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Investigating the influence of thought interference and somatic passivity on outcomes in patients with psychosis

Published online by Cambridge University Press:  13 August 2021

T. Magrangeas ,
A. Kolliakou ,
J. Sanyal ,
R. Patel  and
R. Stewart
T. Magrangeas*
Affiliation:
Institute Of Psychiatry, Psychology And Neuroscience, King’s College London, London, United Kingdom
A. Kolliakou
Affiliation:
Institute Of Psychiatry, Psychology And Neuroscience, King’s College London, London, United Kingdom
J. Sanyal
Affiliation:
Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
R. Patel
Affiliation:
Institute Of Psychiatry, Psychology And Neuroscience, King’s College London, London, United Kingdom Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
R. Stewart
Affiliation:
Institute Of Psychiatry, Psychology And Neuroscience, King’s College London, London, United Kingdom Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

Of the many studies describing psychotic symptoms in schizophrenia, few have investigated their direct influence on prognosis.

Objectives

We aimed to apply natural language-processing (NLP) algorithms in routine healthcare records to identify reported somatic passivity and thought interference symptoms (thought broadcasting, insertion and withdrawal), and determine associations with prognosis by an analysis of routine outcomes.

Methods

Four algorithms were thus developed on de-identified mental healthcare data from a large south London provider and were applied to ascertain recorded symptoms over the three months following first presentation to that service in a cohort of patients with a primary schizophreniform disorder (ICD-10 F20-F29) diagnosis. The primary binary dependent variable for logistic regression analyses was any negative outcome (Mental Health Act section, >2 antipsychotics prescribed, >22 days spent in crisis care) over the subsequent 2 years, adjusted for age, gender, ethnic group, neighbourhood deprivation, diagnostic group, and recorded paranoia, persecutory delusions or auditory hallucinations.

Results

In 9,323 patients, final models indicated significant associations of this composite outcome with baseline somatic passivity (prevalence 4.9%; adjusted odds ratio 1.61, 95% CI 1.37-1.88), thought insertion (10.7%; 1.24, 1.15-1.55) and thought withdrawal (4.9%; 1.36, 1.10-1.69), but not independently with thought broadcast (10.3%; 1.05, 0.91-1.22).

Conclusions

Symptoms traditionally central to the diagnosis of schizophrenia, but under-represented in current diagnostic frameworks, were thus identified as important predictors of short- to medium-term prognosis.

Disclosure

No conflict of interest - past support from Janssen; GSK; Takeda; Induction Healthcare; Holmusk; the NIHR; SLaM NHS Trust; the MRC; KCL; the NIHR ARC; KCH NHS Trust; the Academy of Medical Sciences; The Wellcome Trust; BHF; Arthritis Research UK; the Roya

Keywords

Natural-Language Processingprognosisschizophréniapsychosis
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S806 - S807
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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