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Grey matter abnormalities in Brazilians with first-episode psychosis^*

Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

JULIA M. LAPPIN, MRCPsych

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

MARCIA SCAZUFCA, PhD

Department of Psychiatry, Faculty of Medicine and Section of Epidemiology, University Hospital, University of São Paulo, São Paulo, Brazil

EDSON AMARO, Jr, MD, PhD and CLAUDIA C. LEITE, MD, PhD

Department of Radiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil

CLAUDIO C. DE CASTRO, MD, PhD,, ROBIN M. MURRAY, FRCPsych and PHILIP K. McGUIRE, MD, PhD, MRCPsych

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

PAULO R. MENEZES, MD, PhD

Department of Preventive Medicine, Faculty of Medicine and Section of Epidemiology, University Hospital, University of São Paulo, Sã Paulo, Brazil

GERALDO F. BUSATTO, MD, PhD

Department of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil

Correspondence: Dr Geraldo F. Busatto, Departamento de Psiquiatria, Faculdade de Medicina – Universidade de São Paulo, Rua Ovídio Pires Campos, s/n – CEP 05403-903, São Paulo – SP Brazil. Email: geraldo.busatto{at}hcnet.usp.br

Declaration of interest None. Funding detailed in Acknowledgements.

^* Preliminary analyses of these data were presented in abstract form at the XII and XIII Biennial Winter Work-shops on Schizophrenia Research, 2004 and 2006.

Background In low- and middle-income countries people with schizophrenia are reported to experience better outcomes than those in high-income countries.

Aims To examine structural brain differences in people with first-episode psychosis and controls in Brazil.

Method Magnetic resonance imaging using voxel-based morphometry was performed on 122 people with first-episode psychosis and 94 controls.

Results There were significant decreases in grey matter in the left superior temporal and inferior prefrontal cortices, insula bilaterally and the right hippocampal region in first-episode psychosis (P<0.05, corrected for multiple comparisons). The subgroup of people with schizophrenia (n=62) exhibited a similar pattern of decrease in grey matter relative to controls.

Conclusions Structural abnormalities reported in psychosis in high-income countries are also present in first-episode psychosis in Brazil.