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1
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Zurlo L, Dal Bò E, Gentili C, Cecchetto C. Olfactory dysfunction in schizophrenia and other psychotic disorders: A comprehensive and updated meta-analysis. Schizophr Res 2025; 275:62-75. [PMID: 39671833 DOI: 10.1016/j.schres.2024.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 11/21/2024] [Accepted: 12/05/2024] [Indexed: 12/15/2024]
Abstract
Olfaction plays a key role in our daily life, influencing food enjoyment, threat detection, mood and social relationships. Numerous studies have provided evidence of abnormal olfactory function in schizophrenia and other psychotic disorders. This pre-registered meta-analysis was conducted to (a) provide an updated overview of olfactory function in schizophrenia-spectrum disorders, and (b) examine the modulatory effects of demographic and clinical variables on distinct olfactory abilities. We complied with the PRISMA guidelines, searching throughout PubMed, MEDLINE, and PsycInfo, until the 12th of August 2023. A total of 73 publications were included, comprising data from 3282 patients and 3321 healthy controls. Results revealed that (a) patients performed significantly worse in higher-order olfactory tests (identification and discrimination) compared to healthy controls, while no differences were observed in odor sensitivity; (b) patients' performance in odor identification was moderated by education, as well as disease duration and negative symptoms. Our findings support the presence of olfactory impairments in schizophrenia-spectrum disorders, leading to significantly poorer performance in both odor identification and discrimination, but not sensitivity, when compared to healthy controls.
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Affiliation(s)
- Letizia Zurlo
- Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131 Padua, Italy.; Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy
| | - Elisa Dal Bò
- Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy
| | - Claudio Gentili
- Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131 Padua, Italy.; Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy
| | - Cinzia Cecchetto
- Department of General Psychology, University of Padua, Via Venezia 8, 35131 Padua, Italy..
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2
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Whearty KM, Ruiz I, Knippenberg AR, Strauss GP. Anhedonia reflects an encoding deficit for pleasant stimuli in schizophrenia: Evidence from the emotion-induced memory trade-off eye-tracking paradigm. Neuropsychology 2024; 38:475-485. [PMID: 38602815 PMCID: PMC11864075 DOI: 10.1037/neu0000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVE The present study explored the hypothesis that anhedonia reflects an emotional memory impairment for pleasant stimuli, rather than diminished hedonic capacity in individuals with schizophrenia (SZ). METHOD Participants included 30 SZ and 30 healthy controls (HCs) subjects who completed an eye-tracking emotion-induced memory trade-off task where contextually relevant pleasant, unpleasant, or neutral items were inserted into the foreground of neutral background scenes. Passive viewing and poststimulus elaboration blocks were administered to assess differential encoding mechanisms, and immediate and 1-week recognition testing phases were completed to assess the effects of delay interval. Participants also made self-reports of positive emotion, negative emotion, and arousal in response to the stimuli. RESULTS Results indicated that SZ experienced stimuli similarly to HC. Both groups demonstrated the typical emotion-induced memory trade-off during the passive viewing and poststimulus elaboration encoding blocks, as indicated by more hits for emotional than neutral items and fewer hits for backgrounds paired with emotional than neutral items. Eye-tracking data also indicated that both groups were more likely to fixate earlier and have longer dwell time on emotional than neutral items. At the 1-week delay, the emotion-induced memory trade-off was eliminated in both groups, and SZ showed fewer overall hits across valence conditions. Greater severity of anhedonia was specifically associated with impaired recognition for pleasant stimuli at the immediate recognition phase. CONCLUSIONS Findings suggest that anhedonia in SZ is associated with emotional memory impairment, particularly a deficit in encoding positive stimuli. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Kayla M. Whearty
- Department of Neurology, North Shore University Hospital/Long Island Jewish Medical Center, Northwell Health
| | - Ivan Ruiz
- Department of Psychology, University of Georgia
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3
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Marin C, Alobid I, Fuentes M, López-Chacón M, Mullol J. Olfactory Dysfunction in Mental Illness. Curr Allergy Asthma Rep 2023; 23:153-164. [PMID: 36696016 PMCID: PMC9875195 DOI: 10.1007/s11882-023-01068-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE OF REVIEW Olfactory dysfunction contributes to the psychopathology of mental illness. In this review, we describe the neurobiology of olfaction, and the most common olfactory alterations in several mental illnesses. We also highlight the role, hitherto underestimated, that the olfactory pathways play in the regulation of higher brain functions and its involvement in the pathophysiology of psychiatric disorders, as well as the effect of inflammation on neurogenesis as a possible mechanism involved in olfactory dysfunction in psychiatric conditions. RECENT FINDINGS The olfactory deficits present in anxiety, depression, schizophrenia or bipolar disorder consist of specific alterations of different components of the sense of smell, mainly the identification of odours, as well as the qualifications of their hedonic valence (pleasant or unpleasant). Epidemiological findings have shown that both environmental factors, such as air pollutants, and inflammatory disease of the upper respiratory tract, can contribute to an increased risk of mental illness, at least in part, due to peripheral inflammatory mechanisms of the olfactory system. In this review, we describe the neurobiology of olfaction, and the most common olfactory function alterations in several psychiatric conditions and its role as a useful symptom for the differential diagnosis. We also highlight the effect of inflammation on neurogenesis as a possible mechanism involved in olfactory dysfunction in these psychiatric conditions.
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Affiliation(s)
- Concepció Marin
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CELLEX, Department 2B, Villarroel 170, 08036, Barcelona, Catalonia, Spain. .,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Health Institute Carlos III, Madrid, Spain.
| | - Isam Alobid
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CELLEX, Department 2B, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Health Institute Carlos III, Madrid, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Mireya Fuentes
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CELLEX, Department 2B, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Health Institute Carlos III, Madrid, Spain
| | - Mauricio López-Chacón
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CELLEX, Department 2B, Villarroel 170, 08036, Barcelona, Catalonia, Spain.,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Health Institute Carlos III, Madrid, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Joaquim Mullol
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CELLEX, Department 2B, Villarroel 170, 08036, Barcelona, Catalonia, Spain. .,Centre for Biomedical Investigation in Respiratory Diseases (CIBERES), Health Institute Carlos III, Madrid, Spain. .,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Catalonia, Spain.
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4
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Larsen EM, Donaldson KR, Jonas KG, Lian W, Bromet EJ, Kotov R, Mohanty A. Pleasant and unpleasant odor identification ability is associated with distinct dimensions of negative symptoms transdiagnostically in psychotic disorders. Schizophr Res 2022; 248:183-193. [PMID: 36084492 PMCID: PMC10774004 DOI: 10.1016/j.schres.2022.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/12/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
Negative symptoms are among the greatest sources of functional impairment for individuals with schizophrenia, yet their mechanisms remain poorly understood. Olfactory impairment is associated with negative symptoms. The processing of pleasant olfactory stimuli is subserved by reward-related neural circuitry while unpleasant olfactory processing is subserved by emotion-related neural circuitry, suggesting that these two odor dimensions may offer a window into differential mechanisms of negative symptoms. We examined whether pleasant and unpleasant odor identification bears differential relationships with avolition and inexpressivity dimensions of negative symptoms, whether these relationships are transdiagnostic, and whether pleasant and unpleasant odor processing also relate differently to other domains of functioning in a sample of individuals diagnosed with schizophrenia (N = 54), other psychotic disorders (N = 65), and never-psychotic adults (N = 160). Hierarchical regressions showed that pleasant odor identification was uniquely associated with avolition, while unpleasant odor identification was uniquely associated with inexpressivity. These relationships were largely transdiagnostic across groups. Additionally, pleasant and unpleasant odor identification displayed signs of specificity with other functional and cognitive measures. These results align with past work suggesting dissociable pathomechanisms of negative symptoms and provide a potential avenue for future work using valence-specific olfactory dysfunction as a semi-objective and low-cost marker for understanding and predicting the severity of specific negative symptom profiles.
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Affiliation(s)
- Emmett M. Larsen
- Department of Psychology, Stony Brook University, Stony Brook, NY
| | | | - Katherine G. Jonas
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Wenxuan Lian
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY
| | - Aprajita Mohanty
- Department of Psychology, Stony Brook University, Stony Brook, NY
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5
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Carnemolla SE, Hsieh JW, Sipione R, Landis BN, Kumfor F, Piguet O, Manuel AL. Olfactory dysfunction in frontotemporal dementia and psychiatric disorders: A systematic review. Neurosci Biobehav Rev 2020; 118:588-611. [PMID: 32818582 DOI: 10.1016/j.neubiorev.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Frontotemporal dementia (FTD) is a progressive neurodegenerative disease. Diagnosis of FTD, especially the behavioural variant, is challenging because of symptomatic overlap with psychiatric disorders (depression, schizophrenia, bipolar disorder). Olfactory dysfunction is common in both FTD and psychiatric disorders, and often appears years before symptom onset. This systematic review analysed 74 studies on olfactory function in FTD, depression, schizophrenia and bipolar disorder to identify differences in olfactory dysfunction profiles, focusing on the most common smell measures: odour identification and discrimination. Results revealed that FTD patients were severely impaired in odour identification but not discrimination; in contrast, patients diagnosed with schizophrenia showed impairments in both measures, while those diagnosed with depression showed no olfactory impairments. Findings in bipolar disorder were mixed. Therefore, testing odour identification and discrimination differentiates FTD from depression and schizophrenia, but not from bipolar disorder. Given the high prevalence of odour identification impairments in FTD, and that smell dysfunction predicts neurodegeneration in other diseases, olfactory testing seems a promising avenue towards improving diagnosis between FTD and psychiatric disorders.
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Affiliation(s)
| | - Julien Wen Hsieh
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Rebecca Sipione
- Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Basile N Landis
- Rhinology -Olfactology Unit, Department of Otorhinolaryngology- Head and Neck Surgery, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, CH-1211 Geneva 14, Switzerland; Laboratory of Inner ear and Olfaction, University of Geneva Faculty of Medicine, 1, rue Michel-Servet, 1211 Geneva 4, Switzerland
| | - Fiona Kumfor
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Olivier Piguet
- The University of Sydney, Brain & Mind Centre, Sydney, Australia; The University of Sydney, School of Psychology, Sydney, Australia
| | - Aurélie L Manuel
- The University of Sydney, Brain & Mind Centre, Sydney, Australia.
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6
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López-Díaz Á, Menéndez-Sampil C, Pérez-Romero A, Palermo-Zeballos FJ, Valdés-Florido MJ. Characterization of deficit schizophrenia and reliability of the bidimensional model of its negative symptomatology. Nord J Psychiatry 2020; 74:400-406. [PMID: 32149549 DOI: 10.1080/08039488.2020.1736151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Cumulative evidence has demonstrated important differences between deficit (DS) and non-deficit (NDS) schizophrenia, suggesting that DS may be a separate disease. However, most data come from the same research groups and more replication is needed to validate this hypothesis.Aims: Our study aimed to examine the distribution of DS, to compare their characteristics with NDS patients and to analyze the reliability of the two-factor structure of its negative symptomatology in a Spanish clinical sample.Methods: Sixty clinically stabilized patients with schizophrenia were evaluated. The Schedule for the Deficit Syndrome was used for DS/NDS categorization. Patient characteristics included age, gender, education, age at onset of psychosis, duration of illness, family history of psychosis, type of antipsychotic regimen, schizophrenia subtype and severity of the disease.Results: DS prevalence was 28.3%. Bivariate analysis revealed statistical differences between DS and NDS in terms of years of education and schizophrenia subtype. Factor analysis replicated the two-factor solution consisting of the 'Expressive deficit' and 'Avolition-apathy' domains reported in previous studies.Conclusions: Our results were consistent with the published data and indicated that the DS profile in the Spanish population is similar to that in other populations, which would corroborate the homogeneity of DS within the schizophrenia spectrum and contribute to the hypothesis that DS constitutes a separate disease.
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Affiliation(s)
- Álvaro López-Díaz
- UGC Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain.,Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | | | - Ana Pérez-Romero
- UGC Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain
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7
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Li ZL, Huang GJ, Li ZT, Li SB, Wang YL, Zhao JB, Wen JF, Hummel T, Zou LQ. Chemosensory Anhedonia in Patients With Schizophrenia and Individuals With Schizotypy: A Questionnaire Study. Front Psychiatry 2020; 11:481. [PMID: 32581867 PMCID: PMC7287037 DOI: 10.3389/fpsyt.2020.00481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 05/11/2020] [Indexed: 12/04/2022] Open
Abstract
Anhedonia, the loss or decline of the ability to enjoy pleasure, is an important clinical characteristic of schizophrenia. Schizotypal traits refer to the appearance of subclinical symptoms of schizophrenia across normal people. Still, few studies have investigated chemosensory anhedonia in schizophrenia patients and schizotypy individuals. Seventy-one schizophrenia patients (SCZ), 162 schizotypy individuals (SCT) as selected by the Schizotypal Personality Questionnaire (SPQ), and 182 healthy controls (HC) participated in our study. We used the Positive and Negative Syndrome Scale (PANSS) to measure the clinical symptoms of schizophrenia patients. All participants completed the Chemosensory Pleasure Scale (CPS), which was used to assess participants' smell and taste hedonic capacities. We found that the three groups differed in chemosensory anhedonia. The SCZ group presented more severe chemosensory anhedonia than the SCT group, and the SCT group presented more severe chemosensory anhedonia than the HC group. We also found that chemosensory hedonic capacity was negatively correlated with negative schizotypal traits in the SCT group. Our results suggested that chemosensory anhedonia is an important characteristic of schizophrenia spectrum disorders.
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Affiliation(s)
- Zi-lin Li
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Gao-jie Huang
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Ze-tian Li
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Shu-bin Li
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Yi-le Wang
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Jiu-bo Zhao
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Jin-feng Wen
- Department of Psychology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Lai-quan Zou
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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8
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Lui SSY, Chiu MWY, Chui WWH, Wong JOY, Man CMY, Cheung EFC, Chan RCK. Impaired olfactory identification and hedonic judgment in schizophrenia patients with prominent negative symptoms. Cogn Neuropsychiatry 2020; 25:126-138. [PMID: 31856651 DOI: 10.1080/13546805.2019.1704709] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Evidence suggests that schizophrenia patients have olfactory dysfunctions, but the relationship between olfactory identification, hedonic judgement, and negative symptomatology remains unclear. Few studies have investigated whether co-activation of pleasant and unpleasant emotions are more prevalent in schizophrenia patients.Methods: Thirty schizophrenia outpatients with prominent negative symptoms (PNS), 30 outpatients without PNS, and 30 controls completed the University of Pennsylvania Smell Identification Test, and were asked to identify the odourants and to rate their emotions. The effects of gender and medications on olfactory function were examined.Results: Schizophrenia patients exhibited olfactory identification impairments, even after accounting for gender and medication effects. Patients with PNS demonstrated larger magnitude of deficit than those without. Patients with PNS reported less pleasure to positive-valenced odourants, and less unpleasantness to negative-valenced odourants than controls. Olfactory anhedonia in patients with PNS disappeared after controlling for medication effect. Schizophrenia patients do not exhibit affective ambivalence in olfaction.Conclusions: Schizophrenia patients with PNS exhibit deficits in olfactory identification and hedonic judgement, even after controlling for gender and medication effects. Our findings support the close relationship between olfactory dysfunctions and negative symptoms. Further studies should investigate the effect of dopamine-blocking agents on the olfactory hedonic judgment in schizophrenia patients.
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Affiliation(s)
- Simon S Y Lui
- Castle Peak Hospital, Hong Kong Special Administrative Region, People's Republic of China.,Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Mindi W Y Chiu
- Castle Peak Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - William W H Chui
- Castle Peak Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Jessica O Y Wong
- Castle Peak Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Cappy M Y Man
- Castle Peak Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, People's Republic of China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China
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9
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Li ZT, Li SB, Wen JF, Zhang XY, Hummel T, Zou LQ. Early-Onset Schizophrenia Showed Similar but More Severe Olfactory Identification Impairment Than Adult-Onset Schizophrenia. Front Psychiatry 2020; 11:626. [PMID: 32695034 PMCID: PMC7338585 DOI: 10.3389/fpsyt.2020.00626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/15/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND "Early-onset schizophrenia" (EOS) is defined as disease with onset before the age of 18 years. This subset of schizophrenia exhibits worse cognitive function and carries a worse prognosis than adult-onset schizophrenia (AOS). Olfactory impairment has been found in patients with schizophrenia-spectrum disorders. However, most research has focused on olfactory impairment in patients with AOS: olfactory function in EOS is not known. The aim of this study was to investigate the olfactory identification ability in EOS, and its relationship with negative symptoms. METHODS We compared olfactory function between two independent samples: 40 patients with EOS and 40 age- and sex-matched healthy controls (HCs); as well as 40 patients with AOS and 40 age- and sex-matched HCs. The University of Pennsylvania Smell Identification Test was administered. RESULTS The EOS group and AOS group exhibited worse olfactory identification ability than HCs; impairment correlated significantly with negative symptoms. Olfactory identification was worse in patients suffering EOS compared with those suffering AOS. CONCLUSION Olfactory identification impairment may be a trait marker of schizophrenia.
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Affiliation(s)
- Ze-Tian Li
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Shu-Bin Li
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Jin-Feng Wen
- Department of Psychology, Guangdong 999 Brain Hospital, Guangzhou, China
| | - Xiao-Yuan Zhang
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
| | - Lai-Quan Zou
- Chemical Senses and Mental Health Lab, Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden, Germany
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10
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Yee CI, Strauss GP, Allen DN, Haase CM, Kimhy D, Mittal VA. Trait emotional experience in individuals with schizophrenia and youth at clinical high risk for psychosis. BJPsych Open 2019; 5:e78. [PMID: 31500685 PMCID: PMC6737516 DOI: 10.1192/bjo.2019.64] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Disturbances in trait emotions are a predominant feature in schizophrenia. However, less is known about (a) differences in trait emotion across phases of the illness such as the clinical high-risk (CHR) phase and (b) whether abnormalities in trait emotion that are associated with negative symptoms are driven by primary (i.e. idiopathic) or secondary (e.g. depression, anxiety) factors. AIMS To examine profiles of trait affective disturbance and their clinical correlates in individuals with schizophrenia and individuals at CHR for psychosis. METHOD In two studies (sample 1: 56 out-patients diagnosed with schizophrenia and 34 demographically matched individuals without schizophrenia (controls); sample 2: 50 individuals at CHR and 56 individuals not at CHR (controls)), participants completed self-report trait positive affect and negative affect questionnaires, clinical symptom interviews (positive, negative, disorganised, depression, anxiety) and community-based functional outcome measures. RESULTS Both clinical groups reported lower levels of positive affect (specific to joy among individuals with schizophrenia) and higher levels of negative affect compared with controls. For individuals with schizophrenia, links were found between positive affect and negative symptoms (which remained after controlling for secondary factors) and between negative affect and positive symptoms. For individuals at CHR, links were found between both affect dimensions and both types of symptom (which were largely accounted for by secondary factors). CONCLUSIONS Both clinical groups showed some evidence of reduced trait positive affect and elevated trait negative affect, suggesting that increasing trait positive affect and reducing trait negative affect is an important treatment goal across both populations. Clinical correlates of these emotional abnormalities were more integrally linked to clinical symptoms in individuals with schizophrenia and more closely linked to secondary influences such as depression and anxiety in individuals at CHR. DECLARATION OF INTEREST None.
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Affiliation(s)
- Claire I Yee
- Postdoctoral Fellow, Department of Psychology and School of Education and Social Policy, Northwestern University, USA
| | - Gregory P Strauss
- Assistant Professor, Department of Psychology, University of Georgia, USA
| | - Daniel N Allen
- Director of Clinical Training, Department of Psychology, University of Nevada, USA
| | - Claudia M Haase
- Assistant Professor, School of Education and Social Policy, Northwestern University, USA
| | - David Kimhy
- Associate Professor, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA
| | - Vijay A Mittal
- Associate Professor, Department of Psychology, Northwestern University, USA
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11
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Zhao JB, Wang YL, Ma QW, Zhao JB, Zhang XY, Zou LQ. The Chemosensory Pleasure Scale: A New Assessment for Measuring Hedonic Smell and Taste Capacities. Chem Senses 2019; 44:457-464. [PMID: 31201424 DOI: 10.1093/chemse/bjz040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Anhedonia, or the inability to experience pleasure, is a key clinical feature of many mental disorders such as depression and schizophrenia. Although various valid measurements of anhedonia and pleasure experience exist, no scales exist that quantify smell and taste pleasure experiences. The Chemosensory Pleasure Scale (CPS) was therefore designed to assess the hedonic capacity for smell and taste pleasure. We examined the reliability and validity of the CPS in our study. First, we conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to identify and examine the structure of the CPS. Second, the CPS's validity and test-retest stability were investigated. The CPS was correlated with other measurements of anhedonia and pleasure experience. Furthermore, the empirical validity of CPS was also examined in our study. The results indicated that the CPS is a reliable and valid measure for assessing an individual's hedonic capacity for smell and taste pleasure in nonclinical samples. Further application of the CPS for various populations is also discussed herein, especially for patients with mental disorders such as depression, schizophrenia, and autism.
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Affiliation(s)
- Jiu-Bo Zhao
- Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi-Le Wang
- Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Qian-Wen Ma
- Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China
| | - Jing-Bo Zhao
- Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao-Yuan Zhang
- Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Lai-Quan Zou
- Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China.,Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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12
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Urban-Kowalczyk M, Strzelecki D, Śmigielski J, Kotlicka-Antczak M. Odor perception and hedonics in chronic schizophrenia and in first episode psychosis. Neuropsychiatr Dis Treat 2019; 15:647-654. [PMID: 30880989 PMCID: PMC6407904 DOI: 10.2147/ndt.s192523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE The study evaluated olfactory performance and pleasantness rating of odors in patients with first episode psychosis (FEP) and chronic schizophrenia (SCH) with regard to the severity of psychopathological symptoms and plasma β-endorphin concentration. PATIENTS AND METHODS Twenty patients with FEP, 27 with SCH and 29 healthy individuals, were recruited to the research . The University of Pennsylvania Smell Identification Test (UPSIT), subjective odor hedonic judgment and plasma levels of β-endorphin (BE) assay were performed in all participants. RESULTS Individuals with SCH revealed higher BE concentration than other study groups (P=0.000). All patients identified pleasant odors poorer than controls, however, SCH made more identification errors (P=0.000) than those with FEP. Moreover, participants with FEP rated pleasant odors as more pleasant than individuals with chronic schizophrenia and healthy controls (P=0.009). Nevertheless, higher β-endorphin level was related with lower scores in pleasant odor identification (Rs=-0.452; P=0.046) and more severe psychotic symptoms in FEP sample. Chronic schizophrenia patients did not demonstrate any relationship between symptom severity, odor identification performance and β-endorphin concentration. No relationship was found between BE concentration and hedonic judgment of the presented odors among all study groups. Chronically ill subjects identified odors significantly more poorly than those with first episode psychosis. Deficits in identifying pleasant odors might not be the only potential risk factor for undergoing chronic, recurrent schizophrenia. All patients subjectively overrated pleasant odors. Those with SCH and more severe negative symptoms made significantly more identification errors. CONCLUSION The endogenous morphine system deregulation is observed in first episode psychosis as well as in chronic schizophrenia. In first episode schizophrenia higher beta-endorphin concentration is related to pleasant odor identification deficit.
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Affiliation(s)
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland,
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13
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Walsh-Messinger J, Wong PS, Antonius D, McMahon K, Opler LA, Ramirez PM, Malaspina D. Sex differences in hedonic judgement of odors in schizophrenia cases and healthy controls. Psychiatry Res 2018; 269:345-353. [PMID: 30173040 PMCID: PMC6207462 DOI: 10.1016/j.psychres.2018.08.058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/14/2018] [Accepted: 08/16/2018] [Indexed: 01/27/2023]
Abstract
The neurocircuitries subserving affective and olfactory processes overlap, are sexually dimorphic, and show disruptions in schizophrenia, suggesting their intersection may be a window on the core process producing psychosis. This study investigated diagnostic and sex differences in hedonic judgments of odors and smell identification in 26 schizophrenia cases and 27 healthy controls. Associations between olfaction measures and psychiatric symptoms were also examined. Cases and controls had similar identification accuracy of unpleasant odors, but cases were significantly less accurate in naming pleasant odors. In cases, greater negative symptom severity was related to abnormal hedonic judgments; specifically, higher pleasantness ratings for unpleasant odors and higher unpleasantness ratings for pleasant odors. Greater positive symptom severity was associated with lower pleasantness ratings for neutral odors. Regarding sex differences, male cases and female controls rated pleasant odors as significantly more unpleasant than male controls. Correlations between depression severity and pleasantness ratings of neutral odors were in opposite directions in male and female cases. These results suggest that a normal sexual dimorphism in the circuitry for hedonic odor judgments may interact with schizophrenia pathology, supporting the utility of olfactory hedonics as a sex-specific biomarker of this pathology.
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Affiliation(s)
- Julie Walsh-Messinger
- Department of Psychology, University of Dayton, Dayton, OH, USA; Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
| | - Philip S. Wong
- Department of Psychology, Long Island University, Brooklyn,
NY
| | - Daniel Antonius
- Department of Psychiatry, NYU School of Medicine, New York,
NY,University at Buffalo, State University of NY, Buffalo,
NY,Erie County Forensic Mental Health Services, Buffalo,
NY
| | - Kevin McMahon
- Department of Psychiatry, NYU School of Medicine, New York,
NY
| | - Lewis A. Opler
- Department of Psychology, Long Island University, Brooklyn,
NY
| | | | - Dolores Malaspina
- Departments of Psychiatry, Neuroscience, and Genetics,
Icahn School of Medicine at Mount Sinai, New York, NY
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14
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Kamath V, Paksarian D, Cui L, Moberg PJ, Turetsky BI, Merikangas KR. Olfactory processing in bipolar disorder, major depression, and anxiety. Bipolar Disord 2018; 20:547-555. [PMID: 29441710 DOI: 10.1111/bdi.12625] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 12/22/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Although olfactory abnormalities are well established in schizophrenia, considerably less work has examined olfactory performance in other neuropsychiatric conditions. In the current study, we examined odor identification, odor discrimination, detection threshold, and odor hedonic processing performance in individuals with bipolar I disorder (n = 43; n = 13 with psychotic features), bipolar II disorder (n = 48), major depressive disorder (MDD) (n = 134), anxiety (n = 48), and no mental disorder (n = 72) who participated in a community-based family study. METHODS Best estimate DSM-IV diagnoses were based on in-depth personal interviews as well as interviews with family members. Olfactory tests were administered during an in-person clinical visit and were compared using robust linear regression adjusting for age, sex, and psychiatric medication use, as well as nicotine use when necessary. RESULTS Compared to controls, odor identification performance was lower among individuals with MDD (b = -1.37, 95% confidence interval [CI]: -2.50, -0.24) and bipolar I disorder (b = -1.79, 95% CI: -3.51, -0.67). Among the latter group, performance was only reduced among those with psychotic features (b = -3.49, 95% CI: -6.33, -0.65), particularly for pleasant odors (b = -1.46, 95% CI: -2.51, -0.42). Those with MDD showed lower identification accuracy for neutral odors (b = -0.63, 95% CI: -1.20, -0.06). Performances on measures of odor discrimination and detection threshold did not differ by diagnostic group. CONCLUSIONS Collectively, these findings indicate that odor identification difficulties may exist in mood disorders, especially when psychotic features are present. In contrast, the global olfactory dysfunction observed in schizophrenia may not be a feature of other neuropsychiatric conditions.
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Affiliation(s)
- Vidyulata Kamath
- Division of Medical Psychology, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Diana Paksarian
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Paul J Moberg
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Bruce I Turetsky
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
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15
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Abstract
BACKGROUND Anhedonia is a core negative symptom of schizophrenia. Schizophrenia patients report largely intact pleasure in consuming rewards, but have impairments in generating motivated behavior to pursue rewards, and show reduced fMRI activation of the reward pathway during presentation of rewarded stimuli. A computer based task measuring the development of a response bias in favor of rewarded stimuli permits assessment of reward-induced motivation. We hypothesized that subjects with schizophrenia would be impaired on this task. METHODS 58 schizophrenia subjects (SCZ) and 52 healthy controls (CON) were studied with a signal detection task to assess reward responsiveness. In multiple trials over three blocks subjects were asked to correctly identify two stimuli that were paired with unequal chance of monetary reward. The critical outcome variable was response bias, the development of a greater percent correct identification of the stimulus that was rewarded more often. RESULTS An ANOVA on response bias with Block as a repeated-measures factor and Diagnosis as a between-group factor indicated that SCZ subjects achieved a lower bias to rewarded stimuli than CON subjects (F(1,105)=8.82, p=0.004, η2=0.078). Post hoc tests indicated that SCZ subjects had significantly impaired bias in Block 1 (p=0.002) and Block 2 (p=0.05), indicating that SCZ were slower to achieve normal levels of bias during the session. CONCLUSIONS SCZ subjects were slower to develop response bias to rewarded stimuli than CON subjects. This finding is consonant with the hypothesis that people with schizophrenia have a blunted capacity to modify behavior in response to reward.
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Affiliation(s)
- Nicholas Taylor
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA
| | - Jeffrey P Hollis
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA
| | - Sarah Corcoran
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive Northeast #200, Atlanta, GA 30329, USA
| | - Robin Gross
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive Northeast #200, Atlanta, GA 30329, USA
| | - Bruce Cuthbert
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive Northeast #200, Atlanta, GA 30329, USA
| | - Lisette W Swails
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA
| | - Erica Duncan
- Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive Northeast #200, Atlanta, GA 30329, USA.
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16
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Zou LQ, Zhou HY, Lui SSY, Wang Y, Wang Y, Gan J, Zhu XZ, Cheung EFC, Chan RCK. Olfactory identification deficit and its relationship with hedonic traits in patients with first-episode schizophrenia and individuals with schizotypy. Prog Neuropsychopharmacol Biol Psychiatry 2018; 83:137-141. [PMID: 29371026 DOI: 10.1016/j.pnpbp.2018.01.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/18/2018] [Accepted: 01/19/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Olfactory identification impairments have been consistently found in schizophrenia patients. However, few previous studies have investigated this in first-episode patients. There are also inconsistent findings regarding olfactory identification ability in psychometrically-defined schizotypy individuals. In this study, we directly compared the olfactory identification ability of first-episode schizophrenia patients with schizotypy individuals. The relationship between olfactory identification impairments and hedonic traits was also examined. METHODS Thirty-five first-episode schizophrenia patients, 40 schizotypy individuals as defined by the Chapman's Anhedonia Scales and 40 demographically matched controls were recruited. The University of Pennsylvania Smell Identification Test was administered. Hedonic capacity was assessed using the Temporal Experience of Pleasure Scale (TEPS). RESULTS The results showed that both the schizophrenia and schizotypy groups showed poorer olfactory identification ability than controls, and the impairment was significantly correlated with reduced pleasure experiences. CONCLUSION Our findings support olfactory identification impairment as a trait marker for schizophrenia.
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Affiliation(s)
- Lai-Quan Zou
- Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, China; Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Han-Yu Zhou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Simon S Y Lui
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Castle Peak Hospital, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jun Gan
- Medical Psychological Centre, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha, Hunan, China
| | - Xiong-Zhao Zhu
- Medical Psychological Centre, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Psychological Institute of Central South University, Changsha, Hunan, China
| | | | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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17
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Urban-Kowalczyk M, Śmigielski J, Kotlicka-Antczak M. Overrated hedonic judgment of odors in patients with schizophrenia. CNS Neurosci Ther 2018; 24:1156-1162. [PMID: 29638031 DOI: 10.1111/cns.12849] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 02/27/2018] [Accepted: 03/01/2018] [Indexed: 12/01/2022] Open
Abstract
AIMS The odor identification ability and its hedonic judgment in patients with schizophrenia were evaluated in the study. The association between olfactory performance and negative symptoms and β-endorphin concentration was also analyzed. METHODS Study groups consisted of 23 patients with negative symptoms (PN) and 25 without predominant negative symptoms (PP) and 21 healthy individuals. The University of Pennsylvania Smell Identification Test, odor hedonic evaluation, and plasma concentrations of β-endorphin assay in all participants were performed. RESULTS PN perceived the poorer olfactory identification; nevertheless, they evaluated unpleasant odors as more pleasant than PP and controls. Beta-endorphin concentration was significantly higher among PN than in other study groups. No association was observed between β-endorphin and odors identification and odor hedonic judgment among all study groups. CONCLUSIONS There is potential relationship between increased β-endorphin concentration and severity of negative symptoms. Patients with predominant negative symptoms tend to evaluate odors as significantly more pleasant. Individuals with this subtype of schizophrenia might present specific, altered pattern of smell identification and hedonic judgment. Presumably, β-endorphin has no direct influence on olfactory identification performance and hedonic judgment in schizophrenia.
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18
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Abstract
BACKGROUND Though olfactory deficits are well-documented in schizophrenia, fewer studies have examined olfactory performance profiles across the psychosis spectrum. The current study examined odor identification, discrimination, and detection threshold performance in first-episode psychosis (FEP) patients diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, major depression with psychotic features, and other psychotic conditions. METHOD FEP patients (n = 97) and healthy adults (n = 98) completed birhinal assessments of odor identification, discrimination, and detection threshold sensitivity for lyral and citralva. Participants also completed measures of anticipatory pleasure, anhedonia, and empathy. Differences in olfactory performances were assessed between FEP patients and controls and within FEP subgroups. Sex-stratified post hoc analyses were employed for a complete analysis of sex differences. Relationships between self-report measures and olfactory scores were also examined. RESULTS Individuals with psychosis had poorer scores across all olfactory measures when compared to the control group. Within the psychosis cohort, patients with schizophrenia-associated psychosis had poorer odor identification, discrimination, and citralva detection threshold scores relative to controls. In schizophrenia patients, greater olfactory disturbance was associated with increased negative symptomatology, greater self-reported anhedonia, and lower self-reported anticipatory pleasure. Patients with mood-associated psychosis performed comparable to controls though men and women in this cohort showed differential olfactory profiles. CONCLUSIONS These findings indicate that olfactory deficits extend beyond measures of odor identification in FEP with greater deficits observed in schizophrenia-related subgroups of psychosis. Studies examining whether greater olfactory dysfunction confers greater risk for developing schizophrenia relative to other forms of psychosis are warranted.
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Affiliation(s)
- Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
- To whom correspondence should be addressed; Division of Medical Psychology, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 218, Baltimore, MD 21287-7218, US; tel: 410-614-6342, fax: 410-955-0504, e-mail:
| | - Patricia Lasutschinkow
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Koko Ishizuka
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD
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19
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Li LM, Guo HY, Zhao N, Zhang LJ, Zhang N, Liu J, Yang L. Comparison of olfactory function between neuromyelitis optica and multiple sclerosis. Int J Neurosci 2018; 128:772-777. [PMID: 29297712 DOI: 10.1080/00207454.2018.1424152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Olfactory dysfunction (ODF) has been reported in patients with neuromyelitis optica (NMO) and multiple sclerosis (MS). However, the comparison of olfactory function and olfactory-related gray matter (GM) between patients with NMO and MS needed to be further elucidated. MATERIALS AND METHODS Thirty-seven patients with NMO and 37 with MS were enrolled. Olfactory function was evaluated with a Japanese T&T olfactometer test kit, and the neuroanatomical features of olfactory-related GM were assessed using voxel-based morphometry. RESULTS Olfactory deficits were found in 51.4% of patients with NMO and 40.5% of patients with MS. Patients with NMO with ODF had significantly smaller olfactory bulbs than patients with MS with ODF (p = 0.031). Olfactory-related GM atrophy was found in patients with NMO in several regions of the right orbitofrontal cortex and right superior frontal gyrus; in patients with MS, reduced GM volume was found in the right parahippocampal gyrus and piriform cortex (p < 0.05, cluster size > 200 voxels). CONCLUSIONS Olfactory deficits are common in both NMO and MS. However, the neuroanatomical features related to olfactory deficits differ greatly between the two diseases.
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Affiliation(s)
- Li-Min Li
- a Department of Neurology , Tianjin Neurological Institute, Tianjin Medical University General Hospital , Tianjin , China
| | - Hui-Yue Guo
- a Department of Neurology , Tianjin Neurological Institute, Tianjin Medical University General Hospital , Tianjin , China
| | - Ning Zhao
- b Department of Neurology , Anyang District Hospital of Puyang City , Henan Province , China
| | - Lin-Jie Zhang
- a Department of Neurology , Tianjin Neurological Institute, Tianjin Medical University General Hospital , Tianjin , China
| | - Ningnannan Zhang
- c Tianjin Key Laboratory of Functional Imaging, Department of Radiology , Tianjin Medical University General Hospital , Tianjin , China
| | - Jingchun Liu
- c Tianjin Key Laboratory of Functional Imaging, Department of Radiology , Tianjin Medical University General Hospital , Tianjin , China
| | - Li Yang
- a Department of Neurology , Tianjin Neurological Institute, Tianjin Medical University General Hospital , Tianjin , China
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20
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Bora E, Binnur Akdede B, Alptekin K. Neurocognitive impairment in deficit and non-deficit schizophrenia: a meta-analysis. Psychol Med 2017; 47:2401-2413. [PMID: 28468693 DOI: 10.1017/s0033291717000952] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Most studies suggested that patients with deficit schizophrenia have more severe impairment compared with patients with non-deficit schizophrenia. However, it is not clear whether deficit and non-deficit schizophrenia are associated with differential neurocognitive profiles. METHODS The aim of this meta-analytic review was to compare cognitive performances of deficit and non-deficit patients with each other and with healthy controls. In the current meta-analysis, differences in cognitive abilities between 897 deficit and 1636 non-deficit patients with schizophrenia were examined. Cognitive performances of 899 healthy controls were also compared with 350 patients with deficit and 592 non-deficit schizophrenia. RESULTS Both deficit (d = 1.04-1.53) and non-deficit (d = 0.68-1.19) schizophrenia were associated with significant deficits in all cognitive domains. Deficit patients underperformed non-deficit patients in all cognitive domains (d = 0.24-0.84) and individual tasks (d = 0.39-0.93). The relationship between deficit syndrome and impairment in olfaction, social cognition, verbal fluency, and speed-based cognitive tasks were relatively stronger. CONCLUSIONS Our findings suggest that there is consistent evidence for a significant relationship between deficit syndrome and more severe cognitive impairment in schizophrenia.
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Affiliation(s)
- E Bora
- Department of Psychiatry,Dokuz Eylul University School of Medicine,Izmir,Turkey
| | - B Binnur Akdede
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health,Carlton South, Victoria 3053,Australia
| | - K Alptekin
- Department of Psychiatry,Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health,Carlton South, Victoria 3053,Australia
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21
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Abstract
We previously proposed that people with schizophrenia who have primary, enduring negative symptoms have a disease-deficit schizophrenia (DS)-that is separate from that affecting people with schizophrenia without these features. Additional evidence consistent with the separate disease hypothesis has accumulated in recent years. White matter changes may be widespread in deficit compared to nondeficit patients and may relate to problems in early brain migration. These 2 patient groups also appear to differ on metabolic measures prior to antipsychotic treatment. Studies of reward and defeatist beliefs provide the basis for future treatment trials. The 2 factors or groups within negative symptoms broadly defined (both primary and secondary) have also been found in DS, and recent evidence suggests these 2 symptom groups have different correlates and reflect the existence of 2 groups with in DS. Negative symptoms are found in disorders other than schizophrenia, and excess summer birth, a deficit risk factor, has been found in a non-patient group with deficit-like features. It may be useful in future research to determine whether findings in DS extend to patients with other neuropsychiatric disorders who also have negative symptoms.
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Affiliation(s)
- Brian Kirkpatrick
- Department of Psychiatry and Behavioral Sciences, University of Nevada Reno School of Medicine, Reno, NV
| | - Armida Mucci
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli (SUN); University Hospital SUN, Naples, Italy
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22
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Abstract
In the DSM5, negative symptoms are 1 of the 5 core dimensions of psychopathology evaluated for schizophrenia. However, negative symptoms are not pathognomonic-they are also part of the diagnostic criteria for other schizophrenia-spectrum disorders, disorders that sometimes have comorbid psychosis, diagnoses not in the schizophrenia-spectrum, and the general "nonclinical" population. Although etiological models of negative symptoms have been developed for chronic schizophrenia, there has been little attention given to whether these models have transdiagnostic applicability. In the current review, we examine areas of commonality and divergence in the clinical presentation and etiology of negative symptoms across diagnostic categories. It was concluded that negative symptoms are relatively frequent across diagnostic categories, but individual disorders may differ in whether their negative symptoms are persistent/transient or primary/secondary. Evidence for separate dimensions of volitional and expressive symptoms exists, and there may be multiple mechanistic pathways to the same symptom phenomenon among DSM-5 disorders within and outside the schizophrenia-spectrum (ie, equifinality). Evidence for a novel transdiagnostic etiological model is presented based on the Research Domain Criteria (RDoC) constructs, which proposes the existence of 2 such pathways-a hedonic pathway and a cognitive pathway-that can both lead to expressive or volitional symptoms. To facilitate treatment breakthroughs, future transdiagnostic studies on negative symptoms are warranted that explore mechanisms underlying volitional and expressive pathology.
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Affiliation(s)
- Gregory P Strauss
- Department of Psychology, University of Georgia, 125 Baldwin Street, Athens, GA 30602
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA
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23
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Ettinger U, Hurlemann R, Chan RCK. Oxytocin and Schizophrenia Spectrum Disorders. Curr Top Behav Neurosci 2017; 35:515-527. [PMID: 28864974 DOI: 10.1007/7854_2017_27] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In this chapter, we present an overview of studies of oxytocin (OXT) in schizophrenia and the schizophrenia spectrum. We first outline the current state of pharmacological treatment of the symptoms of schizophrenia and point to unmet clinical needs. These relate particularly to the debilitating negative symptoms and social cognitive deficits that are frequently observed in patients suffering from schizophrenia. We argue that new treatments are needed to alleviate these impairments. As OXT has been proposed and investigated as a putative treatment, we will then summarise evidence from studies in patients with schizophrenia that have investigated the effects of OXT at several levels, i.e. at the levels of clinical symptoms, social cognitive function as assessed with experimental and neuropsychological tasks, and brain function as assessed using functional magnetic resonance imaging (fMRI). Finally, we will introduce the concept of the schizophrenia spectrum and highlight the importance of studying OXT effects in subclinical spectrum samples, such as in people with high levels of schizotypal personality. We conclude that the evidence of beneficial effects of OXT in schizophrenia is inconsistent, calling for further research in this field.
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Affiliation(s)
- Ulrich Ettinger
- Department of Psychology, University of Bonn, Bonn, Germany.
| | - René Hurlemann
- Department of Psychiatry, Division of Medical Psychology, University of Bonn - Medical Center, Bonn, Germany
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience (NACN) Lab, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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24
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Pełka-Wysiecka J, Wroński M, Bieńkowski P, Murawiec S, Samochowiec A, Samochowiec J. Odors identification differences in deficit and nondeficit schizophrenia. Pharmacol Rep 2016; 68:390-5. [DOI: 10.1016/j.pharep.2015.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/05/2015] [Accepted: 11/02/2015] [Indexed: 11/15/2022]
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25
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Zou LQ, Geng FL, Liu WH, Wei XH, Jiang XQ, Wang Y, Shi HS, Lui SSY, Cheung EFC, Chan RCK. The neural basis of olfactory function and its relationship with anhedonia in individuals with schizotypy: An exploratory study. Psychiatry Res 2015; 234:202-7. [PMID: 26404551 DOI: 10.1016/j.pscychresns.2015.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 12/27/2022]
Abstract
Previous studies have established a linkage between olfactory deficits and negative symptoms in schizophrenia. However, it is not known whether olfactory function is associated with hedonic traits in individuals with schizotypy. Seventeen individuals with schizotypy and 18 age- and sex-matched controls participated in this study. Hedonic traits were assessed with the Chapman Scales for Physical and Social Anhedonia (CSAS and CPAS). Olfactory function was assessed with the Sniffin' Stick Test (olfactory threshold, odour discrimination and odour identification). All participants undertook a structural imaging scan for grey matter volume measurements. Individuals with schizotypy had significantly higher CSAS and CPAS scores than healthy controls. They had normal olfactory function. Their odour identification ability was inversely correlated with physical and social anhedonia. The volume of the right parahippocampal gyrus was positively associated with odour identification ability, and negatively associated with physical and social anhedonia. Furthermore, mediation analysis suggested that odour identification ability influences anhedonia through its effect on the right parahippocampal gyrus. No such relationship was found in controls. These findings suggest that there is a relationship between odour identification and anhedonia in individuals with schizotypy, and the association may be mediated by parahippocampal gyrus volume.
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Affiliation(s)
- Lai-quan Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China
| | - Fu-lei Geng
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China
| | - Wen-hua Liu
- Faculty of Health Management, Guangzhou Medical University, Guangzhou, China
| | - Xin-hua Wei
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou, China
| | - Xin-qing Jiang
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hai-song Shi
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China; North China Electric Power University, Beijing, China
| | - Simon S Y Lui
- Castle Peak Hospital, Hong Kong Special Administrative Region
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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Whearty KM, Allen DN, Lee BG, Strauss GP. The evaluation of insufficient cognitive effort in schizophrenia in light of low IQ scores. J Psychiatr Res 2015; 68:397-404. [PMID: 26026486 DOI: 10.1016/j.jpsychires.2015.04.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/13/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
Abstract
Low IQ has recently been shown to predict neuropsychological effort test failure in healthy and neurological populations. Although low IQ is common in schizophrenia (SZ), its effect on effort test performance remains unclear in this population. The current study examined the role of IQ in effort test performance in a sample of 60 outpatients with SZ and 30 demographically matched healthy controls (CN). Participants were administered a battery of neuropsychological tests, and insufficient effort was calculated using two embedded effort indices: the Reliable Digit Span Effort Index and the Finger Tapping Effort Index. Results indicated that 16.1% of SZ patients and 0% CN failed both effort measures and that 32.1% of SZ and 3.3% of CN failed one measure. In SZ, IQ in the <70 or 70-79 range was associated with the highest rates of falling below the effort cut-off scores; however, patients with IQs in the low-average or higher range (>80) did not fall below effort cut-offs. Findings suggest that low IQ is a significant predictor of insufficient effort during neuropsychological test performance in schizophrenia, calling into question the validity of neuropsychological effort testing in SZ patients with low IQ.
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Affiliation(s)
- Kayla M Whearty
- State University of New York at Binghamton, Department of Psychology, USA
| | - Daniel N Allen
- University of Nevada Las Vegas, Department of Psychology, USA
| | - Bern G Lee
- University of Nevada Las Vegas, Department of Psychology, USA
| | - Gregory P Strauss
- State University of New York at Binghamton, Department of Psychology, USA.
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27
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Good KP, Sullivan RL. Olfactory function in psychotic disorders: Insights from neuroimaging studies. World J Psychiatry 2015; 5:210-221. [PMID: 26110122 PMCID: PMC4473492 DOI: 10.5498/wjp.v5.i2.210] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/06/2015] [Accepted: 03/18/2015] [Indexed: 02/05/2023] Open
Abstract
Olfactory deficits on measures of identification, familiarity, and memory are consistently noted in patients with psychotic disorders relative to age-matched controls. Olfactory intensity ratings, however, appear to remain intact while the data on hedonics and detection threshold are inconsistent. Despite the behavioral abnormalities noted, no specific regional brain hypoactivity has been identified in psychosis patients, for any of the olfactory domains. However, an intriguing finding emerged from this review in that the amygdala and pirifom cortices were not noted to be abnormal in hedonic processing (nor was the amygdala identified abnormal in any study) in psychotic disorders. This finding is in contrast to the literature in healthy individuals, in that this brain region is strongly implicated in olfactory processing (particularly for unpleasant odorants). Secondary olfactory cortex (orbitofrontal cortices, thalamus, and insula) was abnormally activated in the studies examined, particularly for hedonic processing. Further research, using consistent methodology, is required for better understanding the neurobiology of olfactory deficits. The authors suggest taking age and sex differences into consideration and further contrasting olfactory subgroups (impaired vs intact) to better our understanding of the heterogeneity of psychotic disorders.
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28
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Robabeh S, Mohammad JM, Reza A, Mahan B. The Evaluation of Olfactory Function in Patients With Schizophrenia. Glob J Health Sci 2015; 7:319-330. [PMID: 26153192 PMCID: PMC4803875 DOI: 10.5539/gjhs.v7n6p319] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 04/23/2015] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to compare olfactory threshold, smell identification, intensity and pleasantness ratings between patients with schizophrenia and healthy controls, and (2) to evaluate correlations between ratings of olfactory probes and illness characteristics. Thirty one patients with schizophrenia and 31 control subjects were assessed with the olfactory n-butanol threshold test, the Iran smell identification test (Ir-SIT), and the suprathreshold amyl acetate odor intensity and odor pleasantness rating test. All olfactory tasks were performed unirhinally. Patients with schizophrenia showed disrupted olfaction in all four measures. Longer duration of schizophrenia was associated with a larger impairment of olfactory threshold or microsmic range on the Ir-SIT (P=0.04, P=0.05, respectively). In patients with schizophrenia, female subjects' ratings of pleasantness followed the same trend as control subjects, whereas male patients' ratings showed an opposite trend. Patients exhibiting high positive score on the positive and negative syndrome scale (PANSS) performed better on the olfactory threshold test (r=0.37, P=0.04). The higher odor pleasantness ratings of patients were associated with presence of positive symptoms. The results suggest that both male and female patients with schizophrenia had difficulties on the olfactory threshold and smell identification tests, but appraisal of odor pleasantness was more disrupted in male patients.
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Strauss GP, Keller WR, Koenig JI, Gold JM, Ossenfort KL, Buchanan RW. Plasma oxytocin levels predict olfactory identification and negative symptoms in individuals with schizophrenia. Schizophr Res 2015; 162:57-61. [PMID: 25583247 PMCID: PMC4339311 DOI: 10.1016/j.schres.2014.12.023] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 12/30/2022]
Abstract
Basic neuroscience research provides strong evidence for the role of oxytocin in olfactory processes and social affiliation in rodents. Given prior indication of olfactory impairments that are linked to greater severity of asociality in schizophrenia, we examined the association between plasma oxytocin levels and measures of olfaction and social outcome in a sample of outpatients with schizophrenia (n=39) and demographically matched healthy controls (n=21). Participants completed the 40-item University of Pennsylvania Smell Identification Test (UPSIT), and rated each odor for how positive and how negative it made them feel. Results indicated that individuals with schizophrenia had higher plasma oxytocin levels and lower overall accuracy for UPSIT items than controls. Individuals with schizophrenia also reported experiencing more negative emotionality than controls in response to the olfactory stimuli. Lower plasma oxytocin levels were associated with poorer accuracy for pleasant and unpleasant odors and greater severity of asociality in individuals with schizophrenia. These findings suggest that endogenous oxytocin levels may be an important predictor of olfactory identification deficits and negative symptoms in schizophrenia.
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Affiliation(s)
- Gregory P. Strauss
- Department of Psychology, State University of New York at Binghamton,Correspondence concerning this article should be addressed to Gregory P. Strauss, Ph.D., . Phone: +1-607-777-5408. Fax: +1-607-777-4890. State University of New York at Binghamton, Department of Psychology, PO Box 6000, Binghamton, New York, USA, 13902-6000
| | - William R. Keller
- Maryland Psychiatric Research center and Department of Psychiatry, University of Maryland School of Medicine
| | - James I. Koenig
- Maryland Psychiatric Research center and Department of Psychiatry, University of Maryland School of Medicine
| | - James M. Gold
- Maryland Psychiatric Research center and Department of Psychiatry, University of Maryland School of Medicine
| | | | - Robert W. Buchanan
- Maryland Psychiatric Research center and Department of Psychiatry, University of Maryland School of Medicine
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30
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Lin A, Brewer WJ, Yung AR, Nelson B, Pantelis C, Wood SJ. Olfactory identification deficits at identification as ultra-high risk for psychosis are associated with poor functional outcome. Schizophr Res 2015; 161:156-62. [PMID: 25476117 DOI: 10.1016/j.schres.2014.10.051] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 10/27/2014] [Accepted: 10/27/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND We have previously reported that olfactory identification (OI) deficits are a promising premorbid marker of transition from ultra-high risk (UHR) to schizophrenia, but not to psychotic illness more generally. Whether this remains the case at longer follow-up, and whether there is decline in OI ability are unclear. METHOD The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 81 participants at baseline (identification of risk for psychosis) and 254 individuals at follow-up. Forty-nine participants underwent UPSIT assessment at both time points. UPSIT scores were investigated at an average of 7.08years after identification of risk in relation to transition to psychosis, a diagnosis of schizophrenia, and psychosocial/functional outcome. RESULTS UPSIT scores at baseline and follow-up did not differ between participants who transitioned to psychosis and those who did not. Similarly, there were no significant differences on UPSIT scores at baseline or follow-up between individuals with a diagnosis of schizophrenia and transitioned individuals without schizophrenia. Those with a poor functional outcome showed significantly lower baseline UPSIT scores than participants with good outcome. There was no significant association between functional outcome and follow-up UPSIT scores. There were no significant changes in UPSIT over time for any group. CONCLUSIONS These results suggest that impaired OI is not a good marker of the onset of psychosis and schizophrenia, but may differentiate UHR individuals who experience a poor functional outcome, regardless of transition status.
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Affiliation(s)
- A Lin
- Telethon Kids Institute, The University of Western Australia, Australia.
| | - W J Brewer
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - A R Yung
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia; Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - B Nelson
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia
| | - S J Wood
- Telethon Kids Institute, The University of Western Australia, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Victoria, Australia
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31
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Mesholam-Gately RI, Gibson LE, Seidman LJ, Green AI. Schizophrenia and co-occurring substance use disorder: reward, olfaction and clozapine. Schizophr Res 2014; 155:45-51. [PMID: 24685823 DOI: 10.1016/j.schres.2014.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 03/01/2014] [Accepted: 03/03/2014] [Indexed: 02/04/2023]
Abstract
Co-occurring substance use disorders (SUD), including alcohol, are common in schizophrenia (SZ) and are associated with poor outcome. Emerging data suggest that individuals with SZ have a dysfunctional brain reward circuit that may underlie their frequent use of alcohol and other substances, and further, that the atypical antipsychotic, clozapine (CLOZ), limits alcohol/substance use in these individuals, potentially by ameliorating this brain reward circuit dysfunction. To explore this hypothesis, reward functioning in a SZ sample with a history of co-occurring SUD, treated with either CLOZ (n=13) or typical antipsychotic agents (TYP), haloperidol or fluphenazine (n=14), as well as healthy controls (n=16), was evaluated through ratings of pleasurable and aversive odors, stimuli that are processed by several neural structures thought to play a key role in processing rewarding stimuli. Results suggest that CLOZ treatment is associated with broadening and strengthening the hedonic experience of these rewarding olfactory stimuli, both of a pleasant and unpleasant nature. This hedonic appraisal of odors appeared to be independent of odor perception (intensity ratings) and clinical symptoms. These preliminary findings provide important new data in support of the hypothesis that CLOZ ameliorates some aspects of abnormal brain reward functioning in individuals with co-occurring SZ and SUD. Further research may have valuable treatment implications for this population including interventions for other reward-associated deficits in learning, social interactions and other aspects of behavior and cognition.
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Affiliation(s)
- Raquelle I Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Lauren E Gibson
- Psychology Department, Temple University, Philadelphia, PA, USA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Alan I Green
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Geisel School of Medicine at Dartmouth, The Dartmouth Clinical and Translational Science Institute, Hanover, NH, USA; Department of Pharmacology and Toxicology, Geisel School of Medicine at Dartmouth, The Dartmouth Clinical and Translational Science Institute, Hanover, NH, USA
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32
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Abstract
A selective review of the negative symptoms of schizophrenia is an appropriate article to result from the festschrift honoring William T. Carpenter Jr, as he has made substantial contributions in this area. This review assesses progress in 3 areas in which he has been an important investigator: the distinction between primary vs secondary negative symptoms; the appropriate design for treatment trials; and the nosology of negative symptoms.
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Affiliation(s)
- Brian Kirkpatrick
- *To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, University of Nevada School of Medicine,1664 North Virginia Street, Mail Stop 0354, Reno, NV 89557-0354, US; tel: 775-682-8449, fax: 775-784-1428, e-mail:
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33
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Pedersen CA. Schizophrenia and alcohol dependence: diverse clinical effects of oxytocin and their evolutionary origins. Brain Res 2014; 1580:102-23. [PMID: 24508579 DOI: 10.1016/j.brainres.2014.01.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 01/27/2014] [Accepted: 01/28/2014] [Indexed: 12/31/2022]
Abstract
Beginning in 1979 with the first report that central administration of oxytocin stimulates maternal behavior in virgin rats, decades of animal research and more recent human studies have demonstrated that oxytocin has many pro-social effects. These many findings suggest that oxytocin may be an effective treatment for social deficits that are hallmark features of disorders such as autism and schizophrenia. Effects in preclinical animal models also imply that oxytocin may be an efficacious pharmacotherapy in a wide range of psychiatric disorders including psychoses and addictions. To date, 3 small clinical trials found that daily intranasal oxytocin treatment for 2-8 weeks significantly reduced psychotic symptoms in schizophrenia. Two of these trials also found improvement in social cognition or neurocognition, areas in which patients have significant deficiencies that do not respond to conventional antipsychotic treatment and contribute to disability. In another small trial, intranasal oxytocin potently blocked alcohol withdrawal. After reviewing the rationale for these trials, they are described in more detail. Questions are then asked followed by discussions of the large gaps in our knowledge about brain oxytocin systems in humans. The hope is to highlight important directions for future investigations of the role of oxytocin in the pathophysiology of psychotic disorders and addictions and to extend clinical research in these areas. Heretofore unrecognized roles for which oxytocin may have been selected during the evolution of placental mammalian maternal-infant and other social attachments are considered as possible origins of oxytocin antipsychotic and antiaddiction effects.This article is part of a Special Issue entitled Oxytocin and Social Behav.
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Affiliation(s)
- Cort A Pedersen
- Department of Psychiatry, CB# 7160, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA.
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34
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Lee EY, Eslinger PJ, Du G, Kong L, Lewis MM, Huang X. Olfactory-related cortical atrophy is associated with olfactory dysfunction in Parkinson's disease. Mov Disord 2014; 29:1205-8. [PMID: 24482154 DOI: 10.1002/mds.25829] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 01/02/2014] [Accepted: 01/12/2014] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Olfactory dysfunction is often associated with Parkinson's disease (PD) and can precede characteristic motor symptoms by several years. Olfactory-related cortical atrophy has been reported in PD, although the extent and association between cortical atrophy and olfactory dysfunction have been controversial. The present study examined whether olfactory dysfunction is associated with gray matter (GM) volume in brain regions subserving primary and secondary olfactory processing. METHODS High-resolution T1-weighted brain MRIs were acquired from 40 PD without dementia and 40 matched controls along with smell identification scores. Brain volumes were compared using voxel-based morphometry. RESULTS Compared to controls, PD patients sustained greater GM loss localized to bilateral piriform cortex (PC) and orbitofrontal cortex (OFC). Reduced olfactory performance in PD was significantly associated with lower GM volumes in PC and OFC. CONCLUSIONS Both primary and secondary olfactory cortical atrophy occurred in PD and were associated with olfactory dysfunction.
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Affiliation(s)
- Eun-Young Lee
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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35
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Maurage P, Rombaux P, de Timary P. Olfaction in alcohol-dependence: a neglected yet promising research field. Front Psychol 2014; 4:1007. [PMID: 24550850 PMCID: PMC3879530 DOI: 10.3389/fpsyg.2013.01007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/17/2013] [Indexed: 11/13/2022] Open
Abstract
Olfaction research deeply renewed the knowledge of the pathophysiological mechanisms involved in various psychopathological states and showed that olfactory deficits might constitute an onset or trait marker in psychiatry. However, while alcohol-dependence is the most wide spread psychiatric disorder and while olfaction might be involved in its development and maintenance, olfactory abilities have been little explored in this population. The central aim of this paper is thus to underline the usefulness of olfaction research in alcohol-dependence. After reviewing the few olfaction studies available, a research agenda will be proposed, identifying the major challenges for future research, and particularly: (1) the identification of the origin, extent and cerebral correlates of olfaction deficits; (2) the links between olfaction and emotional-cognitive deficits, and the use of olfaction to understand the pathomechanisms of alcohol-dependence; (3) the interactions between olfaction and other sensory modalities; (4) the use of olfaction to predict the appearance and intensity of cognitive impairments; (5) the impact of olfaction deficits on everyday life in alcohol-dependence.
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Affiliation(s)
- Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain Louvain-la-Neuve, Belgium
| | - Philippe Rombaux
- Department of Otorhinolaryngology, St Luc Hospital and Institute of Neuroscience, Université catholique de Louvain Brussels, Belgium
| | - Philippe de Timary
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain Louvain-la-Neuve, Belgium ; Department of Adult Psychiatry, St Luc Hospital and Institute of Neuroscience, Université catholique de Louvain Brussels, Belgium
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36
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Clepce M, Neumann K, Martus P, Nitsch M, Wielopolski J, Koch A, Kornhuber J, Reich K, Thuerauf N. The Psychophysical Assessment of Odor Valence: Does an Anchor Stimulus Influence the Hedonic Evaluation of Odors? Chem Senses 2013; 39:17-25. [DOI: 10.1093/chemse/bjt050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Kamath V, Turetsky BI, Calkins ME, Bilker WB, Frishberg N, Borgmann-Winter K, Kohler CG, Conroy CG, Gur RE, Moberg PJ. The effect of odor valence on olfactory performance in schizophrenia patients, unaffected relatives and at-risk youth. J Psychiatr Res 2013; 47:1636-41. [PMID: 23953754 PMCID: PMC4198303 DOI: 10.1016/j.jpsychires.2013.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 06/17/2013] [Accepted: 07/18/2013] [Indexed: 12/11/2022]
Abstract
Given the presence of odor identification impairment in individuals with schizophrenia and recent evidence of aberrant odor hedonic processing, the aim of this investigation was to examine the influence of valence and intensity on odor identification in schizophrenia patients, their first-degree family members, and young persons at clinical risk for psychosis. Participants completed the 16-item Sniffin' Stick Odor Identification Test. A logistic regression was conducted to assess the influence of valence and intensity on odor identification accuracy. Identification performance in the schizophrenia patients and youths at clinical risk for psychosis was significantly influenced by odor valence, but not intensity. Identification accuracy in first-degree family members was not influenced by valence or intensity. These data suggest that abnormalities in odor valence perception may represent an environmentally-mediated marker for hedonic disturbance that could have predictive utility in future conversion to psychosis. Further research examining the utility of odor valence measures as markers for psychosis risk is warranted.
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Affiliation(s)
- Vidyulata Kamath
- Neuropsychiatry Section, Department of Psychiatry, Philadelphia, PA, USA; Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, Perelman School of Medicine, Philadelphia, PA, USA; Division of Medical Psychology, Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Bruce I. Turetsky
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, Perelman School of Medicine, Philadelphia, PA, USA
| | - Monica E. Calkins
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA
| | - Warren B. Bilker
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA,Department Biostatistics and Epidemiology, Philadelphia, PA, USA
| | - Nathan Frishberg
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA
| | - Karin Borgmann-Winter
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA,Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Christian G. Kohler
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA
| | - Catherine G. Conroy
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA
| | - Raquel E. Gur
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA
| | - Paul J. Moberg
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, Philadelphia, PA, USA,Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery, Perelman School of Medicine, Philadelphia, PA, USA
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38
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Affiliation(s)
- Gregory P. Strauss
- *To whom correspondence should be addressed; Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, PO Box 21247, Baltimore, MD 21228; tel: +1-410-402-6104, fax: +1-410-402-7198,
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39
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Strauss GP, Horan WP, Kirkpatrick B, Fischer BA, Keller WR, Miski P, Buchanan RW, Green MF, Carpenter WT. Deconstructing negative symptoms of schizophrenia: avolition-apathy and diminished expression clusters predict clinical presentation and functional outcome. J Psychiatr Res 2013; 47:783-90. [PMID: 23453820 PMCID: PMC3686506 DOI: 10.1016/j.jpsychires.2013.01.015] [Citation(s) in RCA: 311] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 01/17/2013] [Accepted: 01/18/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies indicate that negative symptoms reflect a separable domain of pathology from other symptoms of schizophrenia. However, it is currently unclear whether negative symptoms themselves are multi-faceted, and whether sub-groups of patients who display unique negative symptom profiles can be identified. METHODS A data-driven approach was used to examine the heterogeneity of negative symptom presentations in two samples: Study 1 included 199 individuals with schizophrenia assessed with a standard measure of negative symptoms and Study 2 included 169 individuals meeting criteria for deficit schizophrenia (i.e., primary and enduring negative symptoms) assessed with a specialized measure of deficit symptoms. Cluster analysis was used to determine whether different groups of patients with distinct negative symptoms profiles could be identified. RESULTS Across both studies, we found evidence for two distinctive negative symptom sub-groups: one group with predominantly Avolition-Apathy (AA) symptoms and another with a predominantly Diminished Expression (DE) profile. Follow-up discriminant function analyses confirmed the validity of these groups. AA and DE negative symptom sub-groups significantly differed on clinically relevant external validators, including measures of functional outcome, premorbid adjustment, clinical course, disorganized symptoms, social cognition, sex, and ethnicity. CONCLUSIONS These results suggest that distinct subgroups of patients with elevated AA or DE can be identified within the broader diagnosis of schizophrenia and that these subgroups show clinically meaningful differences in presentation. Additionally, AA tends to be associated with poorer outcomes than DE, suggesting that it may be a more severe aspect of psychopathology.
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Affiliation(s)
- Gregory P Strauss
- Department of Psychiatry, University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD 21228, USA.
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40
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Lee MR, Wehring HJ, McMahon RP, Linthicum J, Cascella N, Liu F, Bellack A, Buchanan RW, Strauss GP, Contoreggi C, Kelly DL. Effects of adjunctive intranasal oxytocin on olfactory identification and clinical symptoms in schizophrenia: results from a randomized double blind placebo controlled pilot study. Schizophr Res 2013; 145:110-5. [PMID: 23415472 PMCID: PMC4125132 DOI: 10.1016/j.schres.2013.01.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 12/21/2012] [Accepted: 01/03/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND Deficits in olfactory identification have been widely reported in patients with schizophrenia (SZ) and are associated with negative symptomatology. Adjunctive oxytocin delivered intranasally has been shown to improve some aspects of social cognition as well as positive and negative symptoms in patients with schizophrenia. Given the intranasal delivery route of oxytocin to olfactory pathways and that olfactory abnormalities are a potential endophenotype in SZ, we investigated the effect of intranasal oxytocin on olfactory identification as well as positive and negative symptoms in people with schizophrenia. METHODS Individuals with schizophrenia or schizoaffective disorder (n=28; 16 outpatients, 12 inpatients) were randomized to receive adjunctive intranasal oxytocin 20 IU BID or placebo for 3 weeks. RESULTS All 28 participants completed the clinical trial. Odor identification performance significantly improved on the University of Pennsylvania Smell Identification Test (UPSIT) total score and subscore for pleasant smells. UPSIT score (F=5.20, df=1,23, p=0.032) and subscore for pleasant smells (F=4.56, df=1,23, p=0.044), in patients treated with oxytocin were compared to placebo from baseline to endpoint. Global symptomatology as well as positive and negative symptoms were not improved by intranasal oxytocin. In fact, global symptoms, not positive or negative symptoms, improved in the placebo group. Secondary analysis shows that intranasal oxytocin improved negative symptoms in the small group of inpatients. Intranasal oxytocin was well tolerated during the three week trial. CONCLUSION Adjunctive intranasal oxytocin may improve olfactory identification, particularly in items of positive valence. Larger studies are needed to determine the effects of oxytocin on negative symptoms in SZ. (NCT00884897; http://www.clinicaltrials.gov).
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Affiliation(s)
- Mary R Lee
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, Baltimore, MD 21224, USA.
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Kamath V, Moberg PJ, Kohler CG, Gur RE, Turetsky BI. Odor hedonic capacity and anhedonia in schizophrenia and unaffected first-degree relatives of schizophrenia patients. Schizophr Bull 2013; 39:59-67. [PMID: 21616912 PMCID: PMC3523921 DOI: 10.1093/schbul/sbr050] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE There is increasing evidence that schizophrenia patients have difficulties in the hedonic appraisal of odors. In a prior study, we assessed olfactory hedonic perception birhinally and found that males with schizophrenia failed to attach the appropriate hedonic valence to a pleasant odor, despite correctly perceiving changes in odor intensity. Female patients, in contrast, exhibited normal responses. The current study extends this work by examining odor valence processing in unaffected first-degree relatives of schizophrenia patients, to determine the extent to which this abnormality may be genetically mediated. We also examine odor valence processing unirhinally, rather than birhinally, to probe possible lateralized differences in patients' hedonic processing deficits. METHOD Individuals with schizophrenia (n = 54), first-degree unaffected family members (n = 22), and demographically matched controls (n = 45) were administered the Suprathreshold Amyl Acetate Odor Intensity and Odor Pleasantness Rating Test. RESULTS In contrast to family members and controls, both male and female schizophrenia probands underevaluated the hedonic characteristics of amyl acetate at lower concentrations and overevaluated its pleasantness at concentrations perceived as unpleasant by both controls and relatives. These patient-specific differences could not be explained by differences in smoking habit, medication use, or subjective ratings of odor intensity. However, they were associated with increased levels of anhedonia/asociality and negative symptomatology. CONCLUSIONS Our findings suggest that both male and female schizophrenia patients have difficulties in the unirhinal appraisal of hedonic valence. Normal responses in unaffected first-degree relatives suggest that this is an environmentally, rather than genetically, mediated abnormality denoting negative symptomatology.
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Affiliation(s)
- Vidyulata Kamath
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
| | - Paul J. Moberg
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA,Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Christian G. Kohler
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Raquel E. Gur
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA,Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Bruce I. Turetsky
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA,Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
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Strauss GP, Lee BG, Waltz JA, Robinson BM, Brown JK, Gold JM. Cognition-emotion interactions are modulated by working memory capacity in individuals with schizophrenia. Schizophr Res 2012; 141:257-61. [PMID: 22968207 PMCID: PMC3466085 DOI: 10.1016/j.schres.2012.08.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 08/09/2012] [Accepted: 08/14/2012] [Indexed: 11/28/2022]
Abstract
Prior research provides evidence for aberrant cognition-emotion interactions in schizophrenia. In the current study, we aimed to extend these findings by administering the "distractor devaluation" task to 40 individuals with schizophrenia and 32 demographically matched healthy controls. The task consisted of a simple visual search task for neutral faces, followed by an evaluative response made for one of the search items (or a novel item) to determine whether prior attentional selection results in a devaluation of a previously unattended stimulus. We also manipulated working memory demands by preceding the search array with a memory array that required subjects to hold 0, 1, or 2 items in working memory while performing the search array and devaluation task, to determine whether the normative process by which attentional states influence evaluative response is limited by working memory capacity. Results indicated that individuals with schizophrenia demonstrated the typical distractor devaluation effect at working memory load 0, suggesting intact evaluative response. However, the devaluation effect was absent at working memory loads of 1 and 2, suggesting that normal evaluative responses can be abolished in people with schizophrenia when working memory capacity is exceeded. Thus, findings provide further evidence for normal evaluative response in schizophrenia, but clarify that these normal experiences may not hold when working memory demands are too high.
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Affiliation(s)
- Gregory P. Strauss
- Correspondence concerning this article should be addressed to Gregory P. Strauss, Ph.D., . Phone: +1-410-402-6104. Fax: +1-410-402-7198. University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD, 21228 USA
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From semantics to feelings: how do individuals with schizophrenia rate the emotional valence of words? SCHIZOPHRENIA RESEARCH AND TREATMENT 2012; 2012:431823. [PMID: 22966437 PMCID: PMC3420789 DOI: 10.1155/2012/431823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 03/15/2012] [Indexed: 11/17/2022]
Abstract
Schizophrenia is characterized by both emotional and language abnormalities. However, in spite of reports of preserved evaluation of valence of affective stimuli, such as pictures, it is less clear how individuals with schizophrenia assess verbal material with emotional valence, for example, the overall unpleasantness/displeasure relative to pleasantness/attraction of a word. This study aimed to investigate how schizophrenic individuals rate the emotional valence of adjectives, when compared with a group of healthy controls. One hundred and eighty-four adjectives differing in valence were presented. These adjectives were previously categorized as "neutral," "positive" (pleasant), or "negative" (unpleasant) by five judges not participating in the current experiment. Adjectives from the three categories were matched on word length, frequency, and familiarity. Sixteen individuals with schizophrenia diagnosis and seventeen healthy controls were asked to rate the valence of each word, by using a computerized version of the Self-Assessment Manikin (Bradley and Lang, 1994). Results demonstrated similar ratings of emotional valence of words, suggesting a similar representation of affective knowledge in schizophrenia, at least in terms of the valence dimension.
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Childs EJ, Sobel EM, Palmer CGS, Sinsheimer JS. Detection of intergenerational genetic effects with application to HLA-B matching as a risk factor for schizophrenia. Hum Hered 2011; 72:161-72. [PMID: 22004985 DOI: 10.1159/000332051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/23/2011] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND METHODS Association studies using unrelated individuals cannot detect intergenerational genetic effects contributing to disease. To detect these effects, we improve the extended maternal-fetal genotype (EMFG) incompatibility test to estimate any combination of maternal effects, offspring effects, and their interactions at polymorphic loci or multiple SNPs, using any size pedigrees. We explore the advantages of using extended pedigrees rather than nuclear families. We apply our methods to schizophrenia pedigrees to investigate whether the previously associated mother-daughter HLA-B matching is a genuine risk or the result of bias. RESULTS Simulations demonstrate that using the EMFG test with extended pedigrees increases power and precision, while partitioning extended pedigrees into nuclear families can underestimate intergenerational effects. Application to actual data demonstrates that mother-daughter HLA-B matching remains a schizophrenia risk factor. Furthermore, ascertainment and mate selection biases cannot by themselves explain the observed HLA-B matching and schizophrenia association. CONCLUSIONS Our results demonstrate the power of the EMFG test to examine intergenerational genetic effects, highlight the importance of pedigree rather than case/control or case-mother/control-mother designs, illustrate that pedigrees provide a means to examine alternative, non-causal mechanisms, and they strongly support the hypothesis that HLA-B matching is causally involved in the etiology of schizophrenia in females.
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Affiliation(s)
- Erica J Childs
- Department of Biostatistics, University of California, Los Angeles, CA 90095, USA
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Kamath V, Bedwell JS, Compton MT. Is the odour identification deficit in schizophrenia influenced by odour hedonics? Cogn Neuropsychiatry 2011; 16:448-60. [PMID: 21390925 DOI: 10.1080/13546805.2011.552561] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION. While smell identification deficits have been well documented in schizophrenia, less work has examined identification accuracy for pleasant and unpleasant odours. The current investigation examined odour identification performance for pleasant and unpleasant odours in a sample of inpatients with schizophrenia and nonpsychiatric community controls. METHOD. The Brief Smell Identification Test was used to investigate accuracy in the identification of pleasant and unpleasant odours in 23 schizophrenia inpatients and 21 nonpsychiatric controls. RESULTS. Results revealed that schizophrenia patients showed reduced accuracy on pleasant odours, but intact performance for unpleasant odours. CONCLUSIONS. Results provide preliminary support for a specific deficit in identifying pleasant odours in patients with schizophrenia. Future studies separating odours by valence categories are warranted.
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Affiliation(s)
- Vidyulata Kamath
- Department of Psychology, University of Central Florida, Orlando, USA.
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46
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Maurage P, Callot C, Chang B, Philippot P, Rombaux P, de Timary P. Olfactory impairment is correlated with confabulation in alcoholism: towards a multimodal testing of orbitofrontal cortex. PLoS One 2011; 6:e23190. [PMID: 21858026 PMCID: PMC3155545 DOI: 10.1371/journal.pone.0023190] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 07/11/2011] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Olfactory abilities are now a flourishing field in psychiatry research. As the orbitofrontal cortex appears to be simultaneously implicated in odour processing and executive impairments, it has been proposed that olfaction could constitute a cognitive marker of psychiatric states. While this assumption appears promising, very few studies have been conducted on this topic among psychopathological populations. The present study thus aimed at exploring the links between olfaction and executive functions. These links were evaluated using two tasks of comparable difficulty, one known to rely on orbitofrontal cortex processing (i.e., a confabulation task), and one not associated with this area (i.e., Stop-Signal task). METHODOLOGY/PRINCIPAL FINDINGS Twenty recently detoxified alcoholic individuals and twenty paired controls took part in an experiment evaluating olfactory abilities and executive functioning (i.e., Stop-Signal task and confabulation task). Comorbidities and potential biasing variables were also controlled for. Alcoholic individuals exhibited impaired performance for high-level olfactory processing and significant confabulation problems as compared to controls (but no deficit in Stop-Signal task), even when the influence of comorbidities was taken into account. Most importantly, olfactory abilities and confabulation rates were significantly correlated in both groups. CONCLUSIONS/SIGNIFICANCE Alcoholism jointly leads to olfactory and memory source impairments, and these two categories of deficits are associated. These results strongly support the proposition that olfactory and confabulation measures both index orbitofrontal functioning, and suggest that olfaction could become a reliable cognitive marker in psychiatric disorders. Moreover, it underlines the need to take into account these olfactory and source memory impairments in a clinical context.
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Affiliation(s)
- Pierre Maurage
- Neuroscience, Systems and Cognition (NEUROCS) Research Unit, Institute of Psychology, Catholic University of Louvain, Louvain-la-Neuve, Belgium.
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Identification of pleasant, neutral, and unpleasant odors in schizophrenia. Psychiatry Res 2011; 187:30-5. [PMID: 21239063 PMCID: PMC3073768 DOI: 10.1016/j.psychres.2010.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2010] [Revised: 11/19/2010] [Accepted: 12/05/2010] [Indexed: 12/21/2022]
Abstract
Recent work on odor hedonics in schizophrenia has indicated that patients display abnormalities in hedonic judgments of odors in comparison to healthy comparison participants. In the current study, identification accuracy for pleasant, neutral, and unpleasant odors in individuals with schizophrenia and healthy controls was examined. Thirty-three schizophrenia patients (63% male) and thirty-one healthy volunteers (65% male) were recruited. The groups were well matched on age, sex, and smoking status. Participants were administered the University of Pennsylvania Smell Identification Test, which was subsequently divided into 16 pleasant, 15 neutral, and 9 unpleasant items. Analysis of identification z-scores for pleasant, neutral, and unpleasant odors revealed a significant diagnosis by valence interaction. Post-hoc analysis revealed that schizophrenia participants made more identification errors on pleasant and neutral odors compared to healthy controls, with no differences observed for unpleasant odors. No effect was seen for sex. The findings from the current investigation suggest that odor identification accuracy in patients is influenced by odor valence. This pattern of results parallels a growing body of literature indicating that patients display aberrant pleasantness ratings for pleasant odors and highlights the need for additional research on the influence of odor valence on olfactory identification performance in individuals with schizophrenia.
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Strauss GP, Herbener ES. Patterns of emotional experience in schizophrenia: differences in emotional response to visual stimuli are associated with clinical presentation and functional outcome. Schizophr Res 2011; 128:117-23. [PMID: 21330110 PMCID: PMC3085645 DOI: 10.1016/j.schres.2011.01.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Revised: 01/10/2011] [Accepted: 01/12/2011] [Indexed: 11/17/2022]
Abstract
The current study examined whether patterns of emotional response are differentially associated with symptom presentation and functional outcome in individuals with schizophrenia. Participants included 49 outpatients with schizophrenia and 50 demographically matched controls. All participants rated their emotional response to 131 images from the International Affective Picture Systems (IAPS) library on both arousal and valence scales. Stimuli were split into categories of positive versus negatively valenced stimuli based on control subject ratings. Cluster analysis was used to assess whether there were reliably distinct patterns of emotional response within the patient sample. Follow-up discriminant function analysis indicated that these groups were adequately separated. Sixty percent of the individuals with schizophrenia rated valence and arousal similarly to healthy subjects, while 40% displayed an atypical profile. Schizophrenia sub-groups classified by these two emotional response styles significantly differed on measures of functional outcome, severity of negative symptoms, and self-reported anhedonia. Findings are discussed in relation to current theories of emotional experience in schizophrenia.
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Affiliation(s)
- Gregory P. Strauss
- Department of Psychiatry, University of Illinois at Chicago,Department of Psychiatry, University of Maryland School of Medicine, Maryland Psychiatric Research Center,Correspondence concerning this article should be addressed to Gregory P. Strauss, Ph.D., . Phone: +1-410-402-6053. Fax: +1-410-402-7198. University of Maryland School of Medicine, Maryland Psychiatric Research Center, P.O. Box 21247, Baltimore, MD, 21228 USA
| | - Ellen S. Herbener
- Department of Psychiatry, University of Illinois at Chicago,Department of Psychology, University of Illinois at Chicago
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Seubert J, Loughead J, Kellermann T, Boers F, Brensinger CM, Habel U. Multisensory integration of emotionally valenced olfactory-visual information in patients with schizophrenia and healthy controls. J Psychiatry Neurosci 2010; 35:185-94. [PMID: 20420769 PMCID: PMC2861135 DOI: 10.1503/jpn.090094] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Patients with schizophrenia frequently have deficits in social cognition, and difficulties in the discrimination of emotional facial expressions have been discussed as an important contributing factor. We investigated whether this impairment is aggravated by difficulties relating the observed facial expression to contextual information, as is often provided by emotionally valenced crossmodal stimulation. METHODS We investigated the effects of odorant primes on the accuracy and speed of emotional face recognition. Healthy controls and patients with schizophrenia were exposed to 2-second odorant stimuli: vanillin (pleasant), ambient air (neutral) and hydrogen sulfide (unpleasant). The odours were followed by an emotional face recognition task, in which participants determined if a face showed happiness, disgust or neutral affect. RESULTS Controls showed improved performance in the categorization of disgusted faces after all types of odour stimulation irrespective of the emotional valence. However, in controls, the response time for happy faces was slower after presentation of any odour. Schizophrenia patients showed an attenuated effect of olfactory priming on disgust recognition, which resulted in the increased performance differences between the groups. This effect was particularly strong for the unpleasant odour. LIMITATIONS The study design did not allow us to fully differentiate between the effects of perceived odour intensity and valence. A possible contribution of cognitive deficits on the observed effects should be investigated in future studies. CONCLUSION Our results provide novel evidence for a special connection between the presentation of odorant cues and the accuracy of recognition of disgusted faces in healthy controls. This recognition advantage is disturbed in patients with schizophrenia and appears to contribute to the observed deficit in emotional face recognition.
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Affiliation(s)
- Janina Seubert
- Department of Psychiatry and Psychotherapy, Rheinisch-Westfälische Technische Hochschule, Aachen University, Germany.
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Ishizuka K, Tajinda K, Colantuoni C, Morita M, Winicki J, Le C, Lin S, Schretlen D, Sawa A, Cascella NG. Negative symptoms of schizophrenia correlate with impairment on the University of Pennsylvania smell identification test. Neurosci Res 2009; 66:106-10. [PMID: 19819272 DOI: 10.1016/j.neures.2009.10.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 09/09/2009] [Accepted: 10/01/2009] [Indexed: 10/20/2022]
Abstract
Deficits in odor identification have been most frequently described in schizophrenia (SZ). A relationship between dysfunction in odor identification and negative symptoms of SZ has also been reported. Furthermore, deficit SZ (a subtype of the illness with primary, enduring negative symptoms) has been found to be associated with a particularly poor performance on odor identification tests indicating that deficits in smell identification could be differentially expressed in some subtypes of SZ. We describe correlations of performance on smell identification with positive and negative symptoms of SZ. Patients with SZ (n=15) and normal controls (n=19) were tested by the University of Pennsylvania Smell Identification Test (UPSIT). Psychopathology was assessed with the Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS). SZ patients performed more poorly on the UPSIT test than did normal controls. Consistent with previous findings, we observed a correlation of SANS with UPSIT performance. In particular, specific subdomains of SANS, such as blunted affect, apathy and anhedonia, were associated with odor identification deficits. Furthermore, UPSIT score predicts these subdomains of negative symptoms. No correlation was observed between positive symptom and odor identification deficits. Our study further reinforces a relation between olfactory identification deficit and negative symptoms in SZ and suggests that smell identification could be a candidate endophenotype relevant to negative symptoms of SZ.
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Affiliation(s)
- Koko Ishizuka
- Department of Psychiatry, Johns Hopkins University School of Medicine, United States
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