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Are we really mapping psychosis risk? Neuroanatomical signature of affective disorders in subjects at ultra high risk

Published online by Cambridge University Press:  30 April 2014

G. Modinos ,
P. Allen ,
M. Frascarelli ,
S. Tognin ,
L. Valmaggia ,
L. Xenaki ,
P. Keedwell ,
M. Broome ,
I. Valli  and
J. Woolley
...Show all authors
G. Modinos
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
P. Allen
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
M. Frascarelli
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
S. Tognin
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
L. Valmaggia
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
L. Xenaki
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
P. Keedwell
Affiliation:
Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
M. Broome
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
I. Valli
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
J. Woolley
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
J. M. Stone
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
A. Mechelli
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
M. L. Phillips
Affiliation:
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA, USA
P. McGuire
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
P. Fusar-Poli*
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
*
*Address for correspondence: P. Fusar-Poli, M.D., Ph.D., Department of Psychosis Studies, Institute of Psychiatry, Box PO 63, 16 De Crespigny Park, London SE5 8AF, UK. (Email: paolo.fusar-poli@kcl.ac.uk)
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Abstract

Background.

The majority of people at ultra high risk (UHR) of psychosis also present with co-morbid affective disorders such as depression or anxiety. The neuroanatomical and clinical impact of UHR co-morbidity is unknown.

Method.

We investigated group differences in grey matter volume using baseline magnetic resonance images from 121 participants in four groups: UHR with depressive or anxiety co-morbidity; UHR alone; major depressive disorder; and healthy controls. The impact of grey matter volume on baseline and longitudinal clinical/functional data was assessed with regression analyses.

Results.

The UHR-co-morbidity group had lower grey matter volume in the anterior cingulate cortex than the UHR-alone group, with an intermediate effect between controls and patients with major depressive disorder. In the UHR-co-morbidity group, baseline anterior cingulate volume was negatively correlated with baseline suicidality/self-harm and obsessive–compulsive disorder symptoms.

Conclusions.

Co-morbid depression and anxiety disorders contributed distinctive grey matter volume reductions of the anterior cingulate cortex in people at UHR of psychosis. These volumetric deficits were correlated with baseline measures of depression and anxiety, suggesting that co-morbid depressive and anxiety diagnoses should be carefully considered in future clinical and imaging studies of the psychosis high-risk state.

Keywords

Anterior cingulate cortexco-morbiditygrey matter volumehigh riskneuroimagingschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 16 , December 2014 , pp. 3491 - 3501
Copyright
Copyright © Cambridge University Press 2014 

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