1
|
Bonivento C, Kambeitz-Ilankovic L, Maggioni E, Borgwardt S, Lencer R, Meisenzahl E, Kambeitz J, Ruhrmann S, Salokangas RKR, Bertolino A, Stainton A, Wenzel J, Pantelis C, Wood SJ, Upthegrove R, Koutsouleris N, Brambilla P. Neurocognitive skills and vulnerability for psychosis in depression and across the psychotic spectrum: findings from the PRONIA Consortium - CORRIGENDUM. Br J Psychiatry 2024; 224:185. [PMID: 38497099 DOI: 10.1192/bjp.2024.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
|
2
|
Wannan CMJ, Nelson B, Addington J, Allott K, Anticevic A, Arango C, Baker JT, Bearden CE, Billah T, Bouix S, Broome MR, Buccilli K, Cadenhead KS, Calkins ME, Cannon TD, Cecci G, Chen EYH, Cho KIK, Choi J, Clark SR, Coleman MJ, Conus P, Corcoran CM, Cornblatt BA, Diaz-Caneja CM, Dwyer D, Ebdrup BH, Ellman LM, Fusar-Poli P, Galindo L, Gaspar PA, Gerber C, Glenthøj LB, Glynn R, Harms MP, Horton LE, Kahn RS, Kambeitz J, Kambeitz-Ilankovic L, Kane JM, Kapur T, Keshavan MS, Kim SW, Koutsouleris N, Kubicki M, Kwon JS, Langbein K, Lewandowski KE, Light GA, Mamah D, Marcy PJ, Mathalon DH, McGorry PD, Mittal VA, Nordentoft M, Nunez A, Pasternak O, Pearlson GD, Perez J, Perkins DO, Powers AR, Roalf DR, Sabb FW, Schiffman J, Shah JL, Smesny S, Spark J, Stone WS, Strauss GP, Tamayo Z, Torous J, Upthegrove R, Vangel M, Verma S, Wang J, Rossum IWV, Wolf DH, Wolff P, Wood SJ, Yung AR, Agurto C, Alvarez-Jimenez M, Amminger P, Armando M, Asgari-Targhi A, Cahill J, Carrión RE, Castro E, Cetin-Karayumak S, Mallar Chakravarty M, Cho YT, Cotter D, D’Alfonso S, Ennis M, Fadnavis S, Fonteneau C, Gao C, Gupta T, Gur RE, Gur RC, Hamilton HK, Hoftman GD, Jacobs GR, Jarcho J, Ji JL, Kohler CG, Lalousis PA, Lavoie S, Lepage M, Liebenthal E, Mervis J, Murty V, Nicholas SC, Ning L, Penzel N, Poldrack R, Polosecki P, Pratt DN, Rabin R, Rahimi Eichi H, Rathi Y, Reichenberg A, Reinen J, Rogers J, Ruiz-Yu B, Scott I, Seitz-Holland J, Srihari VH, Srivastava A, Thompson A, Turetsky BI, Walsh BC, Whitford T, Wigman JTW, Yao B, Yuen HP, Ahmed U, Byun A(JS, Chung Y, Do K, Hendricks L, Huynh K, Jeffries C, Lane E, Langholm C, Lin E, Mantua V, Santorelli G, Ruparel K, Zoupou E, Adasme T, Addamo L, Adery L, Ali M, Auther A, Aversa S, Baek SH, Bates K, Bathery A, Bayer JMM, Beedham R, Bilgrami Z, Birch S, Bonoldi I, Borders O, Borgatti R, Brown L, Bruna A, Carrington H, Castillo-Passi RI, Chen J, Cheng N, Ching AE, Clifford C, Colton BL, Contreras P, Corral S, Damiani S, Done M, Estradé A, Etuka BA, Formica M, Furlan R, Geljic M, Germano C, Getachew R, Goncalves M, Haidar A, Hartmann J, Jo A, John O, Kerins S, Kerr M, Kesselring I, Kim H, Kim N, Kinney K, Krcmar M, Kotler E, Lafanechere M, Lee C, Llerena J, Markiewicz C, Matnejl P, Maturana A, Mavambu A, Mayol-Troncoso R, McDonnell A, McGowan A, McLaughlin D, McIlhenny R, McQueen B, Mebrahtu Y, Mensi M, Hui CLM, Suen YN, Wong SMY, Morrell N, Omar M, Partridge A, Phassouliotis C, Pichiecchio A, Politi P, Porter C, Provenzani U, Prunier N, Raj J, Ray S, Rayner V, Reyes M, Reynolds K, Rush S, Salinas C, Shetty J, Snowball C, Tod S, Turra-Fariña G, Valle D, Veale S, Whitson S, Wickham A, Youn S, Zamorano F, Zavaglia E, Zinberg J, Woods SW, Shenton ME. Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis. Schizophr Bull 2024; 50:496-512. [PMID: 38451304 PMCID: PMC11059785 DOI: 10.1093/schbul/sbae011] [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: 03/08/2024]
Abstract
This article describes the rationale, aims, and methodology of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). This is the largest international collaboration to date that will develop algorithms to predict trajectories and outcomes of individuals at clinical high risk (CHR) for psychosis and to advance the development and use of novel pharmacological interventions for CHR individuals. We present a description of the participating research networks and the data processing analysis and coordination center, their processes for data harmonization across 43 sites from 13 participating countries (recruitment across North America, Australia, Europe, Asia, and South America), data flow and quality assessment processes, data analyses, and the transfer of data to the National Institute of Mental Health (NIMH) Data Archive (NDA) for use by the research community. In an expected sample of approximately 2000 CHR individuals and 640 matched healthy controls, AMP SCZ will collect clinical, environmental, and cognitive data along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech and facial expression samples, novel measures derived from digital health technologies including smartphone-based daily surveys, and passive sensing as well as actigraphy. The study will investigate a range of clinical outcomes over a 2-year period, including transition to psychosis, remission or persistence of CHR status, attenuated positive symptoms, persistent negative symptoms, mood and anxiety symptoms, and psychosocial functioning. The global reach of AMP SCZ and its harmonized innovative methods promise to catalyze the development of new treatments to address critical unmet clinical and public health needs in CHR individuals.
Collapse
Affiliation(s)
- Cassandra M J Wannan
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Kelly Allott
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Justin T Baker
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Carrie E Bearden
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tashrif Billah
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Canada
| | - Matthew R Broome
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
- Early Intervention for Psychosis Services, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Kate Buccilli
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Kang Ik K Cho
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jimmy Choi
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, USA
| | - Scott R Clark
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Basil Hetzel Institute, Woodville, SA, Australia
| | - Michael J Coleman
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Philippe Conus
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP–Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara A Cornblatt
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Covadonga M Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Dominic Dwyer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research, CNSR Mental Health Centre, Glostrup, Copenhagen, Denmark
| | - Lauren M Ellman
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Liliana Galindo
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pablo A Gaspar
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Carla Gerber
- Behavioral Health Services, PeaceHealth Medical Group, Eugene, OR, USA
| | - Louise Birkedal Glenthøj
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Robert Glynn
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health and Harvard Medical School, Boston, MA, USA
| | - Michael P Harms
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Leslie E Horton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph Kambeitz
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - John M Kane
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Tina Kapur
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marek Kubicki
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Kathryn E Lewandowski
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Health Care System, San Diego, CA, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | | | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116D, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Patrick D McGorry
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Angela Nunez
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Ofer Pasternak
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, USA
| | - Jesus Perez
- CAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Medicine, Institute of Biomedical Research (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Albert R Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - David R Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fred W Sabb
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jai L Shah
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jessica Spark
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | | | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - John Torous
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Rachel Upthegrove
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Canada
- Birmingham Womens and Childrens, NHS Foundation Trust, Birmingham, UK
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Inge Winter-van Rossum
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Phillip Wolff
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Stephen J Wood
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Alison R Yung
- Institute of Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Carla Agurto
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Paul Amminger
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Marco Armando
- Youth Early Detection/Intervention in Psychosis Platform (Plateforme ERA), Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and The University of Lausanne, Lausanne, Switzerland
| | | | - John Cahill
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Ricardo E Carrión
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Eduardo Castro
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Suheyla Cetin-Karayumak
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Youngsun T Cho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - David Cotter
- Department Psychiatry, Beaumont Hospital, Dublin 9, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Simon D’Alfonso
- School of Computing and Information Systems, The University of Melbourne, Parkville, VIC, Australia
| | - Michaela Ennis
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Shreyas Fadnavis
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Caroline Gao
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Tina Gupta
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Holly K Hamilton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Gil D Hoftman
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Grace R Jacobs
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Johanna Jarcho
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Christian G Kohler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paris Alexandros Lalousis
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Suzie Lavoie
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Einat Liebenthal
- Program for Specialized Treatment Early in Psychosis (STEP), CMHC, New Haven, CT, USA
| | - Josh Mervis
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Vishnu Murty
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Spero C Nicholas
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Lipeng Ning
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Nora Penzel
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Russell Poldrack
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | - Danielle N Pratt
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Rachel Rabin
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | | | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Avraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jenna Reinen
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Jack Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Bernalyn Ruiz-Yu
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Isabelle Scott
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Vinod H Srihari
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Program for Specialized Treatment Early in Psychosis (STEP), CMHC, New Haven, CT, USA
| | - Agrima Srivastava
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew Thompson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Bruce I Turetsky
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara C Walsh
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Thomas Whitford
- Orygen, Parkville, VIC, Australia
- School of Psychology, University of New South Wales (UNSW), Kensington, NSW, Australia
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center,Groningen, Netherlands
| | - Beier Yao
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Hok Pan Yuen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Andrew (Jin Soo) Byun
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Yoonho Chung
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Kim Do
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
| | - Larry Hendricks
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Kevin Huynh
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Erlend Lane
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Carsten Langholm
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Eric Lin
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
- Medical Informatics Fellowship, Veteran Affairs Boston Healthcare System, Boston, MA, USA
- Food and Drug Administration, Silver Spring, MD, USA
| | - Valentina Mantua
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Gennarina Santorelli
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Kosha Ruparel
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Eirini Zoupou
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Tatiana Adasme
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Lauren Addamo
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Laura Adery
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Munaza Ali
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Andrea Auther
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Samantha Aversa
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | - Seon-Hwa Baek
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Kelly Bates
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Alyssa Bathery
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Johanna M M Bayer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Rebecca Beedham
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Zarina Bilgrami
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sonia Birch
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ilaria Bonoldi
- Department of Psychosis Studies, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Owen Borders
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Lisa Brown
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Alejandro Bruna
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Holly Carrington
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Rolando I Castillo-Passi
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana—Universidad del Desarrollo, Santiago, Chile
| | - Justine Chen
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicholas Cheng
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ann Ee Ching
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Chloe Clifford
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Beau-Luke Colton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Pamela Contreras
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Sebastián Corral
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Monica Done
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrés Estradé
- Early Psychosis Detection and Clinical Intervention (EPIC) Lab, Department of Psychosis Studies, King’s College London, London, UK
| | - Brandon Asika Etuka
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Melanie Formica
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Rachel Furlan
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Mia Geljic
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Carmela Germano
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ruth Getachew
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Anastasia Haidar
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica Hartmann
- Department of Public Mental Health, Central Institute of Mental Health, Heidelberg Univeristy, Mannheim, Germany
| | - Anna Jo
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Omar John
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Kerins
- Early Psychosis Detection and Clinical Intervention (EPIC) Lab, Department of Psychosis Studies, King’s College London, London, UK
| | - Melissa Kerr
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Irena Kesselring
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Nicholas Kim
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Kyle Kinney
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Marija Krcmar
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Elana Kotler
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Melanie Lafanechere
- School of Psychology, University of Birmingham, Edgbaston, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Clarice Lee
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Joshua Llerena
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | | | | | - Aissata Mavambu
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | | | - Amelia McDonnell
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Alessia McGowan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Rebecca McIlhenny
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brittany McQueen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Yohannes Mebrahtu
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Martina Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | | | - Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Neal Morrell
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Mariam Omar
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alice Partridge
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Christina Phassouliotis
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Anna Pichiecchio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Christian Porter
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Umberto Provenzani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Nicholas Prunier
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jasmine Raj
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Susan Ray
- Northwell Health, Glen Oaks, NY, USA
| | - Victoria Rayner
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Manuel Reyes
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana—Universidad del Desarrollo, Santiago, Chile
| | - Kate Reynolds
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sage Rush
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Cesar Salinas
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Jashmina Shetty
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Callum Snowball
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sophie Tod
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Daniela Valle
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Simone Veale
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Whitson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alana Wickham
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Youn
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Francisco Zamorano
- Unidad de imágenes cuantitativas avanzadas, departamento de imágenes, clínica alemana, universidad del Desarrollo, Santiago, Chile
- Facultad de ciencias para el cuidado de la salud, Universidad San Sebastián, Campus Los Leones, Santiago, Chile
| | - Elissa Zavaglia
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | - Jamie Zinberg
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
3
|
Dong MS, Rokicki J, Dwyer D, Papiol S, Streit F, Rietschel M, Wobrock T, Müller-Myhsok B, Falkai P, Westlye LT, Andreassen OA, Palaniyappan L, Schneider-Axmann T, Hasan A, Schwarz E, Koutsouleris N. Multimodal workflows optimally predict response to repetitive transcranial magnetic stimulation in patients with schizophrenia: a multisite machine learning analysis. Transl Psychiatry 2024; 14:196. [PMID: 38664377 PMCID: PMC11045783 DOI: 10.1038/s41398-024-02903-1] [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] [Received: 08/28/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
The response variability to repetitive transcranial magnetic stimulation (rTMS) challenges the effective use of this treatment option in patients with schizophrenia. This variability may be deciphered by leveraging predictive information in structural MRI, clinical, sociodemographic, and genetic data using artificial intelligence. We developed and cross-validated rTMS response prediction models in patients with schizophrenia drawn from the multisite RESIS trial. The models incorporated pre-treatment sMRI, clinical, sociodemographic, and polygenic risk score (PRS) data. Patients were randomly assigned to receive active (N = 45) or sham (N = 47) rTMS treatment. The prediction target was individual response, defined as ≥20% reduction in pre-treatment negative symptom sum scores of the Positive and Negative Syndrome Scale. Our multimodal sequential prediction workflow achieved a balanced accuracy (BAC) of 94% (non-responders: 92%, responders: 95%) in the active-treated group and 50% in the sham-treated group. The clinical, clinical + PRS, and sMRI-based classifiers yielded BACs of 65%, 76%, and 80%, respectively. Apparent sadness, inability to feel, educational attainment PRS, and unemployment were most predictive of non-response in the clinical + PRS model, while grey matter density reductions in the default mode, limbic networks, and the cerebellum were most predictive in the sMRI model. Our sequential modelling approach provided superior predictive performance while minimising the diagnostic burden in the clinical setting. Predictive patterns suggest that rTMS responders may have higher levels of brain grey matter in the default mode and salience networks which increases their likelihood of profiting from plasticity-inducing brain stimulation methods, such as rTMS. The future clinical implementation of our models requires findings to be replicated at the international scale using stratified clinical trial designs.
Collapse
Grants
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- SCHW 1768/1-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FA-210/1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01KU1905A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01KU1905A Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie (Federal Ministry for Education, Science, Research and Technology)
- 01ZX1904A Bundesministerium für Bildung, Wissenschaft und Kultur (Federal Ministry of Education, Science and Culture)
- ENP-161423 Gouvernement du Canada | Canadian Institutes of Health Research (Instituts de Recherche en Santé du Canada)
Collapse
Affiliation(s)
- Mark Sen Dong
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Jaroslav Rokicki
- Centre of Research and Education in Forensic Psychiatry, Oslo Univerisity Hospital, Oslo, Norway
| | - Dominic Dwyer
- The University of Melbourne, Melbourne, VIC, Australia
| | - Sergi Papiol
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Fabian Streit
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marcella Rietschel
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Thomas Wobrock
- Centre for Mental Health, Darmstadt-Dieburg District Clinic, Gross-Umstadt, Germany
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany
| | | | - Ole A Andreassen
- Centre for Precision Psychiatry, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
- Robarts Research Institute, Western University, London Ontario, Canada
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Alkomiet Hasan
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Emanuel Schwarz
- Department for Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany.
- Max Planck Institute of Psychiatry, Munich, Germany.
- Partner site Munich-Augsburg, DZPG (German Centre for Mental Health), Munich / Augsburg, Germany.
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| |
Collapse
|
4
|
Woods SW, Parker S, Kerr MJ, Walsh BC, Wijtenburg SA, Prunier N, Nunez AR, Buccilli K, Mourgues-Codern C, Brummitt K, Kinney KS, Trankler C, Szacilo J, Colton BL, Ali M, Haidar A, Billah T, Huynh K, Ahmed U, Adery LL, Marcy PJ, Allott K, Amminger P, Arango C, Broome MR, Cadenhead KS, Chen EY, Choi J, Conus P, Cornblatt BA, Glenthøj LB, Horton LE, Kambeitz J, Kapur T, Keshavan MS, Koutsouleris N, Langbein K, Lavoie S, Diaz-Caneja CM, Mathalon DH, Mittal VA, Nordentoft M, Pasternak O, Pearlson GD, Ramos PAG, Shah JL, Smesny S, Stone WS, Strauss GP, Wang J, Corcoran CM, Perkins DO, Schiffman J, Perez J, Mamah D, Ellman LM, Powers AR, Coleman MJ, Anticevic A, Fusar-Poli P, Kane JM, Kahn RS, McGorry PD, Bearden CE, Shenton ME, Nelson B, Calkins ME, Hendricks L, Bouix S, Addington J, McGlashan TH, Yung AR. Development of the PSYCHS: Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS. Early Interv Psychiatry 2024; 18:255-272. [PMID: 37641537 PMCID: PMC10899527 DOI: 10.1111/eip.13457] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 02/25/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 08/31/2023]
Abstract
AIM To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR-P): the Structured Interview for Psychosis-risk Syndromes (SIPS) and the Comprehensive Assessment of At-Risk Mental States (CAARMS). METHODS The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR-P through an intensive series of joint videoconferences. RESULTS Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and modest harmonization for CHR-P criteria. The semi-structured interview, named Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS (PSYCHS), generates CHR-P criteria and severity scores for both CAARMS and SIPS. CONCLUSIONS Using the PSYCHS for CHR-P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta-analyses.
Collapse
Affiliation(s)
- Scott W. Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Sophie Parker
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Melissa J. Kerr
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Barbara C. Walsh
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - S. Andrea Wijtenburg
- Division of Translational Research, National Institute of Mental Health, Bethesda, MD, USA
| | - Nicholas Prunier
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Angela R. Nunez
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Kate Buccilli
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Catalina Mourgues-Codern
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Kali Brummitt
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Kyle S. Kinney
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Carli Trankler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Julia Szacilo
- CAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Beau-Luke Colton
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Munaza Ali
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Anastasia Haidar
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Tashrif Billah
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Kevin Huynh
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Uzair Ahmed
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Laura L. Adery
- Departments of Psychiatry and Biobehavioral Sciences & Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | | | - Kelly Allott
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Paul Amminger
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Matthew R. Broome
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | | | | | - Jimmy Choi
- Olin Neuropsychiatry Research Center, Hartford HealthCare Behavioral Health Network, Hartford, CT, USA
| | - Philippe Conus
- Chef de Service Service de Psychiatrie Générale Dép. de Psychiatrie CHUV Lausanne, Switzerland
| | - Barbara A. Cornblatt
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA
- Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Louise Birkedal Glenthøj
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
| | - Leslie E. Horton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Joseph Kambeitz
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Tina Kapur
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Germany
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Suzie Lavoie
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Covadonga Martinez Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Daniel H. Mathalon
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116D, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Chicago, IL, USA
| | - Merete Nordentoft
- Mental Health Services in the Capital Region, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ofer Pasternak
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Godfrey D. Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, Hartford, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Jai L. Shah
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - William S. Stone
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Cheryl M. Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Diana O. Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Jesus Perez
- CAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Institute of Biomedical Research (IBSAL), Department of Medicine, Universidad de Salamanca, Salamanca, Spain
| | - Daniel Mamah
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Lauren M. Ellman
- Department of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA
| | - Albert R. Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Michael J. Coleman
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King’s College London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - John M. Kane
- Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine, Hempstead, NY, USA
| | - Rene S. Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Patrick D. McGorry
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Carrie E. Bearden
- Departments of Psychiatry and Biobehavioral Sciences & Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Martha E. Shenton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Monica E. Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Larry Hendricks
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Sylvain Bouix
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Software Engineering and Information Technology, École de Technologie Supérieure, Université du Québec, Montréal, QC, Canada
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB Canada
| | - Thomas H. McGlashan
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Alison R. Yung
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Orygen, Parkville, Victoria, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | | |
Collapse
|
5
|
Koutsouleris N, Buciuman MO, Vetter CS, Weyer CFC, Zhutovsky P, Perdomo ST, Khuntia A, Milaneschi Y, Popovic D, Ruef A, Dwyer D, Chisholm K, Kambeitz L, Antonucci L, Ruhrmann S, Kambeitz J, Riecher-Rössler A, Upthegrove R, Salokangas R, Hietala J, Pantelis C, Lencer R, Meisenzahl E, Wood S, Brambilla P, Borgwardt S, Bertolino A, Falkai P. Distinct multimodal biological and functional profiles of symptom-based subgroups in recent-onset psychosis. Res Sq 2024:rs.3.rs-3949072. [PMID: 38559014 PMCID: PMC10980097 DOI: 10.21203/rs.3.rs-3949072/v1] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Symptom heterogeneity characterizes psychotic disorders and hinders the delineation of underlying biomarkers. Here, we identify symptom-based subtypes of recent-onset psychosis (ROP) patients from the multi-center PRONIA (Personalized Prognostic Tools for Early Psychosis Management) database and explore their multimodal biological and functional signatures. We clustered N = 328 ROP patients based on their maximum factor scores in an exploratory factor analysis on the Positive and Negative Syndrome Scale items. We assessed inter-subgroup differences and compared to N = 464 healthy control (HC) individuals regarding gray matter volume (GMV), neurocognition, polygenic risk scores, and longitudinal functioning trajectories. Finally, we evaluated factor stability at 9- and 18-month follow-ups. A 4-factor solution optimally explained symptom heterogeneity, showing moderate longitudinal stability. The ROP-MOTCOG (Motor/Cognition) subgroup was characterized by GMV reductions within salience, control and default mode networks, predominantly throughout cingulate regions, relative to HC individuals, had the most impaired neurocognition and the highest genetic liability for schizophrenia. ROP-SOCWD (Social Withdrawal) patients showed GMV reductions within medial fronto-temporal regions of the control, default mode, and salience networks, and had the lowest social functioning across time points. ROP-POS (Positive) evidenced GMV decreases in salience, limbic and frontal regions of the control and default mode networks. The ROP-AFF (Affective) subgroup showed GMV reductions in the salience, limbic, and posterior default-mode and control networks, thalamus and cerebellum. GMV reductions in fronto-temporal regions of the salience and control networks were shared across subgroups. Our results highlight the existence of behavioral subgroups with distinct neurobiological and functional profiles in early psychosis, emphasizing the need for refined symptom-based diagnosis and prognosis frameworks.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Lana Kambeitz
- University of Cologne, Faculty of Medicine and University Hospital
| | - Linda Antonucci
- Faculty of Medicine and University Hospital, University of Cologne, Cologne
| | - Stephan Ruhrmann
- Faculty of Medicine and University Hospital, University of Cologne, Cologne
| | - Joseph Kambeitz
- Faculty of Medicine and University Hospital, University of Cologne, Cologne
| | | | | | | | | | | | | | | | | | | | | | - Alessandro Bertolino
- Group of Psychiatric Neuroscience, Department of Basic Medical Science, Neuroscience and Sense Organs, Aldo Moro University, Bari
| | | |
Collapse
|
6
|
Hoheisel L, Kambeitz-Ilankovic L, Wenzel J, Haas SS, Antonucci LA, Ruef A, Penzel N, Schultze-Lutter F, Lichtenstein T, Rosen M, Dwyer DB, Salokangas RKR, Lencer R, Brambilla P, Borgwardt S, Wood SJ, Upthegrove R, Bertolino A, Ruhrmann S, Meisenzahl E, Koutsouleris N, Fink GR, Daun S, Kambeitz J. Alterations of Functional Connectivity Dynamics in Affective and Psychotic Disorders. Biol Psychiatry Cogn Neurosci Neuroimaging 2024:S2451-9022(24)00065-X. [PMID: 38461964 DOI: 10.1016/j.bpsc.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/23/2024] [Accepted: 02/15/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Psychosis and depression patients exhibit widespread neurobiological abnormalities. The analysis of dynamic functional connectivity (dFC), allows for the detection of changes in complex brain activity patterns, providing insights into common and unique processes underlying these disorders. METHODS In the present study, we report the analysis of dFC in a large patient sample including 127 clinical high-risk patients (CHR), 142 recent-onset psychosis (ROP) patients, 134 recent-onset depression (ROD) patients, and 256 healthy controls (HC). A sliding window-based technique was used to calculate the time-dependent FC in resting-state MRI data, followed by clustering to reveal recurrent FC states in each diagnostic group. RESULTS We identified five unique FC states, which could be identified in all groups with high consistency (rmean = 0.889, sd = 0.116). Analysis of dynamic parameters of these states showed a characteristic increase in the lifetime and frequency of a weakly-connected FC state in ROD patients (p < 0.0005) compared to most other groups, and a common increase in the lifetime of a FC state characterised by high sensorimotor and cingulo-opercular connectivities in all patient groups compared to the HC group (p < 0.0002). Canonical correlation analysis revealed a mode which exhibited significant correlations between dFC parameters and clinical variables (r = 0.617, p < 0.0029), which was associated with positive psychosis symptom severity and several dFC parameters. CONCLUSIONS Our findings indicate diagnosis-specific alterations of dFC and underline the potential of dynamic analysis to characterize disorders such as depression, psychosis and clinical risk states.
Collapse
Affiliation(s)
- Linnea Hoheisel
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany; Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany; Department of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Linda A Antonucci
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Nora Penzel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Dominic B Dwyer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia; Orygen, Parkville, VIC, Australia
| | | | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stephan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Stephen J Wood
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom; Birmingham Early Interventions Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Gereon R Fink
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany; Department of Neurology, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Silvia Daun
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany; Institute of Zoology, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany; Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
| |
Collapse
|
7
|
Koehler JC, Dong MS, Song DY, Bong G, Koutsouleris N, Yoo H, Falter-Wagner CM. Classifying autism in a clinical population based on motion synchrony: a proof-of-concept study using real-life diagnostic interviews. Sci Rep 2024; 14:5663. [PMID: 38453972 PMCID: PMC10920641 DOI: 10.1038/s41598-024-56098-y] [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] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 03/01/2024] [Indexed: 03/09/2024] Open
Abstract
Predictive modeling strategies are increasingly studied as a means to overcome clinical bottlenecks in the diagnostic classification of autism spectrum disorder. However, while some findings are promising in the light of diagnostic marker research, many of these approaches lack the scalability for adequate and effective translation to everyday clinical practice. In this study, our aim was to explore the use of objective computer vision video analysis of real-world autism diagnostic interviews in a clinical sample of children and young individuals in the transition to adulthood to predict diagnosis. Specifically, we trained a support vector machine learning model on interpersonal synchrony data recorded in Autism Diagnostic Observation Schedule (ADOS-2) interviews of patient-clinician dyads. Our model was able to classify dyads involving an autistic patient (n = 56) with a balanced accuracy of 63.4% against dyads including a patient with other psychiatric diagnoses (n = 38). Further analyses revealed no significant associations between our classification metrics with clinical ratings. We argue that, given the above-chance performance of our classifier in a highly heterogeneous sample both in age and diagnosis, with few adjustments this highly scalable approach presents a viable route for future diagnostic marker research in autism.
Collapse
Affiliation(s)
- Jana Christina Koehler
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
| | - Mark Sen Dong
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Da-Yea Song
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Guiyoung Bong
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Heejeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | | |
Collapse
|
8
|
Eckardt F, Mittas R, Horlava N, Schiefelbein J, Asani B, Michalakis S, Gerhardt M, Priglinger C, Keeser D, Koutsouleris N, Priglinger S, Theis F, Peng T, Schworm B. Deep Learning-Based Retinal Layer Segmentation in Optical Coherence Tomography Scans of Patients with Inherited Retinal Diseases. Klin Monbl Augenheilkd 2024. [PMID: 38086412 DOI: 10.1055/a-2227-3742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
BACKGROUND In optical coherence tomography (OCT) scans of patients with inherited retinal diseases (IRDs), the measurement of the thickness of the outer nuclear layer (ONL) has been well established as a surrogate marker for photoreceptor preservation. Current automatic segmentation tools fail in OCT segmentation in IRDs, and manual segmentation is time-consuming. METHODS AND MATERIAL Patients with IRD and an available OCT scan were screened for the present study. Additionally, OCT scans of patients without retinal disease were included to provide training data for artificial intelligence (AI). We trained a U-net-based model on healthy patients and applied a domain adaption technique to the IRD patients' scans. RESULTS We established an AI-based image segmentation algorithm that reliably segments the ONL in OCT scans of IRD patients. In a test dataset, the dice score of the algorithm was 98.7%. Furthermore, we generated thickness maps of the full retinal thickness and the ONL layer for each patient. CONCLUSION Accurate segmentation of anatomical layers on OCT scans plays a crucial role for predictive models linking retinal structure to visual function. Our algorithm for segmentation of OCT images could provide the basis for further studies on IRDs.
Collapse
Affiliation(s)
- Franziska Eckardt
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Robin Mittas
- Institute for Computational Biology, Helmholtz Munich, Munich, Germany
| | - Nastassya Horlava
- Institute for Computational Biology, Helmholtz Munich, Munich, Germany
| | | | - Ben Asani
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stylianos Michalakis
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Maximilian Gerhardt
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Claudia Priglinger
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry und Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry und Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Siegfried Priglinger
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Fabian Theis
- Institute for Computational Biology, Helmholtz Munich, Munich, Germany
| | - Tingying Peng
- Institute for Computational Biology, Helmholtz Munich, Munich, Germany
| | - Benedikt Schworm
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
9
|
Koehler JC, Dong MS, Bierlich AM, Fischer S, Späth J, Plank IS, Koutsouleris N, Falter-Wagner CM. Machine learning classification of autism spectrum disorder based on reciprocity in naturalistic social interactions. Transl Psychiatry 2024; 14:76. [PMID: 38310111 PMCID: PMC10838326 DOI: 10.1038/s41398-024-02802-5] [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] [Received: 01/13/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024] Open
Abstract
Autism spectrum disorder is characterized by impaired social communication and interaction. As a neurodevelopmental disorder typically diagnosed during childhood, diagnosis in adulthood is preceded by a resource-heavy clinical assessment period. The ongoing developments in digital phenotyping give rise to novel opportunities within the screening and diagnostic process. Our aim was to quantify multiple non-verbal social interaction characteristics in autism and build diagnostic classification models independent of clinical ratings. We analyzed videos of naturalistic social interactions in a sample including 28 autistic and 60 non-autistic adults paired in dyads and engaging in two conversational tasks. We used existing open-source computer vision algorithms for objective annotation to extract information based on the synchrony of movement and facial expression. These were subsequently used as features in a support vector machine learning model to predict whether an individual was part of an autistic or non-autistic interaction dyad. The two prediction models based on reciprocal adaptation in facial movements, as well as individual amounts of head and body motion and facial expressiveness showed the highest precision (balanced accuracies: 79.5% and 68.8%, respectively), followed by models based on reciprocal coordination of head (balanced accuracy: 62.1%) and body (balanced accuracy: 56.7%) motion, as well as intrapersonal coordination processes (balanced accuracy: 44.2%). Combinations of these models did not increase overall predictive performance. Our work highlights the distinctive nature of non-verbal behavior in autism and its utility for digital phenotyping-based classification. Future research needs to both explore the performance of different prediction algorithms to reveal underlying mechanisms and interactions, as well as investigate the prospective generalizability and robustness of these algorithms in routine clinical care.
Collapse
Affiliation(s)
| | - Mark Sen Dong
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
| | - Afton M Bierlich
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
| | - Stefanie Fischer
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
- Goethe University Frankfurt, University Hospital, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Frankfurt am Main, Germany
| | - Johanna Späth
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
| | - Irene Sophia Plank
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Medical Faculty, LMU, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | | |
Collapse
|
10
|
Şahin D, Kambeitz-Ilankovic L, Wood S, Dwyer D, Upthegrove R, Salokangas R, Borgwardt S, Brambilla P, Meisenzahl E, Ruhrmann S, Schultze-Lutter F, Lencer R, Bertolino A, Pantelis C, Koutsouleris N, Kambeitz J. Algorithmic fairness in precision psychiatry: analysis of prediction models in individuals at clinical high risk for psychosis. Br J Psychiatry 2024; 224:55-65. [PMID: 37936347 DOI: 10.1192/bjp.2023.141] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND Computational models offer promising potential for personalised treatment of psychiatric diseases. For their clinical deployment, fairness must be evaluated alongside accuracy. Fairness requires predictive models to not unfairly disadvantage specific demographic groups. Failure to assess model fairness prior to use risks perpetuating healthcare inequalities. Despite its importance, empirical investigation of fairness in predictive models for psychiatry remains scarce. AIMS To evaluate fairness in prediction models for development of psychosis and functional outcome. METHOD Using data from the PRONIA study, we examined fairness in 13 published models for prediction of transition to psychosis (n = 11) and functional outcome (n = 2) in people at clinical high risk for psychosis or with recent-onset depression. Using accuracy equality, predictive parity, false-positive error rate balance and false-negative error rate balance, we evaluated relevant fairness aspects for the demographic attributes 'gender' and 'educational attainment' and compared them with the fairness of clinicians' judgements. RESULTS Our findings indicate systematic bias towards assigning less favourable outcomes to individuals with lower educational attainment in both prediction models and clinicians' judgements, resulting in higher false-positive rates in 7 of 11 models for transition to psychosis. Interestingly, the bias patterns observed in algorithmic predictions were not significantly more pronounced than those in clinicians' predictions. CONCLUSIONS Educational bias was present in algorithmic and clinicians' predictions, assuming more favourable outcomes for individuals with higher educational level (years of education). This bias might lead to increased stigma and psychosocial burden in patients with lower educational attainment and suboptimal psychosis prevention in those with higher educational attainment.
Collapse
Affiliation(s)
- Derya Şahin
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany; and Department of Psychology, Faculty of Psychology and Educational Sciences, Ludwig-Maximilian University, Munich, Germany
| | - Stephen Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia; and Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Victoria, Australia
| | - Dominic Dwyer
- Department of Psychology, Faculty of Psychology and Educational Sciences, Ludwig-Maximilian University, Munich, Germany; and Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Victoria, Australia
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, UK; and Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Stefan Borgwardt
- Department of Psychiatry (University Psychiatric Clinics, UPK), University of Basel, Basel, Switzerland; and Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; and Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; and University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany; and Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Nikolaos Koutsouleris
- Department of Psychology, Faculty of Psychology and Educational Sciences, Ludwig-Maximilian University, Munich, Germany; Max-Planck Institute of Psychiatry, Munich, Germany; and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| |
Collapse
|
11
|
Wenzel J, Badde L, Haas SS, Bonivento C, Van Rheenen TE, Antonucci LA, Ruef A, Penzel N, Rosen M, Lichtenstein T, Lalousis PA, Paolini M, Stainton A, Dannlowski U, Romer G, Brambilla P, Wood SJ, Upthegrove R, Borgwardt S, Meisenzahl E, Salokangas RKR, Pantelis C, Lencer R, Bertolino A, Kambeitz J, Koutsouleris N, Dwyer DB, Kambeitz-Ilankovic L. Transdiagnostic subgroups of cognitive impairment in early affective and psychotic illness. Neuropsychopharmacology 2024; 49:573-583. [PMID: 37737273 PMCID: PMC10789737 DOI: 10.1038/s41386-023-01729-7] [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] [Received: 05/12/2023] [Revised: 08/03/2023] [Accepted: 08/26/2023] [Indexed: 09/23/2023]
Abstract
Cognitively impaired and spared patient subgroups were identified in psychosis and depression, and in clinical high-risk for psychosis (CHR). Studies suggest differences in underlying brain structural and functional characteristics. It is unclear whether cognitive subgroups are transdiagnostic phenomena in early stages of psychotic and affective disorder which can be validated on the neural level. Patients with recent-onset psychosis (ROP; N = 140; female = 54), recent-onset depression (ROD; N = 130; female = 73), CHR (N = 128; female = 61) and healthy controls (HC; N = 270; female = 165) were recruited through the multi-site study PRONIA. The transdiagnostic sample and individual study groups were clustered into subgroups based on their performance in eight cognitive domains and characterized by gray matter volume (sMRI) and resting-state functional connectivity (rsFC) using support vector machine (SVM) classification. We identified an impaired subgroup (NROP = 79, NROD = 30, NCHR = 37) showing cognitive impairment in executive functioning, working memory, processing speed and verbal learning (all p < 0.001). A spared subgroup (NROP = 61, NROD = 100, NCHR = 91) performed comparable to HC. Single-disease subgroups indicated that cognitive impairment is stronger pronounced in impaired ROP compared to impaired ROD and CHR. Subgroups in ROP and ROD showed specific symptom- and functioning-patterns. rsFC showed superior accuracy compared to sMRI in differentiating transdiagnostic subgroups from HC (BACimpaired = 58.5%; BACspared = 61.7%, both: p < 0.01). Cognitive findings were validated in the PRONIA replication sample (N = 409). Individual cognitive subgroups in ROP, ROD and CHR are more informative than transdiagnostic subgroups as they map onto individual cognitive impairment and specific functioning- and symptom-patterns which show limited overlap in sMRI and rsFC. CLINICAL TRIAL REGISTRY NAME: German Clinical Trials Register (DRKS). Clinical trial registry URL: https://www.drks.de/drks_web/ . Clinical trial registry number: DRKS00005042.
Collapse
Affiliation(s)
- Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
| | - Luzie Badde
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, NY, USA
| | | | - Tamsyn E Van Rheenen
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
- Department of Translational Biomedicine and Neuroscience - University of Bari Aldo Moro, Bari, Italy
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Department of Translational Biomedicine and Neuroscience - University of Bari Aldo Moro, Bari, Italy
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Paris Alexandros Lalousis
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - Marco Paolini
- Department of Radiology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Alexandra Stainton
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Muenster, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University of Münster, Münster, Germany
| | - Paolo Brambilla
- Department of Neuosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Mental Health, University of Milan, Milan, Italy
| | - Stephen J Wood
- Orygen, Melbourne, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Rachel Upthegrove
- School of Psychology, University of Birmingham, Birmingham, UK
- Institute of Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Stefan Borgwardt
- Translational Psychiatry Unit (TPU), Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne & Western Health, Melbourne, VIC, Australia
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Muenster, Münster, Germany
- Translational Psychiatry Unit (TPU), Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Alessandro Bertolino
- Department of Translational Biomedicine and Neuroscience - University of Bari Aldo Moro, Bari, Italy
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, UK
- Max Planck Institute for Psychiatry, Munich, Germany
| | - Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
- Orygen, Melbourne, VIC, Australia
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
- Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Munich, Germany
| |
Collapse
|
12
|
Chekroud AM, Hawrilenko M, Loho H, Bondar J, Gueorguieva R, Hasan A, Kambeitz J, Corlett PR, Koutsouleris N, Krumholz HM, Krystal JH, Paulus M. Illusory generalizability of clinical prediction models. Science 2024; 383:164-167. [PMID: 38207039 DOI: 10.1126/science.adg8538] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 11/10/2023] [Indexed: 01/13/2024]
Abstract
It is widely hoped that statistical models can improve decision-making related to medical treatments. Because of the cost and scarcity of medical outcomes data, this hope is typically based on investigators observing a model's success in one or two datasets or clinical contexts. We scrutinized this optimism by examining how well a machine learning model performed across several independent clinical trials of antipsychotic medication for schizophrenia. Models predicted patient outcomes with high accuracy within the trial in which the model was developed but performed no better than chance when applied out-of-sample. Pooling data across trials to predict outcomes in the trial left out did not improve predictions. These results suggest that models predicting treatment outcomes in schizophrenia are highly context-dependent and may have limited generalizability.
Collapse
Affiliation(s)
- Adam M Chekroud
- Spring Health, New York City, NY 10010, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | | | - Hieronimus Loho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | | | | | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Augsburg, 86159 Augsburg, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Philip R Corlett
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT 06520, USA
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Martin Paulus
- Laureate Institute for Brain Research, Tulsa, OK 74136, USA
| |
Collapse
|
13
|
Walter N, Wenzel J, Haas SS, Squarcina L, Bonivento C, Ruef A, Dwyer D, Lichtenstein T, Bastrük Ö, Stainton A, Antonucci LA, Brambilla P, Wood SJ, Upthegrove R, Borgwardt S, Lencer R, Meisenzahl E, Salokangas RKR, Pantelis C, Bertolino A, Koutsouleris N, Kambeitz J, Kambeitz-Ilankovic L. A multivariate cognitive approach to predict social functioning in recent onset psychosis in response to computerized cognitive training. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110864. [PMID: 37717645 DOI: 10.1016/j.pnpbp.2023.110864] [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: 05/09/2023] [Revised: 08/01/2023] [Accepted: 09/13/2023] [Indexed: 09/19/2023]
Abstract
Clinical and neuroimaging data has been increasingly used in recent years to disentangle heterogeneity of treatment response to cognitive training (CT) and predict which individuals may achieve the highest benefits. CT has small to medium effects on improving cognitive and social functioning in recent onset psychosis (ROP) patients, who show the most profound cognitive and social functioning deficits among psychiatric patients. We employed multivariate pattern analysis (MVPA) to investigate the potential of cognitive data to predict social functioning improvement in response to 10 h of CT in patients with ROP. A support vector machine (SVM) classifier was trained on the naturalistic data of the Personalized Prognostic Tools for Early Psychosis Management (PRONIA) study sample to predict functioning in an independent sample of 70 ROP patients using baseline cognitive data. PRONIA is a part of a FP7 EU grant program that involved 7 sites across 5 European countries, designed and conducted with the main aim of identifying (bio)markers associated with an enhanced risk of developing psychosis in order to improve early detection and prognosis. Social functioning was predicted with a balanced accuracy (BAC) of 66.4% (Sensitivity 78.8%; Specificity 54.1%; PPV 60.5%; NPV 74.1%; AUC 0.64; P = 0.01). The most frequently selected cognitive features (mean feature weights > ± 0.2) included the (1) correct number of symbol matchings within the Digit Symbol Substitution Test, (2) the number of distracting stimuli leading to an error within 300 and 200 trials in the Continuous Performance Test and (3) the dynamics of verbal fluency between 15 and 30 s within the Verbal Fluency Test, phonetic part. Next, the SVM classifier generated on the PRONIA sample was applied to the intervention sample, that obtained 54 ROP patients who were randomly assigned to a social cognitive training (SCT) or treatment as usual (TAU) group and dichotomized into good (GF-S ≥ 7) and poor (GF-S < 7) functioning patients based on their level of Global Functioning-Social (GF-S) score at follow-up (FU). By applying the initial PRONIA classifier, using out-of-sample cross-validation (OOCV) to the sample of ROP patients who have undergone the CT intervention, a BAC of 59.3% (Sensitivity 70.4%; Specificity 48.1%; PPV 57.6%; NPV 61.9%; AUC 0.63) was achieved at T0 and a BAC of 64.8% (Sensitivity 66.7%; Specificity 63.0%; PPV 64.3%; NPV 65.4%; AUC 0.66) at FU. After SCT intervention, a significant improvement in predicted social functioning values was observed in the SCT compared to TAU group (P ≤0.05; ES[Cohens' d] = 0.18). Due to a small sample size and modest variance of social functioning of the intervention sample it was not feasible to predict individual response to SCT in the current study. Our findings suggest that the use of baseline cognitive data could provide a robust individual estimate of future social functioning, while prediction of individual response to SCT using cognitive data that can be generated in the routine patient care remains to be addressed in large-scale cognitive training trials.
Collapse
Affiliation(s)
- Nina Walter
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Kerpenerstr.62, 50931, Cologne, Germany
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Kerpenerstr.62, 50931, Cologne, Germany
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, New York, United States of America
| | | | | | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; Orygen Youth Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Kerpenerstr.62, 50931, Cologne, Germany
| | - Öznur Bastrük
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Kerpenerstr.62, 50931, Cologne, Germany
| | - Alexandra Stainton
- Orygen Youth Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Linda A Antonucci
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Paolo Brambilla
- Department of Neuosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Mental Health, University of Milan, Milan, Italy
| | - Stephen J Wood
- Orygen Youth Health, Melbourne, Australia; School of Psychology, University of Birmingham, United Kingdom; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Rachel Upthegrove
- School of Psychology, University of Birmingham, United Kingdom; Institute of Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Stefan Borgwardt
- Translational Psychiatry Unit (TPU), Department of Psychiatry and Psychotherapy, University of Luebeck, Germany
| | - Rebekka Lencer
- Translational Psychiatry Unit (TPU), Department of Psychiatry and Psychotherapy, University of Luebeck, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & NorthWestern Mental Health, Melbourne, Australia
| | - Alessandro Bertolino
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; Max Planck Institute for Psychiatry, Munich, Germany; Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, United Kingdom
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Kerpenerstr.62, 50931, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Kerpenerstr.62, 50931, Cologne, Germany; Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Munich, Germany.
| |
Collapse
|
14
|
Yang Z, Wen J, Erus G, Govindarajan ST, Melhem R, Mamourian E, Cui Y, Srinivasan D, Abdulkadir A, Parmpi P, Wittfeld K, Grabe HJ, Bülow R, Frenzel S, Tosun D, Bilgel M, An Y, Yi D, Marcus DS, LaMontagne P, Benzinger TL, Heckbert SR, Austin TR, Waldstein SR, Evans MK, Zonderman AB, Launer LJ, Sotiras A, Espeland MA, Masters CL, Maruff P, Fripp J, Toga A, O’Bryant S, Chakravarty MM, Villeneuve S, Johnson SC, Morris JC, Albert MS, Yaffe K, Völzke H, Ferrucci L, Bryan NR, Shinohara RT, Fan Y, Habes M, Lalousis PA, Koutsouleris N, Wolk DA, Resnick SM, Shou H, Nasrallah IM, Davatzikos C. Five dominant dimensions of brain aging are identified via deep learning: associations with clinical, lifestyle, and genetic measures. medRxiv 2023:2023.12.29.23300642. [PMID: 38234857 PMCID: PMC10793523 DOI: 10.1101/2023.12.29.23300642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Brain aging is a complex process influenced by various lifestyle, environmental, and genetic factors, as well as by age-related and often co-existing pathologies. MRI and, more recently, AI methods have been instrumental in understanding the neuroanatomical changes that occur during aging in large and diverse populations. However, the multiplicity and mutual overlap of both pathologic processes and affected brain regions make it difficult to precisely characterize the underlying neurodegenerative profile of an individual from an MRI scan. Herein, we leverage a state-of-the art deep representation learning method, Surreal-GAN, and present both methodological advances and extensive experimental results that allow us to elucidate the heterogeneity of brain aging in a large and diverse cohort of 49,482 individuals from 11 studies. Five dominant patterns of neurodegeneration were identified and quantified for each individual by their respective (herein referred to as) R-indices. Significant associations between R-indices and distinct biomedical, lifestyle, and genetic factors provide insights into the etiology of observed variances. Furthermore, baseline R-indices showed predictive value for disease progression and mortality. These five R-indices contribute to MRI-based precision diagnostics, prognostication, and may inform stratification into clinical trials.
Collapse
Affiliation(s)
- Zhijian Yang
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Graduate Group in Applied Mathematics and Computational Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Junhao Wen
- Laboratory of AI and Biomedical Science (LABS), Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Guray Erus
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sindhuja T. Govindarajan
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Randa Melhem
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth Mamourian
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yuhan Cui
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dhivya Srinivasan
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Abdulkadir
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Paraskevi Parmpi
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University of Greifswald, Germany
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea
| | - Daniel S. Marcus
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Pamela LaMontagne
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L.S. Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Susan R. Heckbert
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Thomas R. Austin
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Shari R. Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, USA
| | - Michele K. Evans
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Alan B. Zonderman
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Lenore J. Launer
- Neuroepidemiology Section, Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA
| | - Aristeidis Sotiras
- Department of Radiology and Institute of Informatics, Washington University in St. Luis, St. Luis, MO63110, USA
| | - Mark A. Espeland
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Colin L. Masters
- Florey Institute, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Paul Maruff
- Florey Institute, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, Australian e-Health Research Centre CSIRO, Brisbane, Queensland, Australia
| | - Arthur Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Sid O’Bryant
- Institute for Translational Research University of North Texas Health Science Center Fort Worth Texas USA
| | - Mallar M. Chakravarty
- Computational Brain Anatomy (CoBrA) Laboratory, Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Verdun, Quebec, Canada
| | - Sylvia Villeneuve
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - John C. Morris
- Knight Alzheimer Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristine Yaffe
- Departments of Neurology, Psychiatry and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Luigi Ferrucci
- Translational Gerontology Branch, Longitudinal Studies Section, National Institute on Aging, National Institutes of Health, MedStar Harbor Hospital, 3001 S. Hanover Street, Baltimore, MD, USA
| | - Nick R. Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Russell T. Shinohara
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Yong Fan
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mohamad Habes
- Biggs Alzheimer’s Institute, University of Texas San Antonio Health Science Center, USA
| | - Paris Alexandros Lalousis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Nikolaos Koutsouleris
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Section for Precision Psychiatry, Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - David A. Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Haochang Shou
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Ilya M. Nasrallah
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
15
|
Wen J, Nasrallah IM, Abdulkadir A, Satterthwaite TD, Yang Z, Erus G, Robert-Fitzgerald T, Singh A, Sotiras A, Boquet-Pujadas A, Mamourian E, Doshi J, Cui Y, Srinivasan D, Skampardoni I, Chen J, Hwang G, Bergman M, Bao J, Veturi Y, Zhou Z, Yang S, Dazzan P, Kahn RS, Schnack HG, Zanetti MV, Meisenzahl E, Busatto GF, Crespo-Facorro B, Pantelis C, Wood SJ, Zhuo C, Shinohara RT, Gur RC, Gur RE, Koutsouleris N, Wolf DH, Saykin AJ, Ritchie MD, Shen L, Thompson PM, Colliot O, Wittfeld K, Grabe HJ, Tosun D, Bilgel M, An Y, Marcus DS, LaMontagne P, Heckbert SR, Austin TR, Launer LJ, Espeland M, Masters CL, Maruff P, Fripp J, Johnson SC, Morris JC, Albert MS, Bryan RN, Resnick SM, Fan Y, Habes M, Wolk D, Shou H, Davatzikos C. Genomic loci influence patterns of structural covariance in the human brain. Proc Natl Acad Sci U S A 2023; 120:e2300842120. [PMID: 38127979 PMCID: PMC10756284 DOI: 10.1073/pnas.2300842120] [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] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 10/31/2023] [Indexed: 12/23/2023] Open
Abstract
Normal and pathologic neurobiological processes influence brain morphology in coordinated ways that give rise to patterns of structural covariance (PSC) across brain regions and individuals during brain aging and diseases. The genetic underpinnings of these patterns remain largely unknown. We apply a stochastic multivariate factorization method to a diverse population of 50,699 individuals (12 studies and 130 sites) and derive data-driven, multi-scale PSCs of regional brain size. PSCs were significantly correlated with 915 genomic loci in the discovery set, 617 of which are newly identified, and 72% were independently replicated. Key pathways influencing PSCs involve reelin signaling, apoptosis, neurogenesis, and appendage development, while pathways of breast cancer indicate potential interplays between brain metastasis and PSCs associated with neurodegeneration and dementia. Using support vector machines, multi-scale PSCs effectively derive imaging signatures of several brain diseases. Our results elucidate genetic and biological underpinnings that influence structural covariance patterns in the human brain.
Collapse
Affiliation(s)
- Junhao Wen
- Laboratory of AI and Biomedical Science, Department of Neurology, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA90033
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Ilya M. Nasrallah
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
- Department of Radiology, University of Pennsylvania, Philadelphia, PA19104
| | - Ahmed Abdulkadir
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Theodore D. Satterthwaite
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Zhijian Yang
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Guray Erus
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Timothy Robert-Fitzgerald
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Ashish Singh
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Aristeidis Sotiras
- Department of Radiology, Washington University School of Medicine, St. Louis, MO63110
| | - Aleix Boquet-Pujadas
- Biomedical Imaging Group, Department of Biomedical Engineering, École Polytechnique Fédérale de Lausanne, Lausanne1015, Switzerland
| | - Elizabeth Mamourian
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Jimit Doshi
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Yuhan Cui
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Dhivya Srinivasan
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Ioanna Skampardoni
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Jiong Chen
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Gyujoon Hwang
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Mark Bergman
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Jingxuan Bao
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA19104
| | - Yogasudha Veturi
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Zhen Zhou
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Shu Yang
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA19104
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonWC2R 2LS, United Kingdom
| | - Rene S. Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Hugo G. Schnack
- Department of Psychiatry, University Medical Center Utrecht, Utrecht 3584 CX Ut, Netherlands
| | - Marcus V. Zanetti
- Institute of Psychiatry, Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo05508-070, Brazil
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Heinrich Heine University, Düsseldorf40204, Germany
| | - Geraldo F. Busatto
- Institute of Psychiatry, Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo05508-070, Brazil
| | - Benedicto Crespo-Facorro
- Hospital Universitario Virgen del Rocio, School of Medicine, University of Sevilla,Sevilla41004, Spain
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Stephen J. Wood
- Orygen and the Centre for Youth Mental Health, Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Chuanjun Zhuo
- Key Laboratory of Real Tine Tracing of Brain Circuits in Psychiatry and Neurology, Department of Psychiatry, Tianjin Medical University, Tianjin300070, China
| | - Russell T. Shinohara
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich 80539, Germany
| | - Daniel H. Wolf
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Andrew J. Saykin
- Indiana Alzheimer’s Disease Research Center, Department of Radiology, Indiana University School of Medicine, Indianapolis, IN46202-3082
| | - Marylyn D. Ritchie
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Li Shen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA19104
| | - Paul M. Thompson
- Imaging Genetics Center, Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA90033
| | - Olivier Colliot
- Institut du Cerveau, Sorbonne Université, Paris75013, France
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, German Center for Neurodegenerative Diseases, University Medicine Greifswald, Greifswald17475, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, German Center for Neurodegenerative Diseases, University Medicine Greifswald, Greifswald17475, Germany
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Baltimore21224, MD
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Baltimore21224, MD
| | - Daniel S. Marcus
- Department of Radiology, Washington University School of Medicine, St. Louis, MO63110
| | - Pamela LaMontagne
- Department of Radiology, Washington University School of Medicine, St. Louis, MO63110
| | - Susan R. Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA98195
| | - Thomas R. Austin
- Department of Epidemiology, University of Washington, Seattle, WA98195
| | - Lenore J. Launer
- Neuroepidemiology Section, Intramural Research Program, National Institute on Aging, Washington, MD20817
| | - Mark Espeland
- Sticht Center for Healthy Aging and Alzheimer’s Prevention, Divisions of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC27101
| | - Colin L. Masters
- Florey Institute of Neuroscience and Mental Health, Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC3010, Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC3010, Australia
| | - Jurgen Fripp
- Health and Biosecurity, Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD4029, Australia
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Institute, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI53792
| | - John C. Morris
- Knight Alzheimer Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, MO63110
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD21205
| | - R. Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA19104
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, NIH, Baltimore21224, MD
| | - Yong Fan
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX78229
| | - David Wolk
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
- Department of Neurology, University of Pennsylvania, Philadelphia, PA19104
| | - Haochang Shou
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| | - Christos Davatzikos
- AI in Biomedical Imaging Laboratory, Department of Radiology, Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA19104
| |
Collapse
|
16
|
Buciuman MO, Oeztuerk OF, Popovic D, Enrico P, Ruef A, Bieler N, Sarisik E, Weiske J, Dong MS, Dwyer DB, Kambeitz-Ilankovic L, Haas SS, Stainton A, Ruhrmann S, Chisholm K, Kambeitz J, Riecher-Rössler A, Upthegrove R, Schultze-Lutter F, Salokangas RKR, Hietala J, Pantelis C, Lencer R, Meisenzahl E, Wood SJ, Brambilla P, Borgwardt S, Falkai P, Antonucci LA, Bertolino A, Liddle P, Koutsouleris N. Structural and Functional Brain Patterns Predict Formal Thought Disorder's Severity and Its Persistence in Recent-Onset Psychosis: Results From the PRONIA Study. Biol Psychiatry Cogn Neurosci Neuroimaging 2023; 8:1207-1217. [PMID: 37343661 DOI: 10.1016/j.bpsc.2023.06.001] [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] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/01/2023] [Accepted: 06/03/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Formal thought disorder (FThD) is a core feature of psychosis, and its severity and long-term persistence relates to poor clinical outcomes. However, advances in developing early recognition and management tools for FThD are hindered by a lack of insight into the brain-level predictors of FThD states and progression at the individual level. METHODS Two hundred thirty-three individuals with recent-onset psychosis were drawn from the multisite European Prognostic Tools for Early Psychosis Management study. Support vector machine classifiers were trained within a cross-validation framework to separate two FThD symptom-based subgroups (high vs. low FThD severity), using cross-sectional whole-brain multiband fractional amplitude of low frequency fluctuations, gray matter volume and white matter volume data. Moreover, we trained machine learning models on these neuroimaging readouts to predict the persistence of high FThD subgroup membership from baseline to 1-year follow-up. RESULTS Cross-sectionally, multivariate patterns of gray matter volume within the salience, dorsal attention, visual, and ventral attention networks separated the FThD severity subgroups (balanced accuracy [BAC] = 60.8%). Longitudinally, distributed activations/deactivations within all fractional amplitude of low frequency fluctuation sub-bands (BACslow-5 = 73.2%, BACslow-4 = 72.9%, BACslow-3 = 68.0%), gray matter volume patterns overlapping with the cross-sectional ones (BAC = 62.7%), and smaller frontal white matter volume (BAC = 73.1%) predicted the persistence of high FThD severity from baseline to follow-up, with a combined multimodal balanced accuracy of BAC = 77%. CONCLUSIONS We report the first evidence of brain structural and functional patterns predictive of FThD severity and persistence in early psychosis. These findings open up avenues for the development of neuroimaging-based diagnostic, prognostic, and treatment options for the early recognition and management of FThD and associated poor outcomes.
Collapse
Affiliation(s)
- Madalina-Octavia Buciuman
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Munich, Germany; Max Planck Institute for Psychiatry, Munich, Germany
| | - Oemer Faruk Oeztuerk
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Munich, Germany; Max Planck Institute for Psychiatry, Munich, Germany
| | - David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Munich, Germany; Max Planck Institute for Psychiatry, Munich, Germany
| | - Paolo Enrico
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Nadia Bieler
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Elif Sarisik
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Munich, Germany; Max Planck Institute for Psychiatry, Munich, Germany
| | - Johanna Weiske
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Mark Sen Dong
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Victoria, Australia
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexandra Stainton
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | | | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | | | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-Universität, Düsseldorf, Germany; Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | | | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Carlton South, Melbourne, Victoria, Australia; NorthWestern Mental Health, Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-Universität, Düsseldorf, Germany
| | - Stephen J Wood
- Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia; School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lüebeck, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; Max Planck Institute for Psychiatry, Munich, Germany
| | - Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy; Department of Translational Biomedicine and Neuroscience (DiBraiN) - University of Bari "Aldo Moro," Bari, Italy
| | - Peter Liddle
- Division of Mental Health and Clinical Neuroscience, Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; Max Planck Institute for Psychiatry, Munich, Germany; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
| |
Collapse
|
17
|
Radua J, Koutsouleris N. Ten Simple Rules for Using Machine Learning in Mental Health Research. Biol Psychiatry 2023:S0006-3223(23)01724-9. [PMID: 37981177 DOI: 10.1016/j.biopsych.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023]
Affiliation(s)
- Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain.
| | - Nikolaos Koutsouleris
- Section of Precision Psychiatry, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Max Planck Institute of Psychiatry, Munich, Germany
| |
Collapse
|
18
|
Plank IS, Koehler JC, Nelson AM, Koutsouleris N, Falter-Wagner CM. Automated extraction of speech and turn-taking parameters in autism allows for diagnostic classification using a multivariable prediction model. Front Psychiatry 2023; 14:1257569. [PMID: 38025455 PMCID: PMC10658003 DOI: 10.3389/fpsyt.2023.1257569] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Autism spectrum disorder (ASD) is diagnosed on the basis of speech and communication differences, amongst other symptoms. Since conversations are essential for building connections with others, it is important to understand the exact nature of differences between autistic and non-autistic verbal behaviour and evaluate the potential of these differences for diagnostics. In this study, we recorded dyadic conversations and used automated extraction of speech and interactional turn-taking features of 54 non-autistic and 26 autistic participants. The extracted speech and turn-taking parameters showed high potential as a diagnostic marker. A linear support vector machine was able to predict the dyad type with 76.2% balanced accuracy (sensitivity: 73.8%, specificity: 78.6%), suggesting that digitally assisted diagnostics could significantly enhance the current clinical diagnostic process due to their objectivity and scalability. In group comparisons on the individual and dyadic level, we found that autistic interaction partners talked slower and in a more monotonous manner than non-autistic interaction partners and that mixed dyads consisting of an autistic and a non-autistic participant had increased periods of silence, and the intensity, i.e. loudness, of their speech was more synchronous.
Collapse
Affiliation(s)
- I. S. Plank
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - J. C. Koehler
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - A. M. Nelson
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - N. Koutsouleris
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
| | - C. M. Falter-Wagner
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
19
|
Stainton A, Chisholm K, Griffiths SL, Kambeitz-Ilankovic L, Wenzel J, Bonivento C, Brambilla P, Iqbal M, Lichtenstein TK, Rosen M, Antonucci LA, Maggioni E, Kambeitz J, Borgwardt S, Riecher-Rössler A, Andreou C, Schmidt A, Schultze-Lutter F, Meisenzahl E, Ruhrmann S, Salokangas RKR, Pantelis C, Lencer R, Romer G, Bertolino A, Upthegrove R, Koutsouleris N, Allott K, Wood SJ. Prevalence of cognitive impairments and strengths in the early course of psychosis and depression. Psychol Med 2023; 53:5945-5957. [PMID: 37409883 PMCID: PMC10520593 DOI: 10.1017/s0033291723001770] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/12/2023] [Accepted: 06/01/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Studies investigating cognitive impairments in psychosis and depression have typically compared the average performance of the clinical group against healthy controls (HC), and do not report on the actual prevalence of cognitive impairments or strengths within these clinical groups. This information is essential so that clinical services can provide adequate resources to supporting cognitive functioning. Thus, we investigated this prevalence in individuals in the early course of psychosis or depression. METHODS A comprehensive cognitive test battery comprising 12 tests was completed by 1286 individuals aged 15-41 (mean age 25.07, s.d. 5.88) from the PRONIA study at baseline: HC (N = 454), clinical high risk for psychosis (CHR; N = 270), recent-onset depression (ROD; N = 267), and recent-onset psychosis (ROP; N = 295). Z-scores were calculated to estimate the prevalence of moderate or severe deficits or strengths (>2 s.d. or 1-2 s.d. below or above HC, respectively) for each cognitive test. RESULTS Impairment in at least two cognitive tests was as follows: ROP (88.3% moderately, 45.1% severely impaired), CHR (71.2% moderately, 22.4% severely impaired), ROD (61.6% moderately, 16.2% severely impaired). Across clinical groups, impairments were most prevalent in tests of working memory, processing speed, and verbal learning. Above average performance (>1 s.d.) in at least two tests was present for 40.5% ROD, 36.1% CHR, 16.1% ROP, and was >2 SDs in 1.8% ROD, 1.4% CHR, and 0% ROP. CONCLUSIONS These findings suggest that interventions should be tailored to the individual, with working memory, processing speed, and verbal learning likely to be important transdiagnostic targets.
Collapse
Affiliation(s)
- Alexandra Stainton
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Siân Lowri Griffiths
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
- Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Munich, Germany
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Mariam Iqbal
- Department of Psychology, Woodbourne Priory Hospital, Birmingham, UK
| | - Theresa K. Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Linda A. Antonucci
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari “Aldo Moro”, Bari, Italy
| | - Eleonora Maggioni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
- Department of Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | | | - Christina Andreou
- Department of Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - André Schmidt
- Department of Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, VIC, Australia
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Georg Romer
- Department of Child Adolescent Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Alessandro Bertolino
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari “Aldo Moro”, Bari, Italy
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
- Birmingham Early Intervention Service, Birmingham Women's and Children NHS Foundation Trust, Birmingham, UK
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kelly Allott
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen J. Wood
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Psychology, University of Birmingham, Edgbaston, UK
| |
Collapse
|
20
|
Bonivento C, Kambeitz-Ilankovic L, Maggioni E, Borgwardt S, Lencer R, Meisenzahl E, Kambeitz J, Ruhrmann S, Salokangas RKR, Bertolino A, Stainton A, Wenzel J, Pantelis C, Wood SJ, Upthegrove R, Koutsouleris N, Brambilla P. Neurocognitive skills and vulnerability for psychosis in depression and across the psychotic spectrum: findings from the PRONIA Consortium. Br J Psychiatry 2023; 223:485-492. [PMID: 37846967 DOI: 10.1192/bjp.2023.98] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
BACKGROUND Neurocognitive deficits are a core feature of psychosis and depression. Despite commonalities in cognitive alterations, it remains unclear if and how the cognitive deficits in patients at clinical high risk for psychosis (CHR) and those with recent-onset psychosis (ROP) are distinct from those seen in recent-onset depression (ROD). AIMS This study was carried out within the European project 'Personalized Prognostic Tools for Early Psychosis Management', and aimed to characterise the cognitive profiles of patients with psychosis or depression. METHOD We examined cognitive profiles for patients with ROP (n = 105), patients with ROD (n = 123), patients at CHR (n = 116) and healthy controls (n = 372) across seven sites in five European countries. Confirmatory factor analysis identified four cognitive factors independent of gender, education and site: speed of processing, attention and working memory, verbal learning and spatial learning. RESULTS Patients with ROP performed worse than healthy controls in all four domains (P < 0.001), whereas performance of patients with ROD was not affected (P > 0.05). Patients at CHR performed worse than healthy controls in speed of processing (P = 0.001) and spatial learning (P = 0.003), but better than patients with ROP across all cognitive domains (all P ≤ 0.01). CHR and ROD groups did not significantly differ in any cognitive domain. These findings were independent of comorbid depressive symptoms, substance consumption and illness duration. CONCLUSIONS These results show that neurocognitive abilities are affected in CHR and ROP, whereas ROD seems spared. Although our findings may support the notion that those at CHR have a specific vulnerability to psychosis, future studies investigating broader transdiagnostic risk cohorts in longitudinal designs are needed.
Collapse
Affiliation(s)
| | - Lana Kambeitz-Ilankovic
- Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany; and Faculty of Psychology and Educational Sciences, Department of Psychology, Ludwig-Maximilian University, Germany
| | - Eleonora Maggioni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy
| | - Stefan Borgwardt
- Translational Psychiatry Unit, Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Rebekka Lencer
- Institute for Translational Psychiatry, Münster University, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Germany
| | - Joseph Kambeitz
- Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany; and Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Germany
| | - Stephan Ruhrmann
- Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany
| | | | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Italy
| | - Alexandra Stainton
- Orygen, Melbourne, Australia; and Centre for Youth Mental Health, University of Melbourne, Australia
| | - Julian Wenzel
- Faculty of Medicine and University Hospital of Cologne, University of Cologne, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Australia
| | - Stephen J Wood
- Orygen, Melbourne, Australia; School of Psychology, University of Birmingham, UK; and Centre for Youth Mental Health, University of Melbourne, Australia
| | - Rachel Upthegrove
- School of Psychology, University of Birmingham, UK; Institute for Mental Health, University of Birmingham, UK; and Centre for Human Brain Health, University of Birmingham, UK
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Germany; Max Planck Institute for Psychiatry, Germany; and Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; and Department of Pathophysiology and Transplantation, University of Milan, Italy
| |
Collapse
|
21
|
Blackman G, Neri G, Al-Doori O, Teixeira-Dias M, Mazumder A, Pollak TA, Hird EJ, Koutsouleris N, Bell V, Kempton MJ, McGuire P. Prevalence of Neuroradiological Abnormalities in First-Episode Psychosis: A Systematic Review and Meta-analysis. JAMA Psychiatry 2023; 80:1047-1054. [PMID: 37436735 PMCID: PMC10339221 DOI: 10.1001/jamapsychiatry.2023.2225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/08/2023] [Indexed: 07/13/2023]
Abstract
Importance Individuals presenting with first-episode psychosis (FEP) may have a secondary ("organic") etiology to their symptoms that can be identified using neuroimaging. Because failure to detect such cases at an early stage can have serious clinical consequences, it has been suggested that brain magnetic resonance imaging (MRI) should be mandatory for all patients presenting with FEP. However, this remains a controversial issue, partly because the prevalence of clinically relevant MRI abnormalities in this group is unclear. Objective To derive a meta-analytic estimate of the prevalence of clinically relevant neuroradiological abnormalities in FEP. Data Sources Electronic databases Ovid, MEDLINE, PubMed, Embase, PsychINFO, and Global Health were searched up to July 2021. References and citations of included articles and review articles were also searched. Study Selection Magnetic resonance imaging studies of patients with FEP were included if they reported the frequency of intracranial radiological abnormalities. Data Extraction and Synthesis Independent extraction was undertaken by 3 researchers and a random-effects meta-analysis of pooled proportions was calculated. Moderators were tested using subgroup and meta-regression analyses. Heterogeneity was evaluated using the I2 index. The robustness of results was evaluated using sensitivity analyses. Publication bias was assessed using funnel plots and Egger tests. Main Outcomes and Measures Proportion of patients with a clinically relevant radiological abnormality (defined as a change in clinical management or diagnosis); number of patients needed to scan to detect 1 such abnormality (number needed to assess [NNA]). Results Twelve independent studies (13 samples) comprising 1613 patients with FEP were included. Of these patients, 26.4% (95% CI, 16.3%-37.9%; NNA of 4) had an intracranial radiological abnormality, and 5.9% (95% CI, 3.2%-9.0%) had a clinically relevant abnormality, yielding an NNA of 18. There were high degrees of heterogeneity among the studies for these outcomes, 95% to 73%, respectively. The most common type of clinically relevant finding was white matter abnormalities, with a prevalence of 0.9% (95% CI, 0%-2.8%), followed by cysts, with a prevalence of 0.5% (95% CI, 0%-1.4%). Conclusions and Relevance This systematic review and meta-analysis found that 5.9% of patients presenting with a first episode of psychosis had a clinically relevant finding on MRI. Because the consequences of not detecting these abnormalities can be serious, these findings support the use of MRI as part of the initial clinical assessment of all patients with FEP.
Collapse
Affiliation(s)
- Graham Blackman
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Giulia Neri
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Omar Al-Doori
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Maria Teixeira-Dias
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Asif Mazumder
- Department of Neuroradiology, King’s College Hospital NHS Foundation Trust, London, United Kingdom
- Department of Radiology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Thomas A. Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Emily J. Hird
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Nikolaos Koutsouleris
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck Institute of Psychiatry, Munich, Germany
| | - Vaughan Bell
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Matthew J. Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| |
Collapse
|
22
|
Theisen C, Rosen M, Meisenzahl E, Koutsouleris N, Lichtenstein T, Ruhrmann S, Kambeitz J, Kambeitz-Ilankovic L, Riecher-Rössler A, Chisholm K, Upthegrove R, Antonucci LA, Bertolino A, Pigoni A, Salokangas RKR, Pantelis C, Wood SJ, Lencer R, Falkai P, Hietala J, Brambilla P, Schmidt A, Andreou C, Borgwardt S, Osman N, Schultze-Lutter F. The heterogeneity of attenuated and brief limited psychotic symptoms: association of contents with age, sex, country, religion, comorbidities, and functioning. Front Psychiatry 2023; 14:1209485. [PMID: 37484669 PMCID: PMC10361815 DOI: 10.3389/fpsyt.2023.1209485] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The Attenuated Psychosis Symptoms (APS) syndrome mostly represents the ultra-high-risk state of psychosis but, as does the Brief Intermittent Psychotic Symptoms (BIPS) syndrome, shows a large variance in conversion rates. This may be due to the heterogeneity of APS/BIPS that may be related to the effects of culture, sex, age, and other psychiatric morbidities. Thus, we investigated the different thematic contents of APS and their association with sex, age, country, religion, comorbidity, and functioning to gain a better understanding of the psychosis-risk syndrome. Method A sample of 232 clinical high-risk subjects according to the ultra-high risk and basic symptom criteria was recruited as part of a European study conducted in Germany, Italy, Switzerland, and Finland. Case vignettes, originally used for supervision of inclusion criteria, were investigated for APS/BIPS contents, which were compared for sex, age, country, religion, functioning, and comorbidities using chi-squared tests and regression analyses. Result We extracted 109 different contents, mainly of APS (96.8%): 63 delusional, 29 hallucinatory, and 17 speech-disorganized contents. Only 20 contents (18.3%) were present in at least 5% of the sample, with paranoid and referential ideas being the most frequent. Thirty-one (28.5%) contents, in particular, bizarre ideas and perceptual abnormalities, demonstrated an association with age, country, comorbidity, or functioning, with regression models of country and obsessive-compulsive disorders explaining most of the variance: 55.8 and 38.3%, respectively. Contents did not differ between religious groups. Conclusion Psychosis-risk patients report a wide range of different contents of APS/BIPS, underlining the psychopathological heterogeneity of this group but also revealing a potential core set of contents. Compared to earlier reports on North-American samples, our maximum prevalence rates of contents were considerably lower; this likely being related to a stricter rating of APS/BIPS and cultural influences, in particular, higher schizotypy reported in North-America. The various associations of some APS/BIPS contents with country, age, comorbidities, and functioning might moderate their clinical severity and, consequently, the related risk for psychosis and/or persistent functional disability.
Collapse
Affiliation(s)
- Christian Theisen
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Research Center Jülich, Institute for Cognitive Neuroscience (INM-3), Jülich, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
- Department of Psychology, Aston University, Birmingham, United Kingdom
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Linda A. Antonucci
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen J. Wood
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
- Orygen, The National Centre of Excellence for Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Jarmo Hietala
- Department of Psychiatry, Medical Faculty, University of Turku, Turku, Finland
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Mental Health, University of Milan, Milan, Italy
| | - André Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Naweed Osman
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| |
Collapse
|
23
|
Giuliani L, Koutsouleris N, Giordano GM, Koenig T, Mucci A, Perrottelli A, Reuf A, Altamura M, Bellomo A, Brugnoli R, Corrivetti G, Di Lorenzo G, Girardi P, Monteleone P, Niolu C, Galderisi S, Maj M. A multivariate approach to investigate the associations of electrophysiological indices with schizophrenia clinical and functional outcome. Eur Psychiatry 2023:1-36. [PMID: 37231770 DOI: 10.1192/j.eurpsy.2023.2410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Affiliation(s)
- Luigi Giuliani
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Nikolaos Koutsouleris
- University Hospital, Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Thomas Koenig
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Armida Mucci
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Anne Reuf
- University Hospital, Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Mario Altamura
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Roberto Brugnoli
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Giulio Corrivetti
- Department of Mental Health of ASL (Local Health Company) of Salerno, Salerno, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Paolo Girardi
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Cinzia Niolu
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
24
|
Mondelli V, Blackman G, Kempton MJ, Pollak TA, Iyegbe C, Valmaggia LR, Amminger P, Barrantes-Vidal N, Bressan R, van der Gaag M, de Haan L, Krebs MO, Nordentoft M, Ruhrmann S, Riecher-Rössler A, Rutten BPF, Sachs G, Koutsouleris N, McGuire P. Serum immune markers and transition to psychosis in individuals at clinical high risk. Brain Behav Immun 2023; 110:290-296. [PMID: 36940754 DOI: 10.1016/j.bbi.2023.03.014] [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] [Received: 07/20/2022] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023] Open
Abstract
Individuals at clinical high risk (CHR) for psychosis have been found to have altered cytokine levels, but whether these changes are related to clinical outcomes remains unclear. We addressed this issue by measuring serum levels of 20 immune markers in 325 participants (n = 269 CHR, n = 56 healthy controls) using multiplex immunoassays, and then followed up the CHR sample to determine their clinical outcomes. Among 269 CHR individuals, 50 (18.6 %) developed psychosis by two years. Univariate and machine learning techniques were used to compare levels of inflammatory markers in CHR subjects and healthy controls, and in CHR subjects who had (CHR-t), or had not (CHR-nt) transitioned to psychosis. An ANCOVA identified significant group differences (CHR-t, CHR-nt and controls) and post-hoc tests indicated that VEGF levels and the IL-10/IL-6 ratio were significantly higher in CHR-t than CHR-nt, after adjusting for multiple comparisons. Using a penalised logistic regression classifier, CHR participants were distinguished from controls with an area-under the curve (AUC) of 0.82, with IL-6 and IL-4 levels the most important discriminating features. Transition to psychosis was predicted with an AUC of 0.57, with higher VEGF level and IL-10/IL-6 ratio the most important discriminating features. These data suggest that alterations in the levels of peripheral immune markers are associated with the subsequent onset of psychosis. The association with increased VEGF levels could reflect altered blood-brain-barrier (BBB) permeability, while the link with an elevated IL-10/IL-6 ratio points to an imbalance between anti- and pro-inflammatory cytokines.
Collapse
Affiliation(s)
- Valeria Mondelli
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK; National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK.
| | - Graham Blackman
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Matthew J Kempton
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Thomas A Pollak
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Conrad Iyegbe
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Lucia R Valmaggia
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, London, UK
| | - Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, Australia
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Australia
| | - Rodrigo Bressan
- LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP), Australia
| | - Mark van der Gaag
- VU University, Department of Clinical Psychology and Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands
| | - Lieuwe de Haan
- AMC, Academic Psychiatric Centre, Department Early Psychosis, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; Arkin Amsterdam, The Netherlands
| | - Marie-Odile Krebs
- University Paris Descartes, Hôpital Sainte-Anne, C'JAAD, Service Hospitalo-Universitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, P.O. Box 616, 6200 MD 464 Maastricht, The Netherlands; Max-Planck Institute of Psychiatry, Munich, Germany
| | - Gabriele Sachs
- Medical University of Vienna, Department of Psychiatry and Psychotherapy, The Netherlands
| | - Nikolaos Koutsouleris
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK; Medical University of Vienna, Department of Psychiatry and Psychotherapy, The Netherlands; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Philip McGuire
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| |
Collapse
|
25
|
Dwyer DB, Chand GB, Pigoni A, Khuntia A, Wen J, Antoniades M, Hwang G, Erus G, Doshi J, Srinivasan D, Varol E, Kahn RS, Schnack HG, Meisenzahl E, Wood SJ, Zhuo C, Sotiras A, Shinohara RT, Shou H, Fan Y, Schaulfelberger M, Rosa P, Lalousis PA, Upthegrove R, Kaczkurkin AN, Moore TM, Nelson B, Gur RE, Gur RC, Ritchie MD, Satterthwaite TD, Murray RM, Di Forti M, Ciufolini S, Zanetti MV, Wolf DH, Pantelis C, Crespo-Facorro B, Busatto GF, Davatzikos C, Koutsouleris N, Dazzan P. Psychosis brain subtypes validated in first-episode cohorts and related to illness remission: results from the PHENOM consortium. Mol Psychiatry 2023; 28:2008-2017. [PMID: 37147389 PMCID: PMC10575777 DOI: 10.1038/s41380-023-02069-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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] [Received: 06/10/2022] [Revised: 03/15/2023] [Accepted: 04/05/2023] [Indexed: 05/07/2023]
Abstract
Using machine learning, we recently decomposed the neuroanatomical heterogeneity of established schizophrenia to discover two volumetric subgroups-a 'lower brain volume' subgroup (SG1) and an 'higher striatal volume' subgroup (SG2) with otherwise normal brain structure. In this study, we investigated whether the MRI signatures of these subgroups were also already present at the time of the first-episode of psychosis (FEP) and whether they were related to clinical presentation and clinical remission over 1-, 3-, and 5-years. We included 572 FEP and 424 healthy controls (HC) from 4 sites (Sao Paulo, Santander, London, Melbourne) of the PHENOM consortium. Our prior MRI subgrouping models (671 participants; USA, Germany, and China) were applied to both FEP and HC. Participants were assigned into 1 of 4 categories: subgroup 1 (SG1), subgroup 2 (SG2), no subgroup membership ('None'), and mixed SG1 + SG2 subgroups ('Mixed'). Voxel-wise analyses characterized SG1 and SG2 subgroups. Supervised machine learning analyses characterized baseline and remission signatures related to SG1 and SG2 membership. The two dominant patterns of 'lower brain volume' in SG1 and 'higher striatal volume' (with otherwise normal neuromorphology) in SG2 were identified already at the first episode of psychosis. SG1 had a significantly higher proportion of FEP (32%) vs. HC (19%) than SG2 (FEP, 21%; HC, 23%). Clinical multivariate signatures separated the SG1 and SG2 subgroups (balanced accuracy = 64%; p < 0.0001), with SG2 showing higher education but also greater positive psychosis symptoms at first presentation, and an association with symptom remission at 1-year, 5-year, and when timepoints were combined. Neuromorphological subtypes of schizophrenia are already evident at illness onset, separated by distinct clinical presentations, and differentially associated with subsequent remission. These results suggest that the subgroups may be underlying risk phenotypes that could be targeted in future treatment trials and are critical to consider when interpreting neuroimaging literature.
Collapse
Affiliation(s)
- Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany.
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
- Orygen, Melbourne, VIC, Australia.
| | - Ganesh B Chand
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Lucca, Italy
| | - Adyasha Khuntia
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
- Max-Planck Institute of Psychiatry, Munich, Germany
| | - Junhao Wen
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mathilde Antoniades
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gyujoon Hwang
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jimit Doshi
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dhivya Srinivasan
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erdem Varol
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Statistics, Zuckerman Institute, Columbia University, New York, NY, USA
| | - Rene S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hugo G Schnack
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eva Meisenzahl
- LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
- University of Birmingham, Edgbaston, UK
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC-Lab), Nankai University Affiliated Tianjin Anding Hospital; Department of Psychiatry, Tianjin Medical University, Tianjin, China
| | - Aristeidis Sotiras
- Department of Radiology and Institute for Informatics, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Russell T Shinohara
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Pedro Rosa
- Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paris A Lalousis
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, UK
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, UK
- Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Tyler M Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Marylyn D Ritchie
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Theodore D Satterthwaite
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Robin M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Simone Ciufolini
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Marcus V Zanetti
- Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
| | - Daniel H Wolf
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Benedicto Crespo-Facorro
- Mental Health Service, Hospital Universitario Virgen del Rocío, Seville, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM), Madrid, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
- Department of Psychiatry, Universidad de Sevilla, Seville, Spain
| | - Geraldo F Busatto
- Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany.
- Max-Planck Institute of Psychiatry, Munich, Germany.
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Paola Dazzan
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| |
Collapse
|
26
|
Hwang G, Wen J, Sotardi S, Brodkin ES, Chand GB, Dwyer DB, Erus G, Doshi J, Singhal P, Srinivasan D, Varol E, Sotiras A, Dazzan P, Kahn RS, Schnack HG, Zanetti MV, Meisenzahl E, Busatto GF, Crespo-Facorro B, Pantelis C, Wood SJ, Zhuo C, Shinohara RT, Shou H, Fan Y, Di Martino A, Koutsouleris N, Gur RE, Gur RC, Satterthwaite TD, Wolf DH, Davatzikos C. Assessment of Neuroanatomical Endophenotypes of Autism Spectrum Disorder and Association With Characteristics of Individuals With Schizophrenia and the General Population. JAMA Psychiatry 2023; 80:498-507. [PMID: 37017948 PMCID: PMC10157419 DOI: 10.1001/jamapsychiatry.2023.0409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Importance Autism spectrum disorder (ASD) is associated with significant clinical, neuroanatomical, and genetic heterogeneity that limits precision diagnostics and treatment. Objective To assess distinct neuroanatomical dimensions of ASD using novel semisupervised machine learning methods and to test whether the dimensions can serve as endophenotypes also in non-ASD populations. Design, Setting, and Participants This cross-sectional study used imaging data from the publicly available Autism Brain Imaging Data Exchange (ABIDE) repositories as the discovery cohort. The ABIDE sample included individuals diagnosed with ASD aged between 16 and 64 years and age- and sex-match typically developing individuals. Validation cohorts included individuals with schizophrenia from the Psychosis Heterogeneity Evaluated via Dimensional Neuroimaging (PHENOM) consortium and individuals from the UK Biobank to represent the general population. The multisite discovery cohort included 16 internationally distributed imaging sites. Analyses were performed between March 2021 and March 2022. Main Outcomes and Measures The trained semisupervised heterogeneity through discriminative analysis models were tested for reproducibility using extensive cross-validations. It was then applied to individuals from the PHENOM and the UK Biobank. It was hypothesized that neuroanatomical dimensions of ASD would display distinct clinical and genetic profiles and would be prominent also in non-ASD populations. Results Heterogeneity through discriminative analysis models trained on T1-weighted brain magnetic resonance images of 307 individuals with ASD (mean [SD] age, 25.4 [9.8] years; 273 [88.9%] male) and 362 typically developing control individuals (mean [SD] age, 25.8 [8.9] years; 309 [85.4%] male) revealed that a 3-dimensional scheme was optimal to capture the ASD neuroanatomy. The first dimension (A1: aginglike) was associated with smaller brain volume, lower cognitive function, and aging-related genetic variants (FOXO3; Z = 4.65; P = 1.62 × 10-6). The second dimension (A2: schizophrenialike) was characterized by enlarged subcortical volumes, antipsychotic medication use (Cohen d = 0.65; false discovery rate-adjusted P = .048), partially overlapping genetic, neuroanatomical characteristics to schizophrenia (n = 307), and significant genetic heritability estimates in the general population (n = 14 786; mean [SD] h2, 0.71 [0.04]; P < 1 × 10-4). The third dimension (A3: typical ASD) was distinguished by enlarged cortical volumes, high nonverbal cognitive performance, and biological pathways implicating brain development and abnormal apoptosis (mean [SD] β, 0.83 [0.02]; P = 4.22 × 10-6). Conclusions and Relevance This cross-sectional study discovered 3-dimensional endophenotypic representation that may elucidate the heterogeneous neurobiological underpinnings of ASD to support precision diagnostics. The significant correspondence between A2 and schizophrenia indicates a possibility of identifying common biological mechanisms across the 2 mental health diagnoses.
Collapse
Affiliation(s)
- Gyujoon Hwang
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Junhao Wen
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Laboratory of AI & Biomedical Science (LABS), Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Marina del Rey
| | - Susan Sotardi
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Edward S Brodkin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ganesh B Chand
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Radiology, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Guray Erus
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jimit Doshi
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Pankhuri Singhal
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Dhivya Srinivasan
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Erdem Varol
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Statistics, Zuckerman Institute, Columbia University, New York, New York
| | - Aristeidis Sotiras
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Radiology, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rene S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hugo G Schnack
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marcus V Zanetti
- Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
| | - Eva Meisenzahl
- LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany
| | - Geraldo F Busatto
- Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Benedicto Crespo-Facorro
- University Hospital Virgen del Rocio, Department of Psychiatry, School of Medicine, IBiS-CIBERSAM, University of Sevilla, Seville, Spain
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Stephen J Wood
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory, Tianjin Anding Hospital, Tianjin, China
- Department of Psychiatry, Tianjin Medical University, Tianjin, China
| | - Russell T Shinohara
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Haochang Shou
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Yong Fan
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Adriana Di Martino
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience at the New York University Child Study Center, New York
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Theodore D Satterthwaite
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Daniel H Wolf
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Christos Davatzikos
- AI 2 D Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| |
Collapse
|
27
|
Popovic D, Schiltz K, Dobrowolny H, Meyer-Lotz G, Guest PC, Jordan W, Borucki K, Koutsouleris N, Bogerts B, Bernstein HG, Mandelli A, Bahn S, Furlan R, Steiner J. Serum levels of neurofilament light-chain (NfL), a biomarker of axonal and synaptic damage, predict 5-year outcome in acutely ill schizophrenia patients. Journal of Affective Disorders Reports 2023. [DOI: 10.1016/j.jadr.2023.100568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
|
28
|
Susai SR, Föcking M, Mongan D, Heurich M, Coutts F, Egerton A, Whetton T, Winter-van Rossum I, Unwin RD, Pollak TA, Weiser M, Leboyer M, Rujescu D, Byrne JF, Gifford GW, Dazzan P, Koutsouleris N, Kahn RS, Cotter DR, McGuire P. Association of Complement and Coagulation Pathway Proteins With Treatment Response in First-Episode Psychosis: A Longitudinal Analysis of the OPTiMiSE Clinical Trial. Schizophr Bull 2023:7077182. [PMID: 36916850 DOI: 10.1093/schbul/sbac201] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND AND HYPOTHESIS Treatment response to specific antipsychotic medications is difficult to predict on clinical grounds alone. The current study hypothesizes that the baseline complement pathway activity predicts the treatment response and investigates the relationship between baseline plasma biomarkers with treatment response to antipsychotic medications. STUDY DESIGN Baseline plasma samples were collected from first episode of psychosis patients (n = 243) from a multi-center clinical trial. The participants were treated with amisulpride for 4 weeks. Levels of complement and coagulation proteins at baseline were measured using both data-dependent and data-independent mass spectrometry approaches. The primary outcome was remission status at 4 weeks and the secondary outcomes included change in psychotic and functional symptoms over the period of treatment. In addition, immunoassays were performed at baseline for complement C1R, as well as for activation markers C4a and sC5b-9. STUDY RESULTS The plasma level of complement variant C4A was significantly associated with remission at 4 weeks. Moreover, higher levels of several complement and coagulation pathway proteins were associated with a reduction in psychotic symptoms and an improvement in functioning. Immunoassays showed an association of baseline levels of C1R and C4a as well as complement activation marker sC5b-9 levels with treatment response. CONCLUSION The results demonstrated that the response to antipsychotic treatment might be related to pre-treatment levels of plasma complement and coagulation pathway proteins. This is consistent with independent evidence associating immune dysfunction with the pathophysiology of psychosis. Moreover, these results inform the development of novel therapeutic approaches that target the complement system for psychosis.
Collapse
Affiliation(s)
- Subash Raj Susai
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Melanie Föcking
- 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
| | - Meike Heurich
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Fiona Coutts
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Tony Whetton
- School of Veterinary Medicine, School of Biosciences and Medicine, University of Surrey, Guildford, GU2 7XH, UK
| | - Inge Winter-van Rossum
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Richard D Unwin
- Stoller Biomarker Discovery Centre and Division of Cancer Sciences, School of Medicine, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, M13 9NY, UK
| | - Thomas A Pollak
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - Mark Weiser
- Stanley Medical Research Institute, Kensington, MD, USA.,Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Marion Leboyer
- Université Paris Est Creteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, FHU ADA¨T, INSERMU955, IMRB, Translational Neuropsychiatry laboratory, F-94010 Creteil, France
| | - Dan Rujescu
- University Clinic and Outpatient Clinic for Psychiatry, Psychotherapy and Psychosomatics, Martin Luther University of Halle-Wittenberg, Halle, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Jonah F Byrne
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - George W Gifford
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Nikolaos Koutsouleris
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David R Cotter
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| |
Collapse
|
29
|
Smith KA, Blease C, Faurholt-Jepsen M, Firth J, Van Daele T, Moreno C, Carlbring P, Ebner-Priemer UW, Koutsouleris N, Riper H, Mouchabac S, Torous J, Cipriani A. Digital mental health: challenges and next steps. BMJ Ment Health 2023; 26:e300670. [PMID: 37197797 PMCID: PMC10231442 DOI: 10.1136/bmjment-2023-300670] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/28/2023] [Indexed: 05/19/2023]
Abstract
Digital innovations in mental health offer great potential, but present unique challenges. Using a consensus development panel approach, an expert, international, cross-disciplinary panel met to provide a framework to conceptualise digital mental health innovations, research into mechanisms and effectiveness and approaches for clinical implementation. Key questions and outputs from the group were agreed by consensus, and are presented and discussed in the text and supported by case examples in an accompanying appendix. A number of key themes emerged. (1) Digital approaches may work best across traditional diagnostic systems: we do not have effective ontologies of mental illness and transdiagnostic/symptom-based approaches may be more fruitful. (2) Approaches in clinical implementation of digital tools/interventions need to be creative and require organisational change: not only do clinicians and patients need training and education to be more confident and skilled in using digital technologies to support shared care decision-making, but traditional roles need to be extended, with clinicians working alongside digital navigators and non-clinicians who are delivering protocolised treatments. (3) Designing appropriate studies to measure the effectiveness of implementation is also key: including digital data raises unique ethical issues, and measurement of potential harms is only just beginning. (4) Accessibility and codesign are needed to ensure innovations are long lasting. (5) Standardised guidelines for reporting would ensure effective synthesis of the evidence to inform clinical implementation. COVID-19 and the transition to virtual consultations have shown us the potential for digital innovations to improve access and quality of care in mental health: now is the ideal time to act.
Collapse
Affiliation(s)
- Katharine A Smith
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Charlotte Blease
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Participatory eHealth and Health Data Research Group, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Faurholt-Jepsen
- Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Joseph Firth
- Division of Psychology and Mental Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Tom Van Daele
- Expertise Unit Psychology, Technology and Society, Thomas More University of Applied Sciences, Mechelen, Belgium
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, Universidad Complutense de Madrid Facultad de Medicina, Madrid, Spain
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Ulrich W Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
- mHealth Methods in Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, München, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Max-Planck Institute of Psychiatry, Munich, Germany
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Duivendrecht, Netherlands
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Stephane Mouchabac
- Department of Psychiatry, Hôpital Saint-Antoine, Sorbonne Université, Paris, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Brain Institute (ICM), INSERM, CNRS, Hôpital de la Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - John Torous
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| |
Collapse
|
30
|
Haidl TK, Hedderich DM, Rosen M, Kaiser N, Seves M, Lichtenstein T, Penzel N, Wenzel J, Kambeitz-Ilankovic L, Ruef A, Popovic D, Schultze-Lutter F, Chisholm K, Upthegrove R, Salokangas RKR, Pantelis C, Meisenzahl E, Wood SJ, Brambilla P, Borgwardt S, Ruhrmann S, Kambeitz J, Koutsouleris N. The non-specific nature of mental health and structural brain outcomes following childhood trauma. Psychol Med 2023; 53:1005-1014. [PMID: 34225834 DOI: 10.1017/s0033291721002439] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Childhood trauma (CT) is associated with an increased risk of mental health disorders; however, it is unknown whether this represents a diagnosis-specific risk factor for specific psychopathology mediated by structural brain changes. Our aim was to explore whether (i) a predictive CT pattern for transdiagnostic psychopathology exists, and whether (ii) CT can differentiate between distinct diagnosis-dependent psychopathology. Furthermore, we aimed to identify the association between CT, psychopathology and brain structure. METHODS We used multivariate pattern analysis in data from 643 participants of the Personalised Prognostic Tools for Early Psychosis Management study (PRONIA), including healthy controls (HC), recent onset psychosis (ROP), recent onset depression (ROD), and patients clinically at high-risk for psychosis (CHR). Participants completed structured interviews and self-report measures including the Childhood Trauma Questionnaire, SCID diagnostic interview, BDI-II, PANSS, Schizophrenia Proneness Instrument, Structured Interview for Prodromal Symptoms and structural MRI, analyzed by voxel-based morphometry. RESULTS (i) Patients and HC could be distinguished by their CT pattern with a reasonable precision [balanced accuracy of 71.2% (sensitivity = 72.1%, specificity = 70.4%, p ≤ 0.001]. (ii) Subdomains 'emotional neglect' and 'emotional abuse' were most predictive for CHR and ROP, while in ROD 'physical abuse' and 'sexual abuse' were most important. The CT pattern was significantly associated with the severity of depressive symptoms in ROD, ROP, and CHR, as well as with the PANSS total and negative domain scores in the CHR patients. No associations between group-separating CT patterns and brain structure were found. CONCLUSIONS These results indicate that CT poses a transdiagnostic risk factor for mental health disorders, possibly related to depressive symptoms. While differences in the quality of CT exposure exist, diagnostic differentiation was not possible suggesting a multi-factorial pathogenesis.
Collapse
Affiliation(s)
- Theresa K Haidl
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Dennis M Hedderich
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine Technical University of Munich, Munich, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Nathalie Kaiser
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Mauro Seves
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Thorsten Lichtenstein
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharine Chisholm
- Institute of Mental Health, University of Birmingham, Birmingham, UK
- Department of Psychology, Aston University, Birmingham, UK
| | - Rachel Upthegrove
- Institute of Mental Health, University of Birmingham, Birmingham, UK
- Early Intervention Service, Birmingham Womens and Childrens NHS Foundation Trust, UK
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Victoria, Australia
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Stephen J Wood
- Institute of Mental Health, University of Birmingham, Birmingham, UK
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefan Borgwardt
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Max-Planck Institute of Psychiatry Munich, Munich, Germany
| |
Collapse
|
31
|
Popovic D, Wertz M, Geisler C, Kaufmann J, Lähteenvuo M, Lieslehto J, Witzel J, Bogerts B, Walter M, Falkai P, Koutsouleris N, Schiltz K. Patterns of risk-Using machine learning and structural neuroimaging to identify pedophilic offenders. Front Psychiatry 2023; 14:1001085. [PMID: 37151966 PMCID: PMC10157073 DOI: 10.3389/fpsyt.2023.1001085] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/27/2023] [Indexed: 05/09/2023] Open
Abstract
Background Child sexual abuse (CSA) has become a focal point for lawmakers, law enforcement, and mental health professionals. With high prevalence rates around the world and far-reaching, often chronic, individual, and societal implications, CSA and its leading risk factor, pedophilia, have been well investigated. This has led to a wide range of clinical tools and actuarial instruments for diagnosis and risk assessment regarding CSA. However, the neurobiological underpinnings of pedosexual behavior, specifically regarding hands-on pedophilic offenders (PO), remain elusive. Such biomarkers for PO individuals could potentially improve the early detection of high-risk PO individuals and enhance efforts to prevent future CSA. Aim To use machine learning and MRI data to identify PO individuals. Methods From a single-center male cohort of 14 PO individuals and 15 matched healthy control (HC) individuals, we acquired diffusion tensor imaging data (anisotropy, diffusivity, and fiber tracking) in literature-based regions of interest (prefrontal cortex, anterior cingulate cortex, amygdala, and corpus callosum). We trained a linear support vector machine to discriminate between PO and HC individuals using these WM microstructure data. Post hoc, we investigated the PO model decision scores with respect to sociodemographic (age, education, and IQ) and forensic characteristics (psychopathy, sexual deviance, and future risk of sexual violence) in the PO subpopulation. We assessed model specificity in an external cohort of 53 HC individuals. Results The classifier discriminated PO from HC individuals with a balanced accuracy of 75.5% (sensitivity = 64.3%, specificity = 86.7%, P 5000 = 0.018) and an out-of-sample specificity to correctly identify HC individuals of 94.3%. The predictive brain pattern contained bilateral fractional anisotropy in the anterior cingulate cortex, diffusivity in the left amygdala, and structural prefrontal cortex-amygdala connectivity in both hemispheres. This brain pattern was associated with the number of previous child victims, the current stance on sexuality, and the professionally assessed risk of future sexual violent reoffending. Conclusion Aberrant white matter microstructure in the prefronto-temporo-limbic circuit could be a potential neurobiological correlate for PO individuals at high-risk of reoffending with CSA. Although preliminary and exploratory at this point, our findings highlight the general potential of MRI-based biomarkers and particularly WM microstructure patterns for future CSA risk assessment and preventive efforts.
Collapse
Affiliation(s)
- David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Forensic Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- *Correspondence: David Popovic,
| | - Maximilian Wertz
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Forensic Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Carolin Geisler
- Department of Dermatology, Venereology, and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Joern Kaufmann
- Department of Neurology, Otto-von-Guericke-University, Magdeburg, Germany
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
- Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - Johannes Lieslehto
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland
| | - Joachim Witzel
- Central State Forensic Psychiatric Hospital of Saxony-Anhalt, Uchtspringe, Germany
| | - Bernhard Bogerts
- Salus Institut, Salus gGmbH, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University, Magdeburg, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Kolja Schiltz
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Forensic Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
| |
Collapse
|
32
|
Lencer R, Schwarzer J, Meyhoefer I, Antonucci LA, Kambeitz-Ilankovic L, Surmann M, Bienek O, Romer G, Dannlowski U, Hahn T, Korda A, Dwyer DB, Ruef A, Haas SS, Kambeitz J, Salokangas RK, Pantelis C, Schultze-Lutter F, Meisenzahl E, Brambilla P, Bertolino A, Borgwardt S, Upthegrove R, Koutsouleris N. Visual disturbances in recent-onset psychosis and clinical high-risk state for psychosis. J Vis 2022. [DOI: 10.1167/jov.22.14.3529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nikolaos Koutsouleris
- Ludwig Maximilian University Munich
- Max-Planck-Institute of Psychiatry Munich
- King's College London
| |
Collapse
|
33
|
Koutsouleris N, Hauser TU, Skvortsova V, De Choudhury M. From promise to practice: towards the realisation of AI-informed mental health care. The Lancet Digital Health 2022; 4:e829-e840. [DOI: 10.1016/s2589-7500(22)00153-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/14/2022] [Accepted: 07/27/2022] [Indexed: 11/07/2022]
|
34
|
Lalousis PA, Schmaal L, Wood SJ, Reniers RLEP, Barnes NM, Chisholm K, Griffiths SL, Stainton A, Wen J, Hwang G, Davatzikos C, Wenzel J, Kambeitz-Ilankovic L, Andreou C, Bonivento C, Dannlowski U, Ferro A, Lichtenstein T, Riecher-Rössler A, Romer G, Rosen M, Bertolino A, Borgwardt S, Brambilla P, Kambeitz J, Lencer R, Pantelis C, Ruhrmann S, Salokangas RKR, Schultze-Lutter F, Schmidt A, Meisenzahl E, Koutsouleris N, Dwyer D, Upthegrove R. Neurobiologically Based Stratification of Recent-Onset Depression and Psychosis: Identification of Two Distinct Transdiagnostic Phenotypes. Biol Psychiatry 2022; 92:552-562. [PMID: 35717212 PMCID: PMC10128104 DOI: 10.1016/j.biopsych.2022.03.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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] [Received: 09/30/2021] [Revised: 02/04/2022] [Accepted: 03/01/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Identifying neurobiologically based transdiagnostic categories of depression and psychosis may elucidate heterogeneity and provide better candidates for predictive modeling. We aimed to identify clusters across patients with recent-onset depression (ROD) and recent-onset psychosis (ROP) based on structural neuroimaging data. We hypothesized that these transdiagnostic clusters would identify patients with poor outcome and allow more accurate prediction of symptomatic remission than traditional diagnostic structures. METHODS HYDRA (Heterogeneity through Discriminant Analysis) was trained on whole-brain volumetric measures from 577 participants from the discovery sample of the multisite PRONIA study to identify neurobiologically driven clusters, which were then externally validated in the PRONIA replication sample (n = 404) and three datasets of chronic samples (Centre for Biomedical Research Excellence, n = 146; Mind Clinical Imaging Consortium, n = 202; Munich, n = 470). RESULTS The optimal clustering solution was two transdiagnostic clusters (cluster 1: n = 153, 67 ROP, 86 ROD; cluster 2: n = 149, 88 ROP, 61 ROD; adjusted Rand index = 0.618). The two clusters contained both patients with ROP and patients with ROD. One cluster had widespread gray matter volume deficits and more positive, negative, and functional deficits (impaired cluster), and one cluster revealed a more preserved neuroanatomical signature and more core depressive symptomatology (preserved cluster). The clustering solution was internally and externally validated and assessed for clinical utility in predicting 9-month symptomatic remission, outperforming traditional diagnostic structures. CONCLUSIONS We identified two transdiagnostic neuroanatomically informed clusters that are clinically and biologically distinct, challenging current diagnostic boundaries in recent-onset mental health disorders. These results may aid understanding of the etiology of poor outcome patients transdiagnostically and improve development of stratified treatments.
Collapse
Affiliation(s)
- Paris Alexandros Lalousis
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom.
| | - Lianne Schmaal
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen J Wood
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Renate L E P Reniers
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom; Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Nicholas M Barnes
- Institute of Clinical Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Department of Psychology, Aston University, Birmingham, United Kingdom
| | - Sian Lowri Griffiths
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Alexandra Stainton
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Junhao Wen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gyujoon Hwang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christos Davatzikos
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Carolina Bonivento
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Adele Ferro
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Georg Romer
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany; Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Paolo Brambilla
- Department of Psychiatry, University of Basel, Basel, Switzerland; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Ludwig Maxmilians University, Munich, Germany
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephan Ruhrmann
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | | | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - André Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maxmilians University, Munich, Germany
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig Maxmilians University, Munich, Germany
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom; Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom; Birmingham Early Interventions Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| |
Collapse
|
35
|
Squarcina L, Kambeitz-Ilankovic L, Bonivento C, Prunas C, Oldani L, Wenzel J, Ruef A, Dwyer D, Ferro A, Borgwardt S, Kambeitz J, Lichtenstein TK, Meisenzahl E, Pantelis C, Rosen M, Upthegrove R, Antonucci LA, Bertolino A, Lencer R, Ruhrmann S, Salokangas RRK, Schultze-Lutter F, Chisholm K, Stainton A, Wood SJ, Koutsouleris N, Brambilla P. Relationships between global functioning and neuropsychological predictors in subjects at high risk of psychosis or with a recent onset of depression. World J Biol Psychiatry 2022; 23:573-581. [PMID: 35048791 DOI: 10.1080/15622975.2021.2014955] [Citation(s) in RCA: 2] [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] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Psychotic disorders are frequently associated with decline in functioning and cognitive difficulties are observed in subjects at clinical high risk (CHR) for psychosis. In this work, we applied automatic approaches to neurocognitive and functioning measures, with the aim of investigating the link between global, social and occupational functioning, and cognition. METHODS 102 CHR subjects and 110 patients with recent onset depression (ROD) were recruited. Global assessment of functioning (GAF) related to symptoms (GAF-S) and disability (GAF-D). and global functioning social (GF-S) and role (GF-R), at baseline and of the previous month and year, and a set of neurocognitive measures, were used for classification and regression. RESULTS Neurocognitive measures related to GF-R at baseline (r = 0.20, p = 0.004), GF-S at present (r = 0.14, p = 0.042) and of the past year (r = 0.19, p = 0.005), for GAF-F of the past month (r = 0.24, p < 0.001) and GAF-D of the past year (r = 0.28, p = 0.002). Classification reached values of balanced accuracy of 61% for GF-R and GAF-D. CONCLUSION We found that neurocognition was related to psychosocial functioning. More specifically, a deficit in executive functions was associated to poor social and occupational functioning.
Collapse
Affiliation(s)
- Letizia Squarcina
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Cecilia Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucio Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefan Borgwardt
- Department of Psychiatry, (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, University of Lubeck, Lubeck, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Theresa Katharina Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Linda A Antonucci
- Department of Education, Psychology and Communication, University of Bari "Aldo Moro" - Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lubeck, Lubeck, Germany.,Institute for Translational Psychiatry, Westfalische-Wilhelms-University Munster, Munster, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Dusseldorf, Germany.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Katharine Chisholm
- Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| | - Alexandra Stainton
- Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Parkville, Australia.,Orygen, Melbourne, Australia.,Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.,Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | |
Collapse
|
36
|
Fusar-Poli P, Manchia M, Koutsouleris N, Leslie D, Woopen C, Calkins ME, Dunn M, Tourneau CL, Mannikko M, Mollema T, Oliver D, Rietschel M, Reininghaus EZ, Squassina A, Valmaggia L, Kessing LV, Vieta E, Correll CU, Arango C, Andreassen OA. Ethical considerations for precision psychiatry: A roadmap for research and clinical practice. Eur Neuropsychopharmacol 2022; 63:17-34. [PMID: 36041245 DOI: 10.1016/j.euroneuro.2022.08.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [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: 04/13/2022] [Revised: 07/04/2022] [Accepted: 08/05/2022] [Indexed: 12/14/2022]
Abstract
Precision psychiatry is an emerging field with transformative opportunities for mental health. However, the use of clinical prediction models carries unprecedented ethical challenges, which must be addressed before accessing the potential benefits of precision psychiatry. This critical review covers multidisciplinary areas, including psychiatry, ethics, statistics and machine-learning, healthcare and academia, as well as input from people with lived experience of mental disorders, their family, and carers. We aimed to identify core ethical considerations for precision psychiatry and mitigate concerns by designing a roadmap for research and clinical practice. We identified priorities: learning from somatic medicine; identifying precision psychiatry use cases; enhancing transparency and generalizability; fostering implementation; promoting mental health literacy; communicating risk estimates; data protection and privacy; and fostering the equitable distribution of mental health care. We hope this blueprint will advance research and practice and enable people with mental health problems to benefit from precision psychiatry.
Collapse
Affiliation(s)
- 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; South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | - Monica E Calkins
- Neurodevelopment and Psychosis Section and Lifespan Brain Institute of Penn/CHOP, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, USA
| | - Michael Dunn
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore
| | - Christophe Le Tourneau
- Institut Curie, Department of Drug Development and Innovation (D3i), INSERM U900 Research unit, Paris-Saclay University, France
| | - Miia Mannikko
- European Federation of Associations of Families of People with Mental Illness (EUFAMI), Leuven, Belgium
| | - Tineke Mollema
- Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN), Brussels, Belgium
| | - 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
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Alessio Squassina
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Italy
| | - Lucia Valmaggia
- South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry, KU Leuven, Belgium
| | - Lars Vedel Kessing
- Copenhagen Affective disorder Research Center (CADIC), Psychiatric Center Copenhagen, Denmark; Department of clinical Medicine, University of Copenhagen, Denmark
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Christoph U Correll
- The Zucker Hillside Hospital, Department of Psychiatry, 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
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Gregorio Marañón; Health Research Institute (IiGSM), School of Medicine, Universidad Complutense de Madrid; Biomedical Research Center for Mental Health (CIBERSAM), Madrid, Spain
| | - Ole A Andreassen
- NORMENT, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | |
Collapse
|
37
|
Moore TM, Calkins ME, Rosen AFG, Butler ER, Ruparel K, Fusar-Poli P, Koutsouleris N, McGuire P, Cannon TD, Gur RC, Gur RE. Development of a probability calculator for psychosis risk in children, adolescents, and young adults. Psychol Med 2022; 52:3159-3167. [PMID: 33431073 PMCID: PMC8273212 DOI: 10.1017/s0033291720005231] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 01/07/2023]
Abstract
BACKGROUND Assessment of risks of illnesses has been an important part of medicine for decades. We now have hundreds of 'risk calculators' for illnesses, including brain disorders, and these calculators are continually improving as more diverse measures are collected on larger samples. METHODS We first replicated an existing psychosis risk calculator and then used our own sample to develop a similar calculator for use in recruiting 'psychosis risk' enriched community samples. We assessed 632 participants age 8-21 (52% female; 48% Black) from a community sample with longitudinal data on neurocognitive, clinical, medical, and environmental variables. We used this information to predict psychosis spectrum (PS) status in the future. We selected variables based on lasso, random forest, and statistical inference relief; and predicted future PS using ridge regression, random forest, and support vector machines. RESULTS Cross-validated prediction diagnostics were obtained by building and testing models in randomly selected sub-samples of the data, resulting in a distribution of the diagnostics; we report the mean. The strongest predictors of later PS status were the Children's Global Assessment Scale; delusions of predicting the future or having one's thoughts/actions controlled; and the percent married in one's neighborhood. Random forest followed by ridge regression was most accurate, with a cross-validated area under the curve (AUC) of 0.67. Adjustment of the model including only six variables reached an AUC of 0.70. CONCLUSIONS Results support the potential application of risk calculators for screening and identification of at-risk community youth in prospective investigations of developmental trajectories of the PS.
Collapse
Affiliation(s)
- Tyler M. Moore
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute, Penn Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Monica E. Calkins
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute, Penn Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Adon F. G. Rosen
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ellyn R. Butler
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute, Penn Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- OASIS service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Germany
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Tyrone D. Cannon
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT 06520, USA
| | - Ruben C. Gur
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute, Penn Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Raquel E. Gur
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute, Penn Medicine and Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| |
Collapse
|
38
|
Cao H, Zhang Y, Baumbach J, Burton PR, Dwyer D, Koutsouleris N, Matschinske J, Marcon Y, Rajan S, Rieg T, Ryser-Welch P, Späth J, Herrmann C, Schwarz E. dsMTL - a computational framework for privacy-preserving, distributed multi-task machine learning. Bioinformatics 2022; 38:4919-4926. [PMID: 36073911 DOI: 10.1093/bioinformatics/btac616] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/12/2022] Open
Abstract
MOTIVATION In multi-cohort machine learning studies, it is critical to differentiate between effects that are reproducible across cohorts and those that are cohort-specific. Multi-task learning (MTL) is a machine learning approach that facilitates this differentiation through the simultaneous learning of prediction tasks across cohorts. Since multi-cohort data can often not be combined into a single storage solution, there would be the substantial utility of an MTL application for geographically distributed data sources. RESULTS Here, we describe the development of "dsMTL", a computational framework for privacy-preserving, distributed multi-task machine learning that includes three supervised and one unsupervised algorithms. First, we derive the theoretical properties of these methods and the relevant machine learning workflows to ensure the validity of the software implementation. Second, we implement dsMTL as a library for the R programming language, building on the DataSHIELD platform that supports the federated analysis of sensitive individual-level data. Third, we demonstrate the applicability of dsMTL for comorbidity modeling in distributed data. We show that comorbidity modeling using dsMTL outperformed conventional, federated machine learning, as well as the aggregation of multiple models built on the distributed datasets individually. The application of dsMTL was computationally efficient and highly scalable when applied to moderate-size (n < 500), real expression data given the actual network latency. AVAILABILITY dsMTL is freely available at https://github.com/transbioZI/dsMTLBase (server-side package) and https://github.com/transbioZI/dsMTLClient (client-side package). SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
Collapse
Affiliation(s)
- Han Cao
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Youcheng Zhang
- Health Data Science Unit, Medical Faculty Heidelberg & BioQuant, Heidelberg, 69120, Germany
| | - Jan Baumbach
- Chair of Computational Systems Biology, University of Hamburg, Hamburg, Germany.,Computational Biomedicine Lab, Department of Mathematics and Computer Science, University of Southern Denmark, Odense, Denmark
| | - Paul R Burton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Section for Neurodiagnostic Applications, Ludwig-Maximilian University, Munich 80638, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Section for Neurodiagnostic Applications, Ludwig-Maximilian University, Munich 80638, Germany
| | - Julian Matschinske
- Chair of Computational Systems Biology, University of Hamburg, Hamburg, Germany
| | | | - Sivanesan Rajan
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Thilo Rieg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Patricia Ryser-Welch
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Julian Späth
- Chair of Computational Systems Biology, University of Hamburg, Hamburg, Germany
| | | | - Carl Herrmann
- Health Data Science Unit, Medical Faculty Heidelberg & BioQuant, Heidelberg, 69120, Germany
| | - Emanuel Schwarz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
39
|
Chand GB, Singhal P, Dwyer DB, Wen J, Erus G, Doshi J, Srinivasan D, Mamourian E, Varol E, Sotiras A, Hwang G, Dazzan P, Kahn RS, Schnack HG, Zanetti MV, Meisenzahl E, Busatto GF, Crespo-Facorro B, Pantelis C, Wood SJ, Zhuo C, Shinohara RT, Shou H, Fan Y, Koutsouleris N, Kaczkurkin AN, Moore TM, Verma A, Calkins ME, Gur RE, Gur RC, Ritchie MD, Satterthwaite TD, Wolf DH, Davatzikos C. Schizophrenia Imaging Signatures and Their Associations With Cognition, Psychopathology, and Genetics in the General Population. Am J Psychiatry 2022; 179:650-660. [PMID: 35410495 PMCID: PMC9444886 DOI: 10.1176/appi.ajp.21070686] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 12/21/2022]
Abstract
OBJECTIVE The prevalence and significance of schizophrenia-related phenotypes at the population level is debated in the literature. Here, the authors assessed whether two recently reported neuroanatomical signatures of schizophrenia-signature 1, with widespread reduction of gray matter volume, and signature 2, with increased striatal volume-could be replicated in an independent schizophrenia sample, and investigated whether expression of these signatures can be detected at the population level and how they relate to cognition, psychosis spectrum symptoms, and schizophrenia genetic risk. METHODS This cross-sectional study used an independent schizophrenia-control sample (N=347; ages 16-57 years) for replication of imaging signatures, and then examined two independent population-level data sets: typically developing youths and youths with psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort (N=359; ages 16-23 years) and adults in the UK Biobank study (N=836; ages 44-50 years). The authors quantified signature expression using support-vector machine learning and compared cognition, psychopathology, and polygenic risk between signatures. RESULTS Two neuroanatomical signatures of schizophrenia were replicated. Signature 1 but not signature 2 was significantly more common in youths with psychosis spectrum symptoms than in typically developing youths, whereas signature 2 frequency was similar in the two groups. In both youths and adults, signature 1 was associated with worse cognitive performance than signature 2. Compared with adults with neither signature, adults expressing signature 1 had elevated schizophrenia polygenic risk scores, but this was not seen for signature 2. CONCLUSIONS The authors successfully replicated two neuroanatomical signatures of schizophrenia and describe their prevalence in population-based samples of youths and adults. They further demonstrated distinct relationships of these signatures with psychosis symptoms, cognition, and genetic risk, potentially reflecting underlying neurobiological vulnerability.
Collapse
Affiliation(s)
- Ganesh B Chand
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Pankhuri Singhal
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Dominic B Dwyer
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Junhao Wen
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Jimit Doshi
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Dhivya Srinivasan
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Elizabeth Mamourian
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Erdem Varol
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Aristeidis Sotiras
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Gyujoon Hwang
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Paola Dazzan
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Rene S Kahn
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Hugo G Schnack
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Marcus V Zanetti
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Eva Meisenzahl
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Geraldo F Busatto
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Benedicto Crespo-Facorro
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Christos Pantelis
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Stephen J Wood
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Chuanjun Zhuo
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Russell T Shinohara
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Haochang Shou
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Nikolaos Koutsouleris
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Antonia N Kaczkurkin
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Tyler M Moore
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Anurag Verma
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Monica E Calkins
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Raquel E Gur
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Ruben C Gur
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Marylyn D Ritchie
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Theodore D Satterthwaite
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Daniel H Wolf
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, Satterthwaite, Wolf, Davatzikos, Shinohara, Shou), Department of Radiology (Chand, Wen, Erus, Doshi, Srinivasan, Mamourian, Varol, Sotiras, Hwang, Fan, R.E. Gur, R.C. Gur, Davatzikos), Department of Genetics (Singhal, Verma, Ritchie), Department of Psychiatry (Kaczkurkin, Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite, Wolf), and Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics (Shinohara, Shou), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Radiology, School of Medicine (Chand, Sotiras), and Institute of Informatics (Sotiras), Washington University in St. Louis; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich (Dwyer, Koutsouleris); Department of Statistics, Zuckerman Institute, Columbia University, New York (Varol); Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Dazzan); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Kahn); Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Schnack); Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Zanetti, Busatto); Hospital Sírio-Libanês, São Paulo, Brazil (Zanetti); LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany (Meisenzahl); Department of Psychiatry, School of Medicine, University Hospital Virgen del Rocio, IBiS-CIBERSAM, University of Sevilla, Spain (Crespo-Facorro); Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Australia (Pantelis); Orygen, National Centre of Excellence for Youth Mental Health, Melbourne, Australia, and Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia (Wood); School of Psychology, University of Birmingham, Edgbaston, U.K. (Wood); Department of Psychiatric Neuroimaging Genetics and Comorbidity Laboratory, Nankai University Affiliated Tianjin Anding Hospital, and Department of Psychiatry, Tianjin Medical University, Tianjin, China (Zhuo); Department of Psychology, Vanderbilt University, Nashville (Kaczkurkin); Lifespan Brain Institute of Penn Medicine and Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia (Moore, Calkins, R.E. Gur, R.C. Gur, Satterthwaite)
| |
Collapse
|
40
|
Koutsouleris N, Pantelis C, Velakoulis D, McGuire P, Dwyer DB, Urquijo-Castro MF, Paul R, Dong S, Popovic D, Oeztuerk O, Kambeitz J, Salokangas RKR, Hietala J, Bertolino A, Brambilla P, Upthegrove R, Wood SJ, Lencer R, Borgwardt S, Maj C, Nöthen M, Degenhardt F, Polyakova M, Mueller K, Villringer A, Danek A, Fassbender K, Fliessbach K, Jahn H, Kornhuber J, Landwehrmeyer B, Anderl-Straub S, Prudlo J, Synofzik M, Wiltfang J, Riedl L, Diehl-Schmid J, Otto M, Meisenzahl E, Falkai P, Schroeter ML. Exploring Links Between Psychosis and Frontotemporal Dementia Using Multimodal Machine Learning: Dementia Praecox Revisited. JAMA Psychiatry 2022; 79:907-919. [PMID: 35921104 PMCID: PMC9350851 DOI: 10.1001/jamapsychiatry.2022.2075] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 06/12/2022] [Indexed: 12/04/2022]
Abstract
Importance The behavioral and cognitive symptoms of severe psychotic disorders overlap with those seen in dementia. However, shared brain alterations remain disputed, and their relevance for patients in at-risk disease stages has not been explored so far. Objective To use machine learning to compare the expression of structural magnetic resonance imaging (MRI) patterns of behavioral-variant frontotemporal dementia (bvFTD), Alzheimer disease (AD), and schizophrenia; estimate predictability in patients with bvFTD and schizophrenia based on sociodemographic, clinical, and biological data; and examine prognostic value, genetic underpinnings, and progression in patients with clinical high-risk (CHR) states for psychosis or recent-onset depression (ROD). Design, Setting, and Participants This study included 1870 individuals from 5 cohorts, including (1) patients with bvFTD (n = 108), established AD (n = 44), mild cognitive impairment or early-stage AD (n = 96), schizophrenia (n = 157), or major depression (n = 102) to derive and compare diagnostic patterns and (2) patients with CHR (n = 160) or ROD (n = 161) to test patterns' prognostic relevance and progression. Healthy individuals (n = 1042) were used for age-related and cohort-related data calibration. Data were collected from January 1996 to July 2019 and analyzed between April 2020 and April 2022. Main Outcomes and Measures Case assignments based on diagnostic patterns; sociodemographic, clinical, and biological data; 2-year functional outcomes and genetic separability of patients with CHR and ROD with high vs low pattern expression; and pattern progression from baseline to follow-up MRI scans in patients with nonrecovery vs preserved recovery. Results Of 1870 included patients, 902 (48.2%) were female, and the mean (SD) age was 38.0 (19.3) years. The bvFTD pattern comprising prefrontal, insular, and limbic volume reductions was more expressed in patients with schizophrenia (65 of 157 [41.2%]) and major depression (22 of 102 [21.6%]) than the temporo-limbic AD patterns (28 of 157 [17.8%] and 3 of 102 [2.9%], respectively). bvFTD expression was predicted by high body mass index, psychomotor slowing, affective disinhibition, and paranoid ideation (R2 = 0.11). The schizophrenia pattern was expressed in 92 of 108 patients (85.5%) with bvFTD and was linked to the C9orf72 variant, oligoclonal banding in the cerebrospinal fluid, cognitive impairment, and younger age (R2 = 0.29). bvFTD and schizophrenia pattern expressions forecasted 2-year psychosocial impairments in patients with CHR and were predicted by polygenic risk scores for frontotemporal dementia, AD, and schizophrenia. Findings were not associated with AD or accelerated brain aging. Finally, 1-year bvFTD/schizophrenia pattern progression distinguished patients with nonrecovery from those with preserved recovery. Conclusions and Relevance Neurobiological links may exist between bvFTD and psychosis focusing on prefrontal and salience system alterations. Further transdiagnostic investigations are needed to identify shared pathophysiological processes underlying the neuroanatomical interface between the 2 disease spectra.
Collapse
Affiliation(s)
- Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Max-Planck Institute of Psychiatry, Munich, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia
| | - Philip McGuire
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dominic B. Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | | | - Riya Paul
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Sen Dong
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Oemer Oeztuerk
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | | | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Rachel Upthegrove
- Institute of Mental Health, University of Birmingham, Birmingham, United Kingdom
- Early Intervention Service, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom
| | - Stephen J. Wood
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, Melbourne, Australia
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
- Institute for Translational Psychiatry, University Muenster, Muenster, Germany
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
- Department of Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Carlo Maj
- Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Markus Nöthen
- Institute of Human Genetics, School of Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, School of Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - Maryna Polyakova
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Karsten Mueller
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig Maximilian University Munich, Munich, Germany
| | - Klaus Fassbender
- Department of Neurology, Saarland University Hospital, Homburg, Germany
| | - Klaus Fliessbach
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Holger Jahn
- Department of Psychiatry and Psychotherapy, University Hospital Hamburg, Hamburg, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | | | - Johannes Prudlo
- Department of Neurology, University Medicine Rostock, Rostock, Germany
| | - Matthis Synofzik
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Neurodegenerative Diseases, Center of Neurology, Hertie Institute for Clinical Brain Research, Tübingen, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- Department of Psychiatry and Psychotherapy, Medical University Göttingen, Göttingen, Germany
| | - Lina Riedl
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany
| | - Matthias L. Schroeter
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| |
Collapse
|
41
|
Rost N, Brückl TM, Koutsouleris N, Binder EB, Müller-Myhsok B. Creating sparser prediction models of treatment outcome in depression: a proof-of-concept study using simultaneous feature selection and hyperparameter tuning. BMC Med Inform Decis Mak 2022; 22:181. [PMID: 35836174 PMCID: PMC9284749 DOI: 10.1186/s12911-022-01926-2] [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] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/07/2022] [Indexed: 12/03/2022] Open
Abstract
Background Predicting treatment outcome in major depressive disorder (MDD) remains an essential challenge for precision psychiatry. Clinical prediction models (CPMs) based on supervised machine learning have been a promising approach for this endeavor. However, only few CPMs have focused on model sparsity even though sparser models might facilitate the translation into clinical practice and lower the expenses of their application. Methods In this study, we developed a predictive modeling pipeline that combines hyperparameter tuning and recursive feature elimination in a nested cross-validation framework. We applied this pipeline to a real-world clinical data set on MDD treatment response and to a second simulated data set using three different classification algorithms. Performance was evaluated by permutation testing and comparison to a reference pipeline without nested feature selection. Results Across all models, the proposed pipeline led to sparser CPMs compared to the reference pipeline. Except for one comparison, the proposed pipeline resulted in equally or more accurate predictions. For MDD treatment response, balanced accuracy scores ranged between 61 and 71% when models were applied to hold-out validation data. Conclusions The resulting models might be particularly interesting for clinical applications as they could reduce expenses for clinical institutions and stress for patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-022-01926-2.
Collapse
Affiliation(s)
- Nicolas Rost
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany. .,International Max Planck Research School for Translational Psychiatry, Munich, Germany.
| | - Tanja M Brückl
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany.,Max Planck Institute of Psychiatry, Munich, Germany.,Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany
| | - Bertram Müller-Myhsok
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804, Munich, Germany.,Department of Health Data Science, University of Liverpool, Liverpool, UK
| |
Collapse
|
42
|
Dwyer DB, Buciuman MO, Ruef A, Kambeitz J, Sen Dong M, Stinson C, Kambeitz-Ilankovic L, Degenhardt F, Sanfelici R, Antonucci LA, Lalousis PA, Wenzel J, Urquijo-Castro MF, Popovic D, Oeztuerk OF, Haas SS, Weiske J, Hauke D, Neufang S, Schmidt-Kraepelin C, Ruhrmann S, Penzel N, Lichtenstein T, Rosen M, Chisholm K, Riecher-Rössler A, Egloff L, Schmidt A, Andreou C, Hietala J, Schirmer T, Romer G, Michel C, Rössler W, Maj C, Borisov O, Krawitz PM, Falkai P, Pantelis C, Lencer R, Bertolino A, Borgwardt S, Noethen M, Brambilla P, Schultze-Lutter F, Meisenzahl E, Wood SJ, Davatzikos C, Upthegrove R, Salokangas RKR, Koutsouleris N. Clinical, Brain, and Multilevel Clustering in Early Psychosis and Affective Stages. JAMA Psychiatry 2022; 79:677-689. [PMID: 35583903 PMCID: PMC9118078 DOI: 10.1001/jamapsychiatry.2022.1163] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/13/2022]
Abstract
Importance Approaches are needed to stratify individuals in early psychosis stages beyond positive symptom severity to investigate specificity related to affective and normative variation and to validate solutions with premorbid, longitudinal, and genetic risk measures. Objective To use machine learning techniques to cluster, compare, and combine subgroup solutions using clinical and brain structural imaging data from early psychosis and depression stages. Design, Setting, and Participants A multisite, naturalistic, longitudinal cohort study (10 sites in 5 European countries; including major follow-up intervals at 9 and 18 months) with a referred patient sample of those with clinical high risk for psychosis (CHR-P), recent-onset psychosis (ROP), recent-onset depression (ROD), and healthy controls were recruited between February 1, 2014, to July 1, 2019. Data were analyzed between January 2020 and January 2022. Main Outcomes and Measures A nonnegative matrix factorization technique separately decomposed clinical (287 variables) and parcellated brain structural volume (204 gray, white, and cerebrospinal fluid regions) data across CHR-P, ROP, ROD, and healthy controls study groups. Stability criteria determined cluster number using nested cross-validation. Validation targets were compared across subgroup solutions (premorbid, longitudinal, and schizophrenia polygenic risk scores). Multiclass supervised machine learning produced a transferable solution to the validation sample. Results There were a total of 749 individuals in the discovery group and 610 individuals in the validation group. Individuals included those with CHR-P (n = 287), ROP (n = 323), ROD (n = 285), and healthy controls (n = 464), The mean (SD) age was 25.1 (5.9) years, and 702 (51.7%) were female. A clinical 4-dimensional solution separated individuals based on positive symptoms, negative symptoms, depression, and functioning, demonstrating associations with all validation targets. Brain clustering revealed a subgroup with distributed brain volume reductions associated with negative symptoms, reduced performance IQ, and increased schizophrenia polygenic risk scores. Multilevel results distinguished between normative and illness-related brain differences. Subgroup results were largely validated in the external sample. Conclusions and Relevance The results of this longitudinal cohort study provide stratifications beyond the expression of positive symptoms that cut across illness stages and diagnoses. Clinical results suggest the importance of negative symptoms, depression, and functioning. Brain results suggest substantial overlap across illness stages and normative variation, which may highlight a vulnerability signature independent from specific presentations. Premorbid, longitudinal, and genetic risk validation suggested clinical importance of the subgroups to preventive treatments.
Collapse
Affiliation(s)
- Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Madalina-Octavia Buciuman
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,International Max-Planck Research School for Translational Psychiatry, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Mark Sen Dong
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Caedyn Stinson
- Max-Planck School of Cognition, Leipzig, Germany.,Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Rachele Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany
| | - Linda A Antonucci
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Paris Alexandros Lalousis
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,International Max-Planck Research School for Translational Psychiatry, Munich, Germany
| | - Oemer Faruk Oeztuerk
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,International Max-Planck Research School for Translational Psychiatry, Munich, Germany
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Johanna Weiske
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Daniel Hauke
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland.,Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom.,Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
| | - Susanne Neufang
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Katharine Chisholm
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, United Kingdom.,Department of Psychology, Aston University, Birmingham, United Kingdom
| | | | - Laura Egloff
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - André Schmidt
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Timo Schirmer
- GE Healthcare GmbH (previously GE Global Research GmbH), Munich, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University of Münster, Münster, Germany
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Carlo Maj
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Oleg Borisov
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Peter M Krawitz
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Stefan Borgwardt
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Markus Noethen
- Institute of Human Genetics, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | | | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia.,Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Victoria, Australia
| | - Christos Davatzikos
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.,Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, United Kingdom.,Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | |
Collapse
|
43
|
Haas SS, Doucet GE, Antoniades M, Modabbernia A, Corcoran CM, Kahn RS, Kambeitz J, Kambeitz-Ilankovic L, Borgwardt S, Brambilla P, Upthegrove R, Wood SJ, Salokangas RK, Hietala J, Meisenzahl E, Koutsouleris N, Frangou S. Evidence of discontinuity between psychosis-risk and non-clinical samples in the neuroanatomical correlates of social function. Schizophr Res Cogn 2022; 29:100252. [PMID: 35391789 PMCID: PMC8980307 DOI: 10.1016/j.scog.2022.100252] [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] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/26/2022] [Accepted: 03/27/2022] [Indexed: 11/28/2022]
Abstract
Objective Social dysfunction is a major feature of clinical-high-risk states for psychosis (CHR-P). Prior research has identified a neuroanatomical pattern associated with impaired social function outcome in CHR-P. The aim of the current study was to test whether social dysfunction in CHR-P is neurobiologically distinct or in a continuum with the lower end of the normal distribution of individual differences in social functioning. Methods We used a machine learning classifier to test for the presence of a previously validated brain structural pattern associated with impaired social outcome in CHR-P (CHR-outcome-neurosignature) in the neuroimaging profiles of individuals from two non-clinical samples (total n = 1763) and examined its association with social function, psychopathology and cognition. Results Although the CHR-outcome-neurosignature could be detected in a subset of the non-clinical samples, it was not associated was adverse social outcomes or higher psychopathology levels. However, participants whose neuroanatomical profiles were highly aligned with the CHR-outcome-neurosignature manifested subtle disadvantage in fluid (PFDR = 0.004) and crystallized intelligence (PFDR = 0.01), cognitive flexibility (PFDR = 0.02), inhibitory control (PFDR = 0.01), working memory (PFDR = 0.0005), and processing speed (PFDR = 0.04). Conclusions We provide evidence of divergence in brain structural underpinnings of social dysfunction derived from a psychosis-risk enriched population when applied to non-clinical samples. This approach appears promising in identifying brain mechanisms bound to psychosis through comparisons of patient populations to non-clinical samples with the same neuroanatomical profiles.
Collapse
Affiliation(s)
- Shalaila S. Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, USA
| | - Gaelle E. Doucet
- Institute for Human Neuroscience, Boys Town National Research Hospital, 14090 Mother Teresa Lane, Boys Town, NE 68010, USA
| | - Mathilde Antoniades
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia 19104, USA
| | - Amirhossein Modabbernia
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, USA
| | - Cheryl M. Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, USA
| | - René S. Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, USA
| | - Joseph Kambeitz
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Nussbaumstraße 7, 80336 München, Germany
| | - Stefan Borgwardt
- Department of Psychiatry, University Psychiatric Clinics (UPK), University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland,Department of Psychiatry, Psychosomatics and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck 23538, Germany
| | - Paolo Brambilla
- Department of Neuroscience and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122 Milano, Italy,Department of Pathophysiology and Mental Health, University of Milan, Via Francesco Sforza 35, 20122 Milano, Italy
| | - Rachel Upthegrove
- Early Intervention Service, Birmingham Womens and Childrens NHS Trust, Steelhouse Lane, Birmingham, B4 6NH, UK,Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Stephen J. Wood
- Department of Pathophysiology and Mental Health, University of Milan, Via Francesco Sforza 35, 20122 Milano, Italy,Orygen, 35 Poplar Rd, Parkville, VIC 3052, Australia,Centre for Youth Mental Health, University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia
| | - Raimo K.R. Salokangas
- Department of Psychiatry, University of Turku and Turku University Hospital, FI-20014 Turun yliopisto, Finland
| | - Jarmo Hietala
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Moorenstrße 5, 40225 Düsseldorf, Germany
| | - Eva Meisenzahl
- Max-Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 München, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Nussbaumstraße 7, 80336 München, Germany,Max-Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 München, Germany,Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, SE5 8AF London, UK
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, USA,Department of Psychiatry, Djavad Mowafaghian Centre for Brain Health, 2215 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada,Corresponding author at: Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, NY, 10029, NY, USA.
| |
Collapse
|
44
|
Abstract
Progress in developing personalised care for mental disorders is supported by numerous proof-of-concept machine learning studies in the area of risk assessment, diagnostics and precision prescribing. Most of these studies primarily use clinical data, but models might benefit from additional neuroimaging, blood and genetic data to improve accuracy. Combined, multimodal models might offer potential for stratification of patients for treatment. Clinical implementation of machine learning is impeded by a lack of wider generalisability, with efforts primarily focused on psychosis and dementia. Studies across all diagnostic groups should work to test the robustness of machine learning models, which is an essential first step to clinical implementation, and then move to prospective clinical validation. Models need to exceed clinicians' heuristics to be useful, and safe, in routine decision-making. Engagement of clinicians, researchers and patients in digitalisation and 'big data' approaches are vital to allow the generation and accessibility of large, longitudinal, prospective data needed for precision psychiatry to be applied into real-world psychiatric care.
Collapse
Affiliation(s)
- Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, Germany; and Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany; Max-Planck Institute of Psychiatry, Munich, Germany; and Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Rachel Upthegrove
- Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, UK; and Institute for Mental Health, University of Birmingham, UK
| |
Collapse
|
45
|
Dwyer D, Koutsouleris N. Annual Research Review: Translational machine learning for child and adolescent psychiatry. J Child Psychol Psychiatry 2022; 63:421-443. [PMID: 35040130 DOI: 10.1111/jcpp.13545] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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] [Accepted: 09/06/2021] [Indexed: 12/14/2022]
Abstract
Children and adolescents could benefit from the use of predictive tools that facilitate personalized diagnoses, prognoses, and treatment selection. Such tools have not yet been deployed using traditional statistical methods, potentially due to the limitations of the paradigm and the need to leverage large amounts of digital data. This review will suggest that a machine learning approach could address these challenges and is designed to introduce new readers to the background, methods, and results in the field. A rationale is first introduced followed by an outline of fundamental elements of machine learning approaches. To provide an overview of the use of the techniques in child and adolescent literature, a scoping review of broad trends is then presented. Selected studies are also highlighted in order to draw attention to research areas that are closest to translation and studies that exhibit a high degree of experimental innovation. Limitations to the research, and machine learning approaches generally, are outlined in the penultimate section highlighting issues related to sample sizes, validation, clinical utility, and ethical challenges. Finally, future directions are discussed that could enhance the possibility of clinical implementation and address specific questions relevant to the child and adolescent psychiatry. The review gives a broad overview of the machine learning paradigm in order to highlight the benefits of a shift in perspective towards practically oriented statistical solutions that aim to improve clinical care of children and adolescents.
Collapse
Affiliation(s)
- Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
46
|
Penzel N, Sanfelici R, Antonucci LA, Betz LT, Dwyer D, Ruef A, Cho KIK, Cumming P, Pogarell O, Howes O, Falkai P, Upthegrove R, Borgwardt S, Brambilla P, Lencer R, Meisenzahl E, Schultze-Lutter F, Rosen M, Lichtenstein T, Kambeitz-Ilankovic L, Ruhrmann S, Salokangas RKR, Pantelis C, Wood SJ, Quednow BB, Pergola G, Bertolino A, Koutsouleris N, Kambeitz J, Dwyer D, Ruef A, Kambeitz-Ilankovic L, Sen Dong M, Erkens A, Gussmann E, Haas S, Hasan A, Hoff C, Khanyaree I, Melo A, Muckenhuber-Sternbauer S, Kohler J, Ozturk OF, Popovic D, Rangnick A, von Saldern S, Sanfelici R, Spangemacher M, Tupac A, Urquijo MF, Weiske J, Wosgien A, Kambeitz J, Ruhrmann S, Rosen M, Betz L, Lichtenstein T, Blume K, Seves M, Kaiser N, Penzel N, Pilgram T, Lichtenstein T, Wenzel J, Woopen C, Borgwardt S, Andreou C, Egloff L, Harrisberger F, Lenz C, Leanza L, Mackintosh A, Smieskova R, Studerus E, Walter A, Widmayer S, Upthegrove R, Wood SJ, Chisholm K, Day C, Griffiths SL, Lalousis PA, Iqbal M, Pelton M, Mallikarjun P, Stainton A, Lin A, Salokangas RKR, Denissoff A, Ellila A, From T, Heinimaa M, Ilonen T, Jalo P, Laurikainen H, Lehtinen M, Luutonen A, Makela A, Paju J, Pesonen H, Armio Säilä RL, Sormunen E, Toivonen A, Turtonen O, Solana AB, Abraham M, Hehn N, Schirmer T, Brambilla P, Altamura C, Belleri M, Bottinelli F, Ferro A, Re M, Monzani E, Percudani M, Sberna M, D’Agostino A, Del Fabro L, Perna G, Nobile M, Alciati A, Balestrieri M, Bonivento C, Cabras G, Fabbro F, Garzitto M, PiCCuin S, Bertolino A, Blasi G, Antonucci LA, Pergola G, Caforio G, Faio L, Quarto T, Gelao B, Romano R, Andriola I, Falsetti A, Barone M, Passatiore R, Sangiuliano M, Lencer R, Surman M, Bienek O, Romer G, Dannlowski U, Meisenzahl E, Schultze-Lutter F, Schmidt-Kraepelin C, Neufang S, Korda A, Rohner H. Pattern of predictive features of continued cannabis use in patients with recent-onset psychosis and clinical high-risk for psychosis. Schizophrenia (Heidelb) 2022; 8:19. [PMID: 35264631 PMCID: PMC8907166 DOI: 10.1038/s41537-022-00218-y] [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] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/31/2022] [Indexed: 11/09/2022]
Abstract
Continued cannabis use (CCu) is an important predictor for poor long-term outcomes in psychosis and clinically high-risk patients, but no generalizable model has hitherto been tested for its ability to predict CCu in these vulnerable patient groups. In the current study, we investigated how structured clinical and cognitive assessments and structural magnetic resonance imaging (sMRI) contributed to the prediction of CCu in a group of 109 patients with recent-onset psychosis (ROP). We tested the generalizability of our predictors in 73 patients at clinical high-risk for psychosis (CHR). Here, CCu was defined as any cannabis consumption between baseline and 9-month follow-up, as assessed in structured interviews. All patients reported lifetime cannabis use at baseline. Data from clinical assessment alone correctly classified 73% (p < 0.001) of ROP and 59 % of CHR patients. The classifications of CCu based on sMRI and cognition were non-significant (ps > 0.093), and their addition to the interview-based predictor via stacking did not improve prediction significantly, either in the ROP or CHR groups (ps > 0.065). Lower functioning, specific substance use patterns, urbanicity and a lack of other coping strategies contributed reliably to the prediction of CCu and might thus represent important factors for guiding preventative efforts. Our results suggest that it may be possible to identify by clinical measures those psychosis-spectrum patients at high risk for CCu, potentially allowing to improve clinical care through targeted interventions. However, our model needs further testing in larger samples including more diverse clinical populations before being transferred into clinical practice.
Collapse
Affiliation(s)
- Nora Penzel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Rachele Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany
| | - Linda A Antonucci
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Department of Education, Psychology, Communication, University of Bari, Bari, Italy
| | - Linda T Betz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Kang Ik K Cho
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul Cumming
- Department of Nuclear Medicine, Bern University Hospital, Bern, Switzerland.,School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.,International Research Lab in Neuropsychiatry, Neuroscience Research Institute, Samara State Medical University, Samara, Russia
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.,MRC London Institute of Medical Sciences, Hammersmith Hospital, London, W12 0NN, UK.,Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, W12 0NN, UK.,South London and Maudsley NHS Foundation Trust, London, SE5 8AF, UK
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK.,Early Intervention Service, Birmingham Womens and Childrens NHS Foundation Trust, Birmingham, UK
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCUS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.,Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.,Otto Creutzfeldt Center for Behavioral and Cognitive Neuroscience, University of Münster, Münster, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marlene Rosen
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | - Theresa Lichtenstein
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Stephan Ruhrmann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Stephen J Wood
- Institute for Mental Health, University of Birmingham, Birmingham, UK.,Orygen, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Lenggstr. 31, 8032, Zurich, Switzerland
| | - Giulio Pergola
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Alessandro Bertolino
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany.,Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - Joseph Kambeitz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, Cologne, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Bashyam VM, Doshi J, Erus G, Srinivasan D, Abdulkadir A, Habes M, Fan Y, Masters CL, Maruff P, Zhuo C, Völzke H, Johnson SC, Fripp J, Koutsouleris N, Satterthwaite TD, Wolf DH, Gur RE, Gur RC, Morris JC, Albert MS, Grabe HJ, Resnick SM, Bryan RN, Wittfeld K, Bülow R, Wolk DA, Shou H, Nasrallah IM, Davatzikos C, Davatzikos C. Deep Generative Medical Image Harmonization for Improving Cross-Site Generalization in Deep Learning Predictors. J Magn Reson Imaging 2022; 55:908-916. [PMID: 34564904 PMCID: PMC8844038 DOI: 10.1002/jmri.27908] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [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: 06/07/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In the medical imaging domain, deep learning-based methods have yet to see widespread clinical adoption, in part due to limited generalization performance across different imaging devices and acquisition protocols. The deviation between estimated brain age and biological age is an established biomarker of brain health and such models may benefit from increased cross-site generalizability. PURPOSE To develop and evaluate a deep learning-based image harmonization method to improve cross-site generalizability of deep learning age prediction. STUDY TYPE Retrospective. POPULATION Eight thousand eight hundred and seventy-six subjects from six sites. Harmonization models were trained using all subjects. Age prediction models were trained using 2739 subjects from a single site and tested using the remaining 6137 subjects from various other sites. FIELD STRENGTH/SEQUENCE Brain imaging with magnetization prepared rapid acquisition with gradient echo or spoiled gradient echo sequences at 1.5 T and 3 T. ASSESSMENT StarGAN v2, was used to perform a canonical mapping from diverse datasets to a reference domain to reduce site-based variation while preserving semantic information. Generalization performance of deep learning age prediction was evaluated using harmonized, histogram matched, and unharmonized data. STATISTICAL TESTS Mean absolute error (MAE) and Pearson correlation between estimated age and biological age quantified the performance of the age prediction model. RESULTS Our results indicated a substantial improvement in age prediction in out-of-sample data, with the overall MAE improving from 15.81 (±0.21) years to 11.86 (±0.11) with histogram matching to 7.21 (±0.22) years with generative adversarial network (GAN)-based harmonization. In the multisite case, across the 5 out-of-sample sites, MAE improved from 9.78 (±6.69) years to 7.74 (±3.03) years with histogram normalization to 5.32 (±4.07) years with GAN-based harmonization. DATA CONCLUSION While further research is needed, GAN-based medical image harmonization appears to be a promising tool for improving cross-site deep learning generalization. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 1.
Collapse
Affiliation(s)
- Vishnu M. Bashyam
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA, USA,Corresponding authors: Vishnu Bashyam and Christos Davatzikos, ; , 3700 Hamilton Walk, 7th Floor, Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA 19104; https://www.med.upenn.edu/cbica/
| | - Jimit Doshi
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Guray Erus
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Dhivya Srinivasan
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Abdulkadir
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Mohamad Habes
- Biggs Alzheimer’s Institute, University of Texas San Antonio Health Science Center, USA
| | - Yong Fan
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Colin L. Masters
- Florey Institute of Neuroscience and Mental Health, University of Melbourne
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, University of Melbourne
| | - Chuanjun Zhuo
- Tianjin Mental Health Center, Nankai University Affiliated Tianjin Anding Hospital, Tianjin, China,Department of Psychiatry, Tianjin Medical University, Tianjin, China
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany,German Centre for Cardiovascular Research, Partner Site Greifswald, Germany
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, Australian e-Health Research Centre CSIRO
| | | | - Theodore D. Satterthwaite
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA, USA,Department of Psychiatry, University of Pennsylvania
| | | | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania,Department of Radiology, University of Pennsylvania
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania,Department of Radiology, University of Pennsylvania
| | - John C. Morris
- Department of Neurology, Washington University in St. Louis
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany,German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging
| | - R. Nick Bryan
- Department of Diagnostic Medicine, University of Texas at Austin
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany,German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Germany
| | | | - Haochang Shou
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania
| | | | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA, USA,Corresponding authors: Vishnu Bashyam and Christos Davatzikos, ; , 3700 Hamilton Walk, 7th Floor, Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, PA 19104; https://www.med.upenn.edu/cbica/
| | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Lab, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | |
Collapse
|
48
|
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.
Collapse
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.
| |
Collapse
|
49
|
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.
Collapse
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
| |
Collapse
|
50
|
Antonucci LA, Penzel N, Sanfelici R, Pigoni A, Kambeitz-Ilankovic L, Dwyer D, Ruef A, Sen Dong M, Öztürk ÖF, Chisholm K, Haidl T, Rosen M, Ferro A, Pergola G, Andriola I, Blasi G, Ruhrmann S, Schultze-Lutter F, Falkai P, Kambeitz J, Lencer R, Dannlowski U, Upthegrove R, Salokangas RKR, Pantelis C, Meisenzahl E, Wood SJ, Brambilla P, Borgwardt S, Bertolino A, Koutsouleris N. Using combined environmental-clinical classification models to predict role functioning outcome in clinical high-risk states for psychosis and recent-onset depression. Br J Psychiatry 2022; 220:1-17. [PMID: 35152923 DOI: 10.1192/bjp.2022.16] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Clinical high-risk states for psychosis (CHR) are associated with functional impairments and depressive disorders. A previous PRONIA study predicted social functioning in CHR and recent-onset depression (ROD) based on structural magnetic resonance imaging (sMRI) and clinical data. However, the combination of these domains did not lead to accurate role functioning prediction, calling for the investigation of additional risk dimensions. Role functioning may be more strongly associated with environmental adverse events than social functioning. AIMS We aimed to predict role functioning in CHR, ROD and transdiagnostically, by adding environmental adverse events-related variables to clinical and sMRI data domains within the PRONIA sample. METHOD Baseline clinical, environmental and sMRI data collected in 92 CHR and 95 ROD samples were trained to predict lower versus higher follow-up role functioning, using support vector classification and mixed k-fold/leave-site-out cross-validation. We built separate predictions for each domain, created multimodal predictions and validated them in independent cohorts (74 CHR, 66 ROD). RESULTS Models combining clinical and environmental data predicted role outcome in discovery and replication samples of CHR (balanced accuracies: 65.4% and 67.7%, respectively), ROD (balanced accuracies: 58.9% and 62.5%, respectively), and transdiagnostically (balanced accuracies: 62.4% and 68.2%, respectively). The most reliable environmental features for role outcome prediction were adult environmental adjustment, childhood trauma in CHR and childhood environmental adjustment in ROD. CONCLUSIONS Findings support the hypothesis that environmental variables inform role outcome prediction, highlight the existence of both transdiagnostic and syndrome-specific predictive environmental adverse events, and emphasise the importance of implementing real-world models by measuring multiple risk dimensions.
Collapse
Affiliation(s)
- Linda A Antonucci
- Department of Education Science, Psychology and Communication Science, University of Bari Aldo Moro, Italy; and Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany; and Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Rachele Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany; and Institute for Psychiatry, Max Planck School of Cognition, Germany
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; and Social and Affective Neuroscience Group, MoMiLab, IMT School for Advanced Studies Lucca, Italy
| | - Lana Kambeitz-Ilankovic
- Department of Education Science, Psychology and Communication Science, University of Bari Aldo Moro, Italy; and Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany
| | - Dominic Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany
| | - Mark Sen Dong
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany
| | - Ömer Faruk Öztürk
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany; and Institute for Psychiatry, International Max Planck Research School for Translational Psychiatry, Germany
| | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, UK; and Department of Psychology, Aston University, UK
| | - Theresa Haidl
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy
| | - Giulio Pergola
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Italy
| | - Ileana Andriola
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Italy
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University Düsseldorf, Germany; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Indonesia; and University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, UK; and Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, UK
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, UK; and Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, UK
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Heinrich-Heine University Düsseldorf, Germany
| | - Stephen J Wood
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany; Orygen, Australia; Centre for Youth Mental Health, University of Melbourne, Australia; and School of Psychology, University of Birmingham, UK
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Italy; and Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Stefan Borgwardt
- Institute for Translational Psychiatry, University of Münster, UK; and Department of Psychiatry (Psychiatric University Hospital, University Psychiatric Clinics Basel), University of Basel, Switzerland
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Italy
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University Munich, Germany
| |
Collapse
|