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897. Association between Childhood Adversity and Ultra-High Risk for Psychosis Status in a Populational Sample of Sao Paulo, Brazil
Biological Psychiatry
Saturday Abstracts
Yale University School of Medicine, 8Department of Psychiatry, North Shore University Hospital, Northwell Health System, 9Faculty of Social and Behavioural Sciences, Utrecht University and Altrecht Academic Anxiety Center, Utrecht, Department of Psychiatry, University Medical Center & GGz Drenthe Groningen, 10Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, 11 Department of Psychology, University of Denver, 12 Department of Psychiatry, University of Utah, 13Department of Behavioral Health, Tripler Army Medical Center, 14 Department of Psychiatry, and University of Florida Genetics Institute, University of Florida Background: The unique phenotypic and genetic aspects of obsessive-compulsive (OCD) and attention-deficit/ hyperactivity disorder (ADHD) among individuals with Tourette syndrome (TS) have not been well characterized. Methods: OCD and ADHD symptom patterns were identified among patients with TS and their family members (N53494) using exploratory factor and latent class analyses; clinical associations and heritability of these factors were examined. Results: Factor analyses yielded 2- and 8-factor models for ADHD and OCD, respectively. Both ADHD factors (inattention and hyperactivity/impulsiveness) were genetically related to TS, ADHD, and OCD; all OCD factors (related to symmetry/ contamination, unusual thoughts, aggressive urges, and hoarding) were genetically related to OCD. The OCD aggressive urges factor was genetically associated with TS and ADHD, the symmetry/exactness and fear of harm factors were associated with TS, and the hoarding factor was associated with ADHD. Latent classes based on OCD and ADHD factor sum scores to examine the relationships between OCD and ADHD symptoms in probands and family members revealed a three-class solution: ADHD; OCD1ADHD; and asymmetry/exactness, hoarding, and ADHD. The majority of participants with TS, ADHD, mood, and anxiety disorders, as well as mothers, fathers, and probands, were classified in the ADHD class. In contrast, the largest percentage of participants with OCD and disruptive behavior disorders were classified in the asymmetry/exactness, hoarding, and ADHD class. Conclusions: Symmetry/exactness, aggressive urges, fear of harm, and hoarding show complex genetic relationships with TS, OCD, and ADHD, and transcend diagnostic boundaries, perhaps representing a failure of top-down cognitive control common to all three disorders. Supported By: National Institutes of Health, grant numbers R01MH096767 ("Refining the Tourette syndrome phenotype across diagnoses to aid gene discovery," PI: Carol Mathews), U01NS040024 ("A genetic linkage study of GTS," PI: David Pauls/Jeremiah Scharf), K23MH085057 ("Translational phenomics and genomics of Gilles de la Tourette syndrome," PI: Jeremiah Scharf), K02MH00508 ("Genetics of a behavioral disorder: Tourette syndrome," PI: David Pauls), and R01NS016648 ("A genetic study of GTS, OCD, and ADHD," PI: David Pauls), and from the Tourette Syndrome Association. Keywords: Tourette's Syndrome, Obsessive Compulsive Disorder (OCD), ADHD, Heritability, Endophenotypes
S362
897. Association between Childhood Adversity and Ultra-High Risk for Psychosis Status in a Populational Sample of Sao Paulo, Brazil Alexandre Loch1, Tania Maria Alves1, Elder Lanzani Freitas1, Lucas Hortencio1, Julio Cesar Andrade1, Martinus Theodorus van de Bilt1, Marcos Roberto Fontoni1, Mauricio Serpa1, Camille Chianca1, Wagner Farid Gattaz1, and Wulf Roessler2 University of Sao Paulo, 2Charité, University Medicine, Berlin
1
Background: The relationship between childhood adversity and ultra-high risk for psychosis (UHR) status is still inconsistent and unavailable cross-culturally. Our aim was to assess this association in a Latin-American sample. Methods: 1950 individuals (18-35 years of age) randomly drawn from the general population of Sao Paulo (Brazil) were screened with the Prodromal Questionnaire. Those with the highest scores were recruited for this cohort study, consisting in: interview with the Structured Interview for Psychosis-Risk Syndromes (SIPS), neuropsychological assessment, assessments with the 28-item self-report Childhood Trauma Questionnaire (CTQ) and other data collection. The CTQ contains five subscales, assessing abuse (Emotional, Physical, and Sexual), and neglect (Emotional and Physical). We present results of participants included until the present date (n554). Results: Mean age524 years; 55.6% were females; 23 individuals were UHR and 31 controls; groups did not statistically differ regarding demographic variables. MannWhitney test showed significant differences between controls and UHR in CTQ-Emotional Abuse subscale (Mean rank520.87 vs. 36.43, respectively, p,0.001), and in the CTQ-Sexual abuse subscale (Mean rank525.05 vs. 30.80, respectively, p50.50). Backwards-stepwise logistic regression included sociodemographic variables and CTQsubscales scores as independent variables and UHR-status as the dependent variable. CTQ-Emotional abuse subscale was retained in the final model (OR54.08,95%IC51.60– 10.42,p50.003). Conclusions: Our results suggest that UHR individuals tend to present more childhood emotional abuse than controls. This is the first time an UHR sample is assessed concerning childhood abuse in a Latin-American country. Further investigation should determine whether childhood trauma is able to predict full-blown psychosis and persistence of psychotic experience. Supported By: Other: Collegium Helveticum Keywords: Schizophrenia Spectrum, Prodrome, UltraHigh Risk
898. Religiosity in Acute Psychiatric Inpatients: Relationship with Demographics and Psychotic Disorders Noha Abdel Gawad, Pratikkumar Desai, Allison Engstrom, Melissa Allen, and Teresa Pigott The University of Texas Health Science Center at Houston
Biological Psychiatry May 15, 2017; 81:S277–S413 www.sobp.org/journal
Saturday Abstracts
Yale University School of Medicine, 8Department of Psychiatry, North Shore University Hospital, Northwell Health System, 9Faculty of Social and Behavioural Sciences, Utrecht University and Altrecht Academic Anxiety Center, Utrecht, Department of Psychiatry, University Medical Center & GGz Drenthe Groningen, 10Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, 11 Department of Psychology, University of Denver, 12 Department of Psychiatry, University of Utah, 13Department of Behavioral Health, Tripler Army Medical Center, 14 Department of Psychiatry, and University of Florida Genetics Institute, University of Florida Background: The unique phenotypic and genetic aspects of obsessive-compulsive (OCD) and attention-deficit/ hyperactivity disorder (ADHD) among individuals with Tourette syndrome (TS) have not been well characterized. Methods: OCD and ADHD symptom patterns were identified among patients with TS and their family members (N53494) using exploratory factor and latent class analyses; clinical associations and heritability of these factors were examined. Results: Factor analyses yielded 2- and 8-factor models for ADHD and OCD, respectively. Both ADHD factors (inattention and hyperactivity/impulsiveness) were genetically related to TS, ADHD, and OCD; all OCD factors (related to symmetry/ contamination, unusual thoughts, aggressive urges, and hoarding) were genetically related to OCD. The OCD aggressive urges factor was genetically associated with TS and ADHD, the symmetry/exactness and fear of harm factors were associated with TS, and the hoarding factor was associated with ADHD. Latent classes based on OCD and ADHD factor sum scores to examine the relationships between OCD and ADHD symptoms in probands and family members revealed a three-class solution: ADHD; OCD1ADHD; and asymmetry/exactness, hoarding, and ADHD. The majority of participants with TS, ADHD, mood, and anxiety disorders, as well as mothers, fathers, and probands, were classified in the ADHD class. In contrast, the largest percentage of participants with OCD and disruptive behavior disorders were classified in the asymmetry/exactness, hoarding, and ADHD class. Conclusions: Symmetry/exactness, aggressive urges, fear of harm, and hoarding show complex genetic relationships with TS, OCD, and ADHD, and transcend diagnostic boundaries, perhaps representing a failure of top-down cognitive control common to all three disorders. Supported By: National Institutes of Health, grant numbers R01MH096767 ("Refining the Tourette syndrome phenotype across diagnoses to aid gene discovery," PI: Carol Mathews), U01NS040024 ("A genetic linkage study of GTS," PI: David Pauls/Jeremiah Scharf), K23MH085057 ("Translational phenomics and genomics of Gilles de la Tourette syndrome," PI: Jeremiah Scharf), K02MH00508 ("Genetics of a behavioral disorder: Tourette syndrome," PI: David Pauls), and R01NS016648 ("A genetic study of GTS, OCD, and ADHD," PI: David Pauls), and from the Tourette Syndrome Association. Keywords: Tourette's Syndrome, Obsessive Compulsive Disorder (OCD), ADHD, Heritability, Endophenotypes
S362
897. Association between Childhood Adversity and Ultra-High Risk for Psychosis Status in a Populational Sample of Sao Paulo, Brazil Alexandre Loch1, Tania Maria Alves1, Elder Lanzani Freitas1, Lucas Hortencio1, Julio Cesar Andrade1, Martinus Theodorus van de Bilt1, Marcos Roberto Fontoni1, Mauricio Serpa1, Camille Chianca1, Wagner Farid Gattaz1, and Wulf Roessler2 University of Sao Paulo, 2Charité, University Medicine, Berlin
1
Background: The relationship between childhood adversity and ultra-high risk for psychosis (UHR) status is still inconsistent and unavailable cross-culturally. Our aim was to assess this association in a Latin-American sample. Methods: 1950 individuals (18-35 years of age) randomly drawn from the general population of Sao Paulo (Brazil) were screened with the Prodromal Questionnaire. Those with the highest scores were recruited for this cohort study, consisting in: interview with the Structured Interview for Psychosis-Risk Syndromes (SIPS), neuropsychological assessment, assessments with the 28-item self-report Childhood Trauma Questionnaire (CTQ) and other data collection. The CTQ contains five subscales, assessing abuse (Emotional, Physical, and Sexual), and neglect (Emotional and Physical). We present results of participants included until the present date (n554). Results: Mean age524 years; 55.6% were females; 23 individuals were UHR and 31 controls; groups did not statistically differ regarding demographic variables. MannWhitney test showed significant differences between controls and UHR in CTQ-Emotional Abuse subscale (Mean rank520.87 vs. 36.43, respectively, p,0.001), and in the CTQ-Sexual abuse subscale (Mean rank525.05 vs. 30.80, respectively, p50.50). Backwards-stepwise logistic regression included sociodemographic variables and CTQsubscales scores as independent variables and UHR-status as the dependent variable. CTQ-Emotional abuse subscale was retained in the final model (OR54.08,95%IC51.60– 10.42,p50.003). Conclusions: Our results suggest that UHR individuals tend to present more childhood emotional abuse than controls. This is the first time an UHR sample is assessed concerning childhood abuse in a Latin-American country. Further investigation should determine whether childhood trauma is able to predict full-blown psychosis and persistence of psychotic experience. Supported By: Other: Collegium Helveticum Keywords: Schizophrenia Spectrum, Prodrome, UltraHigh Risk
898. Religiosity in Acute Psychiatric Inpatients: Relationship with Demographics and Psychotic Disorders Noha Abdel Gawad, Pratikkumar Desai, Allison Engstrom, Melissa Allen, and Teresa Pigott The University of Texas Health Science Center at Houston
Biological Psychiatry May 15, 2017; 81:S277–S413 www.sobp.org/journal