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Published in: BMC Psychiatry 1/2007

Open Access 01-12-2007 | Research article

Inflammation-related genes up-regulated in schizophrenia brains

Authors: Peter Saetre, Lina Emilsson, Elin Axelsson, Johan Kreuger, Eva Lindholm, Elena Jazin

Published in: BMC Psychiatry | Issue 1/2007

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Abstract

Background

Multiple studies have shown that brain gene expression is disturbed in subjects suffering from schizophrenia. However, disentangling disease effects from alterations caused by medication is a challenging task. The main goal of this study is to find transcriptional alterations in schizophrenia that are independent of neuroleptic treatment.

Methods

We compared the transcriptional profiles in brain autopsy samples from 55 control individuals with that from 55 schizophrenic subjects, subdivided according to the type of antipsychotic medication received.

Results

Using global and high-resolution mRNA quantification techniques, we show that genes involved in immune response (GO:0006955) are up regulated in all groups of patients, including those not treated at the time of death. In particular, IFITM2, IFITM3, SERPINA3, and GBP1 showed increased mRNA levels in schizophrenia (p-values from qPCR ≤ 0.01). These four genes were co-expressed in both schizophrenic subjects and controls. In-vitro experiments suggest that these genes are expressed in both oligodendrocyte and endothelial cells, where transcription is inducible by the inflammatory cytokines TNF-α, IFN-α and IFN-γ.

Conclusion

Although the modified genes are not classical indicators of chronic or acute inflammation, our results indicate alterations of inflammation-related pathways in schizophrenia. In addition, the observation in oligodendrocyte cells suggests that alterations in inflammatory-related genes may have consequences for myelination. Our findings encourage future research to explore whether anti-inflammatory agents can be used in combination with traditional antipsychotics for a more efficient treatment of schizophrenia.
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Literature
1.
go back to reference McInnes LA, Lauriat TL: RNA metabolism and dysmyelination in schizophrenia. Neurosci Biobehav Rev. 2006, 30 (4): 551-561. 10.1016/j.neubiorev.2005.10.003.CrossRefPubMed McInnes LA, Lauriat TL: RNA metabolism and dysmyelination in schizophrenia. Neurosci Biobehav Rev. 2006, 30 (4): 551-561. 10.1016/j.neubiorev.2005.10.003.CrossRefPubMed
2.
go back to reference Mirnics K, Levitt P, Lewis DA: Critical Appraisal of DNA Microarrays in Psychiatric Genomics. Biol Psychiatry. 2006, 60 (2): 163-176.CrossRefPubMed Mirnics K, Levitt P, Lewis DA: Critical Appraisal of DNA Microarrays in Psychiatric Genomics. Biol Psychiatry. 2006, 60 (2): 163-176.CrossRefPubMed
3.
go back to reference Hakak Y, Walker JR, Li C, Wong WH, Davis KL, Buxbaum JD, Haroutunian V, Fienberg AA: Genome-wide expression analysis reveals dysregulation of myelination-related genes in chronic schizophrenia. Proc Natl Acad Sci U S A. 2001, 98 (8): 4746-4751. 10.1073/pnas.081071198.CrossRefPubMedPubMedCentral Hakak Y, Walker JR, Li C, Wong WH, Davis KL, Buxbaum JD, Haroutunian V, Fienberg AA: Genome-wide expression analysis reveals dysregulation of myelination-related genes in chronic schizophrenia. Proc Natl Acad Sci U S A. 2001, 98 (8): 4746-4751. 10.1073/pnas.081071198.CrossRefPubMedPubMedCentral
4.
go back to reference Tkachev D, Mimmack ML, Ryan MM, Wayland M, Freeman T, Jones PB, Starkey M, Webster MJ, Yolken RH, Bahn S: Oligodendrocyte dysfunction in schizophrenia and bipolar disorder. Lancet. 2003, 362 (9386): 798-805. 10.1016/S0140-6736(03)14289-4.CrossRefPubMed Tkachev D, Mimmack ML, Ryan MM, Wayland M, Freeman T, Jones PB, Starkey M, Webster MJ, Yolken RH, Bahn S: Oligodendrocyte dysfunction in schizophrenia and bipolar disorder. Lancet. 2003, 362 (9386): 798-805. 10.1016/S0140-6736(03)14289-4.CrossRefPubMed
5.
go back to reference Aston C, Jiang L, Sokolov BP: Microarray analysis of postmortem temporal cortex from patients with schizophrenia. J Neurosci Res. 2004, 77 (6): 858-866. 10.1002/jnr.20208.CrossRefPubMed Aston C, Jiang L, Sokolov BP: Microarray analysis of postmortem temporal cortex from patients with schizophrenia. J Neurosci Res. 2004, 77 (6): 858-866. 10.1002/jnr.20208.CrossRefPubMed
6.
go back to reference Sugai T, Kawamura M, Iritani S, Araki K, Makifuchi T, Imai C, Nakamura R, Kakita A, Takahashi H, Nawa H: Prefrontal abnormality of schizophrenia revealed by DNA microarray: impact on glial and neurotrophic gene expression. Ann N Y Acad Sci. 2004, 1025: 84-91. 10.1196/annals.1316.011.CrossRefPubMed Sugai T, Kawamura M, Iritani S, Araki K, Makifuchi T, Imai C, Nakamura R, Kakita A, Takahashi H, Nawa H: Prefrontal abnormality of schizophrenia revealed by DNA microarray: impact on glial and neurotrophic gene expression. Ann N Y Acad Sci. 2004, 1025: 84-91. 10.1196/annals.1316.011.CrossRefPubMed
7.
go back to reference Dracheva S, Davis KL, Chin B, Woo DA, Schmeidler J, Haroutunian V: Myelin-associated mRNA and protein expression deficits in the anterior cingulate cortex and hippocampus in elderly schizophrenia patients. Neurobiol Dis. 2006, 21 (3): 531-540. 10.1016/j.nbd.2005.08.012.CrossRefPubMed Dracheva S, Davis KL, Chin B, Woo DA, Schmeidler J, Haroutunian V: Myelin-associated mRNA and protein expression deficits in the anterior cingulate cortex and hippocampus in elderly schizophrenia patients. Neurobiol Dis. 2006, 21 (3): 531-540. 10.1016/j.nbd.2005.08.012.CrossRefPubMed
8.
go back to reference Aberg K, Saetre P, Jareborg N, Jazin E: Human QKI, a potential regulator of mRNA expression of human oligodendrocyte-related genes involved in schizophrenia. Proc Natl Acad Sci U S A. 2006, 103 (19): 7482-7487. 10.1073/pnas.0601213103.CrossRefPubMedPubMedCentral Aberg K, Saetre P, Jareborg N, Jazin E: Human QKI, a potential regulator of mRNA expression of human oligodendrocyte-related genes involved in schizophrenia. Proc Natl Acad Sci U S A. 2006, 103 (19): 7482-7487. 10.1073/pnas.0601213103.CrossRefPubMedPubMedCentral
9.
go back to reference Aberg K, Saetre P, Lindholm E, Ekholm B, Pettersson U, Adolfsson R, Jazin E: Human QKI, a new candidate gene for schizophrenia involved in myelination. Am J Med Genet B Neuropsychiatr Genet. 2006, 141 (1): 84-90.CrossRef Aberg K, Saetre P, Lindholm E, Ekholm B, Pettersson U, Adolfsson R, Jazin E: Human QKI, a new candidate gene for schizophrenia involved in myelination. Am J Med Genet B Neuropsychiatr Genet. 2006, 141 (1): 84-90.CrossRef
10.
11.
go back to reference Lin A, Kenis G, Bignotti S, Tura GJ, De Jong R, Bosmans E, Pioli R, Altamura C, Scharpe S, Maes M: The inflammatory response system in treatment-resistant schizophrenia: increased serum interleukin-6. Schizophr Res. 1998, 32 (1): 9-15. 10.1016/S0920-9964(98)00034-6.CrossRefPubMed Lin A, Kenis G, Bignotti S, Tura GJ, De Jong R, Bosmans E, Pioli R, Altamura C, Scharpe S, Maes M: The inflammatory response system in treatment-resistant schizophrenia: increased serum interleukin-6. Schizophr Res. 1998, 32 (1): 9-15. 10.1016/S0920-9964(98)00034-6.CrossRefPubMed
12.
go back to reference Giovannoni G, Baker D: Inflammatory disorders of the central nervous system. Curr Opin Neurol. 2003, 16 (3): 347-350. 10.1097/00019052-200306000-00015.CrossRefPubMed Giovannoni G, Baker D: Inflammatory disorders of the central nervous system. Curr Opin Neurol. 2003, 16 (3): 347-350. 10.1097/00019052-200306000-00015.CrossRefPubMed
13.
go back to reference Altamura AC, Bassetti R, Bocchio L, Santini A, Mundo E: Season of birth and inflammatory response system in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2003, 27 (5): 879-880. 10.1016/S0278-5846(03)00122-2.CrossRefPubMed Altamura AC, Bassetti R, Bocchio L, Santini A, Mundo E: Season of birth and inflammatory response system in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2003, 27 (5): 879-880. 10.1016/S0278-5846(03)00122-2.CrossRefPubMed
14.
15.
go back to reference Sundberg R, Castensson A, Jazin E: Statistical modeling in case-control real-time RT-PCR assays, for identification of differentially expressed genes in schizophrenia. Biostatistics. 2006, 7 (1): 130-144. 10.1093/biostatistics/kxi045.CrossRefPubMed Sundberg R, Castensson A, Jazin E: Statistical modeling in case-control real-time RT-PCR assays, for identification of differentially expressed genes in schizophrenia. Biostatistics. 2006, 7 (1): 130-144. 10.1093/biostatistics/kxi045.CrossRefPubMed
18.
go back to reference Beissbarth T, Speed TP: GOstat: find statistically overrepresented Gene Ontologies within a group of genes. Bioinformatics. 2004, 20 (9): 1464-1465. 10.1093/bioinformatics/bth088.CrossRefPubMed Beissbarth T, Speed TP: GOstat: find statistically overrepresented Gene Ontologies within a group of genes. Bioinformatics. 2004, 20 (9): 1464-1465. 10.1093/bioinformatics/bth088.CrossRefPubMed
19.
go back to reference Castensson A, Emilsson L, Preece P, Jazin EE: High-resolution quantification of specific mRNA levels in human brain autopsies and biopsies. Genome Res. 2000, 10 (8): 1219-1229. 10.1101/gr.10.8.1219.CrossRefPubMedPubMedCentral Castensson A, Emilsson L, Preece P, Jazin EE: High-resolution quantification of specific mRNA levels in human brain autopsies and biopsies. Genome Res. 2000, 10 (8): 1219-1229. 10.1101/gr.10.8.1219.CrossRefPubMedPubMedCentral
20.
go back to reference Venetsanakos E, Mirza A, Fanton C, Romanov SR, Tlsty T, McMahon M: Induction of tubulogenesis in telomerase-immortalized human microvascular endothelial cells by glioblastoma cells. Exp Cell Res. 2002, 273 (1): 21-33. 10.1006/excr.2001.5424.CrossRefPubMed Venetsanakos E, Mirza A, Fanton C, Romanov SR, Tlsty T, McMahon M: Induction of tubulogenesis in telomerase-immortalized human microvascular endothelial cells by glioblastoma cells. Exp Cell Res. 2002, 273 (1): 21-33. 10.1006/excr.2001.5424.CrossRefPubMed
21.
go back to reference de Arriba Zerpa GA, Saleh MC, Fernandez PM, Guillou F, Espinosa de los Monteros A, de Vellis J, Zakin MM, Baron B: Alternative splicing prevents transferrin secretion during differentiation of a human oligodendrocyte cell line. J Neurosci Res. 2000, 61 (4): 388-395. 10.1002/1097-4547(20000815)61:4<388::AID-JNR5>3.0.CO;2-Q.CrossRefPubMed de Arriba Zerpa GA, Saleh MC, Fernandez PM, Guillou F, Espinosa de los Monteros A, de Vellis J, Zakin MM, Baron B: Alternative splicing prevents transferrin secretion during differentiation of a human oligodendrocyte cell line. J Neurosci Res. 2000, 61 (4): 388-395. 10.1002/1097-4547(20000815)61:4<388::AID-JNR5>3.0.CO;2-Q.CrossRefPubMed
22.
go back to reference Feher LZ, Kalman J, Puskas LG, Gyulveszi G, Kitajka K, Penke B, Palotas M, Samarova EI, Molnar J, Zvara A, Matin K, Bodi N, Hugyecz M, Pakaski M, Bjelik A, Juhasz A, Bogats G, Janka Z, Palotas A: Impact of haloperidol and risperidone on gene expression profile in the rat cortex. Neurochem Int. 2005, 47 (4): 271-280. 10.1016/j.neuint.2005.04.020.CrossRefPubMed Feher LZ, Kalman J, Puskas LG, Gyulveszi G, Kitajka K, Penke B, Palotas M, Samarova EI, Molnar J, Zvara A, Matin K, Bodi N, Hugyecz M, Pakaski M, Bjelik A, Juhasz A, Bogats G, Janka Z, Palotas A: Impact of haloperidol and risperidone on gene expression profile in the rat cortex. Neurochem Int. 2005, 47 (4): 271-280. 10.1016/j.neuint.2005.04.020.CrossRefPubMed
23.
go back to reference Niederkorn JY: See no evil, hear no evil, do no evil: the lessons of immune privilege. Nat Immunol. 2006, 7 (4): 354-359. 10.1038/ni1328.CrossRefPubMed Niederkorn JY: See no evil, hear no evil, do no evil: the lessons of immune privilege. Nat Immunol. 2006, 7 (4): 354-359. 10.1038/ni1328.CrossRefPubMed
24.
go back to reference Rothermundt M, Arolt V, Bayer TA: Review of immunological and immunopathological findings in schizophrenia. Brain Behav Immun. 2001, 15 (4): 319-339. 10.1006/brbi.2001.0648.CrossRefPubMed Rothermundt M, Arolt V, Bayer TA: Review of immunological and immunopathological findings in schizophrenia. Brain Behav Immun. 2001, 15 (4): 319-339. 10.1006/brbi.2001.0648.CrossRefPubMed
25.
go back to reference Sham PC, O'Callaghan E, Takei N, Murray GK, Hare EH, Murray RM: Schizophrenia following pre-natal exposure to influenza epidemics between 1939 and 1960. Br J Psychiatry. 1992, 160: 461-466.CrossRefPubMed Sham PC, O'Callaghan E, Takei N, Murray GK, Hare EH, Murray RM: Schizophrenia following pre-natal exposure to influenza epidemics between 1939 and 1960. Br J Psychiatry. 1992, 160: 461-466.CrossRefPubMed
26.
go back to reference Patterson PH: Maternal infection: window on neuroimmune interactions in fetal brain development and mental illness. Curr Opin Neurobiol. 2002, 12 (1): 115-118. 10.1016/S0959-4388(02)00299-4.CrossRefPubMed Patterson PH: Maternal infection: window on neuroimmune interactions in fetal brain development and mental illness. Curr Opin Neurobiol. 2002, 12 (1): 115-118. 10.1016/S0959-4388(02)00299-4.CrossRefPubMed
27.
go back to reference Tohmi M, Tsuda N, Watanabe Y, Kakita A, Nawa H: Perinatal inflammatory cytokine challenge results in distinct neurobehavioral alterations in rats: implication in psychiatric disorders of developmental origin. Neurosci Res. 2004, 50 (1): 67-75. 10.1016/j.neures.2004.05.010.CrossRefPubMed Tohmi M, Tsuda N, Watanabe Y, Kakita A, Nawa H: Perinatal inflammatory cytokine challenge results in distinct neurobehavioral alterations in rats: implication in psychiatric disorders of developmental origin. Neurosci Res. 2004, 50 (1): 67-75. 10.1016/j.neures.2004.05.010.CrossRefPubMed
28.
go back to reference Meyer U, Schwendener S, Feldon J, Yee BK: Prenatal and postnatal maternal contributions in the infection model of schizophrenia. Exp Brain Res. 2006, 173 (2): 243-257. 10.1007/s00221-006-0419-5.CrossRefPubMed Meyer U, Schwendener S, Feldon J, Yee BK: Prenatal and postnatal maternal contributions in the infection model of schizophrenia. Exp Brain Res. 2006, 173 (2): 243-257. 10.1007/s00221-006-0419-5.CrossRefPubMed
29.
go back to reference Battle YL, Martin BC, Dorfman JH, Miller LS: Seasonality and infectious disease in schizophrenia: the birth hypothesis revisited. J Psychiatr Res. 1999, 33 (6): 501-509. 10.1016/S0022-3956(99)00022-9.CrossRefPubMed Battle YL, Martin BC, Dorfman JH, Miller LS: Seasonality and infectious disease in schizophrenia: the birth hypothesis revisited. J Psychiatr Res. 1999, 33 (6): 501-509. 10.1016/S0022-3956(99)00022-9.CrossRefPubMed
30.
go back to reference Vestal DJ: The guanylate-binding proteins (GBPs): proinflammatory cytokine-induced members of the dynamin superfamily with unique GTPase activity. J Interferon Cytokine Res. 2005, 25 (8): 435-443. 10.1089/jir.2005.25.435.CrossRefPubMed Vestal DJ: The guanylate-binding proteins (GBPs): proinflammatory cytokine-induced members of the dynamin superfamily with unique GTPase activity. J Interferon Cytokine Res. 2005, 25 (8): 435-443. 10.1089/jir.2005.25.435.CrossRefPubMed
31.
go back to reference Naschberger E, Bauer M, Sturzl M: Human guanylate binding protein-1 (hGBP-1) characterizes and establishes a non-angiogenic endothelial cell activation phenotype in inflammatory diseases. Adv Enzyme Regul. 2005, 45: 215-227. 10.1016/j.advenzreg.2005.02.011.CrossRefPubMed Naschberger E, Bauer M, Sturzl M: Human guanylate binding protein-1 (hGBP-1) characterizes and establishes a non-angiogenic endothelial cell activation phenotype in inflammatory diseases. Adv Enzyme Regul. 2005, 45: 215-227. 10.1016/j.advenzreg.2005.02.011.CrossRefPubMed
32.
go back to reference Horvath AJ, Irving JA, Rossjohn J, Law RH, Bottomley SP, Quinsey NS, Pike RN, Coughlin PB, Whisstock JC: The murine orthologue of human antichymotrypsin: a structural paradigm for clade A3 serpins. J Biol Chem. 2005, 280 (52): 43168-43178. 10.1074/jbc.M505598200.CrossRefPubMed Horvath AJ, Irving JA, Rossjohn J, Law RH, Bottomley SP, Quinsey NS, Pike RN, Coughlin PB, Whisstock JC: The murine orthologue of human antichymotrypsin: a structural paradigm for clade A3 serpins. J Biol Chem. 2005, 280 (52): 43168-43178. 10.1074/jbc.M505598200.CrossRefPubMed
33.
go back to reference Berninger RW: Protease inhibitors of human plasma. Alpha 1-antitrypsin. J Med. 1985, 16 (1-3): 23-99.PubMed Berninger RW: Protease inhibitors of human plasma. Alpha 1-antitrypsin. J Med. 1985, 16 (1-3): 23-99.PubMed
34.
go back to reference Tanaka SS, Yamaguchi YL, Tsoi B, Lickert H, Tam PP: IFITM/Mil/fragilis family proteins IFITM1 and IFITM3 play distinct roles in mouse primordial germ cell homing and repulsion. Dev Cell. 2005, 9 (6): 745-756. 10.1016/j.devcel.2005.10.010.CrossRefPubMed Tanaka SS, Yamaguchi YL, Tsoi B, Lickert H, Tam PP: IFITM/Mil/fragilis family proteins IFITM1 and IFITM3 play distinct roles in mouse primordial germ cell homing and repulsion. Dev Cell. 2005, 9 (6): 745-756. 10.1016/j.devcel.2005.10.010.CrossRefPubMed
35.
go back to reference Lubeseder-Martellato C, Guenzi E, Jorg A, Topolt K, Naschberger E, Kremmer E, Zietz C, Tschachler E, Hutzler P, Schwemmle M, Matzen K, Grimm T, Ensoli B, Sturzl M: Guanylate-binding protein-1 expression is selectively induced by inflammatory cytokines and is an activation marker of endothelial cells during inflammatory diseases. Am J Pathol. 2002, 161 (5): 1749-1759.CrossRefPubMedPubMedCentral Lubeseder-Martellato C, Guenzi E, Jorg A, Topolt K, Naschberger E, Kremmer E, Zietz C, Tschachler E, Hutzler P, Schwemmle M, Matzen K, Grimm T, Ensoli B, Sturzl M: Guanylate-binding protein-1 expression is selectively induced by inflammatory cytokines and is an activation marker of endothelial cells during inflammatory diseases. Am J Pathol. 2002, 161 (5): 1749-1759.CrossRefPubMedPubMedCentral
36.
go back to reference Setzu A, Lathia JD, Zhao C, Wells K, Rao MS, Ffrench-Constant C, Franklin RJ: Inflammation stimulates myelination by transplanted oligodendrocyte precursor cells. Glia. 2006, 54 (4): 297-303. 10.1002/glia.20371.CrossRefPubMed Setzu A, Lathia JD, Zhao C, Wells K, Rao MS, Ffrench-Constant C, Franklin RJ: Inflammation stimulates myelination by transplanted oligodendrocyte precursor cells. Glia. 2006, 54 (4): 297-303. 10.1002/glia.20371.CrossRefPubMed
37.
go back to reference Rhodes KE, Raivich G, Fawcett JW: The injury response of oligodendrocyte precursor cells is induced by platelets, macrophages and inflammation-associated cytokines. Neuroscience. 2006, 140 (1): 87-100. 10.1016/j.neuroscience.2006.01.055.CrossRefPubMed Rhodes KE, Raivich G, Fawcett JW: The injury response of oligodendrocyte precursor cells is induced by platelets, macrophages and inflammation-associated cytokines. Neuroscience. 2006, 140 (1): 87-100. 10.1016/j.neuroscience.2006.01.055.CrossRefPubMed
38.
go back to reference Cabrera Gomez JA, Cordero Gutierrez JR, Fernandez Lopez O, Reyes Gutierrez B, Romero Garcia K, Simon Consuegra J, Feas Cruz R, Gonzalez Quevedo A, Alfaro Capdegille I, Del Pino Falcon M, et al: Treatment of schizophrenic disorder, paranoid type, with intramuscular recombinant alpha-2b interferon. Biotherapy. 1993, 7 (1): 27-37. 10.1007/BF01878151.CrossRefPubMed Cabrera Gomez JA, Cordero Gutierrez JR, Fernandez Lopez O, Reyes Gutierrez B, Romero Garcia K, Simon Consuegra J, Feas Cruz R, Gonzalez Quevedo A, Alfaro Capdegille I, Del Pino Falcon M, et al: Treatment of schizophrenic disorder, paranoid type, with intramuscular recombinant alpha-2b interferon. Biotherapy. 1993, 7 (1): 27-37. 10.1007/BF01878151.CrossRefPubMed
39.
go back to reference Browning CH: Nonsteroidal anti-inflammatory drugs and severe psychiatric side effects. Int J Psychiatry Med. 1996, 26 (1): 25-34. 10.2190/1B32-79EA-B6H5-395V.CrossRefPubMed Browning CH: Nonsteroidal anti-inflammatory drugs and severe psychiatric side effects. Int J Psychiatry Med. 1996, 26 (1): 25-34. 10.2190/1B32-79EA-B6H5-395V.CrossRefPubMed
40.
go back to reference Skurkovich SV, Aleksandrovsky YA, Chekhonin VP, Ryabukhin IA, Chakhava KO, Skurkovich B: Improvement in negative symptoms of schizophrenia with antibodies to tumor necrosis factor-alpha and to interferon-gamma: a case report. J Clin Psychiatry. 2003, 64 (6): 734-735.CrossRefPubMed Skurkovich SV, Aleksandrovsky YA, Chekhonin VP, Ryabukhin IA, Chakhava KO, Skurkovich B: Improvement in negative symptoms of schizophrenia with antibodies to tumor necrosis factor-alpha and to interferon-gamma: a case report. J Clin Psychiatry. 2003, 64 (6): 734-735.CrossRefPubMed
Metadata
Title
Inflammation-related genes up-regulated in schizophrenia brains
Authors
Peter Saetre
Lina Emilsson
Elin Axelsson
Johan Kreuger
Eva Lindholm
Elena Jazin
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2007
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-7-46

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