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Eur Psychiatry. 2014 Sep;29(7):456-62. doi: 10.1016/j.eurpsy.2013.10.006. Epub 2013 Dec 15.

Associations between brain morphology and outcome in schizophrenia in a general population sample.

Author information

1
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O.BOX 26, 90029 Oulu, Finland. Electronic address: erika.jaaskelainen@oulu.fi.
2
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland.
3
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, P.O. BOX 50, 90029 OYS, Finland.
4
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O.BOX 26, 90029 Oulu, Finland; University of Oulu, Institute of Health Sciences, P.O. BOX 5000, 90014, Oulu, Finland.
5
Department of Diagnostic Radiology, Oulu University Hospital, P.O. BOX 50, 90029 OYS, Finland.
6
University of Cambridge, Department of Psychiatry, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.
7
University of Cambridge, Department of Psychiatry, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK; Institute Of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, 235, Euston Road, London NW1 2BU, UK.
8
University of Oulu, Department of Psychiatry, P.O. BOX 5000, 90014, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, P.O.BOX 26, 90029 Oulu, Finland.

Abstract

OBJECTIVE:

To analyse associations between brain morphology and longitudinal and cross-sectional measures of outcomes in schizophrenia in a general population sample.

METHODS:

The sample was the Northern Finland 1966 Birth Cohort. In 1999-2001, structural brain MRI and measures of clinical and functional outcomes were analysed for 54 individuals with schizophrenia around the age of 34. Sex, total grey matter, duration of illness and the use of antipsychotic medication were used as covariates.

RESULTS:

After controlling for multiple covariates, increased density of the left limbic area was associated with less hospitalisations and increased total white matter volume with being in remission. Higher density of left frontal grey matter was associated with not being on a disability pension and higher density of the left frontal lobe and left limbic area were related to better functioning. Higher density of the left limbic area was associated with better longitudinal course of illness.

CONCLUSIONS:

This study, based on unselected general population data, long follow-up and an extensive database, confirms findings of previous studies, that morphological abnormalities in several brain structures are associated with outcome. The difference in brain morphology in patients with good and poor outcomes may reflect separable aetiologies and developmental trajectories in schizophrenia.

KEYWORDS:

Brain; MRI; Outcome; Prognosis; Psychosis; Schizophrenia

PMID:
24342739
DOI:
10.1016/j.eurpsy.2013.10.006
[Indexed for MEDLINE]

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