4
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      Predicting Remission in Subjects at Clinical High Risk for Psychosis Using Mismatch Negativity

      1 , 2 , 2 , 3 , 1 , 2
      Schizophrenia Bulletin
      Oxford University Press (OUP)

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          <div class="section"> <a class="named-anchor" id="s1"> <!-- named anchor --> </a> <h5 class="section-title" id="d5197128e153">Background</h5> <p id="d5197128e155">The declining transition rate to psychotic disorder and the increasing rate of nonpsychotic poor outcomes among subjects at clinical high risk (CHR) for psychosis have increased the need for biomarkers to predict remission regardless of transition. This study investigated whether mismatch negativity (MMN) predicts the prognosis of CHR individuals during a 6-year follow-up period. </p> </div><div class="section"> <a class="named-anchor" id="s2"> <!-- named anchor --> </a> <h5 class="section-title" id="d5197128e158">Methods</h5> <p id="d5197128e160">A total of 47 healthy control (HC) subjects and 48 subjects at CHR for psychosis participated in the MMN assessment. The clinical statuses of the CHR subjects were examined at baseline and regularly for up to 6 years. The CHR subjects were divided into remitter and nonremitter groups, and the baseline MMN amplitudes and latencies were compared across the remitter, nonremitter, and HC groups. Regression analyses were performed to identify the predictive factors of remission, the improvement of attenuated positive symptoms, and functional recovery. </p> </div><div class="section"> <a class="named-anchor" id="s3"> <!-- named anchor --> </a> <h5 class="section-title" id="d5197128e163">Results</h5> <p id="d5197128e165">CHR nonremitters showed reduced MMN amplitudes at baseline compared to CHR remitters and HC subjects. A logistic regression analysis revealed that the baseline MMN amplitude at the frontal electrode site was the only significant predictor of remission. In a multiple regression analysis, the MMN amplitude, antipsychotic use, and years of education predicted an improvement in attenuated positive symptoms. The MMN amplitude at baseline predicted functional recovery. </p> </div><div class="section"> <a class="named-anchor" id="s4"> <!-- named anchor --> </a> <h5 class="section-title" id="d5197128e168">Conclusions</h5> <p id="d5197128e170">These results suggest that MMN is a putative predictor of prognosis regardless of the transition to psychotic disorder in subjects at CHR. Early prognosis prediction and the provision of appropriate interventions based on the initial CHR status might be aided using MMN. </p> </div>

          Related collections

          Most cited references42

          • Record: found
          • Abstract: found
          • Article: not found

          The psychosis high-risk state: a comprehensive state-of-the-art review.

          During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk.

            A substantial proportion of people at clinical high risk of psychosis will develop a psychotic disorder over time. However, the risk of transition to psychosis varies between centers, and some recent work suggests that the risk of transition may be declining. To quantitatively examine the literature to date reporting the transition risk to psychosis in subjects at clinical high risk. The electronic databases were searched until January 2011. All studies reporting transition risks in patients at clinical high risk were retrieved. Twenty-seven studies met the inclusion criteria, comprising a total of 2502 patients. Transition risks, as well as demographic, clinical, and methodologic variables, were extracted from each publication or obtained directly from its authors. There was a consistent transition risk, independent of the psychometric instruments used, of 18% after 6 months of follow-up, 22% after 1 year, 29% after 2 years, and 36% after 3 years. Significant moderators accounting for heterogeneity across studies and influencing the transition risks were the age of participants, publication year, treatments received, and diagnostic criteria used. There was no publication bias, and a sensitivity analysis confirmed the robustness of the core findings. The state of clinical high risk is associated with a very high risk of developing psychosis within the first 3 years of clinical presentation, and the risk progressively increases across this period. The transition risk varies with the age of the patient, the nature of the treatment provided, and the way the syndrome and transition to psychosis are defined.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              International consensus study of antipsychotic dosing.

              Potency equivalents for anti-psychotic drugs are required to guide clinical dosing and for designing and interpreting research studies. Available dosing guidelines are limited by the methods and data from which they were generated. With a two-step Delphi method, the authors surveyed a diverse group of international clinical and research experts, seeking consensus regarding antipsychotic dosing. The authors determined median clinical dosing equivalents and recommended starting, target range, and maximum doses for 61 drugs, adjusted for selected clinical circumstances. Participants (N=43) from 18 countries provided dosing recommendations regarding treatment of psychotic disorders for 37 oral agents and 14 short-acting and 10 long-acting parenteral agents. With olanzapine 20 mg/day as reference, estimated clinical equivalency ratios of oral agents ranged from 0.025 for sulpiride to 10.0 for trifluperidol. Seventeen patient and treatment characteristics, including age, hepatic and renal function, illness stage and severity, sex, and diagnosis, were associated with dosing modifications. In the absence of adequate prospective, randomized drug-drug comparisons, the present findings provide broad, international, expert consensus-based recommendations for most clinically employed antipsychotic drugs. They can support clinical practice, trial design, and interpretation of comparative antipsychotic trials.
                Bookmark

                Author and article information

                Journal
                Schizophrenia Bulletin
                Oxford University Press (OUP)
                0586-7614
                1745-1701
                May 2018
                April 06 2018
                July 31 2017
                May 2018
                April 06 2018
                July 31 2017
                : 44
                : 3
                : 575-583
                Affiliations
                [1 ]Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
                [2 ]Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, Republic of Korea
                [3 ]Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
                Article
                10.1093/schbul/sbx102
                5890455
                29036493
                b85cc2bf-9114-4f88-ab73-f836b0e3cf2c
                © 2017

                https://academic.oup.com/journals/pages/about_us/legal/notices

                History

                Comments

                Comment on this article