Olanzapine compared to quetiapine in adolescents with a first psychotic episode

Objective: To compare the efficacy, safety, and tolerability of olanzapine and quetiapine in adolescents with first episode psychosis. Method: Fifty adolescents (age 16 ± 1.25) with a first episode of psychosis were randomized to quetiapine or olanzapine in a 6-month open label study. Efficacy and side effect scales, as well as vital signs and laboratory data were recorded at baseline, 7, 15, 30, 90, and 180 days (end of study). Results: Out of the total sample included in the study, 32 patients completed the trial (quetiapine n = 16, olanzapine n = 16). Patients in both treatment groups had a significant reduction in all clinical scales with the exception of the negative scale of the Positive and Negative Symptom Scale (PANSS) for olanzapine and the general psychopathology scale of the PANSS for quetiapine. The only difference between treatment arms on the clinical scales was observed on the patients' strength and difficulties questionnaire (SDQ) scale, with greater improvement for olanzapine. Patients on olanzapine gained 15.5 kg and patients on quetiapine gained 5.5 kg. Conclusion: Olanzapine and quetiapine reduced psychotic symptoms in this adolescent sample. Patients on olanzapine gained significantly more weight. Side effects with both drugs seemed to be more prevalent than those reported in adult studies

Relación entre empleo y bienestar emocional en personas con trastorno mental grave

Las personas con un diagnóstico de trastorno mental grave (TMG) tienen tasas de desempleo notablemente superiores a las de la población general. Esto se asocia con mayor riesgo de exclusión social y de marginalidad, y favorece la cronicidad de las dificultades personales y sociales. Este estudio observacional pretende evaluar la relación entre el empleo y el estado emocional subjetivo en personas con TMG. El estudio incluyó 744 participantes (304 con TMG usuarias de recursos de rehabilitación psicosocial, 168 personas con TMG con empleo protegido y 272 personas sin TMG con empleo ordinario), con una edad media de 41.9 años y 50.1% mujeres. De los 744 participantes, 577 (77.6%) tuvieron empleo remunerado (409 (60.9%) empleo ordinario y 168 (29.1%) empleo protegido); 244 (32.8%) comunicaron que tenían un diagnóstico de psicosis y 400 (53.8%) que tenían reconocida la discapacidad. Las personas con empleo tuvieron mejores valores de bienestar psicológico subjetivo (p=0.013) que las personas sin empleo, independientemente del diagnóstico o de la discapacidad. Sin embargo, no hubo diferencias significativas en bienestar psicológico subjetivo entre las personas con empleo ordinario y con empleo protegido (p=0.687). Como conclusión, las personas con empleo remunerado tuvieron mayor bienestar psicológico subjetivo que las personas sin empleo, independientemente del diagnóstico, de la discapacidad o de que el empleo fuera ordinario o protegido

The role of depression in the prediction of a "late" remission in first-episode psychosis:An analysis of the OPTiMiSE study

Objective: The identification of predictors of psychosis remission could guide early clinical decision-making for treatment of first-episode schizophrenia (FES). Methods: We analyzed two non-independent subsamples of patients with FES ages 18-40 years from the OPTiMiSE study dataset to investigate the demographic and clinical factors that might help to differentiate "late" re-mitters (i.e., not in remission at week 2 or 4, but achieving remission within a 10-week follow-up period) from non-remitters within the same period. Results: Subsample 1 included 216 individuals (55 females, mean age 25.9 years) treated with amisulpride in an open-label design who were not in remission at week 2. Early symptomatic response between baseline and week 2 (odds ratio (OR)- 4.186, 95% confidence interval (CI)- 2.082-8.416, p < 0.001) and older age (OR- 1.081, 95% = CI 1.026-1.138, p- 0.003) were the only variables significantly associated with a higher probability of psychosis remission at week 4. Subsample 2 was composed of the 72 participants (19 females, mean age 25.1 years) who were not in remission at week 4 and completed a 6-week double-blind randomized trial comparing continuation of amisulpride with switch to olanzapine. Depression at baseline (as measured with the Calgary Depression Scale for Schizophrenia) was significantly associated with a nearly 3-fold lower likelihood of psychosis remission during the 10-week follow-up (hazard ratio = 2.865, 95% CI = 1.187-6.916, p = 0.019). Conclusion: Our results reinforce the importance of assessing depressive symptoms in people with FES and support the relevance of an early response (as early as 2 weeks) as a predictor of clinical outcome in this population. (C) 2021 Elsevier B.V. All rights reserved

Chemi-Structural Stabilization of Formamidinium Lead Iodide Perovskite by Using Embedded Quantum Dots

The approaches to stabilize the perovskite structure of formamidinium lead iodide (FAPI) commonly result in a blue shift of the band gap, which limits the maximum photoconversion efficiency. Here, we report the use of PbS colloidal quantum dots (QDs) as a stabilizing agent, preserving the original low band gap of 1.5 eV. The surface chemistry of PbS plays a pivotal role by developing strong bonds with the black phase but weak ones with the yellow phase. As a result, a stable perovskite FAPI black phase can be formed at temperatures as low as 85 °C in just 10 min, setting a record of concomitantly fast and low-temperature formation for FAPI, with important consequences for industrialization. FAPI thin films obtained through this procedure reach an open-circuit potential (Voc) of 1.105 V, 91% of the maximum theoretical Voc, and preserve the efficiency for more than 700 h. These findings reveal the potential of strategies exploiting the chemi-structural properties of external additives to relax the tolerance factor and optimize the optoelectronic performance of perovskite materials

Fronto-Parietal Gray Matter Volume Loss Is Associated with Decreased Working Memory Performance in Adolescents with a First Episode of Psychosis.

Cognitive maturation during adolescence is modulated by brain maturation. However, it is unknown how these processes intertwine in early onset psychosis (EOP). Studies examining longitudinal brain changes and cognitive performance in psychosis lend support for an altered development of high-order cognitive functions, which parallels progressive gray matter (GM) loss over time, particularly in fronto-parietal brain regions. We aimed to assess this relationship in a subsample of 33 adolescents with first-episode EOP and 47 matched controls over 2 years. Backwards stepwise regression analyses were conducted to determine the association and predictive value of longitudinal brain changes over cognitive performance within each group. Fronto-parietal GM volume loss was positively associated with decreased working memory in adolescents with psychosis (frontal left (B = 0.096, p = 0.008); right (B = 0.089, p = 0.015); parietal left (B = 0.119, p = 0.007), right (B = 0.125, p = 0.015)) as a function of age. A particular decrease in frontal left GM volume best predicted a significant amount (22.28%) of the variance of decreased working memory performance over time, accounting for variance in age (14.9%). No such association was found in controls. Our results suggest that during adolescence, EOP individuals seem to follow an abnormal neurodevelopmental trajectory, in which fronto-parietal GM volume reduction is associated with the differential age-related working memory dysfunction in this group

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

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