Predicting the development of schizophrenia in high-risk populations: Systematic review of the predictive validity of prodromal criteria

Chuma, Jefter; Mahadun, Prem

doi:10.1192/bjp.bp.110.086868

Cited by 30 publications

(20 citation statements)

References 46 publications

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“…Prodromal symptoms preceding onset of the first psychotic episode in schizophrenia have been described for over a century (comprehensively reviewed and described in Fusar-Poli et al (2014)). During this period, individuals typically present with mild symptoms including specific and non-specific behavioural abnormalities, pseudoneurotic symptoms and subtle cognitive and affective changes (Chuma and Mahadun, 2011). Recent research efforts have progressively shifted towards preventive psychiatry and prospective identification of subjects before the onset of psychosis, during the prodromal phase, also known as Ultra-High Risk (UHR) phase of psychosis (de Koning et al, 2009).…”

Section: Early Detection Of Schizophreniamentioning

confidence: 99%

Applications of blood-based protein biomarker strategies in the study of psychiatric disorders

Chan

Gottschalk

Haenisch

et al. 2014

Progress in Neurobiology

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Section: Early Detection Of Schizophreniamentioning

confidence: 99%

Applications of blood-based protein biomarker strategies in the study of psychiatric disorders

Chan

Gottschalk

Haenisch

et al. 2014

Progress in Neurobiology

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“…Recently, Chuma and Mahadun (2011) conducted a systematic review of studies examining the sensitivity and specificity of clinical tests for predicting psychosis in an at-risk population, providing the necessary information for applying DCA to assess the usefulness of tests for prodromal psychosis among at-risk patients. Chuma and Mahadun (2011) examined test performance characteristics of basic-symptoms and UHR criteria tests used with people presenting for psychiatric assessment who did not have a clinical diagnosis of psychosis but were judged to be at risk of psychosis. Of the 12 studies assessing UHR criteria tests, participants were followed for 6-84 months (average 18 months) to assess whether a diagnosis of clinical psychosis was subsequently made.…”

Section: Tests For Prodromal Psychosismentioning

confidence: 99%

Decision curve analysis for assessing the usefulness of tests for making decisions to treat: An application to tests for prodromal psychosis.

Pulleyblank¹,

Chuma²,

Gilbody³

et al. 2013

Psychological Assessment

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For a test to be considered useful for making treatment decisions, it is necessary that making treatment decisions based on the results of the test be a preferable strategy to making treatment decisions without the test. Decision curve analysis is a framework for assessing when a test would be expected to be useful, which integrates evidence of a test's performance characteristics (sensitivity and specificity), condition prevalence among at-risk patients, and patient preferences for treatment. We describe decision curve analysis generally and illustrate its potential through an application to tests for prodromal psychosis. Clinical psychosis is often preceded by a prodromal phase, but not all those with prodromal symptoms proceed to develop full psychosis. Patients identified as at risk for developing psychosis may be considered for proactive treatment to mitigate development of clinically defined psychosis. Tests exist to help identify those at-risk patients most likely to develop psychosis, but it is uncertain when these tests would be considered useful for making proactive treatment decisions. We apply decision curve analysis to results from a systematic review of studies investigating clinical tests for predicting the development of psychosis in at-risk populations, and present resulting decision curves that illustrate when the tests may be expected to be useful for making proactive treatment decisions.

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“…The scarcity of data of this format in the biomedical literature has been described and criticized previously (Gale et al, 2013). Future work could look to extract and combine more risk data across published studies and databases, or encourage authors to make risk data available in the required formats, and then use meta-analysis to determine more accurate estimates of the relationship between individual risk factors and outcomes (Chuma and Mahadun, 2011). From three simulated groups of patients with high, moderate, and low probability of achieving favorable long-term outcome based on their clinical characteristics at FEP, the stepwise evolution of probabilities is shown when MRI at FEP and assessment of negative symptoms and function at 8 months are added as investigations.…”

Section: Limitationsmentioning

confidence: 99%

The use of clinical and biological characteristics to predict outcome following First Episode Psychosis

Schubert

Clark

Baune

2014

Aust N Z J Psychiatry

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Objective: Psychotic illnesses such as schizophrenia and other non-affective psychoses are heterogeneous in disease course and functional outcomes. We review evidence from investigations in clinical psychiatry, neuroimaging, neurocognition, and blood biomarker research suggesting that distinct bio-psycho-social patterns exist at the onset and during the early phase of a First Episode Psychosis (FEP), which can describe the risk of individual illness progression and functional trajectories.Method: A selective literature review was performed on articles drawn from Medline searches for relevant key words. A simulation model was constructed from data derived from two recent publications, selected as examples of studies that investigated multivariate predictors of long-term outcome following FEP. Results:We illustrate how illness trajectories following FEP could be described based on multimodal sociodemographic, clinical, psychological, and neurobiological information. A clinical modeling simulation shows that risk trajectories for achieving long-term favorable or unfavorable outcomes can differ significantly depending on baseline characteristics in combination with MRI and functional measurements within 6 months of disease onset. Conclusions:Multimodal trajectory modeling may be useful to describe longitudinal outcomes following FEP. Rich longitudinal data on predictors and outcomes, and better integration of multimodal (sociodemographic, clinical, psychological, biological) data, are required to operationalize this approach. This technique may improve our understanding of course of illness and help to provide a more personalized approach to the assessment and treatment of people presenting with FEP.

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Predicting the development of schizophrenia in high-risk populations: Systematic review of the predictive validity of prodromal criteria

Abstract: Both ultra-high-risk criteria and basic-symptoms criteria are useful in predicting the development of schizophrenia among high-risk populations.

Cited by 30 publications

References 46 publications

Applications of blood-based protein biomarker strategies in the study of psychiatric disorders

Applications of blood-based protein biomarker strategies in the study of psychiatric disorders

Decision curve analysis for assessing the usefulness of tests for making decisions to treat: An application to tests for prodromal psychosis.

The use of clinical and biological characteristics to predict outcome following First Episode Psychosis

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