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Byrne JF, Healy C, Föcking M, Susai SR, Mongan D, Wynne K, Kodosaki E, Heurich M, de Haan L, Hickie IB, Smesny S, Thompson A, Markulev C, Young AR, Schäfer MR, Riecher-Rössler A, Mossaheb N, Berger G, Schlögelhofer M, Nordentoft M, Chen EYH, Verma S, Nieman DH, Woods SW, Cornblatt BA, Stone WS, Mathalon DH, Bearden CE, Cadenhead KS, Addington J, Walker EF, Cannon TD, Cannon M, McGorry P, Amminger P, Cagney G, Nelson B, Jeffries C, Perkins D, Cotter DR. Proteomic Biomarkers for the Prediction of Transition to Psychosis in Individuals at Clinical High Risk: A Multi-cohort Model Development Study. Schizophr Bull 2024; 50:579-588. [PMID: 38243809 PMCID: PMC11059811 DOI: 10.1093/schbul/sbad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Psychosis risk prediction is one of the leading challenges in psychiatry. Previous investigations have suggested that plasma proteomic data may be useful in accurately predicting transition to psychosis in individuals at clinical high risk (CHR). We hypothesized that an a priori-specified proteomic prediction model would have strong predictive accuracy for psychosis risk and aimed to replicate longitudinal associations between plasma proteins and transition to psychosis. This study used plasma samples from participants in 3 CHR cohorts: the North American Prodrome Longitudinal Studies 2 and 3, and the NEURAPRO randomized control trial (total n = 754). Plasma proteomic data were quantified using mass spectrometry. The primary outcome was transition to psychosis over the study follow-up period. Logistic regression models were internally validated, and optimism-corrected performance metrics derived with a bootstrap procedure. In the overall sample of CHR participants (age: 18.5, SD: 3.9; 51.9% male), 20.4% (n = 154) developed psychosis within 4.4 years. The a priori-specified model showed poor risk-prediction accuracy for the development of psychosis (C-statistic: 0.51 [95% CI: 0.50, 0.59], calibration slope: 0.45). At a group level, Complement C8B, C4B, C5, and leucine-rich α-2 glycoprotein 1 (LRG1) were associated with transition to psychosis but did not surpass correction for multiple comparisons. This study did not confirm the findings from a previous proteomic prediction model of transition from CHR to psychosis. Certain complement proteins may be weakly associated with transition at a group level. Previous findings, derived from small samples, should be interpreted with caution.
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Affiliation(s)
- Jonah F Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Subash Raj Susai
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - David Mongan
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Kieran Wynne
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Eleftheria Kodosaki
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, UK
| | - Meike Heurich
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, UK
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Jena, Germany
| | - Andrew Thompson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Connie Markulev
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Alison Ruth Young
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Miriam R Schäfer
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | | | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Monika Schlögelhofer
- BioPsyC—Biopsychosocial Corporation, Non-profit Association for Research Funding Ltd, Vienna, Austria
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, 2/F New Clinical Building, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Swapna Verma
- Office of Education, Duke-NUS Graduate Medical School, Singapore, Singapore
- Department of Psychosis & East Region, Institute of Mental Health, Singapore, Singapore
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - William S Stone
- 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 and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116d, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, CA, USA
| | | | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Pat McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Gerard Cagney
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Diana Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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van Doorn M, Nijhuis LA, Monsanto A, van Amelsvoort T, Popma A, Jaspers MWM, Noordzij ML, Öry FG, Alvarez-Jimenez M, Nieman DH. Corrigendum: Usability, feasibility, and effect of a biocueing intervention in addition to a moderated digital social therapy-platform in young people with emerging mental health problems: a mixed-method approach. Front Psychiatry 2024; 15:1364965. [PMID: 38384589 PMCID: PMC10880443 DOI: 10.3389/fpsyt.2024.1364965] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/23/2024] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2022.871813.].
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Affiliation(s)
| | | | - Anne Monsanto
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Arne Popma
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Monique W. M. Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC-Location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Matthijs L. Noordzij
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
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van Doorn M, Monsanto A, Wang CL, Verfaillie SCJ, van Amelsvoort TAMJ, Popma A, Jaspers MWM, Öry F, Alvarez-Jimenez M, Gleeson JF, Nieman DH. The Effects of a Digital, Transdiagnostic, Clinically and Peer-Moderated Treatment Platform for Young People With Emerging Mental Health Complaints: Repeated Measures Within-Subjects Study. JMIR Mhealth Uhealth 2023; 11:e50636. [PMID: 38090802 PMCID: PMC10753424 DOI: 10.2196/50636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/19/2023] [Accepted: 10/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND To address the growing prevalence of youth mental health problems, early intervention is crucial to minimize individual, societal, and economic impacts. Indicative prevention aims to target emerging mental health complaints before the onset of a full-blown disorder. When intervening at this early stage, individuals are more responsive to treatment, resulting in cost-effective outcomes. The Moderated Online Social Therapy platform, which was successfully implemented and proven effective in Australia, is a digital, peer- and clinically moderated treatment platform designed for young people. The Netherlands was the first country outside Australia to implement this platform, under the name Engage Young People Early (ENYOY). It has the potential to reduce the likelihood of young people developing serious mental health disorders. OBJECTIVE This study aims to investigate the effects on young people using the ENYOY-platform in relation to psychological distress, psychosocial functioning, and positive health parameters. METHODS Dutch-speaking young people with emerging mental health complaints (N=131) participated in the ENYOY-platform for 6 months in a repeated measures within-subjects study. Psychological distress, psychosocial functioning, and positive health parameters were assessed at baseline and 3, 6, and 12 months. Repeated measures ANOVA was conducted and adjusted for age, sex, therapy, and community activity. The Reliable Change Index and Clinically Significant Index were computed to compare the baseline with the 6- and 12-month measurements. The missing data rate was 22.54% and the dropout rate 62.6% (82/131). RESULTS The primary analysis (77/131, 58.8%) showed that psychological distress decreased and psychosocial functioning improved over time with large effect sizes (P<.001 in both cases; ηp2=0.239 and 0.318, respectively) independent of age (P=.76 for psychological distress and P=.48 for psychosocial functioning), sex (P=.24 and P=.88, respectively), therapy activity (P=.49 and P=.80, respectively), or community activity (P=.59 and P=.48, respectively). Similarly, secondary analyses (51/131, 38.9%) showed significant effects of time on the quality of life, well-being, and meaningfulness positive health parameters (P<.05; ηp2=0.062, 0.140, and 0.121, respectively). Improvements in all outcome measures were found between baseline and 3 and 6 months (P≤.001-.01; d=0.23-0.62) and sustained at follow-up (P=.18-.97; d=0.01-0.16). The Reliable Change Index indicated psychological distress improvements in 38% (39/102) of cases, no change in 54.9% (56/102) of cases, and worsening in 5.9% (6/102) of cases. Regarding psychosocial functioning, the percentages were 50% (51/102), 43.1% (44/102), and 6.9% (7/102), respectively. The Clinically Significant Index demonstrated clinically significant changes in 75.5% (77/102) of cases for distress and 89.2% (91/102) for functioning. CONCLUSIONS This trial demonstrated that the ENYOY-platform holds promise as a transdiagnostic intervention for addressing emerging mental health complaints among young people in the Netherlands and laid the groundwork for further clinical research. It would be of great relevance to expand the population on and service delivery of the platform. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-021-03315-x.
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Affiliation(s)
- Marilon van Doorn
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Anne Monsanto
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
- Antes, Rotterdam, Netherlands
| | - Chen Lu Wang
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | - Sander C J Verfaillie
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | | | - Arne Popma
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | - Monique W M Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - John F Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Dorien H Nieman
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
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van Doorn M, Monsanto A, Boeschoten CM, van Amelsvoort T, Popma A, Öry FG, Alvarez-Jimenez M, Gleeson J, Jaspers MWM, Nieman DH. Moderated digital social therapy for young people with emerging mental health problems: A user-centered mixed-method design and usability study. Front Digit Health 2023; 4:1020753. [PMID: 36698649 PMCID: PMC9869113 DOI: 10.3389/fdgth.2022.1020753] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Over 25% of Dutch young people are psychologically unhealthy. Individual and societal consequences that follow from having mental health complaints at this age are substantial. Young people need care which is often unavailable. ENgage YOung people earlY (ENYOY) is a moderated digital social therapy-platform that aims to help youngsters with emerging mental health complaints. Comprehensive research is being conducted into the effects and to optimize and implement the ENYOY-platform throughout the Netherlands. The aim of this study is to explore the usability and user experience of the ENYOY-platform. Methods A user-centered mixed-method design was chosen. 26 young people aged 16-25 with emerging mental health complaints participated. Semi-structured interviews were conducted to explore usability, user-friendliness, impact, accessibility, inclusivity, and connection (Phase 1). Phase 2 assessed usability problems using the concurrent and retrospective Think Aloud-method. User experience and perceived helpfulness were assessed using a 10-point rating scale and semi-structured interviews (Phase 3). The Health Information Technology Usability Evaluation Scale (Health-ITUES; Phase 1) and System Usability Scale (SUS; Phase 2 and 3) were administered. Qualitative data was analyzed using thematic analysis. Task completion rate and time were tracked and usability problems were categorized using the Nielsen's rating scale (Phase 2). Results Adequate to high usability was found (Phase 1 Health-ITUES 4.0(0.34); Phase 2 SUS 69,5(13,70); Phase 3 SUS 71,6(5,63)). Findings from Phase 1 (N = 10) indicated that users viewed ENYOY as a user-friendly, safe, accessible, and inclusive initiative which helped them reduce their mental health complaints and improve quality of life. Phase 2 (N = 10) uncovered 18 usability problems of which 5 of major severity (e.g. troubles accessing the platform). Findings from Phase 3 (N = 6) suggested that users perceived the coaching calls the most helpful [9(0.71)] followed by the therapy content [6.25(1.41)]. Users liked the social networking aspect but rated it least helpful [6(2.1)] due to inactivity. Conclusion The ENYOY-platform has been found to have adequate to high usability and positive user experiences were reported. All findings will be transferred to the developmental team to improve the platform. Other evaluation methods and paring these with quantitative outcomes could provide additional insight in future research.
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Affiliation(s)
- Marilon van Doorn
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands,Correspondence: M. van Doorn
| | - Anne Monsanto
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | - Cato M. Boeschoten
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Arne Popma
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia,Orygen, Parkville, VIC, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Monique W. M. Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC-Location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Dorien H. Nieman
- Amsterdam University Medical Centers (Location AMC), Amsterdam, Netherlands
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Chavez-Baldini U, Nieman DH, Keestra A, Lok A, Mocking RJT, de Koning P, Krzhizhanovskaya VV, Bockting CL, van Rooijen G, Smit DJA, Sutterland AL, Verweij KJH, van Wingen G, Wigman JT, Vulink NC, Denys D. The relationship between cognitive functioning and psychopathology in patients with psychiatric disorders: a transdiagnostic network analysis. Psychol Med 2023; 53:476-485. [PMID: 34165065 PMCID: PMC9899564 DOI: 10.1017/s0033291721001781] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 03/05/2021] [Accepted: 04/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Patients with psychiatric disorders often experience cognitive dysfunction, but the precise relationship between cognitive deficits and psychopathology remains unclear. We investigated the relationships between domains of cognitive functioning and psychopathology in a transdiagnostic sample using a data-driven approach. METHODS Cross-sectional network analyses were conducted to investigate the relationships between domains of psychopathology and cognitive functioning and detect clusters in the network. This naturalistic transdiagnostic sample consists of 1016 psychiatric patients who have a variety of psychiatric diagnoses, such as depressive disorders, anxiety disorders, obsessive-compulsive and related disorders, and schizophrenia spectrum and other psychotic disorders. Psychopathology symptoms were assessed using various questionnaires. Core cognitive domains were assessed with a battery of automated tests. RESULTS Network analysis detected three clusters that we labelled: general psychopathology, substance use, and cognition. Depressive and anxiety symptoms, verbal memory, and visual attention were the most central nodes in the network. Most associations between cognitive functioning and symptoms were negative, i.e. increased symptom severity was associated with worse cognitive functioning. Cannabis use, (subclinical) psychotic experiences, and anhedonia had the strongest total negative relationships with cognitive variables. CONCLUSIONS Cognitive functioning and psychopathology are independent but related dimensions, which interact in a transdiagnostic manner. Depression, anxiety, verbal memory, and visual attention are especially relevant in this network and can be considered independent transdiagnostic targets for research and treatment in psychiatry. Moreover, future research on cognitive functioning in psychopathology should take a transdiagnostic approach, focusing on symptom-specific interactions with cognitive domains rather than investigating cognitive functioning within diagnostic categories.
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Affiliation(s)
- UnYoung Chavez-Baldini
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Dorien H. Nieman
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Amos Keestra
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Roel J. T. Mocking
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Pelle de Koning
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | | | - Claudi L.H. Bockting
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Geeske van Rooijen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Dirk J. A. Smit
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Arjen L. Sutterland
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Karin J. H. Verweij
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Guido van Wingen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Johanna T.W. Wigman
- University Medical Center Groningen, University Center Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, CC72, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Nienke C. Vulink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Cheng N, McLaverty A, Nelson B, Markulev C, Schäfer MR, Berger M, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Street R, Thompson A, Yuen HP, Hester R, Yung AR, McGorry PD, Allott K, Amminger GP. Effects of omega-3 polyunsaturated fatty acid supplementation on cognitive functioning in youth at ultra-high risk for psychosis: secondary analysis of the NEURAPRO randomised controlled trial. BJPsych Open 2022; 8:e165. [PMID: 36073014 PMCID: PMC9534907 DOI: 10.1192/bjo.2022.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cognitive impairments are well-established features of psychotic disorders and are present when individuals are at ultra-high risk for psychosis. However, few interventions target cognitive functioning in this population. AIMS To investigate whether omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation improves cognitive functioning among individuals at ultra-high risk for psychosis. METHOD Data (N = 225) from an international, multi-site, randomised controlled trial (NEURAPRO) were analysed. Participants were given omega-3 supplementation (eicosapentaenoic acid and docosahexaenoic acid) or placebo over 6 months. Cognitive functioning was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS). Mixed two-way analyses of variance were computed to compare the change in cognitive performance between omega-3 supplementation and placebo over 6 months. An additional biomarker analysis explored whether change in erythrocyte n-3 PUFA levels predicted change in cognitive performance. RESULTS The placebo group showed a modest greater improvement over time than the omega-3 supplementation group for motor speed (ηp2 = 0.09) and BACS composite score (ηp2 = 0.21). After repeating the analyses without individuals who transitioned, motor speed was no longer significant (ηp2 = 0.02), but the composite score remained significant (ηp2 = 0.02). Change in erythrocyte n-3 PUFA levels did not predict change in cognitive performance over 6 months. CONCLUSIONS We found no evidence to support the use of omega-3 supplementation to improve cognitive functioning in ultra-high risk individuals. The biomarker analysis suggests that this finding is unlikely to be attributed to poor adherence or consumption of non-trial n-3 PUFAs.
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Affiliation(s)
- Nicholas Cheng
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Alison McLaverty
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Barnaby Nelson
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Connie Markulev
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Miriam R Schäfer
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Maximus Berger
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia; and Department of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | | | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Australia
| | - Gregor E Berger
- Child and Adolescent Psychiatric Service, Canton of Zurich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, The Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, The Netherlands
| | - Merete Nordentoft
- Mental Health Centre Copenhagen, Department of Clinical Medicine, Copenhagen University Hospital, Denmark
| | | | - Swapna Verma
- Early Psychosis Intervention, Institute of Mental Health, Singapore
| | - Rebekah Street
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Andrew Thompson
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Hok Pan Yuen
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Robert Hester
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Alison Ruth Yung
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Australia; and School of Health Sciences, University of Manchester, UK
| | - Patrick D McGorry
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
| | - Kelly Allott
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia; and Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - G Paul Amminger
- Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
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7
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Susai SR, Mongan D, Healy C, Cannon M, Cagney G, Wynne K, Byrne JF, Markulev C, Schäfer MR, Berger M, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Street R, Thompson A, Ruth Yung A, Nelson B, McGorry PD, Föcking M, Paul Amminger G, Cotter D. Machine learning based prediction and the influence of complement - Coagulation pathway proteins on clinical outcome: Results from the NEURAPRO trial. Brain Behav Immun 2022; 103:50-60. [PMID: 35341915 DOI: 10.1016/j.bbi.2022.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 11/10/2021] [Revised: 02/21/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Functional outcomes are important measures in the overall clinical course of psychosis and individuals at clinical high-risk (CHR), however, prediction of functional outcome remains difficult based on clinical information alone. In the first part of this study, we evaluated whether a combination of biological and clinical variables could predict future functional outcome in CHR individuals. The complement and coagulation pathways have previously been identified as being of relevance to the pathophysiology of psychosis and have been found to contribute to the prediction of clinical outcome in CHR participants. Hence, in the second part we extended the analysis to evaluate specifically the relationship of complement and coagulation proteins with psychotic symptoms and functional outcome in CHR. MATERIALS AND METHODS We carried out plasma proteomics and measured plasma cytokine levels, and erythrocyte membrane fatty acid levels in a sub-sample (n = 158) from the NEURAPRO clinical trial at baseline and 6 months follow up. Functional outcome was measured using Social and Occupational Functional assessment Score (SOFAS) scale. Firstly, we used support vector machine learning techniques to develop predictive models for functional outcome at 12 months. Secondly, we developed linear regression models to understand the association between 6-month follow-up levels of complement and coagulation proteins with 6-month follow-up measures of positive symptoms summary (PSS) scores and functional outcome. RESULTS AND CONCLUSION A prediction model based on clinical and biological data including the plasma proteome, erythrocyte fatty acids and cytokines, poorly predicted functional outcome at 12 months follow-up in CHR participants. In linear regression models, four complement and coagulation proteins (coagulation protein X, Complement C1r subcomponent like protein, Complement C4A & Complement C5) indicated a significant association with functional outcome; and two proteins (coagulation factor IX and complement C5) positively associated with the PSS score. Our study does not provide support for the utility of cytokines, proteomic or fatty acid data for prediction of functional outcomes in individuals at high-risk for psychosis. However, the association of complement protein levels with clinical outcome suggests a role for the complement system and the activity of its related pathway in the functional impairment and positive symptom severity of CHR patients.
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Affiliation(s)
- Subash Raj Susai
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - David Mongan
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Gerard Cagney
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Kieran Wynne
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland; Systems Biology Ireland, University College Dublin, Dublin, Ireland
| | - Jonah F Byrne
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Connie Markulev
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Miriam R Schäfer
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Maximus Berger
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Department of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- BioPsyC-Biopsychosocial Corporation - Non-Profit Association for Research Funding, Vienna, Austria
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Gregor E Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zürich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Department of Clinical Medicine, Copenhagen University Hospital, Denmark
| | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Rebekah Street
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Andrew Thompson
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Alison Ruth Yung
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Australia; School of Health Sciences, University of Manchester, UK
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Patrick D McGorry
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Melanie Föcking
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - G Paul Amminger
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - David Cotter
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
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8
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van Doorn M, Nijhuis LA, Monsanto A, van Amelsvoort T, Popma A, Jaspers MWM, Noordzij ML, Öry FG, Alvarez-Jimenez M, Nieman DH. Usability, Feasibility, and Effect of a Biocueing Intervention in Addition to a Moderated Digital Social Therapy-Platform in Young People With Emerging Mental Health Problems: A Mixed-Method Approach. Front Psychiatry 2022; 13:871813. [PMID: 35693972 PMCID: PMC9174529 DOI: 10.3389/fpsyt.2022.871813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/22/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction To optimize treatment, it is of utmost importance to take into account the myriad of biological, social, and psychological changes that young people go through during adolescence which make them more vulnerable for developing mental health problems. Biocueing, a non-invasive method to transform physiological parameters into an observable signal, could strengthen stress- and emotion regulation by cueing physiologically unusual values in daily life. The aim of this study is to investigate the usability, feasibility, and exploratory effect of biocueing in addition to ENgage YOung people earlY (ENYOY), a moderated digital social therapy-platform, in young people with emerging mental health complaints. Methods A user-centered mixed-method design was used. A focus group was conducted to optimize the ENYOY-platform and biocueing intervention. Biocueing was operationalized by a smartwatch and the Sense-IT app. A within-subjects design was used; 10 days for all participants 'biofeedback off' (control), followed by 10 days 'biofeedback on' (experimental). Emotional awareness and perceived stress were measured using ecological momentary assessment. Eight individuals participated. User-friendliness, usability, and acceptance were assessed using a qualitative design. Results Findings from the focus group resulted in several adaptations of the biocueing intervention to the ENYOY-platform and vice versa. The average measurement compliance rate was 78.8%. Level-one findings showed different individual effects on perceived stress and emotional awareness. Level-two analyses showed no overall effects on perceived stress (B = -0.020, p = 0.562) and overall positive effects on emotional awareness (B = 0.030, p = 0.048) with small effect sizes (Improvement Rate Difference = 0.05-0.35). The intervention was found to be acceptable and showed moderate usability. Participants indicated they experienced improvements in reflection on feelings and changes in behavior, such as pausing and evaluating the situation. Conclusion These preliminary results show that biocueing could be a promising addition to digital treatment platforms and help young people become more emotionally aware. Improvements should be made regarding the usability and acceptability of the smartwatch, as well as more extensive integration of the biocueing intervention with a digital treatment platform. It would be relevant to gain a better understanding of which individuals would benefit most from an additional biocueing intervention.
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Affiliation(s)
| | | | - Anne Monsanto
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Arne Popma
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Monique W. M. Jaspers
- Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC-Location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Matthijs L. Noordzij
- Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
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9
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Solmi M, Estradé A, Thompson T, Agorastos A, Radua J, Cortese S, Dragioti E, Leisch F, Vancampfort D, Thygesen LC, Aschauer H, Schloegelhofer M, Akimova E, Schneeberger A, Huber CG, Hasler G, Conus P, Cuénod KQD, von Känel R, Arrondo G, Fusar-Poli P, Gorwood P, Llorca PM, Krebs MO, Scanferla E, Kishimoto T, Rabbani G, Skonieczna-Żydecka K, Brambilla P, Favaro A, Takamiya A, Zoccante L, Colizzi M, Bourgin J, Kamiński K, Moghadasin M, Seedat S, Matthews E, Wells J, Vassilopoulou E, Gadelha A, Su KP, Kwon JS, Kim M, Lee TY, Papsuev O, Manková D, Boscutti A, Gerunda C, Saccon D, Righi E, Monaco F, Croatto G, Cereda G, Demurtas J, Brondino N, Veronese N, Enrico P, Politi P, Ciappolino V, Pfennig A, Bechdolf A, Meyer-Lindenberg A, Kahl KG, Domschke K, Bauer M, Koutsouleris N, Winter S, Borgwardt S, Bitter I, Balazs J, Czobor P, Unoka Z, Mavridis D, Tsamakis K, Bozikas VP, Tunvirachaisakul C, Maes M, Rungnirundorn T, Supasitthumrong T, Haque A, Brunoni AR, Costardi CG, Schuch FB, Polanczyk G, Luiz JM, Fonseca L, Aparicio LV, Valvassori SS, Nordentoft M, Vendsborg P, Hoffmann SH, Sehli J, Sartorius N, Heuss S, Guinart D, Hamilton J, Kane J, Rubio J, Sand M, Koyanagi A, Solanes A, Andreu-Bernabeu A, Cáceres ASJ, Arango C, Díaz-Caneja CM, Hidalgo-Mazzei D, Vieta E, Gonzalez-Peñas J, Fortea L, Parellada M, Fullana MA, Verdolini N, Fárková E, Janků K, Millan M, Honciuc M, Moniuszko-Malinowska A, Łoniewski I, Samochowiec J, Kiszkiel Ł, Marlicz M, Sowa P, Marlicz W, Spies G, Stubbs B, Firth J, Sullivan S, Darcin AE, Aksu H, Dilbaz N, Noyan O, Kitazawa M, Kurokawa S, Tazawa Y, Anselmi A, Cracco C, Machado AI, Estrade N, De Leo D, Curtis J, Berk M, Ward P, Teasdale S, Rosenbaum S, Marx W, Horodnic AV, Oprea L, Alexinschi O, Ifteni P, Turliuc S, Ciuhodaru T, Bolos A, Matei V, Nieman DH, Sommer I, van Os J, van Amelsvoort T, Sun CF, Guu TW, Jiao C, Zhang J, Fan J, Zou L, Yu X, Chi X, de Timary P, van Winke R, Ng B, Pena E, Arellano R, Roman R, Sanchez T, Movina L, Morgado P, Brissos S, Aizberg O, Mosina A, Krinitski D, Mugisha J, Sadeghi-Bahmani D, Sadeghi M, Hadi S, Brand S, Errazuriz A, Crossley N, Ristic DI, López-Jaramillo C, Efthymiou D, Kuttichira P, Kallivayalil RA, Javed A, Afridi MI, James B, Seb-Akahomen OJ, Fiedorowicz J, Carvalho AF, Daskalakis J, Yatham LN, Yang L, Okasha T, Dahdouh A, Gerdle B, Tiihonen J, Shin JI, Lee J, Mhalla A, Gaha L, Brahim T, Altynbekov K, Negay N, Nurmagambetova S, Jamei YA, Weiser M, Correll CU. Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times - Children and Adolescents (COH-FIT-C&A). J Affect Disord 2022; 299:367-376. [PMID: 34606810 PMCID: PMC8486586 DOI: 10.1016/j.jad.2021.09.090] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/17/2021] [Accepted: 09/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. METHODS The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT - www.coh-fit.com) is an on-line anonymous survey, available in 30 languages, involving >230 investigators from 49 countries supported by national/international professional associations. COH-FIT has thee waves (until the pandemic is declared over by the WHO, and 6-18 months plus 24-36 months after its end). In addition to adults, COH-FIT also includes adolescents (age 14-17 years), and children (age 6-13 years), recruited via non-probability/snowball and representative sampling and assessed via self-rating and parental rating. Non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to promote health and prevent mental and physical illness in children and adolescents will be generated by COH-FIT. Co-primary outcomes are changes in well-being (WHO-5) and a composite psychopathology P-Score. Multiple behavioral, family, coping strategy and service utilization factors are also assessed, including functioning and quality of life. RESULTS Up to June 2021, over 13,000 children and adolescents from 59 countries have participated in the COH-FIT project, with representative samples from eleven countries. LIMITATIONS Cross-sectional and anonymous design. CONCLUSIONS Evidence generated by COH-FIT will provide an international estimate of the COVID-19 effect on children's, adolescents' and families', mental and physical health, well-being, functioning and quality of life, informing the formulation of present and future evidence-based interventions and policies to minimize adverse effects of the present and future pandemics on youth.
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Affiliation(s)
- Marco Solmi
- University of Ottawa, Department of Psychiatry, Ontario, Canada; The Ottawa Hospital, Department of Mental Health, Ontario, Canada; University of Ottawa, Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, Ottawa Ontario; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, and NHS Trust, Southampton, United Kingdom.
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Trevor Thompson
- University of Greenwich, School of Human Sciences, London, United Kingdom.
| | - Agorastos Agorastos
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece.
| | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain; Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Samuele Cortese
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom.
| | - Elena Dragioti
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden; University of Ioannina, Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, Ioannina, Greece.
| | - Friedrich Leisch
- University of Natural Resources and Life Sciences, Wien, Austria.
| | - Davy Vancampfort
- Katholieke Universiteit Leuven (KU Leuven), Department of Rehabilitation Sciences, Leuven, Belgium.
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Denmark.
| | - Harald Aschauer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | - Monika Schloegelhofer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | - Elena Akimova
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | | | - Christian G Huber
- University of Basel, Universitäre Psychiatrische Kliniken Basel (UPK), Basel, Switzerland.
| | - Gregor Hasler
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland.
| | - Philippe Conus
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland.
| | - Kim Q Do Cuénod
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland.
| | - Roland von Känel
- University Hospital Zurich, Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Switzerland.
| | - Gonzalo Arrondo
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom; University of Navarra, Mind-Brain Group, Institute for Culture and Society (ICS), Pamplona, Spain.
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Philip Gorwood
- Université de Paris, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France; Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France.
| | - Pierre-Michel Llorca
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France.
| | - Marie-Odile Krebs
- Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France; Université de Paris, PEPIT, GHU Paris Psychiatrie et Neuroscience, Paris, France.
| | - Elisabetta Scanferla
- Université de Paris, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France.
| | - Taishiro Kishimoto
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Golam Rabbani
- The National Foundation of Mental Health of Bangladesh, Bangladesh.
| | | | - Paolo Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Angela Favaro
- University of Padua, Neurosciences Department, Padua, Italy.
| | - Akihiro Takamiya
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Leonardo Zoccante
- Integrated University Hospital of Verona, Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Verona, Italy.
| | - Marco Colizzi
- University of Verona, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy.
| | - Julie Bourgin
- Service de Psychiatrie de l'enfant et de l'adolescent, GHNE, 91440 Bures Sur Yvette, France.
| | - Karol Kamiński
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland.
| | - Maryam Moghadasin
- Kharazmi University, Department of Clinical Psychology, Faculty of Psychology and Education, Tehran, Iran.
| | - Soraya Seedat
- Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa.
| | - Evan Matthews
- Waterford Institute of Technology, School of Health Sciences, Waterford, Ireland.
| | - John Wells
- Waterford Institute of Technology, School of Health Sciences, Waterford, Ireland.
| | | | - Ary Gadelha
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil.
| | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Department of Psychiatry, Tainan, Taiwan; Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands.
| | - Jun Soo Kwon
- Seoul National University College of Medicine, Department of Psychiatry, Seoul, Republic of Korea.
| | - Minah Kim
- Seoul National University Hospital, Department of Neuropsychiatry, Seoul, Republic of Korea.
| | - Tae Young Lee
- Pusan National University Yangsan Hospital, Department of Psychiatry, Yangsan, Republic of Korea.
| | - Oleg Papsuev
- Moscow Research Institute of Psychiatry, Moscow, Russia.
| | - Denisa Manková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Andrea Boscutti
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | | | - Diego Saccon
- AULSS4 Veneto Orientale, Addictions Department, Italy.
| | - Elena Righi
- University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Modena, Italy.
| | | | | | - Guido Cereda
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Jacopo Demurtas
- University of Modena and Reggio Emilia, Clinical and Experimental Medicine PhD Program, Modena, Italy.
| | - Natascia Brondino
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Nicola Veronese
- University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy.
| | - Paolo Enrico
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Pierluigi Politi
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Valentina Ciappolino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Andrea Pfennig
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany.
| | | | | | - Kai G Kahl
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Germany.
| | - Katharina Domschke
- University of Freiburg, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
| | - Michael Bauer
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany.
| | | | - Sibylle Winter
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
| | | | - Istvan Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Judit Balazs
- Eotvos Lorand University, Institute of Psychology, Budapest, Hungary; Bjørknes University College, Oslo, Norway.
| | - Pal Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Zsolt Unoka
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Dimitris Mavridis
- University of Ioannina, Department of Primary Education, Ioannina, Greece.
| | - Konstantinos Tsamakis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
| | - Vasilios P Bozikas
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece.
| | | | - Michael Maes
- Chulalongkorn University, Department of Psychiatry, Thailand.
| | | | | | - Ariful Haque
- The National Foundation of Mental Health of Bangladesh, Bangladesh.
| | - Andre R Brunoni
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil.
| | | | - Felipe Barreto Schuch
- Universidade Federal de Santa Maria, Department of Sports Methods and Techniques, Santa Maria, RS, Brazil.
| | - Guilherme Polanczyk
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil.
| | - Jhoanne Merlyn Luiz
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil.
| | - Lais Fonseca
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil.
| | - Luana V Aparicio
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil.
| | - Samira S Valvassori
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil.
| | | | | | - Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Denmark.
| | - Jihed Sehli
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland.
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Switzerland.
| | - Sabina Heuss
- FHNW University of Applied Sciences and Arts Northwestern Switzerland, Switzerland.
| | - Daniel Guinart
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departament de Psiquiatria, Barcelona, Spain.
| | - Jane Hamilton
- University of Texas Health Science Center Houston, McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, USA.
| | - John Kane
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, New York, USA.
| | - Jose Rubio
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, New York, USA.
| | | | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, Research and Development Unit, CIBERSAM, ICREA, Barcelona, Spain.
| | - Aleix Solanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Alvaro Andreu-Bernabeu
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Antonia San José Cáceres
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Celso Arango
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Covadonga M Díaz-Caneja
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | | | - Eduard Vieta
- University of Barcelona, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain.
| | - Javier Gonzalez-Peñas
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Mara Parellada
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Miquel A Fullana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Norma Verdolini
- University of Barcelona, Hospital Clínic, Bipolar and Depressive Disorders Unit, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Spain.
| | - Eva Fárková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Karolina Janků
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Mark Millan
- Institute de Recherché de Servier (IDRS), France.
| | - Mihaela Honciuc
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France.
| | | | - Igor Łoniewski
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland; Sanprobi Sp. z o.o. Sp. k, Poland.
| | - Jerzy Samochowiec
- Pomeranian Medical University in Szczecin, Department of Psychiatry, Szczecin, Poland.
| | - Łukasz Kiszkiel
- University of Białystok, Institute of Sociology, Society and Cognition Unit, Białystok, Poland.
| | - Maria Marlicz
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland.
| | - Paweł Sowa
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland.
| | - Wojciech Marlicz
- Pomeranian Medical University in Szczecin, Department of Gastroenterology, Szczecin, Poland; The Centre for Digestive Diseases Endoklinika, Szczecin, Poland.
| | - Georgina Spies
- Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa.
| | | | - Joseph Firth
- University of Manchester, Division of Psychology and Mental Health, Manchester, United Kingdom.
| | | | - Asli Enez Darcin
- Istanbul Basaksehir Cam ve Sakura City Hospital, Department of Psychiatry, Istanbul, Turkey.
| | - Hatice Aksu
- Adnan Menderes University Department of Child and Adolescent Psychiatry, Aydın, Turkey.
| | - Nesrin Dilbaz
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey.
| | - Onur Noyan
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey.
| | - Momoko Kitazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Shunya Kurokawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Yuki Tazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Alejandro Anselmi
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Cecilia Cracco
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Ana Inés Machado
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Natalia Estrade
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Diego De Leo
- Griffith University, South East Queensland, Australia.
| | - Jackie Curtis
- Mindgardens Neuroscience Network, Sydney, Australia.
| | - Michael Berk
- Deakin University School of Medicine, Victoria, Australia.
| | - Philip Ward
- UNSW Sydney, School of Psychiatry, Sydney, Australia.
| | - Scott Teasdale
- Deakin University School of Medicine, Victoria, Australia.
| | | | - Wolfgang Marx
- Deakin University School of Medicine, Victoria, Australia.
| | - Adrian Vasile Horodnic
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | - Liviu Oprea
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | | | - Petru Ifteni
- Transilvania University of Brasov, Faculty of Medicine, Brasov, Romania.
| | - Serban Turliuc
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | | | - Alexandra Bolos
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | - Valentin Matei
- Psychiatry Department, University of Medicine and Pharmacy "Carol Davila" Bucharest, "Prof. Dr. Alexandru Obregia" Psychiatric Hospital, Bucharest, Romania.
| | - Dorien H Nieman
- Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, The Netherlands.
| | - Iris Sommer
- University Medical Center Groningen, University of Groningen, Cognitive Neurosciences, Department of Biomedical Sciences of Cells & Systems, Groningen, The Netherlands; University Medical Center Groningen, University of Groningen, Department of Psychiatry, Groningen, The Netherlands.
| | - Jim van Os
- Utrecht University Medical Centre, Department of Psychiatry, Utrecht, The Netherlands.
| | - Therese van Amelsvoort
- Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands.
| | - Ching-Fang Sun
- China Medical University Hospital, Mind-Body Interface Research Center, Taichung, Taiwan; Department of Psychiatry and Behavioral Medicine, Carilion Clinic Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Ta-Wei Guu
- China Medical University Beigang Hospital, Division of Psychiatry, Department of Internal Medicine, Taiwan.
| | - Can Jiao
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Jieting Zhang
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Jialin Fan
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Liye Zou
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Xin Yu
- Peking University Institute of Mental Health, Department of Public Mental Health, Pekin, China.
| | - Xinli Chi
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Philippe de Timary
- UCLouvain, Institute of Neuroscience and Cliniques Universitaires Saint-Luc, Department of Adult Psychiatry, Brussels, Belgium.
| | - Ruud van Winke
- Katholieke Universiteit Leuven (KU Leuven), Department of Neurosciences, Leuven, Belgium.
| | | | | | | | | | | | - Larisa Movina
- Moscow Research Institute of Psychiatry, Moscow, Russia.
| | - Pedro Morgado
- University of Minho, Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga Guimarães, Portugal.
| | - Sofia Brissos
- Lisbon's Psychiatric Hospital Centre, Department of Psychiatry, Portugal.
| | - Oleg Aizberg
- Belarusian Medical Academy of Postgraduate Education, Belarus.
| | - Anna Mosina
- Clienia AG, Wetzikon Psychiatric Centre, Switzerland.
| | | | - James Mugisha
- Kyambogo University, Department of Sociology and Social Administration, Kampala, Uganda.
| | - Dena Sadeghi-Bahmani
- Stanford University, Department of Psychology, California, USA; Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.
| | - Masoud Sadeghi
- Kermanshah University of Medical Sciences, Medical Biology Research Center, Kermanshah, Iran.
| | | | - Serge Brand
- Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland; Kermanshah University of Medical Sciences, Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
| | - Antonia Errazuriz
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile.
| | - Nicolas Crossley
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile.
| | - Dragana Ignjatovic Ristic
- University of Kragujevac, Department of Psychiatry, Faculty of Medical Sciences, Kragujevac, Serbia.
| | | | - Dimitris Efthymiou
- University of Nicosia, Department of Life and Health Sciences, Nicosia, Cyprus.
| | | | | | - Afzal Javed
- Chairman, Pakistan Psychiatric Research Centre-Fountain House, Lahore, Pakistan.
| | - Muhammad Iqbal Afridi
- Dean, Faculty of Psychiatry, College of Physicians and Surgeons, Pakistan; Dean, Jinnah Postgraduate Medical Centre, Karachi, Pakistan; Dean, Faculty of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
| | - Bawo James
- Federal Neuropsychiatric Hospital, Department of Clinical Services, Benin-City, Nigeria.
| | | | - Jess Fiedorowicz
- University of Ottawa, Department of Psychiatry, Ontario, Canada.
| | | | | | | | - Lin Yang
- University of Calgary, Alberta Health Services, Calgary, Canada.
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egyp.
| | - Aïcha Dahdouh
- Oran 1 University, Department of Psychiatry-Addictology, Oran, Algeria.
| | - Björn Gerdle
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden.
| | - Jari Tiihonen
- Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Jae Il Shin
- Yonsei University College of Medicine, Department of Pediatrics, Seoul, South Korea.
| | - Jinhee Lee
- Yonsei University Wonju College of Medicine, Department of Psychiatry, Wonju, South Korea.
| | - Ahmed Mhalla
- University of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia.
| | - Lotfi Gaha
- University of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia.
| | - Takoua Brahim
- University of Monastir, University Hospital of Monastir, Department of Psychiatry, Monastir, Tunisia.
| | - Kuanysh Altynbekov
- Republican Scientific and Practical Center of Mental Health, Kazakhstan.
| | - Nikolay Negay
- Republican Scientific and Practical Center of Mental Health, Kazakhstan.
| | | | | | | | - Christoph U Correll
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany; The Zucker Hillside Hospital, Northwell Health, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA.
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Solmi M, Estradé A, Thompson T, Agorastos A, Radua J, Cortese S, Dragioti E, Leisch F, Vancampfort D, Thygesen LC, Aschauer H, Schloegelhofer M, Akimova E, Schneeberger A, Huber CG, Hasler G, Conus P, Cuénod KQD, von Känel R, Arrondo G, Fusar-Poli P, Gorwood P, Llorca PM, Krebs MO, Scanferla E, Kishimoto T, Rabbani G, Skonieczna-Żydecka K, Brambilla P, Favaro A, Takamiya A, Zoccante L, Colizzi M, Bourgin J, Kamiński K, Moghadasin M, Seedat S, Matthews E, Wells J, Vassilopoulou E, Gadelha A, Su KP, Kwon JS, Kim M, Lee TY, Papsuev O, Manková D, Boscutti A, Gerunda C, Saccon D, Righi E, Monaco F, Croatto G, Cereda G, Demurtas J, Brondino N, Veronese N, Enrico P, Politi P, Ciappolino V, Pfennig A, Bechdolf A, Meyer-Lindenberg A, Kahl KG, Domschke K, Bauer M, Koutsouleris N, Winter S, Borgwardt S, Bitter I, Balazs J, Czobor P, Unoka Z, Mavridis D, Tsamakis K, Bozikas VP, Tunvirachaisakul C, Maes M, Rungnirundorn T, Supasitthumrong T, Haque A, Brunoni AR, Costardi CG, Schuch FB, Polanczyk G, Luiz JM, Fonseca L, Aparicio LV, Valvassori SS, Nordentoft M, Vendsborg P, Hoffmann SH, Sehli J, Sartorius N, Heuss S, Guinart D, Hamilton J, Kane J, Rubio J, Sand M, Koyanagi A, Solanes A, Andreu-Bernabeu A, Cáceres ASJ, Arango C, Díaz-Caneja CM, Hidalgo-Mazzei D, Vieta E, Gonzalez-Peñas J, Fortea L, Parellada M, Fullana MA, Verdolini N, Fárková E, Janků K, Millan M, Honciuc M, Moniuszko-Malinowska A, Łoniewski I, Samochowiec J, Kiszkiel Ł, Marlicz M, Sowa P, Marlicz W, Spies G, Stubbs B, Firth J, Sullivan S, Darcin AE, Aksu H, Dilbaz N, Noyan O, Kitazawa M, Kurokawa S, Tazawa Y, Anselmi A, Cracco C, Machado AI, Estrade N, De Leo D, Curtis J, Berk M, Ward P, Teasdale S, Rosenbaum S, Marx W, Horodnic AV, Oprea L, Alexinschi O, Ifteni P, Turliuc S, Ciuhodaru T, Bolos A, Matei V, Nieman DH, Sommer I, van Os J, van Amelsvoort T, Sun CF, Guu TW, Jiao C, Zhang J, Fan J, Zou L, Yu X, Chi X, de Timary P, van Winke R, Ng B, Pena E, Arellano R, Roman R, Sanchez T, Movina L, Morgado P, Brissos S, Aizberg O, Mosina A, Krinitski D, Mugisha J, Sadeghi-Bahmani D, Sadeghi M, Hadi S, Brand S, Errazuriz A, Crossley N, Ristic DI, López-Jaramillo C, Efthymiou D, Kuttichira P, Kallivayalil RA, Javed A, Afridi MI, James B, Seb-Akahomen OJ, Fiedorowicz J, Carvalho AF, Daskalakis J, Yatham LN, Yang L, Okasha T, Dahdouh A, Gerdle B, Tiihonen J, Shin JI, Lee J, Mhalla A, Gaha L, Brahim T, Altynbekov K, Negay N, Nurmagambetova S, Jamei YA, Weiser M, Correll CU. The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults): Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic. J Affect Disord 2022; 299:393-407. [PMID: 34949568 PMCID: PMC8288233 DOI: 10.1016/j.jad.2021.07.048] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 07/11/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. METHODS . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/regions, endorsed by national/international professional associations. COH-FIT is a multi-wave, on-line anonymous, cross-sectional survey [wave 1: 04/2020 until the end of the pandemic, 12 months waves 2/3 starting 6/24 months threreafter] for adults, adolescents (14-17), and children (6-13), utilizing non-probability/snowball and representative sampling. COH-FIT aims to identify non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to improve social/health outcomes in the general population/vulnerable subgrous during/after COVID-19. In adults, co-primary outcomes are change from pre-COVID-19 to intra-COVID-19 in well-being (WHO-5) and a composite psychopathology P-Score. Key secondary outcomes are a P-extended score, global mental and physical health. Secondary outcomes include health-service utilization/functioning, treatment adherence, functioning, symptoms/behaviors/emotions, substance use, violence, among others. RESULTS . Starting 04/26/2020, up to 14/07/2021 >151,000 people from 155 countries/territories/regions and six continents have participated. Representative samples of ≥1,000 adults have been collected in 15 countries. Overall, 43.0% had prior physical disorders, 16.3% had prior mental disorders, 26.5% were health care workers, 8.2% were aged ≥65 years, 19.3% were exposed to someone infected with COVID-19, 76.1% had been in quarantine, and 2.1% had been COVID 19-positive. LIMITATIONS . Cross-sectional survey, preponderance of non-representative participants. CONCLUSIONS . Results from COH-FIT will comprehensively quantify the impact of COVID-19, seeking to identify high-risk groups in need for acute and long-term intervention, and inform evidence-based health policies/strategies during this/future pandemics.
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Affiliation(s)
- Marco Solmi
- University of Ottawa, Department of Psychiatry, Ontario, Canada; The Ottawa Hospital, Department of Mental Health, Ontario, Canada; University of Ottawa, Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, Ottawa Ontario; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Centre for Innovation in Mental Health-Developmental Lab, School of Psychology, University of Southampton, and NHS Trust, Southampton, United Kingdom.
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Trevor Thompson
- University of Greenwich, School of Human Sciences, London, United Kingdom.
| | - Agorastos Agorastos
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece.
| | - Joaquim Radua
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain; Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Samuele Cortese
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom.
| | - Elena Dragioti
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden; University of Ioannina, Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, Ioannina, Greece.
| | - Friedrich Leisch
- University of Natural Resources and Life Sciences, Wien, Austria.
| | - Davy Vancampfort
- Katholieke Universiteit Leuven (KU Leuven), Department of Rehabilitation Sciences, Leuven, Belgium.
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Denmark.
| | - Harald Aschauer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | - Monika Schloegelhofer
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | - Elena Akimova
- BioPsyC - Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
| | | | - Christian G. Huber
- University of Basel, Universitäre Psychiatrische Kliniken Basel (UPK), Basel, Switzerland
| | - Gregor Hasler
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland.
| | - Philippe Conus
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland.
| | - Kim Q. Do Cuénod
- University of Lausanne, Department of Psychiatry, Lausanne, Switzerland
| | - Roland von Känel
- University Hospital Zurich, Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Switzerland.
| | - Gonzalo Arrondo
- University of Southampton, Centre for Innovation in Mental Health, Southampton, United Kingdom; University of Navarra, Mind-Brain Group, Institute for Culture and Society (ICS), Pamplona, Spain.
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology& Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Philip Gorwood
- Université de Paris, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France; Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France.
| | - Pierre-Michel Llorca
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France.
| | - Marie-Odile Krebs
- Institute de Psychiatrie et Neuroscience de Paris, INSERM U1266, F-75014, Paris, France; Université de Paris, PEPIT, GHU Paris Psychiatrie et Neuroscience, Paris, France.
| | - Elisabetta Scanferla
- Université de Paris, CMME, GHU Paris Psychiatrie et Neurosciences, Paris, France.
| | - Taishiro Kishimoto
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Golam Rabbani
- The National Foundation of Mental Health of Bangladesh, Bangladesh.
| | | | - Paolo Brambilla
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Angela Favaro
- University of Padua, Neurosciences Department, Padua, Italy.
| | - Akihiro Takamiya
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Leonardo Zoccante
- Integrated University Hospital of Verona, Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Verona, Italy.
| | - Marco Colizzi
- University of Verona, Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy.
| | - Julie Bourgin
- Service de Psychiatrie de l'enfant et de l'adolescent, GHNE, 91440 Bures Sur Yvette, France.
| | - Karol Kamiński
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland.
| | - Maryam Moghadasin
- Kharazmi University, Department of Clinical Psychology, Faculty of Psychology and Education, Tehran, Iran.
| | - Soraya Seedat
- Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa.
| | - Evan Matthews
- Waterford Institute of Technology, School of Health Sciences, Waterford, Ireland.
| | - John Wells
- Waterford Institute of Technology, School of Health Sciences, Waterford, Ireland.
| | | | - Ary Gadelha
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil.
| | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Department of Psychiatry, Tainan, Taiwan; Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands.
| | - Jun Soo Kwon
- Seoul National University College of Medicine, Department of Psychiatry, Seoul, Republic of Korea.
| | - Minah Kim
- Seoul National University Hospital, Department of Neuropsychiatry, Seoul, Republic of Korea.
| | - Tae Young Lee
- Pusan National University Yangsan Hospital, Department of Psychiatry, Yangsan, Republic of Korea.
| | - Oleg Papsuev
- Moscow Research Institute of Psychiatry, Moscow, Russia.
| | - Denisa Manková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Andrea Boscutti
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | | | - Diego Saccon
- AULSS4 Veneto Orientale, Addictions Department, Italy.
| | - Elena Righi
- University of Modena and Reggio Emilia, Department of Biomedical, Metabolic and Neural Sciences, Modena, Italy.
| | | | | | - Guido Cereda
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Jacopo Demurtas
- University of Modena and Reggio Emilia, Clinical and Experimental Medicine PhD Program, Modena, Italy.
| | - Natascia Brondino
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Nicola Veronese
- University of Palermo, Department of Internal Medicine, Geriatrics Section, Palermo, Italy.
| | - Paolo Enrico
- University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Pierluigi Politi
- University of Pavia, Department of Brain and Behavioral Sciences, Pavia, Italy.
| | - Valentina Ciappolino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Neurosciences and Mental Health, Milan, Italy.
| | - Andrea Pfennig
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany.
| | | | | | - Kai G. Kahl
- Hannover Medical School, Department of Psychiatry, Social Psychiatry and Psychotherapy, Germany
| | - Katharina Domschke
- University of Freiburg, Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.
| | - Michael Bauer
- Technische Universität Dresden, University Hospital Carl Gustav Carus, Department of Psychiatry and Psychotherapy, Dresden, Germany.
| | | | - Sibylle Winter
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
| | | | - Istvan Bitter
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Judit Balazs
- Eotvos Lorand University, Institute of Psychology, Budapest, Hungary; Bjørknes University College, Oslo, Norway.
| | - Pal Czobor
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Zsolt Unoka
- Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary.
| | - Dimitris Mavridis
- University of Ioannina, Department of Primary Education, Ioannina, Greece.
| | - Konstantinos Tsamakis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
| | - Vasilios P. Bozikas
- Aristotle University of Thessaloniki, II. Dept. of Psychiatry, Division of Neurosciences, Medical School, Faculty of Health Sciences, Greece
| | | | - Michael Maes
- Chulalongkorn University, Department of Psychiatry, Thailand.
| | | | | | - Ariful Haque
- The National Foundation of Mental Health of Bangladesh, Bangladesh.
| | - Andre R. Brunoni
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil
| | | | - Felipe Barreto Schuch
- Universidade Federal de Santa Maria, Department of Sports Methods and Techniques, Santa Maria, RS, Brazil.
| | - Guilherme Polanczyk
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil.
| | - Jhoanne Merlyn Luiz
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil.
| | - Lais Fonseca
- Universidade Federal de São Paulo, Department of Psychiatry, São Paulo, Brazil.
| | - Luana V. Aparicio
- Faculdade de Medicina da Universidade de São Paulo, Departments of Internal Medicine and Psychiatry, São Paulo, Brazil
| | - Samira S. Valvassori
- Universidade do Extremo Sul Catarinense, Translational Psychiatry Laboratory, Graduate Program in Health Sciences, Criciúma, SC, Brazil
| | | | | | - Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Denmark.
| | - Jihed Sehli
- University of Fribourg, Fribourg Network of Mental Health (RFSM), Fribourg, Switzerland.
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Switzerland.
| | - Sabina Heuss
- FHNW University of Applied Sciences and Arts Northwestern Switzerland, Switzerland.
| | - Daniel Guinart
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA; Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Departament de Psiquiatria, Barcelona, Spain.
| | - Jane Hamilton
- University of Texas Health Science Center Houston, McGovern Medical School, Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, USA.
| | - John Kane
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, New York, USA.
| | - Jose Rubio
- The Zucker Hillside Hospital, Northwell Health, New York, USA; Feinstein Institutes for Medical Research, New York, USA.
| | | | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, Research and Development Unit, CIBERSAM, ICREA, Barcelona, Spain.
| | - Aleix Solanes
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Alvaro Andreu-Bernabeu
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Antonia San José Cáceres
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Celso Arango
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Covadonga M. Díaz-Caneja
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain
| | | | - Eduard Vieta
- University of Barcelona, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain.
| | - Javier Gonzalez-Peñas
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain.
| | - Mara Parellada
- Hospital General Universitario Gregorio Marañón, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health (IPS MARAÑÓN), IiSGM, CIBERSAM, Madrid, Spain.
| | - Miquel A. Fullana
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Imaging of Mood- and Anxiety-Related Disorders (IMARD), CIBERSAM, Barcelona, Spain
| | - Norma Verdolini
- University of Barcelona, Hospital Clínic, Bipolar and Depressive Disorders Unit, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Spain.
| | - Eva Fárková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Karolina Janků
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Mark Millan
- Institute de Recherché de Servier (IDRS), France.
| | - Mihaela Honciuc
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de Psychiatrie B, Clermont-Ferrand, France.
| | | | - Igor Łoniewski
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland; Sanprobi Sp. z o.o. Sp. k, Poland.
| | - Jerzy Samochowiec
- Pomeranian Medical University in Szczecin, Department of Psychiatry, Szczecin, Poland.
| | - Łukasz Kiszkiel
- University of Białystok, Institute of Sociology, Society and Cognition Unit, Białystok, Poland.
| | - Maria Marlicz
- Pomeranian Medical University in Szczecin, Department of Biochemical Sciences, Szczecin, Poland.
| | - Paweł Sowa
- Medical University of Białystok, Department of Population Medicine and Lifestyle Diseases Prevention, Bialystok, Poland.
| | - Wojciech Marlicz
- Pomeranian Medical University in Szczecin, Department of Gastroenterology, Szczecin, Poland; The Centre for Digestive Diseases Endoklinika, Szczecin, Poland.
| | - Georgina Spies
- Stellenbosch University, Department of Psychiatry, Faculty of Medicine and Health Sciences, South Africa.
| | | | - Joseph Firth
- University of Manchester, Division of Psychology and Mental Health, Manchester, United Kingdom.
| | | | - Asli Enez Darcin
- Istanbul Basaksehir Cam ve Sakura City Hospital, Department of Psychiatry, Istanbul, Turkey.
| | - Hatice Aksu
- Adnan Menderes University Department of Child and Adolescent Psychiatry, Aydın, Turkey.
| | - Nesrin Dilbaz
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey.
| | - Onur Noyan
- Uskudar University, Department of Psychiatry and Psychology, Istanbul, Turkey.
| | - Momoko Kitazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Shunya Kurokawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Yuki Tazawa
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan.
| | - Alejandro Anselmi
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Cecilia Cracco
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Ana Inés Machado
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Natalia Estrade
- Universidad Católica, Department of Psychology, Montevideo, Uruguay.
| | - Diego De Leo
- Griffith University, South East Queensland, Australia.
| | - Jackie Curtis
- Mindgardens Neuroscience Network, Sydney, Australia.
| | - Michael Berk
- Deakin University School of Medicine, Victoria, Australia.
| | - Philip Ward
- UNSW Sydney, School of Psychiatry, Sydney, Australia.
| | - Scott Teasdale
- Deakin University School of Medicine, Victoria, Australia.
| | | | - Wolfgang Marx
- Deakin University School of Medicine, Victoria, Australia.
| | - Adrian Vasile Horodnic
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | - Liviu Oprea
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | | | - Petru Ifteni
- Transilvania University of Brasov, Faculty of Medicine, Brasov, Romania.
| | - Serban Turliuc
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | | | - Alexandra Bolos
- University of Medicine and Pharmacy Grigore T. Popa, Faculty of Medicine, Iasi, Romania.
| | - Valentin Matei
- Psychiatry Department, University of Medicine and Pharmacy "Carol Davila" Bucharest, "Prof. Dr. Alexandru Obregia" Psychiatric Hospital, Bucharest, Romania.
| | - Dorien H. Nieman
- Academisch Medisch Centrum Universiteit van Amsterdam, Amsterdam, The Netherlands
| | - Iris Sommer
- University Medical Center Groningen, University of Groningen, Cognitive Neurosciences, Department of Biomedical Sciences of Cells & Systems, Groningen, The Netherlands; University Medical Center Groningen, University of Groningen, Department of Psychiatry, Groningen, The Netherlands.
| | - Jim van Os
- Utrecht University Medical Centre, Department of Psychiatry, Utrecht, The Netherlands.
| | - Therese van Amelsvoort
- Maastricht University, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands.
| | - Ching-Fang Sun
- China Medical University Hospital, Mind-Body Interface Research Center, Taichung, Taiwan; Department of Psychiatry and Behavioral Medicine, Carilion Clinic Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
| | - Ta-wei Guu
- China Medical University Beigang Hospital, Division of Psychiatry, Department of Internal Medicine, Taiwan
| | - Can Jiao
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Jieting Zhang
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Jialin Fan
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Liye Zou
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Xin Yu
- Peking University Institute of Mental Health, Department of Public Mental Health, Pekin, China.
| | - Xinli Chi
- Shenzhen University, School of Psychology, Shenzhen, China.
| | - Philippe de Timary
- UCLouvain, Institute of Neuroscience and Cliniques Universitaires Saint-Luc, Department of Adult Psychiatry, Brussels, Belgium.
| | - Ruud van Winke
- Katholieke Universiteit Leuven (KU Leuven), Department of Neurosciences, Leuven, Belgium.
| | | | | | | | | | | | - Larisa Movina
- Moscow Research Institute of Psychiatry, Moscow, Russia.
| | - Pedro Morgado
- University of Minho, Life and Health Sciences Research Institute (ICVS), School of Medicine, Braga, Portugal; ICVS/3B's - PT Government Associate Laboratory, Braga Guimarães, Portugal.
| | - Sofia Brissos
- Lisbon's Psychiatric Hospital Centre, Department of Psychiatry, Portugal.
| | - Oleg Aizberg
- Belarusian Medical Academy of Postgraduate Education, Belarus.
| | - Anna Mosina
- Clienia AG, Wetzikon Psychiatric Centre, Switzerland.
| | | | - James Mugisha
- Kyambogo University, Department of Sociology and Social Administration, Kampala, Uganda.
| | - Dena Sadeghi-Bahmani
- Stanford University, Department of Psychology, California, USA; Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.
| | - Masoud Sadeghi
- Kermanshah University of Medical Sciences, Medical Biology Research Center, Kermanshah, Iran.
| | | | - Serge Brand
- Universitäre Psychiatrische Kliniken Basel (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland; Kermanshah University of Medical Sciences, Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
| | - Antonia Errazuriz
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile.
| | - Nicolas Crossley
- Pontificia Universidad Católica de Chile, Department of Psychiatry, School of Medicine, Santiago, Chile.
| | - Dragana Ignjatovic Ristic
- University of Kragujevac, Department of Psychiatry, Faculty of Medical Sciences, Kragujevac, Serbia.
| | | | - Dimitris Efthymiou
- University of Nicosia, Department of Life and Health Sciences, Nicosia, Cyprus.
| | | | | | - Afzal Javed
- Chairman, Pakistan Psychiatric Research Centre-Fountain House, Lahore, Pakistan.
| | - Muhammad Iqbal Afridi
- Dean, Faculty of Psychiatry, College of Physicians and Surgeons, Pakistan; Dean, Jinnah Postgraduate Medical Centre, Karachi, Pakistan; Dean, Faculty of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
| | - Bawo James
- Federal Neuropsychiatric Hospital, Department of Clinical Services, Benin-City, Nigeria.
| | | | - Jess Fiedorowicz
- University of Ottawa, Department of Psychiatry, Ontario, Canada.
| | | | | | | | - Lin Yang
- University of Calgary, Alberta Health Services, Calgary, Canada.
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egyp.
| | - Aïcha Dahdouh
- Oran 1 University, Department of Psychiatry-Addictology, Oran, Algeria.
| | - Björn Gerdle
- Linköping University, Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping, Sweden.
| | - Jari Tiihonen
- Karolinska Institutet, Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Jae Il Shin
- Yonsei University College of Medicine, Department of Pediatrics, Seoul, South Korea.
| | - Jinhee Lee
- Yonsei University Wonju College of Medicine, Department of Psychiatry, Wonju, South Korea.
| | - Ahmed Mhalla
- University of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia.
| | - Lotfi Gaha
- University of Monastir, Research Unit "Vulnerability to Mental Disorders" LR05ES10, Monastir, Tunisia.
| | - Takoua Brahim
- University of Monastir, University Hospital of Monastir, Department of Psychiatry, Monastir, Tunisia.
| | - Kuanysh Altynbekov
- Republican Scientific and Practical Center of Mental Health, Kazakhstan.
| | - Nikolay Negay
- Republican Scientific and Practical Center of Mental Health, Kazakhstan.
| | | | | | | | - Christoph U. Correll
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany,The Zucker Hillside Hospital, Northwell Health, New York, USA,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA
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11
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Susai SR, Mongan D, Healy C, Cannon M, Nelson B, Markulev C, Schäfer MR, Berger M, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, McGorry PD, Föcking M, Cotter D, Amminger GP. The association of plasma inflammatory markers with omega-3 fatty acids and their mediating role in psychotic symptoms and functioning: An analysis of the NEURAPRO clinical trial. Brain Behav Immun 2022; 99:147-156. [PMID: 34624483 DOI: 10.1016/j.bbi.2021.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 07/21/2021] [Revised: 09/17/2021] [Accepted: 09/25/2021] [Indexed: 12/12/2022] Open
Abstract
There is increasing evidence that dysregulation of polyunsaturated fatty acids (FAs) mediated membrane function plays a role in the pathophysiology of schizophrenia. Even though preclinical findings have supported the anti-inflammatory properties of omega-3 FAs on brain health, their biological roles as anti-inflammatory agents and their therapeutic role on clinical symptoms of psychosis risk are not well understood. In the current study, we investigated the relationship of erythrocyte omega-3 FAs with plasma immune markers in a clinical high risk for psychosis (CHR) sample. In addition, a mediation analysis was performed to examine whether previously reported associations between omega-3 FAs and clinical outcomes were mediated via plasma immune markers. Clinical outcomes for CHR participants in the NEURAPRO clinical trial were measured using the Brief Psychiatric Rating Scale (BPRS), Schedule for the Scale of Assessment of Negative Symptoms (SANS) and Social and Occupational Functioning Assessment Scale (SOFAS) scales. The erythrocyte omega-3 index [eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA)] and plasma concentrations of inflammatory markers were quantified at baseline (n = 268) and 6 month follow-up (n = 146) by gas chromatography and multiplex immunoassay, respectively. In linear regression models, the baseline plasma concentrations of Interleukin (IL)-15, Intercellular adhesion molecule (ICAM)-1 and Vascular cell adhesion molecule (VCAM)-1 were negatively associated with baseline omega-3 index. In addition, 6-month change in IL-12p40 and TNF-α showed a negative association with change in omega-3 index. In longitudinal analyses, the baseline and 6 month change in omega-3 index was negatively associated with VCAM-1 and TNF-α respectively at follow-up. Mediation analyses provided little evidence for mediating effects of plasma immune markers on the relationship between omega-3 FAs and clinical outcomes (psychotic symptoms and functioning) in CHR participants. Our results indicate a predominantly anti-inflammatory relationship of omega-3 FAs on plasma inflammatory status in CHR individuals, but this did not appear to convey clinical benefits at 6 month and 12 month follow-up. Both immune and non-immune biological effects of omega-3 FAs would be resourceful in understanding the clinical benefits of omega-3 FAs in CHR papulation.
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Affiliation(s)
- Subash Raj Susai
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - David Mongan
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Connie Markulev
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Miriam R Schäfer
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Maximus Berger
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- BioPsyC-Biopsychosocial Corporation - Non-Profit Association for Research Funding, Austria; Department of Child and Adolescent Psychiatry, Medical University Vienna, Austria
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Gregor E Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zürich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Department of Clinical Medicine, Copenhagen University Hospital, Denmark
| | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Andrew Thompson
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Alison Ruth Yung
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia; Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Australia; School of Health Sciences, University of Manchester, UK
| | - Patrick D McGorry
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia
| | - Melanie Föcking
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - David Cotter
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - G Paul Amminger
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia; Orygen, 35 Poplar Rd, Parkville 3052, Australia; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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12
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Shetty JJ, Nicholas C, Nelson B, McGorry PD, Lavoie S, Markulev C, Schäfer MR, Thompson A, Yuen HP, Yung AR, Nieman DH, de Haan L, Amminger GP, Hartmann JA. Greater preference for eveningness is associated with negative symptoms in an ultra-high risk for psychosis sample. Early Interv Psychiatry 2021; 15:1793-1798. [PMID: 33538110 DOI: 10.1111/eip.13112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 01/28/2020] [Revised: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 01/16/2023]
Abstract
AIM Investigating biological processes in at-risk individuals may help elucidate the aetiological mechanisms underlying psychosis development, refine prediction models and improve intervention strategies. This study examined the associations between sleep disturbances, chronotype, depressive and psychotic symptoms in individuals at ultra-high risk for psychosis. METHODS A sample of 81 ultra-high risk patients completed clinical interviews and self-report assessments of chronotype and sleep during the Neurapro clinical trial. Mixed regression was used to investigate the cross-sectional associations between symptoms and sleep disturbances/chronotype. RESULTS Sleep disturbances were significantly associated with increased depressive and attenuated positive psychotic symptoms. Greater preference for eveningness was significantly associated with increased negative symptoms, but not with depressive or attenuated positive psychotic symptoms. CONCLUSION Sleep disturbances and chronotype may impact the emerging psychopathology experienced by ultra-high risk individuals. Further, the preliminary relationship observed between greater preference for eveningness and negative symptoms offers a unique opportunity to treat negative symptoms through chronobiological approaches.
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Affiliation(s)
- Jashmina J Shetty
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christian Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick D McGorry
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Suzie Lavoie
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Connie Markulev
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Miriam R Schäfer
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Thompson
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Hok Pan Yuen
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alison R Yung
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
| | - G Paul Amminger
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica A Hartmann
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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13
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Sandini C, Zöller D, Schneider M, Tarun A, Armondo M, Nelson B, Amminger PG, Yuen HP, Markulev C, Schäffer MR, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EY, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, McGorry PD, Van De Ville D, Eliez S. Characterization and prediction of clinical pathways of vulnerability to psychosis through graph signal processing. eLife 2021; 10:59811. [PMID: 34569937 PMCID: PMC8476129 DOI: 10.7554/elife.59811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/09/2021] [Indexed: 11/21/2022] Open
Abstract
Causal interactions between specific psychiatric symptoms could contribute to the heterogenous clinical trajectories observed in early psychopathology. Current diagnostic approaches merge clinical manifestations that co-occur across subjects and could significantly hinder our understanding of clinical pathways connecting individual symptoms. Network analysis techniques have emerged as alternative approaches that could help shed light on the complex dynamics of early psychopathology. The present study attempts to address the two main limitations that have in our opinion hindered the application of network approaches in the clinical setting. Firstly, we show that a multi-layer network analysis approach, can move beyond a static view of psychopathology, by providing an intuitive characterization of the role of specific symptoms in contributing to clinical trajectories over time. Secondly, we show that a Graph-Signal-Processing approach, can exploit knowledge of longitudinal interactions between symptoms, to predict clinical trajectories at the level of the individual. We test our approaches in two independent samples of individuals with genetic and clinical vulnerability for developing psychosis. Novel network approaches can allow to embrace the dynamic complexity of early psychopathology and help pave the way towards a more a personalized approach to clinical care.
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Affiliation(s)
- Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Anjali Tarun
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Marco Armondo
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Barnaby Nelson
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Paul G Amminger
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Hok Pan Yuen
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Connie Markulev
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Monica R Schäffer
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Ian B Hickie
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | | | - Eric Yh Chen
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland
| | - Lieuwe de Haan
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Andrew Thompson
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,North Warwickshire Early Intervention in Psychosis Service, Conventry and Warwickshire National Health Service Partnership Trust, Coventry, United Kingdom
| | - Alison Ruth Yung
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Patrick D McGorry
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Dimitri Van De Ville
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
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14
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McLaverty A, Allott KA, Berger M, Hester R, McGorry PD, Nelson B, Markulev C, Yuen HP, Schäfer MR, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, Amminger GP. Omega-3 fatty acids and neurocognitive ability in young people at ultra-high risk for psychosis. Early Interv Psychiatry 2021; 15:874-881. [PMID: 32893462 DOI: 10.1111/eip.13025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 01/20/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Neurocognitive impairments are core early features of psychosis and are observed in those at ultra-high risk (UHR) for psychosis. The aim of the present study was to explore whether neurocognition is associated with polyunsaturated fatty acids (PUFAs), as has been observed in other clinical populations. METHOD Erythrocyte levels of total omega-3-and omega-6 PUFAs the omega-3/omega-6 ratio, were measured in 265 UHR individuals. Six domains of neurocognition as well a Composite Score, were assessed using the Brief Assessment of Cognition in Schizophrenia. Pearson's correlations were used to assess the relationship between PUFAs and neurocognition. All analyses were controlled for tobacco smoking. RESULTS Verbal Fluency correlated positively with eicosapentaenoic acid (P = .024) and alpha-linolenic acid (P = .01), and negatively with docosahexanoic acid (P = .007) and Working Memory positively correlated with omega-3/omega-6 ratio (P = .007). CONCLUSIONS The current results provide support for a relationship between Verbal Fluency and omega-3 PUFAs in UHR. Further investigation is required to elucidate whether these biomarkers are useful as risk markers or in understanding the biological underpinning of neurocognitive impairment in this population.
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Affiliation(s)
- Alison McLaverty
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Kelly A Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Maximus Berger
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Rob Hester
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Connie Markulev
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Hok Pan Yuen
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Miriam R Schäfer
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Nilufar Mossaheb
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Stefan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Gregor Emanuel Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Andrew Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Alison Ruth Yung
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - G Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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15
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O'Donoghue B, Geros H, Sizer H, Addington J, Amminger GP, Beaden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Berger GE, Chen EYH, de Haan L, Hartmann JA, Hickie IB, Ising HK, Lavoie S, Lin A, Markulev C, Mathalon DH, McGlashan TH, Mifsud NG, Mossaheb N, Nieman DH, Nordentoft M, Perkins DO, Riecher-Rössler A, Schäfer MR, Schlögelhofer M, Seidman LJ, Smesny S, Thompson A, Tsuang MT, van der Gaag M, Verma S, Walker EF, Wood SJ, Woods SW, Yuen HP, Yung AR, McGorry PD, Nelson B. The association between migrant status and transition in an ultra-high risk for psychosis population. Soc Psychiatry Psychiatr Epidemiol 2021; 56:943-952. [PMID: 33399885 DOI: 10.1007/s00127-020-02012-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 09/13/2019] [Accepted: 12/08/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Migrant status is one of the most replicated and robust risk factors for developing a psychotic disorder. This study aimed to determine whether migrant status in people identified as Ultra-High Risk for Psychosis (UHR) was associated with risk of transitioning to a full-threshold psychotic disorder. METHODS Hazard ratios for the risk of transition were calculated from five large UHR cohorts (n = 2166) and were used to conduct a meta-analysis using the generic inverse-variance method using a random-effects model. RESULTS 2166 UHR young people, with a mean age of 19.1 years (SD ± 4.5) were included, of whom 221 (10.7%) were first-generation migrants. A total of 357 young people transitioned to psychosis over a median follow-up time of 417 days (I.Q.R.147-756 days), representing 17.0% of the cohort. The risk of transition to a full-threshold disorder was not increased for first-generation migrants, (HR = 1.08, 95% CI 0.62-1.89); however, there was a high level of heterogeneity between studies The hazard ratio for second-generation migrants to transition to a full-threshold psychotic disorder compared to the remainder of the native-born population was 1.03 (95% CI 0.70-1.51). CONCLUSIONS This meta-analysis did not find a statistically significant association between migrant status and an increased risk for transition to a full-threshold psychotic disorder; however, several methodological issues could explain this finding. Further research should focus on examining the risk of specific migrant groups and also ensuring that migrant populations are adequately represented within UHR clinics.
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Affiliation(s)
- Brian O'Donoghue
- Orygen, Melbourne, Australia. .,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
| | - Hellen Geros
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Holly Sizer
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - G Paul Amminger
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,Department of Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Carrie E Beaden
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, USA
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | - Gregor Emanuel Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zürich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Jessica A Hartmann
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Ian B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, Australia
| | - Helga K Ising
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Suzie Lavoie
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Connie Markulev
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, San Francisco, CA, USA.,SFVA Medical Center, San Francisco, CA, USA
| | | | - Nathan G Mifsud
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Nilufar Mossaheb
- Department of Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | | | - Miriam R Schäfer
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, USA.,Massachusetts General Hospital, Boston, MA, USA
| | - Stephan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Andrew Thompson
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Mark van der Gaag
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit , Amsterdam, The Netherlands
| | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Stephen J Wood
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Hok Pan Yuen
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Alison Ruth Yung
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, England
| | - Patrick D McGorry
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Barnaby Nelson
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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16
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van Doorn M, Nijhuis LA, Egeler MD, Daams JG, Popma A, van Amelsvoort T, McEnery C, Gleeson JF, Öry FG, Avis KA, Ruigt E, Jaspers MWM, Alvarez-Jimenez M, Nieman DH. Online Indicated Preventive Mental Health Interventions for Youth: A Scoping Review. Front Psychiatry 2021; 12:580843. [PMID: 33995136 PMCID: PMC8116558 DOI: 10.3389/fpsyt.2021.580843] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 03/30/2021] [Indexed: 12/16/2022] Open
Abstract
Objective: Between the ages of 12 and 25 the onset of mental disorders typically occurs, and the burden of mental health problems is greatest for this group. Indicated preventive interventions to target individuals with subclinical symptoms to prevent the transition to clinical levels of disorders have gained considerable traction. However, the threshold to seek help appears to be high even when help is needed. Online interventions could offer a solution, especially during the COVID-19 pandemic. This scoping review will present an overview of the recent research of indicated online preventive interventions for youth (12-25 years) experiencing the early stages of mental health complaints with the aim of identifying the nature and extent of the research evidence. Methods: The 5-stage framework by Arksey and O'Malley was used. Academic literature published from 2013 onwards in printed or electronic format was included from Scopus, PsychINFO, and Ovid MEDLINE(R) ALL. Results: The search yielded 11,122 results, with the final selection resulting in inclusion of 30 articles for this review. In total, the articles included 4,950 participants. 26.7% of the selected articles focused on youth between 12 and 25 years. Of the articles 60% did not screen for, nor exclude participants with clinical levels of symptoms. Most studies used a common evidence-based therapy for the disorder-category targeted. More than half of the online interventions included some form of human support. Adherence levels ranged between 27.9 and 98%. The results indicate general effectiveness, usability and acceptability of online indicated preventive interventions. The most commonly used approach was CBT (n = 12 studies). Studies varied in their size, rigor of study, effectiveness and outcome measures. Online interventions with a combination of clinical and peer moderation (n = 3 studies) appear to result in the most stable and highest effect sizes. Conclusion: Online indicated preventive mental health interventions for youth with emerging mental health issues show promise in reducing various mental health complaints, and increasing positive mental health indicators such as well-being and resilience. Additionally, high levels of usability and acceptability were found. However, the included studies show important methodological shortcomings. Also, the research has mainly focused on specific diagnostic categories, meaning there is a lack of transdiagnostic approaches. Finally, clear definitions of- as well as instruments to measure- emerging or subclinical mental health symptoms in youth remain are missing.
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Affiliation(s)
| | | | - Mees D. Egeler
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Joost G. Daams
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Arne Popma
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Carla McEnery
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - John F. Gleeson
- Orygen, Parkville, VIC, Australia
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Ferko G. Öry
- Erasmus University College, Rotterdam, Netherlands
| | - Kate A. Avis
- Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Emma Ruigt
- Amsterdam University Medical Centers, Amsterdam, Netherlands
- Minddistrict, Amsterdam, Netherlands
| | | | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
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17
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Salazar de Pablo G, De Micheli A, Nieman DH, Correll CU, Kessing LV, Pfennig A, Bechdolf A, Borgwardt S, Arango C, van Amelsvoort T, Vieta E, Solmi M, Oliver D, Catalan A, Verdino V, Di Maggio L, Bonoldi I, Vaquerizo-Serrano J, Baccaredda Boy O, Provenzani U, Ruzzi F, Calorio F, Nosari G, Di Marco B, Famularo I, Molteni S, Filosi E, Mensi M, Balottin U, Politi P, Shin JI, Fusar-Poli P. Universal and selective interventions to promote good mental health in young people: Systematic review and meta-analysis. Eur Neuropsychopharmacol 2020; 41:28-39. [PMID: 33162291 DOI: 10.1016/j.euroneuro.2020.10.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [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] [Received: 05/06/2020] [Revised: 07/24/2020] [Accepted: 10/16/2020] [Indexed: 12/31/2022]
Abstract
Promotion of good mental health in young people is important. Our aim was to evaluate the consistency and magnitude of the efficacy of universal/selective interventions to promote good mental health. A systematic PRISMA/RIGHT-compliant meta-analysis (PROSPERO: CRD42018088708) search of Web of Science until 04/31/2019 identified original studies comparing the efficacy of universal/selective interventions for good mental health vs a control group, in samples with a mean age <35 years. Meta-analytical random-effects model, heterogeneity statistics, assessment of publication bias, study quality and sensitivity analyses investigated the efficacy (Hedges' g=effect size, ES) of universal/selective interventions to promote 14 good mental health outcomes defined a-priori. 276 studies were included (total participants: 159,508, 79,142 interventions and 80,366 controls), mean age=15.0 (SD=7.4); female=56.0%. There was a significant overall improvement in 10/13 good mental health outcome categories that could be meta-analysed: compared to controls, interventions significantly improved (in descending order of magnitude) mental health literacy (ES=0.685, p<0.001), emotions (ES=0.541, p<0.001), self-perceptions and values (ES=0.49, p<0.001), quality of life (ES=0.457, p=0.001), cognitive skills (ES=0.428, p<0.001), social skills (ES=0.371, p<0.001), physical health (ES=0.285, p<0.001), sexual health (ES=0.257, p=0.017), academic/occupational performance (ES=0.211, p<0.001) and attitude towards mental disorders (ES=0.177, p=0.006). Psychoeducation was the most effective intervention for promoting mental health literacy (ES=0.774, p<0.001) and cognitive skills (ES=1.153, p=0.03). Physical therapy, exercise and relaxation were more effective than psychoeducation and psychotherapy for promoting physical health (ES=0.498, p<0.001). In conclusion, several universal/selective interventions can be effective to promote good mental health in young people. Future research should consolidate and extend these findings.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- 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 Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 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 (IiSGM), CIBERSAM, Madrid, Spain
| | - Andrea De Micheli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, the Netherlands
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience; The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Centre (FRITZ), Vivantes Klinikum Am Urban, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Klinikum im Friedrichshain, Charité-Universitätsmedizin, Berlin, Germany; Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; ORYGEN, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Celso Arango
- 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 (IiSGM), CIBERSAM, Madrid, Spain
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Neurosciences Department, University of Padova, Italy
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Spain
| | - Valeria Verdino
- 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 Molecular and Developmental Medicine, Division on Psychiatry, University of Siena, Italy
| | - Lucia Di Maggio
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Ilaria Bonoldi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Julio Vaquerizo-Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ottone Baccaredda Boy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Umberto Provenzani
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Francesca Ruzzi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Federica Calorio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Benedetto Di Marco
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Irene Famularo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Silvia Molteni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Eleonora Filosi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Martina Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Child and Adolescent Neuropsychiatric Unit
| | - Umberto Balottin
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - 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; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK.
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18
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Alqarni A, Mitchell TW, McGorry PD, Nelson B, Markulev C, Yuen HP, Schäfer MR, Berger M, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, Amminger GP, Meyer BJ. Comparison of erythrocyte omega-3 index, fatty acids and molecular phospholipid species in people at ultra-high risk of developing psychosis and healthy people. Schizophr Res 2020; 226:44-51. [PMID: 31301881 DOI: 10.1016/j.schres.2019.06.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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] [Received: 03/07/2019] [Revised: 06/19/2019] [Accepted: 06/22/2019] [Indexed: 12/12/2022]
Abstract
People classified as ultra-high risk (UHR) of developing psychosis have reduced cellular membrane omega-3 and omega-6 polyunsaturated fatty acids (PUFA). We aimed to compare omega-3 index, fatty acids and molecular phospholipid species from erythrocytes of people with UHR (n = 285) with age-matched healthy controls (n = 120) assessed by mass spectrometry. Lower proportions of PUFA were observed in the UHR group compared to healthy controls; specifically, eicosapentaenoic acid (EPA) was 29.3% lower, docosahexaenoic acid (DHA) was 27.2% lower, arachidonic acid (AA) was 15.8% lower and the omega-3 index was 26.9% lower. The AA to EPA ratio was higher in the UHR group compared to the healthy group. Smoking status had no significant effect on PUFA levels in healthy or the UHR groups. BMI was associated with PUFA levels in the UHR group only and the statistical model only explains 2% of the variance of the PUFA levels. The proportion of nervonic acid was 64.4% higher in the UHR group compared to healthy controls. At a lipid class level, the UHR group had 16% higher concentrations of sphingomyelin (SM) and 46% lower concentrations phosphatidylethanolamine (PE) compared to healthy group. Of the 49 individual molecular phospholipids, twenty-seven phospholipid species were lower in the UHR group. In conclusion, there are clear differences in the proportions of erythrocyte fatty acids and phospholipids between UHR and healthy controls and UHR had higher concentrations of SM and lower concentrations of PE. These differences may represent a promising prodromal risk biomarker in the UHR population to aid clinical diagnosis.
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Affiliation(s)
- Ayedh Alqarni
- School of Medicine, Molecular Horizons, Lipid Research Centre, University of Wollongong, and Illawarra Health & Medical Research Institute, Wollongong, Australia; King Fahad Specialist Hospital, Dammam City, Saudi Arabia
| | - Todd W Mitchell
- School of Medicine, Molecular Horizons, Lipid Research Centre, University of Wollongong, and Illawarra Health & Medical Research Institute, Wollongong, Australia
| | - Patrick D McGorry
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Barnaby Nelson
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Connie Markulev
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Hok Pan Yuen
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Miriam R Schäfer
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Maximus Berger
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Nilufar Mossaheb
- Department of Psychiatry, Medical University of Vienna, Vienna, Austria
| | | | - Stefan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, Australia
| | - Gregor E Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, the Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, the Netherlands
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Andrew Thompson
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, England, United Kingdom of Great Britain and Northern Ireland; North Warwickshire Early Intervention in Psychosis Service, Coventry and Warwickshire National Health Service Partnership Trust, Coventry, England, United Kingdom of Great Britain and Northern Ireland
| | - Alison Ruth Yung
- Institute of Brain, Behaviour, and Mental Health, University of Manchester, Manchester, England, United Kingdom of Great Britain and Northern Ireland; Greater Manchester West National Health Service Mental Health Foundation Trust, Manchester, England, United Kingdom of Great Britain and Northern Ireland
| | - G Paul Amminger
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Barbara J Meyer
- School of Medicine, Molecular Horizons, Lipid Research Centre, University of Wollongong, and Illawarra Health & Medical Research Institute, Wollongong, Australia.
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19
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Fusar-Poli P, Salazar de Pablo G, Correll CU, Meyer-Lindenberg A, Millan MJ, Borgwardt S, Galderisi S, Bechdolf A, Pfennig A, Kessing LV, van Amelsvoort T, Nieman DH, Domschke K, Krebs MO, Koutsouleris N, McGuire P, Do KQ, Arango C. Prevention of Psychosis: Advances in Detection, Prognosis, and Intervention. JAMA Psychiatry 2020; 77:755-765. [PMID: 32159746 DOI: 10.1001/jamapsychiatry.2019.4779] [Citation(s) in RCA: 248] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE Detection, prognosis, and indicated interventions in individuals at clinical high risk for psychosis (CHR-P) are key components of preventive psychiatry. OBJECTIVE To provide a comprehensive, evidence-based systematic appraisal of the advancements and limitations of detection, prognosis, and interventions for CHR-P individuals and to formulate updated recommendations. EVIDENCE REVIEW Web of Science, Cochrane Central Register of Reviews, and Ovid/PsychINFO were searched for articles published from January 1, 2013, to June 30, 2019, to identify meta-analyses conducted in CHR-P individuals. MEDLINE was used to search the reference lists of retrieved articles. Data obtained from each article included first author, year of publication, topic investigated, type of publication, study design and number, sample size of CHR-P population and comparison group, type of comparison group, age and sex of CHR-P individuals, type of prognostic assessment, interventions, quality assessment (using AMSTAR [Assessing the Methodological Quality of Systematic Reviews]), and key findings with their effect sizes. FINDINGS In total, 42 meta-analyses published in the past 6 years and encompassing 81 outcomes were included. For the detection component, CHR-P individuals were young (mean [SD] age, 20.6 [3.2] years), were more frequently male (58%), and predominantly presented with attenuated psychotic symptoms lasting for more than 1 year before their presentation at specialized services. CHR-P individuals accumulated several sociodemographic risk factors compared with control participants. Substance use (33% tobacco use and 27% cannabis use), comorbid mental disorders (41% with depressive disorders and 15% with anxiety disorders), suicidal ideation (66%), and self-harm (49%) were also frequently seen in CHR-P individuals. CHR-P individuals showed impairments in work (Cohen d = 0.57) or educational functioning (Cohen d = 0.21), social functioning (Cohen d = 1.25), and quality of life (Cohen d = 1.75). Several neurobiological and neurocognitive alterations were confirmed in this study. For the prognosis component, the prognostic accuracy of CHR-P instruments was good, provided they were used in clinical samples. Overall, risk of psychosis was 22% at 3 years, and the risk was the highest in the brief and limited intermittent psychotic symptoms subgroup (38%). Baseline severity of attenuated psychotic (Cohen d = 0.35) and negative symptoms (Cohen d = 0.39) as well as low functioning (Cohen d = 0.29) were associated with an increased risk of psychosis. Controlling risk enrichment and implementing sequential risk assessments can optimize prognostic accuracy. For the intervention component, no robust evidence yet exists to favor any indicated intervention over another (including needs-based interventions and control conditions) for preventing psychosis or ameliorating any other outcome in CHR-P individuals. However, because the uncertainty of this evidence is high, needs-based and psychological interventions should still be offered. CONCLUSIONS AND RELEVANCE This review confirmed recent substantial advancements in the detection and prognosis of CHR-P individuals while suggesting that effective indicated interventions need to be identified. This evidence suggests a need for specialized services to detect CHR-P individuals in primary and secondary care settings, to formulate a prognosis with validated psychometric instruments, and to offer needs-based and psychological interventions.
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Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, United Kingdom.,Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - Christoph U Correll
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, New York.,The Feinstein Institute for Medical Research, Center for Psychiatric Neuroscience, Manhasset, New York.,Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.,Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Mark J Millan
- Centre for Therapeutic Innovation in Neuropsychiatry, Institut de Recherche Servier, Croissy sur Seine, Paris, France
| | - Stefan Borgwardt
- Department of Psychiatry, University of Basel, Basel, Switzerland.,Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine with Early Intervention and Recognition Centre, Vivantes Klinikum Am Urban, Charité-Universitätsmedizin, Berlin, Germany.,Vivantes Klinikum im Friedrichshain, Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Charité-Universitätsmedizin, Berlin, Germany.,Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Center, Psychiatric Center Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center School for Mental Health and Neuroscience, Maastricht, the Netherlands
| | - Dorien H Nieman
- Amsterdam University Medical Centers, Academic Medical Center, Department of Psychiatry, Amsterdam, the Netherlands
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation (NeuroModul), Medical Faculty, University of Freiburg, Germany
| | - Marie-Odile Krebs
- INSERM, IPNP UMR S1266, Laboratoire de Physiopathologie des Maladies Psychiatriques, Université Paris Descartes, Université de Paris, CNRS, GDR3557-Institut de Psychiatrie, Paris, France.,Faculté de Médecine Paris Descartes, GHU Paris-Sainte-Anne, Service Hospitalo-Universitaire, Paris, France
| | - Nikolaos Koutsouleris
- University Hospital, Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany.,Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, United Kingdom
| | - Philip McGuire
- Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, United Kingdom
| | - Kim Q Do
- Center for Psychiatric Neuroscience, Lausanne University Hospital, Lausanne-Prilly, Switzerland
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
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20
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Hadar H, Zhang H, Phillips LJ, Amminger GP, Berger GE, Chen EYH, de Haan L, Hartmann JA, Hickie IB, Lavoie S, Markulev C, McGorry PD, Mossaheb N, Nieman DH, Nordentoft M, Riecher-Rössler A, Schäfer MR, Schlögelhofer M, Smesny S, Thompson A, Verma S, Yuen HP, Yung AR, Nelson B. Do schizotypal or borderline personality disorders predict onset of psychotic disorder or persistent attenuated psychotic symptoms in patients at high clinical risk? Schizophr Res 2020; 220:275-277. [PMID: 32305167 DOI: 10.1016/j.schres.2020.03.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 03/13/2020] [Accepted: 03/29/2020] [Indexed: 11/28/2022]
Affiliation(s)
- H Hadar
- Psychology Department, University of Otago, Dunedin, New Zealand
| | - H Zhang
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - L J Phillips
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - G P Amminger
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - G E Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - E Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong
| | - L de Haan
- Department of Psychiatry, Amsterdam UMC, Academic Medical Center, Amsterdam, Netherlands
| | - J A Hartmann
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - I B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - S Lavoie
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - C Markulev
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - P D McGorry
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - N Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria; Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - D H Nieman
- Department of Psychiatry, Amsterdam UMC, Academic Medical Center, Amsterdam, Netherlands
| | - M Nordentoft
- Psychiatric Centre Bispebjerg, Copenhagen, Denmark
| | | | - M R Schäfer
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - M Schlögelhofer
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - S Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - A Thompson
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - S Verma
- Institute of Mental Health, Singapore, Singapore
| | - H P Yuen
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - A R Yung
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Institute of Brain, Behaviour, and Mental Health, University of Manchester, Manchester, United Kingdom
| | - B Nelson
- Centre for Youth Mental Health, The University of Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
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21
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Nieman DH, Chavez-Baldini U, Vulink NC, Smit DJA, van Wingen G, de Koning P, Sutterland AL, Mocking RJT, Bockting C, Verweij KJH, Lok A, Denys D. Protocol Across study: longitudinal transdiagnostic cognitive functioning, psychiatric symptoms, and biological parameters in patients with a psychiatric disorder. BMC Psychiatry 2020; 20:212. [PMID: 32393362 PMCID: PMC7216345 DOI: 10.1186/s12888-020-02624-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/26/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Patients with psychiatric disorders, such as major depressive disorder, schizophrenia or obsessive-compulsive disorder, often suffer from cognitive dysfunction. The nature of these dysfunctions and their relation with clinical symptoms and biological parameters is not yet clear. Traditionally, cognitive dysfunction is studied in patients with specific psychiatric disorders, disregarding the fact that cognitive deficits are shared across disorders. The Across study aims to investigate cognitive functioning and its relation with psychiatric symptoms and biological parameters transdiagnostically and longitudinally. METHODS The study recruits patients diagnosed with a variety of psychiatric disorders and has a longitudinal cohort design with an assessment at baseline and at one-year follow-up. The primary outcome measure is cognitive functioning. The secondary outcome measures include clinical symptoms, electroencephalographic, genetic and blood markers (e.g., fatty acids), and hair cortisol concentration levels. DISCUSSION The Across study provides an opportunity for a transdiagnostic, bottom-up, data-driven approach of investigating cognition in relation to symptoms and biological parameters longitudinally in patients with psychiatric disorders. The study may help to find new clusters of symptoms, biological markers, and cognitive dysfunctions that have better prognostic value than the current diagnostic categories. Furthermore, increased insight into the relationship among cognitive deficits, biological parameters, and psychiatric symptoms can lead to new treatment possibilities. TRIAL REGISTRATION Netherlands Trial Register (NTR): NL8170.
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Affiliation(s)
- Dorien H. Nieman
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - UnYoung Chavez-Baldini
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Nienke C. Vulink
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Dirk J. A. Smit
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Guido van Wingen
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Pelle de Koning
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Arjen L. Sutterland
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Roel J. T. Mocking
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Claudi Bockting
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Karin J. H. Verweij
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Anja Lok
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
| | - Damiaan Denys
- grid.7177.60000000084992262Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands
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22
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Nelson B, Yuen HP, Amminger GP, Berger G, Chen EYH, de Haan L, Hartmann JA, Hickie IB, Lavoie S, Markulev C, Mossaheb N, Nieman DH, Nordentoft M, Polari A, Riecher-Rössler A, Schäfer MR, Schlögelhofer M, Smesny S, Tedja A, Thompson A, Verma S, Yung AR, McGorry PD. Distress related to attenuated psychotic symptoms: Static and dynamic association with transition to psychosis, non-remission and transdiagnostic symptomatology in clinical high-risk patients in an international intervention trial. ACTA ACUST UNITED AC 2020. [DOI: 10.1093/schizbullopen/sgaa006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
This study examined whether distress in relation to attenuated psychotic symptoms (DAPS) is associated with clinical outcomes in an ultra-high-risk (UHR) for psychosis sample. We also investigated whether DAPS is associated with cognitive style (attributional style and cognitive biases) and whether amount of psychosocial treatment provided is associated with reduction in DAPS. The study was a secondary analysis of the ‘Neurapro’ clinical trial of omega-3 fatty acids. 304 UHR patients were recruited across ten early intervention services. Data from baseline assessment, regular assessments over 12 months and medium term follow up (mean=3.4 years) were used for analysis. Findings indicated: a positive association between DAPS assessed over time and transition to psychosis; a significant positive association between baseline and longitudinal DAPS and transdiagnostic clinical and functional outcomes; a significant positive association between baseline and longitudinal DAPS and non-remission of UHR status. There was no relationship between severity of DAPS and cognitive style. A greater amount of psychosocial treatment (cognitive-behavioural case management) was associated with an increase in DAPS scores. The study indicates that UHR patients who are more distressed by their attenuated psychotic symptoms are more likely to have a poorer clinical trajectory transdiagnostically. Assessment of DAPS may therefore function as a useful marker of risk for a range of poor outcomes. The findings underline the value of repeated assessment of variables and incorporation of dynamic change into predictive modelling. More research is required into mechanisms driving distress associated with symptoms and the possible bidirectional relationship between symptom severity and associated distress.
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Affiliation(s)
- B Nelson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - H P Yuen
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - G P Amminger
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - G Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland
| | - E Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong
| | - L de Haan
- Academic Medical Center, Amsterdam, the Netherlands
| | - J A Hartmann
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - I B Hickie
- Brain and Mind Research Institute, University of Sydney, Australia
| | - S Lavoie
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - C Markulev
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - N Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
| | - D H Nieman
- Academic Medical Center, Amsterdam, the Netherlands
| | - M Nordentoft
- CORE-Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - A Polari
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - M R Schäfer
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - M Schlögelhofer
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Austria
| | - S Smesny
- University Hospital Jena, Jena, Germany
| | - A Tedja
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - A Thompson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - S Verma
- Institute of Mental Health, Singapore, Singapore
| | - A R Yung
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - P D McGorry
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Department of Psychology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne
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23
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Youn S, Phillips LJ, Amminger GP, Berger G, Chen EYH, de Haan L, Hartmann JA, Hickie IB, Lavoie S, Markulev C, McGorry PD, Mossaheb N, Nieman DH, Nordentoft M, Riecher-Rössler A, Schäfer MR, Schlögelhofer M, Smesny S, Thompson A, Verma S, Yuen HP, Yung AR, Nelson B. Basic symptoms in young people at ultra-high risk of psychosis: Association with clinical characteristics and outcomes. Schizophr Res 2020; 216:255-261. [PMID: 31866077 DOI: 10.1016/j.schres.2019.11.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/06/2019] [Accepted: 11/25/2019] [Indexed: 12/30/2022]
Abstract
There has been limited research into the predictive value of basic symptoms and their relationship with other psychopathology in patients identified using the 'ultra high risk' (UHR) for psychosis approach. The current study investigated whether basic symptoms, specifically cognitive disturbances (COGDIS), were associated with a greater risk of transition to psychotic disorder and persistent attenuated psychotic symptoms (APS) at medium term follow-up (mean = 3.4 years) in UHR patients, as well as with general psychopathology at baseline. The sample included 304 UHR participants (mean age = 19.12 years) involved in an international multicenter trial of omega-3 fatty acids. UHR individuals who also met the COGDIS criteria (basic symptoms risk criteria) did not have a greater risk of transition than those who met the UHR criteria alone. However, meeting COGDIS risk criteria was associated with a greater likelihood of meeting the UHR attenuated psychotic symptoms risk group (i.e., having persistent attenuated psychotic symptoms) at 12-month follow-up (odds ratio = 1.85; 95% CI = 1.03, 3.32). Greater severity of cognitive basic symptoms was also independently associated with more severe general psychopathology at study entry. The findings do not support the notion that combined risk identification approaches (UHR and basic symptoms) aid in the identification of individuals at greatest risk of psychosis, although this interpretation is limited by the modest transition to psychosis rate (13%) and the time of follow up. However, the findings indicate that basic symptoms may be a clinically useful marker of more severe general psychopathology in UHR groups and risk for persistent attenuated psychotic symptoms.
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Affiliation(s)
- S Youn
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - L J Phillips
- Department of Psychology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
| | - G P Amminger
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - G Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland
| | - E Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong
| | - L de Haan
- Academic Medical Center, Amsterdam, the Netherlands
| | - J A Hartmann
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - I B Hickie
- Brain and Mind Research Institute, University of Sydney, Australia
| | - S Lavoie
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - C Markulev
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - P D McGorry
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - N Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
| | - D H Nieman
- Academic Medical Center, Amsterdam, the Netherlands
| | - M Nordentoft
- Psychiatric Centre Bispebjerg, Copenhagen, Denmark
| | | | - M R Schäfer
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - M Schlögelhofer
- Department of Psychiatry, Medical University of Vienna, Austria
| | - S Smesny
- University Hospital Jena, Jena, Germany
| | - A Thompson
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - S Verma
- Institute of Mental Health, Singapore, Singapore
| | - H P Yuen
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - A R Yung
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - B Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia.
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24
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Amminger GP, Nelson B, Markulev C, Yuen HP, Schäfer MR, Berger M, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, McGorry PD. The NEURAPRO Biomarker Analysis: Long-Chain Omega-3 Fatty Acids Improve 6-Month and 12-Month Outcomes in Youths at Ultra-High Risk for Psychosis. Biol Psychiatry 2020; 87:243-252. [PMID: 31690495 DOI: 10.1016/j.biopsych.2019.08.030] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Received: 06/07/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND NEURAPRO was a multicenter, placebo-controlled trial of long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs) (fish oil) in 304 individuals at ultra-high risk for psychotic disorders. The study failed to show benefits of n-3 PUFAs over placebo. Although the randomized controlled trial design is placed at the top of the evidence hierarchy, this methodology has limitations in fish oil randomized controlled trials, as not only is the test agent present in the intervention group, but also n-3 fats are present in the diet and the body tissue of all participants. METHODS Analysis of biomarker data (eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], n-3 index, EPA+DHA) collected as part of NEURAPRO was conducted on 218 participants with longitudinal biomarker data to determine if n-3 PUFAs measured in erythrocytes at baseline and month 6 predicted clinical outcomes. RESULTS Increases of the n-3 index, EPA, and DHA predicted less severe psychopathology and better functioning at both follow-up time points. Higher baseline levels and increases of n-3 index also predicted overall clinical improvement at month 6 (n-3 index baseline: adjusted odds ratio [95% confidence interval (CI)] = 1.79 [1.30-2.48]; n-3 PUFA increase: adjusted odds ratio [95% CI] = 1.43 [1.16-1.76]) and at month 12 (n-3 index baseline: adjusted odds ratio [95% CI] = 2.60 [1.71-3.97]; n-3 PUFA increase: adjusted odds ratio [95% CI] = 1.36 [1.06-1.74]). CONCLUSIONS These data suggest that n-3 PUFAs can exert therapeutic effects in ultra-high-risk individuals. This finding has implications for early intervention and treatment guidelines, as n-3 PUFA supplementation can easily and safely be used in a wide variety of settings, from primary care to specialist services.
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Affiliation(s)
- G Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Connie Markulev
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Hok Pan Yuen
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Miriam R Schäfer
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Maximus Berger
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Nilufar Mossaheb
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Stephan Smesny
- Department of Psychiatry, Jena University Hospital, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Gregor E Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | | | | | | | - Andrew Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Alison Ruth Yung
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Institute of Brain, Behaviour, and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; The Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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25
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Hartmann JA, Schmidt SJ, McGorry PD, Berger M, Berger GE, Chen EY, de Haan L, Hickie IB, Lavoie S, Markulev C, Mossaheb N, Nieman DH, Nordentoft M, Polari A, Riecher-Rössler A, Schäfer MR, Schlögelhofer M, Smesny S, Thompson A, Verma SK, Yuen HP, Yung AR, Amminger GP, Nelson B. Trajectories of symptom severity and functioning over a three-year period in a psychosis high-risk sample: A secondary analysis of the Neurapro trial. Behav Res Ther 2020; 124:103527. [DOI: 10.1016/j.brat.2019.103527] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/31/2019] [Accepted: 11/20/2019] [Indexed: 11/26/2022]
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26
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Berger M, Nelson B, Markulev C, Yuen HP, Schäfer MR, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Mitchell TW, Meyer BJ, Thompson A, Yung AR, McGorry PD, Amminger GP. Corrigendum: Relationship Between Polyunsaturated Fatty Acids and Psychopathology in the NEURAPRO Clinical Trial. Front Psychiatry 2020; 11:514. [PMID: 32595533 PMCID: PMC7304282 DOI: 10.3389/fpsyt.2020.00514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2019.00393.].
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Affiliation(s)
- Maximus Berger
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Barnaby Nelson
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Connie Markulev
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Hok Pan Yuen
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Miriam R Schäfer
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria.,Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Stefan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Gregor E Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Todd W Mitchell
- School of Medicine and Lipid Research Centre, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Barbara J Meyer
- School of Medicine and Lipid Research Centre, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Andrew Thompson
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alison Ruth Yung
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.,Institute of Brain, Behaviour, and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Patrick D McGorry
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - G Paul Amminger
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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27
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Vanheule S, Adriaens P, Bazan A, Bracke P, Devisch I, Feys JL, Froyen B, Gerard S, Nieman DH, Van Os J, Calmeyn M. Belgian Superior Health Council advises against the use of the DSM categories. Lancet Psychiatry 2019; 6:726. [PMID: 31448753 DOI: 10.1016/s2215-0366(19)30284-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Stijn Vanheule
- Belgian Superior Health Council, Brussels, Belgium; Department of Psycho-analysis and Clinical Consulting, Ghent University, B-9000 Ghent, Belgium.
| | - Pieter Adriaens
- Belgian Superior Health Council, Brussels, Belgium; Institute of Philosophy, KU Leuven, Belgium
| | - Ariane Bazan
- Belgian Superior Health Council, Brussels, Belgium; Research Center for Clinical Psychology, Psychopathology and Psychosomatics, Université libre de Bruxelles, Brussels, Belgium
| | - Piet Bracke
- Belgian Superior Health Council, Brussels, Belgium; Department of Sociology, Ghent University, B-9000 Ghent, Belgium
| | - Ignaas Devisch
- Belgian Superior Health Council, Brussels, Belgium; Department of Public Health and Family Medicine, Ghent University, B-9000 Ghent, Belgium
| | - Jean-Louis Feys
- Belgian Superior Health Council, Brussels, Belgium; Psychiatric Hospital St Bernard, Manage, Belgium
| | | | | | - Dorien H Nieman
- Belgian Superior Health Council, Brussels, Belgium; Department of Psychiatry, Amsterdam University Medical Centers, Netherlands
| | - Jim Van Os
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, Netherlands; Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands; Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Marc Calmeyn
- Psychiatric Hospital Onze-Lieve-Vrouw, Bruges, Belgium
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28
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Domen AC, van de Weijer SCF, Jaspers MW, Denys D, Nieman DH. The validation of a new online cognitive assessment tool: The MyCognition Quotient. Int J Methods Psychiatr Res 2019; 28:e1775. [PMID: 30761648 PMCID: PMC6850139 DOI: 10.1002/mpr.1775] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 01/04/2019] [Accepted: 01/06/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Cognitive impairment affects many psychiatric patients, influences daily functioning, and should be an important treatment focus. Assessment of cognitive status is crucial in cognitive remediation studies. However, current test batteries have limitations. A new, online tool, the MyCognition Quotient (MyCQ), was developed to assess cognition within 30 min. We present the psychometric properties and aim to determine the validity of the MyCQ by comparing it with the Cambridge Neuropsychological Automated Test Battery (CANTAB). METHODS Eighty-seven patients diagnosed with obsessive compulsive disorder, schizophrenia/schizoaffective disorder, or major depressive disorder were included. Patients completed both the MyCQ and CANTAB. RESULTS Our hypothesized domains of psychomotor speed, attention, episodic memory, working memory, and executive functioning were confirmed by principal component analysis. The MyCQ total score correlated highly with the CANTAB total score. The MyCQ domains of psychomotor speed, attention, and episodic memory showed moderate to high correlations with corresponding CANTAB domains. Working memory and executive functioning had limited divergent validity. CONCLUSION The MyCQ appears to be a promising instrument for assessing cognition online within a mixed psychiatric population. It is cost-efficient, easily administered, and usable in different psychiatric populations, which makes it a good candidate for both clinical and community studies.
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Affiliation(s)
- Anna C Domen
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | | | - Monique W Jaspers
- Center for Human Factors Engineering of Health Information Technology, Department of Medical Informatics, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands
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29
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Bolt LK, Amminger GP, Farhall J, McGorry PD, Nelson B, Markulev C, Yuen HP, Schäfer MR, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, Allott KA. Neurocognition as a predictor of transition to psychotic disorder and functional outcomes in ultra-high risk participants: Findings from the NEURAPRO randomized clinical trial. Schizophr Res 2019; 206:67-74. [PMID: 30558978 DOI: 10.1016/j.schres.2018.12.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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] [Received: 06/27/2018] [Revised: 11/30/2018] [Accepted: 12/08/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Neurocognitive impairments experienced by individuals at ultra-high risk (UHR) for psychosis are potential predictors of outcome within this population, however there is inconsistency regarding the specific neurocognitive domains implicated. This study aimed to examine whether baseline neurocognition predicted transition to psychosis, or functional outcomes, at medium-term (mean = 3.4 years) follow-up, while controlling for other clinical/treatment variables associated with transition to psychosis. METHOD Analysis of data collected as part of a multi-centre RCT of omega-3 fatty acids and cognitive-behavioural case management (NEURAPRO) for UHR individuals was conducted on the 294 participants (134 males, 160 females) who completed neurocognitive assessment (Brief Assessment of Cognition for Schizophrenia) at baseline. Transition to psychosis was determined using the Comprehensive Assessment of At-Risk Mental States (CAARMS), and functioning was measured with the Global Functioning: Social and Role Scales. RESULTS Mean baseline z-scores indicated that UHR participants performed a quarter to half a standard deviation below normative means in all domains (range mean z = -0.24 to -0.47), except for executive functioning (mean z = 0.16). After adjusting for covariates, poorer Executive (p = .010) and Motor (p = .030) functions were predictive of transition to psychosis. Processing Speed and Verbal Fluency were significant predictors of role functioning at 12 months (p = .004), and social functioning at medium-term follow-up (p = .015), respectively. CONCLUSIONS Neurocognitive abilities are independent predictors of both transition to psychosis and functional outcomes within the UHR population. Further research is needed to determine the best combination of risk variables in UHR individuals for prediction of psychosis transition, functioning and other psychopathology outcomes.
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Affiliation(s)
- Luke K Bolt
- Department of Psychology and Counselling, La Trobe University, Bundoora, Australia
| | - G Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria.
| | - John Farhall
- Department of Psychology and Counselling, La Trobe University, Bundoora, Australia.
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
| | - Connie Markulev
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
| | - Hok Pan Yuen
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
| | - Miriam R Schäfer
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Nilufar Mossaheb
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria.
| | - Monika Schlögelhofer
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria.
| | - Stefan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany.
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia.
| | - Gregor Emanuel Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland.
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong.
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam University Medical Centers, the Netherlands.
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers, the Netherlands.
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore.
| | - Andrew Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, England, United Kingdom of Great Britain and Northern Ireland; North Warwickshire Early Intervention in Psychosis Service, Coventry and Warwickshire National Health Service Partnership Trust, Coventry, England, United Kingdom of Great Britain and Northern Ireland.
| | - Alison Ruth Yung
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom of Great Britain and Northern Ireland; Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland.
| | - Kelly A Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
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30
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Berger M, Nelson B, Markulev C, Yuen HP, Schäfer MR, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Mitchell TW, Meyer BJ, Thompson A, Yung AR, McGorry PD, Amminger GP. Relationship Between Polyunsaturated Fatty Acids and Psychopathology in the NEURAPRO Clinical Trial. Front Psychiatry 2019; 10:393. [PMID: 31244693 PMCID: PMC6562242 DOI: 10.3389/fpsyt.2019.00393] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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] [Received: 01/14/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Deficiencies in membrane polyunsaturated fatty acids (PUFA) such as omega-3 (n-3) fatty acids are thought to contribute to the pathophysiological processes underlying psychotic disorders. Emerging evidence suggests that the levels of PUFA are related to clinical symptoms but significant heterogeneity exists between studies. Here, we investigated associations of membrane PUFA with clinical symptoms and functioning in a large sample of individuals at ultra-high risk (UHR) for psychosis. Methods: A total of 285 participants of the NEURAPRO clinical trial were investigated for erythrocyte PUFA levels, including the n-3 index, n-6/n-3 PUFA ratio, docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA). Severity of general psychopathology [Brief Psychiatric Rating Scale (BPRS)], psychotic symptoms (BPRS psychosis subscale), negative symptoms [Scale for the Assessment of Negative Symptoms (SANS)], manic symptoms [Young Mania Rating Scale (YMRS)], depressive symptoms [Montgomery Asberg Depression Rating Scale (MADRS)], and functioning [Social and Occupational Functioning Scale (SOFAS), Global Functioning Social (GF-S) and Role (GF-R) scales] were assessed concurrently. Partial correlation taking into account the effects of gender, age, and smoking was used to examine the relationship between PUFAs and symptoms severity. Results: The n-3 index negatively correlated with the severity of general psychopathology, psychotic symptoms, depressive symptoms, and manic symptoms. The n-6/n-3 PUFA ratio positively correlated with severity of psychotic and depressive symptoms. The n-3 PUFA DHA negatively correlated with the severity of general psychopathology, positive, manic, and depressive symptoms. EPA negatively correlated with manic symptoms. Nervonic acid, an n-9 monounsaturated fatty acid, positively correlated with general psychopathology, positive and negative symptoms, depressive symptoms, and manic symptoms. The long-chain saturated fatty acid tetracosanoic acid positively correlated with general psychopathology, positive, manic, and depressive symptoms. Conclusions: Partially consistent with a previous study, psychotic symptoms, depressive symptoms, and symptoms of mania were associated with several classes of FAs in the present study. These findings support the relevance of membrane fatty acids for the onset of psychotic symptoms and indicate that FAs should be further evaluated as biomarkers in the UHR for psychosis group. Clinical Trial Registration: ANZCTR, identifier: 12608000475347.
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Affiliation(s)
- Maximus Berger
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Barnaby Nelson
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Connie Markulev
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Hok Pan Yuen
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Miriam R Schäfer
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria.,Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Stefan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Gregor E Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, Netherlands
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Todd W. Mitchell
- School of Medicine and Lipid Research Centre, University of Wollongong, Wollongong, NSW, Australia,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Barbara J. Meyer
- School of Medicine and Lipid Research Centre, University of Wollongong, Wollongong, NSW, Australia,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Andrew Thompson
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alison Ruth Yung
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.,Institute of Brain, Behaviour, and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Patrick D McGorry
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - G Paul Amminger
- Orygen-The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
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31
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Yuen HP, Mackinnon A, Hartmann J, Amminger GP, Markulev C, Lavoie S, Schäfer MR, Polari A, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger G, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, McGorry PD, Nelson B. Dynamic prediction of transition to psychosis using joint modelling. Schizophr Res 2018; 202:333-340. [PMID: 30539771 DOI: 10.1016/j.schres.2018.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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] [Received: 05/12/2018] [Revised: 07/01/2018] [Accepted: 07/01/2018] [Indexed: 10/28/2022]
Abstract
Considerable research has been conducted seeking risk factors and constructing prediction models for transition to psychosis in individuals at ultra-high risk (UHR). Nearly all such research has only employed baseline predictors, i.e. data collected at the baseline time point, even though longitudinal data on relevant measures such as psychopathology have often been collected at various time points. Dynamic prediction, which is the updating of prediction at a post-baseline assessment using baseline and longitudinal data accumulated up to that assessment, has not been utilized in the UHR context. This study explored the use of dynamic prediction and determined if it could enhance the prediction of frank psychosis onset in UHR individuals. An emerging statistical methodology called joint modelling was used to implement the dynamic prediction. Data from the NEURAPRO study (n = 304 UHR individuals), an intervention study with transition to psychosis study as the primary outcome, were used to investigate dynamic predictors. Compared with the conventional approach of using only baseline predictors, dynamic prediction using joint modelling showed significantly better sensitivity, specificity and likelihood ratios. As dynamic prediction can provide an up-to-date prediction for each individual at each new assessment post entry, it can be a useful tool to help clinicians adjust their prognostic judgements based on the unfolding clinical symptomatology of the patients. This study has shown that a dynamic approach to psychosis prediction using joint modelling has the potential to aid clinicians in making decisions about the provision of timely and personalized treatment to patients concerned.
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Affiliation(s)
- H P Yuen
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia.
| | - A Mackinnon
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia; Black Dog Institute, New South Wales, Australia; University of New South Wales, New South Wales, Australia
| | - J Hartmann
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
| | - G P Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
| | - C Markulev
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
| | - S Lavoie
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
| | - M R Schäfer
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - A Polari
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia; Orygen Youth Health, Melbourne, Australia
| | - N Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Austria
| | - M Schlögelhofer
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - S Smesny
- University Hospital Jena, Germany
| | - I B Hickie
- Brain and Mind Centre, University of Sydney, Australia
| | - G Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland
| | - E Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong
| | - L de Haan
- Academic Medical Center, Amsterdam, the Netherlands
| | - D H Nieman
- Academic Medical Center, Amsterdam, the Netherlands
| | - M Nordentoft
- Mental Health Centre Copenhagen, Mental Health Services in the Capital Region, Copenhagen University Hospital, Denmark
| | | | - S Verma
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - A Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, England, UK; North Warwickshire Early Intervention in Psychosis Service, Coventry and Warwickshire NHS Partnership Trust, England, UK
| | - A R Yung
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK; Greater Manchester West NHS Mental Health Foundation Trust, Manchester, England, UK
| | - P D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
| | - B Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia
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32
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Hartmann JA, McGorry PD, Schmidt SJ, Amminger GP, Yuen HP, Markulev C, Berger GE, Chen EYH, de Haan L, Hickie IB, Lavoie S, McHugh MJ, Mossaheb N, Nieman DH, Nordentoft M, Riecher-Rössler A, Schäfer MR, Schlögelhofer M, Smesny S, Thompson A, Verma SK, Yung AR, Nelson B. Opening the Black Box of Cognitive-Behavioural Case Management in Clients with Ultra-High Risk for Psychosis. Psychother Psychosom 2018; 86:292-299. [PMID: 28903120 DOI: 10.1159/000477551] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 05/12/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cognitive-behavioural therapy (CBT) is the first-choice treatment in clients with ultra-high risk (UHR) for psychosis. However, CBT is an umbrella term for a plethora of different strategies, and little is known about the association between the intensity and content of CBT and the severity of symptomatic outcome. METHODS A sample of 268 UHR participants received 6 months of CBT with case management (CBCM) in the context of the multi-centre NEURAPRO trial with monthly assessments of attenuated psychotic symptoms (APS). Using multilevel regressions and controlling for the initial severity of APS, the associations between (1) number of CBCM sessions received and severity of APS and (2) specific CBCM components and severity of APS were investigated. RESULTS In month 1, a higher number of sessions and more assessment of symptoms predicted an increase in APS, while in month 3, a higher number of sessions and more monitoring predicted a decrease in the level of APS. More therapeutic focus on APS predicted an overall increase in APS. CONCLUSIONS Our findings indicate that the association between intensity/content of CBCM and severity of APS in a sample of UHR participants depends on the length of time in treatment. CBCM may positively impact the severity of APS later in the course of treatment. Therefore, it would seem important to keep UHR young people engaged in treatment beyond this initial period. Regarding the specific content of CBCM, a therapeutic focus on APS may not necessarily be beneficial in reducing the severity of APS, a possibility in need of further investigation.
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Affiliation(s)
- Jessica A Hartmann
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
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33
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Nelson B, Amminger GP, Yuen HP, Markulev C, Lavoie S, Schäfer MR, Hartmann JA, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger G, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, McGorry PD. NEURAPRO: a multi-centre RCT of omega-3 polyunsaturated fatty acids versus placebo in young people at ultra-high risk of psychotic disorders-medium-term follow-up and clinical course. NPJ Schizophr 2018; 4:11. [PMID: 29941938 PMCID: PMC6018097 DOI: 10.1038/s41537-018-0052-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/04/2018] [Accepted: 05/11/2018] [Indexed: 11/09/2022]
Abstract
This study reports a medium-term follow-up of a randomised, double-blind, placebo-controlled trial of omega-3 polyunsaturated fatty acids (PUFA) in ultra-high risk for psychosis (UHR) patients. Primary outcomes of interest were transition to psychosis and symptomatic and functional outcome. A secondary aim was to investigate clinical predictors of medium-term outcome. Three hundred four UHR participants were recruited across 10 specialised early psychosis services in Australia, Asia, and Europe. The intervention consisted of 1.4 g/daily of omega-3 PUFA or placebo, plus up to 20 sessions of cognitive-behavioural case management (CBCM), over the 6-month study period, with participants receiving further CBCM sessions on basis of need between months 6-12. Mean time to follow-up was 3.4 (median = 3.3; SD = 0.9) years. There was a modest increase in transitions between 12-month and medium-term follow-up (11-13%) and substantial improvement in symptoms and functioning between baseline and follow-up, with no differences between the treatment groups. Most improvement had been achieved by end of the intervention. 55% of the sample received mental health treatment between end of intervention and follow-up. Omega-3 PUFA did not provide additional benefits to good quality psychosocial intervention over the medium term. Although most improvement had been achieved by end of intervention the substantial rates of post-intervention mental health service use indicate longer-term clinical need in UHR patients. The post-intervention phase treatment or the longer-term effect of CBCM, or a combination of the two, may have contributed to maintaining the gains achieved during the intervention phase and prevented significant deterioration after this time.
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Affiliation(s)
- B Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia. .,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
| | - G P Amminger
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,Department of Psychiatry, Medical University of Vienna, Vienna, Austria
| | - H P Yuen
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - C Markulev
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - S Lavoie
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - M R Schäfer
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Department of Psychiatry, Medical University of Vienna, Vienna, Austria
| | - J A Hartmann
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - N Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - M Schlögelhofer
- Department of Psychiatry, Medical University of Vienna, Vienna, Austria
| | - S Smesny
- University Hospital Jena, Jena, Germany
| | - I B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, Australia
| | - G Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland
| | - E Y H Chen
- Department of Psychiatry, University of Hong Kong, Pokfulam, Hong Kong
| | - L de Haan
- Academic Medical Center, Amsterdam, The Netherlands
| | - D H Nieman
- Academic Medical Center, Amsterdam, The Netherlands
| | - M Nordentoft
- Psychiatric Centre Bispebjerg, Copenhagen, Denmark
| | | | - S Verma
- Institute of Mental Health, Singapore, Singapore
| | - A Thompson
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.,North Warwickshire Early Intervention in Psychosis Service, Coventry and Warwickshire NHS Partnership Trust, Coventry, UK
| | - A R Yung
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Division of Psychology and Mental Health, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - P D McGorry
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Vaessen TSJ, de Jong L, Schäfer AT, Damen T, Uittenboogaard A, Krolinski P, Nwosu CV, Pinckaers FME, Rotee ILM, Smeets APW, Ermiş A, Kennedy JL, Nieman DH, Tiwari A, van Os J, Drukker M. The interaction between cannabis use and the Val158Met polymorphism of the COMT gene in psychosis: A transdiagnostic meta - analysis. PLoS One 2018; 13:e0192658. [PMID: 29444152 PMCID: PMC5812637 DOI: 10.1371/journal.pone.0192658] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Neither environmental nor genetic factors are sufficient to predict the transdiagnostic expression of psychosis. Therefore, analysis of gene-environment interactions may be productive. OBJECTIVE A meta-analysis was performed using papers investigating the interaction between cannabis use and catechol-O-methyl transferase (COMT) polymorphism Val158Met (COMTVal158Met). DATA SOURCES PubMed, Embase, PsychInfo. STUDY ELIGIBILITY CRITERIA All observational studies assessing the interaction between COMTVal158Met and cannabis with any psychosis or psychotic symptoms measure as an outcome. STUDY APPRAISAL AND SYNTHESIS METHODS A meta-analysis was performed using the Meta-analysis of Observational Studies in Epidemiology guidelines and forest plots were generated. Thirteen articles met the selection criteria: 7 clinical studies using a case-only design, 3 clinical studies with a dichotomous outcome, and 3 studies analysing a continuous outcome of psychotic symptoms below the threshold of psychotic disorder. The three study types were analysed separately. Validity of the included studies was assessed using "A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions". RESULTS For case-only studies, a significant interaction was found between cannabis use and COMTVal158Met, with an OR of 1.45 (95% Confidence Interval = 1.05-2.00; Met/Met as the risk genotype). However, there was no evidence for interaction in either the studies including dichotomous outcomes (B = -0.51, 95% Confidence Interval -1.72, 0.70) or the studies including continuous outcomes (B = -0.04 95% Confidence Interval -0.16-0.08). LIMITATION A substantial part of the included studies used the case-only design, which has lower validity and tends to overestimate true effects. CONCLUSION The interaction term between cannabis use and COMTVal158Met was only statistically significant in the case-only studies, but not in studies using other clinical or non-clinical psychosis outcomes. Future additional high quality studies might change current perspectives, yet currently evidence for the interaction remains unconvincing.
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Affiliation(s)
| | - Lea de Jong
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Annika Theresia Schäfer
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Thomas Damen
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Aniek Uittenboogaard
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Pauline Krolinski
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Chinyere Vicky Nwosu
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Iris Leah Marije Rotee
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Ayşegül Ermiş
- Department of Psychiatry, Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Istanbul, Turkey
| | - James L. Kennedy
- Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Dorien H. Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Arun Tiwari
- Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jim van Os
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
- King's College London, King's Health Partners Department of Psychosis Studies; Institute of Psychiatry, London, United Kingdom
| | - Marjan Drukker
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- * E-mail:
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35
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Boot E, Hollak CEM, Huijbregts SCJ, Jahja R, van Vliet D, Nederveen AJ, Nieman DH, Bosch AM, Bour LJ, Bakermans AJ, Abeling NGGM, Bassett AS, van Amelsvoort TAMJ, van Spronsen FJ, Booij J. Cerebral dopamine deficiency, plasma monoamine alterations and neurocognitive deficits in adults with phenylketonuria. Psychol Med 2017; 47:2854-2865. [PMID: 28552082 DOI: 10.1017/s0033291717001398] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Phenylketonuria (PKU), a genetic metabolic disorder that is characterized by the inability to convert phenylalanine to tyrosine, leads to severe intellectual disability and other cerebral complications if left untreated. Dietary treatment, initiated soon after birth, prevents most brain-related complications. A leading hypothesis postulates that a shortage of brain monoamines may be associated with neurocognitive deficits that are observable even in early-treated PKU. However, there is a paucity of evidence as yet for this hypothesis. METHODS We therefore assessed in vivo striatal dopamine D2/3 receptor (D2/3R) availability and plasma monoamine metabolite levels together with measures of impulsivity and executive functioning in 18 adults with PKU and average intellect (31.2 ± 7.4 years, nine females), most of whom were early and continuously treated. Comparison data from 12 healthy controls that did not differ in gender and age were available. RESULTS Mean D2/3R availability was significantly higher (13%; p = 0.032) in the PKU group (n = 15) than in the controls, which may reflect reduced synaptic brain dopamine levels in PKU. The PKU group had lower plasma levels of homovanillic acid (p < 0.001) and 3-methoxy-4-hydroxy-phenylglycol (p < 0.0001), the predominant metabolites of dopamine and norepinephrine, respectively. Self-reported impulsivity levels were significantly higher in the PKU group compared with healthy controls (p = 0.033). Within the PKU group, D2/3R availability showed a positive correlation with both impulsivity (r = 0.72, p = 0.003) and the error rate during a cognitive flexibility task (r = 0.59, p = 0.020). CONCLUSIONS These findings provide further support for the hypothesis that executive functioning deficits in treated adult PKU may be associated with cerebral dopamine deficiency.
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Affiliation(s)
- E Boot
- Department of Nuclear Medicine,Academic Medical Center,Amsterdam,The Netherlands
| | - C E M Hollak
- Division of Endocrinology and Metabolism, Department of Internal Medicine,Academic Medical Center,Amsterdam,The Netherlands
| | - S C J Huijbregts
- Department of Clinical Child and Adolescent Studies & Leiden,Institute for Brain and Cognition, Leiden University,Leiden,The Netherlands
| | - R Jahja
- Division of Metabolic Diseases,University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital,Groningen,The Netherlands
| | - D van Vliet
- Division of Metabolic Diseases,University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital,Groningen,The Netherlands
| | - A J Nederveen
- Department of Radiology,Academic Medical Center,Amsterdam,The Netherlands
| | - D H Nieman
- Department of Psychiatry,Academic Medical Center,Amsterdam,The Netherlands
| | - A M Bosch
- Department of Pediatrics,Emma Children's Hospital, Academic Medical Center,Amsterdam,The Netherlands
| | - L J Bour
- Department of Neurology and Clinical Neurophysiology,Academic Medical Center,Amsterdam,The Netherlands
| | - A J Bakermans
- Department of Radiology,Academic Medical Center,Amsterdam,The Netherlands
| | - N G G M Abeling
- Laboratory for Genetic Metabolic Diseases,Academic Medical Center,Amsterdam,The Netherlands
| | - A S Bassett
- The Dalglish Family 22q Clinic for Adults with 22q11.2 Deletion Syndrome, andCenter for Mental Health, University Health Network,Toronto, Ontario,Canada
| | - T A M J van Amelsvoort
- Department of Psychiatry and Psychology,Maastricht University,Maastricht,The Netherlands
| | - F J van Spronsen
- Division of Metabolic Diseases,University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital,Groningen,The Netherlands
| | - J Booij
- Department of Nuclear Medicine,Academic Medical Center,Amsterdam,The Netherlands
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36
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Ising HK, Lokkerbol J, Rietdijk J, Dragt S, Klaassen RMC, Kraan T, Boonstra N, Nieman DH, van den Berg DPG, Linszen DH, Wunderink L, Veling W, Smit F, van der Gaag M. Four-Year Cost-effectiveness of Cognitive Behavior Therapy for Preventing First-episode Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial. Schizophr Bull 2017; 43:365-374. [PMID: 27306315 PMCID: PMC5605258 DOI: 10.1093/schbul/sbw084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background This study aims to evaluate the long-term cost-effectiveness of add-on cognitive behavior therapy (CBT) for the prevention of psychosis for individuals at ultrahigh risk (UHR) of psychosis. Method The Dutch Early Detection and Intervention randomized controlled trial was used, comparing routine care (RC; n = 101) with routine care plus CBT for UHR (here called CBTuhr; n = 95). A cost-effectiveness analysis was conducted with treatment response (defined as proportion of averted transitions to psychosis) as an outcome and a cost-utility analysis with quality-adjusted life years (QALYs) gained as a secondary outcome. Results The proportion of averted transitions to psychosis was significantly higher in the CBTuhr condition (with a risk difference of 0.122; b = 1.324, SEb = 0.017, z = 7.99, P < 0.001). CBTuhr showed an 83% probability of being more effective and less costly than RC by -US$ 5777 (savings) per participant. In addition, over the 4-year follow-up period, cumulative QALY health gains were marginally (but not significantly) higher in CBTuhr than for RC (2.63 vs. 2.46) and the CBTuhr intervention had a 75% probability of being the superior treatment (more QALY gains at lower costs) and a 92% probability of being cost-effective compared with RC at the Dutch threshold value (US$ 24 560; €20 000 per QALY). Conclusions Add-on preventive CBTuhr had a high likelihood (83%) of resulting in more averted transitions to psychosis and lower costs as compared with RC. In addition, the intervention had a high likelihood (75%) of resulting in more QALY gains and lower costs as compared to RC.
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Affiliation(s)
- Helga K Ising
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Joran Lokkerbol
- Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
- Centre of Economic Evaluation, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Judith Rietdijk
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Sara Dragt
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Rianne M C Klaassen
- Child and Adolescent Department, University Medical Center, Utrecht, The Netherlands
| | - Tamar Kraan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Nynke Boonstra
- Department of Research and Education, Friesland Mental Health Services, Leeuwarden, The Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - David P G van den Berg
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Don H Linszen
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Lex Wunderink
- Department of Research and Education, Friesland Mental Health Services, Leeuwarden, The Netherlands
| | - Wim Veling
- Department of Psychiatry, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Filip Smit
- Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
- Department of Public Mental Health, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Mark van der Gaag
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
- Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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McGorry PD, Nelson B, Markulev C, Yuen HP, Schäfer MR, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EYH, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, Amminger GP. Effect of ω-3 Polyunsaturated Fatty Acids in Young People at Ultrahigh Risk for Psychotic Disorders: The NEURAPRO Randomized Clinical Trial. JAMA Psychiatry 2017; 74:19-27. [PMID: 27893018 DOI: 10.1001/jamapsychiatry.2016.2902] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE A promising treatment to prevent onset and improve outcomes in patients at ultrahigh risk for psychosis is dietary supplementation with long-chain ω-3 polyunsaturated fatty acids (PUFAs). OBJECTIVE To determine whether treatment with ω-3 PUFAs in combination with a high-quality psychosocial intervention (cognitive behavioral case management [CBCM]) is more effective than placebo plus CBCM. DESIGN, SETTING, AND PARTICIPANTS NEURAPRO, a double-blind, placebo-controlled, randomized clinical trial, was conducted from March 1, 2010, to September 30, 2014, in 10 specialized early psychosis treatment services in Australia, Asia, and Europe. The primary analysis used the intention-to-treat approach. INTERVENTIONS A daily dose of 1.4 g of ω-3 PUFAs or placebo (paraffin oil), plus 20 or fewer sessions of CBCM over the 6-month study period. MAIN OUTCOMES AND MEASURES The primary outcome was transition to psychosis status at 6 months. The secondary outcomes were general levels of psychopathology and functioning, as assessed by the Brief Psychiatric Rating Scale (BPRS) (range, 24-168), Scale for the Assessment of Negative Symptoms (SANS) (range, 0-125), Montgomery-Åsberg Depression Rating Scale (MADRS) (range, 0-60), Young Mania Rating Scale (YMRS) (range, 0-44), Social and Occupational Functioning Assessment Scale (SOFAS) (range, 0-100), and the Global Functioning: Social and Role scale (range, 0-10). For SOFAS and Global Functioning: Social and Role scale, higher scores were better; for other measures, lower scores were better. RESULTS In this study of 304 adults at ultrahigh risk for psychotic disorders, 153 (50.3%) received ω-3 PUFAs and 151 (49.7%) received placebo. In all, 139 (45.7%) were male; mean (SD) age was 19.1 (4.6) years. The Kaplan-Meier-estimated 6-month transition rates were 5.1% (95% CI, 1.3%-8.7%) in the control group and 6.7% (95% CI, 2.3%-10.8%) in the ω-3 PUFA group. At 12 months, the rates were 11.2% (95% CI, 5.5%-16.7%) in the control group and 11.5% (95% CI, 5.8%-16.9%) in the ω-3 PUFA group. No significant difference was observed between the transition rates of both groups (hazard ratio, 1.1; 95% CI, 0.55-2.23; P = .76, stratified log-rank test). CONCLUSIONS AND RELEVANCE This trial clearly failed to replicate the findings of the original single-center trial. The most likely explanation is that ω-3 PUFAs lack efficacy under these conditions. However, the lower-than-expected transition rate may have prevented a test of the main hypothesis. Given the substantial symptomatic and functional improvement in both groups, the other treatments received (ie, CBCM and antidepressants) likely produced a ceiling effect beyond which ω-3 PUFAs, even if effective, could not be shown to confer additional benefits. Nevertheless, the main conclusion is that ω-3 PUFAs are not effective under conditions where good quality, evidence-based psychosocial treatment is available. TRIAL REGISTRATION anzctr.org.au Identifier: 12608000475347.
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Affiliation(s)
- Patrick D McGorry
- Orygen, National Centre of Excellence in Youth Mental Health, Melbourne, Australia2Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Barnaby Nelson
- Orygen, National Centre of Excellence in Youth Mental Health, Melbourne, Australia2Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Connie Markulev
- Orygen, National Centre of Excellence in Youth Mental Health, Melbourne, Australia2Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Hok Pan Yuen
- Orygen, National Centre of Excellence in Youth Mental Health, Melbourne, Australia2Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Miriam R Schäfer
- Orygen, National Centre of Excellence in Youth Mental Health, Melbourne, Australia3Department of Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Nilufar Mossaheb
- Department of Psychiatry, Medical University of Vienna, Vienna, Austria
| | | | - Stephan Smesny
- Department of Psychiatry, University Hospital, Jena, Germany
| | - Ian B Hickie
- Brain and Mind Research Institute, University of Sydney, Sydney, Australia
| | - Gregor Emanuel Berger
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Andrew Thompson
- Orygen, National Centre of Excellence in Youth Mental Health, Melbourne, Australia12Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, England13North Warwickshire Early Intervention in Psychosis Service, Coventry and Warwickshire National Health Service Partnership Trust, Coventry, England
| | - Alison Ruth Yung
- Orygen, National Centre of Excellence in Youth Mental Health, Melbourne, Australia14Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, England15Greater Manchester West National Health Service Mental Health Foundation Trust, Manchester, England
| | - G Paul Amminger
- Orygen, National Centre of Excellence in Youth Mental Health, Melbourne, Australia2Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia3Department of Psychiatry, Medical University of Vienna, Vienna, Austria
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Bakker G, Caan MWA, Vingerhoets WAM, da Silva- Alves F, de Koning M, Boot E, Nieman DH, de Haan L, Bloemen OJ, Booij J, van Amelsvoort TAMJ. Cortical Morphology Differences in Subjects at Increased Vulnerability for Developing a Psychotic Disorder: A Comparison between Subjects with Ultra-High Risk and 22q11.2 Deletion Syndrome. PLoS One 2016; 11:e0159928. [PMID: 27828960 PMCID: PMC5102447 DOI: 10.1371/journal.pone.0159928] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/11/2016] [Indexed: 01/14/2023] Open
Abstract
Introduction Subjects with 22q11.2 deletion syndrome (22q11DS) and subjects with ultra-high risk for psychosis (UHR) share a risk of approximately 30% to develop a psychotic disorder. Studying these groups helps identify biological markers of pathophysiological processes involved in the development of psychosis. Total cortical surface area (cSA), total cortical grey matter volume (cGMV), cortical thickness (CT), and local gyrification index (LGI) of the cortical structure have a distinct neurodevelopmental origin making them important target markers to study in relation to the development of psychosis. Materials and Methods Structural T1-weighted high resolution images were acquired using a 3 Tesla Intera MRI system in 18 UHR subjects, 18 22q11DS subjects, and 24 matched healthy control (HC) subjects. Total cSA, total cGMV, mean CT, and regional vertex-wise differences in CT and LGI were assessed using FreeSurfer software. The Positive and Negative Syndrome Scale was used to assess psychotic symptom severity in UHR and 22q11DS subjects at time of scanning. Results 22q11DS subjects had lower total cSA and total cGMV compared to UHR and HC subjects. The 22q11DS subjects showed bilateral lower LGI in the i) prefrontal cortex, ii) precuneus, iii) precentral gyrus and iv) cuneus compared to UHR subjects. Additionally, lower LGI was found in the left i) fusiform gyrus and right i) pars opercularis, ii) superior, and iii) inferior temporal gyrus in 22q11DS subjects compared to HC. In comparison to 22q11DS subjects, the UHR subjects had lower CT of the insula. For both risk groups, positive symptom severity was negatively correlated to rostral middle frontal gyrus CT. Conclusion A shared negative correlation between positive symptom severity and rostral middle frontal gyrus CT in UHR and 22q11DS may be related to their increased vulnerability to develop a psychotic disorder. 22q11DS subjects were characterised by widespread lower degree of cortical gyrification linked to early and postnatal neurodevelopmental pathology. No implications for early neurodevelopmental pathology were found for the UHR subjects, although they did have distinctively lower insula CT which may have arisen from defective pruning processes during adolescence. Implications of these findings in relation to development of psychotic disorders are in need of further investigation in longitudinal studies.
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Affiliation(s)
- Geor Bakker
- Department of Psychiatry & Psychology, University of Maastricht, Maastricht, The Netherlands
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Matthan W. A. Caan
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Wilhelmina A. M. Vingerhoets
- Department of Psychiatry & Psychology, University of Maastricht, Maastricht, The Netherlands
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Fabiana da Silva- Alves
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Erik Boot
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- The Dalglish Family 22q Clinic, Toronto, Ontario, Canada
| | - Dorien H. Nieman
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Oswald J. Bloemen
- Department of Psychiatry & Psychology, University of Maastricht, Maastricht, The Netherlands
- GGZ Centraal, Center for Mental Health Care Innova, Amersfoort, The Netherlands
| | - Jan Booij
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Thérèse A. M. J. van Amelsvoort
- Department of Psychiatry & Psychology, University of Maastricht, Maastricht, The Netherlands
- Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Ising HK, Kraan TC, Rietdijk J, Dragt S, Klaassen RMC, Boonstra N, Nieman DH, Willebrands-Mendrik M, van den Berg DPG, Linszen DH, Wunderink L, Veling W, Smit F, van der Gaag M. Four-Year Follow-up of Cognitive Behavioral Therapy in Persons at Ultra-High Risk for Developing Psychosis: The Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial. Schizophr Bull 2016; 42:1243-52. [PMID: 26994397 PMCID: PMC4988735 DOI: 10.1093/schbul/sbw018] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [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: 11/13/2022]
Abstract
BACKGROUND Previously, we demonstrated that cognitive behavior therapy for ultra-high risk (called CBTuhr) halved the incidence of psychosis over an 18-month period. Follow-up data from the same study are used to evaluate the longer-term effects at 4 years post-baseline. METHOD The Dutch Early Detection and Intervention Evaluation study was a randomized controlled trial of 196 UHR patients comparing CBTuhr with treatment-as-usual (TAU) for comorbid disorders with TAU only. Of the original 196 patients, 113 consented to a 4-year follow-up (57.7%; CBTuhr = 56 vs TAU = 57). Over the study period, psychosis incidence, remission from UHR status, and the effects of transition to psychosis were evaluated. RESULTS The number of participants in the CBTuhr group making the transition to psychosis increased from 10 at 18-month follow-up to 12 at 4-year follow-up whereas it did not change in the TAU group (n = 22); this still represents a clinically important (incidence rate ratio [IRR] = 12/22 = 0.55) and significant effect (F(1,5) = 8.09, P = .03), favoring CBTuhr. The odds ratio of CBTuhr compared to TAU was 0.44 (95% CI: 0.24-0.82) and the number needed to treat was 8. Moreover, significantly more patients remitted from their UHR status in the CBTuhr group (76.3%) compared with the TAU group (58.7%) [t(120) = 2.08, P = .04]. Importantly, transition to psychosis was associated with more severe psychopathology and social functioning at 4-year follow-up. CONCLUSIONS CBTuhr to prevent a first episode of psychosis in persons at UHR of developing psychosis is still effective at 4-year follow-up. Our data also show that individuals meeting the formal criteria of a psychotic disorder have worse functional and social outcomes compared with non-transitioned cases. TRIAL REGISTRATION The trial is registered at Current Controlled Trials as trial number ISRCTN21353122 (http://controlled-trials.com/ISRCTN21353122/gaag).
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Affiliation(s)
- Helga K. Ising
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands;,*To whom correspondence should be addressed; Department of Psychosis Research, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512HN The Hague, The Netherlands; tel: +31-88-3576549, fax: +31-88-3576554, e-mail:
| | - Tamar C. Kraan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Judith Rietdijk
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands;,Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Sara Dragt
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Rianne M. C. Klaassen
- Child and Adolescent Department, University Medical Center, Utrecht, The Netherlands
| | - Nynke Boonstra
- Department of Research and Education, Friesland Mental Health Services, Leeuwarden, The Netherlands
| | - Dorien H. Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | | | | | - Don H. Linszen
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Lex Wunderink
- Department of Research and Education, Friesland Mental Health Services, Leeuwarden, The Netherlands
| | - Wim Veling
- Department of Psychiatry, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Filip Smit
- Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands;,Department of Public Mental Health, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands;,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands;,Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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40
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Bakker G, Caan MWA, Schluter RS, Bloemen OJN, da Silva-Alves F, de Koning MB, Boot E, Vingerhoets WAM, Nieman DH, de Haan L, Booij J, van Amelsvoort TAMJ. Distinct white-matter aberrations in 22q11.2 deletion syndrome and patients at ultra-high risk for psychosis. Psychol Med 2016; 46:2299-2311. [PMID: 27193339 DOI: 10.1017/s0033291716000970] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Patients with a deletion at chromosome 22q11.2 (22q11DS) have 30% lifetime risk of developing a psychosis. People fulfilling clinical criteria for ultra-high risk (UHR) for psychosis have 30% risk of developing a psychosis within 2 years. Both high-risk groups show white-matter (WM) abnormalities in microstructure and volume compared to healthy controls (HC), which have been related to psychotic symptoms. Comparisons of WM pathology between these two groups may specify WM markers related to genetic and clinical risk factors. METHOD Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) were assessed using diffusion tensor magnetic resonance imaging (MRI), and WM volume with structural MRI, in 23 UHR patients, 21 22q11DS patients, and 33 HC. RESULTS Compared to UHR patients 22q11DS patients had (1) lower AD and RD in corpus callosum (CC), cortical fasciculi, and anterior thalamic radiation (ATR), (2) higher FA in CC and ATR, and (3) lower occipital and superior temporal gyrus WM volume. Compared to HC, 22q11DS patients had (1) lower AD and RD throughout cortical fasciculi and (2) higher FA in ATR, CC and inferior fronto-occipital fasciculus. Compared to HC, UHR patients had (1) higher mean MD, RD, and AD in CC, ATR and cortical fasciculi, (2) no differences in FA. CONCLUSIONS UHR and 22q11DS patients share a susceptibility for developing psychosis yet were characterized by distinct patterns of WM alterations relative to HC. While UHR patients were typified by signs suggestive of aberrant myelination, 22q11DS subjects showed signs suggestive of lower axonal integrity.
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Affiliation(s)
- G Bakker
- Department of Psychiatry & Psychology,University of Maastricht,The Netherlands
| | - M W A Caan
- Department of Radiology,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - R S Schluter
- Department of Radiology,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - O J N Bloemen
- Department of Psychiatry & Psychology,University of Maastricht,The Netherlands
| | - F da Silva-Alves
- Department of Psychiatry,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - M B de Koning
- Department of Psychiatry,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - E Boot
- Department of Nuclear Medicine,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - W A M Vingerhoets
- Department of Psychiatry & Psychology,University of Maastricht,The Netherlands
| | - D H Nieman
- Department of Psychiatry,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - L de Haan
- Department of Psychiatry,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
| | - J Booij
- Department of Nuclear Medicine,Academic Medical Center, University of Amsterdam,Amsterdam,The Netherlands
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Ising HK, Ruhrmann S, Burger NAFM, Rietdijk J, Dragt S, Klaassen RMC, van den Berg DPG, Nieman DH, Boonstra N, Linszen DH, Wunderink L, Smit F, Veling W, van der Gaag M. Development of a stage-dependent prognostic model to predict psychosis in ultra-high-risk patients seeking treatment for co-morbid psychiatric disorders. Psychol Med 2016; 46:1839-1851. [PMID: 26979398 DOI: 10.1017/s0033291716000325] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Current ultra-high-risk (UHR) criteria appear insufficient to predict imminent onset of first-episode psychosis, as a meta-analysis showed that about 20% of patients have a psychotic outcome after 2 years. Therefore, we aimed to develop a stage-dependent predictive model in UHR individuals who were seeking help for co-morbid disorders. METHOD Baseline data on symptomatology, and environmental and psychological factors of 185 UHR patients (aged 14-35 years) participating in the Dutch Early Detection and Intervention Evaluation study were analysed with Cox proportional hazard analyses. RESULTS At 18 months, the overall transition rate was 17.3%. The final predictor model included five variables: observed blunted affect [hazard ratio (HR) 3.39, 95% confidence interval (CI) 1.56-7.35, p < 0.001], subjective complaints of impaired motor function (HR 5.88, 95% CI 1.21-6.10, p = 0.02), beliefs about social marginalization (HR 2.76, 95% CI 1.14-6.72, p = 0.03), decline in social functioning (HR 1.10, 95% CI 1.01-1.17, p = 0.03), and distress associated with suspiciousness (HR 1.02, 95% CI 1.00-1.03, p = 0.01). The positive predictive value of the model was 80.0%. The resulting prognostic index stratified the general risk into three risk classes with significantly different survival curves. In the highest risk class, transition to psychosis emerged on average ⩾8 months earlier than in the lowest risk class. CONCLUSIONS Predicting a first-episode psychosis in help-seeking UHR patients was improved using a stage-dependent prognostic model including negative psychotic symptoms (observed flattened affect, subjective impaired motor functioning), impaired social functioning and distress associated with suspiciousness. Treatment intensity may be stratified and personalized using the risk stratification.
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Affiliation(s)
- H K Ising
- Department of Psychiatry,Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - S Ruhrmann
- Department of Psychiatry and Psychotherapy,University of Cologne,Cologne,Germany
| | - N A F M Burger
- Department of Psychiatry,Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - J Rietdijk
- Department of Psychiatry,Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - S Dragt
- Department of Psychiatry,Academic Medical Center,Amsterdam,The Netherlands
| | - R M C Klaassen
- Child and Adolescent Department,University Medical Centre,Utrecht,The Netherlands
| | - D P G van den Berg
- Department of Psychiatry,Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - D H Nieman
- Department of Psychiatry,Academic Medical Center,Amsterdam,The Netherlands
| | - N Boonstra
- Department of Education and Research,GGZ Friesland,Leeuwarden,The Netherlands
| | - D H Linszen
- Department of Psychiatry,Academic Medical Center,Amsterdam,The Netherlands
| | - L Wunderink
- Department of Education and Research,GGZ Friesland,Leeuwarden,The Netherlands
| | - F Smit
- VU University and EMGO+, Institute of Health and Care Research,Amsterdam,The Netherlands
| | - W Veling
- Department of Psychiatry,University Medical Center Groningen and University of Groningen,Groningen,The Netherlands
| | - M van der Gaag
- Department of Psychiatry,Parnassia Psychiatric Institute,The Hague,The Netherlands
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Fusar-Poli P, Cappucciati M, Borgwardt S, Woods SW, Addington J, Nelson B, Nieman DH, Stahl DR, Rutigliano G, Riecher-Rössler A, Simon AE, Mizuno M, Lee TY, Kwon JS, Lam MML, Perez J, Keri S, Amminger P, Metzler S, Kawohl W, Rössler W, Lee J, Labad J, Ziermans T, An SK, Liu CC, Woodberry KA, Braham A, Corcoran C, McGorry P, Yung AR, McGuire PK. Heterogeneity of Psychosis Risk Within Individuals at Clinical High Risk: A Meta-analytical Stratification. JAMA Psychiatry 2016; 73:113-20. [PMID: 26719911 DOI: 10.1001/jamapsychiatry.2015.2324] [Citation(s) in RCA: 292] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IMPORTANCE Individuals can be classified as being at clinical high risk (CHR) for psychosis if they meet at least one of the ultra-high-risk (UHR) inclusion criteria (brief limited intermittent psychotic symptoms [BLIPS] and/or attenuated psychotic symptoms [APS] and/or genetic risk and deterioration syndrome [GRD]) and/or basic symptoms [BS]. The meta-analytical risk of psychosis of these different subgroups is still unknown. OBJECTIVE To compare the risk of psychosis in CHR individuals who met at least one of the major inclusion criteria and in individuals not at CHR for psychosis (CHR-). DATA SOURCES Electronic databases (Web of Science, MEDLINE, Scopus) were searched until June 18, 2015, along with investigation of citations of previous publications and a manual search of the reference lists of retrieved articles. STUDY SELECTION We included original follow-up studies of CHR individuals who reported the risk of psychosis classified according to the presence of any BLIPS, APS and GRD, APS alone, GRD alone, BS, and CHR-. DATA EXTRACTION AND SYNTHESIS Independent extraction by multiple observers and random-effects meta-analysis of proportions. Moderators were tested with meta-regression analyses (Bonferroni corrected). Heterogeneity was assessed with the I2 index. Sensitivity analyses tested robustness of results. Publication biases were assessed with funnel plots and the Egger test. MAIN OUTCOMES AND MEASURES The proportion of each subgroup with any psychotic disorder at 6, 12, 24, 36, and 48 or more months of follow-up. RESULTS Thirty-three independent studies comprising up to 4227 individuals were included. The meta-analytical proportion of individuals meeting each UHR subgroup at intake was: 0.85 APS (95%CI, 0.79-0.90), 0.1 BLIPS (95%CI, 0.06-0.14), and 0.05 GRD (95%CI, 0.03-0.07). There were no significant differences in psychosis risk at any time point between the APS and GRD and the APS-alone subgroups. There was a higher risk of psychosis in the any BLIPS greater than APS greater than GRD-alone subgroups at 24, 36, and 48 or more months of follow-up. There was no evidence that the GRD subgroup has a higher risk of psychosis than the CHR- subgroup. There were too few BS or BS and UHR studies to allow robust conclusions. CONCLUSIONS AND RELEVANCE There is meta-analytical evidence that BLIPS represents separate risk subgroup compared with the APS. The GRD subgroup is infrequent and not associated with an increased risk of psychosis. Future studies are advised to stratify their findings across these different subgroups. The CHR guidelines should be updated to reflect these differences.
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Affiliation(s)
- Paolo Fusar-Poli
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, United Kingdom2OASIS Clinic, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Marco Cappucciati
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, United Kingdom3Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Barnaby Nelson
- Orygen, the National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Daniel R Stahl
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, United Kingdom
| | - Grazia Rutigliano
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, United Kingdom
| | | | - Andor E Simon
- University of Basel Psychiatric Clinics, Basel, Switzerland9Specialized Early Psychosis Outpatient Service for Adolescents and Young Adults, Department of Psychiatry, Bruderholz, Switzerland
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Tae Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - May M L Lam
- Kwai Chung Hospital, New Territories, Hong Kong, People's Republic of China
| | - Jesus Perez
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Szabolcs Keri
- Nyiro Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Paul Amminger
- Orygen, the National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Sibylle Metzler
- Centre for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Wolfram Kawohl
- Centre for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Centre for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Jimmy Lee
- Department of General Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Javier Labad
- Department of Psychiatry, Corporacio Sanitaria Parc Tauli Sabadell, Barcelona, Spain
| | - Tim Ziermans
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, the Netherlands
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kristen A Woodberry
- Center for Psychiatric Research, Maine Medical Center, Portland, Maine22Departments of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Amel Braham
- Psychiatry Department, University Hospital Farhat Hached, Sousse, Tunisia
| | - Cheryl Corcoran
- Department of Psychiatry, Columbia University, New York, New York
| | - Patrick McGorry
- Orygen, the National Centre of Excellence in Youth Mental Health, and Centre for Youth Mental Health, the University of Melbourne, Parkville, Australia
| | - Alison R Yung
- Institute of Brain, Behaviour and Mental Health, University of Manchester, and Greater Manchester West National Health Service Mental Health Foundation Trust, Manchester, United Kingdom
| | - Philip K McGuire
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, United Kingdom
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Kraan T, van Dam DS, Velthorst E, de Ruigh EL, Nieman DH, Durston S, Schothorst P, van der Gaag M, de Haan L. Childhood trauma and clinical outcome in patients at ultra-high risk of transition to psychosis. Schizophr Res 2015; 169:193-198. [PMID: 26585219 DOI: 10.1016/j.schres.2015.10.030] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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] [Received: 07/14/2015] [Revised: 10/14/2015] [Accepted: 10/20/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although transition rates in 'ultra-high risk' (UHR) for psychosis samples are declining, many young individuals at UHR still experience attenuated positive symptoms and impaired functioning at follow-up. The present study examined the association between a history of childhood trauma and transition to psychosis, and symptomatic and functional outcome, in UHR patients. METHOD Data on childhood trauma were available for 125 UHR individuals. Cox regression and linear regression analyses were used to determine the association between childhood trauma, and clinical and functional outcome, during the 24-month follow-up. RESULTS Of the 125 UHR subjects 26 individuals (20.8%) transitioned to psychosis within 24 months. Childhood trauma did not predict transition to psychosis. However, at 24-month follow-up, UHR patients with higher levels of childhood trauma had higher levels of attenuated positive symptoms (b = 0.34, t = 2.925, p < 0.01), general symptoms (b = 0.29, t = 2.707, p < 0.01) and depression (b = 0.32, t = 2.929, p < 0.01) and lower levels of global functioning (b = − 0.33, t = − 2.853, p = 0.01). Childhood trauma was not significantly associated with a differential course of symptoms over time, although in those with higher levels of childhood trauma, attenuated positive symptoms were more persistent at a trend level. CONCLUSIONS Our results suggest that childhood trauma may contribute to a shared vulnerability for several psychopathological domains.
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Affiliation(s)
- Tamar Kraan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands.
| | - Daniella S van Dam
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands; Department of Psychiatry, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands; Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Esther L de Ruigh
- Department of Psychiatry, VU University Medical Center Amsterdam, the Netherlands
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Sarah Durston
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Patricia Schothorst
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University, Amsterdam, the Netherlands; Department of Psychiatry, Parnassia Psychiatric Institute, The Hague, the Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
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44
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Nieman DH, McGorry PD. Detection and treatment of at-risk mental state for developing a first psychosis: making up the balance. Lancet Psychiatry 2015; 2:825-34. [PMID: 26360901 DOI: 10.1016/s2215-0366(15)00221-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/02/2015] [Accepted: 05/01/2015] [Indexed: 12/26/2022]
Abstract
The at-risk mental state (ARMS) has been substantially researched and used as the basis for new clinical settings and strategies over the past two decades. However, it has also caused controversy and intense debate. In this Review, we assess available evidence and propose future directions. Accumulating research suggests that a blend of clinical staging and profiling, which naturally incorporates ARMS, might be a better guide for treatment of patients in different stages of psychiatric illness than the categorical DSM and ICD systems. Furthermore, clinical staging, with its emphasis on balancing risks and benefits, could help to prevent premature treatment or overtreatment with psychotropic drugs. Meta-analyses and reviews show that treatment of ARMS leads to a significant reduction in transition rate to a first psychosis. The debate about stigma associated with ARMS is based on scarce published work. The few studies that have been done suggest that stigma (including self-stigma) arises largely from negative societal views on psychiatric disorders and, depending on the setting and approach, not from engagement in treatment for ARMS per se. The evidence base suggests that definition of ARMS is an important step in implementation of clinical staging and profiling in psychiatry. However, more research across traditional diagnostic boundaries is needed to refine these clinical phenotypes and link them to biomarkers with the goal of personalised stepwise care. Health-system reform is overdue and a parallel process to support this approach is needed, which is similar to how physical forms of non-communicable disease are treated.
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Affiliation(s)
- Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
| | - Patrick D McGorry
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
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45
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Ising HK, Smit F, Veling W, Rietdijk J, Dragt S, Klaassen RMC, Savelsberg NSP, Boonstra N, Nieman DH, Linszen DH, Wunderink L, van der Gaag M. Cost-effectiveness of preventing first-episode psychosis in ultra-high-risk subjects: multi-centre randomized controlled trial. Psychol Med 2015; 45:1435-1446. [PMID: 25330734 DOI: 10.1017/s0033291714002530] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Although there is evidence for the effectiveness of interventions for psychosis among ultra-high-risk (UHR) groups, health economic evaluations are lacking. This study aimed to determine the cost effectiveness and cost-utility of cognitive-behavioural therapy (CBT) to prevent first-episode psychosis. METHOD The Dutch Early Detection and Intervention Evaluation study was a randomized controlled trial of 196 UHR patients with an 18-month follow-up. All participants were treated with routine care (RC) for non-psychotic disorders. The experimental group (n = 95) received add-on CBT to prevent first-episode psychosis. We report the intervention, medical and travel costs, as well as costs arising from loss of productivity. Treatment response was defined as psychosis-free survival and quality-adjusted life years (QALYs) gained. RESULTS In the cost-effectiveness analysis, the proportion of averted psychoses was significantly higher in the CBT condition (89.5% v. 76.2%). CBT showed a 63.7% probability of being more cost effective, because it was less costly than RC by US$844 (£551) per prevented psychosis. In the cost-utility analysis, QALY health gains were slightly higher for CBT than for RC (0.60 v. 0.57) and the CBT intervention had a 52.3% probability of being the superior treatment because, for equal or better QALY gains, the costs of CBT were lower than those of RC. CONCLUSIONS Add-on preventive CBT for UHR resulted in a significant reduction in the incidence of first psychosis. QALY gains show little difference between the two conditions. The CBT intervention proved to be cost saving.
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Affiliation(s)
- H K Ising
- Department of Psychosis Research,Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - F Smit
- Department of Clinical Psychology,VU University and EMGO Institute for Health and Care Research,Amsterdam,The Netherlands
| | - W Veling
- Department of Psychiatry,University Medical Center Groningen,Groningen,The Netherlands
| | - J Rietdijk
- Department of Early Psychosis,Dijk en Duin Psychiatric Institute,Castricum,The Netherlands
| | - S Dragt
- Department of Psychiatry,Academic Medical Center,Amsterdam,The Netherlands
| | - R M C Klaassen
- Department of Child and Adolescent Psychiatry,GGZ Rivierduinen,Leiden,The Netherlands
| | - N S P Savelsberg
- Department of Psychosis Research,Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - N Boonstra
- Department of Research and Education,Friesland Mental Health Services,Leeuwarden,The Netherlands
| | - D H Nieman
- Department of Psychiatry,Academic Medical Center,Amsterdam,The Netherlands
| | - D H Linszen
- Department of Psychiatry,Academic Medical Center,Amsterdam,The Netherlands
| | - L Wunderink
- Department of Research and Education,Friesland Mental Health Services,Leeuwarden,The Netherlands
| | - M van der Gaag
- Department of Psychosis Research,Parnassia Psychiatric Institute,The Hague,The Netherlands
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46
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Nieman DH. New treatments for psychotic disorders. Lancet Psychiatry 2015; 2:282-3. [PMID: 26360061 DOI: 10.1016/s2215-0366(15)00093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 02/17/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam 1105AZ, Netherlands.
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47
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Velthorst E, Koeter M, van der Gaag M, Nieman DH, Fett AKJ, Smit F, Staring ABP, Meijer C, de Haan L. Adapted cognitive-behavioural therapy required for targeting negative symptoms in schizophrenia: meta-analysis and meta-regression. Psychol Med 2015; 45:453-465. [PMID: 24993642 DOI: 10.1017/s0033291714001147] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is an increasing interest in cognitive-behavioural therapy (CBT) interventions targeting negative symptoms in schizophrenia. To date, CBT trials primarily focused on positive symptoms and investigated change in negative symptoms only as a secondary outcome. To enhance insight into factors contributing to improvement of negative symptoms, and to identify subgroups of patients that may benefit most from CBT directed at ameliorating negative symptoms, we reviewed all available evidence on these outcomes. METHOD A systematic search of the literature was conducted in PsychInfo, PubMed and the Cochrane register to identify randomized controlled trials reporting on the impact of CBT interventions on negative symptoms in schizophrenia. Random-effects meta-analyses were performed on end-of-treatment, short-term and long-term changes in negative symptoms. RESULTS A total of 35 publications covering 30 trials in 2312 patients, published between 1993 and 2013, were included. Our results showed studies' pooled effect on symptom alleviation to be small [Hedges' g = 0.093, 95% confidence interval (CI) -0.028 to 0.214, p = 0.130] and heterogeneous (Q = 73.067, degrees of freedom = 29, p < 0.001, τ 2 = 0.081, I 2 = 60.31) in studies with negative symptoms as a secondary outcome. Similar results were found for studies focused on negative symptom reduction (Hedges' g = 0.157, 95% CI -0.10 to 0.409, p = 0.225). Meta-regression revealed that stronger treatment effects were associated with earlier year of publication, lower study quality and with CBT provided individually (as compared with group-based). CONCLUSIONS The co-occurring beneficial effect of conventional CBT on negative symptoms found in older studies was not supported by more recent studies. It is now necessary to further disentangle effective treatment ingredients of older studies in order to guide the development of future CBT interventions aimed at negative symptom reduction.
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Affiliation(s)
- E Velthorst
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - M Koeter
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - M van der Gaag
- Parnassia Psychiatric Institute,The Hague,The Netherlands
| | - D H Nieman
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - A-K J Fett
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - F Smit
- Department of Clinical Psychology, EMGO Institute for Health and Care Research,VU University,Amsterdam,The Netherlands
| | - A B P Staring
- Altrecht Psychiatric Institute,Utrecht,The Netherlands
| | - C Meijer
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
| | - L de Haan
- Academic Medical Center,Department of Psychiatry, Amsterdam,The Netherlands
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48
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van Tricht MJ, Nieman DH, Koelman JTM, Mensink AJM, Bour LJ, van der Meer JN, van Amelsvoort TA, Linszen DH, de Haan L. Sensory gating in subjects at ultra high risk for developing a psychosis before and after a first psychotic episode. World J Biol Psychiatry 2015; 16:12-21. [PMID: 22730901 DOI: 10.3109/15622975.2012.680911] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 11/13/2022]
Abstract
OBJECTIVES To explore sensory gating deficits in subjects at Ultra High Risk (UHR) for psychosis before and after transition to a first psychotic episode. METHODS Sensory gating was assessed with the paired click paradigm in 61 UHR subjects, of whom 18 (30%) made a transition to psychosis (UHR + T) over a 3-year follow-up period and 28 matched healthy controls. Subjects were assessed at inclusion and again after approximately 18 months. P50, N100 (N1) and P200 (P2) sensory gating was established using the amplitude on the first (S1) and second (S2) click, the ratio- (S2/S1) and the difference score (S1-S2). Psychopathology was also assessed. RESULTS At baseline, UHR + T subjects presented smaller N1 difference scores compared to UHR + NT subjects and controls. The N1 difference score contributed modestly to the prediction of a first psychotic episode. Repeated measure analyses revealed smaller N1 and P2 S1 amplitudes, smaller P2 difference scores and larger P2 ratio's at follow-up compared to baseline in UHR + T subjects. CONCLUSION The N1 difference score may be helpful in predicting a first psychosis. N1 and P2 sensory gating measures also showed alterations between the prodromal phase and the first psychosis, suggesting that these changes may relate to the onset of a frank psychotic episode.
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Abstract
BACKGROUND Deep brain stimulation (DBS) is a promising new treatment for patients with treatment-refractory obsessive-compulsive disorder (OCD). However, since most DBS patients only show a partial response, the treatment still needs to be improved. In this study we hypothesized that cognitive-behavioural therapy (CBT) could optimize the post-operative management in DBS and we evaluated the efficacy of CBT as augmentation to DBS targeted at the nucleus accumbens. METHOD A total of 16 patients with treatment-refractory OCD were treated with DBS targeted at the nucleus accumbens. After stabilization of decline in OCD symptoms, a standardized 24-week CBT treatment programme was added to DBS in an open-phase trial of 8 months. Changes in obsessive-compulsive, anxiety and depressive symptoms were evaluated using the Yale-Brown Obsessive Compulsive Scale, Hamilton Anxiety Scale and Hamilton Rating Scale for Depression. RESULTS Following the addition of CBT to DBS, a significant decrease in obsessive-compulsive symptoms was observed, but not in anxiety and depressive symptoms. In a subsequent double-blind phase, in which stimulation was discontinued, OCD symptoms returned to baseline (relapse) and anxiety and depressive symptoms worsened (rebound) compared with baseline. CONCLUSIONS The results of this explorative study suggest that a combined treatment of accumbens DBS and CBT may be optimal for improving obsessive-compulsive symptoms in treatment-refractory OCD. However, a subsequent randomized controlled trial is necessary to draw firm conclusions. It seems that DBS results in affective changes that may be required to enable response prevention in CBT. This may indicate that DBS and CBT act as two complementary treatments.
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Affiliation(s)
- M Mantione
- Department of Psychiatry, Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - D H Nieman
- Department of Psychiatry, Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - M Figee
- Department of Psychiatry, Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
| | - D Denys
- Department of Psychiatry, Academic Medical Center,University of Amsterdam,Amsterdam,The Netherlands
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50
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van Tricht MJ, Bour LJ, Koelman JHTM, Derks EM, Braff DL, de Wilde OM, Boerée T, Linszen DH, de Haan L, Nieman DH. Qualitative and quantitative aspects of information processing in first psychosis: latent class analyses in patients, at-risk subjects, and controls. Psychophysiology 2014; 52:585-93. [PMID: 25376718 DOI: 10.1111/psyp.12379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 09/18/2014] [Indexed: 11/28/2022]
Abstract
We aimed to determine profiles of information processing deficits in the pathway to first psychosis. Sixty-one subjects at ultrahigh risk (UHR) for psychosis were assessed, of whom 18 converted to a first episode of psychosis (FEP) within the follow-up period. Additionally, 47 FEP and 30 control subjects were included. Using 10 neurophysiological parameters associated with information processing, latent class analyses yielded three classes at baseline. Class membership was related to group status. Within the UHR sample, two classes were found. Transition to psychosis was nominally associated with class membership. Neurophysiological profiles were unstable over time, but associations between specific neurophysiological components at baseline and follow-up were found. We conclude that certain constellations of neurophysiological variables aid in the differentiation between controls and patients in the prodrome and after first psychosis.
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Affiliation(s)
- Mirjam J van Tricht
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; Department of Neurology and Clinical Neurophysiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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