Identifying clinical clusters with distinct trajectories in first-episode psychosis through an unsupervised machine learning technique
Por:
Amoretti, S, Verdolini, N, Mezquida, G, Rabelo-da-Ponte, FD, Cuesta, MJ, Pina-Camacho, L, Gomez-Ramiro, M, De-la-Camara, C, Gonzalez-Pinto, A, Diaz-Caneja, CM, Corripio, I, Vieta, E, de la Serna, E, Mane, A, Sole, B, Carvalho, AF, Serra, M, Bernardo, M
Publicada:
1 jun 2021
Ahead of Print:
1 jun 2021
Resumen:
The extreme variability in symptom presentation reveals that individuals diagnosed with a first episode psychosis (FEP) may encompass different sub-populations with potentially different illness courses and, hence, different treatment needs. Previous studies have shown that sociodemographic and family environment factors are associated with more unfavorable symptom trajectories. The aim of this study was to examine the dimensional structure of symptoms and to identify individuals' trajectories at early stage of illness and potential risk factors associated with poor outcomes at follow-up in non-affective FEP. One hundred and forty-four non-affective FEP patients were assessed at baseline and at 2-year follow-up. A Principal component analysis has been conducted to identify dimensions, then an unsupervised machine learning technique (fuzzy clustering) was performed to identify clinical subgroups of patients. Six symptom factors were extracted (positive, negative, depressive, anxiety, disorganization and somatic/cognitive). Three distinct clinical clusters were determined at baseline: mild; negative and moderate; and positive and severe symptoms, and five at follow-up: minimal; mild; moderate; negative and depressive; and severe symptoms. Receiving a low-dose antipsychotic, having a more severe depressive symptomatology and a positive family history for psychiatric disorders were risk factors for poor recovery, whilst having a high cognitive reserve and better premorbid adjustment may confer a better prognosis. The current study provided a better understanding of the heterogeneous profile of FEP. Early identification of patients who could likely present poor outcomes may be an initial step for the development of targeted interventions to improve illness trajectories and preserve psychosocial functioning. (c) 2021 Elsevier B.V. and ECNP. All rights reserved.
Filiaciones:
Amoretti, S:
Univ Barcelona, Hosp Clin Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, Inst Neurosci,IDIBAPS,CIBERSAM, 170 Villarroel St,12-0, Barcelona 08036, Catalonia, Spain
Verdolini, N:
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, Inst Neurosci,IDIBAPS,CIBERSAM, 170 Villarroel St,12-0, Barcelona 08036, Catalonia, Spain
Mezquida, G:
Univ Barcelona, Hosp Clin Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Rabelo-da-Ponte, FD:
Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Lab Mol Psychiat, Rio De Janeiro, Brazil
Cuesta, MJ:
Complejo Hosp Navarra, Dept Psychiat, Pamplona, Spain
Navarra Inst Hlth Res, IdiSNA, Pamplona, Spain
Pina-Camacho, L:
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Univ Complutense, Hosp Gen Univ Gregorio Maranon, Dept Child & Adolescent Psychiat, IiSGM,Sch Med, Madrid, Spain
Gomez-Ramiro, M:
Univ Barcelona, Hosp Clin Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Barcelona Clin Schizophrenia Unit, Barcelona, Spain
De-la-Camara, C:
Univ Barcelona, Hosp Clin Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Univ Zaragoza, Hosp Clin Univ, Zaragoza, Spain
Gonzalez-Pinto, A:
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Univ Zaragoza, Inst Invest Sanitaria IIS, Dept Med & Psychiatry, Zaragoza, Spain
Diaz-Caneja, CM:
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Univ Complutense, Hosp Gen Univ Gregorio Maranon, Dept Child & Adolescent Psychiat, IiSGM,Sch Med, Madrid, Spain
Corripio, I:
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Univ Basque Country, Dept Psychiat, Bioaraba Res Inst, Dept Neuroci, Vitoria, Spain
Vieta, E:
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
de la Serna, E:
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Univ Autonoma Barcelona UAB, Hosp Santa Creu & St Pau, Inst Invest Biomed, IIB,UAB,Psychiat Dept, Barcelona, Spain
Mane, A:
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Univ Barcelona, Dept Child & Adolescent Psychiat & Psychol, Clin Inst Neurosci, Hosp Clin Barcelona,IDIBAPS, 2017SGR881, Barcelona, Spain
Hosp Mar Med Res Inst IMIM, Barcelona, Spain
Sole, B:
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, Inst Neurosci,IDIBAPS,CIBERSAM, 170 Villarroel St,12-0, Barcelona 08036, Catalonia, Spain
Carvalho, AF:
Autonomous Univ Barcelona UAB, Barcelona, Spain
Univ Toronto, Ctr Addict & Mental Hlth CAMH, Dept Psychiat, CAMH, Toronto, ON, Canada
Serra, M:
Univ Barcelona, Hosp Clin, Bipolar & Depress Disorders Unit, Inst Neurosci,IDIBAPS,CIBERSAM, 170 Villarroel St,12-0, Barcelona 08036, Catalonia, Spain
Bernardo, M:
Univ Barcelona, Hosp Clin Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Neurosci Inst,Barcelona Clin Schizophrenia Unit, Barcelona, Spain
Biomed Res Networking Ctr Mental Hlth Network CIB, Barcelona, Spain
Green Accepted
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