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Tsui HKH, Luk SL, Hsiao J, Chan SKW. Facial emotion perception in individuals with clinical high risk for psychosis compared with healthy controls, first-episode psychosis, and in predicting psychosis transition: A systematic review and meta-analysis. Psychiatry Res 2024; 340:116143. [PMID: 39167864 DOI: 10.1016/j.psychres.2024.116143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 08/10/2024] [Accepted: 08/11/2024] [Indexed: 08/23/2024]
Abstract
Facial emotion perception deficits, a possible indicator of illness progression and transdiagnostic phenotype, were examined in high-risk psychosis (CHR) patients through a systematic review and meta-analysis of 35 studies (2567 CHR individuals, 1103 non-transitioned [CHR-NT], 212 transitioned [CHR-T], 512 first-episode psychosis [FEP], and 1936 healthy controls [HC]). CHR showed overall (g = -0.369 [95 % CI, -0.485 to -0.253]) and specific impairments in detecting anger, disgust, fear, happiness, neutrality, and sadness compared to HC, except for surprise. FEP revealed a general deficit than CHR (g = -0.378 [95 % CI, -0.509 to -0.247]), and CHR-T displayed more pronounced baseline impairments than CHR-NT (g = -0.217 [95 % CI, -0.365 to -0.068]). FEP only exhibited a poorer ability to perceive fear, but not other individual emotions, compared to CHR. Similar performances in perceiving individual emotions were observed regardless of transition status (CHR-NT and CHR-T). However, literature comparing the perception of individual emotions among FEP, CHR-T, and CHR is limited. This study primarily characterized the general and overall impairments of facial emotion perception in CHR which could predict transition risk, emphasizing the need for future research on multimodal parameters of emotion perception and associations with other psychiatric outcomes.
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Affiliation(s)
- Harry Kam Hung Tsui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Siu Lee Luk
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Janet Hsiao
- Division of Social Science, Hong Kong University of Science & Technology, Hong Kong SAR, China
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR.
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Hamdan M, Lecardeur L, Habert M, Okassa M, Lacroix A, Calvet B. Staging's determinants in early intervention youth: a retrospective study. L'ENCEPHALE 2024; 50:490-496. [PMID: 37985255 DOI: 10.1016/j.encep.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/10/2023] [Accepted: 08/24/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES Since 2019 our early intervention unit has assessed help-seekers, mainly referred by psychiatric departments, and we have conducted a descriptive retrospective study. Our objective was to identify clinical determinants associated to staging at assessment for our three groups: "no psychosis", "ultra-high risk" and "first episode psychosis". METHODS One hundred and thirteen participants (mean age 20.05±3.28) were enrolled, mainly referred by adult psychiatry (81.4%). We tested the association of each group with the following determinants: age, gender, family history of psychosis, referral (adolescent or adult psychiatry), cognitive, depressive complaint, cannabis active consumption, and current activity (scholar or employment). RESULTS Multivariate analyses showed significant association with depressive symptoms (P=0.019) but an absence of family history of psychosis (P=0.002) or current activity (P=0.09) for "no psychosis" group. "Ultra-high risk" was significantly correlated with a family history of psychosis (P=0.001) and adolescent psychiatry referral (P=0.044) but an absence of depressive complaint (P=0.04). As for "first episode psychosis", we found significant cognitive complaint (P=0.026), family history (P=0.024) and current activity (0.026). CONCLUSIONS As all our participants were seen in tertiary care, adolescent psychiatrists were more efficient in detecting a high-risk state. "No psychosis" help-seekers presented in fact mood issues, which have been confused with attenuated psychotic symptoms by their addressers, who have probably been misled by their absence of activity integration. High-risk and characterized psychotic episodes were logically correlated with family history. Surprisingly, "first episode psychosis" youth were currently integrated in scholarly or professional life despite an active cognitive complaint. Robust studies, especially prospective cohorts, are needed to test these associations.
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Affiliation(s)
- Mirvat Hamdan
- Department of Adult Psychiatry, Early Intervention Unit, Centre Hospitalier Esquirol, 87000 Limoges, France; Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, France; Inserm UMR1094, IRD U270, University Limoges, CHU de Limoges, EpiMaCT- Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France.
| | | | - Marine Habert
- Department of Adult Psychiatry, Early Intervention Unit, Centre Hospitalier Esquirol, 87000 Limoges, France
| | - Mireille Okassa
- Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, France
| | - Aurélie Lacroix
- Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, France; Inserm UMR1094, IRD U270, University Limoges, CHU de Limoges, EpiMaCT- Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Benjamin Calvet
- Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, France; Inserm UMR1094, IRD U270, University Limoges, CHU de Limoges, EpiMaCT- Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
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Krakowski K, Oliver D, Arribas M, Stahl D, Fusar-Poli P. Dynamic and Transdiagnostic Risk Calculator Based on Natural Language Processing for the Prediction of Psychosis in Secondary Mental Health Care: Development and Internal-External Validation Cohort Study. Biol Psychiatry 2024; 96:604-614. [PMID: 38852896 DOI: 10.1016/j.biopsych.2024.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/05/2024] [Accepted: 05/10/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Automatic transdiagnostic risk calculators can improve the detection of individuals at risk of psychosis. However, they rely on assessment at a single point in time and can be refined with dynamic modeling techniques that account for changes in risk over time. METHODS We included 158,139 patients (5007 events) who received a first index diagnosis of a nonorganic and nonpsychotic mental disorder within electronic health records from the South London and Maudsley National Health Service Foundation Trust between January 1, 2008, and October 8, 2021. A dynamic Cox landmark model was developed to estimate the 2-year risk of developing psychosis according to the TRIPOD (Transparent Reporting of a multivariate prediction model for Individual Prognosis or Diagnosis) statement. The dynamic model included 24 predictors extracted at 9 landmark points (baseline, 0, 6, 12, 24, 30, 36, 42, and 48 months): 3 demographic, 1 clinical, and 20 natural language processing-based symptom and substance use predictors. Performance was compared with a static Cox regression model with all predictors assessed at baseline only and indexed via discrimination (C-index), calibration (calibration plots), and potential clinical utility (decision curves) in internal-external validation. RESULTS The dynamic model improved discrimination performance from baseline compared with the static model (dynamic: C-index = 0.9; static: C-index = 0.87) and the final landmark point (dynamic: C-index = 0.79; static: C-index = 0.76). The dynamic model was also significantly better calibrated (calibration slope = 0.97-1.1) than the static model at later landmark points (≥24 months). Net benefit was higher for the dynamic than for the static model at later landmark points (≥24 months). CONCLUSIONS These findings suggest that dynamic prediction models can improve the detection of individuals at risk for psychosis in secondary mental health care settings.
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Affiliation(s)
- Kamil Krakowski
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy; Early Psychosis: Interventions and Clinical-Detection Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-Detection Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Psychiatry, University of Oxford, Oxford, United Kingdom; National Institute for Health and Care Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom; OPEN Early Detection Service, Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom
| | - Maite Arribas
- Early Psychosis: Interventions and Clinical-Detection Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Daniel Stahl
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Paolo Fusar-Poli
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy; Early Psychosis: Interventions and Clinical-Detection Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; OASIS Service, South London and the Maudsley National Health Service Foundation Trust, London, United Kingdom; Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Munich, Germany.
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Koutsouleris N, Fusar-Poli P. From Heterogeneity to Precision: Redefining Diagnosis, Prognosis, and Treatment of Mental Disorders. Biol Psychiatry 2024; 96:508-510. [PMID: 39232589 DOI: 10.1016/j.biopsych.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 07/17/2024] [Indexed: 09/06/2024]
Affiliation(s)
- Nikolaos Koutsouleris
- Section for Precision Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Centre, Ludwig-Maximilians-University, Munich, Germany; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Max Planck Institute of Psychiatry, Munich, Germany.
| | - Paolo Fusar-Poli
- Section for Precision Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Centre, Ludwig-Maximilians-University, Munich, Germany; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Department of Brain and Behavioural Sciences, University of Pavia, Italy
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Peláez T, López-Carrilero R, Espinosa V, Balsells S, Ochoa S, Osma J. Efficacy of the unified protocol for transdiagnostic treatment of comorbid emotional disorders in patients with ultra high risk for psychosis: Results of a randomized controlled trial. J Affect Disord 2024:S0165-0327(24)01529-5. [PMID: 39260577 DOI: 10.1016/j.jad.2024.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 09/04/2024] [Accepted: 09/08/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND The most common reason for help-seeking in ultra-high risk (UHR) for psychosis patients is comorbid symptoms, mainly anxiety and depression. However, psychological interventions are mainly focused on subthreshold psychotic symptoms. There is a growing push to include transdiagnostic therapies in specialized intervention teams for psychosis in young people. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated efficacy in emotional disorders, and its application has recently expanded to other pathologies such as borderline personality disorder (BPD) and bipolar disorder (BD). METHODS This pilot study was conducted with 36 patients with UHR for psychosis and symptoms of comorbid emotional disorders who were receiving treatment in an early intervention programme for psychosis. This is a randomised control trial (RCT) with two conditions: treatment as usual (TAU) with the group and online application of the UP (UP+TAU) (n = 18) and TAU (n = 18). Evaluations were conducted at baseline, after treatment, and at the three-month follow-up. RESULTS Comorbid anxiety and depression symptoms improved significantly in patients in the UP+TAU group compared to those in the TAU. Significant improvements in negative affect, emotional dysregulation, neuroticism, extraversion, functioning, and quality of life were also observed, and satisfaction with the intervention was high. CONCLUSIONS UP may be an acceptable and effective intervention for the treatment of symptoms of comorbid emotional disorders in patients with UHR for psychosis. LIMITATIONS The sample size was small, and further studies are needed to test this intervention with larger samples of patients with UHR for psychosis with emotional comorbidities.
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Affiliation(s)
- Trinidad Peláez
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain; Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain
| | - Raquel López-Carrilero
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
| | - Victoria Espinosa
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Barcelona, Spain; Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain; Fundació de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Sol Balsells
- Fundació de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Barcelona, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain
| | - Jorge Osma
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain..
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Brickwedde M, Anders P, Kühn AA, Lofredi R, Holtkamp M, Kaindl AM, Grent-'t-Jong T, Krüger P, Sander T, Uhlhaas PJ. Applications of OPM-MEG for translational neuroscience: a perspective. Transl Psychiatry 2024; 14:341. [PMID: 39181883 PMCID: PMC11344782 DOI: 10.1038/s41398-024-03047-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 06/25/2024] [Accepted: 08/01/2024] [Indexed: 08/27/2024] Open
Abstract
Magnetoencephalography (MEG) allows the non-invasive measurement of brain activity at millisecond precision combined with localization of the underlying generators. So far, MEG-systems consisted of superconducting quantum interference devices (SQUIDS), which suffer from several limitations. Recent technological advances, however, have enabled the development of novel MEG-systems based on optically pumped magnetometers (OPMs), offering several advantages over conventional SQUID-MEG systems. Considering potential improvements in the measurement of neuronal signals as well as reduced operating costs, the application of OPM-MEG systems for clinical neuroscience and diagnostic settings is highly promising. Here we provide an overview of the current state-of-the art of OPM-MEG and its unique potential for translational neuroscience. First, we discuss the technological features of OPMs and benchmark OPM-MEG against SQUID-MEG and electroencephalography (EEG), followed by a summary of pioneering studies of OPMs in healthy populations. Key applications of OPM-MEG for the investigation of psychiatric and neurological conditions are then reviewed. Specifically, we suggest novel applications of OPM-MEG for the identification of biomarkers and circuit deficits in schizophrenia, dementias, movement disorders, epilepsy, and neurodevelopmental syndromes (autism spectrum disorder and attention deficit hyperactivity disorder). Finally, we give an outlook of OPM-MEG for translational neuroscience with a focus on remaining methodological and technical challenges.
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Affiliation(s)
- Marion Brickwedde
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Department of Child and Adolescent Psychiatry, 13353, Berlin, Germany.
- Physikalisch-Technische Bundesanstalt, Berlin, Germany.
| | - Paul Anders
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
| | - Andrea A Kühn
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Sektion für Bewegungsstörungen und Neuromodulation, Klinik für Neurologie und Experimentelle Neurologie, 10117, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Humboldt-Universität, Berlin, Germany
- NeuroCure, Exzellenzcluster, Charité-Universitätsmedizin Berlin, Berlin, Germany
- DZNE, German center for neurodegenerative diseases, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Roxanne Lofredi
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Sektion für Bewegungsstörungen und Neuromodulation, Klinik für Neurologie und Experimentelle Neurologie, 10117, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Martin Holtkamp
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Department of Neurology, Epilepsy-Center Berlin-Brandenburg, 10117, Berlin, Germany
| | - Angela M Kaindl
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Department of Pediatric Neurology, 13353, Berlin, Germany
- Charité- Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Center for Chronically Sick Children, 13353, Berlin, Germany
- Charité- Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Institute of Cell Biology and Neurobiology, 10117, Berlin, Germany
| | - Tineke Grent-'t-Jong
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Department of Child and Adolescent Psychiatry, 13353, Berlin, Germany
- Institute for Neuroscience and Psychology, Glasgow University, Scotland, United Kingdom
| | - Peter Krüger
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
| | | | - Peter J Uhlhaas
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Department of Child and Adolescent Psychiatry, 13353, Berlin, Germany
- Institute for Neuroscience and Psychology, Glasgow University, Scotland, United Kingdom
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Schleifer CH, Chang SE, Amir CM, O'Hora KP, Fung H, Kang JWD, Kushan-Wells L, Daly E, Di Fabio F, Frascarelli M, Gudbrandsen M, Kates WR, Murphy D, Addington J, Anticevic A, Cadenhead KS, Cannon TD, Cornblatt BA, Keshavan M, Mathalon DH, Perkins DO, Stone W, Walker E, Woods SW, Uddin LQ, Kumar K, Hoftman GD, Bearden CE. Unique functional neuroimaging signatures of genetic versus clinical high risk for psychosis. Biol Psychiatry 2024:S0006-3223(24)01538-5. [PMID: 39181389 DOI: 10.1016/j.biopsych.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND 22q11.2 Deletion Syndrome (22qDel) is a copy number variant (CNV) associated with psychosis and other neurodevelopmental disorders. Adolescents at clinical high risk for psychosis (CHR) are identified based on the presence of subthreshold psychosis symptoms. Whether common neural substrates underlie these distinct high-risk populations is unknown. We compared functional brain measures in 22qDel and CHR cohorts and mapped results to biological pathways. METHODS We analyzed two large multi-site cohorts with resting-state functional MRI (rs-fMRI): 1) 22qDel (n=164, 47% female) and typically developing (TD) controls (n=134, 56% female); 2) CHR individuals (n=244, 41% female) and TD controls (n=151, 46% female) from the North American Prodrome Longitudinal Study-2. We computed global brain connectivity (GBC), local connectivity (LC), and brain signal variability (BSV) across cortical regions, testing case-control differences for 22qDel and CHR separately. Group difference maps were related to published brain maps using autocorrelation-preserving permutation. RESULTS BSV, LC, and GBC are significantly disrupted in 22qDel compared with TD controls (False Discovery Rate q<0.05). Spatial maps of BSV and LC differences are highly correlated with each other, unlike GBC. In CHR, only LC is significantly altered versus controls, with a different spatial pattern compared to 22qDel. Group differences map onto biological gradients, with 22qDel effects strongest in regions with high predicted blood flow and metabolism. CONCLUSION 22qDel and CHR exhibit divergent effects on fMRI temporal variability and multi-scale functional connectivity. In 22qDel, strong and convergent disruptions in BSV and LC not seen in CHR individuals suggest distinct functional brain alterations.
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Affiliation(s)
- Charles H Schleifer
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Sarah E Chang
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Carolyn M Amir
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Kathleen P O'Hora
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Hoki Fung
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Jee Won D Kang
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Leila Kushan-Wells
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Eileen Daly
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Fabio Di Fabio
- Department of Human Neurosciences, Sapienza University, Rome, Italy
| | | | - Maria Gudbrandsen
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK; Centre for Psychological Research (CREW), School of Psychology, University of Roehampton, London, UK
| | - Wendy R Kates
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Alan Anticevic
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, USA
| | | | - Tyrone D Cannon
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, USA
| | - Barbara A Cornblatt
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Elaine Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, USA
| | - Lucina Q Uddin
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Kuldeep Kumar
- Centre de Recherche du CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | - Gil D Hoftman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA; Department of Psychology, University of California, Los Angeles, CA, USA.
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Lindgren M, Therman S. Psychotic-like experiences in a nationally representative study of general population adolescents. Schizophr Res 2024; 270:237-245. [PMID: 38941725 DOI: 10.1016/j.schres.2024.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/17/2024] [Accepted: 06/24/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Subclinical psychotic-like experiences (PLEs) are common among general population adolescents but have been found to correlate with various problems in well-being. Due to limited sample sizes these effects have not been well differentiated by sex and age. METHODS Using a nationally representative survey of almost 160,000 adolescents, we studied endorsement and correlates of PLEs by sex among middle adolescence pupils (ages 14-16) and late adolescence students (ages 16-20). PLEs were investigated with three questionnaire items: auditory and visual hallucinatory experiences and suspicious thought content, using a frequency response scale. RESULTS Weekly PLEs were reported by 14 % of the adolescents, more often in females (17 %) than males (11 %) and in the younger age group (17 %) compared to the older adolescents (10 %). A latent PLE factor represented the three assessed PLEs with good fit. Factor scores were highest for the younger females and lowest for the older males. The PLE factor correlated with two latent factors of other well-being, namely living environment ("adversity", loading most heavily on parental mental abuse; r = 0.63), and concurrent mental health ("distress", loading most heavily on depressive symptoms; r = 0.50). Adversity was associated especially strongly with PLEs in 14-16-year-old males. CONCLUSIONS This cross-sectional study reaching the whole 14-20 age group in schools in Finland offers data on the meaning and relevance of PLEs as general markers of vulnerability. Many adolescents experience PLEs recurrently and these experiences are associated with a wide variety of burden in the adolescent's everyday life.
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Affiliation(s)
- Maija Lindgren
- Mental Health, Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Sebastian Therman
- Mental Health, Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
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Hoheisel L, Kambeitz-Ilankovic L, Wenzel J, Haas SS, Antonucci LA, Ruef A, Penzel N, Schultze-Lutter F, Lichtenstein T, Rosen M, Dwyer DB, Salokangas RKR, Lencer R, Brambilla P, Borgwardt S, Wood SJ, Upthegrove R, Bertolino A, Ruhrmann S, Meisenzahl E, Koutsouleris N, Fink GR, Daun S, Kambeitz J. Alterations of Functional Connectivity Dynamics in Affective and Psychotic Disorders. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:765-776. [PMID: 38461964 DOI: 10.1016/j.bpsc.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/23/2024] [Accepted: 02/15/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Patients with psychosis and patients with depression exhibit widespread neurobiological abnormalities. The analysis of dynamic functional connectivity (dFC) allows for the detection of changes in complex brain activity patterns, providing insights into common and unique processes underlying these disorders. METHODS We report the analysis of dFC in a large sample including 127 patients at clinical high risk for psychosis, 142 patients with recent-onset psychosis, 134 patients with recent-onset depression, and 256 healthy control participants. A sliding window-based technique was used to calculate the time-dependent FC in resting-state magnetic resonance imaging data, followed by clustering to reveal recurrent FC states in each diagnostic group. RESULTS We identified 5 unique FC states, which could be identified in all groups with high consistency (mean r = 0.889 [SD = 0.116]). Analysis of dynamic parameters of these states showed a characteristic increase in the lifetime and frequency of a weakly connected FC state in patients with recent-onset depression (p < .0005) compared with the other groups and a common increase in the lifetime of an FC state characterized by high sensorimotor and cingulo-opercular connectivities in all patient groups compared with the healthy control group (p < .0002). Canonical correlation analysis revealed a mode that exhibited significant correlations between dFC parameters and clinical variables (r = 0.617, p < .0029), which was associated with positive psychosis symptom severity and several dFC parameters. CONCLUSIONS Our findings indicate diagnosis-specific alterations of dFC and underline the potential of dynamic analysis to characterize disorders such as depression and psychosis and clinical risk states.
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Affiliation(s)
- Linnea Hoheisel
- Cognitive Neuroscience (INM-3), Institute of Neurosciences and Medicine, Forschungszentrum Jülich, Jülich, Germany; Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany; Department of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Linda A Antonucci
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Nora Penzel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Dominic B Dwyer
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia
| | | | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stephan Borgwardt
- Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia; Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom; Birmingham Early Interventions Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Gereon R Fink
- Cognitive Neuroscience (INM-3), Institute of Neurosciences and Medicine, Forschungszentrum Jülich, Jülich, Germany; Department of Neurology, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Silvia Daun
- Cognitive Neuroscience (INM-3), Institute of Neurosciences and Medicine, Forschungszentrum Jülich, Jülich, Germany; Institute of Zoology, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Cognitive Neuroscience (INM-3), Institute of Neurosciences and Medicine, Forschungszentrum Jülich, Jülich, Germany; Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
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10
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Bolhuis K, Ghirardi L, Kuja-Halkola R, Lång U, Cederlöf M, Metsala J, Corcoran P, O’Connor K, Dodd P, Larsson H, Kelleher I. Risk of Psychosis Among Individuals Who Have Presented to Hospital With Self-harm: A Prospective Nationwide Register Study in Sweden. Schizophr Bull 2024; 50:881-890. [PMID: 38243843 PMCID: PMC11283185 DOI: 10.1093/schbul/sbae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
BACKGROUND AND HYPOTHESIS Recent research showed that young people who presented to hospital with self-harm in Finland had a significantly elevated risk of later psychosis. We investigated the prospective relationship between hospital presentation for self-harm and risk of psychosis in an unprecedentedly large national Swedish cohort. STUDY DESIGN We used inpatient and outpatient healthcare registers to identify all individuals born between 1981 and 1993 who were alive and living in Sweden on their 12th birthday and who presented to hospital one or more times with self-harm. We compared them with a matched cohort, followed up for up to 20 years, and compared the cumulative incidence of psychotic disorders. Furthermore, we examined whether the strength of the relationship between hospital presentation for self-harm and later psychosis changed over time by examining for cohort effects. STUDY RESULTS In total, 28 908 (2.0%) individuals presented to hospital with self-harm without prior psychosis diagnosis during the follow-up. For individuals who presented to hospital with self-harm, the cumulative incidence of diagnosed psychosis was 20.7% at 20 years follow-up (hazard radio = 13.9, 95% CI 13.3-14.6, P-value <5 × 10-308). There was no evidence of a dilution of the effect over time: while the incidence of hospital self-harm presentation increased, this did not result in an attenuation over time of the strength of the relationship between hospital self-harm presentation and subsequent psychosis. CONCLUSIONS Individuals who present to hospital with self-harm in their teens and 20s represent an important risk group for psychosis prediction and prevention.
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Affiliation(s)
- Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Centre-Sophia Children’s Hospital, Rotterdam, The Netherlands
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Laura Ghirardi
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- MediNeos Observational Research—IQVIA, Data Management & Statistics, Modena, Italy
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ulla Lång
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Finnish Institute for Health and Welfare, Helsinki, Finland
- University of Oulu, School of Medicine, Oulu, Finland
| | - Martin Cederlöf
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Johanna Metsala
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Paul Corcoran
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Karen O’Connor
- Rise, South Lee Mental Health Services, Cork & Department of Psychiatry, University College Cork, Cork, Ireland
- National Clinical Programme for Early Intervention in Psychosis, Health Service Executive Dublin, Dublin, Ireland
| | - Philip Dodd
- National Office for Suicide Prevention, Health Service Executive Dublin, Dublin, Ireland
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ian Kelleher
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- University of Oulu, School of Medicine, Oulu, Finland
- University College Dublin, School of Medicine, Dublin, Ireland
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11
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Paquin V, Malla AK, Iyer SN, Lepage M, Joober R, Shah JL. Combinations and Temporal Associations Among Precursor Symptoms Before a First Episode of Psychosis. Schizophr Bull 2024; 50:860-870. [PMID: 37861419 PMCID: PMC11283192 DOI: 10.1093/schbul/sbad152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
BACKGROUND AND HYPOTHESIS Symptoms that precede a first episode of psychosis (FEP) can ideally be targeted by early intervention services with the aim of preventing or delaying psychosis onset. However, these precursor symptoms emerge in combinations and sequences that do not rest fully within traditional diagnostic categories. To advance our understanding of illness trajectories preceding FEP, we aimed to investigate combinations and temporal associations among precursor symptoms. STUDY DESIGN Participants were from PEPP-Montréal, a catchment-based early intervention program for FEP. Through semistructured interviews, collateral from relatives, and a review of health and social records, we retrospectively measured the presence or absence of 29 precursor symptoms, including 9 subthreshold psychotic and 20 nonpsychotic symptoms. Sequences of symptoms were derived from the timing of the first precursor symptom relative to the onset of FEP. STUDY RESULTS The sample included 390 participants (68% men; age range: 14-35 years). Combinations of precursor symptoms most frequently featured depression, anxiety, and substance use. Of 256 possible pairs of initial and subsequent precursor symptoms, many had asymmetrical associations: eg, when the first symptom was suspiciousness, the incidence rate ratio (IRR) of subsequent anxiety was 3.40 (95% confidence interval [CI]: 1.79, 6.46), but when the first symptom was anxiety, the IRR of subsequent suspiciousness was 1.15 (95% CI: 0.77, 1.73). CONCLUSIONS A detailed examination of precursor symptoms reveals diverse clinical profiles that cut across diagnostic categories and evolve longitudinally prior to FEP. Their identification may contribute to risk assessments and provide insights into the mechanisms of illness progression.
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Affiliation(s)
- Vincent Paquin
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Ashok K Malla
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Srividya N Iyer
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Martin Lepage
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Jai L Shah
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
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12
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Salazar de Pablo G, Guinart D, Armendariz A, Aymerich C, Catalan A, Alameda L, Rogdaki M, Martinez Baringo E, Soler-Vidal J, Oliver D, Rubio JM, Arango C, Kane JM, Fusar-Poli P, Correll CU. Duration of Untreated Psychosis and Outcomes in First-Episode Psychosis: Systematic Review and Meta-analysis of Early Detection and Intervention Strategies. Schizophr Bull 2024; 50:771-783. [PMID: 38491933 PMCID: PMC11283197 DOI: 10.1093/schbul/sbae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND The role of duration of untreated psychosis (DUP) as an early detection and intervention target to improve outcomes for individuals with first-episode psychosis is unknown. STUDY DESIGN PRISMA/MOOSE-compliant systematic review to identify studies until February 1, 2023, with an intervention and a control group, reporting DUP in both groups. Random effects meta-analysis to evaluate (1) differences in DUP in early detection/intervention services vs the control group, (2) the efficacy of early detection strategies regarding eight real-world outcomes at baseline (service entry), and (3) the efficacy of early intervention strategies on ten real-world outcomes at follow-up. We conducted quality assessment, heterogeneity, publication bias, and meta-regression analyses (PROSPERO: CRD42020163640). STUDY RESULTS From 6229 citations, 33 intervention studies were retrieved. The intervention group achieved a small DUP reduction (Hedges' g = 0.168, 95% CI = 0.055-0.283) vs the control group. The early detection group had better functioning levels (g = 0.281, 95% CI = 0.073-0.488) at baseline. Both groups did not differ regarding total psychopathology, admission rates, quality of life, positive/negative/depressive symptoms, and employment rates (P > .05). Early interventions improved quality of life (g = 0.600, 95% CI = 0.408-0.791), employment rates (g = 0.427, 95% CI = 0.135-0.718), negative symptoms (g = 0.417, 95% CI = 0.153-0.682), relapse rates (g = 0.364, 95% CI = 0.117-0.612), admissions rates (g = 0.335, 95% CI = 0.198-0.468), total psychopathology (g = 0.298, 95% CI = 0.014-0.582), depressive symptoms (g = 0.268, 95% CI = 0.008-0.528), and functioning (g = 0.180, 95% CI = 0.065-0.295) at follow-up but not positive symptoms or remission (P > .05). CONCLUSIONS Comparing interventions targeting DUP and control groups, the impact of early detection strategies on DUP and other correlates is limited. However, the impact of early intervention was significant regarding relevant outcomes, underscoring the importance of supporting early intervention services worldwide.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Daniel Guinart
- Institut de Salut Mental, Hospital del Mar, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Psychiatry, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Alvaro Armendariz
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Etiopatogenia i Tractament Dels Trastorns Mental Severs (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Barakaldo, Bizkaia, Spain
| | - Ana Catalan
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Barakaldo, Bizkaia, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Department of Psychiatry, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, University of Sevilla, Sevilla, Spain
| | - Maria Rogdaki
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Estrella Martinez Baringo
- Department of Child and Adolescent Psychiatry, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain
| | - Joan Soler-Vidal
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Hospital Benito Menni CASM, Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Dominic Oliver
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jose M Rubio
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, UK
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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13
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Catalano F, Leuci E, Quattrone E, Palmisano D, Pellegrini P, Pupo S, Menchetti M, Pelizza L. Clinical high risk for psychosis and service disengagement: Incidence and predictors across 2 years of follow-up. Early Interv Psychiatry 2024. [PMID: 39034609 DOI: 10.1111/eip.13599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/23/2024]
Abstract
BACK: Service disengagement is common in subjects at CHR-P (clinical high risk for psychosis), potentially worsening daily functioning and increasing the duration of untreated psychosis. That is why to identify baseline predictors of service disengagement could help better tailoring follow-up on every CHR-P individual. AIMS Since there are few studies on this topic, the goals of this examination were: (1) to calculate service disengagement rates in a CHR-P sample along 2-years of follow-up; and (2) to examine the most relevant predictive factors of disengagement at baseline. METHODS All young CHR-P participants were enrolled within the 'Parma At-Risk Mental States' (PARMS) protocol. At entry, the Global Assessment of Functioning (GAF) scale and the positive and negative syndrome scale (PANSS) were completed. Cox regression analyses were used. RESULTS Hundred and eighty CHR-P subjects were recruited in this examination. During the follow-up, a 2-year service disengagement prevalence rate of 15% was observed. A statistically robust predictive factor of service disengagement was a lower prescription of antidepressant drug at entry. Other relevant baseline predictive factors were migrant status, higher GAF score, lower levels of anxious-depressive symptoms and a lower acceptance of psychosocial interventions. DISCUSSION Baseline presence of anxious-depressive features in CHR-P individuals could favour engagement to specialized EIP services. However, implementing strategies to improve patients' motivation and involvement in care are needed.
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Affiliation(s)
- Fabio Catalano
- Department of Biomedical and Neuromotor Sciences, Università di Bologna, Bologna, Italy
| | - Emanuela Leuci
- Department of Mental Health, Azienda USL di Parma, Parma, Italy
| | | | - Derna Palmisano
- Department of Mental Health, Azienda USL di Parma, Parma, Italy
| | | | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, Università di Bologna, Bologna, Italy
| | - Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences, Università di Bologna, Bologna, Italy
- Department of Mental Health, Azienda USL di Parma, Parma, Italy
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14
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Oliver D, Chesney E, Cullen AE, Davies C, Englund A, Gifford G, Kerins S, Lalousis PA, Logeswaran Y, Merritt K, Zahid U, Crossley NA, McCutcheon RA, McGuire P, Fusar-Poli P. Exploring causal mechanisms of psychosis risk. Neurosci Biobehav Rev 2024; 162:105699. [PMID: 38710421 PMCID: PMC11250118 DOI: 10.1016/j.neubiorev.2024.105699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/17/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
Robust epidemiological evidence of risk and protective factors for psychosis is essential to inform preventive interventions. Previous evidence syntheses have classified these risk and protective factors according to their strength of association with psychosis. In this critical review we appraise the distinct and overlapping mechanisms of 25 key environmental risk factors for psychosis, and link these to mechanistic pathways that may contribute to neurochemical alterations hypothesised to underlie psychotic symptoms. We then discuss the implications of our findings for future research, specifically considering interactions between factors, exploring universal and subgroup-specific factors, improving understanding of temporality and risk dynamics, standardising operationalisation and measurement of risk and protective factors, and developing preventive interventions targeting risk and protective factors.
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Affiliation(s)
- Dominic Oliver
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK; OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK; Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Edward Chesney
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, UK
| | - Alexis E Cullen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, London SE5 8AF, UK
| | - George Gifford
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sarah Kerins
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paris Alexandros Lalousis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Yanakan Logeswaran
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - Kate Merritt
- Division of Psychiatry, Institute of Mental Health, UCL, London, UK
| | - Uzma Zahid
- Department of Psychology, King's College London, London, UK
| | - Nicolas A Crossley
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile
| | - Robert A McCutcheon
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Oxford Health NHS Foundation Trust, Oxford, UK
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK; NIHR Oxford Health Biomedical Research Centre, Oxford, UK; OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS Service, South London and Maudsley NHS Foundation Trust, London SE11 5DL, UK
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Pelizza L, Leuci E, Quattrone E, Azzali S, Pupo S, Paulillo G, Menchetti M, Pellegrini P. Adverse outcome analysis in people at clinical high risk for psychosis: results from a 2-year Italian follow-up study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1177-1191. [PMID: 38091031 DOI: 10.1007/s00127-023-02597-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 11/20/2023] [Indexed: 06/15/2024]
Abstract
PURPOSE Since January 2016, the Parma Department of Mental Health (in Italy) developed a specialized care program for Early Intervention (EI) in individuals at Clinical High Risk for Psychosis (CHR-P). As unfavorable outcomes other than transition to psychosis were not systematically reported in the current literature (thereby compromising more sophisticated prognostic stratifications), the aims of this research were (1) to investigate adverse outcome indicators (i.e., service disengagement, psychosis transition, hospitalization, prolonged functioning impairment, prolonged persistence of CHR-P criteria, suicide attempts) in an Italian CHR-P population enrolled within a specialized EI service across a 2-year follow-up period, and (2) to examine their relevant associations with sociodemographic and clinical characteristics of the CHR-P total sample at baseline. METHODS All participants were young CHR-P help-seekers aged 12-25 years. They completed the "Comprehensive Assessment of At-Risk Mental States" (CAARMS) and the Health of the Nation Outcome Scale (HoNOS). Both univariate and multivariate Cox regression analyses were performed. RESULTS 164 CHR-P individuals were enrolled in this study. Across the follow-up, 30 (18.0%) dropped out the EI program, 23 (14%) transitioned to psychosis, 24 (14.6%) were hospitalized, 23 (14%) had a prolonged persistence of CHR-P criteria and 54 (47%) showed prolonged impairment in socio-occupational functioning. CONCLUSION As almost half of our participants did not functionally remit over time, sustained clinical attention for young CHR individuals people should be offered in the longer term, also to monitor unfavorable outcomes and to improve long-term prognosis.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.
- Department of Biomedical and Neuromotor Sciences, Istituto di Psichiatria "Paolo Ottonello", "Alma Mater Studiorum"-Università di Bologna, Via Pepoli, 5, 40126, Bologna, BO, Italy.
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy
| | - Simona Pupo
- Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, PR, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, Istituto di Psichiatria "Paolo Ottonello", "Alma Mater Studiorum"-Università di Bologna, Via Pepoli, 5, 40126, Bologna, BO, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy
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Salazar de Pablo G, Rodriguez V, Besana F, Civardi SC, Arienti V, Maraña Garceo L, Andrés-Camazón P, Catalan A, Rogdaki M, Abbott C, Kyriakopoulos M, Fusar-Poli P, Correll CU, Arango C. Umbrella Review: Atlas of the Meta-Analytical Evidence of Early-Onset Psychosis. J Am Acad Child Adolesc Psychiatry 2024; 63:684-697. [PMID: 38280414 DOI: 10.1016/j.jaac.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVE Early-onset psychosis (EOP) refers to the development of psychosis before the age of 18 years. We aimed to summarize, for the first time, the meta-analytical evidence in the field of this vulnerable population and to provide evidence-based recommendations. METHOD We performed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant, pre-registered (PROSPERO: CRD42022350868) systematic review of several databases and registers to identify meta-analyses of studies conducted in EOP individuals to conduct an umbrella review. Literature search, screening, data extraction, and quality assessment were carried out independently. Results were narratively reported, clustered across core domains. Quality assessment was performed with the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. RESULTS A total of 30 meta-analyses were included (373 individual studies, 25,983 participants, mean age 15.1 years, 38.3% female). Individuals with EOP showed more cognitive impairments compared with controls and individuals with adult/late-onset psychosis. Abnormalities were observed meta-analytically in neuroimaging markers but not in oxidative stress and inflammatory response markers. In all, 60.1% of EOP individuals had a poor prognosis. Clozapine was the antipsychotic with the highest efficacy for overall, positive, and negative symptoms. Tolerance to medication varied among the evaluated antipsychotics. The risk of discontinuation of antipsychotics for any reason or side effects was low or equal compared to placebo. CONCLUSION EOP is associated with cognitive impairment, involuntary admissions, and poor prognosis. Antipsychotics can be efficacious in EOP, but tolerability and safety need to be taken into consideration. Clozapine should be considered in EOP individuals who are resistant to 2 non-clozapine antipsychotics. Further meta-analytical research is needed on response to psychological interventions and other prognostic factors. PLAIN LANGUAGE SUMMARY This umbrella review summarized the meta-analytical knowledge from 30 meta-analyses on early-onset psychosis. Early-onset psychosis refers to the development of psychosis before the age of 18 years and is associated with cognitive impairment, hospitalization, and poor prognosis. Individuals with early-onset psychosis show more cognitive impairments and abnormalities compared with controls. Clozapine was the antipsychotic with the highest efficacy for positive, negative, and overall symptoms and should be considered in individuals with early-onset psychosis. STUDY PREREGISTRATION INFORMATION Early Onset Psychosis: Umbrella Review on Diagnosis, Prognosis and Treatment factors; https://www.crd.york.ac.uk/PROSPERO/; CRD42022350868.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, United Kingdom.
| | - Victoria Rodriguez
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | | | | | | | - P Andrés-Camazón
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Ana Catalan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Biobizkaia Health Research Institute. Basurto University Hospital, OSI Bilbao-Basurto, and the University of the Basque Country UPV/EHU. Centro de Investigación en Red de Salud Mental (CIBERSAM), Vizcaya, Spain
| | - Maria Rogdaki
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Francis Crick Institute, London, United Kingdom
| | - Chris Abbott
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Marinos Kyriakopoulos
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, United Kingdom; National and Kapodistrian University of Athens, Athens, Greece
| | - Paolo Fusar-Poli
- University of Pavia, Pavia, Italy; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; LMU Munich, Munich, Germany; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; and National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Christoph U Correll
- Charité Universitätsmedizin, Berlin, Germany; The Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York; Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, New York; and the German Center for Mental Health (DZPG), partner site Berlin, Germany
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
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17
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Lo Buglio G, Boldrini T, Polari A, Fiorentino F, Nelson B, Solmi M, Lingiardi V, Tanzilli A. Harmonizing early intervention strategies: scoping review of clinical high risk for psychosis and borderline personality disorder. Front Psychol 2024; 15:1381864. [PMID: 38966724 PMCID: PMC11223645 DOI: 10.3389/fpsyg.2024.1381864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/29/2024] [Indexed: 07/06/2024] Open
Abstract
Aims To map studies assessing both clinical high risk for psychosis (CHR-P) and borderline personality disorder (BPD) in clinical samples, focusing on clinical/research/preventive paradigms and proposing informed research recommendations. Methods We conducted a PRISMA-ScR/JBI-compliant scoping review (protocol: https://osf.io/8mz7a) of primary research studies (cross-sectional/longitudinal designs) using valid measures/criteria to assess CHR-P and BPD (threshold/subthreshold) in clinical samples, reporting on CHR-P/psychotic symptoms and personality disorder(s) in the title/abstract/keywords, identified in Web of Science/PubMed/(EBSCO)PsycINFO until 23/08/2023. Results 33 studies were included and categorized into four themes reflecting their respective clinical/research/preventive paradigm: (i) BPD as a comorbidity in CHR-P youth (k = 20), emphasizing early detection and intervention in psychosis; (ii) attenuated psychosis syndrome (APS) as a comorbidity among BPD inpatients (k = 2), with a focus on hospitalized adolescents/young adults admitted for non-psychotic mental disorders; (iii) mixed samples (k = 7), including descriptions of early intervention services and referral pathways; (iv) transdiagnostic approaches (k = 4) highlighting "clinical high at risk mental state" (CHARMS) criteria to identify a pluripotent risk state for severe mental disorders. Conclusion The scoping review reveals diverse approaches to clinical care for CHR-P and BPD, with no unified treatment strategies. Recommendations for future research should focus on: (i) exploring referral pathways across early intervention clinics to promote timely intervention; (ii) enhancing early detection strategies in innovative settings such as emergency departments; (iii) improving mental health literacy to facilitate help-seeking behaviors; (iv) analysing comorbid disorders as complex systems to better understand and target early psychopathology; (v) investigating prospective risk for BPD; (vi) developing transdiagnostic interventions; (vii) engaging youth with lived experience of comorbidity to gain insight on their subjective experience; (viii) understanding caregiver burden to craft family-focused interventions; (ix) expanding research in underrepresented regions such as Africa and Asia, and; (x) evaluating the cost-effectiveness of early interventions to determine scalability across different countries. Systematic Review Registration https://osf.io/8mz7a.
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Affiliation(s)
- Gabriele Lo Buglio
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Tommaso Boldrini
- Department of Psychology and Educational Science, Pegaso Telematic University, Naples, Italy
| | - Andrea Polari
- Orygen Specialist Programs, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Flavia Fiorentino
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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18
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Boldrini T, Lo Buglio G, Cerasti E, Pontillo M, Muzi L, Salcuni S, Polari A, Vicari S, Lingiardi V, Solmi M. Clinical utility of the at-risk for psychosis state beyond transition: A multidimensional network analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02491-x. [PMID: 38896144 DOI: 10.1007/s00787-024-02491-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
To be relevant to healthcare systems, the clinical high risk for psychosis (CHR-P) concept should denote a specific (i.e., unique) clinical population and provide useful information to guide the choice of intervention. The current study applied network analyses to examine the clinical specificities of CHR-P youths compared to general help-seekers and non-CHR-P youth. 146 CHR-P (mean age = 14.32 years) and 103 non-CHR-P (mean age = 12.58 years) help-seeking youth were recruited from a neuropsychiatric unit and assessed using the Structured Interview for Psychosis-Risk Syndromes, Children's Depression Inventory, Multidimensional Anxiety Scale for Children, Global Functioning: Social, Global Functioning: Role, and Wechsler Intelligence Scale for Children/Wechsler Adult Intelligence Scale. The first network structure comprised the entire help-seeking sample (i.e., help-seekers network), the second only CHR-P patients (i.e., CHR-P network), and the third only non-CHR-P patients (i.e., non-CHR-P network). In the help-seekers network, each variable presented at least one edge. In the CHR-P network, two isolated "archipelagos of symptoms" were identified: (a) a subgraph including functioning, anxiety, depressive, negative, disorganization, and general symptoms; and (b) a subgraph including positive symptoms and the intelligence quotient. In the non-CHR-P network, positive symptoms were negatively connected to functioning, disorganization, and negative symptoms. Positive symptoms were less connected in the CHR-P network, indicating a need for specific interventions alongside those treating comorbid disorders. The findings suggest specific clinical characteristics of CHR-P youth to guide the development of tailored interventions, thereby supporting the clinical utility of the CHR-P concept.
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Affiliation(s)
- Tommaso Boldrini
- Department of Psychology and Educational Science, Pegaso Telematic University, Naples, Italy
| | - Gabriele Lo Buglio
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
| | - Erika Cerasti
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Maria Pontillo
- Child Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Laura Muzi
- Department of Philosophy, Social Sciences, Humanities and Education, University of Perugia, Perugia, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padova, Padua, Italy
| | - Andrea Polari
- Orygen Specialist Programs, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Stefano Vicari
- Child Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Marco Solmi
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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Fortea A, van Eijndhoven P, Calvet-Mirabent A, Ilzarbe D, Batalla A, de la Serna E, Puig O, Castro-Fornieles J, Dolz M, Tor J, Parrilla S, Via E, Stephan-Otto C, Baeza I, Sugranyes G. Age-related change in cortical thickness in adolescents at clinical high risk for psychosis: a longitudinal study. Eur Child Adolesc Psychiatry 2024; 33:1837-1846. [PMID: 37644217 DOI: 10.1007/s00787-023-02278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/03/2023] [Indexed: 08/31/2023]
Abstract
Progression to psychosis has been associated with increased cortical thinning in the frontal, temporal and parietal lobes in individuals at clinical high risk for the disorder (CHR-P). The timing and spatial extent of these changes are thought to be influenced by age. However, most evidence so far stems from adult samples. Longitudinal studies are essential to understanding the neuroanatomical changes associated to transition to psychosis during adolescence, and their relationship with age. We conducted a longitudinal, multisite study including adolescents at CHR-P and healthy controls (HC), aged 10-17 years. Structural images were acquired at baseline and at 18-month follow-up. Images were processed with the longitudinal pipeline in FreeSurfer. We used a longitudinal two-stage model to compute the regional cortical thickness (CT) change, and analyze between-group differences controlling for age, sex and scan, and corrected for multiple comparisons. Linear regression was used to study the effect of age at baseline. A total of 103 individuals (49 CHR-P and 54 HC) were included in the analysis. During follow-up, the 13 CHR-P participants who transitioned to psychosis exhibited greater CT decrease over time in the right parietal cortex compared to those who did not transition to psychosis and to HC. Age at baseline correlated with longitudinal changes in CT, with younger individuals showing greater cortical thinning in this region. The emergence of psychosis during early adolescence may have an impact on typical neuromaturational processes. This study provides new insights on the cortical changes taking place prior to illness onset.
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Affiliation(s)
- Adriana Fortea
- Psychiatry and Psychology Department, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
| | - Philip van Eijndhoven
- Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain Cognition and Behavior, Nijmegen, The Netherlands
| | - Angels Calvet-Mirabent
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain
| | - Daniel Ilzarbe
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Albert Batalla
- UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Olga Puig
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain
| | - Montserrat Dolz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Sara Parrilla
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Esther Via
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Christian Stephan-Otto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Pediatric Computational Imaging Group (PeCIC), Hospital Sant Joan de Déu, Barcelona, Spain
| | - Inmaculada Baeza
- Department of Medicine, University of Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain.
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain.
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain.
| | - Gisela Sugranyes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain.
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), C/Rosselló 149-153, 08036, Barcelona, Spain.
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute Clinic of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain.
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20
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Gammino L, Pelizza L, Emiliani R, D'Adda F, Lupoli P, Pellegrini L, Berardi D, Menchetti M. Cognitive disturbances basic symptoms in help-seeking patients with borderline personality disorder: Characteristics and association with schizotypy. Early Interv Psychiatry 2024. [PMID: 38778517 DOI: 10.1111/eip.13557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 02/04/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
AIM Although the presence of psychotic symptoms has been widely recognized in Borderline Personality Disorder (BPD), no study previously investigated cognitive Basic Symptoms (BS) and their clinical implications in patients with BPD. METHODS This cross-sectional study specifically examined the prevalence of COGDIS (cognitive disturbances) BS criteria in 93 help-seeking outpatients with BPD by using the Schizophrenia Proneness Instrument-Adult Version (SPI-A). We then explored associations of COGDIS with personality traits, functioning and core psychopathological features of BPD. RESULTS The prevalence rates of COGDIS criterion were 62.4%. BPD patients meeting COGDIS criteria reported higher levels of schizotypal personality traits, dissociative experiences and work/social functional impairment compared to individuals without COGDIS criteria. Furthermore, the number of cognitive BSs showed a positive correlation with severity levels of schizotypy. CONCLUSIONS Cognitive BS are common in BPD. Cognitive disturbances are associated with schizotypal personality traits and specific clinical features. The presence of cognitive BSs may identify a more severe subgroup of patients with BPD, potentially vulnerable to psychotic symptoms and reliably identifiable through assessment of schizotypal traits.
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Affiliation(s)
- Lorenzo Gammino
- Department of Mental Health and Addiction DSM-DP, Azienda USL di Bologna, Bologna, Italy
| | - Lorenzo Pelizza
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Bologna, Italy
| | - Roberta Emiliani
- Department of Mental Health and Addiction DSM-DP, Azienda USL di Imola, Imola, Italy
| | - Francesca D'Adda
- Department of Mental Health and Addiction DSM-DP, Azienda USL di Bologna, Bologna, Italy
| | - Pasqualino Lupoli
- Department of Mental Health and Addiction DSM-DP, Azienda USL di Bologna, Bologna, Italy
| | - Luca Pellegrini
- Hertfordshire Partnership NHS University Foundation Trust, Welwyn Garden City, UK
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Centre for Psychedelic Research, Imperial College London, London, UK
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Bologna, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Bologna, Italy
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21
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Campo-Arias A, Herazo E, Caballero-Domínguez CC. Prodromal questionnaire (PQ-16) dimensionality among Colombian adolescent school students. Early Interv Psychiatry 2024. [PMID: 38738641 DOI: 10.1111/eip.13546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
AIMS The study aimed to determine the dimensionality of the Spanish version of the PQ-16 among Colombian adolescent school students. METHODS A validation study was designed with the participation of 334 Colombian adolescent students aged between 13 and 17 (M = 15.2, SD = 1.1); 171 (52.1%) were girls, and 163 (47.9%) were boys, 229 (68.6%) were ninth-grade students and 105 (31.4%) were tenth-grade students. Confirmatory factor analysis was performed, internal consistency was calculated with the Kuder-Richardson and McDonald's omega tests, and correlation with suicide ideation was computed with the Kendall correlation (r). RESULTS The confirmatory factor analysis showed that the PQ-16 adequately fit a unidimensional structure: RMSEA = 0.05 (90%CI 0.04-0.06), CFI = 0.91, TLI = 0.90, SRMR = 0.05, chi-squared = 193.18 (df = 102, p < 0.001) and normalized chi-squared = 1.89. This factor presented high internal consistency: Kuder-Richardson test and McDonald's omega of 0.83. The correlation between the PQ-16 and suicide ideation was r = 0.45 (p < 0.001). CONCLUSION The PQ-16 is a one-dimensional tool with high internal consistency and correlation with suicide ideation among schooled adolescents. Further research should explore the PQ-16 performance against a structured clinical interview.
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Affiliation(s)
| | - Edwin Herazo
- Dirección General, Instituto de Investigación del Comportamiento Humano, Bogotá, Colombia
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Correll CU, Arango C, Fagerlund B, Galderisi S, Kas MJ, Leucht S. Identification and treatment of individuals with childhood-onset and early-onset schizophrenia. Eur Neuropsychopharmacol 2024; 82:57-71. [PMID: 38492329 DOI: 10.1016/j.euroneuro.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 03/18/2024]
Abstract
Approximately 8 % of patients with schizophrenia are diagnosed before age 18, and 18 % experience their first symptoms before age 18. This narrative review explores the management of patients with early-onset schizophrenia (EOS) and childhood-onset schizophrenia (COS) from diagnosis to their transition to adult care settings. Early diagnosis of schizophrenia in children and adolescents is essential for improving outcomes, but delays are common due to overlapping of symptoms with developmental phenomena and other psychiatric conditions, including substance use, and lack of clinicians' awareness. Once diagnosed, antipsychotic treatment is key, with specific second-generation agents generally being preferred due to better tolerability and their broader efficacy evidence-base in youth. Dosing should be carefully individualized, considering age-related differences in drug metabolism and side effect liability. Clinicians must be vigilant in detecting early non-response and consider switching or dose escalation when appropriate. Since early age of illness onset is a consistent risk factor for treatment-resistant schizophrenia (TRS), clinicians need to be competent in diagnosing TRS and using clozapine. Since COS and EOS are associated with cognitive deficits and impaired functioning, psychosocial interventions should be considered to improve overall functioning and quality of life. Good long-term outcomes depend on continuous treatment engagement, and successful transitioning from pediatric to adult care requires careful planning, early preparation, and collaboration between pediatric and adult clinicians. Targeting functional outcomes and quality of life in addition to symptom remission can improve overall patient well-being. Comprehensive evaluations, age-specific assessments, and targeted interventions are needed to address the unique challenges of EOS and COS.
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Affiliation(s)
- Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Department of Psychiatry, Zucker Hillside Hospital, Northwell Health System, Glen Oaks, NY, USA.
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Birgitte Fagerlund
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Silvana Galderisi
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Martien J Kas
- Groningen Institute for Evolutionary Life Sciences (GELIFES), Neurobiology, University of Groningen, the Netherlands
| | - Stefan Leucht
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Germany; Department of Psychiatry, Department of Psychosis Studies, and Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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23
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Ho G, Pratt DN, Bridgwater MA, Schiffman J, Ellman LM, Mittal VA. Factors impacting intent to seek treatment within youth at clinical high risk for psychosis. Schizophr Res 2024; 267:273-281. [PMID: 38581831 PMCID: PMC11102833 DOI: 10.1016/j.schres.2024.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/25/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
Existing work indicates that there is unmet need for care in those at clinical high risk (CHR) for psychosis. However, research on the factors that drive treatment seeking behaviors in this population is limited. Further, it is unknown how help-seeking behavior in CHR individuals compares to those seen in mood disorders, who have a higher rate of treatment seeking behavior. Participants (n = 559) completed an assessment of their intent to seek mental health treatment, attenuated psychosis-risk symptoms, and psychiatric symptoms and diagnoses. Participants were divided into CHR (n = 91), Mood Disorders (MD) (n = 72), or Community Controls (CC) groups (n = 396), whose intent to seek treatment was compared. Associations between intent to seek treatment with past treatment, depression, anxiety, positive and negative symptoms, distress from symptoms, intelligence quotient (IQ) estimates, and insight were assessed in CHR individuals. Further, it was assessed how this differs for the MD group. The MD group reported higher intent to seek treatment than CHR individuals, which reported higher intent to seek treatment than the CC group. In those at CHR, previous treatment, greater depression and anxiety severity, and higher distress all independently predicted higher intent to seek treatment. Depression predicted intent to seek treatment in both MD and CHR individuals. Previous treatment predicted intent to seek treatment in those at CHR. Our findings suggest that depression and past treatment utilization are critical factors in increasing intent to seek treatment in those at CHR, potentially serving as important targets for engaging this population in treatment.
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Affiliation(s)
- Gillian Ho
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
| | - Danielle N Pratt
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA.
| | - Miranda A Bridgwater
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Vijay A Mittal
- Institutes for Policy Research and Innovations in Developmental Sciences, Departments of Psychology, Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL 60208, USA
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24
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Lee TY, Kim NS, Im A. Considering people at clinical high risk for psychosis with normodopaminergia: Clinical case of progression to treatment-resistant schizophrenia in three years. Asian J Psychiatr 2024; 95:104006. [PMID: 38513511 DOI: 10.1016/j.ajp.2024.104006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Tae Young Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea.
| | - Nahrie S Kim
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Aram Im
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
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25
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Davies C, Martins D, Dipasquale O, McCutcheon RA, De Micheli A, Ramella-Cravaro V, Provenzani U, Rutigliano G, Cappucciati M, Oliver D, Williams S, Zelaya F, Allen P, Murguia S, Taylor D, Shergill S, Morrison P, McGuire P, Paloyelis Y, Fusar-Poli P. Connectome dysfunction in patients at clinical high risk for psychosis and modulation by oxytocin. Mol Psychiatry 2024; 29:1241-1252. [PMID: 38243074 PMCID: PMC11189815 DOI: 10.1038/s41380-024-02406-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 01/21/2024]
Abstract
Abnormalities in functional brain networks (functional connectome) are increasingly implicated in people at Clinical High Risk for Psychosis (CHR-P). Intranasal oxytocin, a potential novel treatment for the CHR-P state, modulates network topology in healthy individuals. However, its connectomic effects in people at CHR-P remain unknown. Forty-seven men (30 CHR-P and 17 healthy controls) received acute challenges of both intranasal oxytocin 40 IU and placebo in two parallel randomised, double-blind, placebo-controlled cross-over studies which had similar but not identical designs. Multi-echo resting-state fMRI data was acquired at approximately 1 h post-dosing. Using a graph theoretical approach, the effects of group (CHR-P vs healthy control), treatment (oxytocin vs placebo) and respective interactions were tested on graph metrics describing the topology of the functional connectome. Group effects were observed in 12 regions (all pFDR < 0.05) most localised to the frontoparietal network. Treatment effects were found in 7 regions (all pFDR < 0.05) predominantly within the ventral attention network. Our major finding was that many effects of oxytocin on network topology differ across CHR-P and healthy individuals, with significant interaction effects observed in numerous subcortical regions strongly implicated in psychosis onset, such as the thalamus, pallidum and nucleus accumbens, and cortical regions which localised primarily to the default mode network (12 regions, all pFDR < 0.05). Collectively, our findings provide new insights on aberrant functional brain network organisation associated with psychosis risk and demonstrate, for the first time, that oxytocin modulates network topology in brain regions implicated in the pathophysiology of psychosis in a clinical status (CHR-P vs healthy control) specific manner.
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Affiliation(s)
- Cathy Davies
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry, University Hospitals of Genève, Geneva, Switzerland
| | - Ottavia Dipasquale
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Andrea De Micheli
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach And Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Valentina Ramella-Cravaro
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Umberto Provenzani
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Grazia Rutigliano
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marco Cappucciati
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Dominic Oliver
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Steve Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paul Allen
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Silvia Murguia
- Tower Hamlets Early Detection Service, East London NHS Foundation Trust, London, UK
| | - David Taylor
- Institute of Pharmaceutical Science, King's College London, London, UK
| | - Sukhi Shergill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Kent and Medway Medical School, Canterbury, UK
| | - Paul Morrison
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK
- Outreach And Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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26
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Zhu Y, Maikusa N, Radua J, Sämann PG, Fusar-Poli P, Agartz I, Andreassen OA, Bachman P, Baeza I, Chen X, Choi S, Corcoran CM, Ebdrup BH, Fortea A, Garani RR, Glenthøj BY, Glenthøj LB, Haas SS, Hamilton HK, Hayes RA, He Y, Heekeren K, Kasai K, Katagiri N, Kim M, Kristensen TD, Kwon JS, Lawrie SM, Lebedeva I, Lee J, Loewy RL, Mathalon DH, McGuire P, Mizrahi R, Mizuno M, Møller P, Nemoto T, Nordholm D, Omelchenko MA, Raghava JM, Røssberg JI, Rössler W, Salisbury DF, Sasabayashi D, Smigielski L, Sugranyes G, Takahashi T, Tamnes CK, Tang J, Theodoridou A, Tomyshev AS, Uhlhaas PJ, Værnes TG, van Amelsvoort TAMJ, Waltz JA, Westlye LT, Zhou JH, Thompson PM, Hernaus D, Jalbrzikowski M, Koike S. Using brain structural neuroimaging measures to predict psychosis onset for individuals at clinical high-risk. Mol Psychiatry 2024; 29:1465-1477. [PMID: 38332374 PMCID: PMC11189817 DOI: 10.1038/s41380-024-02426-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/22/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024]
Abstract
Machine learning approaches using structural magnetic resonance imaging (sMRI) can be informative for disease classification, although their ability to predict psychosis is largely unknown. We created a model with individuals at CHR who developed psychosis later (CHR-PS+) from healthy controls (HCs) that can differentiate each other. We also evaluated whether we could distinguish CHR-PS+ individuals from those who did not develop psychosis later (CHR-PS-) and those with uncertain follow-up status (CHR-UNK). T1-weighted structural brain MRI scans from 1165 individuals at CHR (CHR-PS+, n = 144; CHR-PS-, n = 793; and CHR-UNK, n = 228), and 1029 HCs, were obtained from 21 sites. We used ComBat to harmonize measures of subcortical volume, cortical thickness and surface area data and corrected for non-linear effects of age and sex using a general additive model. CHR-PS+ (n = 120) and HC (n = 799) data from 20 sites served as a training dataset, which we used to build a classifier. The remaining samples were used external validation datasets to evaluate classifier performance (test, independent confirmatory, and independent group [CHR-PS- and CHR-UNK] datasets). The accuracy of the classifier on the training and independent confirmatory datasets was 85% and 73% respectively. Regional cortical surface area measures-including those from the right superior frontal, right superior temporal, and bilateral insular cortices strongly contributed to classifying CHR-PS+ from HC. CHR-PS- and CHR-UNK individuals were more likely to be classified as HC compared to CHR-PS+ (classification rate to HC: CHR-PS+, 30%; CHR-PS-, 73%; CHR-UNK, 80%). We used multisite sMRI to train a classifier to predict psychosis onset in CHR individuals, and it showed promise predicting CHR-PS+ in an independent sample. The results suggest that when considering adolescent brain development, baseline MRI scans for CHR individuals may be helpful to identify their prognosis. Future prospective studies are required about whether the classifier could be actually helpful in the clinical settings.
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Affiliation(s)
- Yinghan Zhu
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Norihide Maikusa
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos III, Universitat de Barcelona, Barcelona, Spain
| | | | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Peter Bachman
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Xiaogang Chen
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sunah Choi
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Mental Illness Research, Education, and Clinical Center, James J Peters VA Medical Center, New York City, NY, USA
| | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Adriana Fortea
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic Barcelona, Fundació Clínic Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Ranjini Rg Garani
- Douglas Research Center; Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Birte Yding Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen Copenhagen, Copenhagen, Denmark
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Holly K Hamilton
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Rebecca A Hayes
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
| | - Ying He
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Karsten Heekeren
- Department of Psychiatry and Psychotherapy I, LVR-Hospital Cologne, Cologne, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence at The University of Tokyo Institutes for Advanced Study (WPI-IRCN), The University of Tokyo, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyok, Japan
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Tina D Kristensen
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Irina Lebedeva
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Rachel L Loewy
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Romina Mizrahi
- Douglas Research Center; Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Paul Møller
- Department for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyok, Japan
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen Copenhagen, Copenhagen, Denmark
| | - Maria A Omelchenko
- Department of Youth Psychiatry, Mental Health Research Center, Moscow, Russian Federation
| | - Jayachandra M Raghava
- Centre for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Department of Clinical Physiology, Nuclear Medicine and PET, Functional Imaging, University of Copenhagen Copenhagen, Copenhagen, Denmark
| | - Jan I Røssberg
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Lukasz Smigielski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, 2017SGR-881, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Christian K Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Zhejiang, China
- Key Laboratory of Medical Neurobiology of Zhejiang Province, School of Medicine, Zhejiang University, Zhejiang, China
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Alexander S Tomyshev
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Peter J Uhlhaas
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Tor G Værnes
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South-East Norway, TIPS Sør-Øst, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Therese A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore County, Baltimore, MD, USA
| | - Lars T Westlye
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Juan H Zhou
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA
| | - Shinsuke Koike
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan.
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Wannan CMJ, Nelson B, Addington J, Allott K, Anticevic A, Arango C, Baker JT, Bearden CE, Billah T, Bouix S, Broome MR, Buccilli K, Cadenhead KS, Calkins ME, Cannon TD, Cecci G, Chen EYH, Cho KIK, Choi J, Clark SR, Coleman MJ, Conus P, Corcoran CM, Cornblatt BA, Diaz-Caneja CM, Dwyer D, Ebdrup BH, Ellman LM, Fusar-Poli P, Galindo L, Gaspar PA, Gerber C, Glenthøj LB, Glynn R, Harms MP, Horton LE, Kahn RS, Kambeitz J, Kambeitz-Ilankovic L, Kane JM, Kapur T, Keshavan MS, Kim SW, Koutsouleris N, Kubicki M, Kwon JS, Langbein K, Lewandowski KE, Light GA, Mamah D, Marcy PJ, Mathalon DH, McGorry PD, Mittal VA, Nordentoft M, Nunez A, Pasternak O, Pearlson GD, Perez J, Perkins DO, Powers AR, Roalf DR, Sabb FW, Schiffman J, Shah JL, Smesny S, Spark J, Stone WS, Strauss GP, Tamayo Z, Torous J, Upthegrove R, Vangel M, Verma S, Wang J, Rossum IWV, Wolf DH, Wolff P, Wood SJ, Yung AR, Agurto C, Alvarez-Jimenez M, Amminger P, Armando M, Asgari-Targhi A, Cahill J, Carrión RE, Castro E, Cetin-Karayumak S, Mallar Chakravarty M, Cho YT, Cotter D, D’Alfonso S, Ennis M, Fadnavis S, Fonteneau C, Gao C, Gupta T, Gur RE, Gur RC, Hamilton HK, Hoftman GD, Jacobs GR, Jarcho J, Ji JL, Kohler CG, Lalousis PA, Lavoie S, Lepage M, Liebenthal E, Mervis J, Murty V, Nicholas SC, Ning L, Penzel N, Poldrack R, Polosecki P, Pratt DN, Rabin R, Rahimi Eichi H, Rathi Y, Reichenberg A, Reinen J, Rogers J, Ruiz-Yu B, Scott I, Seitz-Holland J, Srihari VH, Srivastava A, Thompson A, Turetsky BI, Walsh BC, Whitford T, Wigman JTW, Yao B, Yuen HP, Ahmed U, Byun A(JS, Chung Y, Do K, Hendricks L, Huynh K, Jeffries C, Lane E, Langholm C, Lin E, Mantua V, Santorelli G, Ruparel K, Zoupou E, Adasme T, Addamo L, Adery L, Ali M, Auther A, Aversa S, Baek SH, Bates K, Bathery A, Bayer JMM, Beedham R, Bilgrami Z, Birch S, Bonoldi I, Borders O, Borgatti R, Brown L, Bruna A, Carrington H, Castillo-Passi RI, Chen J, Cheng N, Ching AE, Clifford C, Colton BL, Contreras P, Corral S, Damiani S, Done M, Estradé A, Etuka BA, Formica M, Furlan R, Geljic M, Germano C, Getachew R, Goncalves M, Haidar A, Hartmann J, Jo A, John O, Kerins S, Kerr M, Kesselring I, Kim H, Kim N, Kinney K, Krcmar M, Kotler E, Lafanechere M, Lee C, Llerena J, Markiewicz C, Matnejl P, Maturana A, Mavambu A, Mayol-Troncoso R, McDonnell A, McGowan A, McLaughlin D, McIlhenny R, McQueen B, Mebrahtu Y, Mensi M, Hui CLM, Suen YN, Wong SMY, Morrell N, Omar M, Partridge A, Phassouliotis C, Pichiecchio A, Politi P, Porter C, Provenzani U, Prunier N, Raj J, Ray S, Rayner V, Reyes M, Reynolds K, Rush S, Salinas C, Shetty J, Snowball C, Tod S, Turra-Fariña G, Valle D, Veale S, Whitson S, Wickham A, Youn S, Zamorano F, Zavaglia E, Zinberg J, Woods SW, Shenton ME. Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis. Schizophr Bull 2024; 50:496-512. [PMID: 38451304 PMCID: PMC11059785 DOI: 10.1093/schbul/sbae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
This article describes the rationale, aims, and methodology of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). This is the largest international collaboration to date that will develop algorithms to predict trajectories and outcomes of individuals at clinical high risk (CHR) for psychosis and to advance the development and use of novel pharmacological interventions for CHR individuals. We present a description of the participating research networks and the data processing analysis and coordination center, their processes for data harmonization across 43 sites from 13 participating countries (recruitment across North America, Australia, Europe, Asia, and South America), data flow and quality assessment processes, data analyses, and the transfer of data to the National Institute of Mental Health (NIMH) Data Archive (NDA) for use by the research community. In an expected sample of approximately 2000 CHR individuals and 640 matched healthy controls, AMP SCZ will collect clinical, environmental, and cognitive data along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech and facial expression samples, novel measures derived from digital health technologies including smartphone-based daily surveys, and passive sensing as well as actigraphy. The study will investigate a range of clinical outcomes over a 2-year period, including transition to psychosis, remission or persistence of CHR status, attenuated positive symptoms, persistent negative symptoms, mood and anxiety symptoms, and psychosocial functioning. The global reach of AMP SCZ and its harmonized innovative methods promise to catalyze the development of new treatments to address critical unmet clinical and public health needs in CHR individuals.
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Affiliation(s)
- Cassandra M J Wannan
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Kelly Allott
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Justin T Baker
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Carrie E Bearden
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tashrif Billah
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Canada
| | - Matthew R Broome
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
- Early Intervention for Psychosis Services, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Kate Buccilli
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Kang Ik K Cho
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jimmy Choi
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, USA
| | - Scott R Clark
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Basil Hetzel Institute, Woodville, SA, Australia
| | - Michael J Coleman
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Philippe Conus
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP–Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara A Cornblatt
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Covadonga M Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Dominic Dwyer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research, CNSR Mental Health Centre, Glostrup, Copenhagen, Denmark
| | - Lauren M Ellman
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Liliana Galindo
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pablo A Gaspar
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Carla Gerber
- Behavioral Health Services, PeaceHealth Medical Group, Eugene, OR, USA
| | - Louise Birkedal Glenthøj
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Robert Glynn
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health and Harvard Medical School, Boston, MA, USA
| | - Michael P Harms
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Leslie E Horton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph Kambeitz
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - John M Kane
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Tina Kapur
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marek Kubicki
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Kathryn E Lewandowski
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Health Care System, San Diego, CA, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | | | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116D, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Patrick D McGorry
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Angela Nunez
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Ofer Pasternak
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, USA
| | - Jesus Perez
- CAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Medicine, Institute of Biomedical Research (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Albert R Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - David R Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fred W Sabb
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jai L Shah
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jessica Spark
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | | | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - John Torous
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Rachel Upthegrove
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Canada
- Birmingham Womens and Childrens, NHS Foundation Trust, Birmingham, UK
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Inge Winter-van Rossum
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Phillip Wolff
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Stephen J Wood
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Alison R Yung
- Institute of Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Carla Agurto
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Paul Amminger
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Marco Armando
- Youth Early Detection/Intervention in Psychosis Platform (Plateforme ERA), Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and The University of Lausanne, Lausanne, Switzerland
| | | | - John Cahill
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Ricardo E Carrión
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Eduardo Castro
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Suheyla Cetin-Karayumak
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Youngsun T Cho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - David Cotter
- Department Psychiatry, Beaumont Hospital, Dublin 9, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Simon D’Alfonso
- School of Computing and Information Systems, The University of Melbourne, Parkville, VIC, Australia
| | - Michaela Ennis
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Shreyas Fadnavis
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Caroline Gao
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Tina Gupta
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Holly K Hamilton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Gil D Hoftman
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Grace R Jacobs
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Johanna Jarcho
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Christian G Kohler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paris Alexandros Lalousis
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Suzie Lavoie
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Einat Liebenthal
- Program for Specialized Treatment Early in Psychosis (STEP), CMHC, New Haven, CT, USA
| | - Josh Mervis
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Vishnu Murty
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Spero C Nicholas
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Lipeng Ning
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Nora Penzel
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Russell Poldrack
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | - Danielle N Pratt
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Rachel Rabin
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | | | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Avraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jenna Reinen
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Jack Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Bernalyn Ruiz-Yu
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Isabelle Scott
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Vinod H Srihari
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Program for Specialized Treatment Early in Psychosis (STEP), CMHC, New Haven, CT, USA
| | - Agrima Srivastava
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew Thompson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Bruce I Turetsky
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara C Walsh
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Thomas Whitford
- Orygen, Parkville, VIC, Australia
- School of Psychology, University of New South Wales (UNSW), Kensington, NSW, Australia
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center,Groningen, Netherlands
| | - Beier Yao
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Hok Pan Yuen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Andrew (Jin Soo) Byun
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Yoonho Chung
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Kim Do
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
| | - Larry Hendricks
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Kevin Huynh
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Erlend Lane
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Carsten Langholm
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Eric Lin
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
- Medical Informatics Fellowship, Veteran Affairs Boston Healthcare System, Boston, MA, USA
- Food and Drug Administration, Silver Spring, MD, USA
| | - Valentina Mantua
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Gennarina Santorelli
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Kosha Ruparel
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Eirini Zoupou
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Tatiana Adasme
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Lauren Addamo
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Laura Adery
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Munaza Ali
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Andrea Auther
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Samantha Aversa
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | - Seon-Hwa Baek
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Kelly Bates
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Alyssa Bathery
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Johanna M M Bayer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Rebecca Beedham
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Zarina Bilgrami
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sonia Birch
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ilaria Bonoldi
- Department of Psychosis Studies, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Owen Borders
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Lisa Brown
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Alejandro Bruna
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Holly Carrington
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Rolando I Castillo-Passi
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana—Universidad del Desarrollo, Santiago, Chile
| | - Justine Chen
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicholas Cheng
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ann Ee Ching
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Chloe Clifford
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Beau-Luke Colton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Pamela Contreras
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Sebastián Corral
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Monica Done
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrés Estradé
- Early Psychosis Detection and Clinical Intervention (EPIC) Lab, Department of Psychosis Studies, King’s College London, London, UK
| | - Brandon Asika Etuka
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Melanie Formica
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Rachel Furlan
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Mia Geljic
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Carmela Germano
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ruth Getachew
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Anastasia Haidar
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica Hartmann
- Department of Public Mental Health, Central Institute of Mental Health, Heidelberg Univeristy, Mannheim, Germany
| | - Anna Jo
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Omar John
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Kerins
- Early Psychosis Detection and Clinical Intervention (EPIC) Lab, Department of Psychosis Studies, King’s College London, London, UK
| | - Melissa Kerr
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Irena Kesselring
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Nicholas Kim
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Kyle Kinney
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Marija Krcmar
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Elana Kotler
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Melanie Lafanechere
- School of Psychology, University of Birmingham, Edgbaston, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Clarice Lee
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Joshua Llerena
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | | | | | - Aissata Mavambu
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | | | - Amelia McDonnell
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Alessia McGowan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Rebecca McIlhenny
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brittany McQueen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Yohannes Mebrahtu
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Martina Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | | | - Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Neal Morrell
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Mariam Omar
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alice Partridge
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Christina Phassouliotis
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Anna Pichiecchio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Christian Porter
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Umberto Provenzani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Nicholas Prunier
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jasmine Raj
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Susan Ray
- Northwell Health, Glen Oaks, NY, USA
| | - Victoria Rayner
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Manuel Reyes
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana—Universidad del Desarrollo, Santiago, Chile
| | - Kate Reynolds
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sage Rush
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Cesar Salinas
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Jashmina Shetty
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Callum Snowball
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sophie Tod
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Daniela Valle
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Simone Veale
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Whitson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alana Wickham
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Youn
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Francisco Zamorano
- Unidad de imágenes cuantitativas avanzadas, departamento de imágenes, clínica alemana, universidad del Desarrollo, Santiago, Chile
- Facultad de ciencias para el cuidado de la salud, Universidad San Sebastián, Campus Los Leones, Santiago, Chile
| | - Elissa Zavaglia
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | - Jamie Zinberg
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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28
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Bailey B, Solida A, Andreou C, Plessen KJ, Conus P, Mercapide M, Kasparidi A, Conchon C, Sprüngli-Toffel E, Genoud D, Caron C, Golay P, Curtis L, Herbrecht E, Huber CG, Alameda L, Armando M. Pathways to care in youth and young adults at clinical high risk for psychosis in Switzerland: Current situation and clinical implementation of the PsyYoung project. Early Interv Psychiatry 2024. [PMID: 38676537 DOI: 10.1111/eip.13540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 03/22/2024] [Accepted: 04/19/2024] [Indexed: 04/29/2024]
Abstract
AIM We aim to give an insight into the current situation in Switzerland concerning the pathways to care of young people with clinical high risk of psychosis. In a second step we propose a procedure of optimizing pathways to care developed within the project PsyYoung. METHODS A qualitative survey derived and adapted from Kotlicka-Antczak et al. (2020) was conducted in large early detection services of three Swiss cantons (Geneva, Basel-Stadt, Vaud) focusing on pathways to care. More specifically, using questionnaires delivered to the heads of participating services, information was collected on referral sources, on activities to implement outreach campaigns and on the use of a pre-screening tool. RESULTS Main results on referral source indicated that sources were variable but seemed to come primarily from the medical sector and more so from the psychiatric sector. Very few referrals came from non-medical sectors. Outreach activities included the contact to other clinics as well as through brochures and posters. All services but one used the Prodromal Questionnaire - 16 as pre-screening tool. CONCLUSIONS All in all, the results indicate a referral and care pathway system implemented mostly within the medical and particularly mental health sector. Accordingly, the PsyYoung project proposes a procedure for pathways to care which could help overcome the obstacle of referrals being restrained to a narrow field of mental health and to harmonize the referral process within services dedicated to the same aim of helping young people at high risk of developing a psychosis.
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Affiliation(s)
- Barbara Bailey
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Basel, Switzerland
| | | | - Christina Andreou
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
- SRO Spital Oberaargau, Psychiatric Services, Langenthal, Switzerland
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Philippe Conus
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mathieu Mercapide
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
| | - Afrodite Kasparidi
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
| | - Caroline Conchon
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elodie Sprüngli-Toffel
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Davina Genoud
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
| | - Camille Caron
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Basel, Switzerland
| | - Philippe Golay
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Logos Curtis
- Unité de Psychiatrie du Jeune Adulte, Service des spécialités psychiatriques, Département de psychiatrie, Hôpital Universitaire de Geneve, Geneve, Switzerland
| | - Evelyn Herbrecht
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Basel, Switzerland
| | - Christian G Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Basel, Switzerland
| | - Luis Alameda
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Psychology and Neuroscience, King's College of London, London, UK
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM); Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Marco Armando
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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29
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Dolz M, Tor J, Puig O, de la Serna E, Muñoz-Samons D, Pardo M, Alvarez-Subiela X, Rodriguez-Pascual M, Sugranyes G, Ilzarbe D, Baeza I. Clinical and neurodevelopmental predictors of psychotic disorders in children and adolescents at clinical high risk for psychosis: the CAPRIS study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02436-4. [PMID: 38642116 DOI: 10.1007/s00787-024-02436-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 04/04/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND The neurodevelopmental hypothesis of schizophrenia represents the disorder as an expression of an alteration during the brain development process early in life. Neurodevelopmental variables could become a trait marker, and the study of these variables in children and adolescents at clinical high risk for psychosis (CHR) could identify a specific cluster of patients who later developed psychosis. The aim of this study is to describe clinical and neurodevelopment predictors of transition to psychosis in child and adolescent participants at CHR. Naturalistic longitudinal two-center study of 101 CHR and 110 healthy controls (HC) aged 10-17. CHR participants were children and adolescents aged 10-17, meeting one or more of the CHR criteria assessed at baseline and at 18 months' follow-up. Neurodevelopmental variables assessed were obstetric complications, delay in principal development milestones, and presence of a neurodevelopment diagnosis. Pairwise comparisons, linear regressions, and binary logistic regression were performed.A transition rate of 23.3% at 1.5 years was observed. Participants who developed psychosis (CHR-P) showed higher rates of grandiosity and higher proportions of antipsychotic medication intake at baseline compared to participants who did not develop a psychotic disorder (CHR-NP). In terms of neurodevelopment alterations, CHR-P group showed a higher proportion of participants reporting delay in language development than the CHR-NP and HC groups. The odds of psychosis increased by 6.238 CI 95% [1.276-30.492] for a one-unit increase in having a positive score in grandiosity; they increased by 4.257 95% CI [1.293-14.023] for a one-unit increase in taking antipsychotic medication, and by 4.522 95% [1.185-64.180] for showing language development delay. However, the p-values did not reach significance after adjusting for multiple comparisons.A combination of clinical and neurodevelopmental alterations could help predict the transition to psychotic disorder in a CHR child and adolescent sample. Our results suggest the potential utility of collecting information about neurodevelopment and using these variable multifactorial models to predict psychosis disorders.
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Affiliation(s)
- Montserrat Dolz
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
- Universitat Autonoma de Barcelona, Bellaterra, Spain
| | - Jordina Tor
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain.
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain.
| | - Olga Puig
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, Barcelona, SGR2021-01319, Spain
| | - Daniel Muñoz-Samons
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Marta Pardo
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Xavier Alvarez-Subiela
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Marta Rodriguez-Pascual
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Gisela Sugranyes
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002,Esplugues de Llobregat, Barcelona, 08950, Spain
| | - Daniel Ilzarbe
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM-ISCIII, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic Universitari of Barcelona, Barcelona, SGR2021-01319, Spain
- Fundació Clínic per a la Recerca Biomèdica-IDIBAPS, Barcelona, Spain
- Department of Medicine, Institute of Neurosciences, University of Barcelona, Bellaterra, Spain
| | - Inmaculada Baeza
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 39-57, Esplugues de Llobregat, Barcelona, 08950, Spain
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30
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Sancho-Echeverria R, Aymerich C, Rodríguez-Sánchez JM, Gil P, Pedruzo B, González-Torres MÁ, Fusar-Poli P, Arango C, Catalan A. Effect of long-acting antipsychotic treatment on psychiatric hospitalization rate in early psychosis patients: a naturalistic study. Ther Adv Psychopharmacol 2024; 14:20451253241243273. [PMID: 38644940 PMCID: PMC11032064 DOI: 10.1177/20451253241243273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 02/28/2024] [Indexed: 04/23/2024] Open
Abstract
Background The effectiveness of long-acting injectable (LAI) antipsychotics in preventing relapses of first-episode psychosis is currently debated. Objectives The study aimed to investigate the number of psychiatric hospitalizations comparing the LAI cohort versus the oral cohort during different phases of the illness, pre-LAI treatment, during LAI treatment, and after LAI treatment. Design A naturalistic study was conducted on two independent cohorts of early psychosis patients receiving treatment from a specific early intervention service. The first cohort comprised 228 patients who received LAIs, while the second cohort comprised 667 patients who had never received LAIs. Methods This study was designed as a longitudinal observational study conducted within a naturalistic clinical setting in two cohorts of early psychosis patients. Repeated series ANCOVA (ANCOVA-r) was used to study the number of hospitalizations in the different study periods (T1 = from the date of the first psychiatric record to the beginning of the mirror period; T2 = the mirror period; T3 = from the LAI implementation to the LAI discontinuation; and T4 = from the LAI discontinuation to the end). In all cases, discontinuation of LAI involved the return to oral treatment. In all, 35 patients had not T4 as they were still on LAI treatment at the time of database closing (September 2020), and their data were not included in the analysis of the effect of the LAI discontinuation. Results The patients in the LAI cohort were younger, more frequently males, presented more schizophrenia diagnoses, and had a higher number of hospitalizations (2.50 ± 2.61 versus 1.19 ± 1.69; p < 0.001) than the oral cohort. The number of hospitalizations at the end of the follow-up was higher in the LAI cohort [0.20 (standard deviation (SD)) = 0.79] versus 0.45 [SD = 0.45 (SD = 1.13); F(23.90), p < 0.001]. However, after the introduction of LAIs, the differences in hospitalization rates between the two cohorts became less pronounced. Once LAI treatment was ceased, the hospitalization rate increased again. Conclusion In our study, early psychosis patients receiving LAIs experienced a greater decrease in hospitalizations after introducing the LAI treatment than those treated solely with oral medication. These findings support using LAIs as a viable strategy for preventing rehospitalization and improving the overall course of treatment for individuals with early psychosis.
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Affiliation(s)
- Raúl Sancho-Echeverria
- Red de Salud Mental, Biocruces Bizkaia Health Research Institute, c/Ronda, Bilbao, Bizkaia, Spain
| | - Claudia Aymerich
- Biobizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- Basurto University Hospital, OSI Bilbao-Basurto, Bilbao, Bizkaia, Spain
- Centro de Investigación en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Patxi Gil
- Red de Salud Mental, Biocruces Bizkaia Health Research Institute, c/Ronda, Bilbao, Bizkaia, Spain
| | - Borja Pedruzo
- Basurto University Hospital, OSI Bilbao-Basurto, Bilbao, Bizkaia, Spain
| | - Miguel Ángel González-Torres
- Biobizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- Basurto University Hospital, OSI Bilbao-Basurto, Bizkaia, Spain
- University of the Basque Country (UPV/EHU), Barrio Sarriena, Leioa, Bizkaia, Spain
- Centro de Investigación en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- OASIS Service, South London and Maudsley National Health Service Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, UK
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación en Red de Salud Mental, Madrid, Spain
| | - Ana Catalan
- Basurto University Hospital, OSI Bilbao-Basurto, Av, Montevideo 18, 48013 Bilbao, Bizkaia, Spain
- Biobizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- University of the Basque Country (UPV/EHU), Barrio Sarriena, Leioa, Bizkaia, Spain
- Centro de Investigación en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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31
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Jonas KG, Cannon TD, Docherty AR, Dwyer D, Gur RC, Gur RE, Nelson B, Reininghaus U, Kotov R. Psychosis superspectrum I: Nosology, etiology, and lifespan development. Mol Psychiatry 2024; 29:1005-1019. [PMID: 38200290 PMCID: PMC11385553 DOI: 10.1038/s41380-023-02388-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024]
Abstract
This review describes the Hierarchical Taxonomy of Psychopathology (HiTOP) model of psychosis-related psychopathology, the psychosis superspectrum. The HiTOP psychosis superspectrum was developed to address shortcomings of traditional diagnoses for psychotic disorders and related conditions including low reliability, arbitrary boundaries between psychopathology and normality, high symptom co-occurrence, and heterogeneity within diagnostic categories. The psychosis superspectrum is a transdiagnostic dimensional model comprising two spectra-psychoticism and detachment-which are in turn broken down into fourteen narrow components, and two auxiliary domains-cognition and functional impairment. The structure of the spectra and their components are shown to parallel the genetic structure of psychosis and related traits. Psychoticism and detachment have distinct patterns of association with urbanicity, migrant and ethnic minority status, childhood adversity, and cannabis use. The superspectrum also provides a useful model for describing the emergence and course of psychosis, as components of the superspectrum are relatively stable over time. Changes in psychoticism predict the onset of psychosis-related psychopathology, whereas changes in detachment and cognition define later course. Implications of the superspectrum for genetic, socio-environmental, and longitudinal research are discussed. A companion review focuses on neurobiology, treatment response, and clinical utility of the superspectrum, and future research directions.
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Affiliation(s)
- Katherine G Jonas
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA.
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Anna R Docherty
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ruben C Gur
- Brain Behavior Laboratory, Department of Psychiatry and the Penn-CHOP Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Raquel E Gur
- Brain Behavior Laboratory, Department of Psychiatry and the Penn-CHOP Lifespan Brain Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
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Hou Y, Xia H, He T, Zhang B, Qiu G, Chen A. N2 Responses in Youths With Psychosis Risk Syndrome and Their Association With Clinical Outcomes: A Cohort Follow-Up Study Based on the Three-Stimulus Visual Oddball Paradigm. Am J Psychiatry 2024; 181:330-341. [PMID: 38419496 DOI: 10.1176/appi.ajp.20221013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Schizophrenia often occurs during youth, and psychosis risk syndrome occurs before the onset of psychosis. The aim of this study was to determine whether the visual event-related potential responses in youths with psychosis risk syndrome were defective in the presence of interference stimuli and associated with their clinical outcomes. METHODS A total of 223 participants, including 122 patients with psychosis risk syndrome, 50 patients with emotional disorders, and 51 healthy control subjects, were assessed. Baseline EEG was recorded during the three-stimulus visual oddball task. The event-related potentials induced by square pictures with different colors were measured. Almost all patients with psychosis risk syndrome were followed up for 12 months and were reclassified into three subgroups: conversion, symptomatic, and remission. The differences in baseline event-related potential responses were compared among the clinical outcome subgroups. RESULTS The average N2 amplitude of the psychosis risk syndrome group was significantly less negative than that in the healthy control group (d=0.53). The baseline average N2 amplitude in the conversion subgroup was significantly less negative than that in the symptomatic (d=0.58) and remission (d=0.50) subgroups and in the healthy control group (d=0.97). The average N2 amplitude did not differ significantly between the symptomatic and remission subgroups (d=0.02). However, it was significantly less negative in the symptomatic and remission subgroups than in the healthy control group (d=0.46 and d=0.38). No statistically significant results were found in the P3 response. CONCLUSIONS Youths with psychosis risk syndrome had significant N2 amplitude defects in attention processing with interference stimuli. N2 amplitude shows potential as a prognostic biomarker of clinical outcome in the psychosis risk syndrome.
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Affiliation(s)
- Yongqing Hou
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Haishuo Xia
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Tianbao He
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Bohua Zhang
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Guiping Qiu
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Antao Chen
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
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Woods SW, Parker S, Kerr MJ, Walsh BC, Wijtenburg SA, Prunier N, Nunez AR, Buccilli K, Mourgues-Codern C, Brummitt K, Kinney KS, Trankler C, Szacilo J, Colton BL, Ali M, Haidar A, Billah T, Huynh K, Ahmed U, Adery LL, Marcy PJ, Allott K, Amminger P, Arango C, Broome MR, Cadenhead KS, Chen EY, Choi J, Conus P, Cornblatt BA, Glenthøj LB, Horton LE, Kambeitz J, Kapur T, Keshavan MS, Koutsouleris N, Langbein K, Lavoie S, Diaz-Caneja CM, Mathalon DH, Mittal VA, Nordentoft M, Pasternak O, Pearlson GD, Ramos PAG, Shah JL, Smesny S, Stone WS, Strauss GP, Wang J, Corcoran CM, Perkins DO, Schiffman J, Perez J, Mamah D, Ellman LM, Powers AR, Coleman MJ, Anticevic A, Fusar-Poli P, Kane JM, Kahn RS, McGorry PD, Bearden CE, Shenton ME, Nelson B, Calkins ME, Hendricks L, Bouix S, Addington J, McGlashan TH, Yung AR. Development of the PSYCHS: Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS. Early Interv Psychiatry 2024; 18:255-272. [PMID: 37641537 PMCID: PMC10899527 DOI: 10.1111/eip.13457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 08/31/2023]
Abstract
AIM To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR-P): the Structured Interview for Psychosis-risk Syndromes (SIPS) and the Comprehensive Assessment of At-Risk Mental States (CAARMS). METHODS The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR-P through an intensive series of joint videoconferences. RESULTS Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and modest harmonization for CHR-P criteria. The semi-structured interview, named Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS (PSYCHS), generates CHR-P criteria and severity scores for both CAARMS and SIPS. CONCLUSIONS Using the PSYCHS for CHR-P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta-analyses.
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Affiliation(s)
- Scott W. Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Sophie Parker
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Melissa J. Kerr
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Barbara C. Walsh
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - S. Andrea Wijtenburg
- Division of Translational Research, National Institute of Mental Health, Bethesda, MD, USA
| | - Nicholas Prunier
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Angela R. Nunez
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Kate Buccilli
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Catalina Mourgues-Codern
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Kali Brummitt
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Kyle S. Kinney
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Carli Trankler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Julia Szacilo
- CAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Beau-Luke Colton
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Munaza Ali
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Anastasia Haidar
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Tashrif Billah
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Kevin Huynh
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Uzair Ahmed
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Laura L. Adery
- Departments of Psychiatry and Biobehavioral Sciences & Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | | | - Kelly Allott
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Paul Amminger
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Matthew R. Broome
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | | | | | - Jimmy Choi
- Olin Neuropsychiatry Research Center, Hartford HealthCare Behavioral Health Network, Hartford, CT, USA
| | - Philippe Conus
- Chef de Service Service de Psychiatrie Générale Dép. de Psychiatrie CHUV Lausanne, Switzerland
| | - Barbara A. Cornblatt
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA
- Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Louise Birkedal Glenthøj
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
| | - Leslie E. Horton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Joseph Kambeitz
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Tina Kapur
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Germany
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Suzie Lavoie
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Covadonga Martinez Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Daniel H. Mathalon
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116D, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Chicago, IL, USA
| | - Merete Nordentoft
- Mental Health Services in the Capital Region, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ofer Pasternak
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Godfrey D. Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Jai L. Shah
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - William S. Stone
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cheryl M. Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Diana O. Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Jesus Perez
- CAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute of Biomedical Research (IBSAL), Department of Medicine, Universidad de Salamanca, Salamanca, Spain
| | - Daniel Mamah
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Lauren M. Ellman
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Albert R. Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Michael J. Coleman
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King’s College London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - John M. Kane
- Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA
| | - Rene S. Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Patrick D. McGorry
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Carrie E. Bearden
- Departments of Psychiatry and Biobehavioral Sciences & Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Martha E. Shenton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Monica E. Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Larry Hendricks
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Sylvain Bouix
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Software Engineering and Information Technology, École de Technologie Supérieure, Université du Québec, Montréal, QC, Canada
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Thomas H. McGlashan
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Alison R. Yung
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Orygen, Parkville, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
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Davies C, Bossong MG, Martins D, Wilson R, Appiah-Kusi E, Blest-Hopley G, Zelaya F, Allen P, Brammer M, Perez J, McGuire P, Bhattacharyya S. Increased hippocampal blood flow in people at clinical high risk for psychosis and effects of cannabidiol. Psychol Med 2024; 54:993-1003. [PMID: 37845827 DOI: 10.1017/s0033291723002775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
BACKGROUND Hippocampal hyperperfusion has been observed in people at Clinical High Risk for Psychosis (CHR), is associated with adverse longitudinal outcomes and represents a potential treatment target for novel pharmacotherapies. Whether cannabidiol (CBD) has ameliorative effects on hippocampal blood flow (rCBF) in CHR patients remains unknown. METHODS Using a double-blind, parallel-group design, 33 CHR patients were randomized to a single oral 600 mg dose of CBD or placebo; 19 healthy controls did not receive any drug. Hippocampal rCBF was measured using Arterial Spin Labeling. We examined differences relating to CHR status (controls v. placebo), effects of CBD in CHR (placebo v. CBD) and linear between-group relationships, such that placebo > CBD > controls or controls > CBD > placebo, using a combination of hypothesis-driven and exploratory wholebrain analyses. RESULTS Placebo-treated patients had significantly higher hippocampal rCBF bilaterally (all pFWE<0.01) compared to healthy controls. There were no suprathreshold effects in the CBD v. placebo contrast. However, we found a significant linear relationship in the right hippocampus (pFWE = 0.035) such that rCBF was highest in the placebo group, lowest in controls and intermediate in the CBD group. Exploratory wholebrain results replicated previous findings of hyperperfusion in the hippocampus, striatum and midbrain in CHR patients, and provided novel evidence of increased rCBF in inferior-temporal and lateral-occipital regions in patients under CBD compared to placebo. CONCLUSIONS These findings suggest that hippocampal blood flow is elevated in the CHR state and may be partially normalized by a single dose of CBD. CBD therefore merits further investigation as a potential novel treatment for this population.
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Affiliation(s)
- Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthijs G Bossong
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Daniel Martins
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Robin Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Elizabeth Appiah-Kusi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Michael Brammer
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jesus Perez
- CAMEO Early Intervention Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute of Biomedical Research (IBSAL), Department of Medicine, Universidad de Salamanca, Salamanca, Spain
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Iftimovici A, He Q, Jiao C, Duchesnay E, Krebs MO, Kebir O, Chaumette B. Longitudinal MicroRNA Signature of Conversion to Psychosis. Schizophr Bull 2024; 50:363-373. [PMID: 37607340 PMCID: PMC10919777 DOI: 10.1093/schbul/sbad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
BACKGROUND AND HYPOTHESIS The emergence of psychosis in ultra-high-risk subjects (UHR) is influenced by gene-environment interactions that rely on epigenetic mechanisms such as microRNAs. However, whether they can be relevant pathophysiological biomarkers of psychosis' onset remains unknown. STUDY DESIGN We present a longitudinal study of microRNA expression, measured in plasma by high-throughput sequencing at baseline and follow-up, in a prospective cohort of 81 UHR, 35 of whom developed psychosis at follow-up (converters). We combined supervised machine learning and differential graph analysis to assess the relative weighted contribution of each microRNA variation to the difference in outcome and identify outcome-specific networks. We then applied univariate models to the resulting microRNA variations common to both strategies, to interpret them as a function of demographic and clinical covariates. STUDY RESULTS We identified 207 microRNA variations that significantly contributed to the classification. The differential network analysis found 276 network-specific correlations of microRNA variations. The combination of both strategies identified 25 microRNAs, whose gene targets were overrepresented in cognition and schizophrenia genome-wide association studies findings. Interpretable univariate models further supported the relevance of miR-150-5p and miR-3191-5p variations in psychosis onset, independent of age, sex, cannabis use, and medication. CONCLUSIONS In this first longitudinal study of microRNA variation during conversion to psychosis, we combined 2 methodologically independent data-driven strategies to identify a dynamic epigenetic signature of the emergence of psychosis that is pathophysiologically relevant.
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Affiliation(s)
- Anton Iftimovici
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Université de Paris, Paris, France
- CEA Paris-Saclay, Joliot Institute, NeuroSpin, BAOBAB, Centre d'études de Saclay, Gif-sur-Yvette, France
| | - Qin He
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Université de Paris, Paris, France
| | - Chuan Jiao
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Université de Paris, Paris, France
| | - Edouard Duchesnay
- CEA Paris-Saclay, Joliot Institute, NeuroSpin, BAOBAB, Centre d'études de Saclay, Gif-sur-Yvette, France
| | - Marie-Odile Krebs
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Université de Paris, Paris, France
- GHU Paris Psychiatrie et Neurosciences, Pôle hospitalo-universitaire d'Evaluation, Prévention, et Innovation Thérapeutique (PEPIT), Paris, France
| | - Oussama Kebir
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Université de Paris, Paris, France
- GHU Paris Psychiatrie et Neurosciences, Pôle hospitalo-universitaire d'Evaluation, Prévention, et Innovation Thérapeutique (PEPIT), Paris, France
| | - Boris Chaumette
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, GDR 3557-Institut de Psychiatrie, Université de Paris, Paris, France
- GHU Paris Psychiatrie et Neurosciences, Pôle hospitalo-universitaire d'Evaluation, Prévention, et Innovation Thérapeutique (PEPIT), Paris, France
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
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Salazar de Pablo G, Aymerich C, Guinart D, Catalan A, Alameda L, Trotta G, Armendariz A, Martinez Baringo E, Soler-Vidal J, Rubio JM, Garrido-Torres N, Gómez-Vallejo S, Kane JM, Howes O, Fusar-Poli P, Correll CU. What is the duration of untreated psychosis worldwide? - A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies. Psychol Med 2024; 54:652-662. [PMID: 38087871 DOI: 10.1017/s0033291723003458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Duration of untreated psychosis (DUP) has been associated with poor mental health outcomes. We aimed to meta-analytically estimate the mean and median DUP worldwide, evaluating also the influence of several moderating factors. This PRISMA/MOOSE-compliant meta-analysis searched for non-overlapping individual studies from inception until 9/12/2022, reporting mean ± s.d. or median DUP in patients with first episode psychosis (FEP), without language restrictions. We conducted random-effect meta-analyses, stratified analyses, heterogeneity analyses, meta-regression analyses, and quality assessment (PROSPERO:CRD42020163640). From 12 461 citations, 369 studies were included. The mean DUP was 42.6 weeks (95% confidence interval (CI) 40.6-44.6, k = 283, n = 41 320), varying significantly across continents (p < 0.001). DUP was (in descending order) 70.0 weeks (95% CI 51.6-88.4, k = 11, n = 1508) in Africa; 48.8 weeks (95% CI 43.8-53.9, k = 73, n = 12 223) in Asia; 48.7 weeks (95% CI 43.0-54.4, k = 36, n = 5838) in North America; 38.6 weeks (95% CI 36.0-41.3, k = 145, n = 19 389) in Europe; 34.9 weeks (95% CI 23.0-46.9, k = 11, n = 1159) in South America and 28.0 weeks (95% CI 20.9-35.0, k = 6, n = 1203) in Australasia. There were differences depending on the income of countries: DUP was 48.4 weeks (95% CI 43.0-48.4, k = 58, n = 5635) in middle-low income countries and 41.2 weeks (95% CI 39.0-43.4, k = 222, n = 35 685) in high income countries. Longer DUP was significantly associated with older age (β = 0.836, p < 0.001), older publication year (β = 0.404, p = 0.038) and higher proportion of non-White FEP patients (β = 0.232, p < 0.001). Median DUP was 14 weeks (Interquartile range = 8.8-28.0, k = 206, n = 37 215). In conclusion, DUP is high throughout the world, with marked variation. Efforts to identify and intervene sooner in patients with FEP, and to promote global mental health and access to early intervention services (EIS) are critical, especially in developing countries.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Barakaldo, Bizkaia, Spain
| | - Daniel Guinart
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Institut de Salut Mental, Hospital del Mar Research Institute (CIBERSAM), Barcelona, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Barakaldo, Bizkaia, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- University Hospital Virgen del Rocio-IBIS Sevilla, CIBERSAM, ISCIII Spanish Network for Research in Mental Health, Sevilla, Spain
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alvaro Armendariz
- Unidad Terapéutica Centre Educatiu Els Til·lers, Parc Sanitari Sant Joan de Déu, Barcelona
- Grup MERITT: Etiopatogènia i tractament dels trastorns mentals greus
| | - Estrella Martinez Baringo
- Department of Psychiatry and Psychology, Hospital Sant Joan de Déu de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Soler-Vidal
- FIDMAG Germanas Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Benito Menni CASM, Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Jose M Rubio
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Nathalia Garrido-Torres
- University Hospital Virgen del Rocio-IBIS Sevilla, CIBERSAM, ISCIII Spanish Network for Research in Mental Health, Sevilla, Spain
| | - Sandra Gómez-Vallejo
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Faculty of Medicine, Institute of Clinical Sciences, Imperial College London, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) service, South London and Maudsley (SLaM) NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Berlin, Germany
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Berlin, Germany
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Destrée L, McGorry P, Chanen A, Ratheesh A, Davey C, Polari A, Amminger P, Yuen HP, Hartmann J, Dwyer D, Spooner R, Nelson B. Transdiagnostic risk identification: A validation study of the Clinical High At Risk Mental State (CHARMS) criteria. Psychiatry Res 2024; 333:115745. [PMID: 38271886 DOI: 10.1016/j.psychres.2024.115745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/19/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
A set of clinical criteria, the Clinical High At-Risk Mental State (CHARMS) criteria, have been developed to identify symptomatic young people who are at-risk of disorder progression. The current study aimed to validate the CHARMS criteria by testing whether they prospectively identify individuals at-risk of progressing from attenuated symptomatology to a first episode of serious mental disorder, namely first episode psychosis, first episode mania, severe major depression, and borderline personality disorder. 121 young people completed clinical evaluations at baseline, 6- and 12-month follow-up. The Kaplan-Meier method was used to assess transition rates. Cox regression and LASSO were used to examine baseline clinical predictors of transition. Linear mixed effects modelling was used to examine symptom severity. 28 % of CHARMS+ individuals transitioned to a Stage 2 disorder by 12-month follow-up. The CHARMS+ group had more severe symptoms at follow-up than the CHARMS- group. 96 % of Stage 2 transitions were initially to severe depression. Meeting criteria for multiple CHARMS subgroups was associated with higher transition risk: meeting one at-risk group = 24 %; meeting two at-risk groups = 17 %, meeting three at-risk groups = 55 %, meeting four at-risk groups = 50 %. The strongest baseline predictor of transition was severity of depressive symptoms. The CHARMS criteria identified a group of individuals at-risk of imminent onset of severe mental disorder, particularly severe depression. Larger scale studies and longer follow-up periods are required to validate and extend these findings.
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Affiliation(s)
- Louise Destrée
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia; Orygen, Parkville, VIC, Australia.
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew Chanen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Aswin Ratheesh
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher Davey
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrea Polari
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul Amminger
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jessica Hartmann
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Dominic Dwyer
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Rachael Spooner
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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38
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Schneider RB, Auinger P, Dobkin RD, Mills KA, Kulick-Soper CV, Myers TL, Korell M, Pontone GM, Nirenberg MJ. Minor Phenomena in Parkinson's Disease-Prevalence, Associations, and Risk of Developing Psychosis. J Geriatr Psychiatry Neurol 2024; 37:134-145. [PMID: 37542397 DOI: 10.1177/08919887231195220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
BACKGROUND Minor phenomena, including passage phenomena, feeling of presence, and illusions, are common and may represent a prodromal form of psychosis in Parkinson's disease (PD). We examined the prevalence and clinical correlates of minor phenomena, and their potential role as a risk factor for PD psychosis. METHODS A novel questionnaire, the Psychosis and Mild Perceptual Disturbances Questionnaire for PD (PMPDQ), was completed by Fox Insight cohort participants with and without PD. Additional assessments included the Non-Motor Symptoms Questionnaire (NMSQuest), REM Sleep Behavior Disorder Single Question Screen (RBD1Q), Movement Disorder Society-Unified Parkinson Disease Rating Scale Part II, demographic features, and medication usage. For participants with PD, we used regression models to identify clinical associations and predictors of incident psychosis over one year of follow-up. RESULTS Among participants with PD (n = 5950) and without PD (n = 1879), the prevalence of minor phenomena was 43.1% and 31.7% (P < .001). Of the 3760 participants with PD and no baseline psychosis, independent correlates of minor phenomena included positive responses on the NMSQuest apathy/attention/memory (OR 1.7, 95% CI 1.3-2.1, P < .001) or sexual function domain (OR 1.3, 95% CI 1.1-1.6, P = .01) and positive RBD1Q (OR 1.3, 95% CI 1.05-1.5, P = .01). Independent risk factors for incident PD psychosis included the presence of minor phenomena (HR 3.0, 95% CI 2.4-3.9, P < .001), positive response on the NMSQuest apathy/attention/memory domain (HR 1.8, 95% CI 1.3-2.6, P < .001), and positive RBD1Q (HR 1.5, 95% CI 1.1-1.9, P = .004). CONCLUSIONS Minor phenomena are common, associated with specific non-motor symptoms, and an independent predictor of incident psychosis in PD.
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Affiliation(s)
- Ruth B Schneider
- Department of Neurology, University of Rochester, Rochester, NY, USA
- Center for Health & Technology, University of Rochester, Rochester, NY, USA
| | - Peggy Auinger
- Department of Neurology, University of Rochester, Rochester, NY, USA
- Center for Health & Technology, University of Rochester, Rochester, NY, USA
| | - Roseanne D Dobkin
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Kelly A Mills
- Departments of Neurology and Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Taylor L Myers
- Center for Health & Technology, University of Rochester, Rochester, NY, USA
| | - Monica Korell
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gregory M Pontone
- Departments of Neurology and Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Melissa J Nirenberg
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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39
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Cleverley K, Foussias G, Ameis SH, Courtney DB, Goldstein BI, Hawke LD, Kozloff N, Quilty LC, Rotenberg M, Wheeler AL, Andrade BF, Aitken M, Mahleka D, Jani M, Frayne M, Wong JKY, Kelly R, Dickie EW, Felsky D, Haltigan JD, Lai MC, Nikolova YS, Tempelaar W, Wang W, Battaglia M, Husain MO, Kidd S, Kurdyak P, Levitan RD, Lewis SP, Polillo A, Szatmari P, van der Miesen AIR, Ahmadzadasl M, Voineskos AN. The Toronto Adolescent and Youth Cohort Study: Study Design and Early Data Related to Psychosis Spectrum Symptoms, Functioning, and Suicidality. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:253-264. [PMID: 37979943 DOI: 10.1016/j.bpsc.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Psychosis spectrum symptoms (PSSs) occur in a sizable percentage of youth and are associated with poorer cognitive performance, poorer functioning, and suicidality (i.e., suicidal thoughts and behaviors). PSSs may occur more frequently in youths already experiencing another mental illness, but the antecedents are not well known. The Toronto Adolescent and Youth (TAY) Cohort Study aims to characterize developmental trajectories in youths with mental illness and understand associations with PSSs, functioning, and suicidality. METHODS The TAY Cohort Study is a longitudinal cohort study that aims to assess 1500 youths (age 11-24 years) presenting to tertiary care. In this article, we describe the extensive diagnostic and clinical characterization of psychopathology, substance use, functioning, suicidality, and health service utilization in these youths, with follow-up every 6 months over 5 years, including early baseline data. RESULTS A total of 417 participants were enrolled between May 4, 2021, and February 2, 2023. Participants met diagnostic criteria for an average of 3.5 psychiatric diagnoses, most frequently anxiety and depressive disorders. Forty-nine percent of participants met a pre-established threshold for PSSs and exhibited higher rates of functional impairment, internalizing and externalizing symptoms, and suicidality than participants without PSSs. CONCLUSIONS Initial findings from the TAY Cohort Study demonstrate the feasibility of extensive clinical phenotyping in youths who are seeking help for mental health problems. PSS prevalence is much higher than in community-based studies. Our early data support the critical need to better understand longitudinal trajectories of clinical youth cohorts in relation to psychosis risk, functioning, and suicidality.
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Affiliation(s)
- Kristin Cleverley
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - George Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Darren B Courtney
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin I Goldstein
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lisa D Hawke
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Kozloff
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Martin Rotenberg
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anne L Wheeler
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Hospital for Sick Children, Neurosciences and Mental Health Program, Toronto, Ontario, Canada
| | - Brendan F Andrade
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Madison Aitken
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Don Mahleka
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Melanie Jani
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Margot Frayne
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jimmy K Y Wong
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rachel Kelly
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Felsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John D Haltigan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; National Taiwan University Hospital and College of Medicine, Taiwan
| | - Yuliya S Nikolova
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wanda Tempelaar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wei Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marco Battaglia
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Muhammad Omair Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sean Kidd
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert D Levitan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephen P Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Alexia Polillo
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Szatmari
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Hospital for Sick Children, Neurosciences and Mental Health Program, Toronto, Ontario, Canada
| | - Anna I R van der Miesen
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Masoud Ahmadzadasl
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N Voineskos
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Opie JE, Esler TB, Clancy EM, Wright B, Painter F, Vuong A, Booth AT, Newman L, Johns-Hayden A, Hameed M, Hooker L, Olsson C, McIntosh JE. Universal Digital Programs for Promoting Mental and Relational Health for Parents of Young Children: A Systematic Review and Meta-Analysis. Clin Child Fam Psychol Rev 2024; 27:23-52. [PMID: 37917315 PMCID: PMC10920439 DOI: 10.1007/s10567-023-00457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 11/04/2023]
Abstract
Digital parenting programs aim to increase program access, improve psychosocial outcomes for parents and children, and support triage to targeted interventions where required. This meta-analysis assessed the efficacy of online parenting programs in improving parenting skills and capabilities, and by consequence, the mental health and well-being of parents and children, and the quality of the parent-child relationship. Studies were included if they were: (1) online, (2) self-delivered, (3) designed for universal general population prevention, (4) evaluated experimental or quasi-experimental designs, and (5) assessed parent and child emotional and/or relational health, from pregnancy to 5 years of age. A systematic search of electronic databases and grey literature identified 22 studies that met inclusion criteria, including 24 independent samples, with 5671 unique parents. Meta-analyses were conducted using random effects models and Cohen's d effects. Small-to-moderate improvements in parent depression, anxiety, self-efficacy, and social support were observed. No effects on parent stress, satisfaction, or parent-child relationship quality were observed. Meta-regression and sub-group analysis were conducted to identify sensitivity or moderation effects. Collectively, findings suggest any benefits of online parenting programs mostly occur at the time of the intervention, for parent mental health and well-being outcomes, and that enduring effects are unlikely. However, given the cost effectiveness and accessibility of online programs, further research into ways of sustaining effects on parenting outcomes is warranted. Furthermore, given the centrality of the parent-child bond to child development across the lifecourse, additional investment in new digitally facilitated approaches focusing on this bond are likewise warranted.PROSPERO registration CRD42021275647.
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Affiliation(s)
- Jessica E Opie
- La Trobe University, Melbourne, Victoria, Australia.
- The Bouverie Centre, La Trobe University, Melbourne, Australia.
| | | | | | | | - Felicity Painter
- La Trobe University, Melbourne, Victoria, Australia
- The Bouverie Centre, La Trobe University, Melbourne, Australia
| | - An Vuong
- La Trobe University, Melbourne, Victoria, Australia
- The Bouverie Centre, La Trobe University, Melbourne, Australia
| | - Anna T Booth
- La Trobe University, Melbourne, Victoria, Australia
- The Bouverie Centre, La Trobe University, Melbourne, Australia
| | - Louise Newman
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | | | - Mohajer Hameed
- La Trobe University, Melbourne, Victoria, Australia
- The Bouverie Centre, La Trobe University, Melbourne, Australia
| | - Leesa Hooker
- Judith Lumley Centre and La Trobe Rural Health School, La Trobe University, Melbourne, Australia
| | - Craig Olsson
- School of Psychology, Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Jennifer E McIntosh
- La Trobe University, Melbourne, Victoria, Australia
- The Bouverie Centre, La Trobe University, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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41
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Åmlid HO, Carlsson J, Bjørnestad J, Joa I, Hegelstad WTV. We need to talk: a qualitative inquiry into pathways to care for young men at ultra-high risk for psychosis. Front Psychol 2024; 15:1282432. [PMID: 38410399 PMCID: PMC10894910 DOI: 10.3389/fpsyg.2024.1282432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/25/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction It is known from the literature that men are slower to seek help and staying engaged in mental health care compared to women. Seeing that in psychosis, men more often than women have insidious onsets but also a more malign illness course, it is important to find ways to improve timely help-seeking. The aim of this study was to explore barriers and facilitators for help-seeking in young male persons struggling with early signs of psychosis. Methods Qualitative interviews with nine young men who suffer from a first episode of psychosis or psychosis risk symptoms. Results Male stereotypical ideals, significant others, and knowledge of symptoms and where to get help as well characteristics of symptom trajectories appeared to be important determinants of help-seeking behavior. Discussion Interviews indicated that help-seeking in the participants was delayed first, because of reluctancy to disclose distress and second, because significant others were unable to accurately recognize symptoms. Information, awareness, and easy access to care remain important in early detection and intervention in psychosis and psychosis risk. However, more emphasis should be placed on de-stigmatizing mental health problems in men and aiming information specifically at them.
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Affiliation(s)
- Håkon Olav Åmlid
- TIPS – Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Jan Carlsson
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Jone Bjørnestad
- TIPS – Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Inge Joa
- TIPS – Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Institute of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Wenche ten Velden Hegelstad
- TIPS – Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
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Tandon R, Nasrallah H, Akbarian S, Carpenter WT, DeLisi LE, Gaebel W, Green MF, Gur RE, Heckers S, Kane JM, Malaspina D, Meyer-Lindenberg A, Murray R, Owen M, Smoller JW, Yassin W, Keshavan M. The schizophrenia syndrome, circa 2024: What we know and how that informs its nature. Schizophr Res 2024; 264:1-28. [PMID: 38086109 DOI: 10.1016/j.schres.2023.11.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 03/01/2024]
Abstract
With new data about different aspects of schizophrenia being continually generated, it becomes necessary to periodically revisit exactly what we know. Along with a need to review what we currently know about schizophrenia, there is an equal imperative to evaluate the construct itself. With these objectives, we undertook an iterative, multi-phase process involving fifty international experts in the field, with each step building on learnings from the prior one. This review assembles currently established findings about schizophrenia (construct, etiology, pathophysiology, clinical expression, treatment) and posits what they reveal about its nature. Schizophrenia is a heritable, complex, multi-dimensional syndrome with varying degrees of psychotic, negative, cognitive, mood, and motor manifestations. The illness exhibits a remitting and relapsing course, with varying degrees of recovery among affected individuals with most experiencing significant social and functional impairment. Genetic risk factors likely include thousands of common genetic variants that each have a small impact on an individual's risk and a plethora of rare gene variants that have a larger individual impact on risk. Their biological effects are concentrated in the brain and many of the same variants also increase the risk of other psychiatric disorders such as bipolar disorder, autism, and other neurodevelopmental conditions. Environmental risk factors include but are not limited to urban residence in childhood, migration, older paternal age at birth, cannabis use, childhood trauma, antenatal maternal infection, and perinatal hypoxia. Structural, functional, and neurochemical brain alterations implicate multiple regions and functional circuits. Dopamine D-2 receptor antagonists and partial agonists improve psychotic symptoms and reduce risk of relapse. Certain psychological and psychosocial interventions are beneficial. Early intervention can reduce treatment delay and improve outcomes. Schizophrenia is increasingly considered to be a heterogeneous syndrome and not a singular disease entity. There is no necessary or sufficient etiology, pathology, set of clinical features, or treatment that fully circumscribes this syndrome. A single, common pathophysiological pathway appears unlikely. The boundaries of schizophrenia remain fuzzy, suggesting the absence of a categorical fit and need to reconceptualize it as a broader, multi-dimensional and/or spectrum construct.
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Affiliation(s)
- Rajiv Tandon
- Department of Psychiatry, WMU Homer Stryker School of Medicine, Kalamazoo, MI 49008, United States of America.
| | - Henry Nasrallah
- Department of Psychiatry, University of Cincinnati College of Medicine Cincinnati, OH 45267, United States of America
| | - Schahram Akbarian
- Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States of America
| | - William T Carpenter
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, United States of America
| | - Lynn E DeLisi
- Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA 02139, United States of America
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Dusseldorf, Heinrich-Heine University, Dusseldorf, Germany
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute of Neuroscience and Human Behavior, UCLA, Los Angeles, CA 90024, United States of America; Greater Los Angeles Veterans' Administration Healthcare System, United States of America
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States of America
| | - Stephan Heckers
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
| | - John M Kane
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY 11004, United States of America
| | - Dolores Malaspina
- Department of Psychiatry, Neuroscience, Genetics, and Genomics, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States of America
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannhein/Heidelberg University, Mannheim, Germany
| | - Robin Murray
- Institute of Psychiatry, Psychology, and Neuroscience, Kings College, London, UK
| | - Michael Owen
- Centre for Neuropsychiatric Genetics and Genomics, and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jordan W Smoller
- Center for Precision Psychiatry, Department of Psychiatry, Psychiatric and Neurodevelopmental Unit, Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States of America
| | - Walid Yassin
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America
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Bouws J, Henrard A, de Koning M, Schirmbeck F, van Ghesel Grothe S, van Aubel E, Reininghaus U, de Haan L, Myin-Germeys I. Acceptance and Commitment Therapy for individuals at risk for psychosis or with a first psychotic episode: A qualitative study on patients' perspectives. Early Interv Psychiatry 2024; 18:122-131. [PMID: 37212359 DOI: 10.1111/eip.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/08/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Abstract
AIM The aim of this qualitative study is to explore patients' perspectives on Acceptance and Commitment Therapy for early stages of psychosis. Therefore, we interviewed participants of the INTERACT study, that quantitatively investigated Acceptance and Commitment Therapy in Daily Life (ACT-DL) in combination with treatment as usual, for early stages of psychosis, comparing it to treatment as usual. METHODS Within 6 months after finishing ACT-DL, we conducted semi-structured, individual interviews with 19 participants. All interviews were audio-recorded and transcribed. Thematic analysis was used for coding and analysis. RESULTS Two overarching themes were formed: 'the meaning of ACT' and 'what to improve'. Considering the first, participants generally understood and connected with the meaning of ACT, noticing more awareness and acceptance of their thoughts and feelings, and living more in line with their personal values. The second theme included comments on the protocol not being personal or psychosis specific enough and some elements of ACT being too difficult to understand when having active psychotic symptoms. CONCLUSIONS This study suggests that ACT is an acceptable and promising new form of treatment for early stages of psychosis, and it provides relevant information to further develop ACT for this group.
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Affiliation(s)
- Jara Bouws
- Department of Research, Arkin, Centre for Mental Health Care, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ann Henrard
- Department of Neurosciences, Psychiatry Research Group, Centre for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Mariken de Koning
- Department of Research, Arkin, Centre for Mental Health Care, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Evelyne van Aubel
- Department of Neurosciences, Psychiatry Research Group, Centre for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lieuwe de Haan
- Department of Neurosciences, Psychiatry Research Group, Centre for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Inez Myin-Germeys
- Department of Neurosciences, Psychiatry Research Group, Centre for Contextual Psychiatry, KU Leuven, Leuven, Belgium
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Olah J, Spencer T, Cummins N, Diederen K. Automated analysis of speech as a marker of sub-clinical psychotic experiences. Front Psychiatry 2024; 14:1265880. [PMID: 38361830 PMCID: PMC10867252 DOI: 10.3389/fpsyt.2023.1265880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/22/2023] [Indexed: 02/17/2024] Open
Abstract
Automated speech analysis techniques, when combined with artificial intelligence and machine learning, show potential in capturing and predicting a wide range of psychosis symptoms, garnering attention from researchers. These techniques hold promise in predicting the transition to clinical psychosis from at-risk states, as well as relapse or treatment response in individuals with clinical-level psychosis. However, challenges in scientific validation hinder the translation of these techniques into practical applications. Although sub-clinical research could aid to tackle most of these challenges, there have been only few studies conducted in speech and psychosis research in non-clinical populations. This work aims to facilitate this work by summarizing automated speech analytical concepts and the intersection of this field with psychosis research. We review psychosis continuum and sub-clinical psychotic experiences, and the benefits of researching them. Then, we discuss the connection between speech and psychotic symptoms. Thirdly, we overview current and state-of-the art approaches to the automated analysis of speech both in terms of language use (text-based analysis) and vocal features (audio-based analysis). Then, we review techniques applied in subclinical population and findings in these samples. Finally, we discuss research challenges in the field, recommend future research endeavors and outline how research in subclinical populations can tackle the listed challenges.
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Affiliation(s)
- Julianna Olah
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Thomas Spencer
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Nicholas Cummins
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Kelly Diederen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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45
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Hou Y, Qiu G, Xia H, He T, Liu X, Chen A. The specificity of the auditory P300 responses and its association with clinical outcomes in youth with psychosis risk syndrome. Int J Clin Health Psychol 2024; 24:100437. [PMID: 38292829 PMCID: PMC10825643 DOI: 10.1016/j.ijchp.2024.100437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024] Open
Abstract
Background Schizophrenia often occurs in youth, and psychosis risk syndrome (PRS) occurs before the onset of psychosis. Assessing the neuropsychological abnormalities of PRS individuals can help in early identification and active intervention of mental illness. Auditory P300 amplitude defect is an important manifestation of attention processing abnormality in PRS, but it is still unclear whether there are abnormalities in the attention processing of rhythmic compound tone stimuli in PRS individuals, and whether the P300 amplitude induced by these stimuli is specific to PRS individuals and related to their clinical outcomes. Methods In total, 226 participants, including 122 patients with PRS, 51 patients with emotional disorders (ED), and 53 healthy controls (HC) were assessed. Baseline electroencephalography was recorded during the compound tone oddball task. The event-related potentials (ERPs) induced by rhythmic compound tone stimuli of two frequencies (20-Hz, 40-Hz) were measured. Almost all patients with PRS were followed up for 12 months and reclassified into four groups: PRS-conversion, PRS-symptomatic, PRS-emotional disorder, and PRS-complete remission. The differences in baseline ERPs were compared among the clinical outcome groups. Results Regardless of the stimulation frequency, the average P300 amplitude were significantly higher in patients with PRS than in those with ED (p = 0.003, d = 0.48) and in HC (p = 0.002, d = 0.44) group. The average P300 amplitude of PRS-conversion group was significantly higher than that of the PRS-complete remission (p = 0.016, d = 0.72) and HC group (p = 0.001, d = 0.76), and the average P300 amplitude of PRS-symptomatic group was significantly higher than that of the HC group (p = 0.006, d = 0.48). Regardless of the groups (PRS, ED, HC) or the PRS clinical outcome groups, the average P300 amplitude induced by 20-Hz tone stimulation was significantly higher than that induced by 40-Hz stimulation (ps < 0.001, Ƞ2 = 0.074-0.082). The average reaction times of PRS was significantly faster than that of ED (p = 0.01, d = 0.38), and the average reaction times of the participants to 20-Hz target stimulation was significantly faster than that to 40-Hz target stimulation (p < 0.001, d = 0.21). Conclusion The auditory P300 amplitude induced by rhythmic compound tone stimuli is a specific electrophysiological manifestation of PRS, and the auditory P300 amplitude induced by compound tone stimuli shows promise as a putative prognostic biomarker for PRS clinical outcomes, including conversion to psychosis and clinical complete remission.
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Affiliation(s)
- Yongqing Hou
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Mental Health Center of Guangyuan, Sichuan, China
| | - Guiping Qiu
- College of Teacher Education, Ningxia University, Yinchuan, China
| | - Haishuo Xia
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Tianbao He
- Mental Health Center of Guangyuan, Sichuan, China
| | - Xiaoxian Liu
- Faculty of Education, Henan Normal University, Xinxiang, China
| | - Antao Chen
- School of Psychology, Research Center for Exercise and Brain Science, Shanghai University of Sport, Shanghai, China
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46
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Haas SS, Ge R, Agartz I, Amminger GP, Andreassen OA, Bachman P, Baeza I, Choi S, Colibazzi T, Cropley VL, de la Fuente-Sandoval C, Ebdrup BH, Fortea A, Fusar-Poli P, Glenthøj BY, Glenthøj LB, Haut KM, Hayes RA, Heekeren K, Hooker CI, Hwang WJ, Jahanshad N, Kaess M, Kasai K, Katagiri N, Kim M, Kindler J, Koike S, Kristensen TD, Kwon JS, Lawrie SM, Lebedeva I, Lee J, Lemmers-Jansen ILJ, Lin A, Ma X, Mathalon DH, McGuire P, Michel C, Mizrahi R, Mizuno M, Møller P, Mora-Durán R, Nelson B, Nemoto T, Nordentoft M, Nordholm D, Omelchenko MA, Pantelis C, Pariente JC, Raghava JM, Reyes-Madrigal F, Røssberg JI, Rössler W, Salisbury DF, Sasabayashi D, Schall U, Smigielski L, Sugranyes G, Suzuki M, Takahashi T, Tamnes CK, Theodoridou A, Thomopoulos SI, Thompson PM, Tomyshev AS, Uhlhaas PJ, Værnes TG, van Amelsvoort TAMJ, van Erp TGM, Waltz JA, Wenneberg C, Westlye LT, Wood SJ, Zhou JH, Hernaus D, Jalbrzikowski M, Kahn RS, Corcoran CM, Frangou S. Normative Modeling of Brain Morphometry in Clinical High Risk for Psychosis. JAMA Psychiatry 2024; 81:77-88. [PMID: 37819650 PMCID: PMC10568447 DOI: 10.1001/jamapsychiatry.2023.3850] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/25/2023] [Indexed: 10/13/2023]
Abstract
Importance The lack of robust neuroanatomical markers of psychosis risk has been traditionally attributed to heterogeneity. A complementary hypothesis is that variation in neuroanatomical measures in individuals at psychosis risk may be nested within the range observed in healthy individuals. Objective To quantify deviations from the normative range of neuroanatomical variation in individuals at clinical high risk for psychosis (CHR-P) and evaluate their overlap with healthy variation and their association with positive symptoms, cognition, and conversion to a psychotic disorder. Design, Setting, and Participants This case-control study used clinical-, IQ-, and neuroimaging software (FreeSurfer)-derived regional measures of cortical thickness (CT), cortical surface area (SA), and subcortical volume (SV) from 1340 individuals with CHR-P and 1237 healthy individuals pooled from 29 international sites participating in the Enhancing Neuroimaging Genetics Through Meta-analysis (ENIGMA) Clinical High Risk for Psychosis Working Group. Healthy individuals and individuals with CHR-P were matched on age and sex within each recruitment site. Data were analyzed between September 1, 2021, and November 30, 2022. Main Outcomes and Measures For each regional morphometric measure, deviation scores were computed as z scores indexing the degree of deviation from their normative means from a healthy reference population. Average deviation scores (ADS) were also calculated for regional CT, SA, and SV measures and globally across all measures. Regression analyses quantified the association of deviation scores with clinical severity and cognition, and 2-proportion z tests identified case-control differences in the proportion of individuals with infranormal (z < -1.96) or supranormal (z > 1.96) scores. Results Among 1340 individuals with CHR-P, 709 (52.91%) were male, and the mean (SD) age was 20.75 (4.74) years. Among 1237 healthy individuals, 684 (55.30%) were male, and the mean (SD) age was 22.32 (4.95) years. Individuals with CHR-P and healthy individuals overlapped in the distributions of the observed values, regional z scores, and all ADS values. For any given region, the proportion of individuals with CHR-P who had infranormal or supranormal values was low (up to 153 individuals [<11.42%]) and similar to that of healthy individuals (<115 individuals [<9.30%]). Individuals with CHR-P who converted to a psychotic disorder had a higher percentage of infranormal values in temporal regions compared with those who did not convert (7.01% vs 1.38%) and healthy individuals (5.10% vs 0.89%). In the CHR-P group, only the ADS SA was associated with positive symptoms (β = -0.08; 95% CI, -0.13 to -0.02; P = .02 for false discovery rate) and IQ (β = 0.09; 95% CI, 0.02-0.15; P = .02 for false discovery rate). Conclusions and Relevance In this case-control study, findings suggest that macroscale neuromorphometric measures may not provide an adequate explanation of psychosis risk.
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Affiliation(s)
- Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ruiyang Ge
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - G Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
| | - Ole A Andreassen
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Peter Bachman
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
| | - Inmaculada Baeza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)-ISCIII, Madrid Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sunah Choi
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Tiziano Colibazzi
- Department of Psychiatry, Columbia University, New York, New York
- New York State Psychiatric Institute, New York
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Western Health, Carlton South, VIC, Australia
| | | | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Adriana Fortea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)-ISCIII, Madrid Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Fundació Clínic Recerca Biomèdica, Universitat de Barcelona, Barcelona, Spain
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-Detection Lab, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Birte Yding Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Louise Birkedal Glenthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Rebecca A Hayes
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
| | - Karsten Heekeren
- Department of Psychiatry and Psychotherapy, LVR-Hospital Cologne, Cologne, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence at The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Shinsuke Koike
- The University of Tokyo Institute for Diversity and Adaptation of Human Mind, The University of Tokyo, Tokyo, Japan
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Tina D Kristensen
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Stephen M Lawrie
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Irina Lebedeva
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Imke L J Lemmers-Jansen
- Faculty of Behavioural and Movement Sciences, Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Xiaoqian Ma
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco
- San Francisco Veterans Affairs Health Care System, San Francisco, California
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Romina Mizrahi
- Douglas Research Center, McGill Univesity, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Paul Møller
- Department for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway
| | - Ricardo Mora-Durán
- Emergency Department, Hospital Fray Bernardino Álvarez, Mexico City, Mexico
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Nordholm
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Maria A Omelchenko
- Department of Youth Psychiatry, Mental Health Research Center, Moscow, Russian Federation
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Western Health, Carlton South, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Center for Mental Health, Parkville, Victoria, Australia
| | - Jose C Pariente
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Jayachandra M Raghava
- Centre for Neuropsychiatric Schizophrenia Research and Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
- Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Glostrup, Denmark
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Jan I Røssberg
- Oslo University Hospital and University of Oslo, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Wulf Rössler
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daiki Sasabayashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Ulrich Schall
- Priority Centre for Brain and Mental Health Research, The University of Newcastle, Newcastle, New South Wales, Australia
- Priority Research Centre Grow Up Well, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Lukasz Smigielski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gisela Sugranyes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)-ISCIII, Madrid Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Michio Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Tsutomu Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
- Research Center for Idling Brain Science, University of Toyama, Toyama, Japan
| | - Christian K Tamnes
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Anastasia Theodoridou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey
| | - Alexander S Tomyshev
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, Moscow, Russian Federation
| | - Peter J Uhlhaas
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Tor G Værnes
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South-East Norway, TIPS Sør-Øst, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Therese A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine
| | - James A Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore
| | - Christina Wenneberg
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Lars T Westlye
- KG Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- Orygen, Melbourne, Victoria, Australia
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Juan H Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, New York, New York
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Djavad Mowafaghian Centre for Brain Health, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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47
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Martin JC, Clark SR, Hartmann S, Schubert KO. A Tale of Three Spectra: Basic Symptoms in Clinical-High-Risk of Psychosis Vary Across Autism Spectrum Disorder, Schizotypal Personality Disorder, and Borderline Personality Disorder. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae017. [PMID: 39183768 PMCID: PMC11341945 DOI: 10.1093/schizbullopen/sgae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Background and Hypothesis The clinical-high-risk (CHR) approach was developed to prevent psychosis through the detection of psychosis risk. CHR services are transdiagnostic in nature, therefore the appropriate management of comorbidity is a central part of care. Differential diagnosis is particularly challenging across 3 common comorbidities, schizotypal personality disorder (SPD), autism spectrum disorder (ASD), and borderline personality disorder (BPD). Phenomenological research indicates a disturbance of "basic self" may differentiate between these commonly comorbid disorders and can be captured by Huber's basic symptoms (BS) concept. We investigated whether BS vary across these disorders and may inform differential diagnosis in young person's meeting CHR criteria. Study Design A total of 685 participants meeting CHR criteria from the NAPLS-3 cohort completed the COGDIS items of the schizophrenia proneness instrument, a measure of BS, as well as the structured interview for DSM-5 (SCID-5). A logistic regression model was used to investigate the variation of COGDIS across SPD, ASD, and BPD, while controlling for age and SIPs positive severity. Study Results Meeting COGDIS criteria was positively associated with SPD (OR = 1.72, CI = [1.31-2.28], P = .001) but not ASD nor BPD. Conclusions Our results indicate that "basic self-disturbance" as indicated by COGDIS differs across SPD, ASD, and BPD. COGDIS may be useful to inform the management of comorbidities in CHR services, by providing insight into subtle subjective experiences that may benefit from disorder-specific interventions.
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Affiliation(s)
- James C Martin
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - Scott R Clark
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
- Discipline of Psychiatry, Basil Hetzel Institute, Woodville, South Australia, Australia
| | - Simon Hartmann
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
| | - K Oliver Schubert
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide, South Australia, Australia
- Division of Mental Health, Northern Adelaide Local Health Network, SA Health, South Australia
- Headspace Early Psychosis, Sonder, South Australia
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48
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Wasserthal S, Muthesius A, Hurlemann R, Ruhrmann S, Schmidt SJ, Hellmich M, Schultze-Lutter F, Klosterkötter J, Müller H, Meyer-Lindenberg A, Poeppl TB, Walter H, Hirjak D, Koutsouleris N, Fallgatter AJ, Bechdolf A, Brockhaus-Dumke A, Mulert C, Philipsen A, Kambeitz J. N-Acetylcysteine and a Specialized Preventive Intervention for Individuals at High Risk for Psychosis: A Randomized Double-Blind Multicenter Trial. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae005. [PMID: 39144108 PMCID: PMC11207905 DOI: 10.1093/schizbullopen/sgae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis Clinical high risk for psychosis (CHR-P) offers a window of opportunity for early intervention and recent trials have shown promising results for the use of N-acetylcysteine (NAC) in schizophrenia. Moreover, integrated preventive psychological intervention (IPPI), applies social-cognitive remediation to aid in preventing the transition to the psychosis of CHR-P patients. Study Design In this double-blind, randomized, controlled multicenter trial, a 2 × 2 factorial design was applied to investigate the effects of NAC compared to placebo (PLC) and IPPI compared to psychological stress management (PSM). The primary endpoint was the transition to psychosis or deterioration of CHR-P symptoms after 18 months. Study Results While insufficient recruitment led to early trial termination, a total of 48 participants were included in the study. Patients receiving NAC showed numerically higher estimates of event-free survival probability (IPPI + NAC: 72.7 ± 13.4%, PSM + NAC: 72.7 ± 13.4%) as compared to patients receiving PLC (IPPI + PLC: 56.1 ± 15.3%, PSM + PLC: 39.0 ± 17.4%). However, a log-rank chi-square test in Kaplan-Meier analysis revealed no significant difference of survival probability for NAC vs control (point hazard ratio: 0.879, 95% CI 0.281-2.756) or IPPI vs control (point hazard ratio: 0.827, 95% CI 0.295-2.314). The number of adverse events (AE) did not differ significantly between the four groups. Conclusions The superiority of NAC or IPPI in preventing psychosis in patients with CHR-P compared to controls could not be statistically validated in this trial. However, results indicate a consistent pattern that warrants further testing of NAC as a promising and well-tolerated intervention for CHR patients in future trials with adequate statistical power.
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Affiliation(s)
- Sven Wasserthal
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital of Bonn, Bonn, Germany
| | - Ana Muthesius
- Department of Psychiatry and Psychotherapy, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - René Hurlemann
- Department of Psychiatry, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Stefanie J Schmidt
- Division of Clinical Child and Adolescent Psychology, University of Bern, Bern, Switzerland
| | - Martin Hellmich
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Joachim Klosterkötter
- Department of Psychiatry and Psychotherapy, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Hendrik Müller
- Department of Psychiatry and Psychotherapy, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Partner Site Tübingen, Tübingen, Germany
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy CCM, Charité, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Center (FRITZ), Vivantes Klinikum Am Urban, Berlin, Germany
| | | | - Christoph Mulert
- Center of Psychiatry, Justus-Liebig University, Giessen, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital of Bonn, Bonn, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, University of Cologne and University Hospital Cologne, Cologne, Germany
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Fuentes-Claramonte P, Estradé A, Solanes A, Ramella-Cravaro V, Garcia-Leon MA, de Diego-Adeliño J, Molins C, Fung E, Valentí M, Anmella G, Pomarol-Clotet E, Oliver D, Vieta E, Radua J, Fusar-Poli P. Biomarkers for Psychosis: Are We There Yet? Umbrella Review of 1478 Biomarkers. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae018. [PMID: 39228676 PMCID: PMC11369642 DOI: 10.1093/schizbullopen/sgae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Background and Hypothesis This umbrella review aims to comprehensively synthesize the evidence of association between peripheral, electrophysiological, neuroimaging, neuropathological, and other biomarkers and diagnosis of psychotic disorders. Study Design We selected systematic reviews and meta-analyses of observational studies on diagnostic biomarkers for psychotic disorders, published until February 1, 2018. Data extraction was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Evidence of association between biomarkers and psychotic disorders was classified as convincing, highly suggestive, suggestive, weak, or non-significant, using a standardized classification. Quality analyses used the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Study Results The umbrella review included 110 meta-analyses or systematic reviews corresponding to 3892 individual studies, 1478 biomarkers, and 392 210 participants. No factor showed a convincing level of evidence. Highly suggestive evidence was observed for transglutaminase autoantibodies levels (odds ratio [OR] = 7.32; 95% CI: 3.36, 15.94), mismatch negativity in auditory event-related potentials (standardized mean difference [SMD] = 0.73; 95% CI: 0.5, 0.96), P300 component latency (SMD = -0.6; 95% CI: -0.83, -0.38), ventricle-brain ratio (SMD = 0.61; 95% CI: 0.5, 0.71), and minor physical anomalies (SMD = 0.99; 95% CI: 0.64, 1.34). Suggestive evidence was observed for folate, malondialdehyde, brain-derived neurotrophic factor, homocysteine, P50 sensory gating (P50 S2/S1 ratio), frontal N-acetyl-aspartate, and high-frequency heart rate variability. Among the remaining biomarkers, weak evidence was found for 626 and a non-significant association for 833 factors. Conclusions While several biomarkers present highly suggestive or suggestive evidence of association with psychotic disorders, methodological biases, and underpowered studies call for future higher-quality research.
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Affiliation(s)
- Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Andrés Estradé
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Aleix Solanes
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain
| | - Valentina Ramella-Cravaro
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Maria Angeles Garcia-Leon
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Javier de Diego-Adeliño
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain
- Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Conrad Molins
- Psychiatric Service, Hospital Universitari Santa Maria, Lleida, Catalonia, Spain
| | - Eric Fung
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Marc Valentí
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Gerard Anmella
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Dominic Oliver
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford OX3 7JX, UK
- OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Eduard Vieta
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Joaquim Radua
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
- OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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50
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Dheerendra P, Grent-'t-Jong T, Gajwani R, Gross J, Gumley AI, Krishnadas R, Lawrie SM, Schwannauer M, Schultze-Lutter F, Uhlhaas PJ. Intact Mismatch Negativity Responses in Clinical High Risk for Psychosis and First-Episode Psychosis: Evidence From Source-Reconstructed Event-Related Fields and Time-Frequency Data. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:121-131. [PMID: 37778724 DOI: 10.1016/j.bpsc.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/26/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND This study examined whether mismatch negativity (MMN) responses are impaired in participants at clinical high risk for psychosis (CHR-P) and patients with first-episode psychosis (FEP) and whether MMN deficits predict clinical outcomes in CHR-Ps. METHODS Magnetoencephalography data were collected during a duration-deviant MMN paradigm for a group of 116 CHR-P participants, 33 FEP patients (15 antipsychotic-naïve), clinical high risk negative group (n = 38) with substance abuse and affective disorder, and 49 healthy control participants. Analysis of group differences of source-reconstructed event-related fields as well as time-frequency and intertrial phase coherence focused on the bilateral Heschl's gyri and bilateral superior temporal gyri. RESULTS Significant magnetic MMN responses were found across participants in the bilateral Heschl's gyri and bilateral superior temporal gyri. However, MMN amplitude as well as time-frequency and intertrial phase coherence responses were intact in CHR-P participants and FEP patients compared with healthy control participants. Furthermore, MMN deficits were not related to persistent attenuated psychotic symptoms or transitions to psychosis in CHR-P participants. CONCLUSIONS Our data suggest that magnetic MMN responses in magnetoencephalography data are not impaired in early-stage psychosis and may not predict clinical outcomes in CHR-P participants.
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Affiliation(s)
- Pradeep Dheerendra
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, United Kingdom
| | - Tineke Grent-'t-Jong
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, United Kingdom; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Ruchika Gajwani
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Joachim Gross
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Muenster, Germany
| | - Andrew I Gumley
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Rajeev Krishnadas
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, United Kingdom
| | - Stephen M Lawrie
- Department of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Matthias Schwannauer
- Department of Clinical Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany; Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Peter J Uhlhaas
- School of Psychology and Neuroscience, University of Glasgow, Glasgow, United Kingdom; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
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