Validation and recalibration of OxMIV in predicting violent behaviour in patients with schizophrenia spectrum disorders.
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ABSTRACT:
SUBMITTER: Lamsma J
PROVIDER: S-EPMC8748785 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeWe evaluated the patient-control differences and predictive value of the retina as potential biomarkers for schizophrenia.MethodsThe institutional study included both eyes of 58 schizophrenia spectrum disorder (SSD) patients (age 37.2 ± 12.3 years) and 35 controls (age 41.1 ± 15.2 years). Retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer, outer retinal photoreceptor complex, and total macula thicknesses were measured by optical coherence tomography (OCT). Anterior segment parameters including central corneal thickness, anterior chamber depth, and axial length were measured to rule out confounds on the retinal measures.ResultsThe peripapillary RNFL was overall significantly thinner in SSD relative to controls (F = 3.97, P = 0.049), most pronounced in the temporal (5.2 µm difference, F = 6.95, P = 0.010) and inferior quadrants (12.1 µm difference, F = 7.32, P = 0.009). There were no significant group differences in thickness for the macular RNFL, ganglion, or photoreceptor cell related measures (P > 0.05). Peripapillary RNFL, central macula, and outer photoreceptor complex thicknesses were together able to classify SSD patients with 80% sensitivity and 71% specificity; area under the curve = 0.82 (95% confidence interval, 0.75-0.88).ConclusionsSSD patients exhibited significant RNFL thinning relative to controls. Notably, retinal thickness measures including both peripapillary and macular data exhibited improved diagnostic accuracy for SSD as compared to these regions alone.Translational relevanceThis is the first study to evaluate the predictive value of both the inner and outer retina in SSD. OCT retinal thickness measures including peripapillary data in conjunction with macular data may provide an informative, noninvasive in vivo ocular biomarker for schizophrenia.
| S-EPMC8083086 | biostudies-literature
Project description:Although violent behaviour and psychopathology often co-occur, there has been little research on psychiatric disorders among men in treatment for intimate partner violence (IPV). This study aimed to examine the prevalence of a broad spectrum of psychiatric disorders among men voluntarily attending treatment for IPV.5 clinics for IPV treatment, located in the east, south and west of Norway, participated in the study. In a cross-sectional design, men attending therapy for violence against a partner went through a face-to-face structured diagnostic interview, the Mini International Neuropsychiatric Interview.222 men contacted the clinic during the inclusion period; 12 men did not attend and 13 men were referred to outpatient clinics. Of the 197 men who were offered therapy, 13 did not provide consent to participate in the study, 2 were excluded and 3 men missed the interview.A total of 179 men participated in the study. The majority were ethnic Norwegians (88%). A total of 70.9% of the men fulfilled the diagnostic criteria for at least one ongoing psychiatric disorder. Three categories of disorders stood out with approximately equal prevalences: depressive disorders (40.6%), anxiety disorders (38.5%) including post-traumatic stress disorder (18.4%) and alcohol/substance abuse (40.2%). Antisocial personality disorder was present in approximately 2/10 participants. Comorbidity was high, with nearly half of the men (48.0%) assigned two or more diagnoses.Men voluntarily admitted to treatment for IPV harbour a wide spectrum of psychiatric disorders. Our findings suggest a need for screening procedures for psychiatric disorders as well as adoption of treatment interventions according to different types of psychopathologies and therapeutic needs. Limitations include caution in terms of generalisation to other populations not voluntarily admitted to treatment for IPV, and risk of ignoring symptoms not covered by a clinical structured interview.
| S-EPMC3987730 | biostudies-literature
Project description:Absolute and relative risks of violence are increased in patients with psychotic disorders, but the contribution of triggers for violent acts to these risks is uncertain.To examine whether a range of triggers for violent acts are associated with risks of violence in patients diagnosed with psychotic disorders and in individuals without a psychiatric diagnosis.Using a sample of all individuals born in Sweden between 1958 and 1988 (N?=?3?123?724), we identified patients in the National Patient Register who were diagnosed with schizophrenia spectrum disorders (n?=?34?903) and bipolar disorder (n?=?29?692), as well as unaffected controls (n?=?2?763?012). We then identified, within each subsample, persons who had experienced any of the following triggers for violent acts between January 1, 2001, and December 15, 2013: exposure to violence, parental bereavement, self-harm, traumatic brain injury, unintentional injuries, and substance intoxication. By using within-individual models, we conducted conditional logistic regression to compare the risk of the individual engaging in violent acts in the week following the exposure to a trigger with the risk during earlier periods of equivalent length. All time-invariant confounders (eg, genetic and early environmental influences) were controlled for by this research design and we further adjusted for time-varying sociodemographic factors.Adjusted odds ratios (aORs) of violent crime occurring in the week following the exposure to a trigger event compared with earlier periods.Among the sample of 2?827?607 individuals (1?492?186 male and 1?335?421 female), all of the examined trigger events were associated with increased risk of violent crime in the week following exposure. The largest 1-week absolute risk of violent crime was observed following exposure to violence (70-177 violent crimes per 10?000 persons). For most triggers, the relative risks did not vary significantly by diagnosis, including unintentional injuries (aOR range, 3.5-4.8), self-harm (aOR range, 3.9-4.2), and substance intoxication (aOR range, 3.0-4.0). Differences by diagnosis included parental bereavement, which was significantly higher in patients with schizophrenia spectrum disorders (aOR, 5.0; 95% CI, 3.0-8.1) compared with controls (aOR, 1.7; 95% CI, 1.3-2.2).In addition to identifying risk factors for violence, clarifying the timing of the triggers may provide opportunities to improve risk assessment and management in individuals with psychotic disorders.
| S-EPMC5047356 | biostudies-other
Project description:A study of violent behaviour among psychiatric inpatients in a large general hospital is presented. Over the study period of one year a total of 36 incidents of violence involving 26 patients were recorded. Schizophrenia was the most common diagnosis among assailants. Fellow patients were the main victims. Incidence of serious violence was low. Most incidents occurred in the night hours, from inmates of acute wards and mostly without any provocation.
| S-EPMC5529691 | biostudies-other
Project description:Autism spectrum disorder (ASD) refers to a wide spectrum of neurodevelopmental disorders that emerge during infancy and continue throughout a lifespan. Although substantial efforts have been made to develop therapeutic approaches, core symptoms persist lifelong in ASD patients. Identifying the brain temporospatial regions where the risk genes are expressed in ASD patients may help to improve the therapeutic strategies. Accordingly, this work aims to predict the risk genes of ASD and identify the temporospatial regions of the brain structures at different developmental time points for exploring the specificity of ASD gene expression in the brain that would help in possible ASD detection in the future. A dataset consisting of 13 developmental stages ranging from 8 weeks post-conception to 8 years from 26 brain structures was retrieved from the BrainSpan atlas. This work proposes a support vector machine-based risk gene prediction method ASD-Risk to distinguish the risk genes of ASD and non-ASD genes. ASD-Risk used an optimal feature selection algorithm called inheritable bi-objective combinatorial genetic algorithm to identify the brain temporospatial regions for prediction of the risk genes of ASD. ASD-Risk achieved a 10-fold cross-validation accuracy, sensitivity, specificity, area under a receiver operating characteristic curve, and a test accuracy of 81.83%, 0.84, 0.79, 0.84, and 72.27%, respectively. We prioritized the temporospatial features according to their contribution to the prediction accuracy. The top identified temporospatial regions of the brain for risk gene prediction included the posteroventral parietal cortex at 13 post-conception weeks feature. The identified temporospatial features would help to explore the risk genes that are specifically expressed in different brain regions of ASD patients.
| S-EPMC8236850 | biostudies-literature
Project description:Autonomic dysfunction represents a core domain of the pathophysiology of schizophrenia spectrum disorders (SCZ), with aberrant physiologic arousal underlying maladaptive social and cognitive behaviors. Antagonistic parasympathetic and sympathetic systems support autonomic flexibility to appropriately regulate arousal and respond to environmental challenges, which can be modeled using physiologic measures. SCZ patients consistently show heightened basal stress, however, their parasympathetic reactivity to an acute psychosocial stressor is poorly understood. Heart period (HP-arousal), respiratory sinus arrhythmia (RSA-parasympathetic vagal activity), and their relationship were measured in SCZ patients (n?=?19) and healthy controls (n?=?20) at baseline and during psychosocial stress exposure. Parasympathetic vagal control of arousal, reflected in RSA-HP coupling, was assessed for the first time in SCZ. Patients demonstrated blunted physiologic reactivity (less change in heart period and respiratory sinus arrhythmia), a unique increase in respiratory sinus arrhythmia relative to baseline during recovery, and elevated arousal was associated with poor cognitive performance and greater positive symptoms. Arousal regulation was tightly controlled by parasympathetic activity in controls only, indicated by a strong association between changes in heart period and respiratory sinus arrhythmia. Results are the first to demonstrate maladaptive, inefficient parasympathetic arousal regulation (RSA-HP decoupling) in reaction to psychosocial stress in SCZ, representing an autonomic profile incompatible with appropriate social and emotional functioning.
| S-EPMC5984181 | biostudies-literature
Project description:BackgroundCOVID-19 was declared a pandemic in March 2020, by the World Health Organization. The pandemic has had unprecedented worldwide implications, in particular on marginalized populations.AimsThe aim of this study is to review the impact of the pandemic on patients with schizophrenia spectrum disorders.MethodA number of databases were searched for this review, including PubMed, EMBASE, PsycINFO and Google Scholar. Search terms included psychosis and COVID-19, schizophrenia and COVID-19, and severe mental illness and COVID-19. We included all English language papers and preprints. The final search was done on 15 July 2020.ResultsForty-seven relevant studies were identified and included in this review. Studies were summarised into five main subcategories: potential impact of the COVID-19 pandemic on physical health outcomes of patients with schizophrenia spectrum disorders, impact on mental health outcomes, review of case reports and case series to date, treatment recommendation guidelines and risk of increased prevalence of psychosis.ConclusionsPatients with schizophrenia spectrum disorders may be vulnerable to the effects of the COVID-19 pandemic. This patient population has a number of risk factors, including psychosocial adversities and illness related factors. Continuous monitoring and long-term studies of the impact of the pandemic on this patient population are required.
| S-EPMC7804069 | biostudies-literature
Project description:AimsThere is evidence that patients with schizophrenia spectrum disorders present higher mortality in comparison with the general population. The aim of this study was to analyse the causes of mortality and sociodemographic factors associated with mortality, standardised mortality ratios (SMRs), life expectancy and potential years of life lost (YLL) in patients with schizophrenia spectrum disorders in Spain.MethodsThe study included a cohort of patients from the Malaga Schizophrenia Case Register (1418 patients; 907 males; average age 42.31 years) who were followed up for a minimum of 10 years (median = 13.43). The factors associated with mortality were analysed with a survival analysis using Cox's proportional hazards regression model.ResultsThe main causes of mortality in the cohort were circulatory disease (21.45%), cancer (17.09%) and suicide (13.09%). The SMR of the cohort was more than threefold that of the population of Malaga (3.19). The life expectancy at birth was 67.11 years old, which is more than 13 years shorter than that of the population of Malaga. The YLL was 20.74. The variables associated with a higher risk of mortality were age [adjusted hazard ratio (AHR) = 1.069, p < 0.001], male gender (AHR = 1.751, p < 0.001) and type of area of residence (p = 0.028; deprived urban zone v. non-deprived urban area, AHR = 1.460, p = 0.028). In addition, receiving welfare benefit status in comparison with employed status (AHR = 1.940, p = 0.008) was associated with increased mortality.ConclusionsThere is excess mortality in patients with schizophrenia spectrum disorders and also an association with age, gender, socioeconomic inequalities and receiving welfare benefits. Efforts directed towards improved living conditions could have a positive effect on reducing mortality.
| S-EPMC8057505 | biostudies-literature
Project description:Background: Yoga may pose a promising complementary therapy in the multimodal treatment of in-patients with schizophrenia spectrum disorders (SSD). However, to date, no studies have qualitatively examined in-patients' with SSD experiences of Yoga as well as their perceptions of its limitations and benefits as a treatment component. This qualitative study aimed to explore for the first time the mechanisms and processes of Yoga-based Group Intervention (YoGI) for in-patients with SSD in Germany by asking for their subjective experiences. Findings could serve as a preliminary basis for developing an effective and evidence-based YoGI manual tailored to this patient group. Materials and Methods: In total, 25 semi-structured interviews were conducted directly after YoGI, for which responses were either noted down by hand or audio-recorded. The interview guide was pilot-tested and consisted of 14 questions to explore the personal articulated experiences of participation in YoGI from in-patients with SSD. Positive, negative, depressive, and anxiety symptoms were assessed during a diagnostic interview and through questionnaires. The interview data was transcribed, coded by two independent researchers, and analysed using an inductive thematic approach. The research team collaboratively discussed emerging categories to reduce redundancy and form meaningful themes and subthemes. Results: The analysis revealed seven main themes. YoGI was perceived as feasible and focusing on individual adaptation, captured by the theme inclusivity. Nevertheless, participants encountered challenges; thus, physical limitations need to be considered. While practising together, participants experienced interconnectedness and developed a mindful stance as they accepted their limitations and adapted exercises with self-compassion. Patients described that following the flow of the asanas required physical persistence, which ultimately led many participants to experience confidence and relaxation. YoGI affected symptom representation as heightened awareness led participants to notice impeding as well as improved symptoms. Conclusion: YoGI showed various promising effects on in-patients with SSD. Future research should examine to what extent these effects can be sustained and how the mindful approach during YoGI can be transferred to areas outside the Yoga class. Furthermore, a randomised controlled trial could investigate the effectiveness of a manualised YoGI.
| S-EPMC8414901 | biostudies-literature
Project description:BackgroundIn recent years, neuroimaging has been used increasingly to explore the biological underpinnings of violence carried out by schizophrenia patients (SPs). Studies have focused mostly on patients with a history of carrying out severe physical assaults, or comorbid with substance abuse/personality disorder (SA/PD). As a result, participants were unrepresentative and the interpretation of brain-structure changes was confusing. Here, we concentrated on SPs on a general psychiatric ward with a history of relatively lower violence, and individuals comorbid with SA or PD were excluded. We expected to identify the characteristics of brain morphometry in this population, and to explore whether the morphometric changes were universal.MethodsForty-eight violent schizophrenia patients (VSPs), twenty-seven non-VSPs (nVSPs) and 28 nonviolent healthy controls (HCs) were investigated. Voxel-based morphometry was used to evaluate the gray matter volume (GMV) of all study participants. Whole-brain analyses were used to reveal group effects and differences between any two groups. Correlation analyses were undertaken between significant brain regions and behavioral measurements in the VSP group.ResultsPatients showed a significantly smaller GMV in widespread frontal, temporal, and limbic regions compared with HCs. No region was found in which the two patient groups had significantly larger volumes compared with that in HCs. A significant decrease in the GMV of the right fusiform gyrus was found in the VSP group compared with that in the nVSP group (p = 0.004), where the GMV of this region had a negative correlation with the Physical Aggression [subscale of the Modified Overt Aggression Scale (MOAS)] or Hostility score. The VSP group showed a trend of GMV decrease in the left middle temporal cortex compared with that in the nVSP group (p = 0.077). Negative correlation was also found between the GMV of left inferior temporal gyrus/left Superior frontal gyrus, medial and the Hostility score.ConclusionsOur results provide initial evidence demonstrating the generalizability of GMV abnormalities in SPs engaged in varying levels of violence, even when SA or PD have not been implicated. GMV reduction was correlated with only the Physical Aggression subscale score of the MOAS, suggesting that this change in brain morphology may be dependent upon different types of violent actions.
| S-EPMC7493665 | biostudies-literature