving a 72% accuracy. Euclidean Distance Matrix Analysis (EDMA) detected local facial differences involving the eyes, nose and mouth, and the relative separation/position between them. Facial anomalies were more abundant in SCZ patients, with 43-48% distances across the whole face significantly different from control subjects. In BP, the percentage of facial anomalies was lower, 24-32%, especially in women. Some facial differences were common to SCZ and BP, although the sense of change could be different among disorders. Remarkably, EDMA showed facial patterns that are disorder and gender-specific. These results demonstrate that an analysis of the spectrum of psychotic disorders under a gender perspective is crucial to further understand these disorders and to identify reliable biomarkers that can lead to early PD diagnosis

Smoking cessation improves clinical outcome in severe mental disorders and is modulated by genetic variability at CHRNA5 gene

Smoking has been traditionally tolerated for patients with mental disorders due to its hypothesized self-medication function (Schroeder and Morris, 2010).[...

NRN1 Gene as a Potential Marker of Early-Onset Schizophrenia: Evidence from Genetic and Neuroimaging Approaches

Included in the neurotrophins family, the Neuritin 1 gene (NRN1) has emerged as an attractive candidate gene for schizophrenia (SZ) since it has been associated with the risk for the disorder and general cognitive performance. In this work, we aimed to further investigate the association of NRN1 with SZ by exploring its role on age at onset and its brain activity correlates. First, we developed two genetic association analyses using a family-based sample (80 early-onset (EO) trios (offspring onset ≤ 18 years) and 71 adult-onset (AO) trios) and an independent case control sample (120 healthy subjects (HS), 87 EO and 138 AO patients). Second, we explored the effect of NRN1 on brain activity during a working memory task (N-back task; 39 HS, 39 EO and 39 AO; matched by age, sex and estimated IQ). Different haplotypes encompassing the same three Single Nucleotide Polymorphisms(SNPs, rs3763180 rs10484320 rs4960155) were associated with EO in the two samples (GCT, TCC and GTT). Besides, the GTT haplotype was associated with worse N-back task performance in EO and was linked to an inefficient dorsolateral prefrontal cortex activity in subjects with EO compared to HS. Our results show convergent evidence on the NRN1 association with EO both from genetic and neuroimaging approaches, highlighting the role of neurotrophins in the pathophysiology of SZ

Fingerprints as Predictors of Schizophrenia: A Deep Learning Study

Background and hypothesis: The existing developmental bond between fingerprint generation and growth of the central nervous system points to a potential use of fingerprints as risk markers in schizophrenia. However, the high complexity of fingerprints geometrical patterns may require flexible algorithms capable of characterizing such complexity. Study design: Based on an initial sample of scanned fingerprints from 612 patients with a diagnosis of non-affective psychosis and 844 healthy subjects, we have built deep learning classification algorithms based on convolutional neural networks. Previously, the general architecture of the network was chosen from exploratory fittings carried out with an independent fingerprint dataset from the National Institute of Standards and Technology. The network architecture was then applied for building classification algorithms (patients vs controls) based on single fingers and multi-input models. Unbiased estimates of classification accuracy were obtained by applying a 5-fold cross-validation scheme. Study results: The highest level of accuracy from networks based on single fingers was achieved by the right thumb network (weighted validation accuracy = 68%), while the highest accuracy from the multi-input models was attained by the model that simultaneously used images from the left thumb, index and middle fingers (weighted validation accuracy = 70%). Conclusion: Although fitted models were based on data from patients with a well established diagnosis, since fingerprints remain lifelong stable after birth, our results imply that fingerprints may be applied as early predictors of psychosis. Specially, if they are used in high prevalence subpopulations such as those of individuals at high risk for psychosis.This work was supported by several grants funded by the Instituto de Salud Carlos III and the Spanish Ministry of Science and Innovation (co-funded by the European Regional Development Fund/European Social Fund “Investing in your future”): Miguel Servet Research Contract (CPII13/00018 to RS, CPII16/00018 to EP-C, CP20/00072 to MF-V), PFIS Contract (FI19/0352 to MG-R). Research Mobility programme (MV18/00054 to EP-C), Research Projects (PI18/00877 and PI21/00525 to RS). It has also been supported by the Centro de Investigación Biomédica en Red de Salud Mental and the Generalitat de Catalunya: 2014SGR1573 and 2017SGR1365 to EP-C and SLT008/18/00206 to IF-R from the Departament de Salut. The authors have declared that there are no conflicts of interest in relation to the subject of this study.S

Risk and protective factors for anxiety and obsessive-compulsive disorders: an umbrella review of systematic reviews and meta-analyses

A multitude of risk/protective factors for anxiety and obsessive-compulsive disorders have been proposed. We conducted an umbrella review to summarize the evidence of the associations between risk/protective factors and each of the following disorders: specific phobia, social anxiety disorder, generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder, and to assess the strength of this evidence whilst controlling for several biases.Publication databases were searched for systematic reviews and meta-analyses examining associations between potential risk/protective factors and each of the disorders investigated. The evidence of the association between each factor and disorder was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of cases (>1000), random-effects p-values, 95% prediction intervals, confidence interval of the largest study, heterogeneity between studies, study effects, and excess of significance.Nineteen systematic reviews and meta-analyses were included, corresponding to 216 individual studies covering 427 potential risk/protective factors. Only one factor association (early physical trauma as a risk factor for social anxiety disorder, OR 2.59, 95% CI 2.17-3.1) met all the criteria for convincing evidence. When excluding the requirement for more than 1000 cases, five factor associations met the other criteria for convincing evidence and 22 met the remaining criteria for highly suggestive evidence.Although the amount and quality of the evidence for most risk/protective factors for anxiety and obsessive-compulsive disorders is limited, a number of factors significantly increase the risk for these disorders, may have potential prognostic ability and inform prevention