scholarly journals Evaluating the impact of cannabis use on thalamic connectivity in youth at clinical high risk of psychosis

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Lisa Buchy ◽  
Tyrone D. Cannon ◽  
Alan Anticevic ◽  
Kristina Lyngberg ◽  
Kristin S. Cadenhead ◽  
...  
Keyword(s):  
High Risk ◽  
Cannabis Use ◽  
Clinical High Risk ◽  
The Impact

scholarly journals S69. CLINICAL HIGH RISK STATE: STRATIFICATION BASED ON CLINICAL PROFILE AND REDOX STATUS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S60-S60
Author(s):  
Martine Cleusix ◽  
Ines Khadimallah ◽  
Elodie Toffel ◽  
Paul Klauser ◽  
Kim Q Do ◽  
...  
Keyword(s):  
High Risk ◽  
Psychosocial Functioning ◽  
Help Seeking ◽  
Verbal Learning ◽  
Self Esteem ◽  
Cognitive Outcomes ◽  
Clinical Profile ◽  
Clinical High Risk ◽  
Basic Symptoms ◽  
The Impact

Abstract Background The Clinical High Risk state (CHR) concept was implemented to promote the early detection of young help-seeking patients with higher risk of psychotic transition. This category is based on specific clinical criteria (EPA, 2015) and require narrow frequency/duration ratings of subclinical positive psychotic symptoms to allow its definition. Prevalence of CHR “category” appears nevertheless rare in help-seeking young people and the rate of psychotic transition of CHR state is lower than predicted by early studies. Therefore, the binary outcome of transition to psychosis proposed by the “CHR model” actually fails to be an efficient marker to stratify, in neurobiological studies, people with different psychopathological trajectories, notably those who develop psychosis from those who do not. In order to rely on a vulnerability model for schizophrenic psychosis more sensitive to psychosocial functioning and negative dimension, we study prospectively with three years of follow-up a population of help-seekers addressed for clinical suspicion of prodromal state of psychosis. We aimed here to identify subgroups of patients in a sample of subclinical psychotic states using psychological and cognitive outcomes as profiling criteria, focusing not only on transition but also on psychosocial functioning as main outcome. Methods A total of 32 help-seeking adolescents and young adults aged 14 to 35 were referred by health care providers for a specialized evaluation in case of suspicion of a prodromal psychotic state and/or detected by the French version of the Prodromal Questionnaire (PQ-16; cut-off 6/16). Their CHR status was assessed by the Structured Interview for Psychosis-Risk Syndromes (SIPS) and the Schizophrenia Proneness Instrument, Adult (SPI-A). Individuals included in the study presented either a CHR status, a subclinical CHR status or negative symptomatology. All subjects performed an additional neuropsychological battery and blood test for redox markers (Glutathione Peroxidase (GPx) and Glutathione Reductase (GR) activities) (Xin et al, 2016). Based on their clinical profile, we made a stratification of the patients using a Principal Component Analysis. Results Cognitive and psychological outcome stratification of all help-seekers revealed two subgroups (called group1 and group2) of patients with distinct profiles. Individuals in group1 (n=18) had greater levels of basic symptoms and general symptomatology. On the other hand, in group2 (n=14), individuals showed a weaker self-esteem and a lower rate of “living independently”. Cognitive scores for speed processing, attention, verbal learning and social cognition were significantly lower in group2 compared to group1. In addition, these cognitive outcomes were negatively correlated with negative symptoms only in group2. Analysis of redox markers revealed a positive correlation between GPx and GR activities in group1, a correlation disrupted in group2. Discussion Stratification of a cohort of young help-seekers with suspicion of prodromal psychosis, regardless of their CHR status, allowed us to distinguish two subgroups with different clinical profiles: group1 with higher levels of basic symptoms and general symptomatology, and group2 with weaker self-esteem, less autonomy and poorer neurocognition. In addition, analysis of redox markers revealed a redox dysregulation in patients with poorer cognitive profile. Considering the impact of neurocognitive impairment on functioning, special focus to patients of group2 is needed, mostly in clinical practice. Moreover, they might benefit of supplementation with antioxidant compounds such as NAC, which may improve cognitive deficits (Conus et al, 2018).

scholarly journals Relation between cannabis use and subcortical volumes in people at clinical high risk of psychosis

2016 ◽  
Vol 254 ◽  
pp. 3-9 ◽  
Author(s):  
Lisa Buchy ◽  
Daniel H. Mathalon ◽  
Tyrone D. Cannon ◽  
Kristin S. Cadenhead ◽  
Barbara A. Cornblatt ◽  
...  
Keyword(s):  
High Risk ◽  
Cannabis Use ◽  
Clinical High Risk ◽  
Subcortical Volumes

scholarly journals Cannabis use and age at onset of symptoms in subjects at clinical high risk for psychosis

2011 ◽  
Vol 125 (1) ◽  
pp. 45-53 ◽  
Author(s):  
S. Dragt ◽  
D. H. Nieman ◽  
F. Schultze-Lutter ◽  
F. van der Meer ◽  
H. Becker ◽  
...  
Keyword(s):  
High Risk ◽  
Age At Onset ◽  
Cannabis Use ◽  
Clinical High Risk

scholarly journals Personal Beliefs about Experiences in those at Clinical High Risk for Psychosis

2014 ◽  
Vol 43 (6) ◽  
pp. 669-675 ◽  
Author(s):  
Jacqueline Stowkowy ◽  
Diana O. Perkins ◽  
Scott W. Woods ◽  
Karissa Nyman ◽  
Jean Addington
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Intervention Strategies ◽  
Psychotic Symptoms ◽  
Clinical High Risk ◽  
Personal Beliefs ◽  
Negative Beliefs ◽  
The Impact ◽  
Important Objective

Background: Negative beliefs about illness in early psychosis have been shown to have an unfavourable impact on one's quality of life. A shift of focus in psychosis research has been on the detection of individuals considered to be at clinical high risk (CHR) of developing psychosis. Little is known about the impact that beliefs about psychotic like experiences or attenuated psychotic symptoms may have on CHR individuals. Aim: To explore these beliefs in a large sample of young people at CHR of developing psychosis using the Personal Beliefs about Experiences Questionnaire (PBEQ). Method: Beliefs about unusual experiences were assessed in 153 CHR individuals with the PBEQ. Prodromal symptoms (measured by the SIPS) and depression (measured by the CDSS) were also assessed. Results: In CHR individuals, holding more negative beliefs was associated with increased severity in depression and negative symptoms. Higher scores on suspiciousness were associated with increased negative beliefs, and higher levels of grandiosity were associated with decreased negative beliefs. Those who later transitioned to psychosis agreed significantly more with statements concerning control over experiences (i.e. “my experiences frighten me”, “I find it difficult to cope). Conclusions: The results suggest that targeting negative beliefs and other illness related appraisals is an important objective for intervention strategies.

Poster #184 CANNABIS USE IN PATIENTS AT CLINICAL HIGH RISK OF PSYCHOSIS: IMPACT ON PRODROMAL SYMPTOMS AND TRANSITION TO PSYCHOSIS – A SYSTEMATIC REVIEW

2012 ◽  
Vol 136 ◽  
pp. S347
Author(s):  
Floor J. van der Meer ◽  
Eva Veithorst ◽  
Carin J. Meijer ◽  
Marise W. Machielsen ◽  
Paolo Fusar-Poli ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Cannabis Use ◽  
Clinical High Risk ◽  
Prodromal Symptoms

The impact of emotion awareness and regulation on social functioning in individuals at clinical high risk for psychosis

2016 ◽  
Vol 46 (14) ◽  
pp. 2907-2918 ◽  
Author(s):  
D. Kimhy ◽  
K. E. Gill ◽  
G. Brucato ◽  
J. Vakhrusheva ◽  
L. Arndt ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
High Risk ◽  
Social Functioning ◽  
Clinical High Risk ◽  
Emotion Regulation Strategies ◽  
Global Functioning ◽  
Cross Sectional ◽  
Hierarchical Multiple Regression ◽  
Regulation Strategies ◽  
The Impact

BackgroundSocial functioning (SF) difficulties are ubiquitous among individuals at clinical high risk for psychosis (CHR), but it is not yet clear why. One possibility is suggested by the observation that effective SF requires adaptive emotion awareness and regulation. Previous reports have documented deficits in emotion awareness and regulation in individuals with schizophrenia, and have shown that such deficits predicted SF. However, it is unknown whether these deficits are present prior to the onset of psychosis or whether they are linked to SF in CHR individuals.MethodWe conducted a cross-sectional comparison of emotion awareness and regulation in 54 individuals at CHR, 87 with schizophrenia and 50 healthy controls (HC). Then, within the CHR group, we examined links between emotion awareness, emotion regulation and SF as indexed by the Global Functioning Scale: Social (Cornblatt et al. 2007).ResultsGroup comparisons indicated significant differences between HC and the two clinical groups in their ability to identify and describe feelings, as well as the use of suppression and reappraisal emotion-regulation strategies. Specifically, the CHR and schizophrenia groups displayed comparable deficits in all domains of emotion awareness and emotion regulation. A hierarchical multiple regression analysis indicated that difficulties describing feelings accounted for 23.2% of the SF variance.ConclusionsThe results indicate that CHR individuals display substantial emotion awareness and emotion-regulation deficits, at severity comparable with those observed in individuals with schizophrenia. Such deficits, in particular difficulties describing feelings, predate the onset of psychosis and contribute significantly to poor SF in this population.

scholarly journals S94. PREDICTION OF CANNABIS RELAPSE IN CLINICAL HIGH-RISK INDIVIDUALS AND RECENT ONSET PSYCHOSIS - PRELIMINARY RESULTS FROM THE PRONIA STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S69-S70
Author(s):  
Nora Penzel ◽  
Rachele Sanfelici ◽  
Linda Betz ◽  
Linda Antonucci ◽  
Peter Falkai ◽  
...  
Keyword(s):  
Machine Learning ◽  
High Risk ◽  
Random Forest ◽  
Cannabis Use ◽  
Environmental Data ◽  
Clinical High Risk ◽  
Recent Onset ◽  
Cannabis Consumption ◽  
General Functioning

Abstract Background Evidence exists that cannabis consumption is associated with the development of psychosis. Further, continued cannabis use in individuals with recent onset psychosis (ROP) increases the risk for rehospitalization, high symptom severity and low general functioning. Clear inter-individual differences in the vulnerability to the harmful effects of the drug have been pointed out. These findings emphasize the importance of investigating the inter-individual variability in the role of cannabis use in ROP and to understand how cannabis use relates to subclinical conditions that predate the full-blown disease in clinical high-risk (CHR). Specific symptoms have been linked with continued cannabis consume, still research is lacking on how different factors contribute together to an elevated risk of cannabis relapse. Multivariate techniques have the capacity to extract complex patterns from high dimensional data and apply generalized rules to unseen cases. The aim of the study is therefore to assess the predictability of cannabis relapse in ROP and CHR by applying machine learning to clinical and environmental data. Methods All participants were recruited within the multi-site, longitudinal PRONIA study (www.pronia.eu). 112 individuals (58 ROP and 54 CHR) from 8 different European research centres reported lifetime cannabis consume at baseline and were abstinent for at least 4 weeks. We defined cannabis relapse as any cannabis consume between baseline and 9 months follow-up reported by the individual. To predict cannabis relapse, we trained a random forest algorithm implemented in the mlr package, R version 3.5.2. on 183 baseline variables including clinical symptoms, general functioning, demographics and consume patterns within a repeated-nested cross-validation framework. The data underwent pre-processing through pruning of non-informative variables and median-imputation for missing values. The number of trees was set to 500, while the number of nodes, sample fraction and mtry were optimized. All hyperparameters were tuned with the model-based optimization implemented in the mlrMBO R package. Results After 9 months 50 individuals (48 % ROP, 52 % CHR) have relapsed on cannabis use. Relapse was over all timepoints associated with more severe psychotic symptoms measured by PANSS positive and PANSS general (p<0.05) and a significant interaction between positive symptoms and time of measurement (p<0.05). Our random forest classifier could predict cannabis relapse with a balanced accuracy, sensitivity, and specificity of, respectively, 66.5 %, 66.0 % and 67.0 %. The most predictive variables were a higher cumulative frequency of cannabis consumption in the last 3 months, worse general functioning in the last month, higher density of place of living, younger age and a shorter interval time since the last consumption. Discussion Our results using a state-of-the-art machine learning approach suggest that the multivariate signature of baseline demographic and clinical data could predict follow up cannabis relapse above chance level in CHR and ROP. Our findings revealing that cannabis relapse is associated with more severe symptoms is in line with previous literature and emphasizes the need for targeted treatment towards abstinence from cannabis. The information of demographic and clinical patterns might be useful in order to specifically address therapeutic strategies in individuals at higher risk for relapse. This might include special programs for younger patients and taking into account the place of living, like urban areas. Further research is needed in order to validate our model in an independent sample.

Cannabis Use in Patients at Clinical High Risk of Psychosis: Impact on Prodromal Symptoms and Transition to Psychosis

2012 ◽  
Vol 18 (32) ◽  
pp. 5036-5044 ◽  
Author(s):  
Floor J. van der Meer ◽  
Eva Velthorst ◽  
Carin J. Meijer ◽  
Marise W.J. Machielsen ◽  
Lieuwe de Haan
Keyword(s):  
High Risk ◽  
Cannabis Use ◽  
Clinical High Risk ◽  
Prodromal Symptoms

scholarly journals The impact of psychosis on the course of cognition: a prospective, nested case-control study in individuals at clinical high-risk for psychosis

2015 ◽  
Vol 45 (15) ◽  
pp. 3341-3354 ◽  
Author(s):  
R. E. Carrión ◽  
D. McLaughlin ◽  
A. M. Auther ◽  
R. Olsen ◽  
C. U. Correll ◽  
...  
Keyword(s):  
High Risk ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
Disease Status ◽  
Case Control ◽  
Psychotic Symptoms ◽  
Clinical High Risk ◽  
Medication Treatment ◽  
Nested Case Control ◽  
The Impact

BackgroundAlthough cognitive deficits in patients with schizophrenia are rooted early in development, the impact of psychosis on the course of cognitive functioning remains unclear. In this study a nested case-control design was used to examine the relationship between emerging psychosis and the course of cognition in individuals ascertained as clinical high-risk (CHR) who developed psychosis during the study (CHR + T).MethodFifteen CHR + T subjects were administered a neurocognitive battery at baseline and post-psychosis onset (8.04 months, s.d. = 10.26). CHR + T subjects were matched on a case-by-case basis on age, gender, and time to retest with a group of healthy comparison subjects (CNTL, n = 15) and two groups of CHR subjects that did not transition: (1) subjects matched on medication treatment (i.e. antipsychotics and antidepressants) at both baseline and retesting (Meds-matched CHR + NT, n = 15); (2) subjects unmedicated at both assessments (Meds-free CHR + NT, n = 15).ResultsAt baseline, CHR + T subjects showed large global neurocognitive and intellectual impairments, along with specific impairments in processing speed, verbal memory, sustained attention, and executive function. These impairments persisted after psychosis onset and did not further deteriorate. In contrast, CHR + NT subjects demonstrated stable mild to no impairments in neurocognitive and intellectual performance, independent of medication treatment.ConclusionsCognition appears to be impaired prior to the emergence of psychotic symptoms, with no further deterioration associated with the onset of psychosis. Cognitive deficits represent trait risk markers, as opposed to state markers of disease status and may therefore serve as possible predictors of schizophrenia prior to the onset of the full illness.

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