Study Protocol for a Prospective Longitudinal Cohort Study to Identify Proteomic Predictors of Pluripotent Risk for Mental Illness: The Seoul Pluripotent Risk for Mental Illness Study

Abstract

Background: The Seoul Pluripotent Risk for Mental Illness (SPRIM) study was designed to identify predictors leading to mental illness in help-seeking individuals by securing sufficient statistical power through transdiagnostic approaches. The SPRIM study aims to examine the clinical characteristics of high-risk individuals for mental illness and to identify proteomic biomarkers that can predict the onset of mental illness. Methods: This paper describes the study protocol of the SPRIM study. We aim to recruit 150 participants who meet the criteria for high risk for major mental illness, 150 patients with major psychiatric disorders (schizophrenia, bipolar disorder, and major depressive disorder), and 50 matched healthy control subjects for 2 years. Clinical evaluations, self-report measures, and proteomic analyses will be implemented. The assessment points are at baseline, 6, 12, 18, and 24 months. Conclusions: In the present study, we introduced the study protocol of the SPRIM study, which is the first prospective cohort study of transdiagnostic high-risk concepts using proteomic biomarkers. This study has a paradigm that encompasses various diseases without aiming at predicting and preventing the development of a specific mental illness in help-seeking individuals. The transdiagnostic high-risk concept could be extended to provide a perspective for people with various psychopathological tendencies below a threshold, such that they do not meet the existing diagnostic criteria of mental illnesses, to determine what may lead them to a specific disease and help identify appropriate preventative interventions.

Early expressions of psychopathology and risk associated with trans-diagnostic transition to mood and psychotic disorders in adolescents and young adults

“…To enhance options for prevention, we need greater knowledge not only of which ‘at risk’ individuals are most likely to transition to full threshold caseness, but also to develop screening procedures that capture the warning signs and symptoms during the specific timeframe when a ‘risk syndrome’ is most likely to evolve into a severe, impairing, or distressing condition [ 29 – 31 ]. The need to extend trans-diagnostic approaches is recognized in the literature [ 2 , 5 , 27 , 39 ] and in published protocols for future prospective research [ 16 , 35 , 36 , 38 ]. These all acknowledge that FH is an established marker of risk and emphasize that there is no rationale to recommend discontinuing its recording.…”

“…The advantage of this strategy is that it is ‘diagnostically agnostic’ and is more likely to identify symptom constellations that have not been identified previously. This is important for genetic or biological research where investigators are keen to find new ways of dissecting diagnostic or clinical stage entities into homogeneous ‘correlated phenotypes’ or ways of supplementing the clinical stage/diagnosis categories with quantitative measures of phenotypic traits [ 8 , 38 , 41 , 42 ]. The current study offers a template for future studies, which may incorporate symptom ratings alongside PRS or putative phenotypic markers (such as actigraphy-based rest-activity rhythms) to generate new screening instruments and risk prediction algorithms.…”

The Discovery of Clinically Applicable Biomarkers for Bipolar Disorder: A Review of Candidate and Proteomic Approaches

“…The generation of a wealth of proteomic data has the promise of discovering dependable and confirm-ed biomarkers for the most serious psychiatric conditions which also embraces BD. 18 Taking advantage of the extant literature, in the discussion that follows, an appraisal of approaches regarding the discovery of candidate biomarkers is provided. Subsequently, a summary of the current progress in the technology of protein analysis is given to develop an understanding of current methodologies used in the detection of biosignatures of human ailments, including BD.…”

“…The generation of a wealth of proteomic data has the promise of discovering dependable and confirmed biomarkers for the most serious psychiatric conditions which also embraces BD. 18 …”