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Upthegrove R, Lalousis P, Mallikarjun P, Chisholm K, Griffiths SL, Iqbal M, Pelton M, Reniers R, Stainton A, Rosen M, Ruef A, Dwyer DB, Surman M, Haidl T, Penzel N, Kambeitz-llankovic L, Bertolino A, Brambilla P, Borgwardt S, Kambeitz J, Lencer R, Pantelis C, Ruhrmann S, Schultze-Lutter F, Salokangas RKR, Meisenzahl E, Wood SJ, Koutsouleris N. The Psychopathology and Neuroanatomical Markers of Depression in Early Psychosis. Schizophr Bull 2020; 47:249-258. [PMID: 32634220 PMCID: PMC7825071 DOI: 10.1093/schbul/sbaa094] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Depression frequently occurs in first-episode psychosis (FEP) and predicts longer-term negative outcomes. It is possible that this depression is seen primarily in a distinct subgroup, which if identified could allow targeted treatments. We hypothesize that patients with recent-onset psychosis (ROP) and comorbid depression would be identifiable by symptoms and neuroanatomical features similar to those seen in recent-onset depression (ROD). Data were extracted from the multisite PRONIA study: 154 ROP patients (FEP within 3 months of treatment onset), of whom 83 were depressed (ROP+D) and 71 who were not depressed (ROP-D), 146 ROD patients, and 265 healthy controls (HC). Analyses included a (1) principal component analysis that established the similar symptom structure of depression in ROD and ROP+D, (2) supervised machine learning (ML) classification with repeated nested cross-validation based on depressive symptoms separating ROD vs ROP+D, which achieved a balanced accuracy (BAC) of 51%, and (3) neuroanatomical ML-based classification, using regions of interest generated from ROD subjects, which identified BAC of 50% (no better than chance) for separation of ROP+D vs ROP-D. We conclude that depression at a symptom level is broadly similar with or without psychosis status in recent-onset disorders; however, this is not driven by a separable depressed subgroup in FEP. Depression may be intrinsic to early stages of psychotic disorder, and thus treating depression could produce widespread benefit.
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Affiliation(s)
- Rachel Upthegrove
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK,To whom correspondence should be addressed; Institute for Mental Health, University of Birmingham, 52 Prichatts Road, Edgbaston, Birmingham B152TT, UK; tel: +44-(0)121-414-4932, fax:+44-(0)121-414-4897, e-mail:
| | - Paris Lalousis
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Pavan Mallikarjun
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Katharine Chisholm
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK,Department of Psychology, Aston University, Birmingham, UK
| | - Sian Lowri Griffiths
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Mariam Iqbal
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Mirabel Pelton
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Renate Reniers
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK,Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Alexandra Stainton
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Marian Surman
- Department of Mental Health, University of Münster, Münster, Germany
| | - Theresa Haidl
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-llankovic
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefan Borgwardt
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Rebekka Lencer
- Department of Mental Health, University of Münster, Münster, Germany,Department of Psychiatry and Psychotherapy, University Lübeck, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Stephen J Wood
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia,Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
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