Carmen Simonsen

• Busch, Cecilie; Ueland, Torill; Høegh, Margrethe Collier; Simonsen, Carmen; Aminoff, Sofie R. & Barrett, Elizabeth Ann [Show all 11 contributors for this article] (2026). Wish list from people with lived experience of bipolar disorder - for clinicians and researchers. Journal of Affective Disorders Reports. 25, p. 101114–101114. doi: 10.1016/j.jadr.2026.101114. Full text in Research Archive
• Lunding, Synve Hoffart; Kreis, Isabel; Rødevand, Linn; Aas, Monica; Werner, Maren Caroline Frogner & Johansen, Ingrid Torp [Show all 16 contributors for this article] (2025). Self-harming behavior linked to earlier onset of cardiovascular disease in severe mental disorders. European psychiatry. ISSN 0924-9338. 68(1). doi: 10.1192/j.eurpsy.2025.10106. Full text in Research Archive Show summary

  Background People with severe mental disorders (SMDs) have about 15 years shorter life expectancy than the general population. Cardiovascular disease (CVD) is among the leading causes of premature mortality and shares genetic underpinnings with SMDs. We investigated the link between clinical traits in SMDs and time to the first CVD diagnosis. Methods The study included 1,627 well-characterized participants with schizophrenia spectrum (SCZ, N  = 998) and bipolar spectrum disorders (BDs, N  = 629), and a reference group of 1,201 healthy controls. CVD diagnoses were obtained from two Norwegian national registries (covering both primary and specialist health care) for the period of 2006–2020. Applying Cox proportional hazard models, we investigated associations between SMD clinical traits and time to first CVD diagnosis in SMD participants, adjusting for age, sex, diagnosis, and tobacco use. Results Among individuals with SMD, recurring self-harming behavior (SHB) was associated with a shorter time to first CVD diagnosis ( p  = .029) relative to those without SHB. In the subgroup with SHB and a history of attempted suicide(s), more suicide attempts were associated with shorter time to first CVD diagnosis ( p  = .041). Significant associations of time to first CVD diagnosis with age at SMD onset and comorbid substance use disorder were not demonstrated. Conclusions SHB and a history of suicide attempts in individuals with SMD seem to be associated with earlier CVD onset, and may improve the prediction of CVD, in addition to standard cardiovascular risk factors.

• Skoge, Mari; Aminoff, Sofie Ragnhild; Barrett, Elizabeth Ann; Bryhni, Gina Engen; Kling, Kristine & Kvaerner, Kari Jorunn [Show all 13 contributors for this article] (2025). A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability Study. JMIR Human Factors. 12. doi: 10.2196/68813. Full text in Research Archive Show summary

  Abstract Background Strengthening shared decision-making in mental health care may improve the quality of services and treatment outcomes, but its implementation in services for severe mental disorders is currently lacking. Objective This study aims to explore the feasibility and acceptability of iTandem (University of Oslo), a mobile app designed to promote shared decision-making in the treatment of psychotic disorders. In addition, the study aims to investigate mechanisms that potentially contribute to the intended effect of the app. iTandem is a therapy supplement that facilitates patient involvement in decisions regarding treatment goals and focus areas. It is designed for personalized use and contains 8 optional modules: sleep, medication, recovery, mood, psychosis, activity, substance use, and feedback concerning therapy. Methods Patients undergoing assessment or treatment for psychotic disorders and their clinicians were recruited for the study. Patients and clinicians jointly used iTandem as part of standard treatment in a 6-week trial. We used a mixed-methods study design with a clear emphasis on qualitative methods. Feasibility and acceptability were assessed through descriptive statistics based on preintervention and postintervention questionnaires and app usage data, in addition to text responses to open-ended items. We conducted a reflexive thematic analysis of postintervention interviews to elaborate these measures and to explore mechanisms potentially contributing to achieving shared decision-making when using iTandem. Results A total of 9 patients and 8 clinicians completed the trial. The participants evaluated iTandem as a user-friendly and acceptable tool, but there were considerable variations in how the app was integrated into treatment and in perceptions of its clinical value. The thematic analysis suggests that iTandem has the potential to facilitate shared decision-making through supporting cognition and shifting the patient’s role. We also identified scaffolding structures, an analogy of personalized support, as a precondition for these mechanisms and for the overall feasibility and acceptability of iTandem. Conclusions iTandem was generally perceived as a feasible and acceptable tool in the treatment of patients with psychotic disorders. Our findings suggest that nonclinical aspects, such as support structures, are important to the feasibility and acceptability of such digital interventions and patients’ aptness for digitalized treatment in general. Future research should explore related nonclinical aspects further instead of defining potential target groups based on diagnoses and symptom severity alone.

• Romm, Kristin Lie; Skoge, Mari; Barrett, Elizabeth Ann; Berentzen, Lars-Christian; Bergsager, Dagfinn & Fugeli, Pål [Show all 18 contributors for this article] (2025). A Mobile Health Intervention to Support Collaborative Decision-Making in Mental Health Care: Development and Usability. JMIR Formative Research. 9. doi: 10.2196/57614. Full text in Research Archive
• Åsbø, Gina; Haavind, Hanne; Kruse, Sindre Hembre; Wold, Kristin Fjelnseth; Hegelstad, Wenche & Romm, Kristin Lie [Show all 10 contributors for this article] (2025). “Why shouldn’t I expect a lot from life?” – a qualitative study of what facilitates long-term recovery in first-episode psychosis. BMC Psychiatry. 25. doi: 10.1186/s12888-025-06681-y. Full text in Research Archive Show summary

  Background Qualitative research frequently characterises recovery, but more knowledge on subjective experiences of facilitators of long-term recovery in psychosis is needed. This interview study aimed to explore what people with first-episode psychosis (FEP) highlight as important for their long-term recovery. Methods Interviews with 20 individuals in recovery (personal and/or clinical) participating in two follow-up studies, 10 and 20-years after treatment start for a first episode schizophrenia or bipolar spectrum disorder. Interviews were thematically analysed by a research team that included a peer researcher. Results The analysis generated that personal resources and agency were experienced as the overarching facilitators of recovery, with five themes: (1) Doing recovery in everyday life, involving agency in daily life; (2) Re-evaluating risk, involving re-evaluating limitations and stress reduction; (3) Becoming a caregiver, involving development from being cared for to taking care of others; (4) Negotiating normality, involving identity and social inclusion; (5) Owning and sharing your story, involving accepting lived experience and overcoming stigma. Discussion All participants described themselves as the main facilitators of their own recovery, and treatment as secondary to their efforts. Gradually testing limitations and taking risks, providing social support to others, as well as owning and sharing your story were crucial for promoting long-term recovery in FEP. Clinical implications include supporting service users’ agency with strength- based interventions and shared-decision making, as well as refining psychoeducation on stress reduction in a long-term perspective.

• Simonsen, Carmen; Åsbø, Gina; Slade, Michael; Wold, Kristin Fjelnseth; Widing, Line Hustad & Flaaten, Camilla Bärthel [Show all 13 contributors for this article] (2024). A good life with psychosis: Rate of positive outcomes in first-episode psychosis at 10-year follow-up. Psychological Medicine. ISSN 0033-2917. 54(9), p. 2112–2121. doi: 10.1017/S0033291724000205. Full text in Research Archive Show summary

  Background More knowledge about positive outcomes for people with first-episode psychosis (FEP) is needed. An FEP 10-year follow-up study investigated the rate of personal recovery, emotional wellbeing, and clinical recovery in the total sample and between psychotic bipolar spectrum disorders (BD) and schizophrenia spectrum disorders (SZ); and how these positive outcomes overlap. Methods FEP participants (n = 128) were re-assessed with structured clinical interviews at 10-year follow-up. Personal recovery was self-rated with the Questionnaire about the Process of Recovery-15-item scale (total score ⩾45). Emotional wellbeing was self-rated with the Life Satisfaction Scale (score ⩾5) and the Temporal Experience of Pleasure Scale (total score ⩾72). Clinical recovery was clinician-rated symptom-remission and adequate functioning (duration minimum 1 year). Results In FEP, rates of personal recovery (50.8%), life satisfaction (60.9%), and pleasure (57.5%) were higher than clinical recovery (33.6%). Despite lower rates of clinical recovery in SZ compared to BD, they had equal rates of personal recovery and emotional wellbeing. Personal recovery overlapped more with emotional wellbeing than with clinical recovery (χ2). Each participant was assigned to one of eight possible outcome groups depending on the combination of positive outcomes fulfilled. The eight groups collapsed into three equal-sized main outcome groups: 33.6% clinical recovery with personal recovery and/or emotional wellbeing; 34.4% personal recovery and/or emotional wellbeing only; and 32.0% none. Conclusions In FEP, 68% had minimum one positive outcome after 10 years, suggesting a good life with psychosis. This knowledge must be shared to instill hope and underlines that subjective and objective positive outcomes must be assessed and targeted in treatment.

• Berthet, Pierre; Haatveit, Beathe; Kjelkenes, Rikka; Worker, Amanda; Kia, Seyed Mostafa & Wolfers, Thomas [Show all 21 contributors for this article] (2024). A 10-Year Longitudinal Study of Brain Cortical Thickness in People with First-Episode Psychosis Using Normative Models. Schizophrenia Bulletin. ISSN 0586-7614. 51(1), p. 95–107. doi: 10.1093/schbul/sbae107. Full text in Research Archive Show summary

  Background Clinical forecasting models have potential to optimize treatment and improve outcomes in psychosis, but predicting long-term outcomes is challenging and long-term follow-up data are scarce. In this 10-year longitudinal study, we aimed to characterize the temporal evolution of cortical correlates of psychosis and their associations with symptoms. Design Structural magnetic resonance imaging (MRI) from people with first-episode psychosis and controls (n = 79 and 218) were obtained at enrollment, after 12 months (n = 67 and 197), and 10 years (n = 23 and 77), within the Thematically Organized Psychosis (TOP) study. Normative models for cortical thickness estimated on public MRI datasets (n = 42 983) were applied to TOP data to obtain deviation scores for each region and timepoint. Positive and Negative Syndrome Scale (PANSS) scores were acquired at each timepoint along with registry data. Linear mixed effects models assessed effects of diagnosis, time, and their interactions on cortical deviations plus associations with symptoms. Results LMEs revealed conditional main effects of diagnosis and time × diagnosis interactions in a distributed cortical network, where negative deviations in patients attenuate over time. In patients, symptoms also attenuate over time. LMEs revealed effects of anterior cingulate on PANSS total, and insular and orbitofrontal regions on PANSS negative scores. Conclusions This long-term longitudinal study revealed a distributed pattern of cortical differences which attenuated over time together with a reduction in symptoms. These findings are not in line with a simple neurodegenerative account of schizophrenia, and deviations from normative models offer a promising avenue to develop biomarkers to track clinical trajectories over time.

• Kreis, Isabel; Wold, Kristin Fjelnseth; Åsbø, Gina; Simonsen, Carmen; Flaaten, Camilla Bärthel & Engen, Magnus Johan [Show all 10 contributors for this article] (2024). The relationship between visual hallucinations, functioning, and suicidality over the course of illness: a 10-year follow-up study in first-episode psychosis. Schizophrenia. 10(1). doi: 10.1038/s41537-024-00450-8. Full text in Research Archive Show summary

  Visual hallucinations in psychosis are under-researched despite associations with increased illness severity, functional impairments, and suicidality in the few existing studies. Further, there are no long-term longitudinal studies, making it impossible to conclude if these associations are state or trait phenomena. In the current prospective longitudinal study, 184 individuals with first-episode psychosis were assessed with semi-structured clinical interviews and self-report questionnaires at baseline and 10-year follow-up. Participants were grouped based on lifetime experience of visual hallucinations: before or at baseline (VH+/+), first during follow-up (VH−/+), or never (VH−/−). Associations with functioning, suicide attempts, childhood trauma and other markers of illness severity were tested using multinomial logistic regression analysis. At baseline, the VH+/+ group (37.5%), but not VH−/+ (12.5%), had poorer functioning, higher symptom severity, a lower age at onset, and included more individuals with a history of multiple suicide attempts than the VH−/− group (50%). At follow-up, the VH−/+ group, but not VH+/+, had poorer functioning and higher symptom severity than the VH−/− group. However, the number of participants who committed multiple suicide attempts during the follow-up period was again significantly higher in the VH+/+ group. There was no association with childhood trauma. Hence, visual hallucinations are associated with impaired functioning and higher symptom severity, but only in the short-term. However, visual hallucinations that arise early in the course of illness are a risk indicator for repeated suicide attempts throughout the illness course. These findings highlight the relevance of assessing visual hallucinations and monitoring their development over time.

• Åsbø, Gina; Haavind, Hanne; Kruse, Sindre Hembre; Wold, Kristin Fjelnseth; Hegelstad, Wenche & Romm, Kristin Lie [Show all 10 contributors for this article] (2024). Taking what you get or Getting what you Need: A Qualitative Study on Experiences with Mental Health and Welfare Services in Long-Term Recovery in First-Episode Psychosis. Community mental health journal. ISSN 0010-3853. 24. doi: 10.1007/s10597-024-01356-6. Full text in Research Archive Show summary

  How people in long-term recovery (clinical and personal) in first-episode psychosis (schizophrenia and bipolar spectrum disorders) experience the mental health and welfare services they interact with is not frequently studied but has significant implications. We therefore aimed to explore which aspects of these services people with FEP evaluate as important for their long-term recovery. Twenty participants in clinical and/or personal recovery from two Norwegian long-term follow-up studies after FEP (TOP 10-year and TIPS 20-year) were sampled for this interview-based qualitative study. The research-team included service user experience. A deductive analysis based on personal accounts of recovery generated five service aspects. Few specific types of interventions were reported to promote recovery although medications, psychotherapy and employment support were mentioned. Participants valued services based in collaboration and that focused on their resources rather than limitations. The importance of long-term follow-up with a consistent aim was highlighted, as was the inclusion of caregivers and peers. Welfare services contributed to recovery by supporting basic needs and safety, but some experienced social exclusion when not participating in the labor market. This study is unique in exploring the role of services, including welfare, in long-term FEP recovery from service user perspectives. Participants evaluated that services played a more indirect role in long-term recovery by supporting their personal resources, although what they needed from services had frequently not been offered. Their expertise by experience contributes valuable knowledge. Better service coordination and consistent implementation of this knowledge are crucial to support recovery in FEP.

• Wold, Kristin Fjelnseth; Ottesen, Akiah; Flaaten, Camilla Bärthel; Kreis, Isabel; Lagerberg, Trine Vik & Romm, Kristin Lie [Show all 10 contributors for this article] (2024). Childhood trauma and treatment resistance in first-episode psychosis: Investigating the role of premorbid adjustment and duration of untreated psychosis. Schizophrenia Research. ISSN 0920-9964. 270, p. 441–450. doi: 10.1016/j.schres.2024.07.001. Full text in Research Archive Show summary

  Background Early identification of treatment non-response in first-episode psychosis (FEP) is essential to outcome. Despite indications that exposure to childhood trauma (CT) can have adverse effects on illness severity, its impact on treatment non-response and the interplay with other pre-treatment characteristics is sparsely investigated. We use a lack of clinical recovery as an early indicator of treatment resistance to investigate the relationship between CT and treatment resistance status at one-year follow-up and the potential mediation of this effect by other pre-treatment characteristics. Methods This prospective one-year follow-up study involved 141 participants recruited in their first year of treatment for a schizophrenia-spectrum disorder. We investigated clinical status, childhood trauma (CT), premorbid adjustment (PA), and duration of untreated psychosis (DUP) at baseline and clinical status at one-year follow-up. Ordinal regression analyses were conducted to investigate how PA and DUP affected the relationship between CT and one-year outcome in FEP. Results 45 % of the FEP sample reported moderate to severe CT, with significantly higher levels of CT in the early treatment resistant group compared to participants with full or partial early recovery. Ordinal regression analysis showed that CT was a significant predictor of being in a more severe outcome group (OR = 4.59). There was a partial mediation effect of PA and a full mediation effect of DUP on the effect of CT on outcome group membership. Discussion Our findings indicate that reducing treatment delays may mitigate the adverse effects of CT on clinical outcomes and support the inclusion of broad trauma assessment in FEP services.

• Kreis, Isabel; Lagerberg, Trine Vik; Wold, Kristin Fjelnseth; Åsbø, Gina; Simonsen, Carmen & Flaaten, Camilla Bärthel [Show all 11 contributors for this article] (2024). Behind the heterogeneity in the long-term course of first-episode psychosis: Different psychotic symptom trajectories are associated with different patterns of cannabis and stimulant use. Schizophrenia Research. ISSN 0920-9964. 271, p. 91–99. doi: 10.1016/j.schres.2024.07.006. Full text in Research Archive Show summary

  Background Data-driven classification of long-term psychotic symptom trajectories and identification of associated risk factors could assist treatment planning and improve long-term outcomes in psychosis. However, few studies have used this approach, and knowledge about underlying mechanisms is limited. Here, we identify long-term psychotic symptom trajectories and investigate the role of illness-concurrent cannabis and stimulant use. Methods 192 participants with first-episode psychosis were followed up after 10 years. Psychotic symptom trajectories were estimated using growth mixture modeling and tested for associations with baseline characteristics and cannabis and stimulant use during the follow-up (FU) period. Results Four trajectories emerged: (1) Stable Psychotic Remission (54.2 %), (2) Delayed Psychotic Remission (15.6 %), (3) Psychotic Relapse (7.8 %), (4) Persistent Psychotic Symptoms (22.4 %). At baseline, all unfavorable trajectories (2–4) were characterized by more schizophrenia diagnoses, higher symptom severity, and longer duration of untreated psychosis. Compared to the Stable Psychotic Remission trajectory, unstable trajectories (2,3) showed distinct associations with cannabis/stimulant use during the FU-period, with dose-dependent effects for cannabis but not stimulants (Delayed Psychotic Remission: higher rates of frequent cannabis and stimulant use during the first 5 FU-years; Psychotic Relapse: higher rates of sporadic stimulant use throughout the entire FU-period). The Persistent Psychosis trajectory was less clearly linked to substance use during the FU-period. Conclusions The risk for an adverse long-term course could be mitigated by treatment of substance use, where particular attention should be devoted to preventing the use of stimulants while the use reduction of cannabis may already yield positive effects.

• Wold, Kristin Fjelnseth; Kreis, Isabel; Åsbø, Gina; Flaaten, Camilla Bärthel; Widing, Line Hustad & Engen, Magnus Johan [Show all 11 contributors for this article] (2024). Long-term clinical recovery and treatment resistance in first-episode psychosis: a 10-year follow-up study. Schizophrenia. 10(1). doi: 10.1038/s41537-024-00489-7. Full text in Research Archive Show summary

  Illness trajectories in people with first-episode psychosis (FEP) vary significantly over time. Identifying early-course parameters predicting outcomes is essential, but long-term data still needs to be provided. We conducted a 10-year follow-up study of a comprehensive first-episode psychosis (FEP) cohort investigating the prevalence of clinical recovery (CR) and treatment resistance (TR) after ten years, as well as clinical, demographic, and pre-illness predictors of long-term outcomes. 102 participants with FEP DSM-IV Schizophrenia spectrum disorders were recruited within their first year of treatment. The Treatment Response and Resistance in Psychosis Working Group (TRRIP) and the Remission in Schizophrenia Working Group (RSWG) criteria were used to define TR and CR, respectively. At 10-year follow-up, 29 (29%) of the participants were classified as in CR, while 32 (31%) were classified as TR. We also identified a larger middle group (n = 41, 40%) consisting of participants in partial recovery. 7% of all participants had tried Clozapine at the 10-year follow-up. Logistic regression analyses identified insidious onset (OR = 4.16) and baseline disorganized symptoms (OR = 2.96) as significantly associated with an increased risk of developing TR. Good premorbid academic adjustment (OR = 1.60) and acute onset (OR = 3.40) were associated with an increased chance of CR. We identified three long-term outcome groups by using recent consensus definitions. We also identified the potential importance of assessing baseline disorganized symptoms and monitoring patients with insidious onset more closely. Further, the findings suggest that clinicians should pay close attention to early-course parameters and provide adequate treatment to improve long-term outcomes of FEP.

• Ihler, Henrik Myhre; Lyngstad, Siv Hege; Gardsjord, Erlend Strand; Widing, Line Hustad; Flaaten, Camilla Bärthel & Åsbø, Gina [Show all 13 contributors for this article] (2023). The trajectory of two negative symptom dimensions in first-episode psychosis and the role of cannabis use: A 10-year follow-up study. Schizophrenia Research. ISSN 0920-9964. 252, p. 317–325. doi: 10.1016/j.schres.2023.01.024. Full text in Research Archive Show summary

  Objective To investigate the trajectories of diminished expression and apathy over 10 years. Further, to explore the effects of baseline- and persistent cannabis use on the development of diminished expression and apathy during follow-up, while controlling other potential sources and predictors of secondary negative symptoms. Methods 351 participants with a first episode of non-affective psychosis were examined at baseline and invited to follow-up at one year and 10 years. The trajectories of diminished expression and apathy were investigated using linear mixed models. Subsequently, cannabis use and other potential predictors and sources of secondary negative symptoms were added to the model to investigate the respective impact on their trajectories. Results The severity of both diminished expression and apathy decreased during the follow-up period after the first episode of psychosis, with the most improvement observed from baseline to 1-year follow-up. Cannabis use at baseline was associated with a long-lasting higher symptom load for diminished expression, but not apathy. Introducing persistent cannabis use to the model further strengthened the association with diminished expression. Conclusion Both cannabis use at baseline and persistent cannabis use after a first episode of psychosis were associated with more severe symptoms of diminished expression. Our results imply a causal relationship between cannabis use and diminished expression and suggest that measures to reduce cannabis use both before and after psychosis onset may reduce expressive negative symptoms.

• Widing, Line Hustad; Simonsen, Carmen; Bjella, Thomas; Engen, Magnus Johan; Flaaten, Camilla Bärthel & Gardsjord, Erlend Strand [Show all 15 contributors for this article] (2023). Long-term Outcomes of People With DSM Psychotic Disorder NOS. Schizophrenia Bulletin Open. 4(1). doi: 10.1093/schizbullopen/sgad005. Full text in Research Archive Show summary

  Introduction: The Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV diagnostic category “Psychotic disorder not otherwise specified” (PNOS) is seldom investigated, and we lack knowledge about longterm outcomes. We examined long-term symptom severity, global functioning, remission/recovery rates, and diagnostic stability after the first treatment for PNOS. Methods: Participants with first-treatment PNOS (n = 32) were reassessed with structured interviews after 7 to 10 years. The sample also included narrow schizophrenia spectrum disorders (SSD, n = 94) and psychotic bipolar disorders (PBD, n = 54). Symptomatic remission was defined based on the Remission in Schizophrenia Working Group criteria. Clinical recovery was defined as meeting the criteria for symptomatic remission and having adequate functioning for the last 12 months. Results: Participants with baseline PNOS or PBD had lower symptom severity and better global functioning at follow-up than those with SSD. More participants with PNOS and PBD were in symptomatic remission and clinical recovery compared to participants with SSD. Seventeen (53%) PNOS participants retained the diagnosis, while 15 participants were diagnosed with either SSD (22%), affective disorders (19%), or substanceinduced psychotic disorders (6%). Those rediagnosed with SSD did not differ from the other PNOS participants regarding baseline clinical characteristics. Conclusions: Long-term outcomes are more favorable in PNOS and PBD than in SSD. Our findings confirm diagnostic instability but also stability for a subgroup of participants with PNOS. However, it is challenging to predict diagnostic outcomes of PNOS based on clinical characteristics at first treatment.

• Lunding, Synve Hoffart; Ueland, Torill; Aas, Monica; Høegh, Margrethe Collier; Werner, Maren Caroline Frogner & Rødevand, Linn [Show all 16 contributors for this article] (2023). Tobacco smoking related to childhood trauma mediated by cognitive control and impulsiveness in severe mental disorders. Schizophrenia Research. ISSN 0920-9964. 261, p. 236–244. doi: 10.1016/j.schres.2023.09.041. Full text in Research Archive Show summary

  Background People with severe mental disorders (SMDs) show an increased prevalence of tobacco smoking compared to the general population. Tobacco smoking and other adult adverse health behaviors have been associated with traumatic experiences in childhood. In the present study we investigated the relationship between childhood trauma and tobacco smoking in people with SMDs, including the possible mediating role of cognitive- and personality characteristics, i.e. cognitive control, impulsiveness, affective lability and self-esteem. Methods Enrolled in the study were 871 participants with schizophrenia (SCZ, N = 484) and bipolar (BD, N = 387) spectrum disorders. We assessed tobacco smoking behavior (yes/no and amount), and history of childhood trauma with the Childhood Trauma Questionnaire. Data on cognitive control, impulsiveness, affective lability, and self-esteem were available in subsamples. We performed linear and logistic regressions, and conducted mediation analyses in PROCESS. All analyses were as standard adjusted for age, sex, and diagnostic group. Results Experience of one or more subtypes of childhood trauma was significantly associated with smoking tobacco in SMDs (p = 0.002). There were no significant associations between childhood trauma and amount of tobacco smoking. Cognitive control and impulsiveness were significant mediators between childhood trauma and tobacco smoking. Conclusions These findings indicate the experience of childhood trauma as a predisposing factor for tobacco smoking in SMDs. Cognitive control and impulsiveness were suggested as mediating mechanisms, indicating the importance of considering inhibition related self-regulatory aspects in efforts to improve health behavior in individuals with SMDs and childhood trauma.

• Millgate, Edward; Smart, Sophie E.; Pardiñas, Antonio F.; Kravariti, Eugenia; Ajnakina, Olesya & Kępińska, Adrianna P. [Show all 30 contributors for this article] (2023). Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study. Schizophrenia Research. ISSN 0920-9964. 255, p. 173–181. doi: 10.1016/j.schres.2023.03.020. Full text in Research Archive Show summary

  Background Antipsychotic treatment resistance affects up to a third of individuals with schizophrenia, with recent research finding systematic biological differences between antipsychotic resistant and responsive patients. Our aim was to determine whether cognitive impairment at first episode significantly differs between future antipsychotic responders and resistant cases. Methods Analysis of data from seven international cohorts of first-episode psychosis (FEP) with cognitive data at baseline (N = 683) and follow-up data on antipsychotic treatment response: 605 treatment responsive and 78 treatment resistant cases. Cognitive measures were grouped into seven cognitive domains based on the pre-existing literature. We ran multiple imputation for missing data and used logistic regression to test for associations between cognitive performance at FEP and treatment resistant status at follow-up. Results On average patients who were future classified as treatment resistant reported poorer performance across most cognitive domains at baseline. Univariate logistic regressions showed that antipsychotic treatment resistance cases had significantly poorer IQ/general cognitive functioning at FEP (OR = 0.70, p = .003). These findings remained significant after adjusting for additional variables in multivariable analyses (OR = 0.76, p = .049). Conclusions Although replication in larger studies is required, it appears that deficits in IQ/general cognitive functioning at first episode are associated with future treatment resistance. Cognitive variables may be able to provide further insight into neurodevelopmental factors associated with treatment resistance or act as early predictors of treatment resistance, which could allow prompt identification of refractory illness and timely interventions.

• Wold, Kristin Fjelnseth; Ottesen, Akiah; Flaaten, Camilla Bärthel; Johnsen, Erik; Lagerberg, Trine Vik & Romm, Kristin Lie [Show all 11 contributors for this article] (2023). Early identification of treatment non-response in first-episode psychosis. European psychiatry. ISSN 0924-9338. 66(1). doi: 10.1192/j.eurpsy.2023.15. Full text in Research Archive Show summary

  Background Approximately one-third of patients with psychotic disorders does not respond to standard antipsychotic treatments. Consensus criteria for treatment resistance (TR) may aid the identification of non-response and subsequent tailoring of treatments. Since consensus criteria require stability of clinical status, they are challenging to apply in first-episode psychosis (FEP). This study aims to investigate (a) if an adaptation of consensus criteria can be used to identify FEP patients with early signs of TR (no early clinical recovery—no-ECR) after 1 year in treatment and (b) to what extent differences in antipsychotic treatments differentiate between outcome groups. Methods Participants with FEP DSM-IV schizophrenia spectrum disorders were recruited during their first treatment. A total of 207 participated in the 1-year follow-up. Remission and recovery definitions were based on adaptations of the “Remission in Schizophrenia Working Group” criteria and TR on adaptations of the “Treatment Response and Resistance in Psychosis” (TRRIP) working group criteria. Results 97 participants (47%) could be classified as no-ECR, 61 (30%) as ECR, and 49 (23%) as with partial ECR (P-ECR). Statistically significant baseline predictors of no-ECR matched previously identified predictors of long-term TR. Only 35 no-ECR participants had two adequate treatment trials and met the full TRRIP criteria. 21 no-ECR participants were using the same medication over the follow-up year despite the lack of significant effects. Conclusion The difference in the percentage of FEP participants classified as no-ECR versus TR indicates that we may underestimate the prevalence of early TR when using consensus criteria.

• Flaaten, Camilla Bärthel; Melle, Ingrid; Bjella, Thomas; Engen, Magnus Johan; Åsbø, Gina & Wold, Kristin Fjelnseth [Show all 13 contributors for this article] (2023). Long-term course of cognitive functioning in bipolar disorder: A ten-year follow-up study. Bipolar Disorders. ISSN 1398-5647. doi: 10.1111/bdi.13364. Full text in Research Archive Show summary

  Abstract Introduction Cognitive impairments are common in bipolar disorder (BD), but the long‐term course remains understudied. Longitudinal data on cognitive functioning from the start of the first treatment could help clarify pathophysiological processes that shape the illness outcome. We here aim to investigate the 10‐year cognitive course in BD compared to healthy controls (HC) and the effects of clinical symptoms on cognitive trajectories. Methods Fifty‐six BD participants recruited within their first year of treatment and 108 HC completed clinical and cognitive assessments at baseline and 10‐year follow‐up. We derived eight cognitive domain scores and a cognitive composite score, which were further investigated using linear mixed model analyses. Correlation analyses were used to assess associations between the composite score and depressive, manic and psychotic symptoms. Results BD participants performed poorer than HCs in all domains except mental speed and verbal fluency. Verbal learning and memory, verbal fluency and the composite score improved over time in both BD participants and HC, while short‐term memory, mental speed, psychomotor speed and working memory were stable. We found no significant correlations between cognition and symptom level at either time point in BD participants. Conclusions We found evidence of long‐term cognitive stability or improvement in BD participants from first treatment to 10‐year follow‐up. Though the BD group was impaired in all domains except mental speed and verbal fluency, the change in cognitive functioning was parallel to that of HCs. These findings are not consistent with the notion of neuroprogression in BD.

• Aminoff, Sofie Ragnhild; Onyeka, Ifeoma Nkeiruka; Ødegaard, Marte; Simonsen, Carmen Elisabeth; Lagerberg, Trine Vik & Andreassen, Ole [Show all 8 contributors for this article] (2022). Lifetime and point prevalence of psychotic symptoms in adults with bipolar disorders: a systematic review and meta-analysis. Psychological Medicine. ISSN 0033-2917. 52(13), p. 2413–2425. doi: 10.1017/S003329172200201X. Full text in Research Archive Show summary

  Abstract Psychotic symptoms, that we defined as delusions or hallucinations, are common in bipolar disorders (BD). This systematic review and meta-analysis aims to synthesise the literature on both lifetime and point prevalence rates of psychotic symptoms across different BD subtypes, including both BD type I (BDI) and BD type II (BDII). We performed a systematic search of Medline, PsycINFO, Embase and Cochrane Library until 5 August 2021. Fifty-four studies ( N = 23 461) of adults with BD met the predefined inclusion criteria for evaluating lifetime prevalence, and 24 studies ( N = 6480) for evaluating point prevalence. Quality assessment and assessment of publication bias were performed. Prevalence rates were calculated using random effects meta-analysis, here expressed as percentages with a 95% confidence interval (CI). In studies of at least moderate quality, the pooled lifetime prevalence of psychotic symptoms in BDI was 63% (95% CI 57.5–68) and 22% (95% CI 14–33) in BDII. For BDI inpatients, the pooled lifetime prevalence was 71% (95% CI 61–79). There were no studies of community samples or inpatient BDII. The pooled point prevalence of psychotic symptoms in BDI was 54% (95 CI 41–67). The point prevalence was 57% (95% CI 47–66) in manic episodes and 13% (95% CI 7–23.5) in depressive episodes. There were not enough studies in BDII, BDI depression, mixed episodes and outpatient BDI. The pooled prevalence of psychotic symptoms in BDI may be higher than previously reported. More studies are needed for depressive and mixed episodes and community samples. Prospero registration number: CRD 42017052706.

• Flaaten, Camilla Bärthel; Melle, Ingrid; Gardsjord, Erlend Strand; Bjella, Thomas; Engen, Magnus Johan & Vaskinn, Anja [Show all 13 contributors for this article] (2022). Course of intellectual functioning in schizophrenia and bipolar disorder: A 10-year follow-up study. Psychological Medicine. ISSN 0033-2917. p. 1–9. doi: 10.1017/S0033291721004645. Full text in Research Archive Show summary

  Background Intellectual functioning (IQ) is lower in schizophrenia patients compared to healthy controls, with bipolar patients intermediate between the two. Declines in IQ mark the onset of schizophrenia, while stability is generally found post-onset. There are to date few studies on long-term IQ development in bipolar disorder. This study presents 10-year follow-up data on IQ, including premorbid IQ estimates, to track the developmental course from pre-onset levels to long-term outcomes in both patient groups compared to healthy controls. Methods We included 139 participants with schizophrenia, 76 with bipolar disorder and 125 healthy controls. Mixed model analyses were used to estimate developmental slopes for IQ scores from estimated premorbid level (NART IQ) through baseline (WASI IQ) measured within 12 months post-onset, to 10-year follow-up (WASI IQ), with pairwise group comparisons. The best fit was found using a model with a breakpoint at baseline assessment. Results Only the schizophrenia group had significant declines from estimated premorbid to baseline IQ levels compared to controls. When comparing patient groups, schizophrenia patients had steeper declines than the bipolar group. Increases in IQ were found in all groups over the follow-up period. Conclusions Trajectories of IQ from premorbid level to 10-year follow-up indicated declines from estimated premorbid level to illness onset in both patient groups, followed by increases during the follow-up period. Schizophrenia patients had a steeper decline than bipolar patients. During follow-up, increases indicate developmental improvement for both patient groups, but with a maintained lag compared to healthy controls due to lower premorbid levels.

• Pardiñas, Antonio F.; Smart, Sophie E.; Willcocks, Isabella R.; Holmans, Peter A.; Dennison, Charlotte A. & Lynham, Amy J. [Show all 70 contributors for this article] (2022). Interaction Testing and Polygenic Risk Scoring to Estimate the Association of Common Genetic Variants with Treatment Resistance in Schizophrenia. JAMA psychiatry. ISSN 2168-6238. 79(3), p. 260–269. doi: 10.1001/jamapsychiatry.2021.3799. Full text in Research Archive Show summary

  Importance About 20% to 30% of people with schizophrenia have psychotic symptoms that do not respond adequately to first-line antipsychotic treatment. This clinical presentation, chronic and highly disabling, is known as treatment-resistant schizophrenia (TRS). The causes of treatment resistance and their relationships with causes underlying schizophrenia are largely unknown. Adequately powered genetic studies of TRS are scarce because of the difficulty in collecting data from well-characterized TRS cohorts. Objective To examine the genetic architecture of TRS through the reassessment of genetic data from schizophrenia studies and its validation in carefully ascertained clinical samples. Design, Setting, and Participants Two case-control genome-wide association studies (GWASs) of schizophrenia were performed in which the case samples were defined as individuals with TRS (n = 10 501) and individuals with non-TRS (n = 20 325). The differences in effect sizes for allelic associations were then determined between both studies, the reasoning being such differences reflect treatment resistance instead of schizophrenia. Genotype data were retrieved from the CLOZUK and Psychiatric Genomics Consortium (PGC) schizophrenia studies. The output was validated using polygenic risk score (PRS) profiling of 2 independent schizophrenia cohorts with TRS and non-TRS: a prevalence sample with 817 individuals (Cardiff Cognition in Schizophrenia [CardiffCOGS]) and an incidence sample with 563 individuals (Genetics Workstream of the Schizophrenia Treatment Resistance and Therapeutic Advances [STRATA-G]). Main Outcomes and Measures GWAS of treatment resistance in schizophrenia. The results of the GWAS were compared with complex polygenic traits through a genetic correlation approach and were used for PRS analysis on the independent validation cohorts using the same TRS definition. Results The study included a total of 85 490 participants (48 635 [56.9%] male) in its GWAS stage and 1380 participants (859 [62.2%] male) in its PRS validation stage. Treatment resistance in schizophrenia emerged as a polygenic trait with detectable heritability (1% to 4%), and several traits related to intelligence and cognition were found to be genetically correlated with it (genetic correlation, 0.41-0.69). PRS analysis in the CardiffCOGS prevalence sample showed a positive association between TRS and a history of taking clozapine (r2 = 2.03%; P = .001), which was replicated in the STRATA-G incidence sample (r2 = 1.09%; P = .04). Conclusions and Relevance In this GWAS, common genetic variants were differentially associated with TRS, and these associations may have been obscured through the amalgamation of large GWAS samples in previous studies of broadly defined schizophrenia. Findings of this study suggest the validity of meta-analytic approaches for studies on patient outcomes, including treatment resistance.

• Mork, Erlend; Aminoff, Sofie Ragnhild; Barrett, Elizabeth Ann; Simonsen, Carmen Elisabeth; Hegelstad, Wenche & Lagerberg, Trine Vik [Show all 8 contributors for this article] (2022). COVID-19 lockdown – who cares? The first lockdown from the perspective of relatives of people with severe mental illness. BMC Public Health. 22(1), p. 1–12. doi: 10.1186/s12889-022-13458-5. Full text in Research Archive Show summary

  Background Informal care is vital to many people with severe mental illness under normal circumstances. Little is known about how extraordinary circumstances affect relatives with a family member with mental illness. This study investigated the consequences of the first COVID-19 lockdown in Norway from the perspective of relatives of persons with psychotic- and/or bipolar disorders: What were the challenges and for whom? Method Relatives were invited to complete an online survey shortly after the first lockdown was initiated. Both quantitative and qualitative data were collected concerning experiences of relatives’ own and their affected family members’ health and situation. Two hundred and seventy-nine relatives completed the survey, mostly mothers and partners. Results One-third of the relatives reported considerable deterioration in their family members’ mental health, and a substantial minority worried about severe self-harm or suicide. Main themes in the qualitative analyses were “Isolation and its effects on mental health”, “Worrying about the pandemic and its consequences”, “Increased symptomatology” and “Suicide”. Being a relative during the lockdown put heavy strain on the relatives’ own health, in particular disturbance of sleep, concentration, and the ability to take care of others in the family. Relatives of family members with psychotic bipolar disorder, not currently in treatment, or living with their family experienced the situation especially challenging. Conclusions Many relatives found the first lockdown hard for their family. Efforts to integrate relatives’ perspectives in health care and contingency plans under normal circumstances could potentially alleviate some of the extra burden experienced by families during extraordinary circumstances.

• Flaaten, Camilla Bärthel; Melle, Ingrid; Bjella, Thomas; Engen, Magnus Johan; Åsbø, Gina & Wold, Kristin Fjelnseth [Show all 14 contributors for this article] (2022). Domain-specific cognitive course in schizophrenia: Group- and individual-level changes over 10 years. Schizophrenia Research: Cognition. 30, p. 1–8. doi: 10.1016/j.scog.2022.100263. Full text in Research Archive Show summary

  Cognitive impairments in schizophrenia are well-documented, present across several cognitive domains and found to be relatively stable over time. However, there is a high degree of heterogeneity and indications of domain-specific developmental courses. The present study investigated the 10-year cognitive course in participants with first-episode schizophrenia (FES) and healthy controls on eight cognitive domains and a composite score, looking at group- and individual-level changes. A total of 75 FES participants and 91 healthy controls underwent cognitive assessment at baseline and follow-up. Linear mixed models were used for group-level analyses and reliable change index (RCI) analyses were used to investigate individual change. The prevalence of clinically significant impairment was explored at both time points, using a cut-off of < −1.5 SD, with significant cognitive impairment defined as impairment on ≥2 domains. Group-level analyses found main effects of group and time, and time by group interactions. Memory, psychomotor processing speed and verbal fluency improved, while learning, mental processing speed and working memory were stable in both groups. FES participants showed deteriorations in attention and cognitive control. Individual-level analyses mainly indicated stability in both FES and controls, except for a higher prevalence of decline in cognitive control in FES. At baseline, 68.8 % of FES participants had clinically significant impairment, compared to 62.3 % at follow-up. We mainly found long-term stability and modest increases in cognition over time in FES, as well as a high degree of within-group heterogeneity. We also found indications of deterioration in participants with worse cognitive performance at baseline.

• Smart, Sophie E.; Agbedjro, Deborah; Pardiñas, Antonio F.; Ajnakina, Olesya; Alameda, Luis & Andreassen, Ole [Show all 42 contributors for this article] (2022). Clinical predictors of antipsychotic treatment resistance: Development and internal validation of a prognostic prediction model by the STRATA-G consortium. Schizophrenia Research. ISSN 0920-9964. 250, p. 1–9. doi: 10.1016/j.schres.2022.09.009. Full text in Research Archive Show summary

  Introduction Our aim was to, firstly, identify characteristics at first-episode of psychosis that are associated with later antipsychotic treatment resistance (TR) and, secondly, to develop a parsimonious prediction model for TR. Methods We combined data from ten prospective, first-episode psychosis cohorts from across Europe and categorised patients as TR or non-treatment resistant (NTR) after a mean follow up of 4.18 years (s.d. = 3.20) for secondary data analysis. We identified a list of potential predictors from clinical and demographic data recorded at first-episode. These potential predictors were entered in two models: a multivariable logistic regression to identify which were independently associated with TR and a penalised logistic regression, which performed variable selection, to produce a parsimonious prediction model. This model was internally validated using a 5-fold, 50-repeat cross-validation optimism-correction. Results Our sample consisted of N = 2216 participants of which 385 (17 %) developed TR. Younger age of psychosis onset and fewer years in education were independently associated with increased odds of developing TR. The prediction model selected 7 out of 17 variables that, when combined, could quantify the risk of being TR better than chance. These included age of onset, years in education, gender, BMI, relationship status, alcohol use, and positive symptoms. The optimism-corrected area under the curve was 0.59 (accuracy = 64 %, sensitivity = 48 %, and specificity = 76 %). Implications Our findings show that treatment resistance can be predicted, at first-episode of psychosis. Pending a model update and external validation, we demonstrate the potential value of prediction models for TR.

• Widing, Line Hustad; Simonsen, Carmen Elisabeth; Flaaten, Camilla Bärthel; Haatveit, Beathe; Vik, Ruth Kristine & Wold, Kristin Fjelnseth [Show all 9 contributors for this article] (2022). Premorbid characteristics of patients with DSM-IV psychotic disorders. Comprehensive Psychiatry. ISSN 0010-440X. 115, p. 1–7. doi: 10.1016/j.comppsych.2022.152310. Full text in Research Archive Show summary

  Introduction Psychotic disorder not otherwise specified (PNOS) is considered part of the psychosis spectrum, together with schizophrenia spectrum disorders (SSD) and psychotic bipolar spectrum disorders (PBD). The atypical clinical presentations of PNOS conditions may lead to uncertainty regarding treatment choices and expected outcomes. PNOS is understudied, and little is known about patients' premorbid characteristics including premorbid adjustment, prevalence of early cannabis use and childhood trauma. Knowledge about early illness phases can increase our understanding of this diagnostic group. Methods We included 1099 participants from the Norwegian TOP-study; 688 with narrow SSD diagnoses (schizophrenia, schizoaffective disorder, schizophreniform disorder), 274 with PBD (psychotic bipolar 1 and bipolar NOS) and 137 with PNOS diagnosed with the SCID-I for DSM-IV. Participants were assessed with the Premorbid Adjustment Scale (PAS) divided into the areas of premorbid academic and social functioning. We obtained information on age at first exposure to cannabis and use of cannabis before the age of 16. The participants also provided information regarding early traumatic experiences using the Childhood Trauma Questionnaire (CTQ). Results Participants with PNOS and SSD had poorer premorbid academic functioning than those with PBD (F2, 1029 = 7.81, p < 0.001, pη2 = 0.015). Premorbid social adjustment was significantly worse in the SSD group compared to the PBD group (F2, 1024 = 3.10, p = 0.045, pη2 = 0.006), with PNOS in the middle position. Significantly more of the participants with PNOS (17.5%) and SSD (11.5%) used cannabis before the age of 16 compared with PBD (5.3%, Wald χ2 = 6.86, p = 0.03). There were no significant differences between the three groups regarding mean CTQ scores or in the proportion of participants who had experienced at least one type of childhood adversity. Conclusions Participants with PNOS appear as more similar to participants with SSD than to those with PBD regarding early premorbid adjustment and early cannabis use. The results indicate that many conditions classified as PNOS have functional impairments and problematic substance use from an early age. The prevalence of childhood adversities are high in all three groups.

• Åsbø, Gina; Ueland, Torill; Haatveit, Beathe; Bjella, Thomas; Flaaten, Camilla Bärthel & Wold, Kristin Fjelnseth [Show all 13 contributors for this article] (2022). The Time is Ripe for a Consensus Definition of Clinical Recovery in First-episode Psychosis: Suggestions Based on a 10-Year Follow-up Study. Schizophrenia Bulletin. ISSN 0586-7614. 48(4), p. 839–849. doi: 10.1093/schbul/sbac035. Full text in Research Archive Show summary

  Abstract Objectives A consensus definition of clinical recovery in first-episode psychosis (FEP) is required to improve knowledge about recovery rates in this population. To propose criteria for a future consensus definition, this study aims to investigate rates of clinical recovery when using a standard definition (full psychotic symptom remission and adequate functioning for minimum one year) across both affective and nonaffective FEP groups (bipolar spectrum and schizophrenia spectrum disorders). Second, we aim to explore changes in rates when altering the standard definition criteria. Third, to examine the extent to which healthy controls meet the functioning criteria. Study design In total, 142 FEP participants and 117 healthy controls preselected with strict criteria, were re-assessed with structured clinical interviews at 10-year follow-up. Study results A total of 31.7% were in clinical recovery according to the standard definition, with significantly higher recovery rates in bipolar (50.0%) than in schizophrenia spectrum disorders (22.9%). Both groups’ recovery rates decreased equally when extending duration and adding affective symptom remission criteria and increased with looser functioning criteria. In healthy controls, 18.8% did not meet the standard criteria for adequate functioning, decreasing to 4.3% with looser criteria. Conclusions Findings suggest that clinical recovery is common in FEP, although more in bipolar than in schizophrenia spectrum disorders, also when altering the recovery criteria. We call for a future consensus definition of clinical recovery for FEP, and suggest it should include affective symptom remission and more reasonable criteria for functioning that are more in line with the general population.

• Barrett, Elizabeth Ann; Simonsen, Carmen Elisabeth; Aminoff, Sofie Ragnhild; Hegelstad, Wenche; Lagerberg, Trine Vik & Melle, Ingrid [Show all 8 contributors for this article] (2022). The COVID-19 pandemic impact on wellbeing and mental health in people with psychotic and bipolar disorders. Brain and Behavior. p. 1–18. doi: 10.1002/brb3.2559. Full text in Research Archive Show summary

  Introduction The COVID-19 pandemic affects people globally, but it may affect people with psychotic and bipolar disorders disproportionally. Our aims were to investigate the pandemic impact on perceived wellbeing and mental health in this population, including which pandemic-related factors have had an impact. Methods People with psychotic and bipolar disorders (N = 520; female = 81%; psychotic disorders n = 75/bipolar disorder n = 445) completed an online survey about wellbeing and mental health in the early phase of the COVID-19 pandemic (June 5–July 5, 2020). Results Many participants experienced deteriorated wellbeing and mental health after the pandemic outbreak, especially in life satisfaction, meaning in life, positive feelings, depression, anxiety, and self-harm/suicidal ideation. Experienced recovery from mental health difficulties was significantly lower after compared to before the outbreak. Participants with psychotic disorders had significantly poorer wellbeing and mental health than participants with bipolar disorders, although they experienced significantly more worsening only of psychotic symptoms. Nearly half the participants reported coping with the situation; however, most factors potentially important to wellbeing and mental health changed adversely, including sufficiency and quality of treatment. More loneliness, low coping, insufficient mental health treatment during the COVID-19 pandemic, pandemic worry, more insomnia symptoms, and increased alcohol use predicted poor wellbeing and poor mental health. Conclusions During a pandemic, it is particularly important that mental health services strive to offer the best possible treatment under the current conditions and target loneliness, coping strategies, pandemic worry, insomnia, and increased alcohol use to uphold wellbeing and reduce mental health difficulties. For some, teletherapy is an agreeable substitute for traditional therapy.

• Aminoff, Sofie Ragnhild; Mork, Erlend; Barrett, Elizabeth Ann; Simonsen, Carmen Elisabeth; Hegelstad, Wenche & Lagerberg, Trine Vik [Show all 8 contributors for this article] (2022). Locked out during COVID‑19 lockdown— an online survey of relatives of people with psychotic and bipolar disorders in Norway. BMC Public Health. 22(294). doi: 10.1186/s12889-022-12625-y. Full text in Research Archive Show summary

  Background Many relatives of people with psychotic and bipolar disorders experience a high caregiver burden normally. During the first COVID-19 lockdown, mental health services partly shut down in many countries. The impact on relatives is unknown. Aims Explore how relatives of people with psychotic and bipolar disorders experienced changes in treatment and service availability for their family member during the first COVID-19 pandemic lockdown in the spring of 2020, and to what extent they perceived information and support to be satisfactory. To help guide future contingency plans, we were also interested in what relatives would prioritize in the event of a future crisis. Study setting We distributed an anonymous Norwegian online survey inviting relatives of individuals with psychotic and bipolar disorders. We distributed the survey using social media, through snowball sampling, collecting both quantitative and qualitative data. The survey was available between May and June 2020. We used systematic text condensation to analyse qualitative data. Results Two hundred and seventy-nine respondents replied, mostly mothers and partners. A majority experienced a reduction in health care for their family member. Most respondents did not receive any support during the lockdown. However, most found the information they received from the mental health services regarding their family members’ treatment as sufficient. The qualitative data analysis revealed that relatives experienced three major challenges: reductions in treatment for the family member; reduced organised daily activity for the family member; and an increased caretaker load. In the case of a future lockdown, they would prefer increased access to care compared with a normal situation; increased support for relatives; and enhanced information. Conclusions Mental health services in Norway did not manage to meet the needs of patients with severe mental illness and their relatives during the first COVID-19 lockdown. To be better prepared, Norwegian mental health services should consider prioritising infrastructure to ensure access to care and support for both patients and relatives. Digital tools and telephone calls are generally well accepted as substitutes for face-to-face contact.

• Engen, Magnus Johan; Vaskinn, Anja; Melle, Ingrid; Færden, Ann; Lyngstad, Siv Hege & Flaaten, Camilla Bärthel [Show all 12 contributors for this article] (2022). Cognitive and Global Functioning in Patients With First-Episode Psychosis Stratified by Level of Negative Symptoms. A 10-Year Follow-Up Study. Frontiers in Psychiatry. 13:841057, p. 1–13. doi: 10.3389/fpsyt.2022.841057. Full text in Research Archive Show summary

  Negative and cognitive symptoms are core features of schizophrenia that are correlated in cross-sectional designs. To further explore the relationship between these critical symptom dimensions we use a method for stratifying participants based on level and persistence of negative symptoms from absent to sustained levels over a 10-year follow-up period. We investigate associations with cognitive performance and level of global functioning. First-episode psychosis (FEP) participants ( n = 102) and healthy controls ( n = 116) were assessed at baseline and follow-up. A cognitive battery consisting of 14 tests derived into four domains and a composite score were used in the analyses. FEP participants were stratified based on negative symptom items from the Positive and Negative Syndrome Scale (PANSS-R) into four groups with either no, mild, transitory or sustained symptoms over the 10-year follow-up period. Global functioning was measured with Global Assessment of Functioning Scale-Split version. Multivariate and univariate analyses of variance were used to explore between-group differences in level and course of cognitive performance as global functioning. A multivariate analysis with four cognitive domains as dependent variables, showed significant group differences in performance when including healthy controls and the negative symptom groups. The groups with no and mild negative symptoms outperformed the group with sustained levels of negative symptoms on verbal learning and memory. The group with no negative symptoms also outperformed the group with sustained negative symptoms on the cognitive composite score. Significant improvements on verbal learning and memory, executive functioning and the cognitive composite were detected for the entire sample. No differences in cognitive course were detected. There was a significant improvement in global functioning as measured by the GAF-F over the follow-up period ( p &amp;lt; 0.001), without any time x group interactions ( p = 0.25). Participants with sustained negative symptoms had a significantly lower level of global functioning at 10-year follow-up with an additional independent effect of the cognitive composite score, compared to all other groups. Individuals with an early illness course characterized by absence of negative symptoms form a group with better cognitive and functional outcomes than the impairments typically associated with schizophrenia. Individuals with sustained levels of negative symptoms on the other hand may require a combined focus on both negative and cognitive symptoms.

• Lunding, Synve Hoffart; Simonsen, Carmen Elisabeth; Aas, Monica; Rødevand, Linn; Werner, Maren Caroline Frogner & Laskemoen, Jannicke Fjæra [Show all 13 contributors for this article] (2021). Childhood trauma and cardiometabolic risk in severe mental disorders: The mediating role of cognitive control. European psychiatry. ISSN 0924-9338. 64(1). doi: 10.1192/j.eurpsy.2021.14. Full text in Research Archive Show summary

  Background Cardiometabolic risk is increased in severe mental disorders (SMDs), and there appears to be a relationship between childhood trauma and cardiometabolic risk, possibly related to adverse health behavior. The current study examined the association between childhood trauma and serum lipids and adiposity in SMDs and the potential mediating role of cognitive and personality characteristics. Methods Participants with schizophrenia and bipolar spectrum disorders (N = 819) were included, cardiometabolic risk factors (serum lipids, body mass index, and waist circumference) were measured, and history of childhood trauma was assessed by the Childhood Trauma Questionnaire. Cognitive and personality characteristics were available in subsamples, with assessments of cognitive control, impulsiveness, self-esteem, and affective lability. Linear regressions and mediation analyses with Hayes’ PROCESS were performed, adjusting for age, sex, antipsychotic agent propensity of metabolic side-effect, and diagnostic group. Results Experience of three or more subtypes of childhood trauma was positively associated with waist circumference in patients with SMDs (p = 0.014). There were no other significant associations between trauma variables and lipid or adiposity measures in the total sample. Cognitive control was a significant mediator between experience of one or two subtypes of childhood trauma and waist circumference. Conclusions The results indicate childhood trauma as a predisposing factor for increased waist circumference in individuals with SMDs. Poorer cognitive control, suggestive of adverse health behavior, might be a mediating factor of the association, and the findings indicate the potential importance of increased focus on these factors in prevention and treatment regimens targeting cardiometabolic health.

• Gjerde, Priyanthi Borgen; Simonsen, Carmen Elisabeth; Lagerberg, Trine V.; Steen, Nils Eiel; Andreassen, Ole A. & Steen, Vidar M. [Show all 7 contributors for this article] (2021). Sex-Specific Effect of Serum Lipids and Body Mass Index on Psychotic Symptoms, a Cross-Sectional Study of First-Episode Psychosis Patients. Frontiers in Psychiatry. 12. doi: 10.3389/fpsyt.2021.723158. Full text in Research Archive Show summary

  Background: Schizophrenia is a disorder with considerable heterogeneity in course and outcomes, which is in part related to the patients' sex. Studies report a link between serum lipids, body mass index (BMI), and therapeutic response. However, the role of sex in these relationships is poorly understood. In a cross-sectional sample of first-episode psychosis (FEP) patients, we investigated if the relationship between serum lipid levels (total cholesterol, HDL-C, LDL-C, and triglycerides), BMI, and symptoms differs between the sexes. Methods: We included 435 FEP patients (males: N = 283, 65%) from the ongoing Thematically Organized Psychosis (TOP) study. Data on clinical status, antipsychotics, lifestyle, serum lipid levels, and BMI were obtained. The Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS) were used to assess psychotic and depressive symptoms. General linear models were employed to examine the relationship between metabolic variables and symptomatology. Results: We observed a female-specific association between serum HDL-C levels and negative symptoms (B = −2.24, p = 0.03) and between triglycerides levels (B = 1.48, p = 0.04) and BMI (B = 0.27, p = 0.001) with depressive symptoms. When controlling for BMI, only the association between serum HDL-C levels and negative symptoms remained significant. Moreover, the HDL-C and BMI associations remained significant after controlling for demography, lifestyle, and illness-related factors. Conclusion: We found a relationship between metabolic factors and psychiatric symptoms in FEP patients that was sex-dependent.

• Engen, Magnus Johan; Lyngstad, Siv Hege; Ueland, Torill; Simonsen, Carmen Elisabeth; Vaskinn, Anja & Smeland, Olav Bjerkehagen [Show all 11 contributors for this article] (2020). Polygenic scores for schizophrenia and general cognitive ability: associations with six cognitive domains, premorbid intelligence, and cognitive composite score in individuals with a psychotic disorder and in healthy controls. Translational Psychiatry. 10:416(416), p. 1–9. doi: 10.1038/s41398-020-01094-9. Full text in Research Archive Show summary

  Cognitive impairments are considered core features in schizophrenia and other psychotic disorders. Cognitive impairments are, to a lesser degree, also documented in healthy first-degree relatives. Although recent studies have shown (negative) genetic correlations between schizophrenia and general cognitive ability, the association between polygenic risk for schizophrenia and individual cognitive phenotypes remains unclear. We here investigated the association between a polygenic score for schizophrenia (SCZPGS) and six well-defined cognitive domains, in addition to a composite measure of cognitive ability and a measure of premorbid intellectual ability in 731 participants with a psychotic disorder and 851 healthy controls. We also investigated the association between a PGS for general cognitive ability (COGPGS) and the same cognitive domains in the same sample. We found no significant associations between the SCZPGS and any cognitive phenotypes, in either patients with a psychotic disorder or healthy controls. For COGPGS we observed stronger associations with cognitive phenotypes in healthy controls than in participants with psychotic disorders. In healthy controls, the association between COGPGS (at the p value threshold of ≥0.01) and working memory remained significant after Bonferroni correction (β = 0.12, p = 8.6 × 10−5). Altogether, the lack of associations between SCZPGS and COGPGS with cognitive performance in participants with psychotic disorders suggests that either environmental factors or unassessed genetic factors play a role in the development of cognitive impairments in psychotic disorders. Working memory should be further studied as an important cognitive phenotype.

• Laskemoen, Jannicke Fjæra; Aas, Monica; Vaskinn, Anja; Berg, Akiah Ottesen; Lunding, Synve Hoffart & Barrett, Elizabeth Ann [Show all 8 contributors for this article] (2020). Sleep disturbance mediates the link between childhood trauma and clinical outcome in severe mental disorders. Psychological Medicine. ISSN 0033-2917. p. 1–10. doi: 10.1017/S0033291720000914. Full text in Research Archive Show summary

  Background The experience of childhood trauma is linked to more severe symptoms and poorer functioning in severe mental disorders; however, the mechanisms behind this are poorly understood. We investigate the relationship between childhood trauma and sleep disturbances in severe mental disorders including the role of sleep disturbances in mediating the relationship between childhood trauma and the severity of clinical symptoms and poorer functioning. Methods In total, 766 participants with schizophrenia-spectrum (n = 418) or bipolar disorders (n = 348) were assessed with the Childhood Trauma Questionnaire. Sleep disturbances were assessed through the sleep items in the self-reported Inventory of Depressive Symptoms. Clinical symptoms and functioning were assessed with The Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale. Mediation analyses using ordinary least squares regression were conducted to test if sleep disturbances mediated the relationship between childhood trauma and the severity of clinical symptoms and poorer functioning. Results Symptoms of insomnia, but not hypersomnia or delayed sleep phase, were significantly more frequent in participants with childhood trauma experiences compared to those without. Physical abuse, emotional abuse, and emotional neglect were significantly associated with insomnia symptoms. Insomnia symptoms partly mediate the relationship between childhood trauma and the severity of positive and depressive/anxiety symptoms, in addition to poorer functioning. Conclusion We found frequent co-occurrence of childhood trauma history and current insomnia in severe mental disorders. Insomnia partly mediated the relationship between childhood trauma and the severity of clinical symptoms and functional impairment.

• Widing, Line Hustad; Simonsen, Carmen Elisabeth; Flaaten, Camilla Bärthel; Haatveit, Beathe; Vik, Ruth Kristine & Wold, Kristin Fjelnseth [Show all 9 contributors for this article] (2020). Symptom Profiles in Psychotic Disorder Not Otherwise Specified. Frontiers in Psychiatry. 11. doi: 10.3389/fpsyt.2020.580444. Full text in Research Archive Show summary

  Introduction: Approximately 10% of patients with psychotic disorders receive the diagnosis “Psychotic disorder not otherwise specified” (PNOS). However, there is a lack of knowledge about the clinical presentations captured by this diagnosis in the mental health services. Therefore, we examined the symptom profiles of participants with PNOS compared to participants with bipolar disorder (BD) and schizophrenia spectrum disorder (SZ) diagnoses. Methods: We here included 1,221 participants from the Thematically Organized Psychosis-study at Oslo University Hospital; 792 with SZ, 283 with BD, and 146 with PNOS, assessed with SCID-I for DSM-IV. The participants with PNOS were categorized into subgroups based on SCID information. The GAF, PANSS, Alcohol Use Disorders Identification Test (AUDIT), and Drug Use Disorders Identification Test (DUDIT) were used to assess function, clinical symptoms, and substance use. Results: In the PNOS group, 44% did not meet the criteria for any specific psychotic disorder, 35.5% had contradictory information making a specific diagnosis difficult, and 20.5% had inadequate information to make a specific diagnosis. The most frequent reason for a PNOS diagnosis was difficulty ruling out a substance-induced psychotic disorder (n = 41, 28%). Participants with PNOS were younger and more often first-episode than participants with BD and SZ. They were intermediate between BD and SZ for GAF scores (BD>PNOS>SZ) and PANSS scores (BD<PNOS<SZ) and more often scored above the clinical cut-off for substance misuse as measured by the AUDIT (BD = PNOS<SZ), DUDIT (BD = SZ<PNOS) and for the combination of both these measures. Conclusions: A PNOS diagnosis is more common in first-episode than in multi-episode patients. The diagnosis captures a heterogeneous group of psychotic syndromes, with a severity of symptoms and functional loss that is intermediate between BD and SZ.

• Barrett, Elizabeth Ann; Aminoff, Sofie Ragnhild; Simonsen, Carmen Elisabeth & Romm, Kristin Lie (2020). Opening the curtains for better sleep in psychotic disorders - considerations for improving sleep treatment. Comprehensive Psychiatry. ISSN 0010-440X. 103. doi: 10.1016/j.comppsych.2020.152207. Full text in Research Archive Show summary

  Background Sleep disturbances are prevalent in people with psychosis and are related to several negative outcomes. Recent research indicates that sleep disturbances contribute to the development of psychosis and is therefore an important treatment target. Despite this, a study found that sleep problems in people with psychosis were mostly assessed informally and treated with non-recommended interventions. However, it is uncertain whether these findings reflect local practise or rather status quo for how sleep disturbances in the context of psychosis are approached across different treatment sites. We aimed to replicate this study and investigate how sleep disturbances in people with psychosis are viewed, assessed and treated by clinicians across several mental health services, and the clinicians' perceived barriers to sleep treatment. Methods A total of 204 clinicians completed an e-mail survey about sleep problems and psychosis. Results The main findings were highly consistent with previous research; the clinicians found sleep problems in patients with psychosis to be highly prevalent and with negative consequences. However, structured assessments and the use of recommended treatment interventions were rare. This apparent paradox may at least partly be explained by the clinicians' perceived barriers to sleep treatment, including their declared lack of knowledge about sleep assessment and sleep treatment, and beliefs that sleep treatment is (too) demanding in this population. Conclusion Many patients with psychosis across several treatment sites receive less than optimal sleep treatment. Increasing clinicians' knowledge about adequate sleep treatment and its feasibility for patients with psychotic disorders is therefore imperative.

• Lyngstad, Siv Hege; Gardsjord, Erlend Strand; Engen, Magnus Johan; Haatveit, Beathe; Ihler, Henrik Myhre & Wedervang-Resell, Kirsten [Show all 9 contributors for this article] (2020). Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study. European Archives of Psychiatry and Clinical Neuroscience. ISSN 0940-1334. doi: 10.1007/s00406-020-01112-3. Full text in Research Archive Show summary

  Apathy is prevalent in first-episode psychosis (FEP) and associated with reduced global functioning. Investigations of the trajectory of apathy and its early predictors are needed to develop new treatment interventions. We here measured the levels of apathy over the first 10 years of treatment in FEP and in healthy controls (HC). We recruited 198 HC and 198 FEP participants. We measured apathy with the Apathy Evaluation Scale, self-report version, psychotic symptoms with the Positive and Negative Syndrome Scale, depression with the Calgary Depression Scale for Schizophrenia, functioning with the Global Assessment of Functioning Scale, and also estimated the duration of untreated psychosis (DUP). The longitudinal development of apathy and its predictors were explored using linear mixed models analyses. Associations to functioning at 10 years were investigated using multiple hierarchical linear regression analyses. In HC, mean apathy levels were low and stable. In FEP, apathy levels decreased significantly during the first year of treatment, followed by long-term stability. High individual levels of apathy at baseline were associated with higher apathy levels during the follow-up. Long DUP and high baseline levels of depression predicted higher apathy levels at follow-ups. The effect of DUP was persistent, while the effect of baseline depression decreased over time. At 10 years, apathy was statistically significantly associated with reduced functioning. The early phase of the disorder may be critical to the development of apathy in FEP.

• Anderssen, Jannicke Fjæra; Simonsen, Carmen Elisabeth; Büchmann, Camilla Bakkalia; Barrett, Elizabeth Ann; Bjella, Thomas & Lagerberg, Trine Vik [Show all 10 contributors for this article] (2019). Sleep disturbances in schizophrenia spectrum and bipolar disorders ? a transdiagnostic perspective. Comprehensive Psychiatry. ISSN 0010-440X. 91, p. 6–12. doi: 10.1016/j.comppsych.2019.02.006. Full text in Research Archive Show summary

  Background Sleep disturbances are prevalent in severe mental disorders but their type and frequency across diagnostic categories has not been investigated in large scale studies. Methods Participants with Schizophrenia spectrum disorders (SCZ, (N = 617)), Bipolar disorders (BD, (N = 440)), and Healthy Controls (HC, (N = 173)) were included in the study. Sleep disturbances (insomnia, hypersomnia and delayed sleep phase) were identified based on items from the Inventory of Depressive Symptoms – Clinician rated scale. Clinical symptoms were assessed with the Positive and Negative Syndrome scale and level of functioning with the Global assessment of Functioning scale. Results The rate of any sleep disturbance was 78% in SZ, 69% in BD and 39% in HC. Insomnia was the most frequently reported sleep disturbance across all groups. Both diagnostic groups reported significantly more of any sleep disturbances than HC (P < 0.001). Having a sleep disturbance was associated with more severe negative and depressive symptoms and with lower functioning across diagnostic groups (P < 0.001, η2 = 0.0071). Hypersomnia was the only sleep disturbance associated with previous treatment history. Conclusion Sleep disturbances, including insomnia, hypersomnia and delayed sleep phase, are frequent in SCZ and BD, and associated with more severe clinical symptomatology across diagnostic groups. This suggests that sleep disturbance is a clinically relevant transdiagnostic phenomenon.

• Anderssen, Jannicke Fjæra; Büchmann, Camilla Bakkalia; Barrett, Elizabeth Ann; Høegh, Margrethe Collier; Haatveit, Beathe & Vedal, Trude Seselie Jahr [Show all 10 contributors for this article] (2019). Do sleep disturbances contribute to cognitive impairments in schizophrenia spectrum and bipolar disorders? European Archives of Psychiatry and Clinical Neuroscience. ISSN 0940-1334. p. 1–11. doi: 10.1007/s00406-019-01075-0. Full text in Research Archive
• Simonsen, Carmen Elisabeth; Aminoff, Sofie Ragnhild; Vaskinn, Anja; Barrett, Elizabeth Ann; Færden, Ann & Ueland, Torill [Show all 9 contributors for this article] (2019). Perceived and experienced stigma in first-episode psychosis: A 1-year follow-up study. Comprehensive Psychiatry. ISSN 0010-440X. 95:152134, p. 1–8. doi: 10.1016/j.comppsych.2019.152134. Full text in Research Archive Show summary

  Objectives Perceived/experienced stigma and its relationship with clinical outcome were investigated across the first year of treatment in a large sample with first-episode psychosis (FEP). Methods FEP participants (n = 112) in the TOP study were investigated at baseline and 1-year follow-up. Perceived/experienced stigma was measured with items from the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), assessing problems because of barriers and hindrances, and living with dignity because of attitudes and actions of others. Clinical outcome included: symptoms, global functioning, self-rated disability and self-rated life satisfaction. Results In the total sample, 46% perceived/experienced stigma at baseline, which decreased significantly to 32% at 1-year follow-up. Perceived/experienced stigma was present in 1/5 at both time-points (Sustained stigma), in 2/5 at only one time-point (Transient stigma), and in 2/5 it was not present at either time-point (No stigma). Compared to the No stigma group, the Sustained stigma group had significantly higher levels of positive, excited and depressive symptoms and self-rated disability, as well as lower levels of global functioning and life satisfaction at 1 year follow-up, while the Transient stigma group only had poorer functioning and higher self-rated disability. Yet the outcome variables improved across the first year of treatment in all three stigma groups. Conclusion Perceived/experienced stigma was common in FEP, yet the rate decreased across the first year of treatment. Although there was some clinical improvement across the first year of treatment irrespective of stigma, stigma was related to poorer clinical outcome in a bidirectional manner. This suggests that perceived/experienced stigma is an important target in the early stages of treatment.

• Engen, Magnus Johan; Simonsen, Carmen Elisabeth; Melle, Ingrid; Færden, Ann; Lyngstad, Siv Hege & Haatveit, Beathe [Show all 8 contributors for this article] (2019). Cognitive functioning in patients with first-episode psychosis stratified by level of negative symptoms: A 1-year follow-up study. Psychiatry Research. ISSN 0165-1781. 281, p. 1–7. doi: 10.1016/j.psychres.2019.112554. Full text in Research Archive
• Gjerde, Priyanthi Borgen; Simonsen, Carmen Elisabeth; Lagerberg, Trine Vik; Steen, Nils Eiel; Ueland, Torill & Andreassen, Ole Andreas [Show all 8 contributors for this article] (2019). Improvement in verbal learning over the first year of antipsychotic treatment is associated with serum HDL levels in a cohort of first episode psychosis patients. European Archives of Psychiatry and Clinical Neuroscience. ISSN 0940-1334. p. 1–10. doi: 10.1007/s00406-019-01017-w. Full text in Research Archive Show summary

  To investigate whether changes in serum lipids are associated with cognitive performance in first episode psychosis (FEP) patients during their first year of antipsychotic drug treatment. One hundred and thirty-two antipsychotic-treated FEP patients were included through the TOP study along with 83 age- and gender-matched healthy controls (HC). Information regarding cognitive performance, psychotic symptoms, lifestyle, body mass index, serum lipids [total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, and triglycerides] and antipsychotic treatment was obtained at baseline and after 1 year. The cognitive test battery is comprised of assessments for verbal learning, processing speed, working memory, verbal fluency, and inhibition. Mixed-effects models were used to study the relationship between changes over time in serum lipids and cognitive domains, controlling for potential confounders. There was a significant group by HDL interaction effect for verbal learning (F = 11.12, p = 0.001), where an increase in HDL levels was associated with improvement in verbal learning in FEP patients but not in HC. Practice effects, lifestyle, and psychotic symptoms did not significantly affect this relationship. Antipsychotic-treated FEP patients who increased in HDL levels during the first year of follow-up exhibited better verbal learning capacity. Further investigations are needed to clarify the underlying mechanisms.

• Færden, Ann; Lyngstad, Siv Hege; Simonsen, Carmen Elisabeth; Ringen, Petter Andreas; Papsuev, Oleg & Dieset, Ingrid [Show all 10 contributors for this article] (2018). Reliability and validity of the self-report version of the apathy evaluation scale in first-episode Psychosis: Concordance with the clinical version at baseline and 12 months follow-up. Psychiatry Research. ISSN 0165-1781. 267, p. 140–147. doi: 10.1016/j.psychres.2018.05.065. Full text in Research Archive Show summary

  Negative symptoms have traditionally been assessed based on clinicians’ observations. The subjective experience of negative symptoms in people with psychosis may bring new insight. The Apathy Evaluation Scale (AES) is commonly used to study apathy in psychosis and has corresponding self-rated (AES-S) and clinician-rated (AES-C) versions. The aim of the present study was to determine the validity and reliability of the AES-S by investigating its concordance with the AES-C. Eighty-four first-episode (FEP) patients completed the shortened 12-item AES-S and AES-C at baseline (T1) and 12 months (T2). Concordance was studied by degree of correlation, comparison of mean scores, and change and difference between diagnostic groups. The Positive and Negative Symptom Scale (PANSS) was used to study convergent and discriminative properties. High concordance was found between AES-S and AES-C at both T1 and T2 regarding mean values, change from T1 to T2, and the proportion with high levels of apathy. Both versions indicated high levels of apathy in FEP, while associations with PANSS negative symptoms were weaker for AES-S than AES-C. Controlling for depression did not significantly alter results. We concluded that self-rated apathy in FEP patients is in concordance with clinician ratings, but in need of further study.

• Gjerde, Priyanthi Borgen; Dieset, Ingrid; Simonsen, Carmen Elisabeth; Hoseth, Eva Zsuzsanna; Iversen, Trude Seselie Jahr & Lagerberg, Trine Vik [Show all 12 contributors for this article] (2018). Increase in serum HDL level is associated with less negative symptoms after one year of antipsychotic treatment in first-episode psychosis. Schizophrenia Research. ISSN 0920-9964. 197, p. 253–260. doi: 10.1016/j.schres.2017.10.042. Full text in Research Archive Show summary

  Background A potential link between increase in total cholesterol and triglycerides and clinical improvement has been observed during antipsychotic drug treatment in chronic schizophrenia patients, possibly due to drug related effects on lipid biosynthesis. We examined whether changes in serum lipids are associated with alleviation of psychosis symptoms after one year of antipsychotic drug treatment in a cohort of first-episode psychosis (FEP) patients. Methods A total of 132 non-affective antipsychotic-treated FEP patients were included through the Norwegian Thematically Organized Psychosis (TOP) project. Data on antipsychotic usage, serum lipids (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol and triglycerides (TG)), body mass index (BMI) and clinical state were obtained at baseline and after 12 months. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychotic symptoms. Mixed-effects models were employed to examine the relationship between serum lipids and psychotic symptoms while controlling for potential confounders including BMI. Results An increase in HDL during one year of antipsychotic treatment was associated with reduction in PANSS negative subscores (B = − 0.48, p = 0.03). This relationship was not affected by concurrent change in BMI (adjusted HDL: B = − 0.54, p = 0.02). No significant associations were found between serum lipids, BMI and PANSS positive subscores. Conclusion We found that an increase in HDL level during antipsychotic treatment is associated with improvement in negative symptoms in FEP. These findings warrant further investigation to clarify the interaction between lipid pathways and psychosis.

• Lyngstad, Siv Hege; Gardsjord, Erlend Strand; Simonsen, Carmen Elisabeth; Engen, Magnus Johan; Romm, Kristin Lie & Melle, Ingrid [Show all 7 contributors for this article] (2018). Consequences of persistent depression and apathy in first-episode psychosis ? A one-year follow-up study. Comprehensive Psychiatry. ISSN 0010-440X. 86, p. 60–66. doi: 10.1016/j.comppsych.2018.07.015. Full text in Research Archive
• Simonsen, Carmen Elisabeth; Færden, Ann; Ueland, Torill; Vaskinn, Anja; Bjella, Thomas & Andreassen, Ole Andreas [Show all 8 contributors for this article] (2018). Self-rated disability in first treated episode of psychosis: A 1-year follow-up study. Comprehensive Psychiatry. ISSN 0010-440X. 85, p. 48–54. doi: 10.1016/j.comppsych.2018.06.004. Full text in Research Archive Show summary

  Objectives: Knowledge about self-rated disability over time in psychotic disorders is limited. How self-rateddisability relates to clinician-rated global functioning, self-rated life satisfaction and symptomatology wasinvestigated across thefirst year of treatment in early psychosis. Methods: Participants withfirst treated episode of psychosis (n= 115) were investigated at baseline and 1-yearfollow-up. Self-rated Disability was measured with World Health Organization- Disability Assessment Schedule2.0. Clinician-rated global functioning, self-rated life satisfaction, and symptomatology were measured withappropriate scales. Results: Average self-rated disability infirst-treated episode of psychosis was high, corresponding with the 10%highest in a general population sample. However, 37% werenotdisabled at a clinically significant level afterone year. Self-rated disability was highest in the two social domains (Getting along with people and Participationin society), but improved significantly from baseline to 1-year. At 1-year follow-up self-rated disability hadsignificant weak to medium correlations with clinician-rated global functioning and positive symptoms,and mainly medium to strong correlations with life satisfaction and depressive symptoms. Yet only baselinedepression significantly predicted disability after one year. Conclusion: Self-rated disability infirst treated episode of psychosis is high, but improves across thefirst year,indicating signs of early recovery. Moreover,self-rateddisability isrelated, but distinct fromclinician-ratedglobalfunctioning and self-rated life satisfaction, suggesting that self-rated disability should also be assessed in order tomore fully describe outcomes infirst episode psychosis. Thefindings highlight the need for specialised treatmentof depression and social disability in early psychosis.

• Nerhus, Mari; Berg, Akiah Ottesen; Simonsen, Carmen Elisabeth; Haram, Marit; Haatveit, Beathe Christin & Dahl, Sandra Rinne [Show all 11 contributors for this article] (2017). Vitamin D deficiency associated with cognitive functioning in psychotic disorders. Journal of Clinical Psychiatry. ISSN 0160-6689. 78(7), p. e750–e757. doi: 10.4088/JCP.16m10880. Full text in Research Archive
• Demmo, Christine; Lagerberg, Trine Vik; Aminoff, Sofie Ragnhild; Hellvin, Tone; Kvitland, Levi Røstad & Simonsen, Carmen Elisabeth [Show all 10 contributors for this article] (2017). Course of neurocognitive function in first treatment bipolar I disorder: One-year follow-up study. Psychiatry Research. ISSN 0165-1781. 249, p. 286–292. doi: 10.1016/j.psychres.2016.12.048. Full text in Research Archive
• Vaskinn, Anja; Lagerberg, Trine Vik; Bjella, Thomas; Simonsen, Carmen Elisabeth; Andreassen, Ole Andreas & Ueland, Torill [Show all 7 contributors for this article] (2017). Impairment in emotion perception from body movements in individuals with bipolar I and bipolar II disorder is associated with functional capacity. International journal of bipolar disorders. 5(13), p. 1–9. doi: 10.1186/s40345-017-0083-7. Full text in Research Archive Show summary

  Background Individuals with bipolar disorder present with moderate impairments in social cognition during the euthymic state. The impairment extends to theory of mind and to the perception of emotion in faces and voices, but it is unclear if emotion perception from body movements is affected. The main aim of this study was to examine if participants with bipolar disorder perform worse than healthy control participants on a task using point-light displays of human full figures moving in a manner indicative of a basic emotion (angry, happy, sad, fearful, neutral/no emotion). A secondary research question was whether diagnostic subtypes (bipolar I, bipolar II) and history of psychosis impacted on this type of emotion perception. Finally, symptomatic, neurocognitive, and functional correlates of emotion perception from body movements were investigated. Methods Fifty-three individuals with bipolar I (n = 29) or bipolar II (n = 24) disorder, and 84 healthy control participants were assessed for emotion perception from body movements. The bipolar group also underwent clinical, cognitive, and functional assessment. Research questions were analyzed using analyses of variance and bivariate correlations. Results The bipolar disorder group differed significantly from healthy control participants for emotion perception from body movements (Cohen’s d = 0.40). Analyses of variance yielded no effects of sex, diagnostic subtype (bipolar I, bipolar II), or history of psychosis. There was an effect of emotion, indicating that some emotions are easier to recognize. The lack of a significant group × emotion interaction effect points, however, to this being so regardless of the presence of bipolar disorder. Performance was unrelated to manic and depressive symptom load but showed significant associations with neurocognition and functional capacity. Conclusions Individuals with bipolar disorder had a small but significant impairment in the ability to perceive emotions from body movement. The impairment was global, i.e., affecting all emotions and equally present for males and females. The impairment was associated with neurocognition and functional capacity, but not symptom load. Our findings identify pathopsychological factors underlying the functional impairment in bipolar disorder and suggest the consideration of social cognition training as part of the treatment for bipolar disorder.

• Simonsen, Carmen Elisabeth; Færden, Ann; Romm, Kristin Lie; Berg, Akiah Ottesen; Bjella, Thomas & Sundet, Kjetil Søren [Show all 9 contributors for this article] (2017). Early clinical recovery in first-episode psychosis: Symptomatic remission and its correlates at 1-year follow-up. Psychiatry Research. ISSN 0165-1781. 254, p. 118–125. doi: 10.1016/j.psychres.2017.04.050. Full text in Research Archive
• Demmo, Christine; Lagerberg, Trine Vik; Kvitland, Levi Røstad; Aminoff, Sofie Ragnhild; Hellvin, Tone & Simonsen, Carmen Elisabeth [Show all 10 contributors for this article] (2017). Neurocognitive functioning, clinical course and functional outcome in first-treatment bipolar I disorder patients with and without clinical relapse: A 1-year follow-up study. Bipolar Disorders. ISSN 1398-5647. 20(3), p. 228–237. doi: 10.1111/bdi.12569. Full text in Research Archive Show summary

  OBJECTIVES: Due to limited research on the association between recurrence of mood episodes and the longitudinal course of neurocognitive functioning in early phase bipolar I disorder (BD I), the impact of recurrence on neurocognition remains unclear. Further, a strong correlation between neurocognitive impairment and functional impairment has been demonstrated. The longitudinal relationship between neurocognitive impairment and functional outcome in relation to recurrence is, however, not established. METHODS: The current study investigated the longitudinal relationship between neurocognition, recurrence of mood episodes and functional outcome in a sample of first-treatment (FT) BD I patients (N = 42), with and without relapse, during a 1-year follow-up period. The longitudinal course of neurocognitive functioning in the patients was also compared to that of a group of healthy controls (N = 143). RESULTS: Compared to both patients with relapse and healthy controls, no-relapse patients showed neurocognitive improvements. The polarity of the relapse episodes was mostly depressive, and for the no-relapse patients, reduction of symptoms was associated with neurocognitive improvement. No-relapse patients showed better global and occupational functioning. CONCLUSIONS: The current study found different neurocognitive and functional trajectories in FT BD I patients with and without relapse, with differences at follow-up to some degree being mediated by current symptoms. The current findings highlight the importance of treatment focusing on neurocognition and symptom states with the aim of improving functional recovery.

• Berg, Akiah Ottesen; Melle, Ingrid; Zuber, Verena; Simonsen, Carmen Elisabeth; Nerhus, Mari & Ueland, Torill [Show all 9 contributors for this article] (2017). Modelling difficulties in abstract thinking in psychosis: the importance of socio-developmental background. Cognitive Neuropsychiatry. ISSN 1354-6805. 22(1), p. 39–52. doi: 10.1080/13546805.2016.1259998. Full text in Research Archive
• Haukvik, Unn Kristin H.; Hartberg, Cecilie Bhandari; Nerland, Stener; Jørgensen, Kjetil Nordbø; Lange, Elisabeth & Simonsen, Carmen Elisabeth [Show all 11 contributors for this article] (2016). No progressive brain changes during a 1-year follow-up of patients with first-episode psychosis. Psychological Medicine. ISSN 0033-2917. 46(3), p. 589–598. doi: 10.1017/S003329171500210X. Full text in Research Archive Show summary

  Background. First-episode psychosis (FEP) patients show structural brain abnormalities. Whether the changes are progressive or not remain under debate, and the results from longitudinal magnetic resonance imaging (MRI) studies are mixed. We investigated if FEP patients showed a different pattern of regional brain structural change over a 1-year period compared with healthy controls, and if putative changes correlated with clinical characteristics and outcome. Method. MRIs of 79 FEP patients [SCID-I-verified diagnoses: schizophrenia, psychotic bipolar disorder, or other psychoses, mean age 27.6 (S.D. = 7.7) years, 66% male] and 82 healthy controls [age 29.3 (S.D. = 7.2) years, 66% male] were acquired from the same 1.5 T scanner at baseline and 1-year follow-up as part of the Thematically Organized Psychosis (TOP) study, Oslo, Norway. Scans were automatically processed with the longitudinal stream in FreeSurfer that creates an unbiased within-subject template image. General linear models were used to analyse longitudinal change in a wide range of subcortical volumes and detailed thickness and surface area estimates across the entire cortex, and associations with clinical characteristics. Results. FEP patients and controls did not differ significantly in annual percentage change in cortical thickness or area in any cortical region, or in any of the subcortical structures after adjustment for multiple comparisons. Within the FEP group, duration of untreated psychosis, age at illness onset, antipsychotic medication use and remission at follow-up were not related to longitudinal brain change. Conclusions. We found no significant longitudinal brain changes over a 1-year period in FEP patients. Our results do not support early progressive brain changes in psychotic disorders.

• Demmo, Christine; Lagerberg, Trine Vik; Aminoff, Sofie Ragnhild; Hellvin, Tone; Kvitland, Levi Røstad & Simonsen, Carmen Elisabeth [Show all 9 contributors for this article] (2016). History of psychosis and previous episodes as potential explanatory factors for neurocognitive impairment in first-treatment bipolar I disorder. Bipolar Disorders. ISSN 1398-5647. 18(2), p. 136–147. doi: 10.1111/bdi.12377. Full text in Research Archive
• Steen, Nils Eiel; Aas, Monica; Simonsen, Carmen Elisabeth; Dieset, Ingrid; Tesli, Martin Steen & Nerhus, Mari [Show all 13 contributors for this article] (2016). Serum levels of second-generation antipsychotics are associated with cognitive function in psychotic disorders. World Journal of Biological Psychiatry. ISSN 1562-2975. 18(6), p. 471–482. doi: 10.1080/15622975.2016.1245441. Full text in Research Archive
• Steen, Nils Eiel; Aas, Monica; Simonsen, Carmen Elisabeth; Dieset, Ingrid; Tesli, Martin Steen & Nerhus, Mari [Show all 13 contributors for this article] (2016). Serum concentrations of mood stabilizers are associated with memory, but not other cognitive domains in psychosis spectrum disorders; explorative analyses in a naturalistic setting. International journal of bipolar disorders. 4(24). doi: 10.1186/s40345-016-0067-z. Full text in Research Archive Show summary

  Background Mood stabilizers like lithium and anticonvulsants are used in bipolar and related psychotic disorders. There is a lack of knowledge of the relationship of these medications and cognition in the psychosis spectrum. We studied the association between serum concentration of mood stabilizers and cognitive performance in a well-characterized sample of bipolar and schizophrenia spectrum disorders. Methods Serum concentrations of valproate, lamotrigine, and lithium were analyzed for associations to performance on neuropsychological tests in six cognitive domains in individuals with bipolar disorder (n = 167) and in a combined sample of individuals with bipolar or schizophrenia spectrum disorders (n = 217). Linear regression with adjustments for gender, age, and symptom levels of depression, mania, and psychosis were applied for the association analyses. Results There were negative associations between serum levels of valproate and short term delayed recall (bipolar: p = 0.043; combined: p = 0.044) and working memory (bipolar: p = 0.043). A positive association was suggested between serum level of lithium and working memory (bipolar: p = 0.039). There were no other significant relationships between serum levels of valproate, lamotrigine, or lithium and neuropsychological test performance in neither the bipolar disorder nor the combined group. Conclusions Serum levels of mood stabilizers were unrelated to cognitive performance in most domains, indicating that higher dose does not lead to broader cognitive impairments in bipolar and related psychotic disorder patients. However, worsened memory with increasing levels of valproate suggests cautious dosing of anticonvulsants, while increasing lithium level seems to be associated with improved memory. The findings should be interpreted with caution due to the explorative, naturalistic design.

• Aas, Monica; Andreassen, Ole Andreas; Aminoff, Sofie Ragnhild; Færden, Ann; Romm, Kristin Lie & Nesvåg, Ragnar [Show all 10 contributors for this article] (2016). A history of childhood trauma is associated with slower improvement rates: Findings from a one-year follow-up study of patients with a first-episode psychosis. BMC Psychiatry. 16. doi: 10.1186/s12888-016-0827-4. Full text in Research Archive Show summary

  Background The aim of this study was to investigate whether childhood trauma was associated with more severe clinical features in patients with first-episode psychosis, both at the initial assessment and after one year. Methods Ninety-six patients with a first-episode of a DSM-IV diagnosis of psychosis, in addition to 264 healthy controls from the same catchment area, were recruited to the TOP NORMENT study. A history of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). Function and symptom severity were measured using the Global Assessment of Functioning (GAF) Scale divided into function (GAF-F) and symptoms (GAF-S), the Positive and Negative Syndrome Scale (PANSS) and the Young Mania Rating Scale (YMRS). All clinical assessments were completed at two time points: At an initial assessment within the first year of initiating treatment for psychosis and after one year. Results Childhood trauma was associated with significantly reduced global functioning and more severe clinical symptoms at both baseline and follow-up, whereas emotional neglect was associated with a significantly reduced improvement rate for global functioning (GAF-F) over the follow-up period. Conclusion Our data indicate that patients with first-episode psychosis who report a history of childhood trauma constitute a subgroup characterized by more severe clinical features over the first year of treatment, as well as slower improvement rates.

• Steen, Nils Eiel; Aas, Monica; Simonsen, Carmen Elisabeth; Dieset, Ingrid; Tesli, Martin Steen & Nerhus, Mari [Show all 13 contributors for this article] (2015). Serum level of venlafaxine is associated with better memory in psychotic disorders. Schizophrenia Research. ISSN 0920-9964. 169(1-3), p. 386–392. doi: 10.1016/j.schres.2015.10.021. Full text in Research Archive
• Berg, Akiah Ottesen; Barrett, Elizabeth Ann; Nerhus, Mari; Buchmann, Camilla Bakkalia; Simonsen, Carmen Elisabeth & Færden, Ann [Show all 8 contributors for this article] (2015). Psychosis: clinical insight and beliefs in immigrants in their first episode. Early Intervention in Psychiatry. ISSN 1751-7885. 12(2), p. 185–192. doi: 10.1111/eip.12297. Full text in Research Archive Show summary

  Aim: Lack of insight into illness is frequent in psychotic disorders and seen as part of their primary pathology. The recognition of symptoms as psychotic, and beliefs about treatment alternatives, is also influenced by socio-cultural factors. Here we examined clinical insight into illness and beliefs about psychosis in immigrants in their first episode of psychosis compared to a reference group. Methods: 277 first episode psychosis participants were recruited to this cross-sectional study; 40 first- and 40 second-generation immigrants from Europe, Americas and Oceania (n=37), Asia including Turkey (n=28), or Africa (n=15). The Birchwood Insight Scale was used to measure clinical insight and “The Attitudes and Beliefs about Mental Health Problems”, schizophrenia version to assess socio-cultural beliefs. Results: Immigrants did not differ from the reference sample in clinical insight. After controlling for education level first generation immigrants were less likely to recognize psychotic symptoms (OR 2.9; Wald = 8.977, df 1, p =.003) and viewed hospitalization (OR 5.2; Wald = 20.388, df 1, p =.001) and treatment by a psychiatrist (OR 4.9; Wald = 6.609, df 1, p =.01)) as less beneficial than the reference group. Immigrants from Asia held more alternative explanations (OR 0.3; Wald = 6.567, df 1, p=.010). There were significantly stronger associations between clinical insight and socio-cultural beliefs in the reference group. Conclusions: Socio-cultural beliefs about psychosis in immigrants in first episode psychosis calls for more tailored information to this group, and emphasize the importance of treatment interventions involving both a cultural and personal perspective of insight.

• Jónsdóttir, Halldóra; Ilner, Stein E. Opjordsmoen; Birkenæs, Astrid Brate; Simonsen, Carmen Elisabeth; Engh, John & Ringen, Petter Andreas [Show all 10 contributors for this article] (2013). Predictors of medication adherence in patients with schizophrenia and bipolar disorder. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 127(1), p. 23–33. doi: 10.1111/j.1600-0447.2012.01911.x. Full text in Research Archive
• Ringen, Petter Andreas; Melle, Ingrid; Berg, Akiah Ottesen; Agartz, Ingrid; Spigset, Olav & Simonsen, Carmen Elisabeth [Show all 8 contributors for this article] (2013). Cannabis use and premorbid functioning as predictors of poorer neurocognition in schizophrenia spectrum disorder. Schizophrenia Research. ISSN 0920-9964. 143(1), p. 84–89. doi: 10.1016/j.schres.2012.10.021. Full text in Research Archive
• Bourne, Corin; Aydemir, Ömer; Balanzá-Maríinez, Vicent; Bora, Emre; Brissos, Sofia & Cavanagh, Jonathan T.O. [Show all 43 contributors for this article] (2013). Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 128(3), p. 149–162. doi: 10.1111/acps.12133. Full text in Research Archive
• Hellvin, Tone; Sundet, Kjetil Søren; Simonsen, Carmen Elisabeth; Aminoff, Sofie Ragnhild; Lagerberg, Trine Vik & Andreassen, Ole Andreas [Show all 7 contributors for this article] (2012). Neurocognitive functioning in patients recently diagnosed with bipolar disorder. Bipolar Disorders. ISSN 1398-5647. 14(3), p. 227–238. doi: 10.1111/j.1399-5618.2012.01004.x. Full text in Research Archive
• Simonsen, Carmen Elisabeth; Sundet, Kjetil Søren; Vaskinn, Anja; Birkenæs, Astrid Brate; Engh, John & Færden, Ann [Show all 12 contributors for this article] (2011). Neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders depends on history of psychosis rather than diagnostic group. Schizophrenia Bulletin. ISSN 0586-7614. 37(1), p. 73–83. doi: 10.1093/schbul/sbp034. Full text in Research Archive
• Vaskinn, Anja; Sundet, Kjetil Søren; Simonsen, Carmen Elisabeth; Hellvin, Tone; Melle, Ingrid & Andreassen, Ole Andreas (2011). Sex differences in neuropsychological performance and social functioning in schizophrenia and bipolar disorder. Neuropsychology. ISSN 0894-4105. 25, p. 499–510. doi: 10.1037/a0022677. Full text in Research Archive
• Engh, John; Sundet, Kjetil Søren; Simonsen, Carmen Elisabeth; Vaskinn, Anja; Lagerberg, Trine Vik & Ilner, Stein E. Opjordsmoen [Show all 8 contributors for this article] (2011). Verbal learning contributes to cognitive insight in schizophrenia independently of affective and psychotic symptoms. Progress in Neuro-psychopharmacology and Biological Psychiatry. ISSN 0278-5846. 35(4), p. 1059–1063. doi: 10.1016/j.pnpbp.2011.02.021. Full text in Research Archive
• Barrett, Elisabeth Ann; Sundet, Kjetil Søren; Simonsen, Carmen Elisabeth; Agartz, Ingrid; Lorentzen, Steinar & Mehlum, Lars [Show all 9 contributors for this article] (2011). Neurocognitive functioning and suicidality in schizophrenia spectrum disorders. Comprehensive Psychiatry. ISSN 0010-440X. 52(2), p. 156–163. doi: 10.1016/j.comppsych.2010.06.001. Full text in Research Archive
• Ringen, Petter Andreas; Vaskinn, Anja; Sundet, Kjetil Søren; Engh, John; Jónsdóttir, Halldóra & Simonsen, Carmen Elisabeth [Show all 10 contributors for this article] (2010). Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia. Psychological Medicine. ISSN 0033-2917. 40(8), p. 1337–1347. doi: 10.1017/S0033291709991620. Full text in Research Archive
• Hellvin, Tone; Sundet, Kjetil Søren; Vaskinn, Anja; Simonsen, Carmen Elisabeth; Ueland, Toril & Andreassen, Ole Andreas [Show all 7 contributors for this article] (2010). Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder. Scandinavian Journal of Psychology. ISSN 0036-5564. 51(6), p. 525–533. doi: 10.1111/j.1467-9450.2010.00839.x. Full text in Research Archive
• Engh, John; Friis, Svein; Birkenæs, Astrid Brate; Jónsdóttir, Halldóra; Klungsøyr, Ole & Ringen, Petter Andreas [Show all 10 contributors for this article] (2010). Delusions Are Associated With Poor Cognitive Insight in Schizophrenia. Schizophrenia Bulletin. ISSN 0586-7614. 36(4), p. 830–835. doi: 10.1093/schbul/sbn193. Full text in Research Archive
• Simonsen, Carmen Elisabeth; Sundet, Kjetil Søren; Vaskinn, Anja; Ueland, Toril; Romm, Kristin Lie & Hellvin, Tone [Show all 9 contributors for this article] (2010). Psychosocial function in schizophrenia and bipolar disorder: Relationship to neurocognition and clinical symptoms. Journal of the International Neuropsychological Society. ISSN 1355-6177. 16(5), p. 771–783. doi: 10.1017/S1355617710000573. Full text in Research Archive
• Engh, John; Friis, Svein; Birkenæs, Astrid Brate; Jónsdóttir, Halldóra; Klungsøyr, Ole & Ringen, Petter Andreas [Show all 10 contributors for this article] (2009). Delusions are associated with low cognitive insight in schizophrenia. Cognitive insight, delusions and hallucinations. Schizophrenia Bulletin. ISSN 0586-7614. doi: 10.1093/schbul/sbn193. Full text in Research Archive
• Faerden, A; Vaskinn, Anja; Finset, Arnstein; Agartz, Ingrid; Barrett, Elisabeth Ann & Friis, Svein [Show all 9 contributors for this article] (2009). Apathy is associated with executive functioning in first episode psychosis. BMC Psychiatry. 9. doi: 10.1186/1471-244X-9-1. Full text in Research Archive Show summary

  Background The underlying nature of negative symptoms in psychosis is poorly understood. Investigation of the relationship between the different negative subsymptoms and neurocognition is one approach to understand more of the underlying nature. Apathy, one of the subsymptoms, is also a common symptom in other brain disorders. Its association with neurocognition, in particular executive functioning, is well documented in other brain disorders, but only studied in one former study of chronic patients with schizophrenia. This study investigates the association between apathy and neurocognitive functioning in patients with first episode psychosis (FEP), with the hypothesis that apathy is more associated with tests representing executive function than tests representing other neurocognitive domains. Methods Seventy-one FEP patients were assessed with an extensive neuropsychological test battery. Level of apathy was assessed with the abridged Apathy Evaluation Scale (AES-C-Apathy). Results AES-C-Apathy was only significantly associated with tests from the executive domain [Semantic fluency (r =.37, p <.01), Phonetic fluency (r =.25, p <.05)] and working memory [Letter Number Span (r =.26; p =<.05)]; the first two representing the initiation part of executive function. Confounding variables such as co-occuring depression, positive symptoms or use of antipsychotic medication did not significantly influence the results. Conclusion We replicated in FEP patients the relationship between apathy and executive functioning reported in another study for chronic patients with schizophrenia. We also found apathy in FEP to have the same relationship to executive functioning, as assessed with the Verbal fluency tests, as that reported in patients with other brain disorders, pointing to a common underlying nature of this symptom across disorders.

• Vaskinn, Anja; Sundet, Kjetil Søren; Friis, Svein; Ueland, Toril; Simonsen, Carmen Elisabeth & Birkenæs, Astrid Brate [Show all 11 contributors for this article] (2009). Using the Wisconsin Card Sorting Test to assess learning potential in normal IQ schizophrenia: Does it have potential? Nordic Journal of Psychiatry. ISSN 0803-9488. 63(5), p. 405–411. doi: 10.1080/08039480902879941. Full text in Research Archive
• Simonsen, Carmen Elisabeth; Sundet, Kjetil Søren; Vaskinn, Anja; Birkenæs, Astrid Brate; Engh, John & Hansen, Charlotte F [Show all 11 contributors for this article] (2008). Neurocognitive profiles in bipolar I and bipolar II disorder: differences in pattern and magnitude of dysfunction. Bipolar Disorders. ISSN 1398-5647. 10, p. 245–255. Full text in Research Archive
• Vaskinn, Anja; Sundet, Kjetil Søren; Friis, Svein; Ueland, Torill; Simonsen, Carmen Elisabeth & Birkenæs, Astrid Brate [Show all 9 contributors for this article] (2008). Can learning potential in schizophrenia be assessed with the standard CVLT-II? An exploratory study. Scandinavian Journal of Psychology. ISSN 0036-5564. 49, p. 179–186. doi: 10.1111/j.1467-9450.2008.00627.x. Full text in Research Archive
• Vaskinn, Anja; Sundet, Kjetil Søren; Friis, Svein; Simonsen, Carmen Elisabeth; Birkenæs, Astrid Brate & Jónsdóttir, Halldóra [Show all 8 contributors for this article] (2008). Emotion perception and learning potential: Mediators between neurocognition and social problem-solving in schizophrenia? Journal of the International Neuropsychological Society. ISSN 1355-6177. 14, p. 279–288. doi: 10.1017/S1355017708080314. Full text in Research Archive
• Birkenæs, AB; Ilner, Opjordsmoen Stein E.; Brunborg, C; Engh, JA; Jónsdóttir, Halldóra & Ringen, PA [Show all 12 contributors for this article] (2007). The level of cardiovascular risk factors in bipolar disorder equals that of schizophrenia: a comparative study. Journal of Clinical Psychiatry. ISSN 0160-6689. 68(6), p. 917–923. Full text in Research Archive
• Vaskinn, Anja; Sundet, Kjetil Søren; Friis, Svein; Simonsen, Carmen Elisabeth; Birkenæs, Astrid Brate & Engh, John [Show all 10 contributors for this article] (2007). The effect of gender on emotion perception in schizophrenia and bipolar disorder. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 116, p. 263–270. doi: 10.1111/j.1600-0447.2007.00991.x. Full text in Research Archive
• Birkenæs, Astrid Brate; Opjordsmoen, Stein; Brunborg, Cathrine; Engh, John; Jonsdottir, Halldora & Ringen, Petter Andreas [Show all 12 contributors for this article] (2007). The level of cardiovascular risk factors in bipolar disorder equals that of schizophrenia: a comparative study. Journal of Clinical Psychiatry. ISSN 0160-6689. 68, p. 917–923. Full text in Research Archive

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• Aminoff, Sofie Ragnhild; Lagerberg, Trine Vik; Melle, Ingrid; Berg, Akiah Ottesen; Simonsen, Carmen Elisabeth & Ueland, Toril [Show all 7 contributors for this article] (2015). Psykose og samfunn. Universitetsforlaget. ISBN 9788215024691. 208 p. Full text in Research Archive
• Aminoff, Sofie Ragnhild; Berg, Akiah Ottesen; Lagerberg, Trine Vik; Melle, Ingrid; Simonsen, Carmen Elisabeth & Ueland, Torill [Show all 7 contributors for this article] (2015). Psykose og Samfunn. Universitetsforlaget. ISBN 9788215024691. 210 p. Full text in Research Archive

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• Aminoff, Sofie Ragnhild; Barth, Claudia; Skoge, Mari; Lyngstad, Siv Hege; Mork, Erlend & Lagerberg, Trine Vik [Show all 8 contributors for this article] (2026). Menstrual cycle regularity in women with bipolar disorders: associations with premenstrual disturbances, hormonal contraceptives and course of illness. Full text in Research Archive
• Aminoff, Sofie Ragnhild; Barth, Claudia; Skoge, Mari; Lyngstad, Siv Hege; Mork, Erlend & Romm, Kristin Lie [Show all 8 contributors for this article] (2026). Internasjonal oppmerksomhet rundt forskning på bipolar lidelse og menstruasjon. [Internet]. Oslo universitetssykehus. doi: https:/www.oslo-universitetssykehus.no/avdelinger/klinikk-psykisk-helse-og-avhengighet/forsknings-og-innovasjonsavdelingen-i-pha/regionalt-kompetansesenter-for-tidlig-intervensjon-ved-psykoser/internasjonal-oppmerksomhet-om-kvinner-og-bipolar-lidelse/. Full text in Research Archive
• Millgate, Edward; Smart, Sophie E.; Pardiñas, Antonio F.; Kravariti, Eugenia; Ajnakina, Olesya & Kępińska, Adrianna P. [Show all 31 contributors for this article] (2024). Corrigendum to “Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study” (Schizophrenia Research (2023) 255 (173–181), (S0920996423001147), (10.1016/j.schres.2023.03.020)). Schizophrenia Research. ISSN 0920-9964. 270, p. 495–496. doi: 10.1016/j.schres.2024.06.029. Full text in Research Archive
• Skoge, Mari; Aminoff, Sofie Ragnhild; Barrett, Elizabeth Ann; Bryhni, Gina Engen; Gjermundsen, Kristine & Kvaerner, Kari Jorunn [Show all 12 contributors for this article] (2024). Integrating a Mobile App for Shared Decision-Making in Treatment for Psychotic Disorders. Full text in Research Archive
• Vaskinn, Anja; Simonsen, Carmen Elisabeth; Hellvin, Tone; Melle, Ingrid; Andreassen, Ole Andreas & Sundet, Kjetil Søren (2011). SEX DIFFERENCES IN NEUROCOGNITIVE PERFORMANCE ACROSS PSYCHOTIC DISORDERS. Schizophrenia Bulletin. ISSN 0586-7614. 37, p. 255–255. Full text in Research Archive
• Ringen, Petter Andreas; Melle, Ingrid; Berg, Akiah Ottesen; Simonsen, Carmen Elisabeth; Agartz, Ingrid & Sundet, Kjetil Søren [Show all 7 contributors for this article] (2011). THC IN URINE IN SCHIZOPHRENIA: ASSOCIATIONS WITH SYMPTOM LEVELS AND NEUROCOGNITIVE FUNCTIONING. Schizophrenia Bulletin. ISSN 0586-7614. 37, p. 279–280. Full text in Research Archive
• Andreassen, Ole Andreas; Simonsen, Carmen Elisabeth & Sundet, Kjetil Søren (2010). Neurocognition and psychosocial function in bipolar disorder. European Neuropsychopharmacology. ISSN 0924-977X. 20, p. S197–S197. Full text in Research Archive
• Simonsen, Carmen Elisabeth; Sundet, Kjetil Søren; Vaskinn, Anja; Birkenaes, A; Engh, JA & Faerden, A [Show all 12 contributors for this article] (2009). NEUROCOGNITIVE DYSFUNCTION IN BIPOLAR AND SCHIZOPHRENIA SPECTRUM DISORDERS: THE ROLE OF HISTORY OF PSYCHOSIS. Schizophrenia Bulletin. ISSN 0586-7614. 35, p. 297–297. Full text in Research Archive
• Faerden, A; Vaskinn, Anja; Finset, Arnstein; Agartz, Ingrid; Barrett, Elisabeth Ann & Friis, Svein [Show all 10 contributors for this article] (2009). THE NEGATIVE SUBSYMPTOM APATHY AND ITS RELATION TO EXECUTIVE FUNCTIONING IN FIRST EPISODE PSYCHOSIS. Schizophrenia Bulletin. ISSN 0586-7614. 35, p. 274–274. Full text in Research Archive
• Barrett, Elizabeth Ann; Sundet, Kjetil Søren; Simonsen, Carmen Elisabeth; Agartz, Ingrid; Lorentzen, Steinar & Mehlum, Lars [Show all 9 contributors for this article] (2009). SUICIDE ATTEMPTS AND NEUROCOGNITIVE FUNCTIONING IN SCHIZOPHRENIA SPECTRUM DISORDERS. Schizophrenia Bulletin. ISSN 0586-7614. 35, p. 279–279. Full text in Research Archive
• Sundet, Kjetil Søren; Vaskinn, Anja; Simonsen, Carmen Elisabeth; Hansen, Charlotte F; Birkenæs, Astrid Brate & Engh, John [Show all 11 contributors for this article] (2008). Timing of neurocognitive decline in schizophrenia and bipolar disorder. Schizophrenia Research. ISSN 0920-9964. 98, p. 36–36. Full text in Research Archive
• Otnæss, Mona Kolstø; Jensen, Jimmy Kristian; Gadmar, Øystein Bech; Fossem, Anne-Hilde; Coenraads, Edvard & Simonsen, Carmen Elisabeth [Show all 10 contributors for this article] (2006). Encoding-related hippocampal activity in patients with bipolar disorder: An fMRI study. Full text in Research Archive

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