"Selbstscreen-Prodrom" - ein Selbstbeurteilungsinstrument zur Früherkennung von psychischen Erkrankungen und Psychosen

OBJECTIVE: In the past years, the significance of early detection of psychoses has been increasingly recognized. Screening for the onset of disorders should focus on individuals seeking treatment in an outpatient setting and should preferably operate stepwise. Within a prospective study for the early detection of psychoses (FePsy = Früh Erkennung von PSYchosen) the self-rating instrument "Self-screen Prodrome" was developed to differentiate between healthy individuals, individuals with psychosis or an at-risk mental state for psychosis and patients with other ICD-10 diagnoses. METHOD: The "Self-screen Prodrome" was developed by taking established risk factors and early signs of disease into account. In particular, prodromes and pre-psychotic symptoms were captured. A total score and a subscale were analyzed with regard to validity and reliability. RESULTS: The total score "Self-screen Prodrome" distinguished between outpatients with a mental disorder and healthy individuals (Cut-off < or = 6; sensitivity: 85 % specificity: 91 %). Additionally the subscale distinguished between psychosis-(risk)-individuals and outpatients with other ICD-10 psychiatric diagnoses (Cut-off < or = 2; sensitivity: 85 % specificity: 39 %). CONCLUSION: The "Self-screen Prodrome" is a useful instrument that a) separates mentally ill patients from healthy individuals and b) filters individuals with a risk of developing psychoses from patients with other ICD-10 diagnoses for further screening. The next step in the early detection of psychoses for identified individuals should be a detailed psychiatric exploration by experts

Fine motor function and neuropsychological deficits in individuals at risk for schizophrenia

Deficits in fine motor function and neuropsychological performance have been described as risk factors for schizophrenia. In the Basel FEPSY study (Früherkennung von Psychosen; English: Early Detection of Psychosis) individuals at risk for psychosis were identified in a screening procedure (Riecher-Rössler et al. 2005). As a part of the multilevel assessment, 40 individuals at risk for psychosis and 42 healthy controls matched for age, sex and handedness were investigated with a fine motor function test battery and a neuropsychological test battery. Individuals at risk showed lower performances in all subtests of the fine motor function tests, predominantly in dexterity and velocity (wrist/fingers and arm/hand). In the neuropsychological test battery, individuals at risk performed less well compared to healthy controls regarding sustained attention, working memory and perseveration. The combined evaluation of the two test batteries (neuropsychological and fine motor function) separates the two groups into individuals at risk and healthy controls better than each test battery alone. A multilevel approach might therefore be a valuable contribution to detecting beginning schizophreni

Insular volume abnormalities associated with different transition probabilities to psychosis

Background Although individuals vulnerable to psychosis show brain volumetric abnormalities, structural alterations underlying different probabilities for later transition are unknown. The present study addresses this issue by means of voxel-based morphometry (VBM). Method We investigated grey matter volume (GMV) abnormalities by comparing four neuroleptic-free groups: individuals with first episode of psychosis (FEP) and with at-risk mental state (ARMS), with either long-term (ARMS-LT) or short-term ARMS (ARMS-ST), compared to the healthy control (HC) group. Using three-dimensional (3D) magnetic resonance imaging (MRI), we examined 16 FEP, 31 ARMS, clinically followed up for on average 3 months (ARMS-ST, n=18) and 4.5 years (ARMS-LT, n=13), and 19 HC. Results The ARMS-ST group showed less GMV in the right and left insula compared to the ARMS-LT (Cohen's d 1.67) and FEP groups (Cohen's d 1.81) respectively. These GMV differences were correlated positively with global functioning in the whole ARMS group. Insular alterations were associated with negative symptomatology in the whole ARMS group, and also with hallucinations in the ARMS-ST and ARMS-LT subgroups. We found a significant effect of previous antipsychotic medication use on GMV abnormalities in the FEP group. Conclusions GMV abnormalities in subjects at high clinical risk for psychosis are associated with negative and positive psychotic symptoms, and global functioning. Alterations in the right insula are associated with a higher risk for transition to psychosis, and thus may be related to different transition probabilitie

Abyssal Atlantic circulation during the Last Glacial Maximum: Constraining the ratio between transport and vertical mixing

The ocean’s role in regulating atmospheric carbon dioxide on glacial‐interglacial timescales remains an unresolved issue in paleoclimatology. Reduced mixing between deep water masses may have aided oceanic storage of atmospheric CO_2 during the Last Glacial Maximum (LGM), but data supporting this idea have remained elusive. The δ^(13)C of benthic foraminifera indicate the Atlantic Ocean was more chemically stratified during the LGM, but the nonconservative nature of δ^(13)C complicates interpretation of the LGM signal. Here we use benthic foraminiferal δ^(18)O as a conservative tracer to constrain the ratio of meridional transport to vertical diffusivity in the deep Atlantic. Our calculations suggest that the ratio was at least twice as large at the LGM. We speculate that the primary cause was reduced mixing between northern and southern component waters, associated with movement of this water mass boundary away from the zone of intense mixing near the seafloor. The shallower water mass boundary yields an order of magnitude increase in the volume of southern component water, suggesting its residence time may have increased substantially. Our analysis supports the idea that an expanded volume of Antarctic Bottom Water and limited vertical mixing enhanced the abyssal ocean’s ability to trap carbon during glacial times

Do Wealth and Inequality Associate with Health in a Small-Scale Subsistence Society?

In high-income countries, one’s relative socio-economic position and economic inequality may affect health and well-being, arguably via psychosocial stress. We tested this in a small-scale subsistence society, the Tsimane, by associating relative household wealth (n = 871) and community-level wealth inequality (n = 40, Gini = 0.15–0.53) with a range of psychological variables, stressors, and health outcomes (depressive symptoms [n = 670], social conflicts [n = 401], non-social problems [n = 398], social support [n = 399], cortisol [n = 811], body mass index [n = 9,926], blood pressure [n = 3,195], self-rated health [n = 2523], morbidities [n = 1542]) controlling for community-average wealth, age, sex, household size, community size, and distance to markets. Wealthier people largely had better outcomes while inequality associated with more respiratory disease, a leading cause of mortality. Greater inequality and lower wealth were associated with higher blood pressure. Psychosocial factors did not mediate wealth-health associations. Thus, relative socio-economic position and inequality may affect health across diverse societies, though this is likely exacerbated in high-income countries

Reverberation Mapping Measurements of Black Hole Masses in Six Local Seyfert Galaxies

We present the final results from a high sampling rate, multi-month, spectrophotometric reverberation mapping campaign undertaken to obtain either new or improved Hbeta reverberation lag measurements for several relatively low-luminosity AGNs. We have reliably measured thetime delay between variations in the continuum and Hbeta emission line in six local Seyfert 1 galaxies. These measurements are used to calculate the mass of the supermassive black hole at the center of each of these AGNs. We place our results in context to the most current calibration of the broad-line region (BLR) R-L relationship, where our results remove outliers and reduce the scatter at the low-luminosity end of this relationship. We also present velocity-resolved Hbeta time delay measurements for our complete sample, though the clearest velocity-resolved kinematic signatures have already been published.Comment: 52 pages (AASTeX: 29 pages of text, 8 tables, 7 figures), accepted for publication in the Astrophysical Journa