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Poster #T104 BRAIN IMAGING IN PATIENTS WITH SCHIZOPHRENIC SPECTRUM DISORDER
S326
Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384
common SNPs, showed only a 5’-prime UTR polymorphism in CLN5 gene. RT-PCR and qPCR showed no differences in the processing or mRNA levels of this gene between controls and patients. However, when the experiment was expanded to the 13 genes, a significant downregulation in the homozygous patients was found in comparison to heterozygous unaffected in SPRY2. This gene is involved in signal transduction and it has been shown to have a role in multiple processes, including axon growth and brain development. Discussion: Alternative approaches to GWAS are needed to unravel some of the missing heritability in schizophrenia. Homozigosity mapping has been a powerful strategy to identify the genes responsible for many Mendelian diseases but our results suggest it may also be useful in complex diseases like schizophrenia when coupled to next-generation sequencing. A decreased expression of SPRY2 in schizophrenia post-mortem brains has already been described (Pillai, 2008) and our results confirm it. Nevertheless, further research is necessary to clarify whether the differential expression in SPRY2 is a byproduct of antipsychotic drugs or a genuine cause of pathogenic disease.
Poster #T103 STRESS-REACTIVITY AS POSSIBLE PREDICTOR FOR SOCIAL FUNCTIONING IN A SAMPLE OF PSYCHOTIC PATIENTS, UNAFFECTED SIBLINGS AND HEALTHY CONTROLS Mayke Janssens 1 , Tineke Lataster 2 , Claudia Simons 3,2 , Margreet Oorschot 2 , Mariëlle Lardinois 2 , Jim van Os 2 , Inez Myin-Germeys 2 1 School for Mental Health and Neuroscience, Maastricht; 2 Maastricht University; 3 GGz Eindhoven en De Kempen Background: Higher levels of stress-reactivity have consistently been associated with symptomatic outcome, both in the onset as well as the course of psychotic symptoms. The effect of stress-reactivity on functional outcome however is less clear. The present study therefore set out to determine the longitudinal association between stress-reactivity at baseline and social functioning at three-year follow-up in a sample of 45 patients with psychotic disorder, 44 siblings of patients with psychotic disorder and 62 healthy controls. Methods: Individual values (beta’s) of stress-reactivity were calculated by regressing negative affect on the subjective appraisal of activity and event related stress, measured with the experience sampling method (ESM). In order to assess whether stress-reactivity at baseline predicts social functioning at follow-up, multilevel random regression models were estimated with individual level stress-reactivity as dependent variable and social functioning (measured with the Social Functioning Scale) as independent variable. To assess whether the association differs between controls, siblings and patients, the interaction with group was tested. Results: No association was found between stress-reactivity at baseline and social function at follow up. When assessing the subgroup that participated in experience sampling at follow-up however (N=84), significant associations were present between both activity-related stress-reactivity at baseline and social functioning at follow-up (B=−12.87, P=0.023, 95% CI = −23.94; −1.80) and between event-related stress-reactivity at baseline and social functioning at follow-up (B=−6.67, P=0.043, 95% CI = −13.14; −0.20). No significant interaction with group was present. Discussion: Findings on the association between stress-reactivity and social functioning are inconclusive. A significant association was present but only in a subsample consisting of subjects who participated in the ESM study at both time points. In the group of subjects who participated in the ESM study at baseline but not at follow-up, this association was not present. Post hoc analyses aimed at elucidating the difference between these groups (e.g. age, sex, iq, symptom level) were not successful in finding distinctive factors at baseline. Nonetheless, a causal role of stress-reactivity in functional outcome is found in this subsample, and future research in larger samples should elucidate the role of stress-reactivity in social functioning and identify possible distinctive factors in this association.
Poster #T104 BRAIN IMAGING IN PATIENTS WITH SCHIZOPHRENIC SPECTRUM DISORDER Arvid Jensen 1 , Pål Wiktor 2 , Morten Jacobsen 2 1 Department of Psychiatry, Østfold County Hospital; 2 Department of Psychiatry Background: Background: Although schizophrenic patients are only marginally more violent than the healthy population, violence represents a main cause of hospitalization of schizophrenic patients in forensic, security wards. The dominant factors associated with violence are major mental illness, substance abuse, and psychopathy. It remains to define the contribution of each of these factors to the symptomatology. We examined in retrospect the results of imaging studies in a selected population. Imaging has shown that 60% of schizophrenic have definite cerebral atrophy most often as ventricular enlargement. Furthermore, temporal volume reduction appears to be common both in schizotypal personality disorder and chronic schizophrenia. The aim of the study was to compare SPECT, MR and CT findings in schizophrenic patients with and without violence. Methods: Methods: A total of 34 inpatients fulfilled the DSM-IV criteria for schizophrenic spectrum disorder and had been examined with SPECT. Average age was 31,7 years, range 20-65 years. 21 patients were in a forensic unit, 13 patients without any violent history was in an open ward. The length of the stay differed from one to twelve years. Any history of substance abuse was taken from the records. Patients with known violence were additionally examined with HCR-20 risk assessment scheme. For brain scintigraphy we used 99mTc-HMPAO single photon emission computed tomography (SPECT) in the study. Results: Results Neither CT nor MRI revealed pathological findings. SPECT defined areas of changed perfusion in 25 of 34 patients. Among the patients with violence (n=21) SPECT was positive in 18 patients (86%). In the non-violent group (n=13), SPECT var positive in 7 patients (54%). There was significant difference (p=0.040) between the groups. Hypoperfusion was mainly seen in the temporal lobe and in the amygdale area, but also in the parietalt and occipital lobes. Chronic substance abuse was documented in 20 patients (59%). In the violence group 15/21 (71%), and 5/13 (38%) in the non-violent group (n.s). In the violence group 18 of 20 patients scored higher than 20 on HCR-20 Discussion: Discussion SPECT describes perfusion in different mental illnesses and has the ability to detect changes early on in the course of disease, before structural changes are noted in anatomical imaging modalities as MRI. The negative MR/CT in our study may be explained by the protocol, which primerely focused on tumour detection. The reason for the hypoperfusion among our patients is uncertain and further, prospective studies are needed to differenciate the process behind the mental disorder from the toxic influence of abused substances.
Poster #T105 PREVALENCE AND PROFILE OF COGNITIVE DEFICITS IN A COHORT OF FIRST-EPISODE ANTIPSYCHOTIC-NAÏVE SCHIZOPHRENIA PATIENTS Maria H. Jensen 1,2 , Birte Glenthøj 1 , Mette Ødegaard Nielsen 3,4 , Sanne Wulff 5,6 , Birgitte Fagerlund 1 1 Center for Neuropsychiatric Schizophrenia Research; 2 Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research; 3 Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research; 4 CINS & CNSR; 5 Psychiatric Center Glostrup; 6 University of Copenhagen Background: Cognitive deficits are considered a core feature of schizophrenia with prevalence estimates ranging from ca. 75-85%. These deficits are present in the early phase of the illness; however in most first-episode schizophrenia studies the patients are receiving antipsychotic medication, which can affect the results on specific domains such as processing speed. As part of the PECANS project (Pan European Collaboration on Antipsychotic Naïve Schizophrenia) the aim of the present study is to establish the prevalence and profile of cognitive deficits in a cohort of firstepisode antipsychotic-naïve schizophrenia patients, without the potential confounding effects associated with medication and chronicity. Methods: The overall design of the PECANS project is a 2-year longitudinal case-control study with assessment at baseline and follow-ups after 6 weeks, 6 months, 1 and 2 years. Sixty first-episode antipsychotic-naïve
Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384
common SNPs, showed only a 5’-prime UTR polymorphism in CLN5 gene. RT-PCR and qPCR showed no differences in the processing or mRNA levels of this gene between controls and patients. However, when the experiment was expanded to the 13 genes, a significant downregulation in the homozygous patients was found in comparison to heterozygous unaffected in SPRY2. This gene is involved in signal transduction and it has been shown to have a role in multiple processes, including axon growth and brain development. Discussion: Alternative approaches to GWAS are needed to unravel some of the missing heritability in schizophrenia. Homozigosity mapping has been a powerful strategy to identify the genes responsible for many Mendelian diseases but our results suggest it may also be useful in complex diseases like schizophrenia when coupled to next-generation sequencing. A decreased expression of SPRY2 in schizophrenia post-mortem brains has already been described (Pillai, 2008) and our results confirm it. Nevertheless, further research is necessary to clarify whether the differential expression in SPRY2 is a byproduct of antipsychotic drugs or a genuine cause of pathogenic disease.
Poster #T103 STRESS-REACTIVITY AS POSSIBLE PREDICTOR FOR SOCIAL FUNCTIONING IN A SAMPLE OF PSYCHOTIC PATIENTS, UNAFFECTED SIBLINGS AND HEALTHY CONTROLS Mayke Janssens 1 , Tineke Lataster 2 , Claudia Simons 3,2 , Margreet Oorschot 2 , Mariëlle Lardinois 2 , Jim van Os 2 , Inez Myin-Germeys 2 1 School for Mental Health and Neuroscience, Maastricht; 2 Maastricht University; 3 GGz Eindhoven en De Kempen Background: Higher levels of stress-reactivity have consistently been associated with symptomatic outcome, both in the onset as well as the course of psychotic symptoms. The effect of stress-reactivity on functional outcome however is less clear. The present study therefore set out to determine the longitudinal association between stress-reactivity at baseline and social functioning at three-year follow-up in a sample of 45 patients with psychotic disorder, 44 siblings of patients with psychotic disorder and 62 healthy controls. Methods: Individual values (beta’s) of stress-reactivity were calculated by regressing negative affect on the subjective appraisal of activity and event related stress, measured with the experience sampling method (ESM). In order to assess whether stress-reactivity at baseline predicts social functioning at follow-up, multilevel random regression models were estimated with individual level stress-reactivity as dependent variable and social functioning (measured with the Social Functioning Scale) as independent variable. To assess whether the association differs between controls, siblings and patients, the interaction with group was tested. Results: No association was found between stress-reactivity at baseline and social function at follow up. When assessing the subgroup that participated in experience sampling at follow-up however (N=84), significant associations were present between both activity-related stress-reactivity at baseline and social functioning at follow-up (B=−12.87, P=0.023, 95% CI = −23.94; −1.80) and between event-related stress-reactivity at baseline and social functioning at follow-up (B=−6.67, P=0.043, 95% CI = −13.14; −0.20). No significant interaction with group was present. Discussion: Findings on the association between stress-reactivity and social functioning are inconclusive. A significant association was present but only in a subsample consisting of subjects who participated in the ESM study at both time points. In the group of subjects who participated in the ESM study at baseline but not at follow-up, this association was not present. Post hoc analyses aimed at elucidating the difference between these groups (e.g. age, sex, iq, symptom level) were not successful in finding distinctive factors at baseline. Nonetheless, a causal role of stress-reactivity in functional outcome is found in this subsample, and future research in larger samples should elucidate the role of stress-reactivity in social functioning and identify possible distinctive factors in this association.
Poster #T104 BRAIN IMAGING IN PATIENTS WITH SCHIZOPHRENIC SPECTRUM DISORDER Arvid Jensen 1 , Pål Wiktor 2 , Morten Jacobsen 2 1 Department of Psychiatry, Østfold County Hospital; 2 Department of Psychiatry Background: Background: Although schizophrenic patients are only marginally more violent than the healthy population, violence represents a main cause of hospitalization of schizophrenic patients in forensic, security wards. The dominant factors associated with violence are major mental illness, substance abuse, and psychopathy. It remains to define the contribution of each of these factors to the symptomatology. We examined in retrospect the results of imaging studies in a selected population. Imaging has shown that 60% of schizophrenic have definite cerebral atrophy most often as ventricular enlargement. Furthermore, temporal volume reduction appears to be common both in schizotypal personality disorder and chronic schizophrenia. The aim of the study was to compare SPECT, MR and CT findings in schizophrenic patients with and without violence. Methods: Methods: A total of 34 inpatients fulfilled the DSM-IV criteria for schizophrenic spectrum disorder and had been examined with SPECT. Average age was 31,7 years, range 20-65 years. 21 patients were in a forensic unit, 13 patients without any violent history was in an open ward. The length of the stay differed from one to twelve years. Any history of substance abuse was taken from the records. Patients with known violence were additionally examined with HCR-20 risk assessment scheme. For brain scintigraphy we used 99mTc-HMPAO single photon emission computed tomography (SPECT) in the study. Results: Results Neither CT nor MRI revealed pathological findings. SPECT defined areas of changed perfusion in 25 of 34 patients. Among the patients with violence (n=21) SPECT was positive in 18 patients (86%). In the non-violent group (n=13), SPECT var positive in 7 patients (54%). There was significant difference (p=0.040) between the groups. Hypoperfusion was mainly seen in the temporal lobe and in the amygdale area, but also in the parietalt and occipital lobes. Chronic substance abuse was documented in 20 patients (59%). In the violence group 15/21 (71%), and 5/13 (38%) in the non-violent group (n.s). In the violence group 18 of 20 patients scored higher than 20 on HCR-20 Discussion: Discussion SPECT describes perfusion in different mental illnesses and has the ability to detect changes early on in the course of disease, before structural changes are noted in anatomical imaging modalities as MRI. The negative MR/CT in our study may be explained by the protocol, which primerely focused on tumour detection. The reason for the hypoperfusion among our patients is uncertain and further, prospective studies are needed to differenciate the process behind the mental disorder from the toxic influence of abused substances.
Poster #T105 PREVALENCE AND PROFILE OF COGNITIVE DEFICITS IN A COHORT OF FIRST-EPISODE ANTIPSYCHOTIC-NAÏVE SCHIZOPHRENIA PATIENTS Maria H. Jensen 1,2 , Birte Glenthøj 1 , Mette Ødegaard Nielsen 3,4 , Sanne Wulff 5,6 , Birgitte Fagerlund 1 1 Center for Neuropsychiatric Schizophrenia Research; 2 Lundbeck Foundation Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research; 3 Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research; 4 CINS & CNSR; 5 Psychiatric Center Glostrup; 6 University of Copenhagen Background: Cognitive deficits are considered a core feature of schizophrenia with prevalence estimates ranging from ca. 75-85%. These deficits are present in the early phase of the illness; however in most first-episode schizophrenia studies the patients are receiving antipsychotic medication, which can affect the results on specific domains such as processing speed. As part of the PECANS project (Pan European Collaboration on Antipsychotic Naïve Schizophrenia) the aim of the present study is to establish the prevalence and profile of cognitive deficits in a cohort of firstepisode antipsychotic-naïve schizophrenia patients, without the potential confounding effects associated with medication and chronicity. Methods: The overall design of the PECANS project is a 2-year longitudinal case-control study with assessment at baseline and follow-ups after 6 weeks, 6 months, 1 and 2 years. Sixty first-episode antipsychotic-naïve