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Results: (1) We interviewed 281 participants (57% male, 59% white, mean age: 21.6); (130 psychosis, 35 APS, 66 mood, and 50 HC) and 63 parents (31 psychosis, 21 APS, and 11 mood). Psychosis participants reported currently checking SM sites 7.6 times per day, spending on average 1 hour per day online and using SM for the past 7 years. Facebook is by far the most used site in all groups. 52% of psychotic participants used the internet as their primary source for gathering information as symptoms were emerging (27% APS and 19% mood). 69% of participants noticed changes in their social media habits as symptoms emerged (63% psychosis, 84% mood, and 71% APS). 51.4 % of the psychosis group reported that they would have been OK with proactive outreach via the Internet or social media as symptoms emerged. 75% reported that they would have been OK getting help/advice by a professional via the Internet or SM as symptoms emerged. (2) Our preliminary algorithm correctly distinguished individuals with psychotic disorders from those with mood disorders and healthy controls 67% of the time (chance approx 33%). Conclusion: Our work was designed with the goal of developing and refining research strategies utilizing the internet/social media for use in subsequent large-scale studies to significantly reduce DUP and improve pathways to care in the United States. The Internet and social media provide an unparalleled opportunity to supplement and potentially transform early intervention services, and acceptance of this approach appears to be high. Background: Reducing excessive delays in care, as measured by Duration of Untreated Psychosis (DUP), can improve outcomes for schizophrenia spectrum disorders. The program for Specialized Treatment Early in Psychosis (STEP) has delivered a best practice approach to coordinated care for early psychosis since 2006 in greater New Haven, and in 2014 began studying an approach (the Mindmap campaign) to shorten DUP in a 10 town catchment of 400 000 people. Methods: Myriad and regionally idiosyncratic pathways to care in the United States present particular challenges to DUP reduction efforts. Mindmap uses a social-ecological model to leverage multiple nodes along the demand (delays in identifying illness and help seeking) and supply (delays in referring and providing best practice care) constituents of DUP. (1) Detailed assessments of referral sources and an adapted version of the Pathways to Care (PTC) instrument are used to assess these pathways. (ii) Delays to care are measured as the time between the onset of psychosis and initiation of antipsychotic treatment (DUP1) and initiation of STEP care (DUP2). A control site (PREP clinic, Boston) in a quasi-experimental design will allow stronger inferences about the causal role of the campaign in changing DUP. The 36-month campaign was launched in 2015, after a 1-year baseline period to confirm reliability of assessments across the 2 sites. A planned interim analysis at the mid-point of the campaign will use Mann-Whitney U tests to compare 18-month (...

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Structural alterations or quantitative abnormalities of some mitochondrial ion channels and exchangers are associated with altered neuronal functions and increased susceptibility to mental illness. Here we have assessed levels of functionally prominent mitochondrial calcium ion channel proteins in plasma neuron‐derived extracellular vesicles (NDEVs) of living patients with first episodes of psychosis (FP) and matched controls (Cs). NDEVs were enriched with an established method of precipitation and immunoabsorption by anti‐human CD171 neural adhesion protein (L1CAM) antibody and extracted proteins quantified with ELISAs. CD81 exosome marker‐normalized NDEV levels of leucine zipper EF‐hand containing transmembrane 1 protein (LETM1), transient receptor potential cation channel subfamily M, member 4 (TRPM4), and solute carrier family 8 member B1 (SLC24A6) or mitochondrial Na+/Ca2+ exchanger (NCLX) were significantly lower for FP patients (n = 10) than Cs (n = 10), whereas NDEV levels of voltage‐dependent L‐type calcium channel subunit α‐1C (CACNA‐1C) were significantly higher for FP patients than Cs. Abnormal structures or mitochondrial levels of LETM1, NCLX, and CACNA‐1C have been linked through analyses of individual proteins, genome‐wide association studies, and whole exome protein‐coding sequence studies to neurodevelopmental disorders, mental retardation, schizophrenia, and major depressive diseases. A greater understanding of the altered calcium homeostasis in schizophrenia, that is attributable to underlying mitochondrial calcium channel abnormalities, will lead to improved diagnosis and treatment.

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