The effect of task difficulty on decision-making: Differences between obsessive–compulsive disorder and non-affective psychosis

The aim was to determine whether there are differences between groups in jumping to conclusions and the number of beads required to make a decision based on task difficulty. An assessment was made of 19 patients with non-affective psychosis, 19 with obsessive–compulsive disorder (OCD), and 19 healthy controls. The Beads Task scale was used in its two versions. Patients with non-affective psychosis jumped to conclusions. There was significant interaction between group and task difficulty. Increased difficulty of the task did not affect the number of beads patients with non-affective psychosis or OCD needed to make their decision. However, healthy controls needed to see more beads before they could make a decision in the hard test than in the easy one. Patients with non-affective psychosis jump to conclusions, but neither this group nor the OCD patients benefit from the changes in task difficulty when making their decisions

Pleasant and unpleasant ideas of reference and their relation to psychopathology

En trabajos previos registramos la presencia de ideas de referencia con la escala REF de pensamiento referencial. Las diferencias entre pacientes y controles son claras, no siendo así entre categorías diagnósticas, exceptuando los casos de trastornos psicóticos. Objetivos: Nos proponemos verificar si las diferencias entre pacientes y controles se deben a la presencia de autorreferencias agradables (AA) y desagradables (AD) y, especialmente, al considerar los diversos grupos de diagnósticos. Método: Participaron 1600 sujetos, 1245 de población general y 355 pacientes, 63.3% mujeres. Resultados: Se observan diferencias significativas entre pacientes y controles tanto para las AA F (1, 1598)= 62.31 como AD F (1, 1598)= 99.47. Cuando se analizan las categorías diagnósticas, se hallan diferencias en el promedio de AD F (7, 347)= 2.770 y AA F (7, 347)= 3.870, destacando los pacientes psicóticos. Discusión: Los pacientes psicóticos únicamente se diferenciaron de los pacientes con trastornos adaptativos al considerar las AD, y de los trastornos del estado de ánimo, de ansiedad y adaptativos al considerar las AA.In previous works we recorded the presence of ideas of reference (or self-references) with the REF-scale about referential thinking. The differences between patients and controls are clear, but not so clearly between diagnostic categories, except for psychotic disorders. Aims: We try to verify whether the differences between patients and controls are due to the presence of pleasant self-references (PS) or unpleasant self-references (US) and, especially, considering the different diagnostic groups. Method: 1600 subjects participated, 1245 from general population and 355 patients, 63.3% were women. Results: We obtained significant differences between patients and controls, both PS, F (1, 1598) = 62.31, and US, F (1, 1598) = 99.47. When analyzing the diagnostic categories, differences were obtained in mean of US, F (7, 347) = 2.770, and PS, F (7, 347) = 3.870, highlighting psychotic patients. Discussion: Psychotic patients reached statistically significant differences only with adjustment disorders patients, when considering US; and mood disorders, anxiety and adjustment disorders, when considering PS

Predictors of referential thinking: analyses of clinical subjects and controls

Antecedentes: El pensamiento referencial (PR) es una característica común de la actividad mental humana. En psicopatología, el PR se suele asociar a las psicosis. Este estudio analiza las diferencias en PR (auto-referencias, AR) entre una muestra clínica y de control. Se identifican variables que predicen el PR. Método: 120 adultos (70 pacientes, y 50 controles de población general), edad media: 34.49 años (DE: 10.63); 60% mujeres. Resultados: El número de AR entre los pacientes, especialmente entre los diagnosticados de psicosis, fue significativamente mayor que entre los controles. No hubo diferencias significativas en el PR de pacientes con diagnósticos del Eje II, o con diagnósticos en diferentes ejes. Las variables predictivas de AR son: pensamiento psicótico (inventario de personalidad MCMI-II, trastornos del pensamiento), desorganización conceptual (escala psiquiátrica BPRS), edad, y vulnerabilidad para las alteraciones anímicas (escala DAS). Estas variables de estado y rasgo representaron el 56.4% de la varianza del PR. Conclusiones: Hubo más diferencias entre pacientes y controles en frecuencia de AR que de contenido (el PR tiene lugar en un continuo). El PR puede ser tanto una manifestación de estado (con un efecto aditivo de psicopatologías), como de rasgo (característica de los procesos psicóticos y posiblemente asociado a la vulnerabilidad para las alteraciones anímicas)

COVID-19 as a unique opportunity to unravel the link between prenatal maternal infection, brain development and neuropsychiatric disorders in offspring

Study of the effects of prenatal maternal infection on early offspring brain development has long attracted the interest and endeavors of clinicians and neuroscientists.1 Early reports on large-scale ecological data and further birth cohort studies analyzing biomarkers in pregnancy and early life of offspring have yielded evidence that in-utero exposure to infection increases neuropsychiatric disorder risk, particularly schizophrenia and autism spectrum disorders.2, 3, 4 The main hypothesis derived from these studies is that activation of immune-inflammatory pathways during maternal infection may result in abnormal fetal brain development.5 However, such a hypothesis requires detailed testing to reveal the pathogenic and pathophysiological mechanisms behind these neurodevelopmental alterations

Relations between positive psychotic symptoms and ideas of reference observation and communication

The ideas of reference (IOR) are observable in varied psychopathological manifestations, although predominate in psychotic disorders. We tried to study the IOR according to their content (observation, communication, and other IOR). We tried to determine if these kinds of IOR are separable, and also to observe their relationship with some positive symptoms. Participated 364 patients (39 participants with schizophrenia and other psychotic disorders). The instruments used were the Referential Thinking Scale (REF) and BPRS rating-scale. Statistically significant differences between the observation and communication IOR were found, and also between the communication IOR and other IOR. Significant positive correlations between observation IOR and grandiosity were reached, and between observation IOR and suspicion (persecution delusion in BPRS). The observation IOR are rather indicator of delusional severity in general than a specific content of psychopathology, and this kind of IOR are not restricted to the persecutory delusions

Association Between Specific Childhood Adversities and Symptom Dimensions in People With Psychosis: Systematic Review and Meta-Analysis

Despite the accepted link between childhood abuse and positive psychotic symptoms, findings between other ad versities, such as neglect, and the remaining dimensions in people with psychosis have been inconsistent, with evidence not yet reviewed quantitatively. The aim of this study was to systematically examine quantitatively the association between broadly defined childhood adversity (CA), abuse (sexual/physical/emotional), and neglect (physical/emo tional) subtypes, with positive, negative, depressive, manic, and disorganized dimensions in those with psychosis. A search was conducted across EMBASE, MEDLINE, PsychINFO, and Cochrane Libraries using search terms related to psychosis population, CA, and psychopatholog ical dimensions. After reviewing for relevance, data were extracted, synthesized, and meta-analyzed. Forty-seven papers were identified, including 7379 cases across 40 studies examining positive, 37 negative, 20 depressive, 9 disorganized, and 13 manic dimensions. After adjustment for publication bias, general adversity was positively as sociated with all dimensions (ranging from r = 0.08 to r = 0.24). Most forms of abuse were associated with de pressive (ranging from r = 0.16 to r = 0.32), positive (ran ging from r = 0.14 to r = 0.16), manic (r = 0.13), and negative dimensions (ranging from r = 0.05 to r = 0.09), while neglect was only associated with negative (r = 0.13) and depressive dimensions (ranging from r = 0.16 to r = 0.20). When heterogeneity was found, it tended to be explained by one specific study. The depressive dimension was influenced by percentage of women (ranging from r = 0.83 to r = 1.36) and poor-quality scores (ranging from r = −0.21 and r = −0.059). Quality was judged as fair overall. Broadly defined adversity and forms of abuse increase transdimensional severity. Being exposed to ne glect during childhood seems to be exclusively related to negative and depressive dimensions suggesting specific effects

Evaluación del sexismo ambivalente en las y los profesionales de la red de salud mental de Andalucía. Resultados preliminares

Una línea de investigación clave actualmente en Psicología es el estudio del constructo sexismo que aparece relacionado con factores de riesgo psicosocial y de salud en población femenina general. El objetivo de nuestra investigación se dirige al análisis del sexismo ambivalente (hostil y benévolo) en profesionales de salud mental pública de Andalucía mediante un estudio correlacional en una muestra de 945 profesionales, analizando la relación entre sexismo ambivalente y algunas características sociodemográficas, laborales y profesionales. Los resultados mostraron puntuaciones bastantes bajas en sexismo (inferiores a las encontradas en otros estudios) así como diferencias de género significativas tanto en sexismo hostil como benévolo, siendo más sexistas los hombres. De todas las profesiones de la red de salud mental, la Psicología Clínica se mostró como la menos sexista. No se encontraron diferencias significativas en sexismo en función del Modelo Teórico, salvo en quienes usaron Perspectiva de Género, que aparecieron como menos sexistas. Se encontró que a mayor sexismo menor detección de problemas relacionados con la desigualdad de género en la consulta, pero no se encontró relación entre sexismo y formación recibida en Perspectiva de Género.A currently very important line of research in psychology is about Ambivalent Sexism (that has two sub-components: hostile sexism –SH- and benevolent sexism –SB-). This construct appears related to health and psychosocial risk factors in the general female population. This research aims to investigate the relationship between the ambivalent sexism and some features of the professionals of mental health in Andalusia. Using a correlational methodology, we examined the relationship between sexism and some socio-demographic and labor characteristics of 415 professionals working in public mental health services in Andalusia. The results showed that scores in both types of sexism were quite low (less than those found in other studies), and significant differences were found between men and women in sexism (men scored higher on both types of sexism). Of all the network of mental health professions, clinical psychology seems the less sexist. No significant differences were found in sexism depending on the theoretical model (c-behavioural, psychoanalysis, systemic…), except with those who adopted a gender perspective, which appeared as less sexist. Finally, sexism was negatively related to the detection of problems associated with gender in the consultation, but not with training in gender issues

Aripiprazole as a Candidate Treatment of COVID-19 Identified Through Genomic Analysis

Background: Antipsychotics modulate expression of inflammatory cytokines and inducible inflammatory enzymes. Elopiprazole (a phenylpiperazine antipsychotic drug in phase 1) has been characterized as a therapeutic drug to treat SARS-CoV-2 infection in a repurposing study. We aim to investigate the potential effects of aripiprazole (an FDA approved phenylpiperazine) on COVID-19-related immunological parameters. Methods: Differential gene expression profiles of non-COVID-19 vs. COVID-19 RNA-Seq samples (CRA002390 project in GSA database) and drug-naïve patients with non-affective psychosis at baseline and after three months of aripiprazole treatment were identified. An integrative transcriptomic analyses of aripiprazole effects on differentially expressed genes in COVID-19 patients was performed. Findings: 82 out the 377 genes (21.7%) with expression significantly altered by aripiprazole have also their expression altered in COVID-19 patients and in 93.9% of these genes their expression is reverted by aripiprazole. The number of common genes with expression altered in both analyses is significantly higher than expected (Fisher?s Exact Test, two tail; p value = 3.2e-11). 11 KEGG pathways were significantly enriched with genes with altered expression both in COVID-19 patients and aripiprazole medicated non-affective psychosis patients (p adj<0.05). The most significant pathways were associated to immune responses and mechanisms of hyperinflammation-driven pathology (i.e.,?inflammatory bowel disease (IBD)? (the most significant pathway with a p adj of 0.00021), ?Th1 and Th2 cell differentiation? and ?B cell receptor signaling pathway?) that have been also associated with COVID19 clinical outcome. Interpretation: This exploratory investigation may provide further support to the notion that a protective effect is exerted by aripiprazole (phenylpiperazine) by modulating the expression of genes that have shown to be altered in COVID-19 patients. Along with many ongoing studies and clinical trials, repurposing available medications could be of use in countering SARS-CoV-2 infection, but require further studies and trials.Funding: The present study was part of a larger prospective longitudinal study, the “First Episode Psychosis Clinical Program 10” (PAFIP10) study. ClinicalTrials.gov Identifiers: NCT02200588, NCT03481465, and NCT03476473. No pharmaceutical industry or institutional sponsors participated in the study conception and design, data collection, analysis and interpretation of the results, or drafting of the manuscript. This work was supported by: SAF2016- 76046-R and SAF2013-46292-R (MINECO and FEDER) to B.C.F.Acknowledgments: We are highly indebted to the participants and their families for their cooperation in this study. We also thank IDIVAL biobank (Ines Santiuste and Jana Arozamena) for clinical samples and ́ data as well as the PAFIP members (Marga Corredera) for the data collection. We kindly thank all clinical staff at the Hospital Universitario Virgen del Rocio for support to collect clinical records and provide clinical care to COVID-19 patients. We also kindly thank Dra. Marisa Barrigon for helpful discussions regarding clinical data analysis, and Idalino Rocha for manuscript editing and formatting. This manuscript has been released as a pre-print at medRxiv. Available at: https://doi.org/ 10.1101/2020.12.05.20244590 (Crespo-Facorro et al., 2020)

Aripiprazole vs Risperidone Head-to-Head Effectiveness in First-Episode Non-Affective-Psychosis: A 3-Month Randomized, Flexible-Dose, Open-Label Clinical Trial

Background: Antipsychotic choice for the acute phase of a first episode of psychosis (FEP) is of the utmost importance since it may influence long-term outcome. However, head-to-head comparisons between second-generation antipsychotics remain scarce. The aim of this study was to compare the effectiveness in the short term of aripiprazole and risperidone after FEP outbreak. Methods: From February 2011 to October 2018, a prospective, randomized, open-label study was undertaken. Two hundred-sixty-six first-episode drug-naïve patients were randomly assigned to aripiprazole (n = 136) or risperidone (n = 130) and followed-up for 12 weeks. The primary effectiveness measure was all-cause treatment discontinuation. In addition, an analysis based on intention-to-treat principle was conducted to assess clinical efficacy. Results: The overall dropout rate at 12 weeks was small (6.39%). Effectiveness measures were similar between treatment arms as treatment discontinuation rates (? 2 = 0,409; P = .522), and mean time to all-cause discontinuation (log rank ? 2 = -1.009; P = .316) showed no statistically significant differences. Despite no statistically significant differences between groups regarding clinical efficacy, aripiprazole required higher chlorpromazine equivalent dosage (? 2 = 2.160; P = .032) and extended mean time (W = 8183.5; P = .008) to reach clinical response. Sex-related adverse events and rigidity were more frequent in the risperidone group, whereas sialorrhea was on the aripiprazole group. Conclusions: No differences regarding effectiveness were found between aripiprazole and risperidone for the short-phase treatment of FEP. Despite the importance of efficacy during this phase, differences in side effect profiles and patient's preferences are essential factors that may lead clinical decisions for these patients

Longitudinal trajectories in negative symptoms and changes in brain cortical thickness: 10-year follow-up study

Background Understanding the evolution of negative symptoms in first-episode psychosis (FEP) requires long-term longitudinal study designs that capture the progression of this condition and the associated brain changes. Aims To explore the factors underlying negative symptoms and their association with long-term abnormal brain trajectories. Method We followed up 357 people with FEP over a 10-year period. Factor analyses were conducted to explore negative symptom dimensionality. Latent growth mixture modelling (LGMM) was used to identify the latent classes. Analysis of variance (ANOVA) was conducted to investigate developmental trajectories of cortical thickness. Finally, the resulting ANOVA maps were correlated with a wide set of regional molecular profiles derived from public databases. Results Three trajectories (stable, decreasing and increasing) were found in each of the three factors (expressivity, experiential and attention) identified by the factor analyses. Patients with an increasing trajectory in the expressivity factor showed cortical thinning in caudal middle frontal, pars triangularis, rostral middle frontal and superior frontal regions from the third to the tenth year after the onset of the psychotic disorder. The F-statistic map of cortical thickness expressivity differences was associated with a receptor density map derived from positron emission tomography data. Conclusions Stable and decreasing were the most common trajectories. Additionally, cortical thickness abnormalities found at relatively late stages of FEP onset could be exploited as a biomarker of poor symptom outcome in the expressivity dimension. Finally, the brain areas with less density of receptors spatially overlap areas that discriminate the trajectories of the expressivity dimension.Funding: This work was supported by the Instituto de Salud Carlos III (PI14/00639 and PI14/00918) and Fundación Instituto de Investigación Marqués de Valdecilla (NCT0235832 and NCT02534363). M.C.-R. acknowledges funding support from the Consejería de Salud y Familias (Junta de Andalucía) 2020 grant, which covers his salary (RH-0081 2020). R.R.-G. is funded by the EMERGIA Junta de Andalucía programme (EMERGIA20_00139) and the Plan Propio of the University of Seville