Birgit Bennedsen

A range of complications of pregnancy, abnormal fetal growth and development, and complications of delivery have been associated with increased risk of schizophrenia. Few studies have been able to adjust for a broad range of potential confounding factors. A national population nested case-control study based on Danish longitudinal registers was conducted to investigate the risk of schizophrenia associated with exposure to a range of obstetric events. The sample included 1039 first admissions to, or contacts with Danish psychiatric services with an ICD-8 or ICD-10 diagnosis of schizophrenia and 24, 826 individually matched controls. Adjusting for the other obstetric factors, family psychiatric history, and socio-economic and demographic factors, risk of schizophrenia was associated with maternal non-attendance at antenatal appointments (Incidence Rate Ratio (IRR) 2.08, 95% CI: 1.0, 4.4), gestational age of 37 weeks or below (IRR 1.51, 95% CI: 1.0, 2.2), maternal influenza (IRR 8.2, 9...

Patients with obsessive-compulsive disorder (OCD) have impaired memory and executive functions, but it is unclear whether these functions improve after cognitive behavioural therapy (CBT) of OCD symptoms. The primary aim of this study was to investigate whether memory and executive functions change after CBT in patients with OCD. We assessed 39 patients with OCD before and after CBT with neuropsychological tests of memory and executive functions. To correct for practice effects, 39 healthy controls (HCs) were assessed at two parallel time intervals with the neuropsychological tests. There were no changes in memory and executive functions after CBT in patients with OCD when results were corrected for practice effects. Patients performed worse on a test of visuospatial memory and organisational skills (Rey complex figure test [RCFT]) compared to HCs both before and after CBT (ps = .002-.036). The finding of persistent poor RCFT performances indicates that patients with OCD have impaired visuospatial memory and organisational skills that may be trait-related rather than state-dependent. These impairments may need to be considered in treatment. Our findings underline the importance of correcting for practice effects when investigating changes in cognitive functions.

Most studies find that patients with obsessive-compulsive disorder (OCD) have impaired memory and executive functions. Cognitive behavioural therapy (CBT) is the recommended psychotherapeutic treatment of patients with OCD. We hypothesized that impairments in memory and executive functions would predict poor outcome of CBT. To investigate whether memory and executive functions in patients with OCD could predict outcome of CBT. We assessed 39 patients with OCD before CBT with neuropsychological tests of memory and executive functions, the Hamilton Depression Rating Scale, and the Global Assessment of Functioning Scale. Furthermore, we assessed severity of OCD symptoms before and after CBT using the Yale-Brown Obsessive Compulsive Scale. There were no statistically significant differences between recovered (41%) and non-recovered patients (59%) on any neuropsychological test variables or on any baseline demographic variables. Furthermore, change in OCD symptoms was not predicted by ne...

Patients with obsessive-compulsive disorder (OCD) have impaired memory and executive functions, but it is unclear whether these functions improve after cognitive behavioural therapy (CBT) of OCD symptoms. The primary aim of this study was to investigate whether memory and executive functions change after CBT in patients with OCD. We assessed 39 patients with OCD before and after CBT with neuropsychological tests of memory and executive functions. To correct for practice effects, 39 healthy controls (HCs) were assessed at two parallel time intervals with the neuropsychological tests. There were no changes in memory and executive functions after CBT in patients with OCD when results were corrected for practice effects. Patients performed worse on a test of visuospatial memory and organisational skills (Rey complex figure test [RCFT]) compared to HCs both before and after CBT (ps = .002-.036). The finding of persistent poor RCFT performances indicates that patients with OCD have impaired visuospatial memory and organisational skills that may be trait-related rather than state-dependent. These impairments may need to be considered in treatment. Our findings underline the importance of correcting for practice effects when investigating changes in cognitive functions.

Neuropsychological and neuroimaging studies have documented that patients with obsessive-compulsive disorder (OCD) have cognitive difficulties dependent upon fronto-striatal circuits in the brain. It is, however, unclear whether the cognitive difficulties change after treatment. Answering this question could help establish whether cognitive difficulties in OCD are state dependent or more trait-like. To determine whether cognitive functions in OCD change after treatment, based on a systematic literature review, supplemented by a double case report of monozygotic twins with OCD. For the literature review, systematic searches were conducted in PubMed, Embase and PsycINFO from the earliest dates available to September 2010. For the double case report, monozygotic twins underwent blood samples and magnetic resonance imaging before treatment with cognitive behavioral therapy (CBT), antidepressants and small doses of antipsychotic medication. Before and after CBT they were assessed with measures of content and severity of OCD symptoms, and with a comprehensive battery of neuropsychological tests to assess cognitive functions. Results from the studies under review (n = 14) were so inconsistent that it could not be concluded whether cognitive functions in OCD change after treatment. The twins improved some of their cognitive functions after treatment. A better understanding of whether cognitive dysfunctions in OCD are state dependent or trait-like could bring important implications in understanding the pathology and future treatment of OCD.

We investigated whether patients with obsessive-compulsive disorder have poorer memory and executive functions than healthy controls. The relatively inconsistent previous findings on this question reflect a lack of well-matched control groups, the inclusion of patients with comorbidity, and the use of noncomparable neuropsychological tests to assess memory and executive functions. We used well-accepted neuropsychological tests of memory and executive functions to assess 42 patients who had obsessive-compulsive disorder without comorbidity, and 42 healthy controls. We matched the patients and controls pairwise by sex, age, and years of education. The patients performed significantly worse than the controls on the Rey Complex Figure Test, which assesses visuospatial memory and organizational skills. This group difference remained after we controlled for age, education, intelligence, and severity of depressive symptoms. The findings indicate that patients with obsessive-compulsive disorder may have impaired visuospatial memory and organizational skills, and these impairments should be considered in treatment. ClinicalTrials.gov NCT00792038.

There is conflicting evidence about the frequency of adverse pregnancy outcomes among women with schizophrenia. To investigate the risk of preterm birth, low birth weight and intra-uterine growth retardation among women with schizophrenia. A total of 2212 births to 1537 women with schizophrenia in Denmark were compared with a random sample of all deliveries in Denmark in 1973-1993 (122,931 births to 72,742 women). The children of women with schizophrenia were at increased risk of preterm delivery (relative risk = 1.46, 95% CI = 1.19-1.79), low birth weight (relative risk = 1.57, 95% CI = 1.36-1.82) and small for gestational age (relative risk = 1.34, 95% CI = 1.17-1.53). Women with schizophrenia are at increased risk of adverse pregnancy outcome. This may be associated with an increased mortality and general morbidity and risk of schizophrenia in their children.

... Werner and col leagues(1971)found that 44%of births in their Island of Kauai prospective cohort study incurred an obstetric complication―. Is it reasonable to suppose that midwives may systematically under report in some cases and over report in other cases? ...

Women with schizophrenia have increased exposure to risk factors for congenital malformations, stillbirths, and infant deaths among their children. However, the occurrence of these outcomes is unknown. The risks of stillbirth and infant death among 2230 children of women with schizophrenia were compared with the risks among 123 544 children in the general population. The risk of congenital malformations among 746 children of women with schizophrenia were compared with the risk among 56 106 children in the general population. The year of birth, the sex of the child, the mother's age, and parity were included in the analyses as potential confounders. We had no information about socioeconomic status, smoking status, substance abuse, or psychotropic medication use. Children of women with schizophrenia had increased risk of postneonatal death (relative risk [RR], 2.76; 95% confidence interval [CI], 1.67-4.56). This was largely explained by an increased risk of sudden infant death syndrome (RR, 5.23; 95% CI, 2.82-9.69). There was no statistically significant increased risk of stillbirth (RR, 1.51; 95% CI, 0.94-2.40) or neonatal death (RR, 1.26; CI, 0.77-2.06). Children of women with schizophrenia had a marginally statistically significant increase in the risk of congenital malformations (RR, 1.70; 95% CI, 1.04-2.77). Children of women with schizophrenia have a considerable increased risk of death caused by sudden infant death syndrome. However, the results should be interpreted in the light of failure to adjust for socioeconomic status, substance abuse, smoking status, and psychotropic medication use.