Publication: PNAS
Sofia C. Orellana Richard A. I. Bethlehem, Ivan L. Simpson-Kent and Edward T. Bullmore
9 April 2024
Summary
A new study has found that childhood maltreatment can have an impact into adulthood because of how it effects an individual’s risk of poor physical health and traumatic experiences many years later
Annemieke M. Apergis-Schoute, Febe E. van der Flier, Samantha H.Y. Ip, Jonathan W. Kanen, Matilde M. Vaghi, Naomi A. Fineberg, Barbara J. Sahakian, Rudolf N. Cardinal, Trevor W. Robbins
13 July 2023
Summary
People with obsessive-compulsive disorder (OCD) can show both “perseveration” (persisting with an action after it is no longer advantageous) or “shifting” to other actions, depending on the situation they are in. In experimental tests, perseveration was related to the severity of OCD, and improved by medication that influences serotonin neurotransmitter systems.
Publication: International Journal Geriatric Psychiatry
Anne D. Kershenbaum, Annabel C. Price, Rudolf N. Cardinal, Shanquan Chen, James M. Fitzgerald, Jonathan Lewis, Sinéad Moylett, John T. O’Brien
19 May 2023
Summary
Survival is shorter in Lewy body dementia (LBD, referring to both Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB)) compared with Alzheimer’s disease (AD), but the reasons for this difference are not well established.
Researchers identified cohorts of patients with dementia (male and female AD, PDD, and DLB dementia groups) referred into mental health services and linked to National Health Service (NHS) Hospital Episode Statistics and the Office for National Statistics to identify death dates and proximal cause of death. Among patients with DLB and PDD compared to AD ,those with PDD, especially males with PDD, had the highest hazard ratio for death. Aspiration pneumonia and nervous system causes of death accounted for a significant proportion of the excess deaths in the male PDD group compared to the male AD group. Compared with AD, hazard ratios for nervous system causes of death were significantly elevated in all LBD groups. A range of cause‐of‐death categories were significantly more frequent across the LBD groups, with aspiration pneumonia,genitourinary causes and other respiratory causes elevated in more than one group
Publication: Psychological Medicine
Katherine Parkin; Shanquan Chen; Marjan Biria; Helen Beckwith; Isaac Jarratt-Barnham; Naomi A Fineberg; Rudolf N Cardinal; Trevor W Robbins; Emilio Fernandez-Egea
13 January 2022
The paper explores the impact of obsessive-compulsive symptoms (OCS) on the wellbeing of people who take clozapine to manage symptoms of schizophrenia. It highlights that clozapine-associated OCS occur frequently in this group of patients and that these symptoms have a negative impact on people’s wellbeing over time.
Publication: BJPsych Open
Bhardwaj A, Moore A, Cardinal RN, Bradley C, Cross L, Ford TJ
13 January 2021
The Covid-19 crisis necessitated rapid adoption of remote consultations across National Health Service (NHS) child and adolescent mental health services (CAMHS).
This study aimed to understand practitioners’ experiences of rapid implementation of remote consultations across CAMHS in one NHS trust in the east of England.
Data were collected through a brief questionnaire documenting clinicians’ experiences following remote delivery of services. The questionnaire began before ‘lockdown’ and focused on 102 assessment consultations as part of a planned move to virtual assessment.
As the roll-out of remote consultations was extended at lockdown, the researchers extended the questionnaire to include all remote clinical contacts (n = 202).
Despite high levels of initial concern, clinicians’ reports were positive overall; importantly, however, their experiences varied by team. When restrictions on face-to-face working are lifted, a blended approach of remote and face-to-face service delivery is recommended to optimise access and capacity while retaining effective and safe care.
Publication: BMJ Open Diabetes Research & Care
Fernández-Egea E, Walker R, Ziauddeen H, Cardinal RN, Bullmore ET
28 January 2020
The prevalence of diabetes in schizophrenia is twice that in the general population, but there are few reliable predictors of which individuals will develop glucose dysregulation.
This research tested if abnormal birth weight (either too low or too high) and parental diabetes, both variables that can be ascertained in the clinic, can predict diabetes onset in patients with schizophrenia.
Researchers looked at electronic records of a cohort of 190 clozapine-treated patients (37% treated for more than 20 years) and Cox regression survival analysis (with any type of glucose dysregulation as the event) to account for differences in length of treatment before the event and age at clozapine treatment initiation.
Age at clozapine initiation, family history of diabetes and birth weight were significant predictors of glucose dysregulation onset, while gender was not.
Among individuals with 10 years of follow-up, 80% of those with both abnormal birth weight and a family history of diabetes developed diabetes compared with 56% with only abnormal birth weight, 40% with only a family history of diabetes and 20% in those with neither.
Since 48% of cases had at least one risk factor and 6% had both risk factors, there is a substantial proportion of patients for whom preventive strategies could be implemented.
Publication: Revista de Psiquiatría y Salud Mental
Alabaf S, Kirkpatrick B, Chen S, Cardinal RN, Fernández-Egea E
10 April 2021
Schizophrenia typically involves so-called “positive” or psychotic symptoms (symptoms that are present but are unwanted), but sometimes also so-called “negative” or deficit symptoms (aspects of normal behaviour that are absent).
In a group of 167 patients with schizophrenia and being treated with clozapine, those patients with “non-deficit” schizophrenia were more likely than those with “deficit” schizophrenia to have reported cannabis use by the time of their first-episode psychosis, or trauma (related to crime or abuse) prior to that first episode of psychosis.
Patients with “deficit” schizophrenia were more likely to have been born in summer months. The timing of stressors during brain development may influence the pattern of symptoms that emerge.
Publication: Translational Psychiatry
Kanen JW, Arntz FE, Yellowlees R, Cardinal RN, Price A, Christmas DM, Apergis-Schoute AM, Sahakian BJ, Robbins TW
1 February 2021
Serotonin is involved in a wide range of mental capacities essential for navigating the social world, including emotion and impulse control. Much recent work on serotonin and social functioning has focused on decision-making. Here researchers investigated the influence of serotonin on human emotional reactions to social conflict. They used a novel computerised task that required mentally simulating social situations involving unjust harm and found that depleting the serotonin precursor tryptophan-in a double-blind randomised placebo-controlled design-enhanced emotional responses to the scenarios in a large sample of 73 healthy volunteers, and interacted with individual differences in trait personality to produce distinctive human emotions.
Whereas guilt was preferentially elevated in highly empathic participants, annoyance was potentiated in those high in trait psychopathy, with medium to large effect sizes. The findings show how individual differences in personality, when combined with fluctuations of serotonin, may produce diverse emotional phenotypes. This has implications for understanding vulnerability to psychopathology, determining who may be more sensitive to serotonin-modulating treatments, and casts new light on the functions of serotonin in emotional processing.
Publication: Frontiers in Psychiatry
Chen S, She R, Qin P, Kershenbaum A, Fernández-Egea E, Nelder JR, Ma C, Lewis JR, Wang C, Cardinal RN
26 November 2020
To date, there is a paucity of information regarding the effect of COVID-19 or lockdown on mental disorders.
In this study researchers aimed to quantify the medium-term impact of lockdown on referrals to secondary care mental health clinical services.
They conducted a controlled interrupted time series study using data from Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment population ~0.86 million).
The UK lockdown resulted in an instantaneous drop in mental health referrals but then a longer-term acceleration in the referral rate. This acceleration was primarily for urgent or emergency referrals, including referrals to liaison psychiatry and mental health crisis teams. The acceleration was significant for females, males, working-age adults, people of White ethnicity, those living alone, and those who had pre-existing depression, severe mental illness, hypertension / cardiovascular / cerebrovascular disease, personality disorders, asthma / chronic obstructive pulmonary disease, dyslipidemia, anxiety, substance misuse or reactions to severe stress.
No significant post-lockdown acceleration was observed for children / adolescents, older adults, people of ethnic minorities, married / cohabiting people, and those who had previous / pre-existing dementia, diabetes, cancer, eating disorder, a history of self-harm or intellectual disability. This evidence may help service planning and policy-making, including preparation for any future lockdown in response to outbreaks.
Publication: European Neuropsychopharmacology
J.R. Breedon, H. Ziauddeen, J. Stochl, K.D. Ersche
24 November 2020
This research investigates the underlying mechanism of addictive behaviour as exemplified by cocaine addiction, and how it impacts on other behaviours such as eating.
Cocaine is adept at being both highly pleasurable and highly habit-forming and both processes are involved in the development of addiction. But are these behavioural changes specific to just cocaine consumption or do they impact other behaviours? This is an interesting question because food consumption is a paradigmatic example of behaviour that can be dominated by both deliberate (so-called goal-directed) and habitual control. As an example, people on diets will exert a high degree of control over their calorific and nutritional intake (‘goal directed’) only to find themselves falling back into old patterns of eating (‘habits’). This is an important question to ask because what we eat has clear and direct consequences for our health; if cocaine addiction has detrimental implications for food consumption, this will have health consequences, beyond the direct consequence of cocaine use.
The researchers presented participants with pictures of food and asked them to rate how much they were willing to pay for them, and how much they wanted to eat the foods. In addition they used questionnaires to investigate both the reasons why cocaine-addicted individuals use cocaine, and the factors influencing their food-related choices.
The results suggest that cocaine addiction narrows the goals of individuals away from ‘normal’ motivators like food, and diverts it towards cocaine. Further, the results suggest that food behaviour in cocaine addiction is more habitual, supporting the hypothesis that the habits developed are wide-reaching and affect behaviours beyond cocaine.
These results will be of interest to those working with individuals with cocaine addiction – they suggest that more attention should be paid to the eating habits of those affected. Further they add support for the ‘habit theory’ of addiction, and suggest that further research into treatments for cocaine addiction should consider the possibility of habits training, that is, methods of directing this ‘habit bias’ towards healthier, more meaningful, activities.
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