Total serum cholesterol levels and suicide attempts in child and adolescent psychiatric inpatients

Associations between cholesterol and suicidal behavior in adolescent patients have not been explored in depth. In this study, 66 patients consecutively admitted to a psychiatric inpatient unit following attempted suicide were compared with a control group of 54 patients with no history of suicide attempts. The age range of the sample was from 8 to 18 years old. Cholesterol levels were significantly lower in attempted suicide patients than in controls (p < 0.02), supporting the hypothesis that lower cholesterol levels might be associated with suicidal behavior in patients with similar acute phase of their disorder

Verbal Memory and IQ Predict Adaptive Behavior in Children and Adolescents with High-Functioning Autism Spectrum Disorders

Adaptive deficits are commonly found in high functioning autism spectrum disorders (HF-ASD) despite of cognitive potential. Most studies have focused on the relationships between adaptive behavior and intellectual quotient (IQ) and have used correlations to study relationships between them. Few studies have analyzed cognitive variables other than IQ as potential predictors of adaptive behavior in HF-ASD using regression methods. This study aimed to analyze the impact of several cognitive variables on adaptive behavior in a sample of children and adolescents with HF-ASD. METHODS: Sample included 16 child and adolescent boys with HF-ASD (age between 7-17 years). Cognitive assessment included measures of general intelligence, visual memory, verbal memory, working memory and problem solving/flexibility tests. Vineland Adaptive Behavior Scales (VABS) was used to evaluate adaptive behavior. To establish the predictive capacity of the cognitive variables for adaptive functioning, linear regression models were fitted for each adaptive domain using a stepwise method. RESULTS: Verbal memory and IQ emerged as the main independent predictors for VABS adaptive scores. The 41% of the variance in Communication was predicted by IQ. The 35% of the variance in Daily Living Skills was predicted by verbal memory. Almost half of the variance in Socialization was predicted by both, verbal memory and IQ (49%). No other cognitive functions were associated with adaptive scores. CONCLUSIONS: The results highlight the strong impact of IQ and verbal memory on adaptive behavior in HF-ASD patients. These findings could contribute to identify potential targets of intervention

Psychometric properties of the Spanish version of the Passion Scale

Background: Passion has been shown to be involved in psychological processes that emerge in diverse human activities like physical activity and sports, work, leisure, videogaming, pathological gambling, and interpersonal relationships. We aimed to present evidence of validity and internal consistency of the Passion Scale in Spanish based on the Dualistic Model of Passion, comprising harmonious and obsessive dimensions. Method: The sample comprised 1,007 participants (350 females and 657 males), aged 16-65 (Md= 30.0 years). Exploratory Structural Equation Modeling (ESEM), measurement invariance and Multiple-Cause-Multiple-Indicator models (MIMIC) were used. Results: Fit for the ESEM 2-factor solution was acceptable. Near full or partial measurement invariance across sex, type of activity, and age was supported. Relationships between both harmonious and obsessive dimensions and the external variables considered (age, sex, and criterion items) reasonably replicated those found in previous studies. Both scale scores showed adequate internal consistency (α = .81). Conclusions: Empirical evidence for the validity and internal consistency of the Spanish version of the Passion Scale is satisfactory and reveals that the scale is comparable to the English and French versions. Therefore, the Passion Scale can be used in research conducted in SpanishAntecedentes: la pasión es uno de los elementos de los diversos procesos psicológicos presentes en diversas actividades como la actividad física, el deporte, el ocio, el trabajo y las relaciones interpersonales. El objetivo del estudio fue presentar evidencias de validez y fiabilidad de la versión española de la Escala de la Pasión, basada en el modelo dual de la pasión que comprende las dimensiones armoniosa y obsesiva. Método: participaron 1.007 personas (350 mujeres y 657 hombres) de 16-65 años (Md= 30). Se usó modelado de ecuaciones estructurales exploratorio (ESEM), invariancia factorial y modelos de múltiples-indicadores-múltiples-causas (MIMIC). Resultados: el ajuste de la solución de 2 factores con ESEM fue aceptable. Se obtuvo invariancia casi completa o parcial en función del sexo, el tipo de actividad y la edad. Las relaciones entre ambas dimensiones armoniosa y obsesiva y las variables externas consideradas (edad, sexo e ítems criterio) replicaron razonablemente los resultados de estudios previos. Ambas puntuaciones mostraron una consistencia interna adecuada (α = .81). Conclusiones: las evidencias de validez y consistencia interna halladas con la versión española de la Escala de la Pasión son satisfactorias y muestran que la escala es comparable a las versiones inglesa y francesa, pudiéndose usar en investigaciones realizadas en castellan

Development and psychometric properties of the Suicidality:Treatment Occurring in Paediatrics (STOP) Suicidality Assessment Scale (STOP-SAS) in children and adolescents

Background: To create a self-reported, internet-based questionnaire for the assessment of suicide risk in children and adolescents.Methods: As part of the EU project `Suicidality: Treatment Occurring in Paediatrics' (STOP project), we developed web-based Patient Reported Outcome Measures (PROMs) for children and adolescents and for proxy reports by parents and clinicians in order to assess suicidality. Based on a literature review, expert panels and focus groups of patients, we developed the items of the STOP Suicidality Assessment Scale (STOP-SAS) in Spanish and English, translated it into four more languages, and optimized it for web-based presentation using the HealthTracker (TM) platform. Of the total 19 questions developed for the STOP-SAS, four questions that assess low-level suicidality were identified as screening questions (three of them for use with children, and all four for use with adolescents, parents and clinicians). A total of 395 adolescents, 110 children, 637 parents and 716 clinicians completed the questionnaire using the HealthTracker (TM), allowing us to evaluate the internal consistency and convergent validity of the STOP-SAS with the clinician-rated Columbia Suicide Severity Rating Scale (C-SSRS). Validity was also assessed with the receiver operating characteristic (ROC) area of the STOP-SAS with the C-SSRS.Results: The STOP-SAS comprises 19 items in its adolescent, parent, and clinician versions, and 14 items in its children's version. Good internal consistency was found for adolescents (Cronbach's alpha: 0.965), children (Cronbach's alpha: 0.922), parents (Cronbach's alpha: 0.951) and clinicians (Cronbach's alpha: 0.955) versions. A strong correlation was found between the STOP-SAS and the C-SSRS for adolescents (r:0.670), parents (r:0.548), clinicians (r:0.863) and children (r:0.654). The ROC area was good for clinicians' (0.917), adolescents' (0.834) and parents' (0.756) versions but only fair (0.683) for children's version.Conclusions: The STOP-SAS is a comprehensive, web-based PROM developed on the HealthTracker (TM) platform, and co-designed for use by adolescents, children, parents and clinicians. It allows the evaluation of aspects of suicidality and shows good reliability and validity.</p

Evolution of metabolic risk factors over a two-year period in a cohort of first episodes of psychosis

Patients with a first episode of psychosis (FEP) display a broad range of metabolic risk factors related to the development of diverse medical comorbidities. Initial stages of these disorders are essential in understanding the increased vulnerability of developing cardiometabolic disturbances, associated with a reduced life expectancy. This study aimed to evaluate the metabolic profile of a cohort of patients with a FEP and its evolution during a two year follow-up, as well as the factors that influence the changes in their metabolic status. 16 participating centers from the PEPs Project recruited 335 subjects with a FEP and 253 matched healthy controls, aged 9–35 years. We investigated a set of anthropometric measures, vital signs and laboratory data obtained from each participant over two years in a prospective, naturalistic study. From the beginning of the study the FEP group showed differences in the metabolic profile compared to the control group, together with a progressive worsening in the major part of the analyzed variables during the follow-up period, with higher rates of obesity and metabolic syndrome. Certain risk factors were related to determinate clinical variables such as male gender, the presence of affective symptoms or an early onset or to treatment variables such as the use of antipsychotic polypharmacy, antidepressants or mood stabilizers. Our results highlight the extremely high risk of patients at early phases of schizophrenia and other psychotic disorders of developing cardiovascular comorbidity and the fast worsening of the metabolic profile during the first two years

Relationship between cognition and age at onset of first-episode psychosis: comparative study between adolescents, young adults, and adults

Psychotic disorders typically manifest from late adolescence to early adulthood, and an earlier onset might be associated with greater symptom severity and a worse long-term prognosis. This study aimed to compare the cognitive characteristics of patients with first-episode psychosis (FEP) by their age at onset. We included 298 patients diagnosed with FEP and classified them as having an early onset (EOS), youth onset (YOS), or adult onset (AOS) based on age limits of = 25 years (N = 116), respectively. Socio-demographic and clinical variables included age at baseline, gender, socio-economic status, antipsychotic medication, DSM-IV diagnoses assessed by clinical semi-structured interview, psychotic symptom severity, and age at onset. Neuropsychological assessment included six cognitive domains: premorbid intelligence, working memory, processing speed, verbal memory, sustained attention, and executive functioning. The EOS group had lower scores than the YOS or AOS groups in global cognition, executive functioning, and sustained attention. Although the scores in the YOS group were intermediate to those in the EOS and AOS groups for most cognitive factors, no statistically significant differences were detected between the YOS and AOS groups. Age at onset results in specific patterns of cognitive interference. Of note, impairment appears to be greater with EOS samples than with either YOS or AOS samples. A longitudinal study with a larger sample size is needed to confirm our findings

EPA-0882 - Prediction of diagnosis of early-onset schizophrenia spectrum disorders using support vector machines

To develop a Support Vector Machine (SVM) algorithm as a predictive tool for diagnostic outcome in patients with FE-EOP, based on clinical and biomedical data at the emergence of the illness

Cortical thinning over two years after first-episode psychosis depends on age of onset.

[EN] First-episode psychosis (FEP) patients show structural brain abnormalities at the first episode. Whether the cortical changes that follow a FEP are progressive and whether age at onset modulates these changes remains unclear. This is a multicenter MRI study in a deeply phenotyped sample of 74 FEP patients with a wide age range at onset (15-35 years) and 64 neurotypical healthy controls (HC). All participants underwent two MRI scans with a 2-year follow-up interval. We computed the longitudinal percentage of change (PC) for cortical thickness (CT), surface area (CSA) and volume (CV) for frontal, temporal, parietal and occipital lobes. We used general linear models to assess group differences in PC as a function of age at FEP. We conducted post-hoc analyses for metrics where PC differed as a function of age at onset. We found a significant age-by-diagnosis interaction effect for PC of temporal lobe CT (d=0.54; p=002). In a post-hoc-analysis, adolescent-onset (≤19y) FEP showed more severe longitudinal cortical thinning in the temporal lobe than adolescent HC. We did not find this difference in adult-onset FEP compared to adult HC. Our study suggests that, in individuals with psychosis, CT changes that follow the FEP are dependent on the age at first episode, with those with an earlier onset showing more pronounced cortical thinning in the temporal lobe.We are extremely grateful to all subjects who took part in this study. This work was supported by CIBERSAM; Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (PI081203, PI08/0208; PI11/00325; PI1101686, PI14/00612, PI17/01997, PI20/01342), co‐financed by the ERDF from the European Commission “A way of making Europe”, European Union Seventh Framework Program (FP7- HEALTH-2013-2.2.1-2-603196 [Project PSYSCAN]), EU H2020 (IMI‐2 Joint Undertaking under grant agreements 115916 (project PRISM) and 777394 (project AIMS‐2‐TRIALS)), Madrid Regional Government (S2017/BMD‐3740, and AGES-CM-2-CM) and European Union Structural Funds; Fundación Familia Alonso, Fundacion Mutua Madrileña, and Fundación Alicia Koplowitz

Metabolic polygenic risk scores effect on antipsychotic-induced metabolic dysregulation: A longitudinal study in a first episode psychosis cohort

[EN] Objective: Metabolic syndrome is a health-threatening condition suffered by approximately one third of schizophrenia patients and largely attributed to antipsychotic medication. Previous evidence reports a common genetic background of psychotic and metabolic disorders. In this study, we aimed to assess the role of polygenic risk scores (PRSs) on the progression of the metabolic profile in a first-episode psychosis (FEP) cohort. Method: Of the 231 FEP individuals included in the study, 192-220 participants were included in basal analysis and 118-179 in longitudinal 6-month models. Eleven psychopathologic and metabolic PRSs were constructed. Basal and longitudinal PRSs association with metabolic measurements was assessed by statistical analyses.Results: No major association of psychopathological PRSs with the metabolic progression was found. However, high risk individuals for depression and cholesterol-related PRSs reported a higher increase of cholesterol levels during the follow-up (FDR <= 0.023 for all analyses). Their effect was comparable to other well-established pharmacological and environmental risk factors (explaining at least 1.2% of total variance).Conclusion: Our findings provide new evidence of the effects of metabolic genetic risk on the development of metabolic dysregulation. The future establishment of genetic profiling tools in clinical procedures could enable practitioners to better personalize antipsychotic treatment selection and dosage

Cortical thinning over two years after first-episode psychosis depends on age of onset

First-episode psychosis (FEP) patients show structural brain abnormalities at the first episode. Whether the cortical changes that follow a FEP are progressive and whether age at onset modulates these changes remains unclear. This is a multicenter MRI study in a deeply phenotyped sample of 74 FEP patients with a wide age range at onset (15-35 years) and 64 neurotypical healthy controls (HC). All participants underwent two MRI scans with a 2-year follow-up interval. We computed the longitudinal percentage of change (PC) for cortical thickness (CT), surface area (CSA) and volume (CV) for frontal, temporal, parietal and occipital lobes. We used general linear models to assess group differences in PC as a function of age at FEP. We conducted post-hoc analyses for metrics where PC differed as a function of age at onset. We found a significant age-by-diagnosis interaction effect for PC of temporal lobe CT (d = 0.54; p = 002). In a post-hoc-analysis, adolescent-onset (≤19 y) FEP showed more severe longitudinal cortical thinning in the temporal lobe than adolescent HC. We did not find this difference in adult-onset FEP compared to adult HC. Our study suggests that, in individuals with psychosis, CT changes that follow the FEP are dependent on the age at first episode, with those with an earlier onset showing more pronounced cortical thinning in the temporal lobe