Evidence for increased immune mobilization in First Episode Psychosis compared with the prodromal stage in males

The aim of the study was to gauge both the immune and neuroendocrine function in Ultra High Risk for psychosis (UHR) subjects and compare them with a cohort presenting with First Episode Psychosis (FEP). We recruited two groups, the first group consisted of 12 UHR males and the second of 25 males with FEP. We measured serum cortisol levels at 08:00, 12:00, 18:00 with their Area Under Curve with respect to the ground (AUCg) and the increase (AUCi) and we measured serum cytokines levels, Interleukin-1a, IL-1a, IL-2, IL-4,IL-5,IL-6,IL-8, IL-10,IL-12, IL-17a, Tumor Necrosis Factor-a (TNF-a), Interferon-γ (IFN-γ). Dexamethasone Suppression Test (DST) was also performed. The results suggest higher levels of both pro-inflammatory (TNF-a, IL-2, IL-12, IFN-γ) and anti-inflammatory (IL-10) cytokines in the FEP group compared with the UHR counterparts. Regarding the HPA axis function, the prodromal subjects showed a trend for higher AUCg and AUCi change/decrease cortisol levels. On the contrary, the DST results did not differ between the groups. No significant associations were demonstrated within each group among cytokines, cortisol and psychopathology. The findings favor a hypothesis of a relatively increased mobilization of both the pro- and anti-inflammatory cytokine networks, in FEP compared with that of UHR subjects

A Cross-National Investigation of Hallucination-Like Experiences in 10 Countries: The E-CLECTIC Study

Hallucination-like experiences (HLEs) are typically defined as sensory perceptions in the absence of external stimuli. Multidimensional tools, able to assess different facets of HLEs, are helpful for a better characterization of hallucination proneness and to investigate the cross-national variation in the frequencies of HLEs. The current study set out to establish the validity, factor structure, and measurement invariance of the Launay-Slade Hallucinations Scale-Extended (LSHS-E), a tool to assess HLEs. A total of 4419 respondents from 10 countries were enrolled. Network analyses between the LSHS-E and the 3 dimensions of the Community Assessment of Psychic Experiences (CAPE) were performed to assess convergent and divergent validity of the LSHS-E. Confirmatory factor analysis was used to test its measurement invariance. The best fit was a 4-factor model, which proved invariant by country and clinical status, indicating cross-national stability of the hallucination-proneness construct. Among the different components of hallucination-proneness, auditory-visual HLEs had the strongest association with the positive dimension of the CAPE, compared with the depression and negative dimensions. Participants who reported a diagnosis of a mental disorder scored higher on the 4 LSHS-E factors. Small effect size differences by country were found in the scores of the 4 LSHS-E factors even after taking into account the role of socio-demographic and clinical variables. Due to its good psychometric properties, the LSHS-E is a strong candidate tool for large investigations of HLEs

Investigation of social cognition and obsessive - compulsive symtomatology in first episode psychosis patients

Introduction With a prevalence rate of up to 64%, obsessive-compulsive symptoms (OCS) are a very common comorbidity in patients with schizophrenia, while the fully developed syndrome of obsessive-compulsive disorder (OCD) occurs in approximately one in eight patients. Prevalence rates of OCS and OCD in patients with first-episode psychosis (FEP) are similarly high, suggesting that these symptoms are already present at illness onset. A cognitive domain that has so far remained, to the best of our knowledge, completely unexplored in patients with schizophrenia and OCS/OCD is Social Cognition (SC). The latter term refers to a variety of mental processes associated with the perception, interpretation and response to stimuli pertinent to social interaction. The two major domains of SC are Theory of Mind (ToM) and Emotion Perception (EP). The aim of the present study was to investigate the association of OCS/OCD with ToM and EP in patients with a first episode of a schizophrenia spectrum psychosis. Based on previous findings, we hypothesized that (a) Social Cognition deficits are present at the time of illness onset for all patients and (b) that the presence of OCS/OCD aggravate these deficits. Method-Materials We recruited 65 patients with non-affective first episode psychosis (FEP), (52 men, 13 women) and 47 healthy controls (HC), (31 men, 16 women) matched for gender, age and education. The patient group was divided into two subgroups, those with (FEP+; n=38) and those without obsessive-compulsive symptomatology (FEP-; n=27).All patients met DSM-IV criteria for Schizophrenia and other Psychotic Disorders. Diagnosis was conrmed with the Mini-International Neuropsychiatric Interview (MINI). Obsessive compulsive symptomatology was evaluated with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and we assessed symptom severity in patients with the Positive and Negative Syndrome Scale (PANSS). Additionally it was administrated the Calgary Depression Scale for Schizophrenics (CDSS) for the evaluation of depressive symptomatology. For the Social Cognition assessment we used the Perception of Social Inference Test (PESIT) which was developed for the Greek population based on The Awareness of Social Inference Test (TASIT).Conclusions In summary, our findings of impaired Emotion Perception and ToM in first-episode psychotic patients support the notion that these deficits are already present at illness onset. Furthermore, comorbidity with OCS/OCD in non-affective psychosis appears to be associated with larger impairments in ToM but not EP function. Given the significance of SC deficits for psychosocial functioning in patients with psychosis, further studies are needed to examine in more depth the role of clinical symptomatology to SC.ΕισαγωγήΗ συννοσηρότητα των ψυχαναγκαστικών-καταναγκαστικών συμπτωμάτων (ΨΚΣ) στους ασθενείς με σχιζοφρένεια είναι υψηλή με ποσοστά που φτάνουν το 64% ενώ η ανάπτυξη του πλήρους συνδρόμου της Ψυχαναγκαστικής Καταναγκαστικής Διαταραχής (ΨΚΔ) παρουσιάζεται σε έναν στους οκτώ σχιζοφρενείς. Ο επιπολασμός των ΨΚΣ και της ΨΚΔ σε ασθενείς με πρώτο ψυχωτικό επεισόδιο είναι σε παρόμοια υψηλά ποσοστά, γεγονός που υποστηρίζει ότι τα συμπτώματα αυτά είναι παρόντα από τις πρώτες φάσεις της νόσου.Στους ασθενείς αυτούς δεν έχει ποτέ εξεταστεί, στο βαθμό που μπορούμε να γνωρίζουμε, η διάσταση της κοινωνικής γνωστικής αντίληψης. Με τον όρο Κοινωνική Γνωστική Αντίληψη (ΚΓΑ) ή αγγλιστί Social Cognition αναφερόμαστε σε μια ποικιλία νοητικών λειτουργιών που σχετίζονται με την αντίληψη, την ερμηνεία και την απάντηση σε ερεθίσματα που αφορούν τις κοινωνικές διαντιδράσεις. Αντιδράσεις που είναι θεμελιώδους σημασίας στη σχιζοφρένεια μια και ορίζουν σε σημαντικό βαθμό τη λειτουργικότητα των ασθενών και έρευνες υποστηρίζουν ότι είναι ελλειμματικές από την αρχή, ίσως και νωρίτερα, των πρώτων ψυχωσικών εκδηλώσεων. Ο σκοπός της παρούσας μελέτης ήταν, έτσι, να διερευνήσει τη σχέση των ΨΚΣ/ΨΚΔ με την Κοινωνική Γνωστική Αντίληψη στους ασθενείς με πρώτο ψυχωτικό επεισόδιο. Μέθοδος-ΔείγμαΩς υλικό της μελέτης χρησιμοποιήθηκε δείγμα 65 ασθενών (ΠΨΕ=52 άνδρες και 13 γυναίκες) και 47 υγιών ατόμων (31 άνδρες, 16 γυναίκες). Οι ασθενείς διακρίθηκαν σε όσους εμφάνιζαν ΨΚΣ ή ΨΚΔ (ΠΨΕ+=38) και σε αυτούς που δεν εμφάνιζαν ΨΚΣ (ΠΨΕ-=27). Οι ασθενείς που συμμετείχαν ήταν νοσηλευόμενοι για πρώτη φορά σε ψυχιατρική κλινική με ψυχωσική συμπτωματολογία. Οι υγιείς ήταν εθελοντές χωρίς γνωστό ψυχιατρικό ιστορικό. Η διάγνωση των ασθενών τίθετο με τη Mini-International Neuropsychiatric Interview (ΜΙΝΙ) και τους χορηγούνταν η Positive and Negative Syndrome Scale (PANSS) για την εκτίμηση της ψυχωσικής συμπτωματολογίας, η Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) για τα ψυχαναγκαστικά-καταναγκαστικά συμπτώματα και η Calgary Depression Scale (Calgary) που αξιολογεί τα καταθλιπτικά συμπτώματα. Τέλος χρησιμοποιήθηκε η δοκιμασία Perception of Social Inference Test (PESIT) για την εκτίμηση της ΚΓΑ στις δύο κύριες διαστάσεις της δηλαδή αυτή της Θεωρίας του Νου (ΘτΝ) και της Αντίληψης Συναισθημάτων (ΑΣ). Αποτελέσματα-ΣυμπέρασμαΣτις δοκιμασίες Κοινωνικής Γνωστικής Αντίληψης (ΚΓΑ) η ικανότητα των ασθενών είναι περιορισμένη σε σχέση με τους υγιείς όπως αναγνωρίζεται και στη διεθνή βιβλιογραφία. Επιπλέον ελλείμματα εμφανίζουν οι ασθενείς της ΠΨΕ+ ομάδας σε ορισμένες δοκιμασίες. Συγκεκριμένα αυτό ισχύει στις δοκιμασίες της Θεωρίας του Νου (ΘτΝ) ενώ για τις δοκιμασίες της Αντίληψης Συναισθημάτων (ΑΣ) δεν παρατηρείται διαφορά μεταξύ των ομάδων των ασθενών

Evidence for hypothalamus-pituitary-adrenal axis and immune alterations at prodrome of psychosis in males

We aimed to investigate the inflammatory substrate in psychosis by evaluating both the Hypothalamus-Pituitary-Adrenal axis function and immune state at prodrome. This involved the recruitment of Ultra High Risk (UHR) of Psychosis subjects, Healthy Controls (HC) and patients with established Schizophrenia (CHRON). Serum cortisol at 3 different times throughout the day was measured. The Dexamethasone Suppression Test was performed plus 12 circulating cytokines were measured. The UHR subjects presented increased IL-4 levels compared with both the HC and CHRON patients. In contrast the UHR differed only from the CHRON group regarding the endocrine parameters. In conclusion, IL-4 appears to play a key role at prodrome

Social cognition in the course of psychosis and its correlation with biomarkers in a male cohort

Patients diagnosed with schizophrenia display deficits in Theory of Mind (ToM) and Emotion Perception (EP) even before the appearance of full-blown symptomatology.; We evaluated ToM and EP in a male cohort consisting of 25 First Episode Psychosis (FEP) and 16 relapsed schizophrenic patients (CHRON) compared to 12 subjects in Ultra-high Risk (UHR) and 23 healthy controls (CTR). Furthermore, we measured the levels of Cortisol, Insulin like Growth Factor (IGF-1), TNF-a, TNF-b and several interleukins as potential biomarkers.; Deficits in EP and ToM were found in FEP, CHRON patients and UHR subjects compared to CTR. The impairments in these two domains seem to follow different patterns in the course of psychosis. EP was more impaired in subjects with a longer history of symptomatology whereas there was no statistically significant difference regarding ToM. On the other hand IL-4 was the only biomarker correlated to ToM and EP scores in two different samples of our study.; Social Cognition (SC) domains are impaired in patients with psychosis as well as in UHR subjects compared to healthy controls. There are differences in the progress of ToM and EP deficits in the course of psychosis. Interleukins as IL-4 could correlate to SC