Psychosis is a heterogeneous disorder, with approximately one-third of patients experiencing treatment resistance, predominantly among individuals diagnosed with Schizophrenia. Treatment-resistant schizophrenia (TRS) may stem from a distinct biological signature, involving abnormalities in the dopaminergic and glutamatergic systems. However, generalizing research findings has been challenged by inconsistent definition of resistance. Following PRISMA guidelines, a systematic literature search was conducted across four databases (PubMed, Embase, PsycINFO, and Medline) utilizing the treatment response and resistance in psychosis criteria to standardize the definition of resistance. The objective was to identify concordant genetic findings in key dopaminergic and glutamatergic pathways related to TRS, ultimately seeking genetic markers for diagnosis. Eighteen studies of moderate quality were included. The findings tentatively implicate specific glutamatergic and dopaminergic abnormalities in treatment-resistant patients, particularly involving loci within the DRD2, COMT, and NMDAR genes. Despite this concordance, the generalizability of results remains limited by factors like patient heterogeneity, varied study designs, and differences in treatment protocols. Candidate gene studies implicated genes from both dopaminergic and glutamatergic pathways in TRS but demonstrated genetic heterogeneity. Future research should advance beyond candidate-gene studies to use more robust methods, such as polygenic risk scoring, to improve the predictive accuracy of markers characterizing the TRS diagnosis.
M.T. Moreno-Calle, Silvia Iñiguez-Barrio, Maria Aurora Arrue et al.· American Journal of Medical...· 0 citations
BACKGROUND
Parental reflective functioning (PRF) has important developmental roles in the offspring. The relationship between parents' attachment style and PRF, as well as their intergenerational transmission, have been object of investigation in recent years, however, the studies have been mostly limited to mothers and conducted with semi-structured interviews. We aimed to assess this relationship using self-reports (PRF Questionnaire and Experiences in Close Relationships-Revised), and discuss their impact on child development.
METHODS
A total of 240 parents of 262 pre-school children were recruited via online methods. They completed both questionnaires as well as data regarding sex and age of parents and children. General linear models were conducted to assess the relationship between PRF and attachment dimensions, controlled by potential sex and age confounders.
RESULTS
Anxious attachment was significantly associated with the "prementalization" and "certainty about mental states" subscales, with the models explaining 15.8% and 7% of their variability. These associations remained constant when performing sex-disaggregated analyses, and in both cases the sex-specific models explained a greater variability in men than in women. Attachment style didn't show any significant associations with the "interest and curiosity" subscale, nonetheless, differences between fathers and mothers in this latter dimension were also observed in the univariate analysis.
CONCLUSIONS
Parental attachment styles are significantly associated with specific PRF domains, and these associations differ between mothers and fathers. Our results replicate previous findings, obtained mostly with interview-based assessments, and incorporate a sex-specific approach. Finally, the impact of PRF and adult attachment on the socio-emotional and behavioral development of the offspring is reviewed and discussed, as well as the clinical implications that could be derived from the extensive use of these tools.
L. Erkoreka, G. Urrutia· Actas espanolas de psiquiatr...· 0 citations
