APC01 EVIDENCE FOR A PROTHROMBOTIC AND INFLAMMATORY PROFILE AS MEDIATING THE INCREASED RISK OF CVD IN DEPRESSION: RESULTS OF A CASE-CONTROL LONGITUDINAL INTERVENTIONAL STUDY
Loyola McLean
Introduction: Depression is an independent risk factor for coronary heart disease (CVD), with possible mechanisms under investigation. Since thrombosis and inflammation play key roles in CVD, one intermediary mechanism may be a prothrombotic/ inflammatory state associated with depression.
Aims: We hypothesised that clinically depressed individuals would have elevations of prothrombotic and inflammatory factors compared with controls and that treatment would reduce levels.
Method: In our case-control longitudinal interventional study of community outpatients with DSM-IV unipolar major depression (n = 103) but without evidence of CVD and a demographically similar control group (n = 46), we measured depression levels with a semi-structured interview, the Montgomery-Asberg Depression Rating Scale (MADRS). The groups were compared at baseline and after treatment (6 months or more of medication and /or psychotherapy) on a range of haemostatic/inflammatory factors: fibrinogen, von Willebrand factor antigen, plasma and whole blood viscosity, factor VII and platelet, white cell and neutrophil counts. Covariates including cardiovascular risk factors were measured.
Results: A prothrombotic/inflammatory profile was found in the depressed group at baseline before and after adjustments for covariates. After intervention there were significant reductions in fibrinogen, vWFAg and platelet count, associated with a reduction in depression for fibrinogen and platelet count and with treatment type for fibrinogen and vWFAg.
Conclusions: A prothrombotic/ inflammatory profile may explain some of the increased risk of CVD in depression and treatment may improve the risk profile.
APC02 THE YOUTHMOOD PROJECT: MOODGYM IN SCHOOLS
Alison Neil
Background: School-based depression and anxiety early intervention programs have the potential to improve the mental health of adolescents. However, implementation of these programs can be a problem as many teachers feel uncomfortable and not optimally informed about presenting mental health information. Self-directed Internet programs may overcome these barriers, since they do not require extensive teacher involvement.
Aim: The current study aims to evaluate the effectiveness of the MoodGYM school program in reducing adolescents’ symptoms of anxiety and depression at post-test and six-month follow-up.
Method: 30 schools from across Australia were involved in a randomised controlled trial, with schools either assigned to receive MoodGYM over 5 sessions or to undertake usual classroom activities. All participating students (n = 1,471) completed three questionnaires at pre-test, post-test and six-month follow-up.
Results: Using ANCOVA significant reductions in anxiety and depression at post-test and six-month follow-up were demonstrated. More appropriate multi-level modelling techniques, which take advantage of school clustering, are currently being applied to the data set and will be presented.
Conclusions: Findings from the current study will help shape the implementation of web-based mental health resources in schools.
APC03 COMPREHENSIVE GENETIC ASSOCIATION ANALYSIS OF GENES FROM THE REELIN NETWORK IN SCHIZOPHRENIA
Sonja Bouwer
Introduction: Schizophrenia is a complex disorder with phenotypic and pathogenetic heterogeneity that poses a major challenge to genetic research. A genetically distinct schizophrenia subtype, termed the cognitively deficient subtype (CD), was identified in the Western Australian Family Study of Schizophrenia. The memory and cognitive performance of these patients is suggestive of impaired synaptic function, and neuroimaging data show reduced hippocampal volume. Maternal interviews reveal increased incidence of pregnancy complications, and learning difficulties, extreme shyness and social withdrawal observed in the children, all pointing to the CD subtype as a neurodevelopmental disorder. The concept of schizophrenia as a neurodevelopmental disorder with impaired synaptic development/plasticity is supported by consistent neuropathological findings of mild abnormalities in cortical organization, underdeveloped dendrites and reduced Reelin expression.
Aim: This study aims to identify genetic variants in a functional network related to neuronal migration and synaptic development/plasticity that contribute to susceptibility to the CD subtype of schizophrenia.
Method: In this case-control genetic association study we analysed 23 genes of the Reelin pathway involved in neuronal migration, synaptogenesis and synaptic plasticity, covering all the genetic variation of each gene sequence and flanking regions. Association analysis was examined with several phenotypic categories: schizophrenia, the CD and cognitively spared subtypes.
Results: Involvement of previously implicated susceptibility genes DISC1 and PDE4B have been confirmed in this study. Epistasis between variants in the ligand-receptor-adaptor complex upstream of the entire pathway: Reelin, ApoER2, VLDLR and DAB1 has been found in schizophrenia and the CD phenotype.
APC04 STOP-SIGNAL INHIBITION DEFICITS IN SCHIZOPHRENIA
Matthew Hughes
Introduction: The stop-signal task (SST) requires participants to inhibit a response while it is in progress, and permits an estimation of inhibition processing speed (stop-signal reaction time, SSRT). Behavioural studies have found that patients with schizophrenia have difficulty triggering inhibition processes (Badcock et al., 2002), and slower left-lateralised SSRT has been related to increased negative symptomology in early onset patients (Bellgrove et al., 2005). Neuroimaging studies have consistently related stop-signal inhibition to activation within a right lateralised fronto-parietal network (Rubia et al., 2001) with a special role for the right inferior frontal gyrus (rIFG) in faster SSRT processing (Aron et al., 2006; Hughes et al., unpublished data).
Aim: The aim of this study was to assess brain activation during performance of the SST in patients with schizophrenia compared to healthy controls using fMRI.
Method: Patients with a diagnosis of schizophrenia and healthy controls (N = 10 per group; matched for age and sex) were scanned while performing the SST.
Results: Controls and patients activated an anticipated fronto-parietal network, but patient activation was markedly reduced. A matched sample t-test assessing inhibition related activation revealed greater activation in controls principally within rIFG, right middle frontal gyrus, right superior parietal lobe, in addition to bilateral basal ganglia and thalamic nuclei. The relationship between SSRT and rIFG was similar in both groups, however rIFG activation was significantly lower and SSRT significantly longer in the patient group.
Conclusions: Underactivation of this cortico-basal ganglia-thalamic network may underpin behavioural control deficits in patients with schizophrenia.
APC05 ATTENTIONAL BIASES AS A CORRELATE OF CHILDHOOD TRAUMA IN PEOPLE WITH FIRST EPISODE PSYCHOSIS
Sarah Bendall
There is tentative evidence of an association between childhood trauma (CT) and psychosis and it has been suggested that this relationship may be mediated by post-traumatic stress disorder (PTSD). Selective attention to trauma-related information has been found to be a core cognitive abnormality in people with childhood trauma-related PTSD. It is possible to speculate that, if the positive symptoms of psychosis are an intrusive posttraumatic symptom in some people, then those people will exhibit an attentional bias to trauma-related information in the same way as those with PTSD.
Aims: The current study, which is in progress, aims to test this theory.
Methods: Young people aged between 15 and 29 years with either first episode psychosis or no psychiatric disorder were assessed for PTSD symptoms, psychotic symptoms, and CT. They carried out an emotional Stroop test to measure selective attention, in which words of different emotional valence were presented. Participants were asked to name the colour of a presented word without taking account of the meaning of the word. Words were presented in the following categories: neutral (e.g., socks), positive (e.g., smile), negative (e.g., miserable), threat (e.g., spy) physical abuse (e.g., punched) sexual abuse (e.g., molested), emotional abuse (e.g., snigger), and neglect (e.g., lonely). The time taken to colour-name indicated the degree of attentional resource the word meaning required.
Results: will explore the relationship between CT, attentional bias, positive psychotic symptoms and PTSD symptoms.
Conclusions: The results will be discussed in light of theories of CT and psychosis.
APC06 CONFIGURAL FACE PROCESSING IN SCHIZOPHRENIA
Nicole Joshua
Introduction: Schizophrenia patients have consistently shown deficits in facial emotion processing. Much of this research has failed to investigate whether underlying visual perception problems with face processing are responsible for higher-order emotion processing problems. There is evidence to suggest that schizophrenia patients may have problems integrating features into perceptual wholes using configural information.
Aim: To examine the impact of spatial configural alteration on face perception.
Methods: 23 schizophrenia patients and 20 age, gender and IQ-matched healthy control participants completed a fractured faces task. Participants were shown a series of famous faces and were required to name the identity of each face. Initially these faces were presented ‘fractured’, as if a photo was cut into pieces and spread apart. This allowed the features of the face to remain whole, however, alter the internal spatial configuration between the features. Participants were then shown the faces ‘intact’. A difference score was calculated based on the number of correct responses for intact faces minus those for fractured faces.
Results: Overall there was no significant differences in the number of correctly recognised ‘intact’ faces between groups. Interestingly, healthy control participants showed a greater difference between fractured and intact face recognition than schizophrenia patients indicating they were more impaired by configural disruption.
Conclusions: This finding suggests that disruption of configural face information has more of an impact on healthy control participants than schizophrenia patients. Therefore schizophrenia patients may rely less on configural information for face recognition, indicating different visual processing styles compared to healthy control participants.
