bluuebunny/crossref_metadata_2025_split huggingface dataset:
T72. COGNITIVE CLUSTERS IN FIRST-EPISODE PSYCHOSIS AND THEIR RELATIONSHIP TO SYMPTOMATOLOGY AND DEVELOPMENTAL SCHOLASTIC PERFORMANCE
Authors: Tan Eric , Rossell Susan , Subotnik Kenneth , Ventura Joseph , Nuechterlein Keith H 
Published: May 2020

Abstract

Background
Groups with differential levels of cognitive impairment are increasingly recognized among patients with schizophrenia spectrum disorders. Using cluster analytical techniques, this study sought to explore cognitive clusters in a sample of first-episode psychosis patients and compare levels of symptomatology as well as childhood and adolescent scholastic performance between the resultant groups.

Methods
Data from 105 first-episode psychosis patients (n=56 with schizophrenia, n=13 with schizoaffective disorder, depressed type, n=36 with schizophreniform disorder) (mean age=22.06, SD=3.79) in the UCLA Aftercare Research Program were used for this analysis. Cognition was assessed using a modified beta version of the MATRICS Consensus Cognitive Battery which consisted of 16 tasks across seven cognitive domains. Symptomatology and developmental scholastic performance were assessed using the Brief Psychiatric Rating Scale and the Cannon-Spoor Premorbid Adjustment Scale respectively. Hierarchical cluster analysis with Ward’s method and squared Euclidean distance was conducted, confirmed by discriminant function analysis and optimized with k-means clustering. Stability of the solution was evaluated through split-sample (random 80% and 70% samples) and alternate method (average linkage method) replication via Cohen’s κ analysis.

Results
Three clusters were identified: most impaired (n=27), moderately impaired (n=41) and good (n=37). Controlling for multiple comparisons, one-way ANOVAs revealed no significant differences in symptomatology between the groups (p&gt;.008). Significant differences were observed for scholastic performance at three different developmental stages: childhood (p&lt;.0001), early adolescence (p&lt;.0001) and late adolescence (p&lt;.0001), with the good group demonstrating significantly better scholastic performance than both the moderately impaired and most impaired groups (who did not significantly differ from each other) at all three stages.

Discussion
The findings add to growing evidence that cognitive clusters in FEP mirror that of later-stage schizophrenia. Cognitive clusters were not associated with differences in symptom severity, but reflected differing levels of premorbid scholastic performance during the developmental years. This suggests that performance at school may not just be a risk factor for developing schizophrenia, but also related to the severity of impairment and potentially prognosis.
T80. CARDIOMETABOLIC RISK PREDICTION ALGORITHMS AND THEIR APPLICABILITY FOR YOUNG PEOPLE WITH PSYCHOSIS: A SYSTEMATIC REVIEW AND ILLUSTRATIVE EXAMPLE USING ORIGINAL DATA FROM A POPULATION-BASED BIRTH COHORT
Authors: Jang Soomin , Crawford Owen , Perry Benjamin , Jones Peter B , Khandaker Golam 
Published: May 2020

Abstract

Background
Cardiometabolic risk prediction algorithms are used in clinical practice. Young people with psychosis are a high-risk group for developing cardiometabolic disorders, but it is unclear whether existing algorithms are suitable for this group.

Methods
We conducted a systematic review employing PRISMA criteria to identify studies reporting the development and/or validation of cardiometabolic risk prediction algorithms for general or psychiatric populations. A narrative synthesis was conducted to compare algorithms and consider their suitability for young people with psychosis. In addition, we used data from 3,470 young adults aged 18 years from the ALSPAC birth cohort to illustrate the impact of age on model performance of QDiabetes, an established algorithm.

Results
Having screened 6,609 studies, we included 57 risk algorithms designed for type 2 diabetes, cardiovascular disease or stroke, all of which were developed/validated in relatively older participants. Three algorithms featured psychiatric predictors and could be used for young people with psychosis. However, in all of three, age was weighted to a much greater extent than other risk factors. Furthermore, using ALSPAC data, we report that QDiabetes significantly under-predicted cardiometabolic risk in young people. Increasing the sample age to 50, leaving all other predictors unchanged, improved algorithm calibration markedly.

Discussion
Existing cardiometabolic risk prediction algorithms are heavily weighted on age and so under-predict risk in young people. A new or recalibrated algorithm is required for young people with psychosis that appropriately balances the weighting of relevant risk factors.
T91. THE POSITIVE AND NEGATIVE SYNDROME SCALE SUPERIOR TO A SELF-REPORT QUESTIONNAIRE IN THE PHARMACOTHERAPY MONITORING AND OUTCOME SURVEY
Authors: Bartels-Velthuis Annegien , Ties Koen , Visser Ellen , Arends Johan , Pijnenborg Marieke , Wunderink Lex , Jörg Frederike , Veling Wim , Castelein Stynke , Knegtering Henderikus , Bruggeman Richard 
Published: May 2020

Abstract

Background
Aiming to improve the quality of care for patients with a psychotic disorder, the ongoing Pharmacotherapy Monitoring Outcome Survey (PHAMOUS) started in 2006 in four large mental health care organizations in the Northern Netherlands, by adding it to the at that time mandatory Routine Outcome Monitoring program. However, since the cuts in the financial budgets for mental health care, research nurses are increasingly experiencing time-pressure in the assessments. The Positive and Negative Syndrome Scale (PANSS), part of the assessment, is a time-consuming interview, taking approximately 30 minutes. Therefore, we developed and validated a short self-report questionnaire assessing positive psychotic symptoms, the Brief Positive Symptoms Questionnaire (BPSQ).

Methods
The BPSQ was added to PHAMOUS and filled in once by patients in four mental health care institutions in 2017 and 2018. The BPSQ consists of nine items and takes about 2–3 minutes to complete. It was validated against the PANSS positive scale and two items of the Health of the Nations Outcome Scale (HoNOS), with item 6 assessing the problems that patients experience due to hallucinations and delusions and item 8 assessing further mental and behavioural problems.

Results
BPSQ data were obtained from n=287 patients (mean age 47.1 years, 67.6% male). The PANSS was assessed in n=244 and HoNOS data were available for n=156 patients. Scores of one patient were considered unreliable and thus removed from the data set. The BPSQ had a Cronbach’s alpha of .81. Spearman’s correlation coefficient of the BPSQ and the PANSS positive scale was significant (ρ(243) = .63, p &lt; .05). Correlations between the BPSQ and HoNOS items 6 and 8 were significant (ρ(155) = .488, p &lt; .05 and ρ(155) = .251, p &lt; .05 respectively). Post hoc analysis showed that the more severely psychotic the patients were, the less the BPSQ and the PANSS positive scale were corresponding.

Discussion
Given the medium correlation of the BPSQ with the PANSS positive scale and the low concurrent validity with the two relevant HoNOS items, we argue that the widely used and validated PANSS is indispensable in the PHAMOUS assessment of positive symptoms in a chronic population with psychotic disorders. Replication of this study in first-episode psychotic patients is recommended.
T228. SOCIAL REWARD REACTIVITY AND SENSITIVITY IN SCHIZOPHRENIA SPECTRUM CONDITIONS
Authors: Aldridge-Waddon Luke , Vanova Martina , Munneke Jaap , Puzzo Ignazio , Kumari Veena 
Published: May 2020

Abstract

Background
Individuals with schizophrenia spectrum disorders often experience less pleasure during social interaction and frequently demonstrate reduced social motivation. This research examines the extent to which these behaviours may be linked to reduced social reward reactivity and sensitivity, and aims to clarify whether schizophrenia spectrum traits are associated with reduced behavioural and neural responsiveness to social rewards. It includes a systematic review and meta-analyses of social reward sensitivity research in schizophrenia, and also provides preliminary data (participant n = 50) on a novel avatar-based social incentive delay task that was created to further investigate the links between schizophrenia spectrum traits and social reward reactivity.

Methods
First, a systematic review and meta-analyses (literature database search conducted November 2019) found six studies that investigated social reward anticipation and consumption within the schizophrenia continuum (total participant n = 440). Four investigated social reward sensitivity in clinical samples with schizophrenia diagnoses, and two studied the links between social anhedonia traits and social reward responding in normative samples. The novel social incentive delay task presents participants with the opportunity to win animated avatar-based monetary or social rewards by responding to a cued target.

Results
The narrative review and meta-analyses of behavioural data from clinical and normative samples found that individuals with schizophrenia diagnoses or traits demonstrate significantly reduced behavioural anticipation of social rewards in comparison to healthy controls. Furthermore, this reduced reward reactivity was more pronounced for social rewards than for monetary rewards. This effect was also mirrored at neural levels, with individuals with schizophrenia demonstrating reduced social reward-related activation in areas such as the ventral striatum and anterior cingulate cortex. Preliminary behavioural data from the social incentive delay task suggest that, in normative samples, more pronounced negative schizotypal traits are associated with reduced anticipation and consumption of social rewards. Like in the reviewed studies, this reduced anticipation was more marked for social rewards than for monetary rewards.

Discussion
This research suggests that schizophrenia spectrum traits are associated with reduced reactivity and sensitivity to social rewards. It also highlights that this reduced reactivity is demonstrated at behavioural and neural levels, and is more marked for social rewards than for monetary rewards. We consider the implications of these findings for treatment programmes that target atypical social behaviour within schizophrenia spectrum conditions. A series of methodological recommendations for future work investigating social reward reactivity in schizophrenia are also included.
T231. QUALITY OF LIFE IN ANTIPSYCHOTIC-NAïVE YOUTH: EXPLORING THE INTERPLAY WITH METABOLIC SIDE-EFFECTS
Authors: Chintoh Araba , Agarwal Mahavir , Mackenzie Nicole , Remington Gary , Hahn Margaret 
Published: May 2020

Abstract

Background
This observational, exploratory pilot study aims to understand changes in clinical presentation and quality of life (QoL) in antipsychotic-naïve youth. Outcomes for these first-episode psychosis patients will be explored in the context metabolic changes during their first three months of treatment.

Methods
Participants (n = 10) aged 14–29 years were followed throughout their first three months of treatment with an antipsychotic medication (of physician’s/patient’s choice). Participants were evaluated on metabolic indices including weight, waist circumference, and BMI, as well as QoL [Pediatric Quality of Life Index (PedsQL) and PedsQL General Well-Being Scale] and clinical presentation [Clinical Global Impression (CGI) scale]. Descriptive statistics and nonparametric tests were conducted to compare significant changes across these variables.

Results
Significant changes in metabolic indices were observed over the first three months of treatment, as measured in weight gain (p = 0.02), increased waist circumference (p = 0.02) and increased BMI (p = 0.01). Physicians rated clinical improvement in participants, CGI score (p = 0.03). However, patient-rated QoL remained unchanged within all subcategories, including psychosocial (p = 0.52) and general well-being (p = 0.35).

Discussion
It appears that antipsychotic-related metabolic side effects may not impede upon early clinical improvement or impact QoL. In addition, there does not appear to be a relationship between clinical presentation and QoL as our small sample show QoL remains neutral or positive. Taken together, these findings suggest that clinical presentation and metabolic side effects may not be influential in early psychosis. From a clinical perspective, these early pilot data add to the literature highlighting the significant, early, antipsychotic-induced metabolic side effects in youth, and also encouraging clinicians to attend to the interplay between treatment and related QoL. This study is limited by its small sample size and naturalistic treatment allocation. These participants will be followed longitudinally to monitor development of adverse metabolic outcomes as well as changes in QoL in later stages of treatment/illness. The field must to understand how treatment and management of metabolic side effects can be augmented to promote clinical improvement and QoL, given the prevalence of adolescent patients who eventually wish to discontinue antipsychotic drugs because of metabolic side effects.
T234. MEASURING PERSONAL RECOVERY IN PEOPLE WITH A PSYCHOTIC DISORDER BASED ON CHIME: A COMPARISON OF RELIABILITY AND VALIDITY PROPERTIES ON THREE VALIDATED MEASURES
Authors: Sjoerd Vogel Jelle , Bruins Jojanneke , Halbersma Levi , Janine Lieben Rianne , de Jong Steven , Van der Gaag Mark , Castelein Stynke 
Published: May 2020

Abstract

Background
Living well in spite of residual symptoms of mental illness is measured with the construct of personal recovery. The CHIME framework might be suitable to evaluate personal recovery measures and guide instrument choice.

Methods
Three validated measures were evaluated in Dutch patients with a psychotic disorder (N=52). We compared the Recovery Assessment Scale [RAS], the Mental Health Recovery Measure [MHRM] and the Netherlands Empowerment List [NEL]. The measures were assessed on six criteria: content validity (based on CHIME), convergent validity with a social support measure, internal consistency, floor and ceiling effects, item interpretability and ease of administration.

Results
The MHRM scored high on content validity with a balanced distribution of items covering the CHIME framework. The MHRM and NEL showed moderate convergent validity with social support. In all three measures internal consistency was moderate and floor and ceiling effects were absent. The NEL scores demonstrated a high degree of item interpretability. Ease of administration was moderate for all three measures. Finally, the CHIME framework demonstrated good utility as a framework in guiding instrument choice and evaluation of personal recovery measures.

Discussion
The MHRM showed the best overall result. However, differences between measures were minimal. Generalization of the results is limited by cultural and linguistic factors in the assessment for the subjective measures (i.e. content validity and item interpretability). The broad and multi-dimensional construct of personal recovery might lead to ambiguous interpretations. Scientific consensus on a well-defined personal recovery construct is needed.
T237. PERSON-CENTERED PSYCHOSIS CARE –HOW INCREASING PERSON-CENTEREDNESS IN PSYCHOSIS INPATIENT CARE RELATE TO CARE CONSUMPTION AND WARD BURDEN
Authors: Allerby Katarina , Goulding Anneli , Ali Lilas , Gremyr Andreas , Waern Margda 
Published: May 2020

Abstract

Background
Since person-centered care (PCC) is widely embraced and internationally considered to increase effectiveness and quality of complex health care today this study sets out to investigate its relation to ward level outcomes such as length of hospital stay (LoS), involuntary treatments and ward burden. An educational intervention for staff, using a participatory approach, was created to increase the person-centeredness of the care delivered at four inpatient psychosis wards. 6 conference days spread over a 6 months period with practical work at home wards in-between let participants receive information on, discuss and test the principles of PCC, such as acknowledge patients resources, preferences and experiences, working in partnership with patients to co-create the care plan, and documenting agreements.

Methods
Data for all patients receiving care at the inpatient services during data collection periods before (n = 416) and after (n = 375) the intervention, including LoS, length of involuntary stay (LoIS) as well as number of episodes involving restraints, seclusions and forced injections, were extracted from the clinic registry. During the same data collection periods one staff member per day and ward filled out a VAS rating (1 = no burden – 10 =highest imaginable burden) capturing experienced ward burden (n = 505, 60% response rate vs n = 465, 45% response rate). Mean or median of each variable was used for comparative analysis.

Results
A longer LoS was found after implementation (Md = 21.1, n = 416 vs Md = 26.2, n = 375), U = 85894, p = .014, r = .09. LoIS was shorter after implementation (Md = 10.6 vs Md = 6.6), the difference was however not significant U = 74263, p = .231. Analysis of data on involuntary treatments are underway and will be presented. Ward burden was rated significantly lower after implementation (M = 5.4, SD = 1.94 vs M = 4.5, SD = 2.08), t = 7.5 (968), p &lt;.0005.

Discussion
Although study design prevents conclusions on cause and effect, the results indicate a beneficial development for perceived care burden after implementation of PCC. The increased LoS could be interpreted as a result of more thorough attention to patient needs. It could also be due to differences between groups in terms of severity of symptom and functional ability at admission.
T238. RATES AND PREDICTORS OF RELAPSE IN AN AUSTRALIAN FIRST EPISODE PSYCHOSIS COHORT
Authors: Brown Ellie , O’Donoghue Brian 
Published: May 2020

Abstract

Background
Clinical and functional recovery is usually achieved after treatment for a first episode of psychosis (FEP). Unfortunately, subsequent relapse remains common, occurring within a year for approximately 30% of individuals and within five years for 80%. What makes someone more likely to relapse remains poorly understood.

Methods
This study is a naturalistic cohort study of young people (15–25 years old) accessing an early intervention in psychosis service in Melbourne, Australia between 1st January 2011 and 31st December 2016. Demographic and clinical predictors of relapse were collected from patient records and analysed using Cox regression analysis.

Results
A total of 1220 young people presented with a FEP during the study period and 37.7% (N=460) experienced at least one relapse during their episode of care. Over half of all relapses resulted in an admission to hospital. Non-adherence to medication, substance use and psychosocial stressors precipitated relapses. Significant predictors of relapse in this sample were a diagnosis of a schizophrenia spectrum disorder or an affective psychotic disorder, amphetamine use, and substance use during treatment.

Discussion
These findings suggest that relapse occurs frequently for young people who have experienced FEP. This is one of the first studies to find that amphetamine use increases the risk of relapse. Clinical services, especially in Australasia, need to consider how best to manage this co-morbidity in young people with FEP.
M17. PREDICTION OF NEUROLEPTIC AND ANTIDEPRESSANT TREATMENT RESPONSES VIA FMRI OF THE EXTENDED REWARD SYSTEM
Authors: Gruber Oliver , Rauer Lisa , Trost Sarah , Lückel Maximilian 
Published: May 2020

Abstract

Background
Neuroimaging techniques have been developed as important tools to assess brain dysfunctions that underlie mental disorders. In particular, modern functional magnetic resonance imaging (fMRI) holds the promise to provide neurofunctional biomarkers for improved differential diagnosis and optimized treatment of schizophrenic and affective disorders.

Methods
Neurofunctional connectivity MRI of the extended human reward system (Makris et al., 2008) was conducted in a large transnosological cohort of patients suffering from schizophrenia, bipolar disorder or major depressive disorder. Responses to neuroleptic treatments in patients with schizophrenic or bipolar disorder were determined retrospectively, while treatment responses to different antidepressants were directly assessed in a prospective naturalistic clinical study.

Results
Responders to neuroleptic treatment with aripiprazole showed significantly higher reward-related activation in a larger set of brain regions (including ventral striatum, hippocampus, amygdala, pregenual ACC and anteroventral PFC) in comparison to non-responders to aripiprazole. This finding proved to be specific for this neuroleptic treatment when compared to treatments with other atypical or typical neuroleptics. Pre-treatment reward-related activation of the nucleus accumbens, the ventral tegmental area and the amygdala showed a substance-class specific correlation with subsequent antidepressant treatment responses to SSRIs and/or agomelatine.

Discussion
These findings of ongoing studies exemplify the high potential of neuroimaging techniques to foster the development of precision medicine in psychiatry. The identification of neuroimaging markers associated with specific treatment responses may allow the development of “tailored”, i.e. stratified treatment approaches.