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White-matter hyperintensities in first-episode psychosis

Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, University of São Paulo

Cláudio C. de Castro, MD, PhD

Department of Radiology, University of São Paulo

Paulo R. Menezes, MD, PhD

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

Márcia Scazufca, PhD

Laboratory of Psychopathology and Psychiatric Therapeutics, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil

Philip K. McGuire, MD, PhD and Robin M. Murray, MD, PhD

Department of Psychological Medicine, Institute of Psychiatry, London, UK

Geraldo F. Busatto, MD, PhD

Laboratory of Psychiatric Neuroimaging, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil

Correspondence: Marcus V. Zanetti, Centro de Medicina Nuclear, 3° andar, LIM-21, Rua Dr. Ovídio Pires de Campos, s/n, CEP 05403-010, São Paulo, Brazil. Email: marcus_zanetti{at}yahoo.com.br

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

White-matter hyperintensities have been associated with both schizophrenia and mood disorders, particularly bipolar disorder, but results are inconsistent across studies.

Aims

To examine whether white-matter hyperintensities are a vulnerability marker for psychosis or are specifically associated with bipolar disorder.

Method

T₂-weighted magnetic resonance imaging data were acquired in 129 individuals with first-episode psychosis (either affective or non-affective psychoses) and 102 controls who were randomly selected from the same geographical areas. Visual white-matter hyperintensity ratings were used for group and subgroup comparisons.

Results

There were no statistically significant between-group differences in white-matter hyperintensity frequency or severity scores. No significant correlations were found between white-matter hyperintensity scores and duration of illness, duration of untreated psychosis, or severity of psychotic, manic or depressive symptoms.

Conclusions

White-matter hyperintensities are not associated with vulnerability to psychosis in general, or specifically with affective psychoses. Further, first-episode psychosis investigations using more quantitative methods are warranted to confirm these findings.