Multimodal prognosis of negative symptom severity in individuals at increased risk of developing psychosis.
Multimodal prognosis of negative symptom severity in individuals at increased risk of developing psychosis.
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DOI：
10.1038/s41398-021-01409-4
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发表时间：
2021-05-24
影响因子：
6.8
通讯作者：
PRONIA Group
中科院分区：
文献类型：
--
作者：
Hauke DJ;Schmidt A;Studerus E;Andreou C;Riecher-Rössler A;Radua J;Kambeitz J;Ruef A;Dwyer DB;Kambeitz-Ilankovic L;Lichtenstein T;Sanfelici R;Penzel N;Haas SS;Antonucci LA;Lalousis PA;Chisholm K;Schultze-Lutter F;Ruhrmann S;Hietala J;Brambilla P;Koutsouleris N;Meisenzahl E;Pantelis C;Rosen M;Salokangas RKR;Upthegrove R;Wood SJ;Borgwardt S;PRONIA Group
阴性症状经常发生在精神病临床高风险（CHR）个体中，并导致功能障碍。本研究的目的是预测9个月后CHR的阴性症状严重程度。预测模型包括使用精神病风险综合征结构化访谈（SIPS-N）测量的基线阴性症状，全脑旋转，或两者兼而有之，以预测94例CHR中至少中度严重程度的阴性症状。我们还基于SIPS-N和gyrification模型进行了顺序风险分层，将CHR划分为不同的风险组。此外，我们评估了模型预测CHR功能结局的能力，以及它们在预测96例新发精神病（ROP）和97例新发抑郁症（ROD）患者阴性症状方面的跨诊断推广能力。基线SIPS-N和gyrification预测中度/重度阴性症状的平衡准确率分别为68%和62%，而联合模型的准确率为73%。序贯风险分层将CHR分为高（83%）、中（40-64%）和低（19%）风险组，在9个月随访时观察他们出现中度/重度阴性症状的风险。基线SIPS-N模型也能够预测社会（61%），但不能预测角色功能（59%），准确度高于机会，而旋转模型在预测CHR的社会（76%）和角色（74%）功能方面都取得了显著的准确性。最后，只有基线SIPS-N模型显示ROP的跨诊断推广（63%）。这项研究提供了一个多模式的预后模型，以确定那些具有临床相关的阴性症状严重程度和功能损伤的CHR，可能需要进一步的治疗考虑。
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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影响因子：
25.8
作者：
Das, Tushar;Borgwardt, Stefan;Schmidt, Andre
通讯作者：
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影响因子：
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