Multimodal prognosis of negative symptom severity in individuals at increased risk of developing psychosis

The PRONIA Group

doi:10.1038/s41398-021-01409-4

Multimodal prognosis of negative symptom severity in individuals at increased risk of developing psychosis

The PRONIA Group

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Abstract

Negative symptoms occur frequently in individuals at clinical high risk (CHR) for psychosis and contribute to functional impairments. The aim of this study was to predict negative symptom severity in CHR after 9 months. Predictive models either included baseline negative symptoms measured with the Structured Interview for Psychosis-Risk Syndromes (SIPS-N), whole-brain gyrification, or both to forecast negative symptoms of at least moderate severity in 94 CHR. We also conducted sequential risk stratification to stratify CHR into different risk groups based on the SIPS-N and gyrification model. Additionally, we assessed the models’ ability to predict functional outcomes in CHR and their transdiagnostic generalizability to predict negative symptoms in 96 patients with recent-onset psychosis (ROP) and 97 patients with recent-onset depression (ROD). Baseline SIPS-N and gyrification predicted moderate/severe negative symptoms with significant balanced accuracies of 68 and 62%, while the combined model achieved 73% accuracy. Sequential risk stratification stratified CHR into a high (83%), medium (40–64%), and low (19%) risk group regarding their risk of having moderate/severe negative symptoms at 9 months follow-up. The baseline SIPS-N model was also able to predict social (61%), but not role functioning (59%) at above-chance accuracies, whereas the gyrification model achieved significant accuracies in predicting both social (76%) and role (74%) functioning in CHR. Finally, only the baseline SIPS-N model showed transdiagnostic generalization to ROP (63%). This study delivers a multimodal prognostic model to identify those CHR with a clinically relevant negative symptom severity and functional impairments, potentially requiring further therapeutic consideration.

Original language	English
Article number	312
Number of pages	11
Journal	Translational Psychiatry
Volume	11
Issue number	1
Early online date	24 May 2021
DOIs	https://doi.org/10.1038/s41398-021-01409-4
Publication status	Published - Jun 2021

Bibliographical note

Funding Information:
This work was funded by the European Union under the 7th Framework Programme (grant number 602152). D.J.H.’s work was supported by the Swiss National Science Foundation (Ambizione grant; grant number 167952). J.R.’s work was supported by Miguel Servet Research Contract (CPII19/00009) and Research Projects PI19/00394 from the Plan Nacional de I + D + i, the Instituto de Salud Carlos III-Subdirección General de Evaluación y Fomento de la Investigación and the European Regional Development Fund (FEDER, ‘Investing in your future’). R.S. received honoraria for one lecture from Lundbeck outside the submitted work and funding from BMBF and the Max Planck Society. C.P. has received honoraria for talks at educational meetings and has served on an advisory board for Lundbeck, Australia Pty Ltd, and was supported by a National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship (1105825), an NHMRC L3 Investigator Grant (1196508), and NHMRC-EU Grant (ID: 1075379). The remaining authors declare no competing interests.

Publisher Copyright:
© 2021, The Author(s).

ASJC Scopus subject areas

Psychiatry and Mental health
Cellular and Molecular Neuroscience
Biological Psychiatry

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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HaukeD2021MultimodalFinal published version, 1.03 MBLicence: Creative Commons: Attribution (CC BY)

Cite this

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title = "Multimodal prognosis of negative symptom severity in individuals at increased risk of developing psychosis",

abstract = "Negative symptoms occur frequently in individuals at clinical high risk (CHR) for psychosis and contribute to functional impairments. The aim of this study was to predict negative symptom severity in CHR after 9 months. Predictive models either included baseline negative symptoms measured with the Structured Interview for Psychosis-Risk Syndromes (SIPS-N), whole-brain gyrification, or both to forecast negative symptoms of at least moderate severity in 94 CHR. We also conducted sequential risk stratification to stratify CHR into different risk groups based on the SIPS-N and gyrification model. Additionally, we assessed the models{\textquoteright} ability to predict functional outcomes in CHR and their transdiagnostic generalizability to predict negative symptoms in 96 patients with recent-onset psychosis (ROP) and 97 patients with recent-onset depression (ROD). Baseline SIPS-N and gyrification predicted moderate/severe negative symptoms with significant balanced accuracies of 68 and 62%, while the combined model achieved 73% accuracy. Sequential risk stratification stratified CHR into a high (83%), medium (40–64%), and low (19%) risk group regarding their risk of having moderate/severe negative symptoms at 9 months follow-up. The baseline SIPS-N model was also able to predict social (61%), but not role functioning (59%) at above-chance accuracies, whereas the gyrification model achieved significant accuracies in predicting both social (76%) and role (74%) functioning in CHR. Finally, only the baseline SIPS-N model showed transdiagnostic generalization to ROP (63%). This study delivers a multimodal prognostic model to identify those CHR with a clinically relevant negative symptom severity and functional impairments, potentially requiring further therapeutic consideration.",

author = "{The PRONIA Group} and Hauke, {Daniel J.} and Andr{\'e} Schmidt and Erich Studerus and Christina Andreou and Anita Riecher-R{\"o}ssler and Joaquim Radua and Joseph Kambeitz and Anne Ruef and Dwyer, {Dominic B.} and Lana Kambeitz-Ilankovic and Theresa Lichtenstein and Rachele Sanfelici and Nora Penzel and Haas, {Shalaila S.} and Antonucci, {Linda A.} and Lalousis, {Paris Alexandros} and Katharine Chisholm and Frauke Schultze-Lutter and Stephan Ruhrmann and Jarmo Hietala and Paolo Brambilla and Nikolaos Koutsouleris and Eva Meisenzahl and Christos Pantelis and Marlene Rosen and Salokangas, {Raimo K.R.} and Rachel Upthegrove and Wood, {Stephen J.} and Stefan Borgwardt",

note = "Funding Information: This work was funded by the European Union under the 7th Framework Programme (grant number 602152). D.J.H.{\textquoteright}s work was supported by the Swiss National Science Foundation (Ambizione grant; grant number 167952). J.R.{\textquoteright}s work was supported by Miguel Servet Research Contract (CPII19/00009) and Research Projects PI19/00394 from the Plan Nacional de I + D + i, the Instituto de Salud Carlos III-Subdirecci{\'o}n General de Evaluaci{\'o}n y Fomento de la Investigaci{\'o}n and the European Regional Development Fund (FEDER, {\textquoteleft}Investing in your future{\textquoteright}). R.S. received honoraria for one lecture from Lundbeck outside the submitted work and funding from BMBF and the Max Planck Society. C.P. has received honoraria for talks at educational meetings and has served on an advisory board for Lundbeck, Australia Pty Ltd, and was supported by a National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship (1105825), an NHMRC L3 Investigator Grant (1196508), and NHMRC-EU Grant (ID: 1075379). The remaining authors declare no competing interests. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = jun,

doi = "10.1038/s41398-021-01409-4",

language = "English",

volume = "11",

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T1 - Multimodal prognosis of negative symptom severity in individuals at increased risk of developing psychosis

AU - The PRONIA Group

AU - Hauke, Daniel J.

AU - Schmidt, André

AU - Studerus, Erich

AU - Andreou, Christina

AU - Riecher-Rössler, Anita

AU - Radua, Joaquim

AU - Kambeitz, Joseph

AU - Ruef, Anne

AU - Dwyer, Dominic B.

AU - Kambeitz-Ilankovic, Lana

AU - Lichtenstein, Theresa

AU - Sanfelici, Rachele

AU - Penzel, Nora

AU - Haas, Shalaila S.

AU - Antonucci, Linda A.

AU - Lalousis, Paris Alexandros

AU - Chisholm, Katharine

AU - Schultze-Lutter, Frauke

AU - Ruhrmann, Stephan

AU - Hietala, Jarmo

AU - Brambilla, Paolo

AU - Koutsouleris, Nikolaos

AU - Meisenzahl, Eva

AU - Pantelis, Christos

AU - Rosen, Marlene

AU - Salokangas, Raimo K.R.

AU - Upthegrove, Rachel

AU - Wood, Stephen J.

AU - Borgwardt, Stefan

N1 - Funding Information: This work was funded by the European Union under the 7th Framework Programme (grant number 602152). D.J.H.’s work was supported by the Swiss National Science Foundation (Ambizione grant; grant number 167952). J.R.’s work was supported by Miguel Servet Research Contract (CPII19/00009) and Research Projects PI19/00394 from the Plan Nacional de I + D + i, the Instituto de Salud Carlos III-Subdirección General de Evaluación y Fomento de la Investigación and the European Regional Development Fund (FEDER, ‘Investing in your future’). R.S. received honoraria for one lecture from Lundbeck outside the submitted work and funding from BMBF and the Max Planck Society. C.P. has received honoraria for talks at educational meetings and has served on an advisory board for Lundbeck, Australia Pty Ltd, and was supported by a National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship (1105825), an NHMRC L3 Investigator Grant (1196508), and NHMRC-EU Grant (ID: 1075379). The remaining authors declare no competing interests. Publisher Copyright: © 2021, The Author(s).

PY - 2021/6

Y1 - 2021/6

N2 - Negative symptoms occur frequently in individuals at clinical high risk (CHR) for psychosis and contribute to functional impairments. The aim of this study was to predict negative symptom severity in CHR after 9 months. Predictive models either included baseline negative symptoms measured with the Structured Interview for Psychosis-Risk Syndromes (SIPS-N), whole-brain gyrification, or both to forecast negative symptoms of at least moderate severity in 94 CHR. We also conducted sequential risk stratification to stratify CHR into different risk groups based on the SIPS-N and gyrification model. Additionally, we assessed the models’ ability to predict functional outcomes in CHR and their transdiagnostic generalizability to predict negative symptoms in 96 patients with recent-onset psychosis (ROP) and 97 patients with recent-onset depression (ROD). Baseline SIPS-N and gyrification predicted moderate/severe negative symptoms with significant balanced accuracies of 68 and 62%, while the combined model achieved 73% accuracy. Sequential risk stratification stratified CHR into a high (83%), medium (40–64%), and low (19%) risk group regarding their risk of having moderate/severe negative symptoms at 9 months follow-up. The baseline SIPS-N model was also able to predict social (61%), but not role functioning (59%) at above-chance accuracies, whereas the gyrification model achieved significant accuracies in predicting both social (76%) and role (74%) functioning in CHR. Finally, only the baseline SIPS-N model showed transdiagnostic generalization to ROP (63%). This study delivers a multimodal prognostic model to identify those CHR with a clinically relevant negative symptom severity and functional impairments, potentially requiring further therapeutic consideration.

AB - Negative symptoms occur frequently in individuals at clinical high risk (CHR) for psychosis and contribute to functional impairments. The aim of this study was to predict negative symptom severity in CHR after 9 months. Predictive models either included baseline negative symptoms measured with the Structured Interview for Psychosis-Risk Syndromes (SIPS-N), whole-brain gyrification, or both to forecast negative symptoms of at least moderate severity in 94 CHR. We also conducted sequential risk stratification to stratify CHR into different risk groups based on the SIPS-N and gyrification model. Additionally, we assessed the models’ ability to predict functional outcomes in CHR and their transdiagnostic generalizability to predict negative symptoms in 96 patients with recent-onset psychosis (ROP) and 97 patients with recent-onset depression (ROD). Baseline SIPS-N and gyrification predicted moderate/severe negative symptoms with significant balanced accuracies of 68 and 62%, while the combined model achieved 73% accuracy. Sequential risk stratification stratified CHR into a high (83%), medium (40–64%), and low (19%) risk group regarding their risk of having moderate/severe negative symptoms at 9 months follow-up. The baseline SIPS-N model was also able to predict social (61%), but not role functioning (59%) at above-chance accuracies, whereas the gyrification model achieved significant accuracies in predicting both social (76%) and role (74%) functioning in CHR. Finally, only the baseline SIPS-N model showed transdiagnostic generalization to ROP (63%). This study delivers a multimodal prognostic model to identify those CHR with a clinically relevant negative symptom severity and functional impairments, potentially requiring further therapeutic consideration.

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Multimodal prognosis of negative symptom severity in individuals at increased risk of developing psychosis

Abstract

Bibliographical note

ASJC Scopus subject areas

UN SDGs

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