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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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2
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Jacobs KA. Changes of intuition in paranoid personality disorder. Front Psychiatry 2024; 14:1307629. [PMID: 38268566 PMCID: PMC10807694 DOI: 10.3389/fpsyt.2023.1307629] [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: 10/04/2023] [Accepted: 11/24/2023] [Indexed: 01/26/2024] Open
Abstract
Wherever psychopathology operates with the concept of (disorders of) the self and personality, it can address the role of the intuitive access we have toward ourselves, others, and the world. This study discusses the concept of oikeiôsis. It examines its role in explaining paranoia as a change in intuitive self-and-world relatedness. In the first step, symptomatic features of paranoid personality disorder are sketched, with a focus on the explanatory role of attentional and interpretative biases, which correlate with significant changes in intuitive processing. In the second step, the prototypical phenomenality of feelings of unfamiliarity and mistrust are discussed against the backdrop of changes of oikeiôsis in paranoid personality disorder. In the third step, the main therapeutic challenge in treating paranoid personality disorder-building a trustful relationship-is explored. It is concluded that the notion of oikeiôsis resonates particularly with introspection-based therapeutic approaches.
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Affiliation(s)
- Kerrin Artemis Jacobs
- Department of Philosophy, Ethics, and Religious Studies, University of Hokkaido, Sapporo, Japan
- Center for Human Nature, Artificial Intelligence, and Neuroscience (CHAIN), University of Hokkaido, Sapporo, Japan
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3
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Hsu CW, Stahl D, Mouchlianitis E, Peters E, Vamvakas G, Keppens J, Watson M, Schmidt N, Jacobsen P, McGuire P, Shergill S, Kabir T, Hirani T, Yang Z, Yiend J. User-Centered Development of STOP (Successful Treatment for Paranoia): Material Development and Usability Testing for a Digital Therapeutic for Paranoia. JMIR Hum Factors 2023; 10:e45453. [PMID: 38064256 PMCID: PMC10746980 DOI: 10.2196/45453] [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] [Received: 01/01/2023] [Revised: 06/13/2023] [Accepted: 09/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Paranoia is a highly debilitating mental health condition. One novel intervention for paranoia is cognitive bias modification for paranoia (CBM-pa). CBM-pa comes from a class of interventions that focus on manipulating interpretation bias. Here, we aimed to develop and evaluate new therapy content for CBM-pa for later use in a self-administered digital therapeutic for paranoia called STOP ("Successful Treatment of Paranoia"). OBJECTIVE This study aimed to (1) take a user-centered approach with input from living experts, clinicians, and academics to create and evaluate paranoia-relevant item content to be used in STOP and (2) engage with living experts and the design team from a digital health care solutions company to cocreate and pilot-test the STOP mobile app prototype. METHODS We invited 18 people with living or lived experiences of paranoia to create text exemplars of personal, everyday emotionally ambiguous scenarios that could provoke paranoid thoughts. Researchers then adapted 240 suitable exemplars into corresponding intervention items in the format commonly used for CBM training and created 240 control items for the purpose of testing STOP. Each item included newly developed, visually enriching graphics content to increase the engagement and realism of the basic text scenarios. All items were then evaluated for their paranoia severity and readability by living experts (n=8) and clinicians (n=7) and for their item length by the research team. Items were evenly distributed into six 40-item sessions based on these evaluations. Finalized items were presented in the STOP mobile app, which was co-designed with a digital health care solutions company, living or lived experts, and the academic team; user acceptance was evaluated across 2 pilot tests involving living or lived experts. RESULTS All materials reached predefined acceptable thresholds on all rating criteria: paranoia severity (intervention items: ≥1; control items: ≤1, readability: ≥3, and length of the scenarios), and there was no systematic difference between the intervention and control group materials overall or between individual sessions within each group. For item graphics, we also found no systematic differences in users' ratings of complexity (P=.68), attractiveness (P=.15), and interest (P=.14) between intervention and control group materials. User acceptance testing of the mobile app found that it is easy to use and navigate, interactive, and helpful. CONCLUSIONS Material development for any new digital therapeutic requires an iterative and rigorous process of testing involving multiple contributing groups. Appropriate user-centered development can create user-friendly mobile health apps, which may improve face validity and have a greater chance of being engaging and acceptable to the target end users.
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Affiliation(s)
- Che-Wei Hsu
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Daniel Stahl
- Department of Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | | | - Emmanuelle Peters
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
- South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - George Vamvakas
- Department of Biostatistics and Health Informatics, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Jeroen Keppens
- Department of Informatics, King's College London, London, United Kingdom
| | - Miles Watson
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Nora Schmidt
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | | | - Philip McGuire
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Sukhi Shergill
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Thomas Kabir
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Tia Hirani
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Ziyang Yang
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | - Jenny Yiend
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
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Yiend J, Lam CLM, Schmidt N, Crane B, Heslin M, Kabir T, McGuire P, Meek C, Mouchlianitis E, Peters E, Stahl D, Trotta A, Shergill S. Cognitive bias modification for paranoia (CBM-pa): a randomised controlled feasibility study in patients with distressing paranoid beliefs. Psychol Med 2023; 53:4614-4626. [PMID: 35699135 PMCID: PMC10388312 DOI: 10.1017/s0033291722001520] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/30/2022] [Accepted: 05/09/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive Bias Modification for paranoia (CBM-pa) is a novel, theory-driven psychological intervention targeting the biased interpretation of emotional ambiguity associated with paranoia. Study objectives were (i) test the intervention's feasibility, (ii) provide effect size estimates, (iii) assess dose-response and (iv) select primary outcomes for future trials. METHODS In a double-blind randomised controlled trial, sixty-three outpatients with clinically significant paranoia were randomised to either CBM-pa or an active control (text reading) between April 2016 and September 2017. Patients received one 40 min session per week for 6 weeks. Assessments were given at baseline, after each interim session, post-treatment, and at 1- and 3-months post-treatment. RESULTS A total of 122 patients were screened and 63 were randomised. The recruitment rate was 51.2%, with few dropouts (four out of 63) and follow-up rates were 90.5% (1-month) and 93.7% (3-months). Each session took 30-40 min to complete. There was no statistical evidence of harmful effects of the intervention. Preliminary data were consistent with efficacy of CBM-pa over text-reading control: patients randomised to the intervention, compared to control patients, reported reduced interpretation bias (d = -0.48 to -0.76), improved symptoms of paranoia (d = -0.19 to -0.38), and lower depressed and anxious mood (d = -0.03 to -0.29). The intervention effect was evident after the third session. CONCLUSIONS CBM-pa is feasible for patients with paranoia. A fully powered randomised control trial is warranted.
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Affiliation(s)
- Jenny Yiend
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | - Charlene L. M. Lam
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
- Laboratory of Clinical Psychology and Affective Neuroscience, The University of Hong Kong, Hong Kong
| | - Nora Schmidt
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | - Bryony Crane
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | - Margaret Heslin
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | | | - Philip McGuire
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | - Christopher Meek
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | - Elias Mouchlianitis
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | - Emmanuelle Peters
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | - Daniel Stahl
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
| | - Antonella Trotta
- Laboratory of Clinical Psychology and Affective Neuroscience, The University of Hong Kong, Hong Kong
- South London & Maudsley NHS Foundation Trust, London, UK
| | - Sukhwinder Shergill
- Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, UK
- Kent and Medway Medical School, Canterbury, UK
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5
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Williams TF, Walker EF, Strauss GP, Woods SW, Powers AR, Corlett PR, Schiffman J, Waltz JA, Gold JM, Silverstein SM, Ellman LM, Zinbarg RE, Mittal VA. The reliability and validity of the revised Green et al. paranoid thoughts scale in individuals at clinical high-risk for psychosis. Acta Psychiatr Scand 2023; 147:623-633. [PMID: 36905387 PMCID: PMC10463775 DOI: 10.1111/acps.13545] [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: 09/29/2022] [Revised: 01/27/2023] [Accepted: 02/21/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Paranoia is a common and impairing psychosis symptom, which exists along a severity continuum that extends into the general population. Individuals at clinical high-risk for psychosis (CHR) frequently experience paranoia and this may elevate their risk for developing full psychosis. Nonetheless, limited work has examined the efficient measurement of paranoia in CHR individuals. The present study aimed to validate an often-used self-report measure, the revised green paranoid thoughts scale (RGPTS), in this critical population. METHOD Participants were CHR individuals (n = 103), mixed clinical controls (n = 80), and healthy controls (n = 71) who completed self-report and interview measures. Confirmatory factor analysis (CFA), psychometric indices, group differences, and relations to external measures were used to evaluate the reliability and validity of the RGPTS. RESULTS CFA replicated a two-factor structure for the RGPTS and the associated reference and persecution scales were reliable. CHR individuals scored significantly higher on both reference and persecution, relative to both healthy (ds = 1.03, 0.86) and clinical controls (ds = 0.64, 0.73). In CHR participants, correlations between reference and persecution and external measures were smaller than expected, though showed evidence of discriminant validity (e.g., interviewer-rated paranoia, r = 0.24). When examined in the full sample, correlation magnitude was larger and follow-up analyses indicated that reference related most specifically to paranoia (β = 0.32), whereas persecution uniquely related to poor social functioning (β = -0.29). CONCLUSION These results demonstrate the reliability and validity of the RGPTS, though its scales related more weakly to severity in CHR individuals. The RGPTS may be useful in future work aiming to develop symptom-specific models of emerging paranoia in CHR individuals.
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Affiliation(s)
- Trevor F. Williams
- Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - Elaine F. Walker
- Department of Psychology and Program in Neuroscience, Emory University, Atlanta, GA, 30322, USA
| | - Gregory P. Strauss
- Departments of Psychology and Neuroscience, University of Georgia, Athens, GA, 30602, USA
| | - Scott W. Woods
- Department of Psychiatry, Yale University, New Haven, CT, 06519, USA
| | - Albert R. Powers
- Department of Psychiatry, Yale University, New Haven, CT, 06519, USA
| | - Philip R. Corlett
- Department of Psychiatry, Yale University, New Haven, CT, 06519, USA
| | - Jason Schiffman
- Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, University of California, Irvine, CA, 92697, USA
| | - James A. Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21228, USA
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, 21228, USA
| | - Steven M. Silverstein
- Departments of Psychiatry, Neuroscience and Ophthalmology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Lauren M. Ellman
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, 19122, USA
| | - Richard E. Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL, 60208, USA
| | - Vijay A. Mittal
- Institutes for Policy Research (IPR) and Innovations in Developmental Sciences (DevSci), Departments of Psychology, Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL, 60208, USA
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6
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Würtz F, Zahler L, Blackwell SE, Margraf J, Bagheri M, Woud ML. Scrambled but valid? The scrambled sentences task as a measure of interpretation biases in psychopathology: A systematic review and meta-analysis. Clin Psychol Rev 2022; 93:102133. [PMID: 35219928 DOI: 10.1016/j.cpr.2022.102133] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 11/18/2021] [Accepted: 02/13/2022] [Indexed: 11/21/2022]
Abstract
The Scrambled Sentences Task (SST) is frequently used to assess interpretation biases (IBs). However, neither the range of its applications nor the quality of the empirical evidence it provides has been systematically examined. This systematic review investigates the types of samples and disorders in which the SST has been applied and evaluates its psychometric properties via a meta-analysis. The databases PubMed and EBSCOhost (including PsycINFO, PsycARTICLES, PSYNDEX, MEDLINE) were examined (last search: September 2021) and 93 studies from 91 manuscripts were included. Results showed that the SST has been applied predominantly in unselected samples or those with elevated levels of subsyndromal symptoms, with about a third of the studies employing the SST in a clinical population. While the SST was initially developed to assess depression-related IBs, it has now been extended to other disorders, in particular anxiety disorders. Results of the meta-analyses indicated good convergent validity and reliability across disorders, albeit in the context of substantial heterogeneity. Findings concerning divergent validity were mixed with high correlations across disorders between the SST and trait anxiety in particular, questioning its specificity. Future research should consider developing standardized SST versions and investigating its relationships with other measures of IB.
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Affiliation(s)
- Felix Würtz
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany.
| | - Lisa Zahler
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Simon E Blackwell
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Mahdi Bagheri
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Marcella L Woud
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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7
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Leung CJ, Fosuaah A, Frerichs J, Heslin M, Kabir T, Lee TMC, McGuire P, Meek C, Mouchlianitis E, Nath AS, Peters E, Shergill S, Stahl D, Trotta A, Yiend J. A qualitative study of the acceptability of cognitive bias modification for paranoia (CBM-pa) in patients with psychosis. BMC Psychiatry 2019; 19:225. [PMID: 31337373 PMCID: PMC6651961 DOI: 10.1186/s12888-019-2215-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 07/17/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cognitive Bias Modification (CBM) has been used successfully as a computer-based intervention in disorders such as anxiety. However, CBM to modify interpretations of ambiguous information relevant to paranoia has not yet been tested. We conducted a qualitative investigation of a novel intervention called CBM for paranoia (CBM-pa) to examine its acceptability in patients with psychosis. METHODS Eight participants with psychosis who completed CBM-pa were identified by purposive sampling and invited for a semi-structured interview to explore the facilitators and barriers to participation, optimum form of delivery, perceived usefulness of CBM-pa and their opinions on applying CBM-pa as a computerised intervention. The interviews were transcribed and analysed using thematic analysis by researchers working in collaboration with service users. RESULTS Themes emerged relating to participants' perception about delivery, engagement, programme understanding, factors influencing experience, perceived impact and application of CBM-pa. CBM-pa was regarded as easy, straightforward and enjoyable. It was well-accepted among those we interviewed, who understood the procedure as a psychological intervention. Patients reported that it increased their capacity for adopting alternative interpretations of emotionally ambiguous scenarios. Although participants all agreed on the test-like nature of the current CBM-pa format, they considered that taking part in sessions had improved their overall wellbeing. Most of them valued the computer-based interface of CBM-pa but favoured the idea of combining CBM-pa with some form of human interaction. CONCLUSIONS CBM-pa is an acceptable intervention that was well-received by our sample of patients with paranoia. The current findings reflect positively on the acceptability and experience of CBM-pa in the target population. Patient opinion supports further development and testing of CBM-pa as a possible adjunct treatment for paranoia. TRIAL REGISTRATION Current Controlled Trials ISRCTN: 90749868 . Retrospectively registered on 12 May 2016.
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Affiliation(s)
- C. J. Leung
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK ,0000000121742757grid.194645.bLaboratory of Neuropsychology, The University of Hong Kong, Hongkong, Hong Kong
| | - A. Fosuaah
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J. Frerichs
- grid.490917.2The McPin Foundation, London, UK
| | - M. Heslin
- 0000 0001 2322 6764grid.13097.3cHealth Service and Population Research Department, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - T. Kabir
- grid.490917.2The McPin Foundation, London, UK
| | - T. M. C. Lee
- 0000000121742757grid.194645.bLaboratory of Neuropsychology, The University of Hong Kong, Hongkong, Hong Kong ,0000000121742757grid.194645.bThe State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hongkong, Hong Kong
| | - P. McGuire
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK ,0000 0001 2324 5535grid.415717.1South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX UK
| | - C. Meek
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - E. Mouchlianitis
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - A. S. Nath
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - E. Peters
- 0000 0001 2324 5535grid.415717.1South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX UK ,0000 0001 2322 6764grid.13097.3cDepartment of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - S. Shergill
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK ,0000 0001 2324 5535grid.415717.1South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX UK
| | - D. Stahl
- 0000 0001 2322 6764grid.13097.3cDepartment of Biostatistics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - A. Trotta
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J. Yiend
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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