Biomedical subjects

Jim van Os

Publications and source records attributed to Jim van Os.

At least 37 records · Page 2Linked to original sources

PubMed2006

Childhood trauma and emotional reactivity to daily life stress in adult frequent attenders of general practitioners.

OBJECTIVES: Childhood trauma (CT) has consistently been associated with neuroticism--a personality trait reflecting vulnerability to stress. However, not much is known about the impact of a history of trauma on moment-to-moment emotions and experiences in the flow of daily life. The relationship between CT and emotional reactivity to daily life stress was investigated. METHODS: Ninety frequent attenders of general practitioners, of which 29 fulfilled criteria for CT (sexual and/or physical trauma before the age of 19 years), were studied with the Experience Sampling Method (a structured diary technique assessing current context and mood in daily life) to assess: (a) appraised subjective stress related to daily events and activities, and (b) emotional reactivity conceptualized as changes in negative affect (NA). RESULTS: Multilevel regression analysis revealed that subjects with a history of CT reported significantly increased emotional reactivity to daily life stress, as reflected in an increase in NA. This effect was significantly stronger for subjects who experienced trauma before the age of 10 years. CONCLUSION: These results confirm that CT may have long-lasting and enduring effects on adult psychological functioning, as exposed individuals continually react more strongly to small stressors occurring in the natural flow of everyday life. The finding that emotional stress reactivity is most pronounced for subjects who experienced trauma early in life confirms prior evidence suggesting that the effects of trauma are more detrimental when trauma occurs at a younger age.

Adaptation, Psychological↗

PubMed2006

Lower birth weight of Dutch neonates who were in utero at the time of the 9/11 attacks.

OBJECTIVE: Maternal stress during pregnancy has been reported to have an adverse influence on fetal growth. The terrorist attacks of September 11, 2001, on the United States have provoked feelings of insecurity and stress worldwide. Our aim was to test the hypothesis that maternal exposure to these acts of terrorism via the media had an unfavorable influence on mean birth weight in the Netherlands. METHODS: We compared birth weights of 1885 Dutch neonates who were in utero during the attacks with those of 1258 neonates who were in utero exactly 1 year later. RESULTS: In the exposed group, birth weight was lower than in the nonexposed group (difference, 48 g; 95% confidence interval=13.6, 82.9; P=.006). The difference in birth weight could not be explained by tobacco use, maternal age, parity, or other potential confounders or by shorter pregnancy durations. CONCLUSION: These results provide evidence supporting the hypothesis that exposure of Dutch pregnant women to the 9/11 events via the media has had an adverse effect on the birth weight of their offspring.

Birth Weight↗

PubMed2006

Mood reactivity to daily negative events in early adolescence: relationship to risk for psychopathology.

Emotional responses to negative daily experiences in young adolescents may provide important clues to the development of psychopathology, but research is lacking. This study assessed momentary mood reactivity to daily events as a function of risk profile in a school sample, ages 11-14. High-risk (HR, n=25) and low-risk (LR, n=106) subgroups completed frequent self-reports of mood and events for 5 days. HR adolescents reported more negative events involving family and peers. Multilevel modeling results showed that negative events, especially if stressful, were associated with increased negative and decreased positive affects, with heightened responses in HR adolescents. HR adolescents with greater stress over the last 3 months showed additional increases in depressed mood following negative events. Altered reactivity to and dysfunctional appraisals of daily events may link adolescent risk profiles to later mental health problems.

Adolescent↗

PubMed2006

Evidence that trait-anxiety and trait-depression differentially moderate cortical processing of pain.

OBJECTIVES: The purpose of this study was to examine the influence of neuroticism (N) and its different subfacets anxiety (N-anx) and depression (N-dep) on cortical pain processing expressed as event-related potentials (ERPs). METHODS: Seventy-five healthy participants received electrical pain stimuli under condition of simultaneous electroencephalogram registration. Multiple regression analyses were conducted to study the amount of pain-ERP variance. ERP variance was explained by N and its subfacets. RESULTS: N moderated the way pain was processed cortically. Higher levels of N were associated with higher pain-ERP amplitudes. Within this association, differential subfacet effects were observed: N-anx reduced, whereas N-dep augmented pain-ERP amplitudes. DISCUSSION: A personality trait reflecting bias toward negative emotions may moderate the way pain is processed cortically, with directionally different effects depending on whether the trait is expressed predominantly in the realm of anxiety or depression.

Adaptation, Physiological↗

PubMed2006

S100 and impact of ECT on depression and cognition.

OBJECTIVES: The main side effects of electroconvulsive therapy (ECT) are in the realm of cognition. The S100-beta is a calcium-binding protein that is expressed by astrocytes in the central nervous system during depression and has been suggested to modulate the impact of ECT on cognition. METHODS: Serum samples of S100-beta were taken before and 1 and 3 hours after each ECT session in 12 depressed patients (mean age, 54 years), treated with bilateral ECT twice weekly (mean, 6 sessions). Measures of depression (Symptom Checklist-90 depression dimension) and a neurocognitive test battery yielding 3 domains of general cognition, memory, and subjective cognitive impairment were administered 1 day before and 5 and 30 days post-ECT. RESULTS: Electroconvulsive therapy was associated with a reduction in depression and subjective cognitive impairment at 5 and 30 days post-ECT. Electroconvulsive therapy was associated with a small but significant rise in S100-beta 1 hour post-ECT (adjusted B = 0.013, P = 0.035), with a directionally similar but reduced effect size at 3 hours post-ECT (adjusted B = 0.010, P = 0.10). Higher level of S100-beta at baseline was associated with poorer memory function at 5 and 30 days of follow-up (adjusted B per tertile group increase, 0.38, P = 0.013) but also with less subjective cognitive impairment (B = -28.2, P < 0.001) and less depression at follow-up (B = -15, P = 0.009). CONCLUSION: The S100-beta at baseline may be a marker predicting and possibly mediating the differential impact of ECT on cognition and depression.

Adult↗

PubMed2006

Validation of remission criteria for schizophrenia.

OBJECTIVE: Remission criteria for schizophrenia have been proposed, consisting of a time criterion and a symptomatic remission criterion. With longitudinal data of a representative patient group (N=317; median follow-up: 1,132 days), validity of the symptomatic remission criterion was investigated. METHOD: In a group of 145 patients meeting the symptomatic remission criterion at baseline and a group of 172 patients not meeting it at baseline, change over time in remission status was examined in relation to change in various functional outcomes. RESULTS: In both groups, change over time with the symptomatic remission criterion was associated with substantial changes in unmet needs, Global Assessment of Functioning scale scores, satisfaction with services and, to a lesser extent, quality of life. Changing the symptomatic remission criterion to include depression and suicidality did not affect the results. CONCLUSIONS: The proposed symptomatic remission criterion has clinical validity and represents the right balance between parsimony and inclusiveness.

Depressive Disorder↗

PubMed2006

Evidence that early extrapyramidal symptoms predict later tardive dyskinesia: a prospective analysis of 10,000 patients in the European Schizophrenia Outpatient Health Outcomes (SOHO) study.

OBJECTIVE: This study examined whether extrapyramidal symptoms predict incidence of tardive dyskinesia 1 year later. METHOD: Simple, global measures were used to rate extrapyramidal symptoms and tardive dyskinesia in a prospective, observational health outcomes study. Baseline and 3-, 6-, and 12-month data on 9,298 patients were analyzed by using a Cox proportional-hazard model. Onset of tardive dyskinesia was examined in two groups: 1) no tardive dyskinesia at baseline (broad risk set) and 2) no tardive dyskinesia at baseline and 3 months (narrow risk set). RESULTS: Baseline extrapyramidal symptoms predicted later onset of tardive dyskinesia (broad risk set: hazard ratio=2.0, narrow risk set: hazard ratio=1.6). In analyses adjusted for age, gender, and medication exposure, this effect size was not reduced. About half of patients who developed tardive dyskinesia had earlier extrapyramidal symptoms. CONCLUSIONS: Although the association of tardive dyskinesia and extrapyramidal symptoms is significant, extrapyramidal symptoms do not robustly identify individuals at high risk for tardive dyskinesia. However, drug regimens and disease processes that increase extrapyramidal symptoms are likely to result in increased risk of tardive dyskinesia.

Adult↗

PubMed2006

Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness.

BACKGROUND: The reported link between psychological trauma and onset of psychosis remains controversial. AIMS: To examine associations between self-reported psychological trauma and psychotic symptoms as a function of prior evidence of vulnerability to psychosis (psychosis proneness). METHOD: At baseline, 2524 adolescents aged 14-24 years provided self-reports on psychological trauma and psychosis proneness, and at follow-up (on average 42 months later) participants were interviewed for presence of psychotic symptoms. RESULTS: Self-reported trauma was associated with psychotic symptoms, in particular at more severe levels (adjusted OR 1.89, 95% CI1.16-3.08) and following trauma associated with intense fear, helplessness or horror. The risk difference between those with and without self-reported trauma at baseline was 7% in the group with baseline psychosis proneness, but only 1.8% in those without (adjusted test for difference between these two effect sizes: chi2=4.6, P=0.032). CONCLUSIONS: Exposure to psychological trauma may increase the risk of psychotic symptoms in people vulnerable to psychosis.

Adolescent↗

PubMed2006

Incidence of tardive dyskinesia and tardive dystonia in African Caribbean patients on long-term antipsychotic treatment: the Curaçao extrapyramidal syndromes study V.

OBJECTIVE: Tardive dyskinesia (TD) and tardive dystonia (TDt) syndromes represent severe side effects of first-generation antipsychotics (FGAs). Although second-generation antipsychotics (SGAs) confer a lower risk for tardive syndromes, many patients continue to use FGAs alone or in combination with SGAs. Some patients remain free of TD or TDt even after many years of antipsychotic treatment with predominantly FGAs. Do these patients remain at risk for TD or TDt and, consequently, should a switch to SGAs be considered? A longitudinal cohort study in patients on long-term antipsychotic treatment may answer this question. METHOD: A 9-year cohort study (1992-2001) was conducted of the whole, mostly chronic, psychiatric inpatient population on the Caribbean island of Curaçao (N = 194). Almost all patients (95%) were of African Carribean origin. TD and TDt were assessed (1 baseline, 6 follow-ups) with the Abnormal Involuntary Movement Scale and the Fahn-Marsden rating scale, respectively. New cases of TD or TDt were diagnosed if they fulfilled the criteria at 2 successive follow-up visits. RESULTS: In patients with a mean antipsychotic use of approximately 18 years, the yearly incidence rates of TD and TDt were 10.2% (95% CI = 7.7 to 13.5) and 0.7% (95% CI = 0.4 to 1.5), respectively. The severity of TD was strongly associated with the severity of TDt (beta = 0.08, 95% CI = 0.03 to 0.14) and vice versa (beta = 0.10, 95% CI = 0.03 to 0.16). TD severity was positively associated with age and akathisia but negatively associated with parkinsonism. CONCLUSIONS: Patients who are free of TD after many years of antipsychotic treatment still have a considerable risk for TD. Switching to an SGA may be warranted. The risk for incident TDt in this group was very low.

Adult↗

PubMed2005

Data gathering: biased in psychosis?

This study examined whether the probabilistic reasoning bias referred to as a "jumping-to-conclusions" (JTC) style of reasoning, which, according to previous research, is associated with particular psychotic symptoms such as delusions, represents a trait that can also be detected in nonpsychotic relatives of patients with schizophrenia and in nonpsychotic individuals with a high level of psychotic experiences. Participants were, in order of level of psychosis liability, 40 patients with schizophrenia or a schizoaffective disorder, 40 first-degree nonpsychotic relatives, 41 participants from the general population with above average expression of psychotic experiences, and 53 participants from the general population with an average level of psychotic experiences. A "jumping-to-conclusions" bias was assessed using the beads task. A dose-response relationship was found in the association between level of psychosis liability and JTC (defined as needing only a single bead to complete the beads task) (odds ratio [OR] linear trend = 1.59, 95% CI: 1.13-2.24), and, independently, alinear association was apparent between JTC and level of delusional ideation (OR linear trend = 2.59, 95% CI: 1.18-5.69). In addition, the association between psychosis liability and JTC was generally much stronger as the level of delusional ideation was higher. JTC is associated with liability to psychosis (trait), in particular if the psychosis phenotype is characterized by delusional ideation (state).

Adult↗

PubMed2005

Cognitive functioning in patients with schizophrenia and bipolar disorder: a quantitative review.

OBJECTIVE: Evidence suggests that cognitive functioning in bipolar disorder may be impaired even in euthymic states, but it is unclear if the pattern of deficits is similar to the deficits found in schizophrenia. The aim of this study was to review quantitatively the studies on cognitive performance in schizophrenia and bipolar disorder. METHODS: Articles for consideration were identified through a literature search in MEDLINE and PsycLIT in the period between 1985 and October 2004, using the keywords "schizophrenia" combined with "bipolar disorder", or "manic-depress*" or "manic" combined with "cogniti*" or "neuropsycholog*". Thirty-one studies were included that: i) evaluated cognitive performance using standardized and reliable neuropsychological testing procedures; ii) compared adult patients with schizophrenia and with bipolar disorder; iii) reported test scores of both patient groups, or exact p-values, t-values, or F-values; and iv) were published as an original article in a peer-reviewed English language journal. RESULTS: Meta-analyses of all studies indicated that patients with bipolar disorder generally perform better than patients with schizophrenia, but the distribution of effect sizes showed substantial heterogeneity. Results based on a more homogeneous subset of studies that matched patient groups on clinical and demographic characteristics pointed in the same direction, with effect sizes in the moderate range. CONCLUSIONS: Patients with bipolar disorder show better cognitive performance than patients with schizophrenia, even when matched for clinical and demographic characteristics.

Bipolar Disorder↗

PubMed2005

Hospital comorbidity bias and the concept of schizophrenia.

BACKGROUND: The comorbidity bias predicts that if disease definition is based on observations of patients in the hospital, spurious comorbidity of psychopathological dimensions that increase the probability of hospital admission will be included in the disease concept, whereas comorbid dimensions that are not associated with admission will be excluded. The direction of any dimensional comorbidity bias in psychotic illness was assessed in a longitudinal analysis of the psychopathology of patients assessed both inside and outside the hospital. METHOD: Four hundred and eighty patients with broadly defined psychotic disorders were assessed between one and nine times (median two times) over a 5-year period with, amongst others, the Brief Psychiatric Rating Scale. Dimensional comorbidities between positive symptoms, negative symptoms, depression/anxiety, and manic excitement were compared, in addition to their associations with current and future admission status. RESULTS: Higher levels of psychopathology in all symptom domains were associated with both current and future hospital admissions. Associations between the positive, negative, and manic symptom domains were higher for patients in the hospital than for patients outside the hospital, in particular, between positive symptoms and manic excitement (beta=0.28, p<0.001). However, associations between depression and other symptom domains were higher in out-patients as compared to in-patients (positive symptoms and depression, beta=-0.26; p<0.002). CONCLUSION: The current analyses suggest that, to the extent that disease concepts of psychosis do not take into account effects of dimensional comorbidity biases occasioned by differential psychopathology according to treatment setting, "florid" psychotic psychopathology may be overrepresented, whereas depressive symptoms may be spuriously excluded.

Adult↗

PubMed2005

Schizophrenia and urbanicity: a major environmental influence--conditional on genetic risk.

More than 10 studies have consistently shown that around one-third of all schizophrenia incidence may be related to unknown but likely unconfounded environmental factors operating in the urban environment that have an impact on developing children and adolescents to increase, relatively specifically, the later expression of psychosis-like at-risk mental states and overt psychotic disorders. The available evidence suggests that causation (urban environment causes psychosis) is more important than selection (high-risk individuals move into urban areas) and that the effect of the environmental factors in the urban environment is conditional on genetic risk (i.e., there may be gene-environment interaction). The effect associated with urbanicity has grown in more recent birth cohorts, while studies focusing on within-city contrasts have found important within-city variation in the incidence of schizophrenia associated with neighborhood social characteristics. Future approaches may focus on the complex interactions between neighborhood cognitive social capital and genetic risk as the substrate for the increased incidence of schizophrenia in the increasingly urbanized areas that children are growing up in.

Cohort Studies↗

PubMed2005

Subtle fluctuations in psychotic phenomena as functional states of abnormal dopamine reactivity in individuals at risk.

BACKGROUND: Subjects at increased risk for psychosis experience continuous variation in the intensity of subtle psychotic experiences in response to minor stressors. It was investigated whether this psychotic reactivity in individuals at risk for psychosis is the exophenotypic expression of an underlying endophenotype characterized by a hyperreactive dopamine (DA) system. METHODS: First-degree relatives (n = 47) and control subjects (n = 49) were studied with the Experience Sampling Method (ESM), a structured diary technique assessing current context and psychopathology in daily life, to assess psychotic experiences in response to stress. A metabolic perturbation paradigm (administration of 2-deoxy-D-glucose inducing a mild state of glucoprivation) causing plasma elevation of homovanillic acid (HVA) was used as a proxy of DA reactivity. RESULTS: Multilevel regression analyses revealed that the interaction between HVA reactivity and daily stress in their effect on psychotic experiences differed according to underlying vulnerability. In the first-degree relatives, underlying HVA reactivity modified the psychotic experiences to daily stress, whereas no such effect was found in control subjects. CONCLUSIONS: These results suggest that psychotic experiences in response to minor stresses in the flow of daily life may be functional states of an underlying abnormal DA reactivity in subjects at risk to develop psychosis. The results add credence to the suggestion that abnormal DA reactivity may be part of the substrate that increases risk for psychotic symptoms in individuals at risk.

Adult↗

PubMed2005

The environment and schizophrenia: the role of cannabis use.

Cannabis use is associated with poor outcome in existing schizophrenia and may precipitate psychosis in individuals with preexisting liability. To investigate the overall effect size and consistency of the association between cannabis and psychosis, a meta-analysis from prospective studies was carried out. The pooled odds ratio was 2.1 (95% CI: 1.7-2.5) and could not be explained by confounding or reverse causality. Evidence suggests that cannabis is a component cause in the development and prognosis of psychosis, in which mechanisms of gene-environment interaction are most likely to explain this association. Potential new methods to directly link genetic liability to the effects of cannabis are discussed.

Genetic Predisposition to Disease↗

PubMed2005

Dermatoglyphics and Schizophrenia: a meta-analysis and investigation of the impact of obstetric complications upon a-b ridge count.

BACKGROUND: Patients with schizophrenia show deviances in their dermatoglyphics, in particular reductions in palmar a-b ridge counts (ABRCs), which are evidence of an early developmental deviance. However, the severity or the origin of these ABRC changes has not been established. METHOD: (i) We examined the published literature on the ABRC in patients with schizophrenia against controls with a random effects meta-analysis. (ii) We used linear regression to study the ABRC in our sample of families including 125 patients with schizophrenia, 107 of their unaffected relatives and 98 controls. (iii) The effect of obstetric complications on the patient's ABRC was examined using the Lewis Murray scale. RESULTS: The pooled standardised effect size of ABRC differences between patients and controls obtained by our meta-analysis was 0.39 (95% CI: 0.05-0.73; p=0.03). In our sample, there were no significant differences in ABRCs between those with schizophrenia, their relatives and controls. Only those patients with obstetric complications had significantly reduced ABRC compared to controls (p=0.01). CONCLUSIONS: We confirmed the presence of significant yet mild ABRC reductions in schizophrenia. These represent a subtle deviance from the norm and could be present in certain subsets of patients, possibly those who suffered early developmental insults.

Dermatoglyphics↗

PubMed2005

Familial covariation of the subclinical psychosis phenotype and verbal fluency in the general population.

OBJECTIVE: Cognitive impairments may be markers of familial transmission of liability to psychosis. This study examined to what degree the subclinical psychosis phenotype in the general population shows similar familial continuity with cognition, measured with a verbal fluency test, and whether this was similar for men and women. METHODS: Measures of the subclinical psychosis phenotype and verbal fluency were administered to a general population sample of genetically related individuals (n=425). RESULTS: In men but not women, higher levels of the subclinical psychosis phenotype were associated with worse verbal fluency performance both within and across relatives. CONCLUSION: Psychosis and verbal fluency may be more strongly linked in men than in women, and this difference is also expressed at the subclinical level of the phenotype.

Adolescent↗

PubMed2005

Cumulative exposure to estrogen and psychosis: a peak bone mass, case-control study in first-episode psychosis.

The organizational structural effects of estrogen may be cumulative and permanent by impacting on neurodevelopment, giving rise to "neuroprotective" effects and eventually reduction of psychosis risk. Reduction in bone mineral density (BMD, in g/cm2), as a biological marker of reduced cumulative exposure to estrogen, may be a marker of increased psychosis risk. A sample of 19 first-episode female psychosis patients with minimal previous antipsychotic exposure (mean 10 weeks) and 20 female controls underwent advanced fan-beam dual X-ray absorptiometry (DXA) to assess lumbal spine BMD of the region of L1-L4. Mean BMD was around one standard deviation lower in patients (1.13, S.D.=0.10) than in controls (1.25, S.D.=0.12; p=0.0021), and 84% of patients scored below the median value of the controls (OR=5.3, 95% CI: 1.2, 24.2). The results are compatible with the hypothesis that psychosis in women may be associated causally with a reduced protective effect of estrogen over the course of development.

Absorptiometry, Photon↗