Psychiatry Commons^™

A Technology-Enabled Adherence Enhancement System For People With Bipolar Disorder: Results From A Feasibility And Patient Acceptance Analysis, Martha Sajatovic, Kristina A. Cassidy, Johnny Sams, Edna Fuentes-Casiano

Faculty Scholarship

Objective: As poor medication adherence is common in bipolar disorder (BD), technology-assisted approaches may help to monitor and enhance adherence. This study evaluated preliminary feasibility, patient satisfaction and effects on adherence, BD knowledge, and BD symptoms associated with the use of a multicomponent technology-assisted adherence enhancement system. Methods: This prospective study tested the system in five BD patients over a 15-day period. System components included: 1) an automated pill cap with remote monitoring sensor; 2) a multimedia adherence enhancement program; and 3) a treatment incentive program. This study evaluated system usability, patient satisfaction and effects on adherence (Morisky scale), knowledge …

The Cognition-Enhancing Effects Of Psychostimulants Involve Direct Action In The Prefrontal Cortex, Robert C. Spencer, David M. Devilbiss, Craig Berridge

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Psychostimulants are highly effective in the treatment of attention-deficit/hyperactivity disorder. The clinical efficacy of these drugs is strongly linked to their ability to improve cognition dependent on the prefrontal cortex (PFC) and extended frontostriatal circuit. The procognitive actions of psychostimulants are only associated with low doses. Surprisingly, despite nearly 80 years of clinical use, the neurobiology of the procognitive actions of psychostimulants has only recently been systematically investigated. Findings from this research unambiguously demonstrate that the cognition-enhancing effects of psychostimulants involve the preferential elevation of catecholamines in the PFC and the subsequent activation of norepinephrine α2 and dopamine D1 receptors. …

Clinical Management Of Insomnia, Karl Doghramji, Paul P. Doghramji

Department of Psychiatry and Human Behavior Faculty Papers

Throughout the book, we are guided by our main goal of providing practitioners with clinically relevant, evidence-based, and state-of-the-art information in the evaluation and management of insomnia. We have made a concerted attempt to ensure that our reviews are consistent with professional guidelines to the extent that current knowledge permits.

Genetic Polymorphisms And Antidepressant Adverse Effects, Rajnish Mago, S. Gupta, Kelly Huhn, R. Shah

Department of Psychiatry and Human Behavior Faculty Papers

Abstract

Background

Aim: to assess whether pharmacogenetic polymorphisms are associated with increased adverse effects or non-response with certain antidepressants whose metabolism is highly dependent on specific CYP450 isoenzymes. This is interim analysis of an ongoing study

Methods

We used a Case Control design comparing patients with major depressive disorder or generalized anxiety disorder who had had increased adverse effects from specified antidepressants (Cases) to patients who were poor responders to an antidepressant but without significant adverse effects (Controls) Genecept Assay™ (battery of pharmacogenetic tests relevant to psychiatry) was obtained using saliva or cheek swab

Results

Importantly, 57.1% of Cases were …

Distinguishing Originality From Creativity In Adhd: An Assessment Of Creative Personality, Self-Perception, And Cognitive Style Among Attention-Deficit/Hyperactivity Disorder Adults, Jean-Pierre J. Issa

Creative Studies Graduate Student Master's Theses

Debates over whether Attention-Deficit/Hyperactivity Disorder (ADHD) relates to high levels of creativity have been hampered by a lack of rigor when defining creativity. The purpose of the present study was to go beyond the rhetoric by empirically investigating creative personality, creative self-perception, and cognitive style among 49 ADHD adults. Comparative analysis to studies of non-ADHD samples revealed distinctive tendencies: A mean group score of 115.71 (SD=18.02) on the Kirton Adaption-Innovation Inventory (KAI) indicated preferences for originality, nonconformity, paradigm-breaking, and low efficiency that was over one standard deviation higher than average non-ADHD population scores. Combined inattentive/hyperactiveimpulsive subtypes (n …

Negative Symptoms And Impaired Social Functioning Predict Later Psychosis In Latino Youth At Clinical High Risk In The North American Prodromal Longitudinal Studies Consortium, Tracy Alderman, Jean Addington, Carrie Bearden, Tyrone D. Cannon, B. A. Cornblatt, Thomas H. Mcglashan, Diana O. Perkins, Elaine F. Walker, Scott W. Woods, Kristin S. Cadenhead, +2 Additional Authors

Journal Articles

No abstract provided.

Alcohol Confounds Relationship Between Cannabis Misuse And Psychosis Conversion In A High-Risk Sample, A. M. Auther, K. S. Cadenhead, R. E. Carrion, J. Addington, C. E. Bearden, T. D. Cannon, T. H. Mcglashan, E. F. Walker, S. W. Woods, B. A. Cornblatt, +3 Additional Authors

Journal Articles

ObjectiveCannabis use has been examined as a predictor of psychosis in clinical high-risk (CHR) samples, but little is known about the impact of other substances on this relationship. MethodSubstance use was assessed in a large sample of CHR participants (N=370, mean age=18.3) enrolled in the multisite North American Prodrome Longitudinal Study Phase 1 project. Three hundred and forty-one participants with cannabis use data were divided into groups: No Use (NU, N=211); Cannabis Use without impairment (CU, N=63); Cannabis Abuse/Dependence (CA/CD, N=67). Participants (N=283) were followed for 2years to determine psychosis conversion. ResultsAlcohol (45.3%) and cannabis (38.1%) were the most common …

Interpersonal Functioning In Obsessive-Compulsive Personality Disorder, N. M. Cain, E. B. Ansell, H. B. Simpson, A. Pinto

Journal Articles

The core symptoms of obsessive-compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. This study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive-compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others, whereas OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported …

Ld Score Regression Distinguishes Confounding From Polygenicity In Genome-Wide Association Studies, B. K. Bulik-Sullivan, P. R. Loh, H. K. Finucane, S. Ripke, J. Yang, N. Patterson, M. J. Daly, A. L. Price, B. M. Neale, A. Malhotra

Journal Articles

Both polygenicity (many small genetic effects) and confounding biases, such as cryptic relatedness and population stratification, can yield an inflated distribution of test statistics in genome-wide association studies (GWAS). However, current methods cannot distinguish between inflation from a true polygenic signal and bias. We have developed an approach, LD Score regression, that quantifies the contribution of each by examining the relationship between test statistics and linkage disequilibrium (LD). The LD Score regression intercept can be used to estimate a more powerful and accurate correction factor than genomic control. We find strong evidence that polygenicity accounts for the majority of the …

A Common Polymorphism In Scn2a Predicts General Cognitive Ability Through Effects On Pfc Physiology, M. A. Scult, J. W. Trampush, F. Zheng, E. D. Conley, T. Lencz, A. K. Malhotra, D. Dickinson, D. R. Weinberger, A. R. Hariri

Journal Articles

Here we provide novel convergent evidence across three independent cohorts of healthy adults (n = 531), demonstrating that a common polymorphism in the gene encoding the alpha2 subunit of neuronal voltage-gated type II sodium channels (SCN2A) predicts human general cognitive ability or "g." Using meta-analysis, we demonstrate that the minor T allele of a common polymorphism (rs10174400) in SCN2A is associated with significantly higher "g" independent of gender and age. We further demonstrate using resting-state fMRI data from our discovery cohort (n = 236) that this genetic advantage may be mediated by increased capacity for information processing between the dorsolateral …

Demographic Correlates Of Attenuated Positive Psychotic Symptoms, R. N. Waford, A. Macdonald, K. S. Cadenhead, T. D. Cannon, B. A. Cornblatt, R. Heinssen, D. O. Perkins, L. J. Seidman, S. W. Woods, T. H. Mcglashan, +8 Additional Authors

Journal Articles

It is now well established that the utilization of standardized clinical criteria can enhance prediction of psychosis. These criteria are primarily concerned with the presence and severity of attenuated positive symptoms. Because these symptom criteria are used to derive algorithms for designating clinical high risk (CHR) status and for maximizing prediction of psychosis risk, it is important to know whether the symptom ratings vary as a function of demographic factors that have previously been linked with symptoms in diagnosed psychotic patients. Using a sample of 356 CHR individuals from the NAPLS-II multi-site study, we examined the relation of three sex, …

Association Of A Schizophrenia Risk Variant At The Drd2 Locus With Antipsychotic Treatment Response In First-Episode Psychosis, J. P. Zhang, D. G. Robinson, Juan Gallego, M. John, J. Yu, J. Addington, M. Tohen, John Kane, Anil Malhotra, T. Lencz

Journal Articles

Findings from the Psychiatric Genomics Consortium genome-wide association study (GWAS) showed that variation at the DRD2 locus is associated with schizophrenia risk. However, the functional significance of rs2514218, the top DRD2 single nucleotide polymorphism in the GWAS, is unknown. Dopamine D2 receptor binding is a common mechanism of action for all antipsychotic drugs, and DRD2 variants were related to antipsychotic response in previous studies. The present study examined whether rs2514218 genotype could predict antipsychotic response, including efficacy and adverse events, in a cohort of patients with first episode of psychosis treated with either risperidone or aripiprazole for 12 weeks. Subjects …

Clinical And Functional Outcomes After 2 Years In The Early Detection And Intervention For The Prevention Of Psychosis Multisite Effectiveness Trial, W. R. Mcfarlane, B. Levin, L. Travis, F. L. Lucas, S. Lynch, M. Verdi, Barbara Cornblatt, S. F. Taylor, A. M. Auther, E. Spring, +11 Additional Authors

Journal Articles

OBJECTIVE: To test effectiveness of the Early Detection, Intervention, and Prevention of Psychosis Program in preventing the onset of severe psychosis and improving functioning in a national sample of at-risk youth. METHODS: In a risk-based allocation study design, 337 youth (age 12-25) at risk of psychosis were assigned to treatment groups based on severity of positive symptoms. Those at clinically higher risk (CHR) or having an early first episode of psychosis (EFEP) were assigned to receive Family-aided Assertive Community Treatment (FACT); those at clinically lower risk (CLR) were assigned to receive community care. Between-groups differences on outcome variables were adjusted …

Insistence On Sameness Relates To Increased Covariance Of Gray Matter Structure In Autism Spectrum Disorder., Ian W Eisenberg, Gregory L Wallace, Lauren Kenworthy, Stephen J Gotts, Alex Martin

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Autism spectrum disorder (ASD) is characterized by atypical development of cortical and subcortical gray matter volume. Subcortical structural changes have been associated with restricted and repetitive behavior (RRB), a core component of ASD. Behavioral studies have identified insistence on sameness (IS) as a separable RRB dimension prominent in high-functioning ASD, though no simple brain-behavior relationship has emerged. Structural covariance, a measure of morphological coupling among brain regions using magnetic resonance imaging (MRI), has proven an informative measure of anatomical relationships in typical development and neurodevelopmental disorders. In this study, we use this measure to characterize the relationship between brain …

Cannabinoid Cb2 Receptors In A Mouse Model Of A Beta Amyloidosis: Immunohistochemical Analysis And Suitability As A Pet Biomarker Of Neuroinflammation, A. V. Savonenko, T. Melnikova, Y. C. Wang, H. Ravert, Y. J. Gao, J. Koppel, D. Lee, P. Davies, M. G. Pomper, A. G. Horti, +6 Additional Authors

Journal Articles

In Alzheimer's disease (AD), one of the early responses to A beta amyloidosis is recruitment of microglia to areas of new plaque. Microglial receptors such as cannabinoid receptor 2 (CB2) might be a suitable target for development of PET radiotracers that could serve as imaging biomarkers of A beta-induced neuroinflammation. Mouse models of amyloidosis (J20APPswe/ind and APPswe/PS1 Delta E9) were used to investigate the cellular distribution of CB2 receptors. Specificity of CB2 antibody (H60) was confirmed using J20APPswe/ind mice lacking CB2 receptors. APPswe/PS1 Delta E9 mice were used in small animal PET with a CB2-targeting radiotracer, [C-11]A836339. These studies revealed …

Lifetime Prevalence, Age Of Risk, And Genetic Relationships Of Comorbid Psychiatric Disorders In Tourette Syndrome, M. E. Hirschtritt, P. C. Lee, D. L. Pauls, Y. Dion, M. A. Grados, R. A. King, P. Sandor, W. M. Mcmahon, G. J. Lyon, C. A. Mathews, +4 Additional Authors

Journal Articles

IMPORTANCE: Tourette syndrome (TS) is characterized by high rates of psychiatric comorbidity; however, few studies have fully characterized these comorbidities. Furthermore, most studies have included relatively few participants (

Abnormal Resting State Fmri Activity Predicts Processing Speed Deficits In First-Episode Psychosis, M. Argyelan, J. A. Gallego, D. G. Robinson, T. Ikuta, D. Sarpal, M. John, P. B. Kingsley, J. M. Kane, A. K. Malhotra, P. R. Szeszko

Journal Articles

Little is known regarding the neuropsychological significance of resting state functional magnetic resonance imaging (rs-fMRI) activity early in the course of psychosis. Moreover, no studies have used different approaches for analysis of rs-fMRI activity and examined gray matter thickness in the same cohort. In this study, 41 patients experiencing a first-episode of psychosis (including N = 17 who were antipsychotic drug-naive at the time of scanning) and 41 individually age-and sex-matched healthy volunteers completed rs-fMRI and structural MRI exams and neuropsychological assessments. We computed correlation matrices for 266 regions-of-interest across the brain to assess global connectivity. In addition, independent component …

Expanded Genetic Screening Panel For The Ashkenazi Jewish Population, B. Baskovich, I. Peter, J. H. Cho, G. Atzmon, L. Clark, J. Yu, T. Lencz, I. Pe'er, H. Ostrer, C. Oddoux, +7 Additional Authors

Journal Articles

PURPOSE: Carrier screening programs that identify the presence of known mutations have been effective for reducing the incidence of autosomal recessive conditions in the Ashkenazi Jewish (AJ) population and other populations. Yet, these programs have not realized their full potential. Furthermore, many known autosomal recessive and dominant conditions are not screened for and the molecular basis of other conditions for which screening might be offered is unknown. METHODS: Through literature review and annotation of full sequenced genomes from healthy individuals, we expanded the list of mutations. Mutations were identified in a sample of 128 fully sequenced AJ genomes that were …

Prenatal Exposure To Maternal Smoking And Symptom Severity Among Offspring With First-Episode Nonaffective Psychosis, F. Bernardini, C. R. Wan, A. Crisafio, S. H. Massey, M. T. Compton

Journal Articles

No abstract provided.

Role Of Social Media And The Internet In Pathways To Care For Adolescents And Young Adults With Psychotic Disorders And Non-Psychotic Mood Disorders, M. L. Birnbaum, A. F. Rizvi, Christoph Correll, J. M. Kane

Journal Articles

AIMS: Although psychosis often occurs during adolescence, there has been little research on how the ubiquitously used Internet and social media could impact pathways to care. We examined how youth with psychotic spectrum disorders (PSD) versus non-psychotic mood disorders (NPMD) use online resources in the early illness stages. METHODS: Social media use and pathways to care data were collected using a semi-structured interview from 80 youth (PSD = 40 and NPMD = 40) aged 12-21 years within 2 years of symptom onset. RESULTS: A total of 97.5% of participants (mean age = 18.3 years) regularly used social media, spending approximately …

Evaluating The Impact Of Cannabis Use On Thalamic Connectivity In Youth At Clinical High Risk Of Psychosis, L. Buchy, T. D. Cannon, A. Anticevic, K. Lyngberg, K. S. Cadenhead, B. A. Cornblatt, D. O. Perkins, L. J. Seidman, M. T. Tsuang, J. Addington, +5 Additional Authors

Journal Articles

No abstract provided.

Evaluating The Relationship Between Cannabis Use And Iq In Youth And Young Adults At Clinical High Risk Of Psychosis, L. Buchy, L. J. Seidman, K. S. Cadenhead, T. D. Cannon, B. A. Cornblatt, E. F. Walker, S. W. Woods, C. E. Bearden, D. H. Mathalon, J. Addington, +4 Additional Authors

Journal Articles

Among people with psychosis, those with a history of cannabis use show better cognitive performance than those who are cannabis naive. It is unknown whether this pattern is present in youth at clinical high risk (CHR) of psychosis. We evaluated relationships between IQ and cannabis use while controlling for use of other substances known to impact cognition in 678 CHR and 263 healthy control (HC) participants. IQ was estimated using the Vocabulary and Block Design subtests of the Wechsler Abbreviated Scale of Intelligence. Drug and alcohol use severity and frequency were assessed with the Alcohol and Drug Use Scale, and …

Contributions Of Early Cortical Processing And Reading Ability To Functional Status In Individuals At Clinical High Risk For Psychosis, R. Carrion, B. A. Cornblatt, D. Mclaughlin, J. Chang, A. M. Auther, R. H. Olsen, D. C. Javitt

Journal Articles

Background: There is a growing recognition that individuals at clinical high risk need intervention for functional impairments, along with emerging psychosis, as the majority of clinical high risk (CHR) individuals show persistent deficits in social and role functioning regardless of transition to psychosis. Recent studies have demonstrated reduced reading ability as a potential cause of functional disability in schizophrenia, related to underlying deficits in generation of mismatch negativity (MMN). The present study extends these findings to subjects at CHR. Methods: The sample consisted of 34 CHR individuals and 33 healthy comparison subjects (CNTLs) from the Recognition and Prevention (RAP) Program …

The Impact Of Psychosis On The Course Of Cognition: A Prospective, Nested Case-Control Study In Individuals At Clinical High-Risk For Psychosis, R. Carrion, D. Mclaughlin, A. M. Auther, R. Olsen, Christoph Correll, B. A. Cornblatt

Journal Articles

BACKGROUND: Although cognitive deficits in patients with schizophrenia are rooted early in development, the impact of psychosis on the course of cognitive functioning remains unclear. In this study a nested case-control design was used to examine the relationship between emerging psychosis and the course of cognition in individuals ascertained as clinical high-risk (CHR) who developed psychosis during the study (CHR + T). METHOD: Fifteen CHR + T subjects were administered a neurocognitive battery at baseline and post-psychosis onset (8.04 months, s.d. = 10.26). CHR + T subjects were matched on a case-by-case basis on age, gender, and time to retest …

Postnatal Neurodevelopmental Expression And Glutamate-Dependent Regulation Of The Znf804a Rodent Homologue, E. H. Chang, A. Kirtley, T. S. Chandon, P. Borger, S. Husain-Krautter, V. Vingtdeux, A. Malhotra

Journal Articles

The zinc finger protein ZNF804A rs1344706 variant is a replicated genome-wide significant risk variant for schizophrenia and bipolar disorder. While its association with altered brain structure and cognition in patients and healthy risk allele carriers is well documented, the characteristics and function of the gene in the brain remains poorly understood. Here, we used in situ hybridization to determine mRNA expression levels of the ZNF804A rodent homologue, Zfp804a, across multiple postnatal neurodevelopmental time points in the rat brain. We found changes in Zfp804a expression in the rat hippocampus, frontal cortex, and thalamus across postnatal neurodevelopment. Zfp804a mRNA peaked at postnatal …

Responses To Tobacco Smoking-Related Health Messages In Young People With Recent-Onset Schizophrenia, D. J. Coletti, M. Brunette, M. John, J. M. Kane, A. Malhotra, D. G. Robinson

Journal Articles

Virtually no research has examined the responses of youth with recent-onset psychosis (ROP) to smoking-related health warnings. We examined predictors of response and tested hypotheses that participants with ROP would (a) assess warnings as less effective than a healthy comparison (HC) group, and (b) assess video warnings as more effective than pictures. ROP participants (n = 69) hadtreatment; the HC group (n = 79) had no major mental illness. Participants viewed 10 pictorial warnings, 8 videos depicting similar messages, and were interviewed regarding tobacco use, health literacy, and smoking knowledge. We assessed response at baseline and at 4-week follow-up. ROP …

Personality Domains, Duration Of Untreated Psychosis, Functioning, And Symptom Severity In First-Episode Psychosis, M. Compton, R. Bakeman, Y. Alolayan, P. M. Balducci, F. Bernardini, B. Broussard, A. Crisafio, S. Cristofaro, S. Johnson, C. R. Wan, +1 Additional Author

Journal Articles

OBJECTIVES: Early-course psychotic disorders have been extensively studied in terms of phenomenology, but little is known about the influence of personality traits on clinical features of first-episode psychosis. The aim of this study was to explore how the "big five" personality domains (neuroticism, extraversion, openness, agreeableness, and conscientiousness) are associated with treatment delay (duration of untreated psychosis, DUP), functioning, and positive and negative symptom severity. METHODS: Data for these analyses were obtained from 104 participants enrolled from psychiatric inpatient units in Atlanta, Georgia, between August 2008 and March 2011. The NEO Five-Factor Inventory (NEO-FFI) was used to assess personality domains, …

Psychosis Prevention: A Modified Clinical High Risk Perspective From The Recognition And Prevention (Rap) Program, B. A. Cornblatt, R. Carrion, A. Auther, D. Mclaughlin, R. H. Olsen, M. John, C. U. Correll

Journal Articles

OBJECTIVE: Early intervention and prevention of psychosis remain a major challenge. Prediction would be greatly advanced with improved ability to identify individuals at true risk, which, at present, is moderate at best. The authors tested a modified strategy to improve prediction by selecting a more homogeneous high-risk sample (attenuated positive symptom criteria only, age range of mid-teens to early 20s) than is currently standard, combined with a systematic selection of neurodevelopmental deficits. METHOD: A sample of 101 treatment-seeking adolescents (mean age, 15.9 years) at clinical high risk for psychosis were followed clinically for up to 5 years (mean follow-up time, …

Cardiovascular And Cerebrovascular Risk Factors And Events Associated With Second-Generation Antipsychotic Compared To Antidepressant Use In A Non-Elderly Adult Sample: Results From A Claims-Based Inception Cohort Study, C. U. Correll, B. I. Joffe, L. M. Rosen, T. B. Sullivan, R. T. Joffe

Journal Articles

This is a study of the metabolic and distal cardiovascular/cerebrovascular outcomes associated with the use of second-generation antipsychotics (SGAs) compared to antidepressants (ADs) in adults aged 18-65 years, based on data from Thomson Reuters MarketScan (R) Research Databases 2006-2010, a commercial U.S. claims database. Interventions included clinicians' choice treatment with SGAs (allowing any comedications) versus ADs (not allowing SGAs). The primary outcomes of interest were time to inpatient or outpatient claims for the following diagnoses within one year of SGA or AD discontinuation: hypertension, ischemic and hypertensive heart disease, cerebrovascular disease, diabetes mellitus, hyperlipidemia, and obesity. Secondary outcomes included the …

Examining The Psychosis Continuum, P. Derosse, K. H. Karlsgodt

Journal Articles

The notion that psychosis may exist on a continuum with normal experience has been proposed in multiple forms throughout the history of psychiatry. However, in recent years there has been an exponential increase in efforts aimed at elucidating what has been termed the 'psychosis continuum'. The present review seeks to summarize some of the more basic characteristics of this continuum and to present some of the recent findings that provide support for its validity. While there is still considerable work to be done, the emerging data holds considerable promise for advancing our understanding of both risk and resilience to psychiatric …