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Poster #M118 A POPULATION-BASED LONGITUDINAL STUDY OF ATOPIC DISORDERS AND INFLAMMATORY MARKERS IN CHILDHOOD BEFORE PSYCHOTIC EXPERIENCES IN ADOLESCENCE
S232
Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384
gate the relationship between socioeconomic status at birth, as measured at individual-and neighbourhood–level within a wholly rural context in Ireland using a dataset of unusual epidemiological completeness. Methods: Study cohort Cases were identified from the Cavan-Monaghan first episode psychosis study (CAMFEPS). This is a prospective study that seeks the closest approximation to identification of “all” incident cases presenting with a first episode of any psychotic disorder in two rural counties in Ireland, Cavan and Monaghan, since 1995. Study design A matched case-control design was used. Birth certificates of subjects who were born in Ireland were obtained from the general register of births. For each case, the two same-sex entries above and the two below on the birth register were selected as controls. Two measures of socioeconomic status at birth were examined: father’s occupation was extracted from the birth certificate and a social class was assigned according to the census of population classification of occupations, which consists of six categories; the second socioeconomic indicator was the social characteristic of the area of residence at birth, which was ascertained from the “dwelling-place of father” in the birth certificate. Neighbourhood-level indices of material deprivation, social fragmentation and urban-rural classification were obtained from census data. Results: Of 335 cases of first episode psychosis, birth certificates were obtained for 256 cases and 975 controls. Preliminary analyses do not indicate a link between socioeconomic status at birth and risk for psychosis. Additional analyses are ongoing and involve a range of socio-environmental factors. Discussion: This epidemiologically complete, rural cohort presents an opportunity to examine the relationship between individual- and neighbourhood-level socio-environmental factors at birth and risk for first episode psychosis. Our preliminary findings do not support an association between adverse socio-environmental factors proximal to birth and increased risk for psychosis in this rural region. This is in contrast to our recent report of an association between socio-environmental factors proximal to onset and risk for first episode psychosis in the same region.
Poster #M117 EVIDENCE THAT CHILDHOOD URBAN ENVIRONMENT IS ASSOCIATED WITH BLUNTED STRESS REACTIVITY ACROSS GROUPS OF PSYCHOTIC PATIENTS, RELATIVES AND CONTROLS Aleida Frissen 1,2 , Ritsaert Lieverse 1 , Marjan Drukker 1 , Tineke Lataster 1 , Philippe Delespaul 1 , Inez Myin-Germeys 1 , Jim van Os 1 1 Maastricht University; 2 Mondriaan Zorggroep Background: Psychosis is associated with urban upbringing, and increased emotional reactivity is associated with psychosis. The aim of this study was to examine to what degree urban upbringing impacts emotional reactivity, and how this may be relevant for psychotic disorder and familial risk of psychotic disorder. Methods: Patients with a diagnosis of non-affective psychotic disorder (n=58), 59 first degree relatives of patients and 75 healthy comparison subjects were studied with the Experience Sampling Method (a random time sampling technique to assess affective experience in relation to fluctuating stressors in the flow of daily life), to measure a change in negative affect in relation to a stressful event. Urban exposure was defined at 5 levels, considering the population density and the number of moves between birth and the 15th birthday, using data from the Dutch Central Bureau of Statistics and the equivalent database in Belgium. Results: Multilevel random regression analyses showed that urban upbringing was consistently and strongly associated with a reduced increase in negative affect in relation to a stressful event in adulthood in a dose-response fashion in all three groups, particularly in patients and in first-degree relatives of patients. Regression coefficients in the patient group decreased from 0.148 (p<0.001) in the lowest urbanicity level to 0.094 (p<0.001) in the highest urbanicity level. Discussion: The findings suggest that urban upbringing may occasion “habituation” rather than “sensitization” across groups, which may or may not be relevant for the onset of psychotic disorder.
Poster #M118 A POPULATION-BASED LONGITUDINAL STUDY OF ATOPIC DISORDERS AND INFLAMMATORY MARKERS IN CHILDHOOD BEFORE PSYCHOTIC EXPERIENCES IN ADOLESCENCE Golam Khandaker 1 , Stanley Zammit 2 , Glyn Lewis 3 , Peter B. Jones 1 University of Cambridge; 2 University of Cardiff; 3 University College, London
1
Background: Schizophrenia is associated with infection (such as, antibodies to Toxoplasma gondii, prenatal maternal infection, childhood infection), and abnormalities in various components of the immune system. These include increased levels of systemic inflammatory markers (innate immune response), autoantibodies against various brain regions and ion channels, increased prevalence of autoimmune and atopic conditions (adaptive immune response). Atopic disorders such as asthma, eczema, urticaria and allergic rhinitis are underlied by adaptive immune response following exposures to non-infectious antigens. An increased prevalence of asthma in schizophrenia has been reported. Recently, a population-based longitudinal study has reported increased risk of adult schizophrenia among individuals with early-life atopic disorders. The effects of systemic inflammatory makers on the developing brain have been proposed as one mechanism that may underlie the association between atopic disorder and later psychosis. However, empirical data on this topic is limited. Early-life psychotic experiences (PE) may be important antecedents of schizophrenia. They are associated with the risk of adult psychosis as well as a number of risk factors for schizophrenia. Therefore, it has been suggested that studies of early-life PE may be helpful to elucidate the pathophysiology of adult psychotic disorders. Using data from the population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, we report associations between early-life atopic disorders, serum inflammatory markers (interleukin 6 or IL-6, C-reactive protein or CRP) at age 9 years, and the risk of PE at age 13 years. We predicted that atopic disorders will be associated with (1) increased levels of inflammatory markers, and (2) risk of PE. We also predicted that inflammatory markers will be associated with subsequent risk of PE, and finally, that they will explain the association between atopic disorders and PE. Methods: PE were assessed at age 13 years by the face-to-face semistructured psychotic-like symptoms interview (PLIKSi) (n=6,785). The presence of clinician-diagnosed atopic disorders (asthma, eczema) was determined from parent-completed questionnaires at age 10 years (n=7,814). IL-6 and CRP levels were measured in non-fasting serum samples collected at age 9 years (n=5,076). Logistic regression examined the association between (1) atopy and PE, (2) inflammatory markers and PE, (3) mediating effects of inflammatory markers on the atopy-PE association. Linear regression examined the association between atopy and inflammatory markers. Age, gender, social class, ethnicity and body mass index were included as potential confounders. Results: At age 10 years, about 14% of the sample was reported to have asthma, 12% eczema, and 7% both asthma and eczema. Compared with children with no atopy, the risk of PE at age 13 years were increased for all of these groups. The adjusted odds ratio (95% CI) for PE was 1.39 (1.101.77) for asthma, 1.33 (1.04- 1.69) for eczema, and 1.44 (1.06- 1.94) for both asthma and eczema. Atopy was associated with increased serum IL-6 and CRP; however, this did not mediate association between atopy and PE. Inflammatory markers at age 10 years were not associated with the risk of PE at age 13 years. Discussion: Childhood atopic disorders are associated with the risk of PE in early-adolescence. Follow-up of these individuals will be useful to determine the effect of atopy and inflammation on different trajectories of early-life PE.
Poster #M119 PRENATAL AND POSTNATAL EXPOSURES TO MAXIMUM ADVERSITY AMONG HOLOCAUST SURVIVORS AND THE COURSE OF SCHIZOPHRENIA: A POPULATION-BASED STUDY Stephen Z. Levine 1 , Itzhak Levav 2 , Rinat Yoffee 3 , Inna Pugachova 3 1 University of Haifa; 2 Division of Mental Health Services, Ministry of Health, Israel; 3 Ministry of Health, Israel Background: The effects of prenatal and postnatal exposure to protracted
Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384
gate the relationship between socioeconomic status at birth, as measured at individual-and neighbourhood–level within a wholly rural context in Ireland using a dataset of unusual epidemiological completeness. Methods: Study cohort Cases were identified from the Cavan-Monaghan first episode psychosis study (CAMFEPS). This is a prospective study that seeks the closest approximation to identification of “all” incident cases presenting with a first episode of any psychotic disorder in two rural counties in Ireland, Cavan and Monaghan, since 1995. Study design A matched case-control design was used. Birth certificates of subjects who were born in Ireland were obtained from the general register of births. For each case, the two same-sex entries above and the two below on the birth register were selected as controls. Two measures of socioeconomic status at birth were examined: father’s occupation was extracted from the birth certificate and a social class was assigned according to the census of population classification of occupations, which consists of six categories; the second socioeconomic indicator was the social characteristic of the area of residence at birth, which was ascertained from the “dwelling-place of father” in the birth certificate. Neighbourhood-level indices of material deprivation, social fragmentation and urban-rural classification were obtained from census data. Results: Of 335 cases of first episode psychosis, birth certificates were obtained for 256 cases and 975 controls. Preliminary analyses do not indicate a link between socioeconomic status at birth and risk for psychosis. Additional analyses are ongoing and involve a range of socio-environmental factors. Discussion: This epidemiologically complete, rural cohort presents an opportunity to examine the relationship between individual- and neighbourhood-level socio-environmental factors at birth and risk for first episode psychosis. Our preliminary findings do not support an association between adverse socio-environmental factors proximal to birth and increased risk for psychosis in this rural region. This is in contrast to our recent report of an association between socio-environmental factors proximal to onset and risk for first episode psychosis in the same region.
Poster #M117 EVIDENCE THAT CHILDHOOD URBAN ENVIRONMENT IS ASSOCIATED WITH BLUNTED STRESS REACTIVITY ACROSS GROUPS OF PSYCHOTIC PATIENTS, RELATIVES AND CONTROLS Aleida Frissen 1,2 , Ritsaert Lieverse 1 , Marjan Drukker 1 , Tineke Lataster 1 , Philippe Delespaul 1 , Inez Myin-Germeys 1 , Jim van Os 1 1 Maastricht University; 2 Mondriaan Zorggroep Background: Psychosis is associated with urban upbringing, and increased emotional reactivity is associated with psychosis. The aim of this study was to examine to what degree urban upbringing impacts emotional reactivity, and how this may be relevant for psychotic disorder and familial risk of psychotic disorder. Methods: Patients with a diagnosis of non-affective psychotic disorder (n=58), 59 first degree relatives of patients and 75 healthy comparison subjects were studied with the Experience Sampling Method (a random time sampling technique to assess affective experience in relation to fluctuating stressors in the flow of daily life), to measure a change in negative affect in relation to a stressful event. Urban exposure was defined at 5 levels, considering the population density and the number of moves between birth and the 15th birthday, using data from the Dutch Central Bureau of Statistics and the equivalent database in Belgium. Results: Multilevel random regression analyses showed that urban upbringing was consistently and strongly associated with a reduced increase in negative affect in relation to a stressful event in adulthood in a dose-response fashion in all three groups, particularly in patients and in first-degree relatives of patients. Regression coefficients in the patient group decreased from 0.148 (p<0.001) in the lowest urbanicity level to 0.094 (p<0.001) in the highest urbanicity level. Discussion: The findings suggest that urban upbringing may occasion “habituation” rather than “sensitization” across groups, which may or may not be relevant for the onset of psychotic disorder.
Poster #M118 A POPULATION-BASED LONGITUDINAL STUDY OF ATOPIC DISORDERS AND INFLAMMATORY MARKERS IN CHILDHOOD BEFORE PSYCHOTIC EXPERIENCES IN ADOLESCENCE Golam Khandaker 1 , Stanley Zammit 2 , Glyn Lewis 3 , Peter B. Jones 1 University of Cambridge; 2 University of Cardiff; 3 University College, London
1
Background: Schizophrenia is associated with infection (such as, antibodies to Toxoplasma gondii, prenatal maternal infection, childhood infection), and abnormalities in various components of the immune system. These include increased levels of systemic inflammatory markers (innate immune response), autoantibodies against various brain regions and ion channels, increased prevalence of autoimmune and atopic conditions (adaptive immune response). Atopic disorders such as asthma, eczema, urticaria and allergic rhinitis are underlied by adaptive immune response following exposures to non-infectious antigens. An increased prevalence of asthma in schizophrenia has been reported. Recently, a population-based longitudinal study has reported increased risk of adult schizophrenia among individuals with early-life atopic disorders. The effects of systemic inflammatory makers on the developing brain have been proposed as one mechanism that may underlie the association between atopic disorder and later psychosis. However, empirical data on this topic is limited. Early-life psychotic experiences (PE) may be important antecedents of schizophrenia. They are associated with the risk of adult psychosis as well as a number of risk factors for schizophrenia. Therefore, it has been suggested that studies of early-life PE may be helpful to elucidate the pathophysiology of adult psychotic disorders. Using data from the population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, we report associations between early-life atopic disorders, serum inflammatory markers (interleukin 6 or IL-6, C-reactive protein or CRP) at age 9 years, and the risk of PE at age 13 years. We predicted that atopic disorders will be associated with (1) increased levels of inflammatory markers, and (2) risk of PE. We also predicted that inflammatory markers will be associated with subsequent risk of PE, and finally, that they will explain the association between atopic disorders and PE. Methods: PE were assessed at age 13 years by the face-to-face semistructured psychotic-like symptoms interview (PLIKSi) (n=6,785). The presence of clinician-diagnosed atopic disorders (asthma, eczema) was determined from parent-completed questionnaires at age 10 years (n=7,814). IL-6 and CRP levels were measured in non-fasting serum samples collected at age 9 years (n=5,076). Logistic regression examined the association between (1) atopy and PE, (2) inflammatory markers and PE, (3) mediating effects of inflammatory markers on the atopy-PE association. Linear regression examined the association between atopy and inflammatory markers. Age, gender, social class, ethnicity and body mass index were included as potential confounders. Results: At age 10 years, about 14% of the sample was reported to have asthma, 12% eczema, and 7% both asthma and eczema. Compared with children with no atopy, the risk of PE at age 13 years were increased for all of these groups. The adjusted odds ratio (95% CI) for PE was 1.39 (1.101.77) for asthma, 1.33 (1.04- 1.69) for eczema, and 1.44 (1.06- 1.94) for both asthma and eczema. Atopy was associated with increased serum IL-6 and CRP; however, this did not mediate association between atopy and PE. Inflammatory markers at age 10 years were not associated with the risk of PE at age 13 years. Discussion: Childhood atopic disorders are associated with the risk of PE in early-adolescence. Follow-up of these individuals will be useful to determine the effect of atopy and inflammation on different trajectories of early-life PE.
Poster #M119 PRENATAL AND POSTNATAL EXPOSURES TO MAXIMUM ADVERSITY AMONG HOLOCAUST SURVIVORS AND THE COURSE OF SCHIZOPHRENIA: A POPULATION-BASED STUDY Stephen Z. Levine 1 , Itzhak Levav 2 , Rinat Yoffee 3 , Inna Pugachova 3 1 University of Haifa; 2 Division of Mental Health Services, Ministry of Health, Israel; 3 Ministry of Health, Israel Background: The effects of prenatal and postnatal exposure to protracted