Modinos, Gemma, Kempton, Matthew J., Tognin, Stefania ORCID: 0000-0002-1983-9135, Calem, Maria, Porffy, Lilla, Antoniades, Mathilde, Mason, Ava, Azis, Matilda ORCID: 0000-0001-8164-0357, Allen, Paul, Nelson, Barnaby ORCID: 0000-0002-6263-2332, McGorry, Patrick, Pantelis, Christos ORCID: 0000-0002-9565-0238, Riecher-Rossler, Anita, Borgwardt, Stefan ORCID: 0000-0002-5792-3987, Bressan, Rodrigo, Barrantes-Vidal, Neus ORCID: 0000-0002-8671-1238, Krebs, Marie-Odile, Nordentoft, Merete ORCID: 0000-0003-4895-7023, Glenthoj, Birte ORCID: 0000-0003-3056-7262, Ruhrmann, Stephan ORCID: 0000-0002-6022-2364, Sachs, Gabriele ORCID: 0000-0002-8359-9877, Rutten, Bart, van Os, Jim, de Haan, Lieuwe, Velthorst, Eva ORCID: 0000-0002-9240-2909, van der Gaag, Mark ORCID: 0000-0002-3525-6415, Valmaggia, Lucia R., McGuire, Philip ORCID: 0000-0003-4381-0532, Kraan, Tamar C., van Dam, Daniella S., Burger, Nadine, Amminger, G. Paul ORCID: 0000-0001-8969-4595, Politis, Athena, Goodall, Joanne, Rapp, Charlotte, Ittig, Sarah, Studerus, Erich, Smieskova, Renata, Gadelha, Ary, Brietzke, Elisa ORCID: 0000-0003-2697-1342, Asevedo, Graccielle, Asevedo, Elson, Zugman, Andre, Dominguez-Martinez, Tecelli, Monsonet, Manel, Hinojosa, Lidia, Racioppi, Anna ORCID: 0000-0002-5575-2811, Kwapil, Thomas R., Kazes, Mathilde, Daban, Claire, Bourgin, Julie, Gay, Olivier, Mam-Lam-Fook, Celia, Nordholm, Dorte, Randers, Lasse, Krakauer, Kristine, Glenthoj, Louise Birkedal, Gebhard, Dominika, Arnhold, Julia, Klosterkotter, Joachim, Lasser, Iris, Winklbaur, Bernadette and Delespaul, Philippe A. (2020). Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis. JAMA Psychiatry, 77 (2). S. 190 - 201. CHICAGO: AMER MEDICAL ASSOC. ISSN 2168-6238

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Abstract

This case-control study analyzes emotion recognition and neuroimaging data as well as clinical and functional outcomes for individuals at risk for transition to psychosis and those without psychiatric or neurological disorders. Question Is altered emotion recognition associated with adverse clinical and functional outcomes in people at clinical high risk for psychosis? Findings In this case-control study of 213 individuals at clinical high risk for psychosis and 52 healthy participants, abnormalities in the recognition of negative emotion at baseline were associated with neuroanatomical alterations in the medial prefrontal cortex and hippocampus and with a low level of functioning at a 12-month follow-up. Meaning This study found that, in people with high risk for developing psychosis, functional outcomes are associated with the degree to which their emotion processing is altered. Importance The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. Objective To examine the association between alterations in emotion processing and regional gray matter volumes in individuals at clinical high risk (CHR) for psychosis, and the association with subsequent clinical outcomes. Design, Setting, and Participants This naturalistic case-control study with clinical follow-up at 12 months was conducted from July 1, 2010, to August 31, 2016, and collected data from 9 psychosis early detection centers (Amsterdam, Basel, Cologne, Copenhagen, London, Melbourne, Paris, The Hague, and Vienna). Participants (213 individuals at CHR and 52 healthy controls) were enrolled in the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) project. Data were analyzed from October 1, 2018, to April 24, 2019. Main Measures and Outcomes Emotion recognition was assessed with the Degraded Facial Affect Recognition Task. Three-Tesla magnetic resonance imaging scans were acquired from all participants, and gray matter volume was measured in regions of interest (medial prefrontal cortex, amygdala, hippocampus, and insula). Clinical outcomes at 12 months were evaluated for transition to psychosis using the Comprehensive Assessment of At-Risk Mental States criteria, and the level of overall functioning was measured through the Global Assessment of Functioning [GAF] scale. Results A total of 213 individuals at CHR (105 women [49.3%]; mean [SD] age, 22.9 [4.7] years) and 52 healthy controls (25 women [48.1%]; mean [SD] age, 23.3 [4.0] years) were included in the study at baseline. At the follow-up within 2 years of baseline, 44 individuals at CHR (20.7%) had developed psychosis and 169 (79.3%) had not. Of the individuals at CHR reinterviewed with the GAF, 39 (30.0%) showed good overall functioning (GAF score, >= 65), whereas 91 (70.0%) had poor overall functioning (GAF score, <65). Within the CHR sample, better anger recognition at baseline was associated with worse functional outcome (odds ratio [OR], 0.88; 95% CI, 0.78-0.99; P = .03). In individuals at CHR with a good functional outcome, positive associations were found between anger recognition and hippocampal volume (ze = 3.91; familywise error [FWE] P = .02) and between fear recognition and medial prefrontal cortex volume (z = 3.60; FWE P = .02), compared with participants with a poor outcome. The onset of psychosis was not associated with baseline emotion recognition performance (neutral OR, 0.93; 95% CI, 0.79-1.09; P = .37; happy OR, 1.03; 95% CI, 0.84-1.25; P = .81; fear OR, 0.98; 95% CI, 0.85-1.13; P = .77; anger OR, 1.00; 95% CI, 0.89-1.12; P = .96). No difference was observed in the association between performance and regional gray matter volumes in individuals at CHR who developed or did not develop psychosis (FWE P < .05). Conclusions and Relevance In this study, poor functional outcome in individuals at CHR was found to be associated with baseline abnormalities in recognizing negative emotion. This finding has potential implications for the stratification of individuals at CHR and suggests that interventions that target socioemotional processing may improve functional outcomes.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Modinos, GemmaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kempton, Matthew J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tognin, StefaniaUNSPECIFIEDorcid.org/0000-0002-1983-9135UNSPECIFIED
Calem, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Porffy, LillaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antoniades, MathildeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mason, AvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Azis, MatildaUNSPECIFIEDorcid.org/0000-0001-8164-0357UNSPECIFIED
Allen, PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nelson, BarnabyUNSPECIFIEDorcid.org/0000-0002-6263-2332UNSPECIFIED
McGorry, PatrickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pantelis, ChristosUNSPECIFIEDorcid.org/0000-0002-9565-0238UNSPECIFIED
Riecher-Rossler, AnitaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borgwardt, StefanUNSPECIFIEDorcid.org/0000-0002-5792-3987UNSPECIFIED
Bressan, RodrigoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barrantes-Vidal, NeusUNSPECIFIEDorcid.org/0000-0002-8671-1238UNSPECIFIED
Krebs, Marie-OdileUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nordentoft, MereteUNSPECIFIEDorcid.org/0000-0003-4895-7023UNSPECIFIED
Glenthoj, BirteUNSPECIFIEDorcid.org/0000-0003-3056-7262UNSPECIFIED
Ruhrmann, StephanUNSPECIFIEDorcid.org/0000-0002-6022-2364UNSPECIFIED
Sachs, GabrieleUNSPECIFIEDorcid.org/0000-0002-8359-9877UNSPECIFIED
Rutten, BartUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Os, JimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Haan, LieuweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Velthorst, EvaUNSPECIFIEDorcid.org/0000-0002-9240-2909UNSPECIFIED
van der Gaag, MarkUNSPECIFIEDorcid.org/0000-0002-3525-6415UNSPECIFIED
Valmaggia, Lucia R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
McGuire, PhilipUNSPECIFIEDorcid.org/0000-0003-4381-0532UNSPECIFIED
Kraan, Tamar C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Dam, Daniella S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Burger, NadineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Amminger, G. PaulUNSPECIFIEDorcid.org/0000-0001-8969-4595UNSPECIFIED
Politis, AthenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goodall, JoanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rapp, CharlotteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ittig, SarahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Studerus, ErichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smieskova, RenataUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gadelha, AryUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brietzke, ElisaUNSPECIFIEDorcid.org/0000-0003-2697-1342UNSPECIFIED
Asevedo, GraccielleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Asevedo, ElsonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zugman, AndreUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dominguez-Martinez, TecelliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Monsonet, ManelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hinojosa, LidiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Racioppi, AnnaUNSPECIFIEDorcid.org/0000-0002-5575-2811UNSPECIFIED
Kwapil, Thomas R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kazes, MathildeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Daban, ClaireUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bourgin, JulieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gay, OlivierUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mam-Lam-Fook, CeliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nordholm, DorteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Randers, LasseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krakauer, KristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Glenthoj, Louise BirkedalUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gebhard, DominikaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arnhold, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klosterkotter, JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lasser, IrisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Winklbaur, BernadetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Delespaul, Philippe A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-347486
DOI: 10.1001/jamapsychiatry.2019.3501
Journal or Publication Title: JAMA Psychiatry
Volume: 77
Number: 2
Page Range: S. 190 - 201
Date: 2020
Publisher: AMER MEDICAL ASSOC
Place of Publication: CHICAGO
ISSN: 2168-6238
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ULTRA-HIGH RISK; GRAY-MATTER VOLUME; SOCIAL COGNITION; PREFRONTAL CORTEX; NEUTRAL FACES; FEARFUL FACES; SCHIZOPHRENIA; RECOGNITION; ONSET; METAANALYSISMultiple languages
PsychiatryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34748

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