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Grey matter abnormalities in first-episode schizophrenia and affective psychosis

Department of Psychology, University of Westminster, London, UK

PAOLA DAZZAN, MD, PhD

MRCPsych, Institute of Psychiatry, Division of Psychological Medicine, King’s College London, London, UK

KENNETH G. ORR, MD

Sir Charles Gairdner Hospital, Department of Psychiatry, Perth, Australia

GERARD HUTCHINSON, MD, MRCPsych

University of West Indies, Department of Psychiatry, Trinidad and Tobago

XAVIER CHITNIS, MSc

Institute of Psychiatry, Department of Neurology, King’s College London, London, UK

JOHN SUCKLING, PhD

University of Cambridge, Department of Psychiatry, Addenbrooke’s Hospital, Cambridge, UK

DAVID LYTHGOE, PhD

Institute of Psychiatry, Department of Neurology, King’s College London

SARAH-JAYNE POLLOCK, BSc, SUSAN ROSSELL, PhD and JANE SHAPLESKE, MRCPsych

Fulbourn Hospital, Cambridge, UK

PAUL FEARON, MSc, PhD, MRCPsych, CRAIG MORGAN, MSc, PhD, ANTHONY DAVID, MD, FRCPsych and PHILIP K. McGUIRE, MD, MRCPsych, PhD

Institute of Psychiatry, Division of Psychological Medicine, King’s College London

PETER B. JONES, MD, MRCPsych, PhD

University of Cambridge, Department of Psychiatry, Addenbrooke’s Hospital, Cambridge

JULIAN LEFF, MD, FRCPsych and ROBIN M. MURRAY, MD, FRCPsych, PhD

Institute of Psychiatry, Division of Psychological Medicine, King’s College London

Correspondence: Kevin Morgan, Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK. Email: k.d.morgan{at}wmin.ac.uk

Declaration of interests None. Funding is detailed in Acknowledgements.

Background Grey matter and other structural brain abnormalities are consistently reported in first-onset schizophrenia, but less is known about the extent of neuroanatomical changes in first-onset affective psychosis.

Aims To determine which brain abnormalities are specific to (a) schizophrenia and (b) affective psychosis.

Method We obtained dual-echo (proton density/T2-weighted) magnetic resonance images and carried out voxel-based analysis on the images of 73 patients with first-episode psychosis (schizophrenia n=44, affective psychosis n=29) and 58 healthy controls.

Results Both patients with schizophrenia and patients with affective psychosis had enlarged lateral and third ventricle volumes. Regional cortical grey matter reductions (including bilateral anterior cingulate gyrus, left insula and left fusiform gyrus) were evident in affective psychosis but not in schizophrenia, although patients with schizophrenia displayed decreased hippocampal grey matter and increased striatal grey matter at a more liberal statistical threshold.

Conclusions Both schizophrenia and affective psychosis are associated with volumetric abnormalities at the onset of frank psychosis, with some of these evident in common brain areas.