Psychotic disorders as a framework for precision psychiatry

Coutts, Fiona; Koutsouleris, Nikolaos; McGuire, Philip

doi:10.1038/s41582-023-00779-1

Cited by 14 publications

(11 citation statements)

References 176 publications

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“…The specificity of this to paranoia and feeling unreal may indicate that these symptoms are uniquely impacted by experienced disruptions in sleep continuity which can add to existing theoretical models of symptoms expression. Together, these findings support the importance of precision psychiatry, and the need to deliver treatments based on the specific pattern of symptoms and not by their overarching diagnostic label (Coutts, Koutsouleris, & McGuire, 2023).…”

Section: Discussionmentioning

confidence: 58%

Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis

Formica,

Fuller-Tyszkiewicz,

Reininghaus

et al. 2024

Psychol. Med.

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Background Pre-diagnostic stages of psychotic illnesses, including ‘clinical high risk’ (CHR), are marked by sleep disturbances. These sleep disturbances appear to represent a key aspect in the etiology and maintenance of psychotic disorders. We aimed to examine the relationship between self-reported sleep dysfunction and attenuated psychotic symptoms (APS) on a day-to-day basis. Methods Seventy-six CHR young people completed the Experience Sampling Methodology (ESM) component of the European Union Gene-Environment Interaction Study, collected through PsyMate® devices, prompting sleep and symptom questionnaires 10 times daily for 6 days. Bayesian multilevel mixed linear regression analyses were performed on time-variant ESM data using the brms package in R. We investigated the day-to-day associations between sleep and psychotic experiences bidirectionally on an item level. Sleep items included sleep onset latency, fragmentation, and quality. Psychosis items assessed a range of perceptual, cognitive, and bizarre thought content common in the CHR population. Results Two of the seven psychosis variables were unidirectionally predicted by previous night's number of awakenings: every unit increase in number of nightly awakenings predicted a 0.27 and 0.28 unit increase in feeling unreal or paranoid the next day, respectively. No other sleep variables credibly predicted next-day psychotic symptoms or vice-versa. Conclusion In this study, the relationship between sleep disturbance and APS appears specific to the item in question. However, some APS, including perceptual disturbances, had low levels of endorsement amongst this sample. Nonetheless, these results provide evidence for a unidirectional relationship between sleep and some APS in this population.

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Section: Discussionmentioning

confidence: 58%

Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis

Formica,

Fuller-Tyszkiewicz,

Reininghaus

et al. 2024

Psychol. Med.

View full text Add to dashboard Cite

show abstract

“…The optimal validation method uses a separate training and test-set, to verify results in an independent sample ( Haynes, 2015 ), which was only done in two studies ( Sarpal et al, 2016 , Li et al, 2020 ). In addition, future research should provide a clinical generalizable predictor, for example, to populations with the same mental disorder but different comorbidity, and across countries and cultures ( Coutts et al, 2023 ). In summary, optimal handling of fMRI data is a challenging issue and various processing choices will be critical.…”

Section: Discussionmentioning

confidence: 99%

fMRI connectivity as a biomarker of antipsychotic treatment response: A systematic review

Dominicus,

van Rijn,

van der A

et al. 2023

NeuroImage: Clinical

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“…Although several enhanced prediction models are under evaluation, the majority are derivative of ARMS criteria, combining biological and clinical markers in this group. 8 Although this may increase the specificity of prediction, the sensitivity will remain challenged. The attenuated positive symptoms that characterise the ARMS state may not be a universal, or even common, entry point to psychosis.…”

Section: The Limitations Of Positive Symptom Spectrum ‘At-risk Mental...mentioning

confidence: 99%

An exploratory study of psychosis risk factors in individuals who are referred but do not meet criteria for an early intervention in psychosis service

Naughton,

Brady,

Geary

et al. 2024

BJPsych open

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Background The ‘at-risk mental state’ (ARMS) for psychosis has been critiqued for its limited prognostic ability and identification of a limited proportion of those who will develop a first episode of psychosis (FEP). Broadening the search for high-risk groups is key to improving population-level ascertainment of psychosis risk. Aims To explore risk enrichment in diagnostic, demographic and socio-functional domains among individuals referred to an early intervention in psychosis (EIP) service not meeting ARMS or FEP criteria. Method A retrospective file review of 16 years of referrals to a tertiary EIP service in Ireland was undertaken. Diagnostic outcomes from standardised assessments (Structured Clinical Interview for DSM), demographic (age, gender, family history, nationality) and socio-occupational (relationship status, living status, working status) variables were compiled for those not meeting criteria. These were compared with individuals diagnosed with an FEP in the same period. Results From 2005 to 2021 inclusive, of 2025 index assessments, 27.6% (n = 558) did not meet either FEP or ARMS criteria, which is notably higher than the 5.4% (n = 110) meeting ARMS criteria. This group had high psychiatric morbidity, with 65.4% meeting criteria for at least one DSM Axis I disorder. Depressive, anxiety and substance use disorders predominated. Their functional markers were poor, and comparable to the FEP cohort. Conclusions This group is enriched for psychosis risk factors. They are a larger group than those meeting ARMS criteria, a finding that may reflect EIP service configuration. They may be an important focus for further study in the search for at-risk populations beyond the current ARMS model.

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Psychotic disorders as a framework for precision psychiatry

Cited by 14 publications

References 176 publications

Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis

Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis

fMRI connectivity as a biomarker of antipsychotic treatment response: A systematic review

An exploratory study of psychosis risk factors in individuals who are referred but do not meet criteria for an early intervention in psychosis service

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