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Adolescent psychosis risk symptoms predicting persistent psychiatric service use: A 7-year follow-up study.

https://arctichealth.org/en/permalink/ahliterature298906
Source
Eur Psychiatry. 2019 01; 55:102-108
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2019
Author
Maija Lindgren
Minna Jonninen
Markus Jokela
Sebastian Therman
Author Affiliation
Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Electronic address: maija.lindgren@thl.fi.
Source
Eur Psychiatry. 2019 01; 55:102-108
Date
01-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Mental Disorders - epidemiology - therapy
Mental Health Services - statistics & numerical data
Patient Acceptance of Health Care - statistics & numerical data
Prodromal Symptoms
Prognosis
Prospective Studies
Psychiatric Status Rating Scales
Psychopathology
Psychotic Disorders - diagnosis - epidemiology - psychology
Risk Assessment - methods
Risk factors
Utilization Review - statistics & numerical data
Abstract
We investigated whether psychosis risk symptoms predicted psychiatric service use using seven-year register follow-up data.
Our sample included 715 adolescents aged 15-18, referred to psychiatric care for the first time. Psychosis risk symptoms were assessed with the Prodromal Questionnaire (PQ) at the beginning of the treatment. We assessed the power of the overall PQ as well as its positive, negative, general, and disorganized psychosis risk symptom factors in predicting prolonged service use. Baseline psychiatric diagnoses (grouped into 7 categories) were controlled for. Based on both inpatient and outpatient psychiatric treatment after baseline, adolescents were divided into three groups of brief, intermittent, and persistent service use.
Stronger symptoms on any PQ factor as well as the presence of a mood disorder predicted prolonged service use. All of the PQ factors remained significant predictors when adjusted for baseline mood disorder and multimorbidity.
In a prospective follow-up of a large sample using comprehensive mental health records, our findings indicate that assessing psychosis risk symptoms in clinical adolescent settings at the beginning of treatment could predict long-term need for care beyond diagnostic information. Our findings replicate the previous findings that positive psychosis risk symptoms are unspecific markers of severity of psychopathology. Also psychosis risk symptoms of the negative, disorganization, and general clusters are approximately as strongly associated with prolonged psychiatric service use in the upcoming years.
PubMed ID
30447416 View in PubMed
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Alexithymia is common among adolescents with severe disruptive behavior.

https://arctichealth.org/en/permalink/ahliterature101585
Source
J Nerv Ment Dis. 2011 Jul;199(7):506-9
Publication Type
Article
Date
Jul-2011
Author
Marko Manninen
Sebastian Therman
Jaana Suvisaari
Hanna Ebeling
Irma Moilanen
Matti Huttunen
Matti Joukamaa
Author Affiliation
*Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland; †Department of Psychology, University of Helsinki, Helsinki, Finland; ‡Clinic of Child Psychiatry, Oulu University and University Hospital, Oulu, Finland; and §Tampere School of Public Health, University of Tampere and Department of Psychiatry, Tampere University Hospital, Tampere, Finland.
Source
J Nerv Ment Dis. 2011 Jul;199(7):506-9
Date
Jul-2011
Language
English
Publication Type
Article
Abstract
This study aimed to examine alexithymic features and associations between alexithymia and psychiatric symptoms among adolescents living in a closed institution because of severe behavioral problems. Forty-seven adolescents (29 boys and 18 girls) aged 15 to 18 years completed the 20-item Toronto Alexithymia Scale (TAS-20) Questionnaire and the Youth Self-Report, whereas their foster parents completed the Child Behavior Checklist. The TAS-20 scores of the participants were compared with those of an extensive population sample (N = 6000) matched by age and birth year. Reform school adolescents are significantly more alexithymic than the control group, and the TAS-20 scores are correlated with numerous psychiatric problems, mainly in the internalizing spectrum, but also with thought problems and self-reported aggression. Promoting abilities in identifying and describing feelings is important when treating delinquent adolescents.
PubMed ID
21716065 View in PubMed
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Cognitive endophenotypes inform genome-wide expression profiling in schizophrenia.

https://arctichealth.org/en/permalink/ahliterature275391
Source
Neuropsychology. 2016 Jan;30(1):40-52
Publication Type
Article
Date
Jan-2016
Author
Amanda B Zheutlin
Rachael W Viehman
Rebecca Fortgang
Jacqueline Borg
Desmond J Smith
Jaana Suvisaari
Sebastian Therman
Christina M Hultman
Tyrone D Cannon
Source
Neuropsychology. 2016 Jan;30(1):40-52
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bipolar Disorder - genetics - psychology
Cognition
Cognition Disorders - genetics - psychology
Endophenotypes
Female
Finland
Gene Expression Profiling
Gene Expression Regulation
Genome-Wide Association Study
Humans
Leukocytes, Mononuclear
Male
Memory
Microarray Analysis
Middle Aged
RNA - analysis
Registries
Schizophrenia - genetics
Schizophrenic Psychology
Sweden
Twins - genetics - psychology
Abstract
We performed a whole-genome expression study to clarify the nature of the biological processes mediating between inherited genetic variations and cognitive dysfunction in schizophrenia.
Gene expression was assayed from peripheral blood mononuclear cells using Illumina Human WG6 v3.0 chips in twins discordant for schizophrenia or bipolar disorder and control twins. After quality control, expression levels of 18,559 genes were screened for association with the California Verbal Learning Test (CVLT) performance, and any memory-related probes were then evaluated for variation by diagnostic status in the discovery sample (N = 190), and in an independent replication sample (N = 73). Heritability of gene expression using the twin design was also assessed.
After Bonferroni correction (p
Notes
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PubMed ID
26710095 View in PubMed
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Confirmatory factor analysis of psychotic-like experiences in a general population sample.

https://arctichealth.org/en/permalink/ahliterature276306
Source
Psychiatry Res. 2016 Jan 30;235:197-9
Publication Type
Article
Date
Jan-30-2016
Author
Sebastian Therman
Tim B Ziermans
Source
Psychiatry Res. 2016 Jan 30;235:197-9
Date
Jan-30-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Delusions - epidemiology - psychology
Factor Analysis, Statistical
Female
Hallucinations - epidemiology - psychology
Humans
Male
Models, Psychological
Paranoid Disorders - epidemiology - psychology
Psychotic Disorders - epidemiology - psychology
Residence Characteristics
Surveys and Questionnaires
Sweden - epidemiology
Young Adult
Abstract
Psychotic-like experiences (PLEs) are sub-psychotic expressions of the psychosis continuum. Several studies have suggested multifactorial models, including a bifactor model, of the putative PLEs assessed with the popular Community Assessment of Psychic Experiences (CAPE) questionnaire. Our confirmatory results in a gender-balanced population of adolescents and young adults support a three-factor Paranoia-Delusions-Hallucinations structure of PLEs, which excludes Grandiosity and Common Paranormal Beliefs. The best latent models achieved excellent fit when taking the categorical nature of the responses into consideration.
PubMed ID
26738980 View in PubMed
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Dimensions of psychotic experiences among women in the general population.

https://arctichealth.org/en/permalink/ahliterature261645
Source
Int J Methods Psychiatr Res. 2014 Mar;23(1):62-8
Publication Type
Article
Date
Mar-2014
Author
Sebastian Therman
Jaana Suvisaari
Christina M Hultman
Source
Int J Methods Psychiatr Res. 2014 Mar;23(1):62-8
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Adult
Community Health Planning
Female
Follow-Up Studies
Humans
Likelihood Functions
Middle Aged
Psychiatric Status Rating Scales
Psychotic Disorders - diagnosis - psychology
Questionnaires
Residence Characteristics
Sweden - epidemiology
Abstract
Full-information factor analysis of ordinal data was employed to determine the factorial structure of the responses of 31,822 adult Swedish women to the 20 "positive" psychotic experience items of the Community Assessment of Psychic Experiences (CAPE) questionnaire. Five separable but correlated trait dimensions were found, reflecting Paranoia, Grandiosity, Magical Thinking, Delusions, and Hallucinations. High scores on any dimension were associated with a higher probability of questionnaire-assessed lifetime major depressive episodes or generalized anxiety disorder, though Grandiosity was so only to a very small degree. Our results closely match previous findings among adolescents and young women, and demonstrate that psychotic experiences cannot be considered a single trait.
PubMed ID
24375586 View in PubMed
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Predicting psychosis and psychiatric hospital care among adolescent psychiatric patients with the Prodromal Questionnaire.

https://arctichealth.org/en/permalink/ahliterature263214
Source
Schizophr Res. 2014 Sep;158(1-3):7-10
Publication Type
Article
Date
Sep-2014
Author
Sebastian Therman
Maija Lindgren
Marko Manninen
Rachel L Loewy
Matti O Huttunen
Tyrone D Cannon
Jaana Suvisaari
Source
Schizophr Res. 2014 Sep;158(1-3):7-10
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Depersonalization
Factor Analysis, Statistical
Female
Finland
Follow-Up Studies
Hospitalization
Humans
Interview, Psychological - methods
Male
Prodromal Symptoms
Prognosis
Proportional Hazards Models
Psychotic Disorders - diagnosis - psychology - therapy
Questionnaires
Registries
Risk
Self Report
Sensitivity and specificity
Survival Analysis
Abstract
The Prodromal Questionnaire (PQ) identifies psychiatric help-seekers in need of clinical interviews to diagnose psychosis risk. However, some providers use the PQ alone to identify risk. Therefore, we tested its predictive utility among 731 adolescent psychiatric help-seekers, with a 3-9-year register-based follow-up. Nine latent factors corresponded well with postulated subscales. Depersonalization predicted later hospitalization with a psychosis diagnosis (HR 1.6 per SD increase), and Role Functioning predicted any psychiatric hospitalization (HR 1.3). Published cut-off scores were poor predictors of psychosis; endorsement rates were very high for most symptoms. Therefore, we do not recommend using the PQ without second-stage clinical interviews.
PubMed ID
25062972 View in PubMed
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Prodromal psychosis screening in adolescent psychiatry clinics.

https://arctichealth.org/en/permalink/ahliterature131714
Source
Early Interv Psychiatry. 2012 Feb;6(1):69-75
Publication Type
Article
Date
Feb-2012
Author
Rachel L Loewy
Sebastian Therman
Marko Manninen
Matti O Huttunen
Tyrone D Cannon
Author Affiliation
Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94143-0984, USA. rloewy@lppi.ucsf.edu
Source
Early Interv Psychiatry. 2012 Feb;6(1):69-75
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior - psychology
Adolescent Health Services - statistics & numerical data
Community Mental Health Services - methods
Early Diagnosis
Female
Finland
Humans
Male
Predictive value of tests
Psychiatric Status Rating Scales - statistics & numerical data
Psychotic Disorders - diagnosis
Questionnaires
Sensitivity and specificity
Abstract
Research has identified a syndrome conferring ultra-high risk (UHR) for psychosis, although UHR interviews require intensive staff training, time and patient burden. Previously, we developed the Prodromal Questionnaire (PQ) to screen more efficiently for UHR syndromes.
This study examined the concurrent validity of the PQ against UHR status and preliminary predictive validity for later psychotic disorder.
We assessed a consecutive patient sample of 408 adolescents who presented to psychiatry clinics in Helsinki, Finland, seeking mental health treatment, including 80 participants who completed the Structured Interview for Prodromal Syndromes (SIPS).
A cut-off score of 18 or more positive symptoms on the PQ predicted UHR diagnoses on the SIPS with 82% sensitivity and 49% specificity. Three of 14 (21%) participants with high PQ scores and SIPS UHR diagnoses developed full psychotic disorders within 1 year.
Using the PQ and SIPS together can be an efficient two-stage screening process for prodromal psychosis in mental health clinics.
PubMed ID
21883972 View in PubMed
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The relationship between performance and fMRI signal during working memory in patients with schizophrenia, unaffected co-twins, and control subjects.

https://arctichealth.org/en/permalink/ahliterature167127
Source
Schizophr Res. 2007 Jan;89(1-3):191-7
Publication Type
Article
Date
Jan-2007
Author
Katherine H Karlsgodt
David C Glahn
Theo G M van Erp
Sebastian Therman
Matti Huttunen
Marko Manninen
Jaakko Kaprio
Mark S Cohen
Jouko Lönnqvist
Tyrone D Cannon
Author Affiliation
Department of Psychology, UCLA, Los Angeles, CA 90095-1563, USA.
Source
Schizophr Res. 2007 Jan;89(1-3):191-7
Date
Jan-2007
Language
English
Publication Type
Article
Keywords
Aged
Attention - physiology
Brain Mapping
Color Perception - physiology
Discrimination Learning - physiology
Diseases in Twins - genetics - physiopathology
Dominance, Cerebral - physiology
Female
Finland
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Memory, Short-Term - physiology
Middle Aged
Occipital Lobe - physiopathology
Oxygen - blood
Parietal Lobe - physiopathology
Pattern Recognition, Visual - physiology
Prefrontal Cortex - physiopathology
Schizophrenia - genetics - physiopathology
Abstract
While behavioral research shows working memory impairments in schizophrenics and their relatives, functional neuroimaging studies of patients and healthy controls show conflicting findings of hypo- and hyperactivation, possibly indicating different relationships between physiological activity and performance. In a between-subjects regression analysis of fMRI activation and performance, low performance was associated with relatively lower activation in patients than controls, while higher performance was associated with higher activation in patients than controls in DLPFC and parietal cortex, but not occipital cortex, with unaffected twins of schizophrenics being intermediate between the groups. Accordingly, this supports the idea that both hyper and hypoactivation may be possible along a continuum of behavioral performance in a way consistent with a neural inefficiency model. Further, this study offers preliminary evidence that the relationship between behavior and physiology in schizophrenia may be heritable.
PubMed ID
17029749 View in PubMed
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Symptoms associated with psychosis risk in an adolescent birth cohort: improving questionnaire utility with a multidimensional approach.

https://arctichealth.org/en/permalink/ahliterature131398
Source
Early Interv Psychiatry. 2011 Nov;5(4):343-8
Publication Type
Article
Date
Nov-2011
Author
Sebastian Therman
Markus Heinimaa
Jouko Miettunen
Matti Joukamaa
Irma Moilanen
Pirjo Mäki
Juha Veijola
Author Affiliation
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Lintulahdenkuja 4, Helsinki, Finland. sebastian.therman@thl.fi
Source
Early Interv Psychiatry. 2011 Nov;5(4):343-8
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Cohort Studies
Factor Analysis, Statistical
Female
Finland
Humans
Male
Population Surveillance
Psychiatric Status Rating Scales
Psychotic Disorders - diagnosis - psychology
Questionnaires
Reproducibility of Results
Risk factors
Abstract
Specialized self-report questionnaires have been developed for detection of symptoms indicative of psychosis risk. The identification of at-risk individuals is typically based on sum scores, which assume equal severity and discriminability of all symptoms, and a single dimension of illness. Our aim was to test whether separable dimensions of risk could be identified in the general population.
We explored the latent structure of one such questionnaire using full-information item factor analysis, deriving exploratory models from the PROD-Screen questionnaire responses of the adolescent general population based on the Northern Finland 1986 Birth Cohort (n=6611).
A three-dimensional factor structure of positive, negative and general symptoms emerged. The factor structure, the appropriateness of the statistical model and the application of the results to the detection of heightened psychosis risk are discussed.
In explicitly taking into account the multidimensionality and varying symptom severity of the included items, the current model provides an improvement in questionnaire-based assessment of psychosis risk.
PubMed ID
21910849 View in PubMed
Less detail

Verbal recall and recognition in twins discordant for schizophrenia.

https://arctichealth.org/en/permalink/ahliterature157501
Source
Psychiatry Res. 2008 Jun 30;159(3):271-80
Publication Type
Article
Date
Jun-30-2008
Author
Theo G M van Erp
Sebastian Therman
Tiia Pirkola
Annamari Tuulio-Henriksson
David C Glahn
Peter Bachman
Matti O Huttunen
Jouko Lönnqvist
Marja Hietanen
Jaakko Kaprio
Markku Koskenvuo
Tyrone D Cannon
Author Affiliation
Department of Psychology, UCLA, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, USA. vanerp@psych.ucla.edu
Source
Psychiatry Res. 2008 Jun 30;159(3):271-80
Date
Jun-30-2008
Language
English
Publication Type
Article
Keywords
Adult
Control Groups
Diseases in Twins - diagnosis - genetics - pathology
Female
Finland
Hippocampus - pathology
Humans
Language Tests - statistics & numerical data
Male
Memory Disorders - diagnosis - genetics - pathology
Mental Recall
Phenotype
Psychiatric Status Rating Scales - statistics & numerical data
Psychotic Disorders - diagnosis - genetics - pathology
Recognition (Psychology)
Schizophrenia - diagnosis - genetics - pathology
Schizophrenic Psychology
Twins, Dizygotic - genetics
Twins, Monozygotic - genetics
Verbal Learning
Abstract
The nature, neural underpinnings, and etiology of deficits in verbal declarative memory in patients with schizophrenia remain unclear. To examine the contributions of genes and environment to verbal recall and recognition performance in this disorder, the California Verbal Learning Test was administered to a large population-based Finnish twin sample, which included schizophrenic and schizoaffective patients, their non-ill monozygotic (MZ) and dizygotic (DZ) co-twins, and healthy control twins. Compared with controls, patients and their co-twins showed relatively greater performance deficits on free recall compared with recognition. Intra-pair differences between patients and their non-ill co-twins in hippocampal volume and memory performance were highly positively correlated. These findings are consistent with the view that genetic influences are associated with reduced verbal recall in schizophrenia, but that non-genetic influences further compromise these abnormalities in patients who manifest the full-blown schizophrenia phenotype, with this additional degree of disease-related declarative memory deficit mediated in part by hippocampal pathology.
Notes
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PubMed ID
18442861 View in PubMed
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10 records – page 1 of 1.