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  • 1
    Online Resource
    Online Resource
    Investigating the causal nature of the relationship of subcortical brain volume with smoking and alcohol use
    Royal College of Psychiatrists ; 2022
    In:  The British Journal of Psychiatry Vol. 221, No. 1 ( 2022-07), p. 377-385
    Details
    In: The British Journal of Psychiatry, Royal College of Psychiatrists, Vol. 221, No. 1 ( 2022-07), p. 377-385
    Abstract: Structural variation in subcortical brain regions has been linked to substance use, including the most commonly used substances nicotine and alcohol. Pre-existing differences in subcortical brain volume may affect smoking and alcohol use, but there is also evidence that smoking and alcohol use can lead to structural changes. Aims We assess the causal nature of the complex relationship of subcortical brain volume with smoking and alcohol use, using bi-directional Mendelian randomisation. Method Mendelian randomisation uses genetic variants predictive of a certain ‘exposure’ as instrumental variables to test causal effects on an ‘outcome’. Because of random assortment at meiosis, genetic variants should not be associated with confounders, allowing less biased causal inference. We used summary-level data of genome-wide association studies of subcortical brain volumes (nucleus accumbens, amygdala, caudate, hippocampus, pallidum, putamen and thalamus; n = 50 290) and smoking and alcohol use (smoking initiation, n = 848 460; cigarettes per day, n = 216 590; smoking cessation, n = 378 249; alcoholic drinks per week, n = 630 154; alcohol dependence, n = 46 568). The main analysis, inverse-variance weighted regression, was verified by a wide range of sensitivity methods. Results There was strong evidence that liability to alcohol dependence decreased amygdala and hippocampal volume, and smoking more cigarettes per day decreased hippocampal volume. From subcortical brain volumes to substance use, there was no or weak evidence for causal effects. Conclusions Our findings suggest that heavy alcohol use and smoking can causally reduce subcortical brain volume. This adds to accumulating evidence that alcohol and smoking affect the brain, and likely mental health, warranting more recognition in public health efforts.
    Type of Medium: Online Resource
    ISSN: 0007-1250 , 1472-1465
    URL: Article
    DOI: 10.1192/bjp.2021.81
    RVK:
    XA 10000
    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2022
    detail.hit.zdb_id: 2021500-9
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  • 2
    Online Resource
    Online Resource
    The interplay between psychopathological symptoms: transdiagnostic cross-lagged panel network model
    Royal College of Psychiatrists ; 2022
    In:  BJPsych Open Vol. 8, No. 4 ( 2022-07)
    Details
    In: BJPsych Open, Royal College of Psychiatrists, Vol. 8, No. 4 ( 2022-07)
    Abstract: Recent paradigm shifts suggest that psychopathology manifests through dynamic interactions between individual symptoms. Aims To investigate the longitudinal relationships between symptoms in a transdiagnostic sample of patients with psychiatric disorders. Method A two-wave, cross-lagged panel network model of 15 nodes representing symptoms of depression, (social) anxiety and attenuated psychotic symptoms was estimated, using baseline and 1-year follow-up data of 222 individuals with psychiatric disorders. Centrality indices were calculated to determine important predictors and outcomes. Results Our results demonstrated that the strongest relationships in the network were between (a) more suicidal ideation predicting more negative self-view, and (b) autoregressive relationships of social anxiety symptoms positively reinforcing themselves. Negative self-view was the most predictable node in the network as it had the highest ‘in-expected influence’ centrality, and may be an important transdiagnostic outcome symptom. Conclusions The results give insight into longitudinal interactions between symptoms, which interact in ways that do not adhere to broader diagnostic categories. Our results suggest that self-view can also be a transdiagnostic outcome of psychopathology rather than just a predictor, as is normally posited, and may especially have an important relationship with suicidal ideation. Overall, our study demonstrates the dynamic complexity of psychopathology, and further supports the importance of investigating symptom interactions of different psychopathological dimensions over time and across disorders.
    Type of Medium: Online Resource
    ISSN: 2056-4724
    URL: Article
    DOI: 10.1192/bjo.2022.516
    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2022
    detail.hit.zdb_id: 2829557-2
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  • 3
    Online Resource
    Online Resource
    Perceived ethnic discrimination, suicidal ideation and mastery in a multi-ethnic cohort: the HELIUS study
    Royal College of Psychiatrists ; 2023
    In:  BJPsych Open Vol. 9, No. 1 ( 2023-01)
    Details
    In: BJPsych Open, Royal College of Psychiatrists, Vol. 9, No. 1 ( 2023-01)
    Abstract: The association between perceived ethnic discrimination (PED) and mental health conditions is well studied. However, less is known about the association between PED and suicidal ideation, or the role of positive psychosocial factors in this association. Aims To examine the association between PED and suicidal ideation among ethnic minority groups in Amsterdam, The Netherlands, and investigate whether ethnicity and mastery (people's extent of feeling in control of their lives and environment) moderate this association. Method Cross-sectional data from the multi-ethnic HELIUS study were analysed ( n = 17 053) for participants of South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin. PED was measured using the Everyday Discrimination Scale, suicidal ideation using item 9 of the Patient Health Questionnaire-9 and mastery using the Pearlin–Schooler Mastery Scale. Results Logistic regression analyses demonstrated a small positive association between PED and suicidal ideation (OR = 1.068, 95% CI 1.059–1.077), which did not differ among ethnic minority groups. Mastery did not moderate the association between PED and suicidal ideation among the ethnic minority groups. Conclusions Our findings support the hypothesis that PED is associated with suicidal ideation and this association does not significantly vary between ethnic minority groups. Although higher levels of mastery were associated with lower suicidal ideation, mastery did not moderate the relationship between PED and suicidal ideation. Besides targeting ethnic discrimination as a societal problem, future longitudinal research is needed to investigate whether interventions aimed at improving mastery could reduce suicidal ideation in ethnic minority groups.
    Type of Medium: Online Resource
    ISSN: 2056-4724
    URL: Article
    DOI: 10.1192/bjo.2022.640
    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2023
    detail.hit.zdb_id: 2829557-2
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  • 4
    Online Resource
    Online Resource
    Ethnic differences in response to atypical antipsychotics in patients with schizophrenia: individual patient data meta-analysis of randomised placebo-controlled registration trials submitted to the Dutch Medicines Evaluation Board
    Royal College of Psychiatrists ; 2023
    In:  BJPsych Open Vol. 9, No. 2 ( 2023-03)
    Details
    In: BJPsych Open, Royal College of Psychiatrists, Vol. 9, No. 2 ( 2023-03)
    Abstract: Little is known about the effect of ethnicity on the response to antipsychotic medication in patients with schizophrenia. Aims To determine whether ethnicity moderates the response to antipsychotic medication in patients with schizophrenia, and whether this moderation is independent of confounders. Method We analysed 18 short-term, placebo-controlled registration trials of atypical antipsychotic medications in patients with schizophrenia ( N = 3880). A two-step, random-effects, individual patient data meta-analysis was applied to establish the moderating effect of ethnicity (White versus Black) on symptom improvement according to the Brief Psychiatric Rating Scale (BPRS) and on response, defined as 〉 30% BPRS reduction. These analyses were corrected for baseline severity, baseline negative symptoms, age and gender. A conventional meta-analysis was performed to determine the effect size of antipsychotic treatment for each ethnic group separately. Results In the complete data-set, 61% of patients were White, 25.6% of patients were Black and 13.4% of patients were of other ethnicities. Ethnicity did not moderate the efficacy of antipsychotic treatment: pooled β -coefficient for the interaction between treatment and ethnic group was −0.582 (95% CI −2.567 to 1.412) for mean BPRS change, with an odds ratio of 0.875 (95% CI 0.510–1.499) for response. These results were not modified by confounders. Conclusions Atypical antipsychotic medication is equally effective in both Black and White patients with schizophrenia. In registration trials, White and Black patients were overrepresented relative to other ethnic groups, limiting the generalisability of our findings.
    Type of Medium: Online Resource
    ISSN: 2056-4724
    URL: Article
    DOI: 10.1192/bjo.2023.19
    Language: English
    Publisher: Royal College of Psychiatrists
    Publication Date: 2023
    detail.hit.zdb_id: 2829557-2
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