A comparison of neurocognition and functioning in first episode psychosis populations: do research samples reflect the real world?

Kline, Emily; Hendel, Victoria; Friedman‐Yakoobian, Michelle; Mesholam-Gately, Raquelle I.; Findeisen, Ann; Zimmet, Suzanna V.; Wojcik, Joanne; Petryshen, Tracey L.; Woo, Tsung-Ung W.; Goldstein, Jill M.; Shenton, Martha E.; Keshavan, Matcheri S.; McCarley, Robert W.; Seidman, Larry J.

doi:10.1007/s00127-018-1631-x

Cited by 14 publications

(10 citation statements)

References 32 publications

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“…Of particular concern is evidence that people from ethnic minorities are under-represented in mental health research ( 9 , 10 ), despite having higher rates of diagnosis for some conditions, such as psychosis ( 11 ). These factors mean that the groups of individuals who take part in mental health research studies rarely represent the population of people living with mental illness ( 12 ), which could have serious implications for treatment outcomes ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Co-development of a Best Practice Checklist for Mental Health Data Science: A Delphi Study

et al. 2021

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Background: Mental health research is commonly affected by difficulties in recruiting and retaining participants, resulting in findings which are based on a sub-sample of those actually living with mental illness. Increasing the use of Big Data for mental health research, especially routinely-collected data, could improve this situation. However, steps to facilitate this must be enacted in collaboration with those who would provide the data - people with mental health conditions.Methods: We used the Delphi method to create a best practice checklist for mental health data science. Twenty participants with both expertise in data science and personal experience of mental illness worked together over three phases. In Phase 1, participants rated a list of 63 statements and added any statements or topics that were missing. Statements receiving a mean score of 5 or more (out of 7) were retained. These were then combined with the results of a rapid thematic analysis of participants' comments to produce a 14-item draft checklist, with each item split into two components: best practice now and best practice in the future. In Phase 2, participants indicated whether or not each item should remain in the checklist, and items that scored more than 50% endorsement were retained. In Phase 3 participants rated their satisfaction with the final checklist.Results: The final checklist was made up of 14 “best practice” items, with each item covering best practice now and best practice in the future. At the end of the three phases, 85% of participants were (very) satisfied with the two best practice checklists, with no participants expressing dissatisfaction.Conclusions: Increased stakeholder involvement is essential at every stage of mental health data science. The checklist produced through this work represents the views of people with experience of mental illness, and it is hoped that it will be used to facilitate trustworthy and innovative research which is inclusive of a wider range of individuals.

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Section: Introductionmentioning

confidence: 99%

Co-development of a Best Practice Checklist for Mental Health Data Science: A Delphi Study

et al. 2021

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“…More importantly, our data, derived from chart review, includes clinically rich longitudinal data from patients who have ever been seen in the clinic, and are thus free from bias related to including only individuals who are willing and able to sign informed consent. 113 , 114 That cognitive measures, collected through voluntary participation in a FEP research study, were available for only a third of the patients in the analysis underscores the advantages of medical record review in capturing a more representative sample.…”

Section: Discussionmentioning

confidence: 99%

Return to College After a First Episode of Psychosis

Shinn

Cawkwell

Bolton

et al. 2020

Schizophrenia Bulletin Open

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A first episode of psychosis (FEP) can derail a patient’s educational goals, including attainment of a college education, and this can have lasting ramifications for socioeconomic and health outcomes. Despite this, few studies have examined return to college or other indices of real-world educational success after a FEP. In this study, we conducted a longitudinal medical record review of patients in a transdiagnostic outpatient FEP program and performed survival analysis, setting return to college as the endpoint, among the subset of patients whose college education was interrupted. We found that 82% (93/114) of college-enrolled FEP individuals experienced disruptions to their education after FEP, but that return to college also occurred in a substantial proportion (49/88, 56%) among those on leave who had follow-up data. In this sample, the median time to college return was 18 months. When separated by baseline diagnostic category, FEP patients with affective psychotic disorders (FEAP, n=45) showed faster time to college return than those with primary psychotic disorders (FEPP, n=43) (median 12 vs. 24 months; p=0.024, unadjusted). When adjusted for having no more than one psychiatric hospitalization at intake and absence of cannabis use in the 6 months prior to intake (which were also significant predictors), differences by diagnostic category were more significant (hazard ratio 2.66, 95% CI 1.43-4.94, p=0.002). Participation in education is an important outcome for stakeholders, and students with FEP can be successful in accomplishing this goal.

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“…There is limited research on the prevalence, profile and associations of cognitive impairment in FEP patients from low and middle-income countries (LMICs) ( Green, 2016 ; Vinogradov, 2019 ; Kline et al, 2019 ). It is crucial to determine how FEP patients compared to their healthy controls when assessed with the MCCB in LMICs as it prevents wrongly assigning cognitive impairment ( Reichenberg, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients

Mwesiga

Robbins

Akena

et al. 2022

Schizophrenia Research: Cognition

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Introduction The MATRICS consensus cognitive battery (MCCB) is the gold standard for neuropsychological assessment in psychotic disorders but is rarely used in low resource settings. This study used the MCCB to determine the prevalence, profile and associations of various exposures with cognitive impairment in Ugandan first-episode psychosis patients. Methods Patients and matched healthy controls were recruited at Butabika Hospital in Uganda. Clinical variables were first collated, and after the resolution of psychotic symptoms, a neuropsychological assessment of seven cognitive domains was performed using the MCCB. Cognitive impairment was defined as two standard deviations (SD) below the mean in one domain or 1SD below the mean in two domains. Descriptive statistics determined the prevalence and profile of impairment while regression models determined the association between various exposures with cognitive scores while controlling for age, sex and education. Results Neuropsychological assessment with the MCCB found the burden of cognitive impairment in first-episode psychosis patients five times that of healthy controls. The visual learning and memory domain was most impaired in first-episode psychosis patients, while it was the working memory domain for the healthy controls. Increased age was associated with impairment in the domains of the speed of processing (p < 0.001) and visual learning and memory (p = 0.001). Cassava-rich diets and previous alternative and complementary therapy use were negatively associated with impairment in the visual learning (p = 0.04) and attention/vigilance domains (p = 0.012), respectively. There were no significant associations between sex, history of childhood trauma, or illness severity with any cognitive domain. Conclusion A significant burden of cognitive impairment in Ugandan first-episode psychosis patients is consistent with prior data from other contexts. However, the profile of and risk factors for impairment differ from that described in such work. Therefore, interventions to reduce cognitive impairment in FEP patients specific to this setting, including dietary modifications, are required.

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A comparison of neurocognition and functioning in first episode psychosis populations: do research samples reflect the real world?

Cited by 14 publications

References 32 publications

Co-development of a Best Practice Checklist for Mental Health Data Science: A Delphi Study

Co-development of a Best Practice Checklist for Mental Health Data Science: A Delphi Study

Return to College After a First Episode of Psychosis

Prevalence, profile and associations of cognitive impairment in Ugandan first-episode psychosis patients

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