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Basic symptoms and gray matter volumes of patients at clinical high risk for psychosis

Published online by Cambridge University Press:  14 May 2020

Daniela Hubl ,
Chantal Michel Open the ORCID record for Chantal Michel [Opens in a new window] ,
Frauke Schultze-Lutter ,
Martinus Hauf ,
Benno G. Schimmelmann ,
Michael Kaess  and
Jochen Kindler Open the ORCID record for Jochen Kindler [Opens in a new window]
Daniela Hubl
Affiliation:
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
Chantal Michel
Affiliation:
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
Frauke Schultze-Lutter
Affiliation:
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
Martinus Hauf
Affiliation:
Support Center for Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, University of Bern, Switzerland
Benno G. Schimmelmann
Affiliation:
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg Eppendorf, Hamburg, Germany
Michael Kaess
Affiliation:
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
Jochen Kindler*
Affiliation:
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
*
Author for correspondence: Jochen Kindler, E-mail: [email protected]
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Abstract

Background

Clinical high-risk (CHR) for psychosis is indicated by ultra-high risk (UHR) and basic symptom (BS) criteria; however, conversion rates are highest when both UHR and BS criteria are fulfilled (UHR&BS). While BSs are considered the most immediate expression of neurobiological aberrations underlying the development of psychosis, research on neurobiological correlates of BS is scarce.

Methods

We investigated gray matter volumes (GMV) of 20 regions of interest (ROI) previously associated with UHR criteria in 90 patients from the Bern early detection service: clinical controls (CC), first-episode psychosis (FEP), UHR, BS and UHR&BS. We expected lowest GMV in FEP and UHR&BS, and highest volume in CC with UHR and BS in-between.

Results

Significantly, lower GMV was detected in FEP and UHR&BS patients relative to CC with no other significant between-group differences. When ROIs were analyzed separately, seven showed a significant group effect (FDR corrected), with five (inferior parietal, medial orbitofrontal, lateral occipital, middle temporal, precuneus) showing significantly lower GM volume in the FEP and/or UHR&BS groups than in the CC group (Bonferroni corrected). In the CHR group, only COGDIS scores correlated negatively with cortical volumes.

Conclusions

This is the first study to demonstrate that patients who fulfill both UHR and BS criteria – a population that has been associated with higher conversion rates – exhibit more severe GMV reductions relative to those who satisfy BS or UHR criteria alone. This result was mediated by the BS in the UHR&BS group, as only the severity of BS was linked to GMV reductions.

Keywords

Basic symptomsfirst-episode psychosisgray matter volumepsychosis riskultra-high risk
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 15 , November 2021 , pp. 2666 - 2674
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

These authors contributed equally to this work

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