In This Presentation
Identifying predictors and elucidating the fundamental mechanisms underlying onset of psychosis are critical for the development of targeted preemptive interventions. Cannon presents findings on these questions from the North American Prodrome Longitudinal Study (NAPLS), which uses the clinical high-risk for psychosis (CHR-P) paradigm for case ascertainment.
Multivariate models incorporating risk factors from clinical, demographic, neurocognitive, and psychosocial assessments achieve high levels of predictive accuracy when applied to CHR-P samples. An individualized risk calculator is available to scale the risk for newly ascertained cases, which could aid in clinical decision-making and drug trial design.
At risk individuals who convert to psychosis show elevated levels of proinflammatory cytokines, as well as disrupted cerebello-thalamo-cortical functional connectivity at baseline, compared with those who do not. Further, converters show a steeper rate of gray matter reduction, most prominent in prefrontal cortex, that in turn is predicted by higher levels of inflammatory markers at baseline. These findings encourage further work to identify novel targets for interventions related to neuroplasticity and neuroinflammation.