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A longitudinal study of event related potentials and correlations with psychosocial functioning and clinical features in first episode psychosis patients.

ABSTRACT: BACKGROUND:Deficits in auditory event-related potentials (ERPs), brain responses to stimuli indexing different cognitive processes, have been demonstrated widely in chronic schizophrenia (SZ) patients though much less is known about these responses across the early course of psychosis. The present study examined multiple ERP components in first episode psychosis (FEP) patients longitudinally and investigated the relationships between ERPs, psychosocial functioning, and clinical features over time. METHODS:N1, P2, P3a, and P3b ERPs were elicited using a three-stimulus (novelty) auditory oddball paradigm. FEP patients included SZ-spectrum and psychotic bipolar disorder (BD) diagnoses. Data were collected from 41 patients at baseline, 20 patients at 12-month follow-up, 14 at 24-month follow-up, and 29 healthy control subjects. RESULTS:N1 and P2 ERPs were intact across the early stages of psychosis. Baseline P2 was significantly larger in BD than SZ patients. Reduced P3a and P3b ERPs were found in patients followed longitudinally and are stable over time. ERPs tracked distinct aspects of symptomology and medication, though specific associations were inconsistent across time. Baseline P3a amplitude predicted later psychosocial functioning. The pattern of correlations between ERP components in patients differed from controls. DISCUSSION:Baseline P3a ERP, and PANSS general score were significant and independent predictors of later MCAS functioning at 12-month. Overall, individuals with worse functioning and greater symptomology produced smaller amplitudes. Our results highlight the heterogeneity within the FEP population. Correlation patterns among ERPs are similar between patients and controls. P3a and P3b amplitudes appear to link with higher-order cognitive and psychosocial functioning.

SUBMITTER: Monaghan CK

PROVIDER: S-EPMC6988566 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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A longitudinal study of event related potentials and correlations with psychosocial functioning and clinical features in first episode psychosis patients.

Monaghan Caitlin K CK Brickman Sophie S Huynh Polly P Öngür Dost D Hall Mei-Hua MH

International journal of psychophysiology : official journal of the International Organization of Psychophysiology 20190517

<h4>Background</h4>Deficits in auditory event-related potentials (ERPs), brain responses to stimuli indexing different cognitive processes, have been demonstrated widely in chronic schizophrenia (SZ) patients though much less is known about these responses across the early course of psychosis. The present study examined multiple ERP components in first episode psychosis (FEP) patients longitudinally and investigated the relationships between ERPs, psychosocial functioning, and clinical features ...[more]

PMID: 31108121

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Project description:BackgroundThough olfactory deficits are well-documented in schizophrenia, fewer studies have examined olfactory performance profiles across the psychosis spectrum. The current study examined odor identification, discrimination, and detection threshold performance in first-episode psychosis (FEP) patients diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder with psychotic features, major depression with psychotic features, and other psychotic conditions.MethodFEP patients (n = 97) and healthy adults (n = 98) completed birhinal assessments of odor identification, discrimination, and detection threshold sensitivity for lyral and citralva. Participants also completed measures of anticipatory pleasure, anhedonia, and empathy. Differences in olfactory performances were assessed between FEP patients and controls and within FEP subgroups. Sex-stratified post hoc analyses were employed for a complete analysis of sex differences. Relationships between self-report measures and olfactory scores were also examined.ResultsIndividuals with psychosis had poorer scores across all olfactory measures when compared to the control group. Within the psychosis cohort, patients with schizophrenia-associated psychosis had poorer odor identification, discrimination, and citralva detection threshold scores relative to controls. In schizophrenia patients, greater olfactory disturbance was associated with increased negative symptomatology, greater self-reported anhedonia, and lower self-reported anticipatory pleasure. Patients with mood-associated psychosis performed comparable to controls though men and women in this cohort showed differential olfactory profiles.ConclusionsThese findings indicate that olfactory deficits extend beyond measures of odor identification in FEP with greater deficits observed in schizophrenia-related subgroups of psychosis. Studies examining whether greater olfactory dysfunction confers greater risk for developing schizophrenia relative to other forms of psychosis are warranted.

Project description:ObjectiveThe majority of first-episode psychosis (FEP) patients reach clinical remission; however, rates of relapse are high. This study sought to undertake a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the effectiveness of pharmacological and non-pharmacological interventions to prevent relapse in FEP patients.MethodsSystematic review and meta-analysis of RCTs.ResultsOf 66 studies retrieved, 18 were eligible for inclusion. Nine studies investigated psychosocial interventions and 9 pharmacological treatments. The analysis of 3 RCTs of psychosocial interventions comparing specialist FEP programs vs treatment as usual involving 679 patients demonstrated the former to be more effective in preventing relapse (odds ratio [OR]=1.80, 95% confidence interval [CI]=1.31-2.48; P<.001; number needed to treat [NNT]=10). While the analysis of 3 different cognitive-behavioral studies not specifically intended at preventing relapse showed no further benefits compared with specialist FEP programs (OR=1.95, 95% CI=0.76-5.00; P=.17), the combination of specific individual and family intervention targeted at relapse prevention may further improve upon these outcomes (OR=4.88, 95% CI=0.97-24.60; P=.06). Only 3 small studies compared first-generation antipsychotics (FGAs) with placebo with no significant differences regarding relapse prevention although all individual estimates favored FGAs (OR=2.82, 95% CI=0.54-14.75; P=.22). Exploratory analysis involving 1055 FEP patients revealed that relapse rates were significantly lower with second-generation antipsychotics (SGAs) compared with FGAs (OR=1.47, 95% CI=1.07-2.01; P<.02; NNT=10).ConclusionsSpecialist FEP programs are effective in preventing relapse. Cognitive-based individual and family interventions may need to specifically target relapse to obtain relapse prevention benefits that extend beyond those provided by specialist FEP programs. Overall, the available data suggest that FGAs and SGAs have the potential to reduce relapse rates. Future trials should examine the effectiveness of placebo vs antipsychotics in combination with intensive psychosocial interventions in preventing relapse in the early course of psychosis. Further studies should identify those patients who may not need antipsychotic medication to be able to recover from psychosis.

Dataset Information

A longitudinal study of event related potentials and correlations with psychosocial functioning and clinical features in first episode psychosis patients.

Publications

A longitudinal study of event related potentials and correlations with psychosocial functioning and clinical features in first episode psychosis patients.

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