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Background: Over the past two decades, early detection and early intervention in psychosis have become essential goals of psychiatry. However, clinical impressions are insufficient for predicting psychosis outcomes in clinical high-risk (CHR) individuals; a more rigorous and objective model is needed. This study aims to develop and internally validate a model for predicting the transition to psychosis within 10 years. Methods: Two hundred and eight help-seeking individuals who fulfilled the CHR criteria were enrolled from the prospective, naturalistic cohort program for CHR at the Seoul Youth Clinic (SYC). The least absolute shrinkage and selection operator (LASSO)-penalized Cox regression was used to develop a predictive model for a psychotic transition. We performed k -means clustering and survival analysis to stratify the risk of psychosis. Results: The predictive model, which includes clinical and cognitive variables, identified the following six baseline variables as important predictors: 1-year percentage decrease in the Global Assessment of Functioning score, IQ, California Verbal Learning Test score, Strange Stories test score, and scores in two domains of the Social Functioning Scale. The predictive model showed a cross-validated Harrell's C -index of 0.78 and identified three subclusters with significantly different risk levels. Conclusions: Overall, our predictive model showed a predictive ability and could facilitate a personalized therapeutic approach to different risks in high-risk individuals. [ABSTRACT FROM AUTHOR]

Aim: Although the comprehensive assessment of at‐risk mental states (CAARMS) is one of the most widely used instruments for identifying individuals meeting the criteria for ultra‐high risk (UHR) of developing psychosis, the psychometric properties of the Korean version of the CAARMS (CAARMS‐K) have not been studied to date. Thus, we tested the reliability, validity, and factor structure of the CAARMS‐K in a Korean population. Methods: The CAARMS‐K was administered to 96 UHR individuals. The inter‐rater reliability and internal consistency of the CAARMS‐K were evaluated. In addition, its factor structure was investigated using principal‐axis factor analysis. Concurrent validity was examined by comparing the extracted CAARMS‐K factors with the five factors of the positive and negative syndrome scale (PANSS) using Spearman's correlation tests. The percentage of transition to psychosis was examined at 1‐ and 2‐year. Results: The inter‐rater reliability was good (intraclass correlation =.89), and the internal consistency was acceptable (Cronbach's alpha =.812). A five‐factor solution demonstrated the best simple structure and accounted for 43.1% of all‐item variance. The five factors extracted from the factor analysis were similar to the PANSS five factors and significantly correlated with the factors of the PANSS. Among the 96 UHR individuals, 11 (11.5%) and 17 (17.7%) developed psychotic disorders during the 1‐ and 2‐year follow‐up, respectively. Conclusions: The CAARMS‐K is a reliable and valid instrument for the assessment of UHR individuals in Korea. [ABSTRACT FROM AUTHOR]

Objectives: Although neuroanatomical abnormalities in subjects at clinical high risk for psychosis have been considered a putative biomarker of psychosis, relevance of cortical thickness alterations remains contested due to discrepant findings. Inconsistencies persist in Asian clinical high risk studies, despite their advantageous settings well-controlled for confounds. Attributes of cortical thickness alterations in clinical high risk subjects warrant further examination. Methods: We examined cortical thickness at the whole-brain level in 74 clinical high risk subjects and 34 demographically matched healthy controls recruited from Seoul Youth Clinic, South Korea. Clinical symptoms were assessed using the Scale of Prodromal Symptoms, and their associations with cortical thickness were explored using partial correlation analysis. Results: Compared to healthy control, clinical high risk exhibited significant cortical thinning in bilateral prefrontal cortex and inferior parietal lobule clusters. Reduced thickness in the left prefrontal cortex cluster was associated with more severe Scale of Prodromal Symptoms general symptoms scores and the right inferior parietal lobule cluster with Scale of Prodromal Symptoms disorganization symptoms. Conclusions: Thickness deficits found in the present clinical high risk sample demonstrated a degree of consistency with those reported in the previous Seoul Youth Clinic study. While inconsistencies reported between the present and previous Seoul Youth Clinic samples may reflect markedly decreased rate of converters, consistencies may be relevant to clinical attributes beyond transition, such as the prevalence of comorbidities. Particular recruitment strategies employed for sample selections should also be considered for findings in Asian clinical high risk samples. Our results suggest potential utility of cortical thickness alterations in clinical high risk subjects beyond the frame of transition. [ABSTRACT FROM AUTHOR]

Simple Summary: This retrospective study analyzed 237 consecutive patients with coexisting nonalcoholic fatty liver disease and chronic hepatitis B (NAFLD-CHB) with long observation period (median follow-up duration, 13 years). The optimal cutoff for the FIB-4 index of 1.77 was calculated based on the maximum Youden index value, and the value was 1.77 with an AUC of 0.70. The significant higher risk of developing hepatocellular carcinoma (HCC) in patients with a high FIB-4 index (≥1.77) than the patients with a low FIB-4 index (<1.77) (adjusted hazard ratio, 4.35; 95% CI, 1.42–13.24; log-rank test, p = 0.006) were found among the NAFLD-CHB patients whose baseline characteristics were balanced by propensity score matching. The FIB-4 index might be a useful predictor of the development of HCC among NAFLD–CHB patients. Background: The FIB-4 index, a noninvasive tool (FIB-4 index = age × aspartate transaminase (AST)/(platelet count × √alanine aminotransferase (ALT)), is a useful assessment for liver fibrosis. Patients with a high FIB-4 index were reported to have a high risk of developing hepatocellular carcinoma (HCC). This study analyzed the clinical association of the FIB-4 index with HCC development in patients with coexisting nonalcoholic fatty liver disease and chronic hepatitis B (NAFLD–CHB). Methods: This retrospective study analyzed 237 consecutive patients with NAFLD–CHB between January 2006 and December 2010 at the National Police Hospital in Korea. Patients with HCC at baseline and those diagnosed with HCC within 6 months from baseline were excluded. Propensity score matching analysis (PSM) was adopted to balance the baseline characteristics between patients with low and high FIB-4 index values. The cumulative rates of HCC development were compared between the two groups using the Kaplan–Meier method in the matched population. Results: The median follow-up duration was 13 years (interquartile range, 8.2–15.7). The optimal cutoff for the FIB-4 index of 1.77 was calculated based on the maximum Youden index value, with an AUC of 0.70. Among a total of 237 patients with NAFLD–CHB, HCC developed in 20 patients (8.4%) (14 of the 90 patients with a high FIB-4 index vs. 6 of the 147 patients (4.1%) with a low FIB-4 index; log-rank p = 0.003). Patients with a high FIB-4 index had a significantly and independently higher risk of HCC than those with a low FIB-4 index (adjusted hazard ratio, 4.35; 95%; confidence interval, 1.42–13.24; log-rank test, p = 0.006). Conclusion: A high FIB-4 index (≥1.77) might be a useful marker for predicting the development of HCC in patients with NAFLD–CHB. [ABSTRACT FROM AUTHOR]