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Article: The schizophrenia prodrome: promise for prevention.

Cornblatt, B

2011 Volume 3, Issue 2, Page(s) 93–98

Abstract: Converging theoretical, psychopharmacological, neurodevelopmental advances have led to increasing interest in preventive intervention in schizophrenia. In particular, evidence suggests that early treatment is associated with a better prognosis. ... ...

Abstract	Converging theoretical, psychopharmacological, neurodevelopmental advances have led to increasing interest in preventive intervention in schizophrenia. In particular, evidence suggests that early treatment is associated with a better prognosis. Furthermore, based on the reported reduction in severe side effects, the new novel antipsychotics potentially provide the tools for early intervention. Nevertheless, initiation of intervention during the prodrome has become controversial because of such unresolved issues as: (i) how to accurately identify susceptible individuals who are in true need of preventive intervention; (ii) at what developmental point in the prodrome medication should be initiated; (iii) how long medication should be continued; and (iv) what medication is optimal for each phase of the prodrome. By adopting a naturalistic, prospective research strategy, the Recognition and Prevention (RAP) program now underway in New York has been designed to address these and other important questions involved in prodromal research and treatment.
Language	English
Publishing date	2011-10-27
Publishing country	France
Document type	Journal Article
ZDB-ID	2188781-0
ISSN	1294-8322
ISSN	1294-8322
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Article ; Online: Race/ethnicity and socioeconomic status as predictors of outcome following family therapy in youth at clinical high risk for psychosis.

Ruiz-Yu, Bernalyn / Le, Thanh P / Weintraub, Marc J / Zinberg, Jamie / Addington, Jean / O'Brien, Mary P / Walsh, Barbara C / Friedman-Yakoobian, Michelle / Auther, Andrea / Cornblatt / Domingues, Isabel / Cannon, Tyrone D / Miklowitz, David J / Bearden, Carrie E

Early intervention in psychiatry

2024

Abstract: Aim: There is limited research on the effects of sociodemographic and socioeconomic factors on treatment outcomes in youth at clinical high risk for psychosis (CHRp). This study examined sociodemographic factors that may affect functional outcomes ... ...

Abstract	Aim: There is limited research on the effects of sociodemographic and socioeconomic factors on treatment outcomes in youth at clinical high risk for psychosis (CHRp). This study examined sociodemographic factors that may affect functional outcomes within this population. Specifically, we investigated the influence of race/ethnicity (dichotomized as non-Hispanic whites [NHW] vs. people of colour [POC]), socioeconomic status (SES; operationalized as parental years of education), and their interaction on change in psychosocial functioning and symptoms over 6 months in a randomized trial of family-focused therapy. Methods: CHRp youth (N = 128) participated in a randomized trial of family therapy (18 sessions of family therapy vs. 3 sessions of family psychoeducation). Sixty-four participants who self-identified as POC and 64 self-identified NHW participants completed baseline and 6-month follow-up measures of positive and negative symptoms and psychosocial (global, role, and social) functioning. Multiple regression models were conducted to test the main effect of race/ethnicity on changes in positive and negative symptoms and functioning, and whether this effect was moderated by parental education. Results: There was a significant interaction between race/ethnicity and parental education, such that higher parental education was associated with greater improvement in global functioning in NHW participants, but there was no relationship between parental education and global functioning in POC. Additionally, higher parental education was associated with a decrease in negative symptoms in NHW participants but not in POC. There were no significant effects of race/ethnicity or parental education on positive symptoms, nor on social or role functioning. Conclusions: Clinicians may consider tailoring psychosocial treatments according to the needs of diverse families who vary in sociodemographic factors such as educational attainment and race/ethnicity.
Language	English
Publishing date	2024-04-27
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2272425-4
ISSN	1751-7893 ; 1751-7885
ISSN (online)	1751-7893
ISSN	1751-7885
DOI	10.1111/eip.13541
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Article ; Online: Validation of the French version of the Global Functioning: Social and Global Functioning: Role Scales in adolescents and young adults seeking help in early intervention clinics.

Lucarini, Valeria / Kazes, Mathilde / Krebs, Emma / Morin, Valentine / Godignon, Maud / De Gasquet, Marie / Ton, Trang / Féron, Marion / Tanguy, Guillaume / Lévi, Agnès / Bellot, Cécile / Willard, Dominique / Auther, Andrea M / Cornblatt, Barbara / Bralet, Marie-Cécile / Krebs, Marie-Odile

Early intervention in psychiatry

2023 Volume 18, Issue 1, Page(s) 3–9

Abstract: Aim: Social and role functioning impairments characterize patients along the schizophrenia spectrum, but the existing evaluations tools do not specifically address younger population issues. The Global Functioning Social (GF:S) and Global Functioning ... ...

Abstract	Aim: Social and role functioning impairments characterize patients along the schizophrenia spectrum, but the existing evaluations tools do not specifically address younger population issues. The Global Functioning Social (GF:S) and Global Functioning Role (GF:R) scales have been specifically designed for that purpose. The aim of this study is to establish the reliability and concurrent validity of the French version of GF:S and GF:R scales. Methods: The two scales GF: Social (GF:S) and Role (GF:R) have first been translated into French and independently back translated and validated by the original authors. Between March 2021 and March 2022, we enrolled 51 participants (20.3 ± 3.7 years old; female = 22/51) amongst help-seekers referring to two different early mental health services in the Île-de-France. In an ecological design, participants met different diagnoses, 7 (13.7%) met the criteria for Ultra-High Risk of psychosis (UHR) using CAARMS criteria. Results: Inter-rater reliability was excellent for scores related to the past month and to the higher levels of functioning over the past year. Both scales showed good to excellent concurrent validity as measured by correlation with the Social and Occupational Functioning Assessment Scale (SOFAS) and the Personal and Social Performance Scale (PSP). Conclusion: Overall, this study confirms the reliability and validity of the French version of the GF:S and GF:R scales. The use of these scales may improve the evaluation of social and occupational functioning in French-speaking young help-seekers, in a transdiagnostic approach, both in clinical and research settings.
MeSH term(s)	Humans ; Adolescent ; Female ; Young Adult ; Adult ; Reproducibility of Results ; Psychiatric Status Rating Scales ; Psychotic Disorders/diagnosis ; Psychotic Disorders/psychology ; Schizophrenia/diagnosis ; Diagnosis, Differential
Language	English
Publishing date	2023-04-10
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2272425-4
ISSN	1751-7893 ; 1751-7885
ISSN (online)	1751-7893
ISSN	1751-7885
DOI	10.1111/eip.13427
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Article ; Online: Cognitive-Behavioral Social Skills Training Adapted for Youth at Clinical High Risk for Psychosis.

Kelsven, Skylar / Brummit, Kali / Devoe, Dan / Santesteban-Echarri, Olga / Auther, Andrea / Cornblatt, Barbara / Cadenhead, Kristin / Granholm, Eric / Holden, Jason / Kelly, Mickinsey / Addington, Jean

Journal of cognitive psychotherapy

2022

Abstract: Interventions for functional impairments in adolescents and young adults at clinical high risk (CHR) for psychosis are needed. Cognitive-Behavioral Social Skills Training (CBSST) has been found to improve functioning in patients with schizophrenia. The ... ...

Abstract	Interventions for functional impairments in adolescents and young adults at clinical high risk (CHR) for psychosis are needed. Cognitive-Behavioral Social Skills Training (CBSST) has been found to improve functioning in patients with schizophrenia. The CBSST manual was adapted for CHR and implemented across 3 sites. The key changes that were made were to present a focus of normalization and destigmatization of attenuated psychotic symptoms and since CBSST has a major focus on role plays, problem solving and challenging thoughts, examples of these were changed to be more appropriate for this young CHR population. We describe the manual modifications and present fidelity data to examine the success of training and supervision methods in a multi-site randomized controlled trial of CBSST in CHR youth. Fidelity was high and comparable across sites. Case vignettes are presented to demonstrate how CBSST techniques were adapted for UHR individuals to target functional impairments.
Language	English
Publishing date	2022-04-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	639096-1
ISSN	1938-887X ; 0889-8391
ISSN (online)	1938-887X
ISSN	0889-8391
DOI	10.1891/JCP-2021-0029
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Article ; Online: Proteomic Biomarkers for the Prediction of Transition to Psychosis in Individuals at Clinical High Risk: A Multi-cohort Model Development Study.

Byrne, Jonah F / Healy, Colm / Föcking, Melanie / Susai, Subash Raj / Mongan, David / Wynne, Kieran / Kodosaki, Eleftheria / Heurich, Meike / de Haan, Lieuwe / Hickie, Ian B / Smesny, Stefan / Thompson, Andrew / Markulev, Connie / Young, Alison Ruth / Schäfer, Miriam R / Riecher-Rössler, Anita / Mossaheb, Nilufar / Berger, Gregor / Schlögelhofer, Monika /

Schizophrenia bulletin

2024

Abstract: Psychosis risk prediction is one of the leading challenges in psychiatry. Previous investigations have suggested that plasma proteomic data may be useful in accurately predicting transition to psychosis in individuals at clinical high risk (CHR). We ... ...

Abstract	Psychosis risk prediction is one of the leading challenges in psychiatry. Previous investigations have suggested that plasma proteomic data may be useful in accurately predicting transition to psychosis in individuals at clinical high risk (CHR). We hypothesized that an a priori-specified proteomic prediction model would have strong predictive accuracy for psychosis risk and aimed to replicate longitudinal associations between plasma proteins and transition to psychosis. This study used plasma samples from participants in 3 CHR cohorts: the North American Prodrome Longitudinal Studies 2 and 3, and the NEURAPRO randomized control trial (total n = 754). Plasma proteomic data were quantified using mass spectrometry. The primary outcome was transition to psychosis over the study follow-up period. Logistic regression models were internally validated, and optimism-corrected performance metrics derived with a bootstrap procedure. In the overall sample of CHR participants (age: 18.5, SD: 3.9; 51.9% male), 20.4% (n = 154) developed psychosis within 4.4 years. The a priori-specified model showed poor risk-prediction accuracy for the development of psychosis (C-statistic: 0.51 [95% CI: 0.50, 0.59], calibration slope: 0.45). At a group level, Complement C8B, C4B, C5, and leucine-rich α-2 glycoprotein 1 (LRG1) were associated with transition to psychosis but did not surpass correction for multiple comparisons. This study did not confirm the findings from a previous proteomic prediction model of transition from CHR to psychosis. Certain complement proteins may be weakly associated with transition at a group level. Previous findings, derived from small samples, should be interpreted with caution.
Language	English
Publishing date	2024-01-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	439173-1
ISSN	1745-1701 ; 0586-7614
ISSN (online)	1745-1701
ISSN	0586-7614
DOI	10.1093/schbul/sbad184
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Article ; Online: The Early Psychosis Screener for Internet (EPSI)-SR: Predicting 12 month psychotic conversion using machine learning.

Brodey, B B / Girgis, R R / Favorov, O V / Bearden, C E / Woods, S W / Addington, J / Perkins, D O / Walker, E F / Cornblatt, B A / Brucato, G / Purcell, S E / Brodey, I S / Cadenhead, K S

Schizophrenia research

2019 Volume 208, Page(s) 390–396

Abstract: Introduction: A faster and more accurate self-report screener for early psychosis is needed to promote early identification and intervention.: Methods: Self-report Likert-scale survey items were administered to individuals being screened with the ... ...

Abstract	Introduction: A faster and more accurate self-report screener for early psychosis is needed to promote early identification and intervention. Methods: Self-report Likert-scale survey items were administered to individuals being screened with the Structured Interview for Psychosis-risk Syndromes (SIPS) and followed at eight early psychosis clinics. An a priori analytic plan included Spectral Clustering Analysis to reduce the item pool, followed by development of Support Vector Machine (SVM) classifiers. Results: The cross-validated positive predictive value (PPV) of the EPSI at the default cut-off (76.5%) exceeded that of the clinician-administered SIPS (68.5%) at separating individuals who would not convert to psychosis within 12 months from those who either would convert within 12 months or who had already experienced a first episode psychosis (FEP). When used in tandem with the SIPS on clinical high risk participants, the EPSI increased the combined PPV to 86.6%. The SVM classified as FEP/converters only 1% of individuals in non-clinical and 4% of clinical low risk populations. Sensitivity of the EPSI, however, was 51% at the default cut-off. Discussion: The EPSI identifies, comparably to the SIPS but in less time and with fewer resources, individuals who are either at very high risk to develop a psychotic disorder within 12 months or who are already psychotic. At its default cut-off, EPSI misses 49% of current or future psychotic cases. The cut-off can, however, be adjusted based on purpose. The EPSI is the first validated assessment to predict 12-month psychotic conversion. An online screening system, www.eps.telesage.org, is under development.
MeSH term(s)	Diagnosis, Computer-Assisted ; Early Diagnosis ; Humans ; Internet ; Machine Learning ; Predictive Value of Tests ; Psychotic Disorders/diagnosis ; Psychotic Disorders/psychology ; Risk Assessment ; Support Vector Machine
Language	English
Publishing date	2019-02-15
Publishing country	Netherlands
Document type	Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2019.01.015
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Article ; Online: The Early Psychosis Screener (EPS): Quantitative validation against the SIPS using machine learning.

Brodey, B B / Girgis, R R / Favorov, O V / Addington, J / Perkins, D O / Bearden, C E / Woods, S W / Walker, E F / Cornblatt, B A / Brucato, G / Walsh, B / Elkin, K A / Brodey, I S

Schizophrenia research

2018 Volume 197, Page(s) 516–521

Abstract: ... risk Syndromes (SIPS). The Prodromal Questionnaire-Brief Version (PQ-B) and 148 additional items were ... with a 26-item solution (AUC=0.899±0.001). The EPS-26 outperformed the PQ-B (AUC=0.834±0.001). For screening ...

Abstract	Machine learning techniques were used to identify highly informative early psychosis self-report items and to validate an early psychosis screener (EPS) against the Structured Interview for Psychosis-risk Syndromes (SIPS). The Prodromal Questionnaire-Brief Version (PQ-B) and 148 additional items were administered to 229 individuals being screened with the SIPS at 7 North American Prodrome Longitudinal Study sites and at Columbia University. Fifty individuals were found to have SIPS scores of 0, 1, or 2, making them clinically low risk (CLR) controls; 144 were classified as clinically high risk (CHR) (SIPS 3-5) and 35 were found to have first episode psychosis (FEP) (SIPS 6). Spectral clustering analysis, performed on 124 of the items, yielded two cohesive item groups, the first mostly related to psychosis and mania, the second mostly related to depression, anxiety, and social and general work/school functioning. Items within each group were sorted according to their usefulness in distinguishing between CLR and CHR individuals using the Minimum Redundancy Maximum Relevance procedure. A receiver operating characteristic area under the curve (AUC) analysis indicated that maximal differentiation of CLR and CHR participants was achieved with a 26-item solution (AUC=0.899±0.001). The EPS-26 outperformed the PQ-B (AUC=0.834±0.001). For screening purposes, the self-report EPS-26 appeared to differentiate individuals who are either CLR or CHR approximately as well as the clinician-administered SIPS. The EPS-26 may prove useful as a self-report screener and may lead to a decrease in the duration of untreated psychosis. A validation of the EPS-26 against actual conversion is underway.
MeSH term(s)	Adolescent ; Adult ; Female ; Humans ; Interview, Psychological ; Longitudinal Studies ; Machine Learning ; Male ; Prodromal Symptoms ; Psychiatric Status Rating Scales/standards ; Psychotic Disorders/diagnosis ; Risk ; Schizophrenia/diagnosis ; Self Report/standards ; Young Adult
Language	English
Publishing date	2018-01-19
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Validation Study
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2017.11.030
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Article ; Online: Childhood trauma and cognitive functioning in individuals at clinical high risk (CHR) for psychosis.

Velikonja, T / Velthorst, E / Zinberg, J / Cannon, T D / Cornblatt, B A / Perkins, D O / Cadenhead, K S / Tsuang, M T / Addington, J / Woods, S W / McGlashan, T / Mathalon, D H / Stone, W / Keshavan, M / Seidman, L / Bearden, C E

Development and psychopathology

2020 Volume 33, Issue 1, Page(s) 53–64

Abstract: Evidence suggests that early trauma may have a negative effect on cognitive functioning in individuals with psychosis, yet the relationship between childhood trauma and cognition among those at clinical high risk (CHR) for psychosis remains unexplored. ... ...

Abstract	Evidence suggests that early trauma may have a negative effect on cognitive functioning in individuals with psychosis, yet the relationship between childhood trauma and cognition among those at clinical high risk (CHR) for psychosis remains unexplored. Our sample consisted of 626 CHR children and 279 healthy controls who were recruited as part of the North American Prodrome Longitudinal Study 2. Childhood trauma up to the age of 16 (psychological, physical, and sexual abuse, emotional neglect, and bullying) was assessed by using the Childhood Trauma and Abuse Scale. Multiple domains of cognition were measured at baseline and at the time of psychosis conversion, using standardized assessments. In the CHR group, there was a trend for better performance in individuals who reported a history of multiple types of childhood trauma compared with those with no/one type of trauma (Cohen d = 0.16). A history of multiple trauma types was not associated with greater cognitive change in CHR converters over time. Our findings tentatively suggest there may be different mechanisms that lead to CHR states. Individuals who are at clinical high risk who have experienced multiple types of childhood trauma may have more typically developing premorbid cognitive functioning than those who reported minimal trauma do. Further research is needed to unravel the complexity of factors underlying the development of at-risk states.
MeSH term(s)	Bullying ; Child ; Cognition ; Humans ; Longitudinal Studies ; Prodromal Symptoms ; Psychotic Disorders
Language	English
Publishing date	2020-01-20
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1036173-x
ISSN	1469-2198 ; 0954-5794
ISSN (online)	1469-2198
ISSN	0954-5794
DOI	10.1017/S095457941900155X
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Article ; Online: Persistent negative symptoms in youth at clinical high risk for psychosis: A longitudinal study.

Devoe, D J / Lu, L / Cannon, T D / Cadenhead, K S / Cornblatt, B A / McGlashan, T H / Perkins, D O / Seidman, L J / Tsuang, M T / Woods, S W / Walker, E F / Mathalon, D H / Bearden, C E / Addington, J

Schizophrenia research

2020 Volume 227, Page(s) 28–37

Abstract: Background: Severity of negative symptoms has been associated with poor functioning, cognitive deficits, and defeatist beliefs in schizophrenia patients. However, one area that remains understudied is persistent negative symptoms (PNS). Negative ... ...

Abstract	Background: Severity of negative symptoms has been associated with poor functioning, cognitive deficits, and defeatist beliefs in schizophrenia patients. However, one area that remains understudied is persistent negative symptoms (PNS). Negative symptoms, including PNS, have been observed in those at clinical high-risk (CHR) for psychosis. The aim of this study was to determine if PNS were associated with functioning, neurocognition, and defeatist beliefs in a CHR sample. Method: CHR participants (n = 764) were recruited for the North American Prodrome Longitudinal Study. Negative symptoms were rated on the Scale of Psychosis-risk Symptoms. Generalized linear mixed models for repeated measures were used to examine changes over time between and within groups (PNS vs non-PNS). Results: The PNS group (n = 67) had significant deficits in functioning at baseline, 6, 12, 18, and 24-months compared to the non-PNS group (n = 673). Functioning improved over time in the non-PNS group, while functioning in the PNS group remained relatively stable and poor over a two-year period. A consistent trend emerged demonstrating higher defeatist beliefs in the PNS group; however, this result was lost when controlling for persistent depressive symptoms. There were no significant differences between the groups on neurocognition, social cognition, and transition to psychosis. Conclusions: PNS exist in youth at CHR for psychosis, resulting in significant and persistent functional impairment, which remains when controlling for persistent depressive symptoms. PNS remain even in CHR youth who do not transition to psychosis. Thus, PNS may represent an unmet therapeutic need in CHR populations for which there are currently no effective treatments.
MeSH term(s)	Adolescent ; Cognition Disorders ; Humans ; Longitudinal Studies ; Prodromal Symptoms ; Psychotic Disorders/complications ; Psychotic Disorders/epidemiology ; Schizophrenia/complications ; Schizophrenia/epidemiology
Language	English
Publishing date	2020-04-30
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2020.04.004
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Article ; Online: HPA axis function and symptoms in adolescents at clinical high risk for schizophrenia.

Corcoran, C M / Smith, C / McLaughlin, D / Auther, A / Malaspina, D / Cornblatt, B

Schizophrenia research

2012 Volume 135, Issue 1-3, Page(s) 170–174

Abstract: Background: Stress sensitivity and HPA axis activity may be relevant to the development and expression of psychotic disorders. Cortisol secretion has been associated with positive symptoms both in patients with psychotic disorders and in young people at ...

Abstract	Background: Stress sensitivity and HPA axis activity may be relevant to the development and expression of psychotic disorders. Cortisol secretion has been associated with positive symptoms both in patients with psychotic disorders and in young people at clinical risk for psychosis. Herein, we aimed to replicate these findings, to determine which positive symptoms may be associated with cortisol levels, and to explore any associations with affective symptoms and impaired stress tolerance. Methods: Thirty-one clinical high risk patients were evaluated in cross-section for associations between salivary cortisol levels upon clinic entry at 11 am, demographic variables, and clinical symptoms. Results: Salivary cortisol levels were unrelated to medication exposure or demographics, except for higher levels in the ten females studied. Salivary cortisol bore no relationship to overall positive symptom severity but was associated with anxiety, as well as with suspiciousness and impaired stress tolerance, which were themselves highly intercorrelated. Conclusions: Cortisol secretion in the context of a putative novel social situation (i.e. clinic entry) may be a biological correlate of suspiciousness, impaired stress tolerance and affective symptoms in individuals vulnerable to developing psychosis. These associations are consistent with findings from experience sampling studies in individuals at risk for psychosis as well as basic studies of animal models of schizophrenia.
MeSH term(s)	Adolescent ; Child ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Hydrocortisone/metabolism ; Male ; Neuropsychological Tests ; Psychiatric Status Rating Scales ; Retrospective Studies ; Risk Factors ; Saliva/metabolism ; Schizophrenia/complications ; Schizophrenia/metabolism ; Sex Factors ; Statistics, Nonparametric
Chemical Substances	Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2012-01-09
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	639422-x
ISSN	1573-2509 ; 0920-9964
ISSN (online)	1573-2509
ISSN	0920-9964
DOI	10.1016/j.schres.2011.11.035
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