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Kennedy L, Ku BS, Addington J, Amir CM, Bearden CE, Cannon TD, Carrión R, Cornblatt B, Keshavan M, Perkins D, Mathalon D, Stone W, Walker E, Woods S, Cadenhead KS. Occasional cannabis use is associated with higher premorbid functioning and IQ in youth at clinical high-risk (CHR) for psychosis: Parallel findings to psychosis cohorts. Schizophr Res 2024; 271:319-331. [PMID: 39084107 DOI: 10.1016/j.schres.2024.07.032] [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: 09/04/2023] [Revised: 07/12/2024] [Accepted: 07/13/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Neurocognitive deficits have been widely reported in clinical high-risk for psychosis (CHR) populations. Additionally, rates of cannabis use are high among CHR youth and are associated with greater symptom severity. Cannabis use has been sometimes shown to be associated with better neurocognition in more progressed psychosis cohorts, therefore in this study we aimed to determine whether a similar pattern was present in CHR. METHODS CHR participants ages 12-30 from the North American Prodromal Longitudinal Study (NAPLS-3) (N = 698) were grouped according to: "minimal to no cannabis use" (n = 406), "occasional use" (n = 127), or "frequent use" (n = 165). At baseline, cannabis use groups were compared on neurocognitive tests, clinical, and functional measures. Follow-up analyses were used to model relationships between cannabis use frequency, neurocognition, premorbid, and social functioning. RESULTS Occasional cannabis users performed significantly better than other use-groups on measures of IQ, with similar trend-level patterns observed across neurocognitive domains. Occasional cannabis users demonstrated better social, global, and premorbid functioning compared to the other use-groups and less severe symptoms compared to the frequent use group. Follow-up structural equation modeling/path analyses found significant positive associations between premorbid functioning, social functioning, and IQ, which in turn was associated with occasional cannabis use frequency. DISCUSSION Better premorbid functioning positively predicts both better social functioning and higher IQ which in turn is associated with a moderate cannabis use pattern in CHR, similar to reports in first-episode and chronic psychosis samples. Better premorbid functioning likely represents a protective factor in the CHR population and predicts a better functional outcome.
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Affiliation(s)
- L Kennedy
- Department of Psychiatry, University of California San Diego, United States
| | - B S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | | | - C M Amir
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry, University of California Los Angeles, Los Angeles, CA, United States
| | - C E Bearden
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry, University of California Los Angeles, Los Angeles, CA, United States
| | - T D Cannon
- Department of Psychology, Yale University, New Haven, CT, United States; Department of Psychiatry, Yale University, New Haven, CT, United States
| | - R Carrión
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - B Cornblatt
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States
| | - M Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - D Perkins
- University of North Carolina, Chapel Hill, Chapel Hill, NC, United States
| | - D Mathalon
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco
| | - W Stone
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - E Walker
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - S Woods
- Department of Psychology, Yale University, New Haven, CT, United States; Department of Psychiatry, Yale University, New Haven, CT, United States
| | - K S Cadenhead
- Department of Psychiatry, University of California San Diego, United States.
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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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3
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Michaels TI, Simon-Pearson L, Kane JM, Cornblatt B. Racial Disparities Among Clinical High-Risk and First-Episode Psychosis Multisite Research Participants: A Systematic Review. Psychiatr Serv 2024; 75:451-460. [PMID: 38204372 DOI: 10.1176/appi.ps.20230120] [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: 01/12/2024]
Abstract
OBJECTIVE The NIH has mandated equal representation of Black, Indigenous, and people of color (BIPOC) individuals in clinical research, but it is unclear whether such inclusion has been achieved in multisite research studies of individuals at clinical high risk for psychosis or with first-episode psychosis (FEP). An assessment of inclusion rates is important for understanding the social determinants of psychosis and psychosis risk that specifically affect BIPOC individuals. METHODS The authors conducted a systematic review of the literature published between 1993 and 2022 of multisite research studies of clinical high risk for psychosis and FEP in North America to determine ethnoracial inclusion rates. Using an online systematic review tool, the authors checked 2,278 studies for eligibility. Twelve studies met all inclusion criteria. Data were extracted, and demographic characteristics, socioeconomic status, study design, and recruitment strategies used by each study were analyzed. RESULTS Most (62%) of the participants in studies of clinical high risk for psychosis were White. Compared with national data, the demographic characteristics of individuals with clinical high risk were representative across most ethnoracial groups. Black participants (43%) made up the largest ethnoracial group in FEP studies and were overrepresented compared with their representation in the U.S. population. FEP studies were more likely to recruit participants from community mental health centers than were the studies of clinical high risk. CONCLUSIONS Although these results suggest high representation of BIPOC individuals in psychosis research, opportunities exist for an improved focus on ethnoracial representation. The authors offer recommendations for practices that may increase ethnoracial diversity in future psychosis study samples.
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Affiliation(s)
- Timothy I Michaels
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Laura Simon-Pearson
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - John M Kane
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Barbara Cornblatt
- Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York (Michaels, Simon-Pearson, Cornblatt); Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York (Michaels, Kane); Department of Psychology, Hofstra University, Hempstead, New York (Simon-Pearson); Institute of Behavioral Science (Kane) and Center for Psychiatric Neuroscience (Cornblatt), Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
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4
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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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5
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Dhamala E, Chopra S, Ooi LQ, Rubio JM, Yeo BT, Malhotra AK, Holmes AJ. Sex differences in the functional network underpinnings of psychotic-like experiences in children. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.22.590660. [PMID: 38712263 PMCID: PMC11071409 DOI: 10.1101/2024.04.22.590660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Psychotic-like experiences (PLEs) include a range of sub-threshold symptoms that resemble aspects of psychosis but do not necessarily indicate the presence of psychiatric illness. These experiences are highly prevalent in youth and are associated with developmental disruptions across social, academic, and emotional domains. While not all youth who report PLEs develop psychosis, many develop other psychiatric illnesses during adolescence and adulthood. As such, PLEs are theorized to represent early markers of poor mental health. Here, we characterized the similarities and differences in the neurobiological underpinnings of childhood PLEs across the sexes using a large sample from the ABCD Study (n=5,260), revealing sex-specific associations between functional networks connectivity and PLEs. We find that although the networks associated with PLEs overlap to some extent across the sexes, there are also crucial differences. In females, PLEs are associated with dispersed cortical and non-cortical connections, whereas in males, they are primarily associated with functional connections within limbic, temporal parietal, somato/motor, and visual networks. These results suggest that early transdiagnostic markers of psychopathology may be distinct across the sexes, further emphasizing the need to consider sex in psychiatric research as well as clinical practice.
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Affiliation(s)
- Elvisha Dhamala
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA
| | - Sidhant Chopra
- Department of Psychology, Yale University, New Haven, USA
- Department of Psychiatry, Brain Health Institute, Rutgers University, Piscataway, USA
| | - Leon Q.R. Ooi
- Centre for Sleep & Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, Singapore, National University of Singapore, Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jose M. Rubio
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA
| | - B.T. Thomas Yeo
- Centre for Sleep & Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, Singapore, National University of Singapore, Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, USA
| | - Anil K. Malhotra
- Institute of Behavioral Sciences, Feinstein Institutes for Medical Research, Manhasset, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, USA
| | - Avram J. Holmes
- Department of Psychiatry, Brain Health Institute, Rutgers University, Piscataway, USA
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6
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Voineskos AN, Hawco C, Neufeld NH, Turner JA, Ameis SH, Anticevic A, Buchanan RW, Cadenhead K, Dazzan P, Dickie EW, Gallucci J, Lahti AC, Malhotra AK, Öngür D, Lencz T, Sarpal DK, Oliver LD. Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions. World Psychiatry 2024; 23:26-51. [PMID: 38214624 PMCID: PMC10786022 DOI: 10.1002/wps.21159] [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] [Indexed: 01/13/2024] Open
Abstract
Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia. We begin by reviewing research on fMRI biomarkers in schizophrenia and the clinical high risk phase through a historical lens, moving from case-control regional brain activation to global connectivity and advanced analytical approaches, and more recent machine learning algorithms to identify predictive neuroimaging features. Findings from fMRI studies of negative symptoms as well as of neurocognitive and social cognitive deficits are then reviewed. Functional neural markers of these symptoms and deficits may represent promising treatment targets in schizophrenia. Next, we summarize fMRI research related to antipsychotic medication, psychotherapy and psychosocial interventions, and neurostimulation, including treatment response and resistance, therapeutic mechanisms, and treatment targeting. We also review the utility of fMRI and data-driven approaches to dissect the heterogeneity of schizophrenia, moving beyond case-control comparisons, as well as methodological considerations and advances, including consortia and precision fMRI. Lastly, limitations and future directions of research in the field are discussed. Our comprehensive review suggests that, in order for fMRI to be clinically useful in the care of patients with schizophrenia, research should address potentially actionable clinical decisions that are routine in schizophrenia treatment, such as which antipsychotic should be prescribed or whether a given patient is likely to have persistent functional impairment. The potential clinical utility of fMRI is influenced by and must be weighed against cost and accessibility factors. Future evaluations of the utility of fMRI in prognostic and treatment response studies may consider including a health economics analysis.
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Affiliation(s)
- Aristotle N Voineskos
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicholas H Neufeld
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH, USA
| | - Stephanie H Ameis
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Cundill Centre for Child and Youth Depression and McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Alan Anticevic
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kristin Cadenhead
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Erin W Dickie
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julia Gallucci
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anil K Malhotra
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Dost Öngür
- McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Todd Lencz
- Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA
| | - Deepak K Sarpal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lindsay D Oliver
- Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Worthington MA, Collins MA, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan M, Mathalon DH, Perkins DO, Stone WS, Walker EF, Woods SW, Cannon TD. Improving prediction of psychosis in youth at clinical high-risk: pre-baseline symptom duration and cortical thinning as moderators of the NAPLS2 risk calculator. Psychol Med 2024; 54:611-619. [PMID: 37642172 DOI: 10.1017/s0033291723002301] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Clinical implementation of risk calculator models in the clinical high-risk for psychosis (CHR-P) population has been hindered by heterogeneous risk distributions across study cohorts which could be attributed to pre-ascertainment illness progression. To examine this, we tested whether the duration of attenuated psychotic symptom (APS) worsening prior to baseline moderated performance of the North American prodrome longitudinal study 2 (NAPLS2) risk calculator. We also examined whether rates of cortical thinning, another marker of illness progression, bolstered clinical prediction models. METHODS Participants from both the NAPLS2 and NAPLS3 samples were classified as either 'long' or 'short' symptom duration based on time since APS increase prior to baseline. The NAPLS2 risk calculator model was applied to each of these groups. In a subset of NAPLS3 participants who completed follow-up magnetic resonance imaging scans, change in cortical thickness was combined with the individual risk score to predict conversion to psychosis. RESULTS The risk calculator models achieved similar performance across the combined NAPLS2/NAPLS3 sample [area under the curve (AUC) = 0.69], the long duration group (AUC = 0.71), and the short duration group (AUC = 0.71). The shorter duration group was younger and had higher baseline APS than the longer duration group. The addition of cortical thinning improved the prediction of conversion significantly for the short duration group (AUC = 0.84), with a moderate improvement in prediction for the longer duration group (AUC = 0.78). CONCLUSIONS These results suggest that early illness progression differs among CHR-P patients, is detectable with both clinical and neuroimaging measures, and could play an essential role in the prediction of clinical outcomes.
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Affiliation(s)
| | | | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | | | | | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA, USA
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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8
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Mamah D, Mutiso V, Musyimi C, Harms MP, Anokhin AP, Chen S, Torous J, Muyela L, Nashed J, Al-Hosni Y, Odera A, Yarber A, Golosheykin S, Faghankhani M, Sneed M, Ndetei DM. Kenya Psychosis-Risk Outcomes Study (KePROS): Development of an Accelerated Medicine Partnership Schizophrenia-Aligned Project in Africa. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae009. [PMID: 39144113 PMCID: PMC11207935 DOI: 10.1093/schizbullopen/sgae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis The Accelerating Medicines Partnership Schizophrenia (AMP SCZ) funds a longitudinal study of 43 research sites across 5 continents to develop tools to stratify developmental trajectories of youth at clinical high risk for psychosis (CHR) and identify homogenous targets for future clinical trials. However, there are no sites in Africa, leaving a critical gap in our knowledge of clinical and biological outcomes among CHR individuals. Study Design We describe the development of the Kenya Psychosis-Risk Outcomes Study (KePROS), a 5-year NIH-funded project in Kenya designed to harmonize with AMP SCZ. The study will recruit over 100 CHR and 50 healthy participants and conduct multiple clinical and biomarker assessments over 2 years. Capacity building is a key component of the study, including the construction of an electroencephalography (EEG) laboratory and the upgrading of a local 3 T magnetic resonance imaging (MRI) machine. We detail community recruitment, study methodologies and protocols, and unique challenges with this pioneering research in Africa. Study Results This paper is descriptive only. Planned future analyses will investigate possible predictors of clinical outcomes and will be compared to results from other global populations. Conclusions KePROS will provide the research community with a rich longitudinal clinical and biomarker dataset from an African country in the developing Global South, which can be used alongside AMP SCZ data to delineate CHR outcome groups for future treatment development. Training in mental health assessment and investment in cutting-edge biomarker assessment and other technologies is needed to facilitate the inclusion of African countries in large-scale research consortia.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Victoria Mutiso
- African Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Christine Musyimi
- African Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Michael P Harms
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Andrey P Anokhin
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - ShingShiun Chen
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center at Harvard Medical School, Boston, MA, USA
| | - Levi Muyela
- African Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Jerome Nashed
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Yazen Al-Hosni
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Arthur Odera
- African Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Alaina Yarber
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Semyon Golosheykin
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Masoomeh Faghankhani
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Megan Sneed
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - David M Ndetei
- African Mental Health Research and Training Foundation, Nairobi, Kenya
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
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9
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Caballero N, Machiraju S, Diomino A, Kennedy L, Kadivar A, Cadenhead KS. Recent Updates on Predicting Conversion in Youth at Clinical High Risk for Psychosis. Curr Psychiatry Rep 2023; 25:683-698. [PMID: 37755654 PMCID: PMC10654175 DOI: 10.1007/s11920-023-01456-2] [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] [Accepted: 09/05/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE OF REVIEW This review highlights recent advances in the prediction and treatment of psychotic conversion. Over the past 25 years, research into the prodromal phase of psychotic illness has expanded with the promise of early identification of individuals at clinical high risk (CHR) for psychosis who are likely to convert to psychosis. RECENT FINDINGS Meta-analyses highlight conversion rates between 20 and 30% within 2-3 years using existing clinical criteria while research into more specific risk factors, biomarkers, and refinement of psychosis risk calculators has exploded, improving our ability to predict psychotic conversion with greater accuracy. Recent studies highlight risk factors and biomarkers likely to contribute to earlier identification and provide insight into neurodevelopmental abnormalities, CHR subtypes, and interventions that can target specific risk profiles linked to neural mechanisms. Ongoing initiatives that assess longer-term (> 5-10 years) outcome of CHR participants can provide valuable information about predictors of later conversion and diagnostic outcomes while large-scale international biomarker studies provide hope for precision intervention that will alter the course of early psychosis globally.
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Affiliation(s)
- Noe Caballero
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Siddharth Machiraju
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Anthony Diomino
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Leda Kennedy
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Armita Kadivar
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA.
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10
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Jiang S, Huang H, Zhou J, Li H, Duan M, Yao D, Luo C. Progressive trajectories of schizophrenia across symptoms, genes, and the brain. BMC Med 2023; 21:237. [PMID: 37400838 DOI: 10.1186/s12916-023-02935-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/12/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Schizophrenia is characterized by complex psychiatric symptoms and unclear pathological mechanisms. Most previous studies have focused on the morphological changes that occur over the development of the disease; however, the corresponding functional trajectories remain unclear. In the present study, we aimed to explore the progressive trajectories of patterns of dysfunction after diagnosis. METHODS Eighty-six patients with schizophrenia and 120 healthy controls were recruited as the discovery dataset. Based on multiple functional indicators of resting-state brain functional magnetic resonance imaging, we conducted a duration-sliding dynamic analysis framework to investigate trajectories in association with disease progression. Neuroimaging findings were associated with clinical symptoms and gene expression data from the Allen Human Brain Atlas database. A replication cohort of patients with schizophrenia from the University of California, Los Angeles, was used as the replication dataset for the validation analysis. RESULTS Five stage-specific phenotypes were identified. A symptom trajectory was characterized by positive-dominated, negative ascendant, negative-dominated, positive ascendant, and negative surpassed stages. Dysfunctional trajectories from primary and subcortical regions to higher-order cortices were recognized; these are associated with abnormal external sensory gating and a disrupted internal excitation-inhibition equilibrium. From stage 1 to stage 5, the importance of neuroimaging features associated with behaviors gradually shifted from primary to higher-order cortices and subcortical regions. Genetic enrichment analysis identified that neurodevelopmental and neurodegenerative factors may be relevant as schizophrenia progresses and highlighted multiple synaptic systems. CONCLUSIONS Our convergent results indicate that progressive symptoms and functional neuroimaging phenotypes are associated with genetic factors in schizophrenia. Furthermore, the identification of functional trajectories complements previous findings of structural abnormalities and provides potential targets for drug and non-drug interventions in different stages of schizophrenia.
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Affiliation(s)
- Sisi Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, 2019RU035, Chengdu, People's Republic of China
| | - Huan Huang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
| | - Jingyu Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
| | - Hechun Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
| | - Mingjun Duan
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in Medicine, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, 611731, Chengdu, Sichuan, People's Republic of China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, 2019RU035, Chengdu, People's Republic of China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in Medicine, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, 611731, Chengdu, Sichuan, People's Republic of China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, People's Republic of China.
- Research Unit of NeuroInformation, Chinese Academy of Medical Sciences, 2019RU035, Chengdu, People's Republic of China.
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in Medicine, University of Electronic Science and Technology of China, No. 2006, Xiyuan Ave., West Hi-Tech Zone, 611731, Chengdu, Sichuan, People's Republic of China.
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11
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Hagler MA, Ferrara M, Yoviene Sykes LA, Li F, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Perkins DO, Mathalon DH, Seidman LJ, Tsuang MT, Walker EF, Powers AR, Allen AR, Srihari VH, Woods SW. Sampling from different populations: Sociodemographic, clinical, and functional differences between samples of first episode psychosis individuals and clinical high-risk individuals who progressed to psychosis. Schizophr Res 2023; 255:239-245. [PMID: 37028205 PMCID: PMC10207144 DOI: 10.1016/j.schres.2023.03.047] [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: 08/26/2022] [Revised: 02/24/2023] [Accepted: 03/29/2023] [Indexed: 04/09/2023]
Abstract
Over the past two decades, research and clinical resources on clinical high risk (CHR) for psychosis have both expanded, with goals to better understanding risk and protective factors on the course of illness and inform early intervention efforts. However, some studies have highlighted potential sampling bias among CHR research studies, raising questions about generalizability of findings and inequitable access to early detection and intervention. The current study sought to explore these questions by comparing 94 participants in a CHR longitudinal monitoring study across North America (NAPLS-2) who converted to syndromal psychosis over the course of the study (CHR-CV) to 171 participants who presented for treatment at a localized first-episode psychosis service (FES) after converting. CHR-CV participants were significantly more likely to be White and have a college-educated parent, while FES participants were more likely to be Black and first- or second-generation immigrants. On average, CHR-CV participants were younger at onset of attenuated positive symptoms, had a longer period of attenuated symptoms prior to conversion, and were more likely to be treated with antipsychotics prior to conversion compared to those in FES programs. After controlling for time since conversion, CHR-CV participants had higher global functioning and were less likely to have experienced recent psychiatric hospitalization. Findings suggest that CHR research and FES clinics may be sampling from different populations, although conclusions are limited by inconsistent sampling frames and methods. Integrated early detection that targets defined geographic catchments may deliver more epidemiologically representative samples to both CHR research and FES.
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Affiliation(s)
- Matthew A Hagler
- Department of Psychiatry, Yale University, New Haven, CT, United States of America.
| | - Maria Ferrara
- Department of Psychiatry, Yale University, New Haven, CT, United States of America; Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | | | - Fangyong Li
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Departments of Psychology and Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, United States of America
| | | | - Tyrone D Cannon
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, United States of America
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States of America
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, San Francisco, CA, United States of America
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, CA, United States of America
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States of America
| | - Albert R Powers
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Adrienne R Allen
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Vinod H Srihari
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
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12
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Bhatara VS, Daniel J, Whitman C, Vik T, Bernstein B, Simkin DR. Complementary/Integrative Medicine Treatment and Prevention of Youth Psychosis. Child Adolesc Psychiatr Clin N Am 2023; 32:273-296. [PMID: 37147040 DOI: 10.1016/j.chc.2022.08.009] [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] [Indexed: 05/07/2023]
Abstract
The rationale for CIM treatments in youth psychoses is to optimize treatment by targeting symptoms not resolved by antipsychotics, such as negative symptoms (major drivers of disability). Adjunctive omega-3 fatty acids (ω-3 FA) or N-acetyl cystine (NAC usage for > 24-week) can potentially reduce negative symptoms and improve function. ω-3 FA or exercise may prevent progression to psychosis in youth (in prodromal stage). Weekly 90-minute moderate to vigorous physical activity or aerobic exercise can reduce positive and negative symptoms. Awaiting better research, CIM agents are also recommended because they are devoid of any serious side-effects.
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Affiliation(s)
- Vinod S Bhatara
- Department of Psychiatry and Pediatrics, University of South Dakota, Sanford School of Medicine, 2601 W Nicole Drive, Sioux Falls, SD 57105-3329, USA.
| | - Jeremy Daniel
- South Dakota State University, College of Pharmacy and Allied Health Professions, Avera Behavioral Health
| | - Carol Whitman
- University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA
| | - Tamara Vik
- University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA
| | - Bettina Bernstein
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA; Clinical Affiliate Department of Child and Adolescent Psychiatry, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Deborah R Simkin
- Department of Psychiatry, Emory University School of Medicine, 8955 Highway 98 West, Suite 204, Miramar Beach, FL 32550, USA
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13
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Mao Z, Bo Q, Sun Y, Li W, Dong F, Wang C. Prepulse inhibition and attentional modulation in individuals with attenuated psychotic syndrome and at genetically high risk of schizophrenia. Schizophr Res 2023; 254:90-91. [PMID: 36805652 DOI: 10.1016/j.schres.2023.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 01/28/2023] [Accepted: 02/05/2023] [Indexed: 02/19/2023]
Affiliation(s)
- Zhen Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Qijing Bo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
| | - Yue Sun
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Weidi Li
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing 100096, China
| | - Fang Dong
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Chuanyue Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
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14
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North American Prodrome Longitudinal Study (NAPLS 3): Methods and baseline description. Schizophr Res 2022; 243:262-267. [PMID: 32317224 PMCID: PMC7572535 DOI: 10.1016/j.schres.2020.04.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 02/10/2020] [Accepted: 04/06/2020] [Indexed: 12/19/2022]
Abstract
The North American Prodrome Longitudinal Study (NAPLS) is a consortium of nine programs focusing on youth at clinical high risk (CHR) for psychosis. Funded by the National Institute of Mental Health (NIMH), the sites are located at Emory University, Harvard University, University of Calgary, University of California at Los Angeles, at San Diego, and at San Francisco, University of North Carolina Chapel Hill, Yale University, and Zucker Hillside Hospital. There have been two previous endeavors completed by this consortium, known as NAPLS-1 and NAPLS-2. This paper first offers an overview of the methodology of the third phase of the NAPLS consortium, the second five-year prospective study NAPLS-3, which aims to determine mechanisms of the development of psychosis. In addition, we report on the ascertainment and demographics of the 710 CHR participants in NAPLS-3.
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15
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Evaluating Brain Structure as a Predictor of the Transition to Psychosis in Clinical High-Risk Individuals. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 2:90-91. [DOI: 10.1016/j.bpsgos.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/16/2022] [Indexed: 10/18/2022] Open
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16
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Lee TY, Lee SS, Gong BG, Kwon JS. Research Trends in Individuals at High Risk for Psychosis: A Bibliometric Analysis. Front Psychiatry 2022; 13:853296. [PMID: 35573362 PMCID: PMC9099069 DOI: 10.3389/fpsyt.2022.853296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
The study of clinical high risk for psychosis (CHR-P) has progressed rapidly over the last decades and has developed into a significant branch of schizophrenia research. Organizing the information about this rapidly growing subject through bibliometric analysis enables us to gain a better understanding of current research trends and future directions to be pursued. Electronic searches from January 1991 to December 2020 yielded 5,601 studies, and included 1,637 original articles. After processing the data, we were able to determine that this field has grown significantly in a short period of time. It has been confirmed that researchers, institutions, and countries are collaborating closely to conduct research; moreover, these networks are becoming increasingly complex over time. Additionally, there was a shift over time in the focus of the research subject from the prodrome, recognition, prevention, diagnosis to cognition, neuroimaging, neurotransmitters, cannabis, and stigma. We should aim for collaborative studies in which various countries participate, thus covering a wider range of races and cultures than would be covered by only a few countries.
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Affiliation(s)
- Tae Young Lee
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan-si, South Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, South Korea
| | - Soo Sang Lee
- Department of Library Information Archives Studies, Pusan National University, Pusan, South Korea
| | - Byoung-Gyu Gong
- Sorenson Impact Center, University of Utah, Salt Lake City, UT, United States
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Seoul National University College of National Sciences, Seoul, South Korea
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Fisher VL, Ortiz LS, Powers AR. A computational lens on menopause-associated psychosis. Front Psychiatry 2022; 13:906796. [PMID: 35990063 PMCID: PMC9381820 DOI: 10.3389/fpsyt.2022.906796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/07/2022] [Indexed: 11/21/2022] Open
Abstract
Psychotic episodes are debilitating disease states that can cause extreme distress and impair functioning. There are sex differences that drive the onset of these episodes. One difference is that, in addition to a risk period in adolescence and early adulthood, women approaching the menopause transition experience a second period of risk for new-onset psychosis. One leading hypothesis explaining this menopause-associated psychosis (MAP) is that estrogen decline in menopause removes a protective factor against processes that contribute to psychotic symptoms. However, the neural mechanisms connecting estrogen decline to these symptoms are still not well understood. Using the tools of computational psychiatry, links have been proposed between symptom presentation and potential algorithmic and biological correlates. These models connect changes in signaling with symptom formation by evaluating changes in information processing that are not easily observable (latent states). In this manuscript, we contextualize the observed effects of estrogen (decline) on neural pathways implicated in psychosis. We then propose how estrogen could drive changes in latent states giving rise to cognitive and psychotic symptoms associated with psychosis. Using computational frameworks to inform research in MAP may provide a systematic method for identifying patient-specific pathways driving symptoms and simultaneously refine models describing the pathogenesis of psychosis across all age groups.
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Affiliation(s)
- Victoria L Fisher
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
| | - Liara S Ortiz
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
| | - Albert R Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
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18
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Fusar-Poli P, Salazar de Pablo G, Rajkumar RP, López-Díaz Á, Malhotra S, Heckers S, Lawrie SM, Pillmann F. Diagnosis, prognosis, and treatment of brief psychotic episodes: a review and research agenda. Lancet Psychiatry 2022; 9:72-83. [PMID: 34856200 DOI: 10.1016/s2215-0366(21)00121-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 12/25/2022]
Abstract
Brief psychotic episodes represent an intriguing paradox in clinical psychiatry because they elude the standard knowledge that applies to the persisting psychotic disorders such as schizophrenia. This Review describes key diagnostic considerations such as conceptual foundations, current psychiatric classification versus research-based operationalisations, epidemiology, and sociocultural variations; prognostic aspects including the risk of psychosis recurrence, types of psychotic recurrences, other clinical outcomes, prognostic factors; and therapeutic issues such as treatment guidelines and unmet need of care. The advances and challenges associated with the scientific evidence are used to set a research agenda in this area. We conclude that brief psychotic episodes can be reconceptualised within a clinical staging model to promote innovative translational research and improve our understanding and treatment of psychotic disorders.
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Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection 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; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERSAM, Madrid, Spain
| | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Álvaro López-Díaz
- University Hospital Virgen Macarena, Seville, Spain; Institute of Biomedicine of Seville, Seville, Spain
| | | | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Frank Pillmann
- WO Center of Psychiatry, Halle, Germany; Martin Luther University, Halle-Wittenberg, Germany
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19
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Westhoff MLS, Ladwig J, Heck J, Schülke R, Groh A, Deest M, Bleich S, Frieling H, Jahn K. Early Detection and Prevention of Schizophrenic Psychosis-A Review. Brain Sci 2021; 12:11. [PMID: 35053755 PMCID: PMC8774083 DOI: 10.3390/brainsci12010011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 01/04/2023] Open
Abstract
Psychotic disorders often run a chronic course and are associated with a considerable emotional and social impact for patients and their relatives. Therefore, early recognition, combined with the possibility of preventive intervention, is urgently warranted since the duration of untreated psychosis (DUP) significantly determines the further course of the disease. In addition to established diagnostic tools, neurobiological factors in the development of schizophrenic psychoses are increasingly being investigated. It is shown that numerous molecular alterations already exist before the clinical onset of the disease. As schizophrenic psychoses are not elicited by a single mutation in the deoxyribonucleic acid (DNA) sequence, epigenetics likely constitute the missing link between environmental influences and disease development and could potentially serve as a biomarker. The results from transcriptomic and proteomic studies point to a dysregulated immune system, likely evoked by epigenetic alterations. Despite the increasing knowledge of the neurobiological mechanisms involved in the development of psychotic disorders, further research efforts with large population-based study designs are needed to identify suitable biomarkers. In conclusion, a combination of blood examinations, functional imaging techniques, electroencephalography (EEG) investigations and polygenic risk scores should be considered as the basis for predicting how subjects will transition into manifest psychosis.
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Affiliation(s)
- Martin Lennart Schulze Westhoff
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Johannes Ladwig
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Johannes Heck
- Institute for Clinical Pharmacology, Hannover Medical School, D-30625 Hannover, Germany;
| | - Rasmus Schülke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Adrian Groh
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Maximilian Deest
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
| | - Kirsten Jahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, D-30625 Hannover, Germany; (J.L.); (R.S.); (A.G.); (M.D.); (S.B.); (H.F.); (K.J.)
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20
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Fowler D, Berry C, Hodgekins J, Banerjee R, Barton G, Byrne R, Clarke T, Fraser R, Grant K, Greenwood K, Notley C, Parker S, Shepstone L, Wilson J, French P. Social recovery therapy for young people with emerging severe mental illness: the Prodigy RCT. Health Technol Assess 2021; 25:1-98. [PMID: 34842524 DOI: 10.3310/hta25700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Young people with social disability and non-psychotic severe and complex mental health problems are an important group. Without intervention, their social problems can persist and have large economic and personal costs. Thus, more effective evidence-based interventions are needed. Social recovery therapy is an individual therapy incorporating cognitive-behavioural techniques to increase structured activity as guided by the participant's goals. OBJECTIVE This trial aimed to test whether or not social recovery therapy provided as an adjunct to enhanced standard care over 9 months is superior to enhanced standard care alone. Enhanced standard care aimed to provide an optimal combination of existing evidence-based interventions. DESIGN A pragmatic, single-blind, superiority randomised controlled trial was conducted in three UK centres: Sussex, Manchester and East Anglia. Participants were aged 16-25 years with persistent social disability, defined as < 30 hours per week of structured activity with social impairment for at least 6 months. Additionally, participants had severe and complex mental health problems, defined as at-risk mental states for psychosis or non-psychotic severe and complex mental health problems indicated by a Global Assessment of Functioning score ≤ 50 persisting for ≥ 6 months. Two hundred and seventy participants were randomised 1 : 1 to either enhanced standard care plus social recovery therapy or enhanced standard care alone. The primary outcome was weekly hours spent in structured activity at 15 months post randomisation. Secondary outcomes included subthreshold psychotic, negative and mood symptoms. Outcomes were collected at 9 and 15 months post randomisation, with maintenance assessed at 24 months. RESULTS The addition of social recovery therapy did not significantly increase weekly hours in structured activity at 15 months (primary outcome treatment effect -4.44, 95% confidence interval -10.19 to 1.31). We found no evidence of significant differences between conditions in secondary outcomes at 15 months: Social Anxiety Interaction Scale treatment effect -0.45, 95% confidence interval -4.84 to 3.95; Beck Depression Inventory-II treatment effect -0.32, 95% confidence interval -4.06 to 3.42; Comprehensive Assessment of At-Risk Mental States symptom severity 0.29, 95% confidence interval -4.35 to 4.94; or distress treatment effect 4.09, 95% confidence interval -3.52 to 11.70. Greater Comprehensive Assessment of At-Risk Mental States for psychosis scores reflect greater symptom severity. We found no evidence of significant differences at 9 or 24 months. Social recovery therapy was not estimated to be cost-effective. The key limitation was that missingness of data was consistently greater in the enhanced standard care-alone arm (9% primary outcome and 15% secondary outcome missingness of data) than in the social recovery therapy plus enhanced standard care arm (4% primary outcome and 9% secondary outcome missingness of data) at 15 months. CONCLUSIONS We found no evidence for the clinical superiority or cost-effectiveness of social recovery therapy as an adjunct to enhanced standard care. Both arms made large improvements in primary and secondary outcomes. Enhanced standard care included a comprehensive combination of evidence-based pharmacological, psychotherapeutic and psychosocial interventions. Some results favoured enhanced standard care but the majority were not statistically significant. Future work should identify factors associated with the optimal delivery of the combinations of interventions that underpin better outcomes in this often-neglected clinical group. TRIAL REGISTRATION Current Controlled Trials ISRCTN47998710. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment Vol. 25, No. 70. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- David Fowler
- School of Psychology, University of Sussex, Brighton and Hove, UK.,Research and Development Department, Sussex Partnership NHS Foundation Trust, Brighton and Hove, UK
| | - Clio Berry
- School of Psychology, University of Sussex, Brighton and Hove, UK.,Research and Development Department, Sussex Partnership NHS Foundation Trust, Brighton and Hove, UK.,Primary Care and Public Health, Brighton and Sussex Medical School, Brighton and Hove, UK
| | - Joanne Hodgekins
- Norwich Medical School, University of East Anglia, Norwich, UK.,Research and Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Robin Banerjee
- School of Psychology, University of Sussex, Brighton and Hove, UK
| | - Garry Barton
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Rory Byrne
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Timothy Clarke
- Research and Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Rick Fraser
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Brighton and Hove, UK
| | - Kelly Grant
- Norwich Clinical Trials Unit, University of East Anglia, Norwich, UK
| | - Kathryn Greenwood
- School of Psychology, University of Sussex, Brighton and Hove, UK.,Research and Development Department, Sussex Partnership NHS Foundation Trust, Brighton and Hove, UK
| | - Caitlin Notley
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Sophie Parker
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Lee Shepstone
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jon Wilson
- Research and Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Paul French
- Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.,Research and Innovation Department, Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UK
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21
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Worthington MA, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Stone WS, Tsuang MT, Walker EF, Woods SW, Cannon TD. Individualized Prediction of Prodromal Symptom Remission for Youth at Clinical High Risk for Psychosis. Schizophr Bull 2021; 48:395-404. [PMID: 34581405 PMCID: PMC8886593 DOI: 10.1093/schbul/sbab115] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The clinical high-risk period before a first episode of psychosis (CHR-P) has been widely studied with the goal of understanding the development of psychosis; however, less attention has been paid to the 75%-80% of CHR-P individuals who do not transition to psychosis. It is an open question whether multivariable models could be developed to predict remission outcomes at the same level of performance and generalizability as those that predict conversion to psychosis. Participants were drawn from the North American Prodrome Longitudinal Study (NAPLS3). An empirically derived set of clinical and demographic predictor variables were selected with elastic net regularization and were included in a gradient boosting machine algorithm to predict prodromal symptom remission. The predictive model was tested in a comparably sized independent sample (NAPLS2). The classification algorithm developed in NAPLS3 achieved an area under the curve of 0.66 (0.60-0.72) with a sensitivity of 0.68 and specificity of 0.53 when tested in an independent external sample (NAPLS2). Overall, future remitters had lower baseline prodromal symptoms than nonremitters. This study is the first to use a data-driven machine-learning approach to assess clinical and demographic predictors of symptomatic remission in individuals who do not convert to psychosis. The predictive power of the models in this study suggest that remission represents a unique clinical phenomenon. Further study is warranted to best understand factors contributing to resilience and recovery from the CHR-P state.
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Affiliation(s)
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, USA
| | | | | | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA, USA
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Elaine F Walker
- Department of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA,Department of Psychiatry, Yale University, New Haven, CT, USA,To whom correspondence should be addressed; 2 Hillhouse Avenue, PO Box 208205, New Haven, CT 06511, USA; tel: 203-436-1545, fax: 203-432-5281, e-mail:
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22
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Zhang T, Xu L, Chen Y, Wei Y, Tang X, Hu Y, Li Z, Gan R, Wu G, Cui H, Tang Y, Hui L, Li C, Wang J. Conversion to psychosis in adolescents and adults: similar proportions, different predictors. Psychol Med 2021; 51:2003-2011. [PMID: 32248862 DOI: 10.1017/s0033291720000756] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Age effects may be important for improving models for the prediction of conversion to psychosis for individuals in the clinical high risk (CHR) state. This study aimed to explore whether adolescent CHR individuals (ages 9-17 years) differ significantly from adult CHR individuals (ages 18-45 years) in terms of conversion rates and predictors. METHOD Consecutive CHR individuals (N = 517) were assessed for demographic and clinical characteristics and followed up for 3 years. Individuals with CHR were classified as adolescent (n = 244) or adult (n = 273) groups. Age-specific prediction models of psychosis were generated separately using Cox regression. RESULTS Similar conversion rates were found between age groups; 52 out of 216 (24.1%) adolescent CHR individuals and 55 out of 219 (25.1%) CHR adults converted to psychosis. The conversion outcome was best predicted by negative symptoms compared to other clinical variables in CHR adolescents (χ2 = 7.410, p = 0.006). In contrast, positive symptoms better predicted conversion in CHR adults (χ2 = 6.585, p = 0.01). CONCLUSIONS Adolescent and adult CHR individuals may require a different approach to early identification and prediction. These results can inform the development of more precise prediction models based on age-specific approaches.
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Affiliation(s)
- TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - LiHua Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - Ying Chen
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - YanYan Wei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - XiaoChen Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - YeGang Hu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - ZhiXing Li
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - RanPiao Gan
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - GuiSen Wu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - HuiRu Cui
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - YingYing Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - Li Hui
- Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou215137, Jiangsu, PR China
| | - ChunBo Li
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai200030, PR China
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai, PR China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
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23
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Clay KB, Raugh IM, Bartolomeo LA, Strauss GP. Defeatist performance beliefs in individuals at clinical high-risk for psychosis and outpatients with chronic schizophrenia. Early Interv Psychiatry 2021; 15:865-873. [PMID: 32743974 DOI: 10.1111/eip.13024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 12/29/2022]
Abstract
AIM Prior studies indicate that defeatist performance beliefs (DPBs) are elevated in those in the chronic phase of schizophrenia (SZ) and associated with negative symptoms, functional outcome and neurocognitive impairment. However, it is unclear whether these same patterns of results hold in participants at clinical high-risk (CHR) for psychosis. METHODS Two studies were conducted to determine whether prior results in SZ could be replicated and extended to CHR. Participants included 184 healthy controls (CN) and 186 outpatients with chronic SZ for Study 1, and 30 CN and 35 CHR in Study 2. In both studies, participants completed the DPB scale and measures of negative symptoms, psychosocial functioning and neurocognition. RESULTS Both chronic SZ and CHR participants had elevated DPBs compared to CN (p's < .01). In SZ, higher DPBs were associated with greater negative symptoms (r's = .31-.37, p's < .01), poorer social functioning and impaired social cognition (r = -.40, P < .001). In CHR, greater DPBs were associated with poorer social functioning (r = -.52, P < .05) and impairments in the neurocognitive domains of reasoning (r = -.48, P < .05) and processing speed (r = -.41, P < .05). Models testing whether DPBs mediated links between negative symptoms and functioning, negative symptoms and cognition and cognition and functioning were nonsignificant in SZ and CHR samples. CONCLUSIONS Findings generally provide support for the cognitive model of negative symptoms and functioning and suggest that DPBs are an important clinical target across phases of psychotic illness.
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Affiliation(s)
- Kendall B Clay
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Lisa A Bartolomeo
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Gregory P Strauss
- Department of Psychology, University of Georgia, Athens, Georgia, USA
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24
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Anglin DM, Ereshefsky S, Klaunig MJ, Bridgwater MA, Niendam TA, Ellman LM, DeVylder J, Thayer G, Bolden K, Musket CW, Grattan RE, Lincoln SH, Schiffman J, Lipner E, Bachman P, Corcoran CM, Mota NB, van der Ven E. From Womb to Neighborhood: A Racial Analysis of Social Determinants of Psychosis in the United States. Am J Psychiatry 2021; 178:599-610. [PMID: 33934608 PMCID: PMC8655820 DOI: 10.1176/appi.ajp.2020.20071091] [Citation(s) in RCA: 122] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The authors examine U.S.-based evidence that connects characteristics of the social environment with outcomes across the psychosis continuum, from psychotic experiences to schizophrenia. The notion that inequitable social and economic systems of society significantly influence psychosis risk through proxies, such as racial minority and immigrant statuses, has been studied more extensively in European countries. While there are existing international reviews of social determinants of psychosis, none to the authors' knowledge focus on factors in the U.S. context specifically-an omission that leaves domestic treatment development and prevention efforts incomplete and underinformed. In this review, the authors first describe how a legacy of structural racism in the United States has shaped the social gradient, highlighting consequential racial inequities in environmental conditions. The authors offer a hypothesized model linking structural racism with psychosis risk through interwoven intermediary factors based on existing theoretical models and a review of the literature. Neighborhood factors, cumulative trauma and stress, and prenatal and perinatal complications were three key areas selected for review because they reflect social and environmental conditions that may affect psychosis risk through a common pathway shaped by structural racism. The authors describe evidence showing that Black and Latino people in the United States suffer disproportionately from risk factors within these three key areas, in large part as a result of racial discrimination and social disadvantage. This broad focus on individual and community factors is intended to provide a consolidated space to review this growing body of research and to guide continued inquiries into social determinants of psychosis in U.S. contexts.
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Affiliation(s)
- Deidre M Anglin
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Sabrina Ereshefsky
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Mallory J Klaunig
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Miranda A Bridgwater
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Tara A Niendam
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Lauren M Ellman
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Jordan DeVylder
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Griffin Thayer
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Khalima Bolden
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Christie W Musket
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Rebecca E Grattan
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Sarah Hope Lincoln
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Jason Schiffman
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Emily Lipner
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Peter Bachman
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Cheryl M Corcoran
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Natália B Mota
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
| | - Els van der Ven
- Department of Psychology, City College of New York, City University of New York, New York (Anglin, Thayer); Graduate Center, City University of New York (Anglin); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento (Ereshefsky, Niendam, Bolden, Grattan); Department of Psychology, University of Maryland, Baltimore County (Klaunig, Bridgwater, Schiffman); Department of Psychology, Temple University, Philadelphia (Ellman, Lipner); Graduate School of Social Service, Fordham University, New York (DeVylder); Department of Psychology (Musket) and Department of Psychiatry (Bachman), University of Pittsburgh, Pittsburgh; ISN Innovations, Institute for Social Neuroscience, Ivanhoe, Australia (Grattan); Department of Psychological Sciences, Case Western Reserve University, Cleveland (Lincoln); Department of Psychological Science, University of California, Irvine (Schiffman); Department of Psychiatry, Icahn School of Medicine, New York, and James J. Peters VA Medical Center, Bronx, N.Y. (Corcoran); Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil (Mota); Mailman School of Public Health, Columbia University, New York (van der Ven); School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands (van der Ven); Department of Clinical, Neuro, and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam (van der Ven)
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Wu J, Long X, Liu F, Qi A, Chen Q, Guan X, Zhang Q, Yao Y, Shi J, Xie S, Yan W, Hu M, Yuan X, Tang J, Wu S, Zhang T, Wang J, Lu Z. Screening of the college students at clinical high risk for psychosis in China: a multicenter epidemiological study. BMC Psychiatry 2021; 21:253. [PMID: 34001048 PMCID: PMC8127262 DOI: 10.1186/s12888-021-03229-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND To investigate a 3-stage screening procedure and explore the clinical features of subjects at Clinical High Risk (CHR) for psychosis in a representative sample of Chinese college students. METHODS An epidemiological survey of the prevalence of the CHR syndrome in Chinese college students that was selected by stratified random sampling from Shanghai, Nanjing and Nanchang cities was done following a 3-stage procedure. Participants were initially screened with the Prodromal Questionnaire-brief version (PQ-B), and whose distress score of PQ-B exceeded 24 would be invited to a telephone assessment using the subscale for positive symptoms of the Scale of Prodromal Symptoms (SOPS)/Structured Interview for Prodromal Syndromes (SIPS). Lastly, participants who scored 3 or higher in any item of the subscale would be administered with the SIPS interview conducted by trained researchers to confirm the diagnosis of CHR syndrome. RESULTS Twenty-three thousand sixty-three college students completed the survey during September 2017 to October 2018. Seventy-two students were diagnosed as CHR subjects, and the detection rate in the total sample was 0.3%. The peak age range for the first diagnosis of CHR was 17 to 20 years. Thirteen and forty-six were set as the cutoff points of PQ-B total score and distress score to balance the greatest sensitivity and specificity. Binary logistic regression revealed that 8 items in PQ-B showed significant distinction for detecting CHR subjects. CONCLUSIONS The 3-stage screening method can be utilized in the detection of CHR subjects for psychosis in the general population, during which delusional ideas, perceptual abnormalities and suspiciousness deserve great attention.
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Affiliation(s)
- Jiaxin Wu
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China ,grid.24516.340000000123704535Tongji University School of Medicine, Shanghai, 200092 PR China
| | - Xiangyun Long
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China ,grid.24516.340000000123704535Tongji University School of Medicine, Shanghai, 200092 PR China
| | - Fei Liu
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Ansi Qi
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Qi Chen
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Xiaofeng Guan
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Qiong Zhang
- grid.24516.340000000123704535Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065 PR China
| | - Yuhong Yao
- grid.24516.340000000123704535Tongji University School of Medicine, Shanghai, 200092 PR China
| | - Jingyu Shi
- grid.24516.340000000123704535Tongji University School of Medicine, Shanghai, 200092 PR China
| | - Shiping Xie
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029 PR China
| | - Wei Yan
- grid.89957.3a0000 0000 9255 8984Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029 PR China
| | - Maorong Hu
- grid.412604.50000 0004 1758 4073Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 PR China
| | - Xin Yuan
- grid.412604.50000 0004 1758 4073Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 PR China
| | - Jun Tang
- grid.412604.50000 0004 1758 4073Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 PR China
| | - Siliang Wu
- grid.412604.50000 0004 1758 4073Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, 330006 PR China
| | - Tianhong Zhang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030 PR China
| | - Jijun Wang
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030 PR China
| | - Zheng Lu
- Department of Psychiatry, Tongji Hospital of Tongji University, Tongji University School of Medicine, 389 Xincun Road, Shanghai, 200065, PR China. .,Tongji University School of Medicine, Shanghai, 200092, PR China.
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26
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Jalal R, Nair A, Lin A, Eckfeld A, Kushan L, Zinberg J, Karlsgodt KH, Cannon TD, Bearden CE. Social cognition in 22q11.2 deletion syndrome and idiopathic developmental neuropsychiatric disorders. J Neurodev Disord 2021; 13:15. [PMID: 33863277 PMCID: PMC8052741 DOI: 10.1186/s11689-021-09363-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/03/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND 22q11.2 deletion syndrome (22q11DS) is a common recurrent neurogenetic condition associated with elevated risk for developmental neuropsychiatric disorders and intellectual disability. Children and adults with 22q11DS often exhibit marked social impairment as well as neurocognitive deficits, and have elevated rates of both autism spectrum disorder (ASD) and psychosis. However, the relationship between the basic processes of social cognition and cognitive ability has not been well studied in 22q11DS. Here, we examined differences in social cognition in 22q11DS, relative to multiple groups of idiopathic neuropsychiatric disorders, and typically developing healthy controls (HC). Additionally, we examined differences in intellectual functioning and its relationship to social cognitive abilities. Finally, we examined the relationship between social cognitive abilities and real-world social behavior. METHODS We examined social cognition and intellectual functioning in 273 participants (mean age = 17.74 ± 5.18% female = 44.3%): 50 with 22q11DS, 49 youth with first episode psychosis (FEP), 48 at clinical high-risk (CHR) for psychosis, 24 participants with ASD, and 102 HC. Social cognition was assessed using The Awareness of Social Inference Test (TASIT), while reciprocal social behavior was assessed via parent/caregiver ratings on the Social Responsiveness Scale (SRS). Participants were also administered the Wechsler Abbreviated Scale of Intelligence, 2nd edition (WASI-II) to assess intellectual functioning. RESULTS The 22q11DS group exhibited significantly lower social cognitive abilities compared to CHR, FEP, and HC groups after controlling for intellectual functioning, but not in comparison to the ASD group. Significant positive correlations were found between social cognition, as measured by the TASIT and IQ across groups. In contrast, no significant relationships were found between TASIT and real-world social behavior (SRS) for any group. CONCLUSIONS Our findings indicate social cognitive deficits are more prominent in 22q11DS than idiopathic neuropsychiatric conditions across the age range, even after adjusting for global intellectual function. These results contribute to our understanding of the intellectual and social vulnerabilities of 22q11DS in comparison to idiopathic neuropsychiatric disorders. Our findings of robust associations between intellectual ability and social cognition emphasizes the importance of accounting for neurocognitive deficits in social skills interventions and tailoring these existing treatment models for 22q11DS and other populations with intellectual impairment.
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Affiliation(s)
- Rhideeta Jalal
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Aarti Nair
- Department of Psychology, Loma Linda University, Loma Linda, CA, USA.
| | - Amy Lin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Ariel Eckfeld
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Leila Kushan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jamie Zinberg
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Katherine H Karlsgodt
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
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McIlwaine SV, Shah J. Mental Health Services Research Targeting the Clinical High-Risk State for Psychosis: Lessons, Future Directions and Integration with Patient Perspectives. Curr Psychiatry Rep 2021; 23:11. [PMID: 33533984 DOI: 10.1007/s11920-021-01224-0] [Citation(s) in RCA: 3] [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] [Accepted: 01/13/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW We summarize the history of the clinical high-risk stage of psychosis (CHR), current research on this stage and recent critiques of the field, and evaluate current CHR guidelines and frameworks. RECENT FINDINGS Following its identification and characterization, CHR services have successfully been developed in North America, Europe, Australia and elsewhere. As reflected in guidelines, these services and their orientation largely emerged as an outgrowth of the framework pioneered by early intervention services for first-episode psychosis. We critically discuss what is known so far about the subjective experience of the CHR syndrome, the meaning of this "unofficial" diagnosis as well as what is known and unknown about the service-related needs. While a range of outstanding questions remain in the field, there is a particular need for patient-oriented work and to investigate the service-related needs of young people at CHR.
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Affiliation(s)
- Sarah V McIlwaine
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
- Prevention and Early Intervention Programme for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, 7070 boul. Champlain, Verdun, Montreal, QC, H4H 1A8, Canada
| | - Jai Shah
- Prevention and Early Intervention Programme for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, 7070 boul. Champlain, Verdun, Montreal, QC, H4H 1A8, Canada.
- Department of Psychiatry, McGill University, Montreal, QC, Canada.
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Worthington MA, Miklowitz DJ, O'Brien M, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Cannon TD. Selection for psychosocial treatment for youth at clinical high risk for psychosis based on the North American Prodrome Longitudinal Study individualized risk calculator. Early Interv Psychiatry 2021; 15:96-103. [PMID: 31943807 PMCID: PMC7358123 DOI: 10.1111/eip.12914] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/22/2019] [Accepted: 12/14/2019] [Indexed: 01/19/2023]
Abstract
AIM Recent findings suggest that family-focused therapy (FFT) is effective for individuals at clinical high-risk for psychosis (CHR-P). As outcomes of CHR-P individuals are quite varied, certain psychosocial interventions may be differentially effective in subgroups. The present study examined change in positive symptoms for CHR-P individuals at different levels of predicted risk for conversion to psychosis who received either FFT, a brief form of family education termed enhanced care (EC) or treatment as usual. METHODS Participants were drawn from the North American Prodromal Longitudinal Study (NAPLS2). A subset of NAPLS2 participants completed a randomized study involving FFT or EC. The present study includes participants from the FFT-CHR sub-study and non-randomized NAPLS2 participants. Predicted risk of conversion was calculated using the Individualized Risk Calculator for Psychosis. Robust linear regressions evaluated whether the association between predicted risk of conversion and positive symptom change differed across intervention groups. RESULTS A total of 94 participants from the FFT-CHR sub-study (FFT-CHR n = 50, EC n = 44) and 401 non-randomized NAPLS2 participants were included in this study. There was a treatment group by predicted risk of conversion interaction that predicted positive symptom improvement: higher risk individuals improved more with FFT-CHR than EC or the non-randomized NAPLS group, whereas lower-risk individuals did not differ in positive symptom improvement across treatment groups (FFT-CHR vs EC: P = .03, β = 20.27; FFT-CHR vs NAPLS2: P < .001, β = 28.40). CONCLUSIONS Intensive treatments such as FFT-CHR may be most appropriate for individuals at the highest levels of clinical risk for psychosis.
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Affiliation(s)
| | - David J Miklowitz
- Department of Psychiatry, UCLA Semel Institute, University of California, Los Angeles, California
| | - Mary O'Brien
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, California
| | | | | | - Daniel H Mathalon
- Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, California
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Massachusetts General Hospital, Boston, Massachusetts
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, California
| | - Elaine F Walker
- Department of Psychology and Psychiatry, Emory University, Atlanta, Georgia
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, Connecticut.,Department of Psychiatry, Yale University, New Haven, Connecticut
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Worthington MA, Cannon TD. Prediction and Prevention in the Clinical High-Risk for Psychosis Paradigm: A Review of the Current Status and Recommendations for Future Directions of Inquiry. Front Psychiatry 2021; 12:770774. [PMID: 34744845 PMCID: PMC8569129 DOI: 10.3389/fpsyt.2021.770774] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Prediction and prevention of negative clinical and functional outcomes represent the two primary objectives of research conducted within the clinical high-risk for psychosis (CHR-P) paradigm. Several multivariable "risk calculator" models have been developed to predict the likelihood of developing psychosis, although these models have not been translated to clinical use. Overall, less progress has been made in developing effective interventions. In this paper, we review the existing literature on both prediction and prevention in the CHR-P paradigm and, primarily, outline ways in which expanding and combining these paths of inquiry could lead to a greater improvement in individual outcomes for those most at risk.
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Affiliation(s)
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, United States.,Department of Psychiatry, Yale University, New Haven, CT, United States
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Bowman S, McKinstry C, Howie L, McGorry P. Expanding the search for emerging mental ill health to safeguard student potential and vocational success in high school: A narrative review. Early Interv Psychiatry 2020; 14:655-676. [PMID: 32026624 DOI: 10.1111/eip.12928] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/29/2022]
Abstract
AIM Young people experiencing mental ill health are more likely than their healthy aged peers to drop out of high school. This can result in social exclusion and vocational derailment. Identifying young people at risk and taking action before an illness is established or school dropout occurs is an important goal. This study aimed to examine evidence for the risk markers and at risk mental states of the clinical staging model (stage 0-1b) and whether these risk states and early symptoms impact school participation and academic attainment. METHOD This narrative review assembles research from both the psychiatry and education literature. It examines stage 0 to stage 1b of the clinical staging model and links the risk states and early symptoms to evidence about the academic success of young people in high school. RESULTS In accordance with the clinical staging model and evidence from education literature, childhood trauma and parental mental illness can impact school engagement and academic progress. Sleep disturbance can result in academic failure. Undifferentiated depression and anxiety can increase the risk for school dropout. Subthreshold psychosis and hypomanic states are associated with functional impairment and high rates of Not in Employment, Education, or Training (NEET) but are not recognized in the education literature. CONCLUSION Risk markers for emerging mental ill health can be identified in education research and demonstrate an impact on a student's success in high school. Clear referral protocols need to be embedded into school life to reduce risk of progression to later stages of illness and support school participation and success.
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Affiliation(s)
- Siann Bowman
- Department of Occupational Therapy, School of Allied Health, LaTrobe University, Melbourne, Australia
| | - Carol McKinstry
- Department of Occupational Therapy, LaTrobe Rural Health School, LaTrobe University, Melbourne, Australia
| | - Linsey Howie
- Department of Occupational Therapy, School of Clinical and Community Allied Health, LaTrobe University, Melbourne, Australia
| | - Patrick McGorry
- The National Centre of Excellence in Youth Mental Health, Orygen, The University of Melbourne, Melbourne, Australia
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Abstract
Emotion regulation dysfunction is characteristic of psychotic disorders, but little is known about how the use of specific types of emotion regulation strategies differs across phases of psychotic illness. This information is vital for understanding factors contributing to psychosis vulnerability states and developing targeted treatments. Three studies were conducted to examine emotion regulation across phases of psychosis, which included (a) adolescent community members with psychotic-like experiences (PLEs; n = 262) and adolescents without PLEs (n = 1,226); (b) adolescents who met clinical high-risk criteria for a prodromal syndrome (n = 29) and healthy controls (n = 29); and (c) outpatients diagnosed with schizophrenia or schizoaffective disorder (SZ; n = 61) and healthy controls (n = 67). In each study, participants completed the Emotion Regulation Questionnaire and measures of psychiatric symptoms and functional outcome. The three psychosis groups did not differ from each other in reported use of suppression; however, there was evidence for a vulnerability-related, dose-dependent decrease in reappraisal. Across each sample, a lower use of reappraisal was associated with poorer clinical outcomes. Findings indicate that emotion regulation abnormalities occur across a continuum of psychosis vulnerability and represent important targets for intervention.
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Collaborative Approaches to the Clinical High-Risk State: From Data to Mechanism to Intervention. Biol Psychiatry 2020; 88:287-288. [PMID: 32622464 DOI: 10.1016/j.biopsych.2020.05.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/23/2020] [Indexed: 11/20/2022]
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Trask CL, Cohn JR, Paxson AM, Hansen GS, Cicero DC. Form and content of attenuated psychotic symptoms in psychometrically assessed positive and negative schizotypy. Early Interv Psychiatry 2020; 14:321-329. [PMID: 31270947 DOI: 10.1111/eip.12856] [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: 07/26/2018] [Revised: 04/26/2019] [Accepted: 06/09/2019] [Indexed: 11/28/2022]
Abstract
AIM Greater attention is being paid to early detection and identification of individuals who are at high risk of developing psychosis. One area of interest is the particular content types of psychotic-like experiences (PLEs), which can be thought of as attenuated, non-clinical positive symptoms (eg, feeling perplexed by reality). Previous research has examined content of PLEs in clinical high-risk samples. The current study aimed to build upon these findings by analysing content in a psychometrically determined high-risk sample. METHODS One hundred fifty-three undergraduates with scores greater than 1.96 SDs above the mean on a measure of schizotypy symptoms participated in a semi-structured interview for the assessment of prodromal syndromes. Each interview was transcribed verbatim and content of PLEs was rated according to the Content of Attenuated Positive Symptoms scale. RESULTS Frequencies of content items in the psychometric high-risk sample were similar to those found in a clinical high-risk sample. Multiple regression analyses revealed that certain content items were more predictive of decreased global functioning and increased positive symptom severity. CONCLUSIONS Content items that were associated with worse outcomes may be cause for greater concern if endorsed by individuals presenting for treatment. Future research should examine content of PLEs in a longitudinal design to determine whether particular items could predict subsequent conversion to a schizophrenia-spectrum disorder.
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Affiliation(s)
- Christi L Trask
- Department of Psychology, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Jonathan R Cohn
- Department of Psychology, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Aaliyah M Paxson
- Department of Psychology, University of Hawaii at Manoa, Honolulu, Hawaii
| | - Geoffrey S Hansen
- Department of Psychology, University of Hawaii at Manoa, Honolulu, Hawaii
| | - David C Cicero
- Department of Psychology, University of Hawaii at Manoa, Honolulu, Hawaii
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Luther L, Suor JH, Rosen C, Jobe TH, Faull RN, Harrow M. Clarifying the direction of impact of negative symptoms and neurocognition on prospective work functioning in psychosis: A 20-year longitudinal study. Schizophr Res 2020; 220:232-239. [PMID: 32201031 PMCID: PMC8523216 DOI: 10.1016/j.schres.2020.03.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/06/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022]
Abstract
Both neurocognition and negative symptoms have demonstrated strong links to functional outcomes, such as work functioning, among those with severe mental illness (SMI). Prior models have suggested that reduced neurocognition 1) precedes or predicts greater negative symptoms and 2) indirectly influences functional outcomes via its impact on negative symptoms. The current study sought to also test a divergent model: whether greater negative symptoms predict reduced neurocognition and indirectly influence work functioning through their impact on neurocognition. Both models were tested using cross-sectional and prospective data spanning 20-years in a sample of 277 people with a SMI with psychotic features. Results showed that both models were supported in cross-sectional analyses. However, in prospective models predicting work functioning, only the models examining the indirect influence of negative symptoms on work functioning (7.5 to up to 20-years later) through neurocognition demonstrated significant mediation (i.e., a significant indirect effect); further, higher negative symptoms significantly predicted lower prospective neurocognition, while lower neurocognition did not significantly predict greater prospective negative symptoms. Although cross-sectional data were consistent with prior models, our prospective models offered greater support for a putative causal pathway running from negative symptoms to neurocognition-rather than the reverse-to work functioning. Findings have implications for mechanisms contributing to longitudinal work functioning and suggest that targeting negative symptoms prior to neurocognition could be more beneficial for long-term work outcomes.
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Affiliation(s)
- Lauren Luther
- Massachusetts General Hospital, Department of Psychiatry, 149 13th Street, Charlestown, MA 02129, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; University of Illinois at Chicago, Department of Psychiatry, 1601 West Taylor, Chicago, IL 60612, USA.
| | - Jennifer H. Suor
- University of Illinois at Chicago, Department of Psychiatry; 1601 West Taylor, Chicago, IL 60612, U.S.A
| | - Cherise Rosen
- University of Illinois at Chicago, Department of Psychiatry, 1601 West Taylor, Chicago, IL 60612, USA.
| | - Thomas H. Jobe
- University of Illinois at Chicago, Department of Psychiatry; 1601 West Taylor, Chicago, IL 60612, U.S.A
| | - Robert N. Faull
- University of Illinois at Chicago, Department of Psychiatry; 1601 West Taylor, Chicago, IL 60612, U.S.A
| | - Martin Harrow
- University of Illinois at Chicago, Department of Psychiatry, 1601 West Taylor, Chicago, IL 60612, USA.
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Imburgio MJ, Banica I, Hill KE, Weinberg A, Foti D, MacNamara A. Establishing norms for error-related brain activity during the arrow Flanker task among young adults. Neuroimage 2020; 213:116694. [PMID: 32142881 PMCID: PMC7197955 DOI: 10.1016/j.neuroimage.2020.116694] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/14/2020] [Accepted: 02/27/2020] [Indexed: 02/08/2023] Open
Abstract
Psychological assessments typically rely on self-report and behavioral measures. Augmenting these with neurophysiological measures of the construct in question may increase the accuracy and predictive power of these assessments. Moreover, thinking about neurophysiological measures from an assessment perspective may facilitate under-utilized research approaches (e.g., brain-based recruitment of participants). However, the lack of normative data for most neurophysiological measures has prevented the comparison of individual responses to the general population, precluding these approaches. The current work examines the distributions of two event-related potentials (ERPs) commonly used in individual differences research: the error-related negativity (ERN) and error positivity (Pe). Across three lab sites, 800 unselected participants between the ages of 18 and 30 performed the arrow version of a Flanker task while EEG was recorded. Percentile scores and distributions for ERPs on error trials, correct trials, and the difference (ΔERN, ΔPe; error minus correct) at Fz, Cz and Pz are reported. The 25th, 50th, and 75th percentile values for the ΔERN at Cz were -2.37 μV, -5.41 μV, and -8.65 μV, respectively. The same values for ΔPe at Cz were 7.51 μV, 11.18 μV, and 15.55 μV. Females displayed significantly larger ΔPe magnitudes and smaller ΔERN magnitudes than males. Additionally, normative data for behavioral performance (accuracy, post-error slowing, and reaction time) on the Flanker task is reported. Results provide a means by which ERN and Pe amplitudes of young adults elicited by the arrow Flanker task can be benchmarked, facilitating the classification of neural responses as 'large,' 'medium,' or 'small'. The ability to classify responses in this manner is a necessary step towards expanded use of these measures in assessment and research settings. These norms may not apply to ERPs elicited by other tasks, and future work should establish similar norms using other tasks.
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Affiliation(s)
- Michael J Imburgio
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA.
| | - Iulia Banica
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Kaylin E Hill
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Anna Weinberg
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Dan Foti
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Annmarie MacNamara
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
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Schultze-Lutter F, Ruhrmann S, Klosterkötter J. Early detection of psychosis – Establishing a service for persons at risk. Eur Psychiatry 2020; 24:1-10. [DOI: 10.1016/j.eurpsy.2008.08.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Revised: 07/08/2008] [Accepted: 08/08/2008] [Indexed: 10/21/2022] Open
Abstract
AbstractPurposeThe establishment phase of an early detection centre for prodromal psychosis is introduced and characterised, along with its detaining and promoting factors within a universal multi-payer health care system.MethodAcross the first six years (1998–2003), users' characteristics are compared between different diagnostic groups and to the local population statistics; and, for an exemplary 12-months period (3-1-2002 to 2-28-2003), the characteristics of telephone contacts with the service are studied.ResultsRising steadily in number across the first three years, 872 persons, predominately of German citizenship and higher education, consulted the service until 2003, 326 with first-episode psychosis and 144 not fulfilling criteria for a current or beginning psychosis. Of the 402 putatively prodromal patients, 94% reported predictive basic symptoms, 68.9% attenuated and 20.6% transient psychotic symptoms. Most contacts by persons meeting any prodromal criterion were initiated by mental health professionals (psychiatrists or psychologists) and counselling services.ConclusionSupported by public awareness campaigns, an early detection service is well received by its users and private practitioners as reflected by the large proportion of referrals from the latter. However, persons of non-German background as well as of lower education were underrepresented indicating that these sub-groups should be approached by tailored programmes.
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Sullivan SA, Kounali D, Cannon M, David AS, Fletcher PC, Holmans P, Jones H, Jones PB, Linden DEJ, Lewis G, Owen MJ, O'Donovan M, Rammos A, Thompson A, Wolke D, Heron J, Zammit S. A Population-Based Cohort Study Examining the Incidence and Impact of Psychotic Experiences From Childhood to Adulthood, and Prediction of Psychotic Disorder. Am J Psychiatry 2020; 177:308-317. [PMID: 31906710 DOI: 10.1176/appi.ajp.2019.19060654] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors investigated the incidence, course, and outcome of psychotic experiences from childhood through early adulthood in the general population and examined prediction of psychotic disorder. METHODS This was a population-based cohort study using the semistructured Psychosis-Like Symptoms Interview at ages 12, 18, and 24 (N=7,900 with any data). Incidence rates were estimated using flexible parametric modeling, and positive predictive values (PPVs), sensitivity, specificity, and area under the curve were estimated for prediction. RESULTS The incidence rate of psychotic experiences increased between ages 13 and 24, peaking during late adolescence. Of 3,866 participants interviewed at age 24, 313 (8.1%, 95% CI=7.2, 9.0) had a definite psychotic experience since age 12. A total of 109 individuals (2.8%) met criteria for a psychotic disorder up to age 24, of whom 70% had sought professional help. Prediction of current psychotic disorder at age 24 (N=47, 1.2%), by both self-report and interviewer-rated measures of psychotic experiences at age 18 (PPVs, 2.9% and 10.0%, respectively), was improved by incorporating information on frequency and distress (PPVs, 13.3% and 20.0%, respectively), although sensitivities were low. The PPV of an at-risk mental state at age 18 predicting incident disorder at ages 18-24 was 21.1% (95% CI=6.1, 45.6) (sensitivity, 14.3%, 95% CI=4.0, 32.7). CONCLUSIONS The study results show a peak in incidence of psychotic experiences during late adolescence as well as an unmet need for care in young people with psychotic disorders. Because of the low sensitivity, targeting individuals in non-help-seeking samples based only on more severe symptom cutoff thresholds will likely have little impact on population levels of first-episode psychosis.
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Affiliation(s)
- Sarah A Sullivan
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Daphne Kounali
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Mary Cannon
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Anthony S David
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Paul C Fletcher
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Peter Holmans
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Hannah Jones
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Peter B Jones
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - David E J Linden
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Glyn Lewis
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Michael J Owen
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Michael O'Donovan
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Alexandros Rammos
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Andrew Thompson
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Dieter Wolke
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Jon Heron
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
| | - Stanley Zammit
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, U.K. (Sullivan, Kounali, H. Jones, Heron, Zammit); Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Cannon); Institute of Mental Health, University College London (David, Lewis); Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge (Fletcher, P.B. Jones); MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, U.K. (Holmans, Linden, Owen, O'Donovan, Rammos, Zammit); Division of Psychiatry, Warwick Medical School, Warwick, Coventry, U.K. (Thompson); Orygen, Centre of Excellence in Youth Mental Health, Melbourne, Australia (Thompson); and Department of Psychology, Division of Mental Health and Wellbeing, University of Warwick, Coventry, U.K. (Wolke)
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Allswede DM, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Mathalon DH, McGlashan T, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Cannon TD. Characterizing Covariant Trajectories of Individuals at Clinical High Risk for Psychosis Across Symptomatic and Functional Domains. Am J Psychiatry 2020; 177:164-171. [PMID: 31509005 PMCID: PMC7002249 DOI: 10.1176/appi.ajp.2019.18111290] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to characterize differences in outcomes among help-seeking individuals at clinical high risk for psychosis by identifying covariant longitudinal patterns of symptoms and functioning. METHODS Group-based multitrajectory modeling was applied to longitudinal ratings of four symptom domains (positive, negative, disorganized, general) and general functioning among clinical high-risk individuals in an initial discovery sample (N=422). An independent sample (N=133) was used to test replicability. RESULTS Three trajectory groups were identified among clinical high-risk individuals in the discovery sample: group 1 (30%) exhibited substantial improvement across all domains, with half reaching positive outcomes for both functioning and positive symptoms; group 2 (49%) exhibited moderate impairments across domains, with approximately one-quarter meeting criteria for positive outcomes; the remaining participants (group 3; 22%) exhibited consistent levels of severe impairment across domains and did not experience positive outcomes. These trajectory groups and remission patterns were replicated in an independent sample. CONCLUSIONS Replicable subgroups of help-seeking clinical high-risk cases can be ascertained based on distinctive profiles of change over time in symptoms and functioning. Within each of the three identified subgroups, similar patterns of change (i.e., rapid, moderate, or no improvement) were observed across the four symptom domains and functioning. This consistency of change over time across domains within each subgroup is a novel observation supporting the syndrome consistency of clinical high-risk symptoms and signs. The observed trajectory subgroups are suggestive of different degrees of need for clinical interventions, ranging from minimal or supportive for about one-third of cases to increasingly intensive among the remainder.
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Affiliation(s)
- Dana M. Allswede
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Jean Addington
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Carrie E. Bearden
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Kristin S. Cadenhead
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Barbara A. Cornblatt
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Daniel H. Mathalon
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Thomas McGlashan
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Diana O. Perkins
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Larry J. Seidman
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Ming T. Tsuang
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Elaine F. Walker
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Scott W. Woods
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
| | - Tyrone D. Cannon
- Department of Psychology (Allswede, Cannon) and Department of Psychiatry (McGlashan, Woods, Cannon), Yale University, New Haven, Conn.; Department of Psychiatry, University of Calgary, Calgary, Canada (Addington); Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles (Bearden); Department of Psychiatry (Cadenhead, Tsuang) and Center for Behavioral Genomics (Tsuang), University of California, San Diego, La Jolla; Department of
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Breitborde NJK, Guirgis H, Stearns W, Carpenter KM, Lteif G, Pine JG, Storey N, Wastler H, Moe AM. The Ohio State University Early Psychosis Intervention Center (EPICENTER) step-based care programme for individuals at clinical high risk for psychosis: study protocol for an observational study. BMJ Open 2020; 10:e034031. [PMID: 31992606 PMCID: PMC7045181 DOI: 10.1136/bmjopen-2019-034031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION In October 2018, the Substance Abuse and Mental Health Services Administration funded 21 sites throughout the USA to develop, implement and evaluate specialised care programmes for individuals at clinical high risk for developing a psychotic disorder (CHR-P). Per the funding requirements, such programmes were required to provide 'step-based care'-a model in which individuals are initially provided with low-intensity, non-psychosis-specific and more benign (ie, least side effects) interventions and only progress onto higher-intensity, psychosis-specific interventions with a greater risk of more severe side effects should they not meet a priori criteria for clinical response to such lower-intensity interventions. Here, we outline the evaluation component of the step-based care programme for individuals at CHR-P at The Ohio State University Early Psychosis Intervention Center (EPICENTER). METHODS AND ANALYSES The EPICENTER CHR-P programme provides a step-based care model comprising psychotherapy, medication management, family support/education, peer support and vocational/educational support. All participants who opt to receive care at the EPICENTER will complete a standardised assessment battery as part of usual care. This battery will be administered on enrolment and will be re-administered at 6-month intervals throughout individuals' participation in EPICENTER clinical services. Participants will have the opportunity to allow for data from these usual care assessments to be used as part of an evaluation project for this new clinical service. The primary outcome for this evaluation project is time to remission of symptomatic and functional deficits commonly experienced by individuals at CHR-P. Participants will also have the opportunity to participate in a supplemental research project designed to further evaluate treatment outcomes and patient characteristics among individuals participating in EPICENTER clinical services. ETHICS AND DISSEMINATION This project was approved by The Ohio State University Institutional Review Board. Results from this project will be disseminated through publications and presentations. TRIAL REGISTRATION NUMBER NCT03970005; Pre-results.
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Affiliation(s)
- Nicholas J K Breitborde
- Psychiatry and Behavioral Health & Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Hossam Guirgis
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Walter Stearns
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Kristen M Carpenter
- Psychiatry and Behavioral Health, Psychology, & Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA
| | - Ghada Lteif
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Jacob G Pine
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Nichole Storey
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Heather Wastler
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Aubrey M Moe
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
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Noble S, Scheinost D, Constable RT. A decade of test-retest reliability of functional connectivity: A systematic review and meta-analysis. Neuroimage 2019; 203:116157. [PMID: 31494250 PMCID: PMC6907736 DOI: 10.1016/j.neuroimage.2019.116157] [Citation(s) in RCA: 287] [Impact Index Per Article: 57.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 08/30/2019] [Accepted: 09/02/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Once considered mere noise, fMRI-based functional connectivity has become a major neuroscience tool in part due to early studies demonstrating its reliability. These fundamental studies revealed only the tip of the iceberg; over the past decade, many test-retest reliability studies have continued to add nuance to our understanding of this complex topic. A summary of these diverse and at times contradictory perspectives is needed. OBJECTIVES We aimed to summarize the existing knowledge regarding test-retest reliability of functional connectivity at the most basic unit of analysis: the individual edge level. This entailed (1) a meta-analytic estimate of reliability and (2) a review of factors influencing reliability. METHODS A search of Scopus was conducted to identify studies that estimated edge-level test-retest reliability. To facilitate comparisons across studies, eligibility was restricted to studies measuring reliability via the intraclass correlation coefficient (ICC). The meta-analysis included a random effects pooled estimate of mean edge-level ICC, with studies nested within datasets. The review included a narrative summary of factors influencing edge-level ICC. RESULTS From an initial pool of 212 studies, 44 studies were identified for the qualitative review and 25 studies for quantitative meta-analysis. On average, individual edges exhibited a "poor" ICC of 0.29 (95% CI = 0.23 to 0.36). The most reliable measurements tended to involve: (1) stronger, within-network, cortical edges, (2) eyes open, awake, and active recordings, (3) more within-subject data, (4) shorter test-retest intervals, (5) no artifact correction (likely due in part to reliable artifact), and (6) full correlation-based connectivity with shrinkage. CONCLUSION This study represents the first meta-analysis and systematic review investigating test-retest reliability of edge-level functional connectivity. Key findings suggest there is room for improvement, but care should be taken to avoid promoting reliability at the expense of validity. By pooling existing knowledge regarding this key facet of accuracy, this study supports broader efforts to improve inferences in the field.
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Affiliation(s)
- Stephanie Noble
- Interdepartmental Neuroscience Program, Yale University, USA.
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale University, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, USA; Department of Statistics and Data Science, Yale University, USA; Child Study Center, Yale School of Medicine, USA
| | - R Todd Constable
- Interdepartmental Neuroscience Program, Yale University, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, USA; Department of Neurosurgery, Yale School of Medicine, USA
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41
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Cognitive functions associated with developing prefrontal cortex during adolescence and developmental neuropsychiatric disorders. Neurobiol Dis 2019; 131:104322. [DOI: 10.1016/j.nbd.2018.11.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 09/24/2018] [Accepted: 11/09/2018] [Indexed: 12/30/2022] Open
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Ward HB, Lawson MT, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Jeffries CD, Mathalon DH, McGlashan TH, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Perkins DO. Tobacco use and psychosis risk in persons at clinical high risk. Early Interv Psychiatry 2019; 13:1173-1181. [PMID: 30362261 DOI: 10.1111/eip.12751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/14/2018] [Accepted: 09/09/2018] [Indexed: 12/16/2022]
Abstract
AIM To evaluate the role of tobacco use in the development of psychosis in individuals at clinical high risk. METHOD The North American Prodrome Longitudinal Study is a 2-year multi-site prospective case control study of persons at clinical high risk that aims to better understand predictors and mechanisms for the development of psychosis. The cohort consisted of 764 clinical high risk and 279 healthy comparison subjects. Clinical assessments included tobacco and substance use and several risk factors associated with smoking in general population studies. RESULTS Clinical high risk subjects were more likely to smoke cigarettes than unaffected subjects (light smoking odds ratio [OR] = 3.0, 95% confidence interval [CI] = 1.9-5; heavy smoking OR = 4.8, 95% CI = 1.7-13.7). In both groups, smoking was associated with mood, substance use, stress and perceived discrimination and in clinical high risk subjects with childhood emotional neglect and adaption to school. Clinical high risk subjects reported higher rates of several factors previously associated with smoking, including substance use, anxiety, trauma and perceived discrimination. After controlling for these potential factors, the relationship between clinical high risk state and smoking was no longer significant (light smoking OR = 0.9, 95% CI = 0.4-2.2; heavy smoking OR = 0.3, 95% CI = 0.05-2.3). Moreover, baseline smoking status (hazard ratio [HR] = 1.16, 95% CI = 0.82-1.65) and categorization as ever smoked (HR = 1.3, 95% CI = 0.8-2.1) did not predict time to conversion. CONCLUSION Persons at high risk for psychosis are more likely to smoke and have more factors associated with smoking than controls. Smoking status in clinical high risk subjects does not predict conversion. These findings do not support a causal relationship between smoking and psychosis.
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Affiliation(s)
- Heather B Ward
- Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michael T Lawson
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Departments of Psychology and Psychiatry and Behavioral Sciences, UCLA, Los Angeles, California
| | | | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | | | - Clark D Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, North Carolina
| | | | | | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, Massachusetts
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, La Jolla, California
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, Georgia
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
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Lieberman JA, Small SA, Girgis RR. Early Detection and Preventive Intervention in Schizophrenia: From Fantasy to Reality. Am J Psychiatry 2019; 176:794-810. [PMID: 31569988 DOI: 10.1176/appi.ajp.2019.19080865] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Scientific progress in understanding human disease can be measured by the effectiveness of its treatment. Antipsychotic drugs have been proven to alleviate acute psychotic symptoms and prevent their recurrence in schizophrenia, but the outcomes of most patients historically have been suboptimal. However, a series of findings in studies of first-episode schizophrenia patients transformed the psychiatric field's thinking about the pathophysiology, course, and potential for disease-modifying effects of treatment. These include the relationship between the duration of untreated psychotic symptoms and outcome; the superior responses of first-episode patients to antipsychotics compared with patients with chronic illness, and the reduction in brain gray matter volume over the course of the illness. Studies of the effectiveness of early detection and intervention models of care have provided encouraging but inconclusive results in limiting the morbidity and modifying the course of illness. Nevertheless, first-episode psychosis studies have established an evidentiary basis for considering a team-based, coordinated specialty approach as the standard of care for treating early psychosis, which has led to their global proliferation. In contrast, while clinical high-risk research has developed an evidence-based care model for decreasing the burden of attenuated symptoms, no treatment has been shown to reduce risk or prevent the transition to syndromal psychosis. Moreover, the current diagnostic criteria for clinical high risk lack adequate specificity for clinical application. What limits our ability to realize the potential of early detection and intervention models of care are the lack of sensitive and specific diagnostic criteria for pre-syndromal schizophrenia, validated biomarkers, and proven therapeutic strategies. Future research requires methodologically rigorous studies in large patient samples, across multiple sites, that ideally are guided by scientifically credible pathophysiological theories for which there is compelling evidence. These caveats notwithstanding, we can reasonably expect future studies to build on the research of the past four decades to advance our knowledge and enable this game-changing model of care to become a reality.
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Affiliation(s)
- Jeffrey A Lieberman
- Department of Psychiatry (Lieberman, Small, Girgis) and Department of Neurology (Small), College of Physicians and Surgeons, Columbia University, New York; New York State Psychiatric Institute, New York (Lieberman, Small, Girgis)
| | - Scott A Small
- Department of Psychiatry (Lieberman, Small, Girgis) and Department of Neurology (Small), College of Physicians and Surgeons, Columbia University, New York; New York State Psychiatric Institute, New York (Lieberman, Small, Girgis)
| | - Ragy R Girgis
- Department of Psychiatry (Lieberman, Small, Girgis) and Department of Neurology (Small), College of Physicians and Surgeons, Columbia University, New York; New York State Psychiatric Institute, New York (Lieberman, Small, Girgis)
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Værnes TG, Røssberg JI, Møller P. Anomalous self-experiences are strongly associated with negative symptoms in a clinical high-risk for psychosis sample. Compr Psychiatry 2019; 93:65-72. [PMID: 31351243 DOI: 10.1016/j.comppsych.2019.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/01/2019] [Accepted: 07/10/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Anomalous self-experiences (ASE) are considered as central features of the schizophrenia spectrum disorders and prodromal schizophrenia. We investigated total and single-item prevalence of these phenomena in a clinical high-risk (CHR) for psychosis sample, and associations with conventional psychosis-risk symptoms, present and childhood global/psychosocial functioning, and childhood trauma. METHODS The sample (n = 38) included 31 CHR, according to ultra-high risk or cognitive basic symptoms (COGDIS) criteria, and seven with non-progressive attenuated positive symptoms. Psychopathological evaluations included the Examination of Anomalous Self-Experience (EASE), Structured Clinical Interview for Prodromal Syndromes (SIPS), Schizophrenia Proneness Instrument - Adult (SPI-A) (only the COGDIS-criteria), a diagnostic interview (SCID-I), Global Assessment of Functioning - Split version (S-GAF), Premorbid Adjustment Scale (PAS) and Childhood Trauma Questionnaire (CTQ). RESULTS The mean total EASE score was in line with reports from other CHR samples, and was particularly enhanced in schizotypal personality disorder and in subjects fulfilling COGDIS-criteria. The four most frequent EASE-items were present in two-thirds or more of the participants. EASE total was significantly associated with negative and disorganization symptoms. A multiple regression analysis revealed that the level of negative symptoms explained most of the variance in EASE total. CONCLUSIONS These results corroborates other findings that anomalous self-experiences are frequent and important features in CHR conditions and in the schizophrenia spectrum. The strong associations with negative symptoms and cognitive disturbances (COGDIS) should be investigated in longitudinal studies to address causality, psychopathological pathways and schizophrenia spectrum specificity. The weaker correlation between EASE total and positive symptoms may partly be related to a restricted range of positive symptoms.
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Affiliation(s)
- Tor Gunnar Værnes
- Early Intervention in Psychosis Advisory Unit for South-East Norway, TIPS Sør-Øst, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.; NORMENT, Norwegian Centre for Mental Disorders Research, University of Oslo, Norway..
| | - Jan Ivar Røssberg
- Division of Psychiatric Treatment Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Paul Møller
- Dept. for Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Norway
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Radhakrishnan R, Guloksuz S, Ten Have M, de Graaf R, van Dorsselaer S, Gunther N, Rauschenberg C, Reininghaus U, Pries LK, Bak M, van Os J. Interaction between environmental and familial affective risk impacts psychosis admixture in states of affective dysregulation. Psychol Med 2019; 49:1879-1889. [PMID: 30284529 DOI: 10.1017/s0033291718002635] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Evidence suggests that cannabis use, childhood adversity, and urbanicity, in interaction with proxy measures of genetic risk, may facilitate onset of psychosis in the sense of early affective dysregulation becoming 'complicated' by, first, attenuated psychosis and, eventually, full-blown psychotic symptoms. METHODS Data were derived from three waves of the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). The impact of environmental risk factors (cannabis use, childhood adversity, and urbanicity) was analyzed across severity levels of psychopathology defined by the degree to which affective dysregulation was 'complicated' by low-grade psychotic experiences ('attenuated psychosis' - moderately severe) and, overt psychotic symptoms leading to help-seeking ('clinical psychosis' - most severe). Familial and non-familial strata were defined based on family history of (mostly) affective disorder and used as a proxy for genetic risk in models of family history × environmental risk interaction. RESULTS In proxy gene-environment interaction analysis, childhood adversity and cannabis use, and to a lesser extent urbanicity, displayed greater-than-additive risk if there was also evidence of familial affective liability. In addition, the interaction contrast ratio grew progressively greater across severity levels of psychosis admixture (none, attenuated psychosis, clinical psychosis) complicating affective dysregulation. CONCLUSION Known environmental risks interact with familial evidence of affective liability in driving the level of psychosis admixture in states of early affective dysregulation in the general population, constituting an affective pathway to psychosis. There is interest in decomposing family history of affective liability into the environmental and genetic components that underlie the interactions as shown here.
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Affiliation(s)
- Rajiv Radhakrishnan
- Department of Psychiatry,Yale University School of Medicine,New Haven, CT,USA
| | - Sinan Guloksuz
- Department of Psychiatry,Yale University School of Medicine,New Haven, CT,USA
| | - Margreet Ten Have
- Department of Epidemiology,Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - Ron de Graaf
- Department of Epidemiology,Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology,Netherlands Institute of Mental Health and Addiction,Utrecht,The Netherlands
| | - Nicole Gunther
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,the Netherlands
| | - Christian Rauschenberg
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,the Netherlands
| | - Ulrich Reininghaus
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,the Netherlands
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,the Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology,School for Mental Health and Neuroscience, Maastricht University Medical Centre,Maastricht,the Netherlands
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46
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Foss-Feig JH, Velthorst E, Smith L, Reichenberg A, Addington J, Cadenhead KS, Cornblatt BA, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone WS, Keshavan M, Tsuang MT, Walker EF, Woods SW, Cannon TD, Bearden CE. Clinical Profiles and Conversion Rates Among Young Individuals With Autism Spectrum Disorder Who Present to Clinical High Risk for Psychosis Services. J Am Acad Child Adolesc Psychiatry 2019; 58:582-588. [PMID: 30797038 PMCID: PMC7781438 DOI: 10.1016/j.jaac.2018.09.446] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/31/2018] [Accepted: 09/14/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The overlap versus independence of autism spectrum disorder (ASD) and schizophrenia is a topic that has garnered the attention of generations of clinicians and scientists. Although high rates of psychotic symptoms have been identified in individuals with ASD, the nature, prevalence, and prognostic significance of subclinical psychotic experiences in ASD remain poorly understood. METHOD This study sought to compare baseline characteristics, clinical profiles, and conversion outcomes between young individuals at clinical high risk for psychosis (CHR) who presented with or without a prior ASD diagnosis during the second phase of the North American Prodrome Longitudinal Study (NAPLS, N = 764). RESULTS Patients with CHR and ASD (CHR/ASD+, n = 26) tended to exhibit greater social and social cognitive difficulties, but expressed relatively levels of core psychosis symptoms similar to those of to patients with CHR but no ASD (CHR/ASD-). Risk for conversion to co-occurring psychosis (18.2% CHR/ASD+ versus 16.8% CHR/ASD-) was equivalent between CHR/ASD+ and CHR/ASD- groups, and the NAPLS2 Psychosis Risk Calculator predicted conversion to psychosis equally well across groups. CONCLUSION These results suggest that baseline psychosis symptoms, predictors of risk for conversion, and ultimate conversion rates are similar in patients with CHR with and without ASD. They further suggest that ASD must not be considered a mutually exclusive diagnosis when such youth present in CHR settings. Future research is needed to better track trajectories in larger cohorts of individuals with CHR and comorbid ASD and to understand whether treatment recommendations effective in the broader CHR population are useful for this particular population as well.
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Affiliation(s)
- Jennifer H Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Eva Velthorst
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lauren Smith
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Abraham Reichenberg
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | - Daniel H Mathalon
- University of California, San Francisco, CA; VA San Francisco Healthcare System, San Francisco, CA
| | | | | | | | | | | | | | | | - Scott W Woods
- Connecticut Mental Health Center, Yale University, New Haven, CT
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47
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Carrión RE, Auther AM, McLaughlin D, Olsen R, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Cornblatt BA. The Global Functioning: Social and Role Scales-Further Validation in a Large Sample of Adolescents and Young Adults at Clinical High Risk for Psychosis. Schizophr Bull 2019; 45:763-772. [PMID: 30351423 PMCID: PMC6581127 DOI: 10.1093/schbul/sby126] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Traditional measures for assessing functioning with adult patients with schizophrenia have been shown to be insufficient for assessing the issues that occur in adolescents and young adults at clinical high risk (CHR) for psychosis. The current study provides an expanded validation of the Global Functioning: Social (GF:Social) and Role (GF:Role) scales developed specifically for use with CHR individuals and explores the reliability and accuracy of the ratings, the validity of the scores in comparison to other established clinical measures, stability of functioning over a 2-year period, and psychosis predictive ability. METHODS Seven hundred fifty-five CHR individuals and 277 healthy control (HC) participants completed the GF:Social and Role scales at baseline as part of the North American Prodrome Longitudinal Study (NAPLS2). RESULTS Inter-rater reliability and accuracy were high for both scales. Correlations between the GF scores and other established clinical measures demonstrated acceptable convergent and discriminant validity. In addition, GF:Social and Role scores were unrelated to positive symptoms. CHR participants showed large impairments in social and role functioning over 2-years, relative to the HCs, even after adjusting for age, IQ, and attenuated positive symptoms. Finally, social decline prior to baseline was more pronounced in CHR converters, relative to non-converters. CONCLUSIONS The GF scales can be administered in a large-scale multi-site study with excellent inter-rater reliability and accuracy. CHR individuals showed social and role functioning impairments over time that were not confounded by positive symptom severity levels. The results of this study demonstrate that social decline is a particularly effective predictor of conversion outcome.
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Affiliation(s)
- Ricardo E Carrión
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY,Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY,To whom correspondence should be addressed; Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 75-59, 263rd Street, Glen Oaks, NY 11004, US; tel: 718-470-8878, fax: 718-470-8131, e-mail:
| | - Andrea M Auther
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
| | - Danielle McLaughlin
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY
| | - Ruth Olsen
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY
| | - Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California, Los Angeles, Los Angeles, CA
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, School of Medicine, New Haven, CT,Department of Psychiatry, Yale University, School of Medicine, New Haven, CT
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, CA
| | - Thomas H McGlashan
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA
| | - Ming T Tsuang
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA
| | | | - Scott W Woods
- Department of Psychiatry, Yale University, School of Medicine, New Haven, CT
| | - Barbara A Cornblatt
- Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY,Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY,Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
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48
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Barajas A, Pelaez T, González O, Usall J, Iniesta R, Arteaga M, Jackson C, Baños I, Sánchez B, Dolz M, Obiols JE, Haro JM, Ochoa S, Arranz B, Arteaga M, Asensio R, Autonell J, Baños I, Bañuelos M, Barajas A, Barceló M, Blanc M, Borrás M, Busquets E, Carlson J, Carral V, Castro M, Corbacho C, Coromina M, Dachs I, De Miquel L, Dolz M, Domenech MD, Elias M, Espezel I, Falo E, Fargas A, Foix A, Fusté M, Godrid M, Gómez D, González O, Granell L, Gumà L, Haro JM, Herrera S, Huerta E, Lacasa F, Mas N, Martí L, Martínez R, Matalí J, Miñambres A, Muñoz D, Muñoz V, Nogueroles R, Ochoa S, Ortiz J, Pardo M, Planella M, Pelaez T, Peruzzi S, Rivero S, Rodriguez MJ, Rubio E, Sammut S, Sánchez M, Sánchez B, Serrano E, Solís C, Stephanotto C, Tabuenca P, Teba S, Torres A, Urbano D, Usall J, Vilaplana M, Villalta V. Predictive capacity of prodromal symptoms in first-episode psychosis of recent onset. Early Interv Psychiatry 2019; 13:414-424. [PMID: 29116670 DOI: 10.1111/eip.12498] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/16/2017] [Accepted: 08/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Both the nature and number of a wide range of prodromal symptoms have been related to the severity and type of psychopathology in the psychotic phase. However, at present there is an incomplete picture focused mainly on the positive pre-psychotic dimension. AIM To characterize the prodromal phase retrospectively, examining the number and nature of prodromal symptoms as well as their relationship with psychopathology at the onset of first-episode psychosis. METHODS Retrospective study of 79 patients experiencing a first-episode psychosis of less than 1 year from the onset of full-blown psychosis. All patients were evaluated with a comprehensive battery of instruments including socio-demographic and clinical questionnaire, IRAOS interview, PANSS, stressful life events scale (PERI) and WAIS/WISC (vocabulary subtest). Bivariate associations and multiple regression analysis were performed. RESULTS Regression models revealed that several prodromal dimensions of IRAOS (delusions, affect, language, behaviour and non-hallucinatory disturbances of perception) predicted the onset of psychosis, with positive (22.4% of the variance) and disorganized (25.6% of the variance) dimensions being the most widely explained. CONCLUSION In addition to attenuated positive symptoms, other symptoms such as affective, behavioural and language disturbances should also be considered in the definitions criteria of at-high-risk people.
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Affiliation(s)
- Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain.,Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain.,Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Trinidad Pelaez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Olga González
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Judith Usall
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Raquel Iniesta
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Maria Arteaga
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Chris Jackson
- Birmingham Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Iris Baños
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Bernardo Sánchez
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Montserrat Dolz
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Jordi E Obiols
- Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Josep M Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Ciarleglio AJ, Brucato G, Masucci MD, Altschuler R, Colibazzi T, Corcoran CM, Crump FM, Horga G, Lehembre-Shiah E, Leong W, Schobel SA, Wall MM, Yang LH, Lieberman JA, Girgis RR. A predictive model for conversion to psychosis in clinical high-risk patients. Psychol Med 2019; 49:1128-1137. [PMID: 29950184 PMCID: PMC6374204 DOI: 10.1017/s003329171800171x] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The authors developed a practical and clinically useful model to predict the risk of psychosis that utilizes clinical characteristics empirically demonstrated to be strong predictors of conversion to psychosis in clinical high-risk (CHR) individuals. The model is based upon the Structured Interview for Psychosis Risk Syndromes (SIPS) and accompanying clinical interview, and yields scores indicating one's risk of conversion. METHODS Baseline data, including demographic and clinical characteristics measured by the SIPS, were obtained on 199 CHR individuals seeking evaluation in the early detection and intervention for mental disorders program at the New York State Psychiatric Institute at Columbia University Medical Center. Each patient was followed for up to 2 years or until they developed a syndromal DSM-4 disorder. A LASSO logistic fitting procedure was used to construct a model for conversion specifically to a psychotic disorder. RESULTS At 2 years, 64 patients (32.2%) converted to a psychotic disorder. The top five variables with relatively large standardized effect sizes included SIPS subscales of visual perceptual abnormalities, dysphoric mood, unusual thought content, disorganized communication, and violent ideation. The concordance index (c-index) was 0.73, indicating a moderately strong ability to discriminate between converters and non-converters. CONCLUSIONS The prediction model performed well in classifying converters and non-converters and revealed SIPS measures that are relatively strong predictors of conversion, comparable with the risk calculator published by NAPLS (c-index = 0.71), but requiring only a structured clinical interview. Future work will seek to externally validate the model and enhance its performance with the incorporation of relevant biomarkers.
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Affiliation(s)
- Adam J. Ciarleglio
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Research Foundation for Mental Hygiene, New York, NY, USA
| | - Gary Brucato
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Research Foundation for Mental Hygiene, New York, NY, USA
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Michael D. Masucci
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Research Foundation for Mental Hygiene, New York, NY, USA
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Rebecca Altschuler
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Tiziano Colibazzi
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Research Foundation for Mental Hygiene, New York, NY, USA
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | | | - Francesca M. Crump
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Guillermo Horga
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Research Foundation for Mental Hygiene, New York, NY, USA
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Eugénie Lehembre-Shiah
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Wei Leong
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | | | - Melanie M. Wall
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Research Foundation for Mental Hygiene, New York, NY, USA
| | - Lawrence H. Yang
- College of Global Public Health, New York University, New York, NY, USA
| | - Jeffrey A. Lieberman
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Research Foundation for Mental Hygiene, New York, NY, USA
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Ragy R. Girgis
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Research Foundation for Mental Hygiene, New York, NY, USA
- The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
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50
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Lemey C, Larsen ME, Devylder J, Courtet P, Billot R, Lenca P, Walter M, Baca-García E, Berrouiguet S. Clinicians' Concerns About Mobile Ecological Momentary Assessment Tools Designed for Emerging Psychiatric Problems: Prospective Acceptability Assessment of the MEmind App. J Med Internet Res 2019; 21:e10111. [PMID: 31021327 PMCID: PMC6658238 DOI: 10.2196/10111] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 08/27/2018] [Accepted: 10/11/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Many mental disorders are preceded by a prodromal phase consisting of various attenuated and unspecific symptoms and functional impairment. Electronic health records are generally used to capture these symptoms during medical consultation. Internet and mobile technologies provide the opportunity to monitor symptoms emerging in patients' environments using ecological momentary assessment techniques to support preventive therapeutic decision making. OBJECTIVE The objective of this study was to assess the acceptability of a Web-based app designed to collect medical data during appointments and provide ecological momentary assessment features. METHODS We recruited clinicians at 4 community psychiatry departments in France to participate. They used the app to assess patients and to collect data after viewing a video of a young patient's emerging psychiatric consultation. We then asked them to answer a short anonymous self-administered questionnaire that evaluated their experience, the acceptability of the app, and their habit of using new technologies. RESULTS Of 24 practitioners invited, 21 (88%) agreed to participate. Most of them were between 25 and 45 years old, and greater age was not associated with poorer acceptability. Most of the practitioners regularly used new technologies, and 95% (20/21) connected daily to the internet, with 70% (15/21) connecting 3 times a day or more. However, only 57% (12/21) reported feeling comfortable with computers. Of the clinicians, 86% (18/21) would recommend the tool to their colleagues and 67% (14/21) stated that they would be interested in daily use of the app. Most of the clinicians (16/21, 76%) found the interface easy to use and useful. However, several clinicians noted the lack of readability (8/21, 38%) and the need to improve ergonometric features (4/21, 19%), in particular to facilitate browsing through various subsections. Some participants (5/21, 24%) were concerned about the storage of medical data and most of them (11/21, 52%) seemed to be uncomfortable with this. CONCLUSIONS We describe the first step of the development of a Web app combining an electronic health record and ecological momentary assessment features. This online tool offers the possibility to assess patients and to integrate medical data easily into face-to-face conditions. The acceptability of this app supports the feasibility of its broader implementation. This app could help to standardize assessment and to build up a strong database. Used in conjunction with robust data mining analytic techniques, such a database would allow exploration of risk factors, patterns of symptom evolution, and identification of distinct risk subgroups.
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Affiliation(s)
- Christophe Lemey
- EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France.,URCI Mental Health Department, Brest Medical University Hospital, Brest, France.,IMT Atlantique, Lab-STICC, F-29238 Brest, Brest, France
| | - Mark Erik Larsen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Jordan Devylder
- Graduate School of Social Service, Fordham University, New York, NY, United States
| | - Philippe Courtet
- Inserm U1061, La colombière Hospital, University of Montpellier, Montpellier, France.,Department of Emergency Psychiatry and Acute Care, CHU Montpellier, University of Montpellier, Montpellier, France.,Fondamental Foundation, Créteil, France
| | - Romain Billot
- IMT Atlantique, Lab-STICC, F-29238 Brest, Brest, France
| | | | - Michel Walter
- EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France.,URCI Mental Health Department, Brest Medical University Hospital, Brest, France
| | - Enrique Baca-García
- Carlos III Institute Of Health, CIBERSAM (Centro de Investigation en Salud Mental), Madrid, Spain.,Department of Psychiatry, Universitad Catolica Del Maule, Talca, Chile.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain.,Deparment of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain.,Psychiatry Department, Autonoma University, Madrid, Spain.,Department of Psychiatry, IIS-Jimenez Diaz Fondation, Madrid, Spain
| | - Sofian Berrouiguet
- EA 7479 SPURBO, Université de Bretagne Occidentale, Brest, France.,IMT Atlantique, Lab-STICC, F-29238 Brest, Brest, France
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