Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis

Schizophrenia Bulletin, Journal Year: 2024, Volume and Issue: 50(3), P. 496 - 512

Published: March 7, 2024

Abstract This article describes the rationale, aims, and methodology of Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). is largest international collaboration to date that will develop algorithms predict trajectories outcomes individuals at clinical high risk (CHR) for psychosis advance development use novel pharmacological interventions CHR individuals. We present a description participating research networks data processing analysis coordination center, their processes harmonization across 43 sites from 13 countries (recruitment North America, Australia, Europe, Asia, South America), flow quality assessment processes, analyses, transfer National Institute Mental Health (NIMH) Data Archive (NDA) by community. In an expected sample approximately 2000 640 matched healthy controls, AMP SCZ collect clinical, environmental, cognitive along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech facial expression samples, measures derived digital health technologies smartphone-based daily surveys, passive sensing as well actigraphy. The study investigate range over 2-year period, transition psychosis, remission or persistence status, attenuated positive symptoms, persistent negative mood anxiety psychosocial functioning. global reach its harmonized innovative methods promise catalyze new treatments address critical unmet public needs in

Language: Английский

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Data analysis strategies for the Accelerating Medicines Partnership® Schizophrenia Program

Schizophrenia, Journal Year: 2025, Volume and Issue: 11(1)

Published: April 3, 2025

The Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ) project assesses a large sample of individuals at clinical high-risk for developing psychosis (CHR) and community controls. Subjects are enrolled in 43 sites across 5 continents. assessments include domains similar to those acquired previous CHR studies along with novel that collected longitudinally period 2 years. In parallel the data acquisition, multidisciplinary teams experts have been working formulate analysis strategy AMP SCZ project. Here, we describe key principles analysis. primary aim is use baseline multimodal biomarkers predict endpoints individuals. These defined study as transition (i.e., conversion), remission from syndrome, persistent syndrome (non-conversion/non-remission) obtained one year two years after assessment. secondary longitudinal all time points identify trajectories differentiate subgroups design plan informed by reviewing legacy analytic approaches international studies. addition, consider properties newly distinct available data. Legacy used assist pipeline building, perform benchmark experiments, quantify concepts make decisions meant overcome challenges encountered We present project, mitigation strategies address related plan, provide rationales decisions, examples how support Watch Prof. Ofer Pasternak discuss his work this article: https://vimeo.com/1023394132?share=copy#t=0 .

Language: Английский

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Bridging Science and Hope: integrating and Communicating Lived experience in Accelerating Medicines Partnership® Schizophrenia Program

Schizophrenia, Journal Year: 2025, Volume and Issue: 11(1)

Published: April 7, 2025

Language: Английский

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Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysis

Epidemiology and Psychiatric Sciences, Journal Year: 2025, Volume and Issue: 34

Published: Jan. 1, 2025

Abstract Aims Clinical high-risk for psychosis (CHR-P) states exhibit diverse clinical presentations, prompting a shift towards broader outcome assessments beyond manifestation. To elucidate more uniform profiles and their trajectories, we investigated CHR-P in community sample. Methods Participants ( N = 829; baseline age: 16–40 years) comprised individuals from Swiss sample who were followed up over roughly 3 years. latent class analysis was applied to symptom data at follow-up, classes examined demographic differences, as well stability time. Results Similar three-class solutions yielded both time points. Class 1 mainly characterized by subtle, subjectively experienced disturbances mental processes, including thinking, speech perception (basic symptoms [BSs]). 2 subthreshold positive psychotic (i.e., mild delusions or hallucinations) indicative of an ultra-high risk psychosis. 3, the largest group (comprising 90% participants), exhibited lowest probability experiencing any psychosis-related (CHR-P symptoms). Classes included participants with functional impairment psychiatric morbidity. had low having deficits disorders points, suggesting that healthiest health functioning remained stable throughout study period. While 91% Baseline time, most (74%) (88%) moved Follow-up 3. Conclusions Despite some temporal fluctuations, within samples cluster into distinct subgroups, reflecting varying levels severity profiles. This clustering highlights largely nature BSs attenuated community. The association Axis-I emphasizes significance symptoms. These findings highlight need personalized preventive measures targeting specific community-based populations.

Language: Английский

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Screening for Psychotic Experiences and Psychotic Disorders in General Mental Health Treatment Settings: A Systematic Review and Meta-Analysis

Harvard Review of Psychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: March 17, 2025

Abstract Background The absence of systematic psychosis screening within general mental health services contributes to substantial treatment delays and poor long-term outcomes for individuals with psychotic symptoms. We conducted a meta-analysis estimate rates subclinical symptoms experiences (PE), clinical high-risk syndrome (CHR-P), disorders that were identified via studies treatment-seeking individuals. These can inform implementation recommendations routine in settings. Methods PubMed Web Science databases searched identify empirical information on PE, CHR-P, or disorder prevalence by inpatients outpatients (age < 65 years) receiving care. PE was using threshold scores validated self-reported questionnaires, CHR-P gold-standard structured interview assessments. A each outcome the restricted maximum likelihood estimator method assess effect sizes random effects model. Results analyses included 41 independent samples (k = 32 outpatient, k 2 inpatient, 7 combined settings) total 25,751 patients (58% female, mean age: 24.1 years). 44.3% (95% CI: 35.8–52.8%; 28 samples, n 21,957); 26.4% 20.0–32.7%; 14,395); 6.6% 3.3–9.8%; 20,371). Rates did not differ sex, age, setting type. Conclusions high settings underscores need early-detection screening. base be used plan training allocation resources required conduct assessments build capacity delivering interventions early non-specialty

Language: Английский

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Identification of Psychosis Risk and Diagnosis of First-Episode Psychosis: Advice for Clinicians

Psychology Research and Behavior Management, Journal Year: 2024, Volume and Issue: Volume 17, P. 1365 - 1383

Published: March 1, 2024

Early detection of psychotic-spectrum disorders among adolescents and young adults is crucial, as the initial years after psychotic symptom onset encompass a critical period in which psychosocial pharmacological interventions are most effective. Moreover, clinicians researchers recent decades have thoroughly characterized psychosis-risk syndromes, youth experiencing early warning signs indicative heightened risk for developing disorder. These insights created opportunities intervention even earlier illness course, ideally culminating prevention or mitigation psychosis onset. However, identification diagnosis can be complex, clinical presentations heterogeneous, symptoms exist on continuum. When person presents to clinic, it may unclear whether they common, mild psychotic-like symptoms, psychosis, overt better accounted by non-psychotic Therefore, purpose this review provide framework clinicians, including those who treat primary care settings, guiding within presenting clinic via referral specialty clinic. We first descriptions examples first-episode (FEP) well assessment tools used diagnose these conditions. Next, we guidance differential conditions phenotypic overlap with disorders, while considering possibility co-occurring case transdiagnostic treatments encouraged. Finally, conclude an overview screening outreach campaigns, should further optimized reduce duration untreated youth.

Language: Английский

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Pathways to prevention: the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ) Program

Schizophrenia, Journal Year: 2025, Volume and Issue: 11(1)

Published: April 15, 2025

Language: Английский

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Identifying individuals at clinical high risk for psychosis using a battery of tasks sensitive to symptom mechanisms

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: May 8, 2025

The clinical high risk for psychosis (CHR-P) population is important understanding disease progression and treatment; however, standard approaches to identifying CHR-P individuals are expensive labor-intensive. Focusing on neurocognitive mechanisms that underlie individual symptoms (positive, negative, disorganization) may improve screening identification. present study examines whether a behavioral task battery assays symptom can identify predict severity. Participants ( N = 621) were recruited from clinics the community as part of Computerized Assessment Psychosis Risk (CAPR) consortium study. Structured interviews, dimensional calculator, tasks administered. Clinical interviews identified following groups: (a) n 273), (b) non-CHR-P with limited like experiences (PLEs; 120), (c) participants mental disorders no PLEs (CLN; 82), (d) healthy controls (HC; 146). Multinomial logistic regression indicated differentiated groups p < .001), utility (Sensitivity .87, PPV .51, NPV .77), though false positives varied based comparison group (Specificity .21-.43). Tasks also predicted calculator scores (Adjusted R 2 .12), two unique predictors being positive variables associated updating beliefs regarding environmental volatility. Overall, mechanism control groups, suggesting their potential novel tools. Using more efficiently (e.g., enrich samples), lower barriers otherwise be missed.

Language: Английский

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Are Psychiatric Nosologies Limiting the Success of Clinical Prediction Models?

JAMA Psychiatry, Journal Year: 2024, Volume and Issue: unknown

Published: Sept. 18, 2024

This Viewpoint discusses the limitations of clinical prediction models in psychiatric research.

Language: Английский

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Combinations and Temporal Associations Among Precursor Symptoms Before a First Episode of Psychosis

Schizophrenia Bulletin, Journal Year: 2023, Volume and Issue: 50(4), P. 860 - 870

Published: Oct. 20, 2023

Abstract Background and Hypothesis Symptoms that precede a first episode of psychosis (FEP) can ideally be targeted by early intervention services with the aim preventing or delaying onset. However, these precursor symptoms emerge in combinations sequences do not rest fully within traditional diagnostic categories. To advance our understanding illness trajectories preceding FEP, we aimed to investigate temporal associations among symptoms. Study Design Participants were from PEPP-Montréal, catchment-based program for FEP. Through semistructured interviews, collateral relatives, review health social records, retrospectively measured presence absence 29 symptoms, including 9 subthreshold psychotic 20 nonpsychotic Sequences derived timing symptom relative onset Results The sample included 390 participants (68% men; age range: 14–35 years). Combinations most frequently featured depression, anxiety, substance use. Of 256 possible pairs initial subsequent many had asymmetrical associations: eg, when was suspiciousness, incidence rate ratio (IRR) anxiety 3.40 (95% confidence interval [CI]: 1.79, 6.46), but IRR suspiciousness 1.15 CI: 0.77, 1.73). Conclusions A detailed examination reveals diverse clinical profiles cut across categories evolve longitudinally prior Their identification may contribute risk assessments provide insights into mechanisms progression.

Language: Английский

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