A predictive model for conversion to psychosis in clinical high-risk patients

Ciarleglio, Adam; Brucato, Gary; Masucci, Michael D.; Altschuler, Rebecca; Colibazzi, Tiziano; Corcoran, Cheryl; Crump, Francesca M.; Horga, Guillermo; Lehembre-Shiah, Eugénie; Leong, Wei Sun; Schobel, Scott; Wall, Melanie M.; Yang, Lawrence H.; Lieberman, Jeffrey A.; Girgis, Ragy R.

doi:10.1017/s003329171800171x

Cited by 40 publications

(38 citation statements)

References 43 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specific psychotic diagnosis was determined using the structured clinical interview for the DSM‐IV (SCID‐IV) . In some cases where an in‐person interview was not possible, conversion status was obtained by telephone, from family report, medical chart review, and/or through communication with a patient's mental health provider, in keeping with previous studies .…”

Section: Methodsmentioning

confidence: 99%

“…The fourth positive symptom item (P4) of the SOPS elicits information about perceptual abnormalities from multiple modalities but then records overall severity, integrating across modalities. For the purpose of this study, separate component ratings for auditory, visual, somatic/tactile, and gustatory/olfactory perceptual abnormalities were coded by a research staff member (HFN) certified in SIPS administration using SIPS records as described in previous studies . When available, brief clinical vignettes summarizing the screening visit were used to supplement information in the SIPS record, and an expert in SIPS administration and scoring (BCW) was consulted on cases where ratings were unclear.…”

Section: Methodsmentioning

confidence: 99%

“…Recent studies reporting individual effects for both auditory and visual perceptual abnormalities show a protective effect for visual hallucinations most reliably . For this reason, we used the effect size of the visual effect reported in the initial paper , with a beta set to 0.8 and a two‐tailed alpha set at 0.05.…”

Section: Methodsmentioning

confidence: 99%

“…Participants were excluded if they had at any point met criteria for a psychotic disorder, or if symptoms were better explained by another psychiatric disorder. Participants over age 35 at baseline were excluded to better match previously reported samples .…”

Section: Methodsmentioning

confidence: 99%

“…Recently, Lehembre‐Shiah et al reported that baseline presence of auditory perceptual abnormalities in a CHR sample predicted conversion to psychosis, while visual abnormalities had a protective effect and were associated with a longer period until conversion. Lastly, after inclusion by the same group in a multivariate analysis using an overlapping sample, auditory perceptual abnormalities failed to predict conversion, while severity of visual perceptual abnormalities remained inversely predictive of conversion risk .…”

Section: Introductionmentioning

confidence: 91%

See 4 more Smart Citations

Does hallucination perceptual modality impact psychosis risk?

Niles

Walsh

Woods

et al. 2019

Acta Psychiatr Scand

View full text Add to dashboard Cite

Woods SW, Powers AR III. Does hallucination perceptual modality impact psychosis risk?.Objective: Subthreshold perceptual abnormalities are commonly used to identify individuals at clinical high risk (CHR) for developing a psychotic disorder. Predictive validity for modality-specific perceptual abnormality severity on psychosis risk is unknown. Methods: We examined prospectively collected data from 164 individuals age 12-35 meeting criteria for CHR followed for 6-24 months or until conversion to psychosis. Using intake interview notes, baseline perceptual abnormality scores were split into auditory, visual, somatic/tactile, and olfactory/gustatory components, and auditory scores were further split into those for verbal vs non-verbal content. Relationships between perceptual abnormality characteristics and conversion were assessed with Cox proportional hazards regression and logistic regression. Results: Unusual thought content and paranoia were predictive of conversion, but no modality-specific perceptual abnormality score predicted conversion status or days to conversion. However, when auditory perceptual abnormalities were further categorized as verbal vs non-verbal, the severity of verbal experiences was predictive of conversion to psychosis (P = 0.007). Conclusions: Perceptual abnormality scores failed to meaningfully predict conversion to psychosis in either direction in this CHR sample. However, verbal auditory experiences may identify a group of CHR individuals at elevated risk of conversion. Further exploration of the relationship between phenomenological aspects of perceptual abnormalities and conversion risk is warranted. Significant outcomes• Subclinical hallucinations and perceptual abnormalities do not predict risk of conversion among CHR populations.• Verbal auditory experiences may be uniquely associated with greater risk of conversion to psychotic disorders. Limitations• As a retrospective study, severity scores for individual perceptual modalities were not recorded prospectively, but were generated per protocol from original study interview notes as a secondary analysis. Rater knowledge of conversion status was minimized prior to rescoring, but the possibility remains for slight bias owing to this methodology.• Research within the CHR population is often limited by poor retention rates, and this study was no exception. 26.5% of the 223 participants meeting criteria at baseline were lost to follow-up within 6 months.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

See 3 more Smart Citations