Early signs of worry: Psychosis risk symptom visual distortions are independently associated with suicidal ideation

Granö, Niklas; Salmijärvi, Laura; Karjalainen, Marjaana; Kallionpää, Santeri; Roine, Mikko; Taylor, Peter

doi:10.1016/j.psychres.2014.12.031

Cited by 37 publications

(30 citation statements)

References 27 publications

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“…The prevalence of VHs in schizophrenic patients is approximately 25-30% (Waters et al 2014). Prior studies have reported that VHs are experienced in multiple stages of schizophrenia, and has also been reported in children, adolescents, and young adults at high-risk for schizophrenia (Grano et al 2015;Hebert et al 2010;Mittal et al 2015). Furthermore, according to some reports, visual disturbances can be used as an i ndex f or sym pt oms, endophenotypes, biomarkers, and predictors for the study of the clinical, pathological and physiological features of schizophrenia (Garcia-Portilla et al 2019;Guidotti and Grayson 2011).…”

Section: Introductionmentioning

confidence: 99%

Abberant inverted U-shaped brain pattern and trait-related retinal impairment in schizophrenia patients with combined auditory and visual hallucinations: a pilot study

Zhuo

Xiao

Chen

et al. 2020

Brain Imaging and Behavior

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Schizophrenic patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, brain and retinal alterations associated with combined AHs and VHs in schizophrenic patients are unknown. This study aimed o investigate brain and retinal alterations in first episode untreated schizophrenic patients with combined AHs and VHs (FUSCHAV). FUSCHAV patients (n = 120), divided into four groups according to severity of AH and VH symptoms, were compared to healthy controls (n = 30). Gray matter volume (GMV) and global functional connectivity density (gFCD) were recorded to reflect brain structure and functional alterations. Total retinal thickness was acquired by optical coherence tomography to assess retinal impairment. The majority of FUSCHAV patients (85.8%) demonstrated both GMV reduction and gFCD increases along with retinal thinning compared to healthy controls. The severity of GMV reduction and gFCD increase differed between patient groups, ranked from highest to lowest severity as follows: severe AHs combined with severe VHs (FUSCHSASV, 20 patients), moderate AHs combined with severe VHs (FUSCHMASV, 23 patients), severe AHs combined with moderate VHs (FUSCHSAMV, 28 patients), and moderate AHs combined with moderate VHs (FUSCHMAMV, 26). Retinal impairment was similar among the four FUSCHAV groups. GMV reduction and gFCD increases in the frontal-parietal lobule show an inverted U-shaped pattern among FUSCHAV patients according to AH and VH severity, while retinal impairment remains stable among FUSCHAV groups. These findings indicate a reciprocal deterioration in auditory and visual disturbances among FUSCHAV patients.

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Section: Introductionmentioning

confidence: 99%

Abberant inverted U-shaped brain pattern and trait-related retinal impairment in schizophrenia patients with combined auditory and visual hallucinations: a pilot study

Zhuo

Xiao

Chen

et al. 2020

Brain Imaging and Behavior

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“…One study reported a 62% incidence of visual distortions in schizophrenia, with brightness, contrast, and motion increases being the most commonly reported ( Phillipson and Harris, 1985 ). Visual distortions also had the highest predictive validity, among all basic symptoms, for conversion to a psychotic disorder ( Klosterkotter et al, 2001 ), and visual distortions in help-seeking adolescents are associated with suicidal ideation, even after controlling for age, gender, depression, thought disorder, paranoia, and auditory distortions ( Grano et al, 2015 ). Finally, visual impairments contribute substantially to poorer real-world functioning in people with schizophrenia ( Green et al, 2012 , Rassovsky et al, 2011 ).…”

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confidence: 99%

Schizophrenia and the eye

Silverstein

Rosen

2015

Schizophrenia Research: Cognition

157

137

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Although visual processing impairments are common in schizophrenia, it is not clear to what extent these originate in the eye vs. the brain. This review highlights potential contributions, from the retina and other structures of the eye, tovisual processing impairments in schizophrenia and high-risk states. A second goal is to evaluate the status of retinal abnormalities as biomarkers for schizophrenia. The review was motivated by known retinal changes in other disorders (e.g., Parkinson's disease, multiple sclerosis), and their relationships to perceptual and cognitive impairments, and disease progression therein. The evidence reviewed suggests two major conclusions. One is that there are multiple structural and functional disturbances of the eye in schizophrenia, all of which could be factors in the visual disturbances of patients. These include retinal venule widening, retinal nerve fiber layer thinning, dopaminergic abnormalities, abnormal ouput of retinal cells as measured by electroretinography (ERG), maculopathies and retinopathies, cataracts, poor acuity, and strabismus. Some of these are likely to be illness-related, whereas others may be due to medication or comorbid conditions. The second conclusion is that certain retinal findings can serve as biomarkers of neural pathology, and disease progression, in schizophrenia. The strongest evidence for this to date involves findings of widened retinal venules, thinning of the retinal nerve fiber layer, and abnormal ERG amplitudes. These data suggest that a greater understanding of the contribution of retinal and other ocular pathology to the visual and cognitive disturbances of schizophrenia is warranted, and that retinal changes have untapped clinical utility.

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“…A key variable of interest is general psychological distress. PEs are associated with elevated risk for distress (33), and distress as a result of PEs is proposed to lead to self-injurious behaviour (34). In a sample of Australian adolescents with PEs, Martin et al (35) found individuals reporting psychological distress had significantly higher odds of future suicide attempt, whereas individuals reporting little or no psychological distress did not, supporting previous studies (36,37).…”

Section: Introductionmentioning

confidence: 78%

Investigating the role of hallucinatory experiences in the transition from suicidal thoughts to attempts

Hielscher

DeVylder

Connell

et al. 2019

Acta Psychiatr Scand

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Objective Psychotic experiences, including auditory hallucinatory experiences (HEs), are strongly associated with both suicidal thoughts and behaviour. This study examined their role in the ideation‐to‐attempt transition in adolescents, including their direct and indirect effect via potential mediators. Method Participants were from an Australian prospective longitudinal cohort of 1669 adolescents (12–17 years); of which a subsample endorsing baseline suicidal ideation (n = 216) was the focus of most analyses. Suicidal thoughts and behaviours were measured using the Self‐Harm Behaviour Questionnaire. The Diagnostic Interview Schedule for Children was used to assess auditory HEs. Potential mediators of interest were psychological distress and Interpersonal Theory of Suicide (IPTS) constructs. Results Among adolescents reporting suicidal ideation at baseline (n = 216), 6.5% had attempted suicide during follow‐up. The size of auditory HEs’ univariate effect suggests a possible strong relationship with increased risk of incident suicide attempts (OR = 2.40; 95%CI = 0.76–7.56); however, there was inadequate statistical power to produce a precise estimate. When HEs were accompanied by distress there was a nine‐fold increased risk of acting on suicidal thoughts. Distress was independently associated with risk of attempt transition (OR = 4.09), whereas IPTS constructs were poor explanatory variables in most models. Conclusion Adolescents with psychological distress and auditory HEs are at high risk of incident suicide attempts. Further investigations on the role of negative/distressing content of hallucinations in the ideation‐to‐attempt transition are warranted.

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Early signs of worry: Psychosis risk symptom visual distortions are independently associated with suicidal ideation

Cited by 37 publications

References 27 publications

Abberant inverted U-shaped brain pattern and trait-related retinal impairment in schizophrenia patients with combined auditory and visual hallucinations: a pilot study

Abberant inverted U-shaped brain pattern and trait-related retinal impairment in schizophrenia patients with combined auditory and visual hallucinations: a pilot study

Schizophrenia and the eye

Investigating the role of hallucinatory experiences in the transition from suicidal thoughts to attempts

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