Capturing adolescents in need of psychiatric care with psychopathological symptoms: A population-based cohort study

Rotstein, Anat; Goldenberg, Judy; Fund, Suzan; Levine, Stephen Z.; Reichenberg, Abraham

doi:10.1192/j.eurpsy.2021.2251

Cited by 3 publications

(3 citation statements)

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“…In fact, it has been repeatedly confirmed that the long-term trajectory of any mental disorder is highly influenced by treatments provided to patients in the first years of the disease [54][55][56]. Therefore, the early detection and appropriate treatment of any mental disorder is essential to improve the long-term prognosis of patients [57][58][59][60][61][62]. This model must also be applied to other severe mental disorders, including obsessive-compulsive disorder, which has been overlooked and wrongly considered "less" severe compared to psychosis.…”

Section: Discussionmentioning

confidence: 99%

Duration of Untreated Illness in Patients with Obsessive–Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review

Perris,

Cipolla,

Catapano

et al. 2023

JPM

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Background: Duration of untreated illness (DUI)—defined as the time period between the onset of a mental disorder and its first adequate treatment—should influence patients’ long-term prognosis and outcome. In patients with obsessive–compulsive disorder (OCD), DUI lasts on average from 87.5 up to 94.5 months, being significantly longer compared with data available from patients affected by other severe mental disorders, such as schizophrenia and bipolar disorder. We carried out a systematic review in order to assess the impact of DUI on long-term outcomes in OCD patients. Methods: A systemic review has been implemented, searching from inception to April 2023; only papers written in English were included. Results: Seventy-one articles were initially identified; only eight papers were included in the review. The DUI ranged from 7.0 ± 8.5 to 20.9 ± 11.2 years. Patients reporting a longer DUI have a poor long-term outcome in terms of lower level of treatment response and greater symptom severity. Conclusions: The present review confirms that longer DUI has a negative impact on the long-term outcome of patients with OCD. It should be useful to promote the dissemination of early interventions with a specific focus on OCD symptoms.

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Section: Discussionmentioning

confidence: 99%

Duration of Untreated Illness in Patients with Obsessive–Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review

Perris,

Cipolla,

Catapano

et al. 2023

JPM

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“…Psychopathological symptoms were assessed using a modified version of the Brief Symptom Inventory (Derogatis & Melisaratos, 1983 ; Rotstein, Goldenberg, Fund, Levine, & Reichenberg, 2021 ). The inventory covers nine dimensions of psychopathology: psychoticism, paranoid ideation, depression, anxiety, phobic anxiety, somatization, obsession-compulsion, interpersonal sensitivity, hostility (i.e.…”

Section: Methodsmentioning

confidence: 99%

Is cognition integral to psychopathology? A population-based cohort study

et al. 2023

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Background Lower cognitive functioning has been documented across psychiatric disorders and hypothesized to be a core deficit of mental disorders. Situating psychopathology and cognition as part of a unitary construct is therefore important to understanding the etiology of psychiatric disorders. The current study aims to test competing structural models of psychopathology and cognition in a large national cohort of adolescents. Methods The analytic sample consisted of 1189 participants aged 16–17 years, screened by the Israeli Draft Board. Psychopathology was assessed using a modified version of the Brief Symptom Inventory, and cognition was assessed based on four standardized test scores ((1) mathematical reasoning, concentration, and concept manipulation; (2) visual-spatial problem-solving skills and nonverbal abstract reasoning; (3) verbal understanding; (4) categorization and verbal abstraction). Confirmatory factor analysis was implemented to compare competing structural models of psychopathology with and without cognition. Sensitivity analyses examined the models in different subpopulations. Results Confirmatory factor analysis indicated a better model fit of psychopathological symptoms without cognition (RMSEA = 0.037; TLI = 0.991; CFI = 0.992) than with cognition (RMSEA = 0.04–0.042; TLI = 0.987–0.988; CFI = 0.988–0.989). Sensitivity analyses supported the robustness of these results with a single exception. Among participants with low cognitive abilities (N = 139), models that integrated psychopathological symptoms with cognition had a better fit compared to models of psychopathology without cognition. Conclusions The current study suggests that cognition and psychopathology are, generally, independent constructs. However, within low cognitive abilities, cognition was integral to the structure of psychopathology. Our results point toward an increased vulnerability to psychopathology in individuals with low cognitive abilities and may provide valuable information for clinicians.

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“…Our cross-sectional and observational study design cannot discern the causal basis for these findings but helps to refine several testable hypotheses. For example: greater cognitive impairments may partly drive greater psychopathology [63,64] and this effect may be more pronounced in XYY than XXY/KS; greater psychopathology may drive lower performance in IQ tests and this effect may be stronger in XYY than XXY/KS; there may be nonlinear associations between psychopathology and cognitive impairment so that correlations are stronger at the higher levels of psychopathology observed in XYY as compared to XXY/KS (however, see…”

Section: X-and Y-dosage Effects On the Coupling Of Psychopathology An...mentioning

confidence: 99%

X- vs. Y-Chromosome Influences on Human Behavior: A Deep Phenotypic Comparison of Psychopathology in XXY and XYY Syndromes

Schaffer

Rau

Clasen

et al. 2023

Preprint

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Do different genetic disorders impart different psychiatric risk profiles? This question has major implications for biological and translational aspects of psychiatry, but has been difficult to tackle given limited access to shared batteries of fine-grained clinical data across genetic disorders. Using a new suite of generalizable analytic approaches, we examine gold-standard diagnostic ratings, scores on 66 dimensional measures of psychopathology, and measures of cognition and functioning in two different sex chromosome aneuploidies (SCAs) - Klinefelter (XXY/KS) and XYY syndrome (n=102 and 64 vs. n=74 and 60 matched XY controls, total n=300). We focus on SCAs for their high collective prevalence, informativeness regarding differential X- vs. Y-chromosome effects, and potential relevance for normative sex differences. We show that XXY/KS elevates rates for most psychiatric diagnoses as previously reported for XYY, but disproportionately so for anxiety disorders. Fine-mapping across all 66 traits provides a detailed profile of psychopathology in XXY/KS which is strongly correlated with that of XYY (r=.75 across traits) and robust to ascertainment biases, but reveals: (i) a greater penetrance of XYY than KS/XXY for most traits except mood/anxiety problems, and (ii) a disproportionate impact of XYY vs. XXY/KS on social problems. XXY/KS and XXY showed a similar coupling of psychopathology with adaptive function and caregiver strain, but not IQ. This work provides new tools for deep-phenotypic comparisons of genetic disorders in psychiatry and uses these to detail unique and shared effects of the X- and Y-chromosome on human behavior.

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Capturing adolescents in need of psychiatric care with psychopathological symptoms: A population-based cohort study

Abstract: This peer-reviewed article has been accepted for publication but not yet copyedited or typeset, and so may be subject to change during the production process. The article is considered published and may be cited using its DOI.

Cited by 3 publications

References 45 publications

Duration of Untreated Illness in Patients with Obsessive–Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review

Duration of Untreated Illness in Patients with Obsessive–Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review

Is cognition integral to psychopathology? A population-based cohort study

X- vs. Y-Chromosome Influences on Human Behavior: A Deep Phenotypic Comparison of Psychopathology in XXY and XYY Syndromes

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