Importance: There is urgent need to improve the limited prognostic accuracy of clinical instruments to predict psychosis onset in individuals at clinical high risk (CHR) for psychosis. As yet, no reliable biological marker has been established to delineate CHR individuals who will develop psychosis from those who will not.
Objectives: To investigate abnormalities in a graph-based gyrification connectome in the early stages of psychosis and to test the accuracy of this systems-based approach to predict a transition to psychosis among CHR individuals.
Design, Setting, And Participants: This investigation was a cross-sectional magnetic resonance imaging (MRI) study with follow-up assessment to determine the transition status of CHR individuals. Participants were recruited from a specialized clinic for the early detection of psychosis at the Department of Psychiatry (Universitäre Psychiatrische Kliniken [UPK]), University of Basel, Basel, Switzerland. Participants included individuals in the following 4 study groups: 44 healthy controls (HC group), 63 at-risk mental state (ARMS) individuals without later transition to psychosis (ARMS-NT group), 16 ARMS individuals with later transition to psychosis (ARMS-T group), and 38 antipsychotic-free patients with first-episode psychosis (FEP group). The study dates were November 2008 to November 2014. The dates of analysis were March to November 2017.
Main Outcomes And Measures: Gyrification-based structural covariance networks (connectomes) were constructed to quantify global integration, segregation, and small-worldness. Group differences in network measures were assessed using functional data analysis across a range of network densities. The extremely randomized trees algorithm with repeated 5-fold cross-validation was used to delineate ARMS-T individuals from ARMS-NT individuals. Permutation tests were conducted to assess the significance of classification performance measures.
Results: The 4 study groups comprised 161 participants with mean (SD) ages ranging from 24.0 (4.7) to 25.9 (5.7) years. Small-worldness was reduced in the ARMS-T and FEP groups and was associated with decreased integration and increased segregation in both groups (Hedges g range, 0.666-1.050). Using the connectome properties as features, a good classification performance was obtained (accuracy, 90.49%; balanced accuracy, 81.34%; positive predictive value, 84.47%; negative predictive value, 92.18%; sensitivity, 66.11%; specificity, 96.58%; and area under the curve, 88.30%).
Conclusions And Relevance: These findings suggest that there is poor integration in the coordinated development of cortical folding in patients who develop psychosis. These results further suggest that gyrification-based connectomes might be a promising means to generate systems-based measures from anatomical data to improve individual prediction of a transition to psychosis in CHR individuals.
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http://dx.doi.org/10.1001/jamapsychiatry.2018.0391 | DOI Listing |
Early Interv Psychiatry
February 2025
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Aim: Studies have shown that people experiencing early phase psychosis (EPP) are at increased risk for criminal conviction and incarceration. However, there is limited data looking at overall legal burden. To address these gaps in the literature, the goal of this study was to categorise criminal charges and convictions using the United States Federal Bureau of Investigation (FBI) uniform crime reporting (UCR) program, assess frequency of incarcerations, and describe the frequency of substance use disorder (SUD) diagnoses and its relationship to criminal offending and incarceration in a well categorised EPP population.
View Article and Find Full Text PDFBMJ Open
January 2025
The Third People's Hospital of Zhuhai, Zhuhai, Guangdong, China
Objectives: To explore the factors influencing medication adherence and the medication needs of patients with schizophrenia when living in a community in China.
Design: A qualitative study.
Setting: Community and psychiatric ward in Zhuhai city, Guangdong province.
Background: Young people face high rates of mental health issues, yet many do not seek professional help. In 2017, CHAT launched webCHAT - a free, anonymous, one-on-one synchronous web-based text service managed by case managers (CMs) to support young people aged 16 to 30 who may be hesitant about engaging in face-to-face mental health services.
Objective: This study aimed to explore the perspectives and experiences of users who accessed webCHAT for mental health support in Singapore.
Int J Psychiatry Clin Pract
January 2025
Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
Objective: The first-episode psychosis (FEP) and clinical high-risk (CHR) team within the child and adolescent mental health (CAMH) service receives referrals by psychiatric units, CAMH service, schools, and general practitioners. This audit evaluated the implementation of the FEP-CHR team in Ferrara, Italy.
Methods: The FEP-CHR team provides standardised assessment and up to 2-year individualised treatment including pharmacological prescription, cognitive-behavioral psychotherapy, and vocational activities.
Psychol Med
January 2025
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Background: Recent stressful life events (SLE) are a risk factor for psychosis, but limited research has explored how SLEs affect individuals at clinical high risk (CHR) for psychosis. The current study investigated the longitudinal effects of SLEs on functioning and symptom severity in CHR individuals, where we hypothesized CHR would report more SLEs than healthy controls (HC), and SLEs would be associated with poorer outcomes.
Methods: The study used longitudinal data from the EU-GEI High Risk study.
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