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New Opportunities and Challenges of Early Psychosis
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New Opportunities and Challenges of Early Psychosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (31 May 2021) | Viewed by 15233

Special Issue Editor

Prof. Dr. Marta Rapado-Castro

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Guest Editor
1. Ramón y Cajal Senior Research Fellow, Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
2. Assistant Professor, Department of Legal Medicine, Psychiatry and Patology (Psychiatry Area), School of Medicine, Universidad Complutense, Madrid, Spain
Interests: psychotic disorders; prodrome; neurocognition; risk factors; diagnosis; biomarkers; neuroimaging; early life adversity; cognitive-enhancers; early intervention

Special Issue Information

Dear Colleagues,

Over the past two decades, the early psychosis field has advanced and expanded substantially. A great deal of progress has been made understanding phenomenology, neurobiology and outcome during early phase of psychotic disorders. Although there is extensive investigation of early signs of risk and evidence-based treatments, psychotic disorders continue to severely affect both young and adults. Schizophrenia and other psychotic disorders represent the third leading cause of disability-adjusted life years worldwide. Early diagnosis and treatment of first-episode psychosis is crucial for short and long-term prognosis. Delayed identification of symptoms and a longer duration of untreated psychosis may lead to challenges in functional and clinical outcomes. Effective and timely interventions have shown to improve psychopathology, quality of life and vocational development of individuals with psychosis. With major unmet needs such as cognitive and negative symptoms, early psychosis research still faces several conceptual, methodological and treatment challenges. In this Special Issue, we will focus on recent advances in understanding and treating the early phase of psychotic disorders, as well as some of the challenges to furthering the application of a broader preventive model.

Qualitative and quantitative original research or reviews of current knowledge in the early psychosis field are welcomed.

Prof. Dr. Marta Rapado-Castro
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • First-Episode Psychosis
  • Prodrome
  • Risk Factors
  • Biomarkers
  • Prognosis
  • Early Detection
  • Early Intervention
  • Clinical Outcomes
  • Functional outcomes
  • Neuroimaging
  • Neurocognition
  • Diagnosis
  • Novel treatments

Published Papers (6 papers)

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Editorial

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3 pages, 191 KiB  
Editorial
New Opportunities and Challenges of Early Psychosis
by Marta Rapado-Castro
J. Clin. Med. 2022, 11(21), 6531; https://doi.org/10.3390/jcm11216531 - 3 Nov 2022
Viewed by 944
Abstract
Over the past two decades, the early psychosis field has advanced and expanded substantially [...] Full article
(This article belongs to the Special Issue New Opportunities and Challenges of Early Psychosis)

Research

Jump to: Editorial

9 pages, 258 KiB  
Article
Biological Mechanism(s) Underpinning the Association between Antipsychotic Drugs and Weight Gain
by Bruna Panizzutti, Chiara C. Bortolasci, Briana Spolding, Srisaiyini Kidnapillai, Timothy Connor, Mark F. Richardson, Trang T. T. Truong, Zoe S. J. Liu, Laura Gray, Jee Hyun Kim, Olivia M. Dean, Michael Berk and Ken Walder
J. Clin. Med. 2021, 10(18), 4095; https://doi.org/10.3390/jcm10184095 - 10 Sep 2021
Cited by 8 | Viewed by 2531
Abstract
Weight gain and consequent metabolic alterations are common side-effects of many antipsychotic drugs. Interestingly, several studies have suggested that improvement in symptoms and adverse metabolic effects are correlated. We used next generation sequencing data from NT-2 (human neuronal) cells treated with aripiprazole, amisulpride, [...] Read more.
Weight gain and consequent metabolic alterations are common side-effects of many antipsychotic drugs. Interestingly, several studies have suggested that improvement in symptoms and adverse metabolic effects are correlated. We used next generation sequencing data from NT-2 (human neuronal) cells treated with aripiprazole, amisulpride, risperidone, quetiapine, clozapine, or vehicle control, and compared with the Pillinger P-score (ranked from 0 to 1, indicating greater increase in weight gain and related metabolic parameters) to identify the genes most associated with the drugs’ propensity to cause weight gain. The top 500 genes ranked for their correlation with the drugs’ propensity to cause weight gain were subjected to pathway analysis using DAVID (NIH). We further investigated transcription factors (TFs) that are more likely to regulate the genes involved in these processes using the prediction tool of key TFs from TRRUST. The results suggest an enrichment for genes involved in lipid biosynthesis and metabolism, which are of interest for mechanisms underpinning weight-gain. The list of genes involved in the lipid pathways that correlated with weight gain was enriched for genes transcriptionally regulated by SREBF1 and SREBF2. Furthermore, quetiapine significantly increased the expression of SREBF1 and SREBF2 in NT-2 cells. Our results suggest that the effects of these antipsychotic drugs on lipid metabolism may be mediated, at least in part, via regulation of SREBF1/SREBF2 expression, with evidence of a direct effect of quetiapine on the expression of SREBF1/2. The effects of antipsychotic drugs on lipid metabolism may influence white matter structure (therapeutic effect) and the risk of weight gain, lipid disturbances, and, consequently, metabolic syndrome (adverse effects). Understanding the different molecular effects of these drugs could inform a personalized medicine approach in treating patients with schizophrenia. Full article
(This article belongs to the Special Issue New Opportunities and Challenges of Early Psychosis)
20 pages, 778 KiB  
Article
Fronto-Parietal Gray Matter Volume Loss Is Associated with Decreased Working Memory Performance in Adolescents with a First Episode of Psychosis
by Marta Rapado-Castro, Mara Villar-Arenzana, Joost Janssen, David Fraguas, Igor Bombin, Josefina Castro-Fornieles, Maria Mayoral, Ana González-Pinto, Elena de la Serna, Mara Parellada, Dolores Moreno, Beatriz Paya, Montserrat Graell, Inmaculada Baeza, Christos Pantelis and Celso Arango
J. Clin. Med. 2021, 10(17), 3929; https://doi.org/10.3390/jcm10173929 - 31 Aug 2021
Cited by 4 | Viewed by 2206
Abstract
Cognitive maturation during adolescence is modulated by brain maturation. However, it is unknown how these processes intertwine in early onset psychosis (EOP). Studies examining longitudinal brain changes and cognitive performance in psychosis lend support for an altered development of high-order cognitive functions, which [...] Read more.
Cognitive maturation during adolescence is modulated by brain maturation. However, it is unknown how these processes intertwine in early onset psychosis (EOP). Studies examining longitudinal brain changes and cognitive performance in psychosis lend support for an altered development of high-order cognitive functions, which parallels progressive gray matter (GM) loss over time, particularly in fronto-parietal brain regions. We aimed to assess this relationship in a subsample of 33 adolescents with first-episode EOP and 47 matched controls over 2 years. Backwards stepwise regression analyses were conducted to determine the association and predictive value of longitudinal brain changes over cognitive performance within each group. Fronto-parietal GM volume loss was positively associated with decreased working memory in adolescents with psychosis (frontal left (B = 0.096, p = 0.008); right (B = 0.089, p = 0.015); parietal left (B = 0.119, p = 0.007), right (B = 0.125, p = 0.015)) as a function of age. A particular decrease in frontal left GM volume best predicted a significant amount (22.28%) of the variance of decreased working memory performance over time, accounting for variance in age (14.9%). No such association was found in controls. Our results suggest that during adolescence, EOP individuals seem to follow an abnormal neurodevelopmental trajectory, in which fronto-parietal GM volume reduction is associated with the differential age-related working memory dysfunction in this group. Full article
(This article belongs to the Special Issue New Opportunities and Challenges of Early Psychosis)
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19 pages, 3477 KiB  
Article
The Role of Premorbid IQ and Age of Onset as Useful Predictors of Clinical, Functional Outcomes, and Recovery of Individuals with a First Episode of Psychosis
by Mariola Molina-García, David Fraguas, Ángel del Rey-Mejías, Gisela Mezquida, Ana M. Sánchez-Torres, Silvia Amoretti, Antonio Lobo, Ana González-Pinto, Álvaro Andreu-Bernabeu, Iluminada Corripio, Eduard Vieta, Inmaculada Baeza, Anna Mané, Manuel Cuesta, Elena de la Serna, Beatriz Payá, Iñaki Zorrilla, Celso Arango, Miquel Bernardo, Marta Rapado-Castro and Mara Parelladaadd Show full author list remove Hide full author list
J. Clin. Med. 2021, 10(11), 2474; https://doi.org/10.3390/jcm10112474 - 2 Jun 2021
Cited by 8 | Viewed by 3408
Abstract
Background: premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. Methods: we characterized 255 [...] Read more.
Background: premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. Methods: we characterized 255 individuals who have experienced a first episode of psychosis in four a priori defined subgroups based on pIQ (low pIQ < 85; average pIQ ≥ 85) and age of onset (early onset < 18 years; adult onset ≥ 18 years). We conducted clinical and functional assessments at baseline and at two-year follow-up. We calculated symptom remission and recovery rates using the Positive and Negative Symptoms of Schizophrenia Schedule (PANSS) and the Global Assessment Functioning (GAF or Children-GAF). We examined clinical and functional changes with pair-wise comparisons and two-way mixed ANOVA. We built hierarchical lineal and logistic regression models to estimate the predictive value of the independent variables over functioning or recovery rates. Results: early-onset patients had more severe positive symptoms and poorer functioning than adult-onset patients. At two-year follow-up, only early-onset with low pIQ and adult-onset with average pIQ subgroups differed consistently, with the former having more negative symptoms (d = 0.59), poorer functioning (d = 0.82), lower remission (61% vs. 81.1%), and clinical recovery (34.1% vs. 62.2%). Conclusions: early-onset individuals with low pIQ may present persistent negative symptoms, lower functioning, and less recovery likelihood at two-year follow-up. Intensive cognitive and functional programs for these individuals merit testing to improve long-term recovery rates in this subgroup. Full article
(This article belongs to the Special Issue New Opportunities and Challenges of Early Psychosis)
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12 pages, 1185 KiB  
Article
Smoking Is Related to Reduced Motivation, But Not Global Cognition, in the First Two Years of Treatment for First Episode Psychosis
by Brandon Schermitzler, Kathleen Miley, Sophia Vinogradov and Ian S. Ramsay
J. Clin. Med. 2021, 10(8), 1619; https://doi.org/10.3390/jcm10081619 - 11 Apr 2021
Cited by 5 | Viewed by 1935
Abstract
Smoking is highly prevalent in people with psychotic disorders, even in the earliest phases of the illness. The neural mechanisms of nicotine dependence and psychosis overlap and may also be linked to deficits in neurocognition and motivation in psychosis. Both neurocognition and motivation [...] Read more.
Smoking is highly prevalent in people with psychotic disorders, even in the earliest phases of the illness. The neural mechanisms of nicotine dependence and psychosis overlap and may also be linked to deficits in neurocognition and motivation in psychosis. Both neurocognition and motivation are recognized as important clinical targets, though previous research examining the effects of smoking on these features has been inconsistent. Here, we examine the relationships between smoking status and neurocognition and motivation over the first two years of treatment for psychosis through a secondary analysis of the Recovery After an Initial Schizophrenia Episode–Early Treatment Program (RAISE–ETP) dataset. In a sample of 404 individuals with first-episode psychosis, we examined linear mixed-effects models with the group (smoker vs. non-smoker) by time (baseline, 12-month, 24-month) interaction as a predictor of global cognition and motivation. While all individuals showed enhanced global cognition and motivation over the 24-month course of treatment, non-smokers showed significantly greater gains in motivation. These changes in motivation also corresponded to improvements in functioning over the 24-month period. No significant effects of smoking were observed for global cognition. Our findings suggest that motivation and smoking cessation may be important early treatment targets for first-episode psychosis programs. Full article
(This article belongs to the Special Issue New Opportunities and Challenges of Early Psychosis)
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20 pages, 1042 KiB  
Article
Exploring Risk and Resilient Profiles for Functional Impairment and Baseline Predictors in a 2-Year Follow-Up First-Episode Psychosis Cohort Using Latent Class Growth Analysis
by Estela Salagre, Iria Grande, Brisa Solé, Gisela Mezquida, Manuel J. Cuesta, Covadonga M. Díaz-Caneja, Silvia Amoretti, Antonio Lobo, Ana González-Pinto, Carmen Moreno, Laura Pina-Camacho, Iluminada Corripio, Immaculada Baeza, Daniel Bergé, Norma Verdolini, André F. Carvalho, Eduard Vieta, Miquel Bernardo and PEPs Group
J. Clin. Med. 2021, 10(1), 73; https://doi.org/10.3390/jcm10010073 - 28 Dec 2020
Cited by 14 | Viewed by 3383
Abstract
Being able to predict functional outcomes after First-Episode Psychosis (FEP) is a major goal in psychiatry. Thus, we aimed to identify trajectories of psychosocial functioning in a FEP cohort followed-up for 2 years in order to find premorbid/baseline predictors for each trajectory. Additionally, [...] Read more.
Being able to predict functional outcomes after First-Episode Psychosis (FEP) is a major goal in psychiatry. Thus, we aimed to identify trajectories of psychosocial functioning in a FEP cohort followed-up for 2 years in order to find premorbid/baseline predictors for each trajectory. Additionally, we explored diagnosis distribution within the different trajectories. A total of 261 adults with FEP were included. Latent class growth analysis identified four distinct trajectories: Mild impairment-Improving trajectory (Mi-I) (38.31% of the sample), Moderate impairment-Stable trajectory (Mo-S) (18.39%), Severe impairment-Improving trajectory (Se-I) (12.26%), and Severe impairment-Stable trajectory (Se-S) (31.03%). Participants in the Mi-I trajectory were more likely to have higher parental socioeconomic status, less severe baseline depressive and negative symptoms, and better premorbid adjustment than individuals in the Se-S trajectory. Participants in the Se-I trajectory were more likely to have better baseline verbal learning and memory and better premorbid adjustment than those in the Se-S trajectory. Lower baseline positive symptoms predicted a Mo-S trajectory vs. Se-S trajectory. Diagnoses of Bipolar disorder and Other psychoses were more prevalent among individuals falling into Mi-I trajectory. Our findings suggest four distinct trajectories of psychosocial functioning after FEP. We also identified social, clinical, and cognitive factors associated with more resilient trajectories, thus providing insights for early interventions targeting psychosocial functioning. Full article
(This article belongs to the Special Issue New Opportunities and Challenges of Early Psychosis)
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