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8. Elevated serum chemokine CCL22 levels in first-episode psychosis: associations with symptoms, peripheral immune state and in vivo brain glial cell function

Author

Laurikainen, Heikki, Vuorela, Arja, Toivonen, Anna, Reinert-Hartwall, Linnea, Trontti, Kalevi, Lindgren, Maija, Keinänen, Jaakko, Mäntylä, Teemu, Paju, Janina, Ilonen, Tuula, Armio, Reetta-Liina, Walta, Maija, Tuisku, Jouni, Helin, Semi, Marjamäki, Päivi, Hovatta, Iiris, Therman, Sebastian, Vaarala, Outi, Linnaranta, Outi, Kieseppä, Tuula, Salokangas, Raimo K. R., Honkanen, Jarno, Hietala, Jarmo, and Suvisaari, Jaana

Published
2020
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9. Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia : an international multicenter study

Author

Fountoulakis, Konstantinos N., Dragioti, Elena, Theofilidis, Antonis T., Wiklund, Tobias, Atmatzidis, Xenofon, Nimatoudis, Ioannis, Thys, Erik, Wampers, Martien, Hranov, Luchezar, Hristova, Trayana, Aptalidis, Daniil, Milev, Roumen, Iftene, Felicia, Spaniel, Filip, Knytl, Pavel, Furstova, Petra, From, Tiina, Karlsson, Henry, Walta, Maija, Salokangas, Raimo K. R., Azorin, Jean-Michel, Bouniard, Justine, Montant, Julie, Juckel, Georg, Haussleiter, Ida S., Douzenis, Athanasios, Michopoulos, Ioannis, Ferentinos, Panagiotis, Smyrnis, Nikolaos, Mantonakis, Leonidas, Nemes, Zsofia, Gonda, Xenia, Vajda, Dora, Juhasz, Anita, Shrivastava, Amresh, Waddington, John, Pompili, Maurizio, Comparelli, Anna, Corigliano, Valentina, Rancans, Elmars, Navickas, Alvydas, Hilbig, Jan, Bukelskis, Laurynas, Stevovic, Lidija I., Vodopic, Sanja, Esan, Oluyomi, Oladele, Oluremi, Osunbote, Christopher, Rybakowski, Janusz K., Wojciak, Pawel, Domowicz, Klaudia, Figueira, Maria L., Linhares, Ludgero, Crawford, Joana, Panfil, Anca-Livia, Smirnova, Daria, Izmailova, Olga, Lecic-Tosevski, Dusica, Temmingh, Henk, Howells, Fleur, Bobes, Julio, Garcia-Portilla, Maria P., Garcia-Alvarez, Leticia, Erzin, Gamze, Karadag, Hasan, De Sousa, Avinash, Bendre, Anuja, Hoschl, Cyril, Bredicean, Cristina, Papava, Ion, Vukovic, Olivera, Pejuskovic, Bojana, Russell, Vincent, Athanasiadis, Loukas, Konsta, Anastasia, Fountoulakis, Nikolaos K., Stein, Dan, Berk, Michael, Dean, Olivia, Tandon, Rajiv, Kasper, Siegfried, De Hert, Marc, Fountoulakis, Konstantinos N., Dragioti, Elena, Theofilidis, Antonis T., Wiklund, Tobias, Atmatzidis, Xenofon, Nimatoudis, Ioannis, Thys, Erik, Wampers, Martien, Hranov, Luchezar, Hristova, Trayana, Aptalidis, Daniil, Milev, Roumen, Iftene, Felicia, Spaniel, Filip, Knytl, Pavel, Furstova, Petra, From, Tiina, Karlsson, Henry, Walta, Maija, Salokangas, Raimo K. R., Azorin, Jean-Michel, Bouniard, Justine, Montant, Julie, Juckel, Georg, Haussleiter, Ida S., Douzenis, Athanasios, Michopoulos, Ioannis, Ferentinos, Panagiotis, Smyrnis, Nikolaos, Mantonakis, Leonidas, Nemes, Zsofia, Gonda, Xenia, Vajda, Dora, Juhasz, Anita, Shrivastava, Amresh, Waddington, John, Pompili, Maurizio, Comparelli, Anna, Corigliano, Valentina, Rancans, Elmars, Navickas, Alvydas, Hilbig, Jan, Bukelskis, Laurynas, Stevovic, Lidija I., Vodopic, Sanja, Esan, Oluyomi, Oladele, Oluremi, Osunbote, Christopher, Rybakowski, Janusz K., Wojciak, Pawel, Domowicz, Klaudia, Figueira, Maria L., Linhares, Ludgero, Crawford, Joana, Panfil, Anca-Livia, Smirnova, Daria, Izmailova, Olga, Lecic-Tosevski, Dusica, Temmingh, Henk, Howells, Fleur, Bobes, Julio, Garcia-Portilla, Maria P., Garcia-Alvarez, Leticia, Erzin, Gamze, Karadag, Hasan, De Sousa, Avinash, Bendre, Anuja, Hoschl, Cyril, Bredicean, Cristina, Papava, Ion, Vukovic, Olivera, Pejuskovic, Bojana, Russell, Vincent, Athanasiadis, Loukas, Konsta, Anastasia, Fountoulakis, Nikolaos K., Stein, Dan, Berk, Michael, Dean, Olivia, Tandon, Rajiv, Kasper, Siegfried, and De Hert, Marc

Abstract

Background The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia. Methods Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 +/- 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects. Results There was a 3-year later age at onset for females (P < .001) and lower rates of negative symptoms (P < .01) and higher depression/anxiety measures (P < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages (P = .001). No significant effects were found concerning duration of illness. Discussion Our results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples., Funding Agencies|NHMRC Senior Principal Research FellowshipNational Health and Medical Research Council of Australia [APP1059660, APP1156072]

Published
2022
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11. Clinical, brain, and multilevel clustering in early psychosis and affective stages

Author

Dwyer, Dominic B., Buciuman, Madalina-Octavia, Ruef, Anne, Kambeitz, Joseph, Sen Dong, Mark, Stinson, Caedyn, Kambeitz-Ilankovic, Lana, Degenhardt, Franziska, Sanfelici, Rachele, Antonucci, Linda A., Lalousis, Paris Alexandros, Wenzel, Julian, Urquijo-Castro, Maria Fernanda, Popovic, David, Oeztuerk, Oemer Faruk, Haas, Shalaila S., Weiske, Johanna, Hauke, Daniel, Neufang, Susanne, Schmidt-Kraepelin, Christian, Ruhrmann, Stephan, Penzel, Nora, Lichtenstein, Theresa, Rosen, Marlene, Chisholm, Katharine, Riecher-Rössler, Anita, Egloff, Laura, Schmidt, André, Andreou, Christina, Hietala, Jarmo, Schirmer, Timo, Romer, Georg, Michel, Chantal, Rössler, Wulf, Maj, Carlo, Borisov, Oleg, Krawitz, Peter M., Falkai, Peter, Pantelis, Christos, Lencer, Rebekka, Bertolino, Alessandro, Borgwardt, Stefan, Noethen, Markus, Brambilla, Paolo, Schultze-Lutter, Frauke, Meisenzahl, Eva, Wood, Stephen J., Davatzikos, Christos, Upthegrove, Rachel, Salokangas, Raimo K. R., Koutsouleris, Nikolaos, Mackintosh, Amatya, Kaiser, Nathalie, Lichtenstein, Thorsten, Seves, Mauro, Chisholm, Katie, Reniers, Renate, Stainton, Alexandra, From, Tiina, Heinimaa, Markus, Ilonen, Tuula, Jalo, Päivi, Laurikainen, Heikki, Tuominen, Lauri, Luutonen, Sinikka, Paju, Janina, Tikka, Maria, Armio (Säilä), Reetta-Liina, Toivonen, Anna, Walta, Maija, Fabbro, Franco, Balestrieri, Matteo, Bonivento, Carolina, Garzitto, Marco, Cabras, Giuseppe, Piccin, Sara, Castellani, Umberto, Bellani, Marcella, Maieron, Marta, Girometti, Rossano, Zuiani, Chiara, Skafidas, Stan, Velakoulis, Dennis, Everall, Ian, Merritt, Antonia, Jovicevic, Michael, Plicht, Manuel, Bequé, Dirk, Solana Sánchez, Ana Beatriz, Hehn, Nicolas, Herrmann, Katrin, Burke, Michael X., Fernandez, Brice, Altamura, Carlo, Rango, Mario, Ferro, Adele, Belleri, Marika, Maggioni, Eleonora, Squarcina, Letizia, Re, Marta, Delvecchio, Giuseppe, Meneghelli, Anna, Monzani, Emiliano, Sassi, Roberto, Sberna, Maurizio, Gennari, Luciana, Torremante, Patrizia, Surmann, Marian, Dannlowski, Udo, Bienek, Olga, Blasi, Giuseppe, Pergola, Giulio, Quarto, Tiziana, Andriola, Ileana, Romano, Raffaella, Gelao, Barbara, Fazio, Leonardo, Korda, Alexandra, Rohner, Henrik, Mann, Matthias, Geyer, Phillip, Treit, Peter, Müller, Johannes, Frackowiak, Richard, Wasserman, Danuta, Maier, Wolfgang, Binder, Elisabeth, Woopen, Christiane, Spranger, Tade Matthias, Möhrmann, Karl-Heinz, and PRONIA Consortium

Subjects
Adult, Male, Psychiatry and Mental health, Psychotic Disorders, Schizophrenia, Medizin, Brain, Cluster Analysis, Humans, Female, Longitudinal Studies, 610 Medizin und Gesundheit, Original Investigation
Abstract

Importance Approaches are needed to stratify individuals in early psychosis stages beyond positive symptom severity to investigate specificity related to affective and normative variation and to validate solutions with premorbid, longitudinal, and genetic risk measures. Objective To use machine learning techniques to cluster, compare, and combine subgroup solutions using clinical and brain structural imaging data from early psychosis and depression stages. Design, Setting, and Participants A multisite, naturalistic, longitudinal cohort study (10 sites in 5 European countries; including major follow-up intervals at 9 and 18 months) with a referred patient sample of those with clinical high risk for psychosis (CHR-P), recent-onset psychosis (ROP), recent-onset depression (ROD), and healthy controls were recruited between February 1, 2014, to July 1, 2019. Data were analyzed between January 2020 and January 2022. Main Outcomes and Measures A nonnegative matrix factorization technique separately decomposed clinical (287 variables) and parcellated brain structural volume (204 gray, white, and cerebrospinal fluid regions) data across CHR-P, ROP, ROD, and healthy controls study groups. Stability criteria determined cluster number using nested cross-validation. Validation targets were compared across subgroup solutions (premorbid, longitudinal, and schizophrenia polygenic risk scores). Multiclass supervised machine learning produced a transferable solution to the validation sample. Results There were a total of 749 individuals in the discovery group and 610 individuals in the validation group. Individuals included those with CHR-P (n = 287), ROP (n = 323), ROD (n = 285), and healthy controls (n = 464), The mean (SD) age was 25.1 (5.9) years, and 702 (51.7%) were female. A clinical 4-dimensional solution separated individuals based on positive symptoms, negative symptoms, depression, and functioning, demonstrating associations with all validation targets. Brain clustering revealed a subgroup with distributed brain volume reductions associated with negative symptoms, reduced performance IQ, and increased schizophrenia polygenic risk scores. Multilevel results distinguished between normative and illness-related brain differences. Subgroup results were largely validated in the external sample. Conclusions and Relevance The results of this longitudinal cohort study provide stratifications beyond the expression of positive symptoms that cut across illness stages and diagnoses. Clinical results suggest the importance of negative symptoms, depression, and functioning. Brain results suggest substantial overlap across illness stages and normative variation, which may highlight a vulnerability signature independent from specific presentations. Premorbid, longitudinal, and genetic risk validation suggested clinical importance of the subgroups to preventive treatments.

Published
2022

12. Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia: an international multicenter study

Author

Fountoulakis, Konstantinos N., primary, Dragioti, Elena, additional, Theofilidis, Antonis T., additional, Wiklund, Tobias, additional, Atmatzidis, Xenofon, additional, Nimatoudis, Ioannis, additional, Thys, Erik, additional, Wampers, Martien, additional, Hranov, Luchezar, additional, Hristova, Trayana, additional, Aptalidis, Daniil, additional, Milev, Roumen, additional, Iftene, Felicia, additional, Spaniel, Filip, additional, Knytl, Pavel, additional, Furstova, Petra, additional, From, Tiina, additional, Karlsson, Henry, additional, Walta, Maija, additional, Salokangas, Raimo K. R., additional, Azorin, Jean-Michel, additional, Bouniard, Justine, additional, Montant, Julie, additional, Juckel, Georg, additional, Haussleiter, Ida S., additional, Douzenis, Athanasios, additional, Michopoulos, Ioannis, additional, Ferentinos, Panagiotis, additional, Smyrnis, Nikolaos, additional, Mantonakis, Leonidas, additional, Nemes, Zsófia, additional, Gonda, Xenia, additional, Vajda, Dora, additional, Juhasz, Anita, additional, Shrivastava, Amresh, additional, Waddington, John, additional, Pompili, Maurizio, additional, Comparelli, Anna, additional, Corigliano, Valentina, additional, Rancans, Elmars, additional, Navickas, Alvydas, additional, Hilbig, Jan, additional, Bukelskis, Laurynas, additional, Stevovic, Lidija I., additional, Vodopic, Sanja, additional, Esan, Oluyomi, additional, Oladele, Oluremi, additional, Osunbote, Christopher, additional, Rybakowski, Janusz K., additional, Wojciak, Pawel, additional, Domowicz, Klaudia, additional, Figueira, Maria L., additional, Linhares, Ludgero, additional, Crawford, Joana, additional, Panfil, Anca-Livia, additional, Smirnova, Daria, additional, Izmailova, Olga, additional, Lecic-Tosevski, Dusica, additional, Temmingh, Henk, additional, Howells, Fleur, additional, Bobes, Julio, additional, Garcia-Portilla, Maria P., additional, García-Alvarez, Leticia, additional, Erzin, Gamze, additional, Karadağ, Hasan, additional, De Sousa, Avinash, additional, Bendre, Anuja, additional, Hoschl, Cyril, additional, Bredicean, Cristina, additional, Papava, Ion, additional, Vukovic, Olivera, additional, Pejuskovic, Bojana, additional, Russell, Vincent, additional, Athanasiadis, Loukas, additional, Konsta, Anastasia, additional, Fountoulakis, Nikolaos K., additional, Stein, Dan, additional, Berk, Michael, additional, Dean, Olivia, additional, Tandon, Rajiv, additional, Kasper, Siegfried, additional, and De Hert, Marc, additional

Published
2021
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13. Additional file 5 of Short-term functional outcome in psychotic patients: results of the Turku early psychosis study (TEPS)

Author

Salokangas, Raimo K. R., From, Tiina, Ilonen, Tuula, Luutonen, Sinikka, Heinimaa, Markus, Armio, Reetta-Liina, Laurikainen, Heikki, Walta, Maija, Paju, Janina, Toivonen, Anna, Jalo, P��ivi, Tuominen, Lauri, and Hietala, Jarmo

Abstract

Additional file 5: Supplementary Table 4a. Repeated measures ANOVA of functional outcome for patients with first-episode psychosis (FEP, n = 105). Supplementary Table 4b. Repeated measures ANOVA of functional outcomes for patients with confirmed clinical high-risk to psychosis (CHR-P, n = 49). Supplementary Table 4c. Repeated measures ANOVA of functional outcome for patients with nonconfirmed clinical high-risk to psychosis (CHR-N, n = 40).

Published
2021
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15. Short-term Functional Outcome in Psychotic Patients. Results of the Turku Early Psychosis Study (TEPS).

Author

Salokangas, Raimo K. R., primary, From, Tiina, additional, Ilonen, Tuula, additional, Luutonen, Sinikka, additional, Heinimaa, Markus, additional, Armio, Reetta-Liina, additional, Laurikainen, Heikki, additional, Walta, Maija, additional, Paju, Janina, additional, Toivonen, Anna, additional, Jalo, Päivi, additional, Tuominen, Lauri, additional, and Hietala, Jarmo, additional

Published
2021
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16. Modeling psychological function in patients with schizophrenia with the PANSS: an international multi-center study

Author

Fountoulakis, Konstantinos N., primary, Dragioti, Elena, additional, Theofilidis, Antonis T., additional, Wiklund, Tobias, additional, Atmatzidis, Xenofon, additional, Nimatoudis, Ioannis, additional, Thys, Erik, additional, Wampers, Martien, additional, Hranov, Luchezar, additional, Hristova, Trayana, additional, Aptalidis, Daniil, additional, Milev, Roumen, additional, Iftene, Felicia, additional, Spaniel, Filip, additional, Knytl, Pavel, additional, Furstova, Petra, additional, From, Tiina, additional, Karlsson, Henry, additional, Walta, Maija, additional, Salokangas, Raimo K.R., additional, Azorin, Jean-Michel, additional, Bouniard, Justine, additional, Montant, Julie, additional, Juckel, Georg, additional, Haussleiter, Ida S., additional, Douzenis, Athanasios, additional, Michopoulos, Ioannis, additional, Ferentinos, Panagiotis, additional, Smyrnis, Nikolaos, additional, Mantonakis, Leonidas, additional, Nemes, Zsófia, additional, Gonda, Xenia, additional, Vajda, Dora, additional, Juhasz, Anita, additional, Shrivastava, Amresh, additional, Waddington, John, additional, Pompili, Maurizio, additional, Comparelli, Anna, additional, Corigliano, Valentina, additional, Rancans, Elmars, additional, Navickas, Alvydas, additional, Hilbig, Jan, additional, Bukelskis, Laurynas, additional, Stevovic, Lidija I., additional, Vodopic, Sanja, additional, Esan, Oluyomi, additional, Oladele, Oluremi, additional, Osunbote, Christopher, additional, Rybakowski, Janusz K., additional, Wojciak, Pawel, additional, Domowicz, Klaudia, additional, Figueira, Maria L., additional, Linhares, Ludgero, additional, Crawford, Joana, additional, Panfil, Anca-Livia, additional, Smirnova, Daria, additional, Izmailova, Olga, additional, Lecic-Tosevski, Dusica, additional, Temmingh, Henk, additional, Howells, Fleur, additional, Bobes, Julio, additional, Garcia-Portilla, Maria P., additional, García-Alvarez, Leticia, additional, Erzin, Gamze, additional, Karadağ, Hasan, additional, De Sousa, Avinash, additional, Bendre, Anuja, additional, Hoschl, Cyril, additional, Bredicean, Cristina, additional, Papava, Ion, additional, Vukovic, Olivera, additional, Pejuskovic, Bojana, additional, Russell, Vincent, additional, Athanasiadis, Loukas, additional, Konsta, Anastasia, additional, Stein, Dan, additional, Berk, Michael, additional, Dean, Olivia, additional, Tandon, Rajiv, additional, Kasper, Siegfried, additional, and De Hert, Marc, additional

Published
2020
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18. Staging of Schizophrenia With the Use of PANSS : An International Multi-Center Study

Author

Fountoulakis, Konstantinos N., Dragioti, Elena, Theofilidis, Antonis T., Wiklund, Tobias, Atmatzidis, Xenofon, Nimatoudis, Ioannis, Thys, Erik, Wampers, Martien, Hranov, Luchezar, Hristova, Trayana, Aptalidis, Daniil, Milev, Roumen, Iftene, Felicia, Spaniel, Filip, Knytl, Pavel, Furstova, Petra, From, Tiina, Karlsson, Henry, Walta, Maija, Salokangas, Raimo K. R., Azorin, Jean-Michel, Bouniard, Justine, Montant, Julie, Juckel, Georg, Haussleiter, Ida S., Douzenis, Athanasios, Michopoulos, Ioannis, Ferentinos, Panagiotis, Smyrnis, Nikolaos, Mantonakis, Leonidas, Nemes, Zsofia, Gonda, Xenia, Vajda, Dora, Juhasz, Anita, Shrivastava, Amresh, Waddington, John, Pompili, Maurizio, Comparelli, Anna, Corigliano, Valentina, Rancans, Elmars, Navickas, Alvydas, Hilbig, Jan, Bukelskis, Laurynas, Stevovic, Lidija Injac, Vodopic, Sanja, Esan, Oluyomi, Oladele, Oluremi, Osunbote, Christopher, Rybakowski, Janusz K., Wojciak, Pawel, Domowicz, Klaudia, Figueira, Maria Luisa, Linhares, Ludgero, Crawford, Joana, Panfil, Anca-Livia, Smirnova, Daria, Izmailova, Olga, Lecic-Tosevski, Dusica, Temmingh, Henk, Howells, Fleur, Bobes, Julio, Garcia-Portilla, Maria Paz, Garcia-Alvarez, Leticia, Erzin, Gamze, Karadag, Hasan, De Sousa, Avinash, Bendre, Anuja, Hoschl, Cyril, Bredicean, Cristina, Papava, Ion, Vukovic, Olivera, Pejuskovic, Bojana, Russell, Vincent, Athanasiadis, Loukas, Konsta, Anastasia, Stein, Dan, Berk, Michael, Dean, Olivia, Tandon, Rajiv, Kasper, Siegfried, De Hert, Marc, Fountoulakis, Konstantinos N., Dragioti, Elena, Theofilidis, Antonis T., Wiklund, Tobias, Atmatzidis, Xenofon, Nimatoudis, Ioannis, Thys, Erik, Wampers, Martien, Hranov, Luchezar, Hristova, Trayana, Aptalidis, Daniil, Milev, Roumen, Iftene, Felicia, Spaniel, Filip, Knytl, Pavel, Furstova, Petra, From, Tiina, Karlsson, Henry, Walta, Maija, Salokangas, Raimo K. R., Azorin, Jean-Michel, Bouniard, Justine, Montant, Julie, Juckel, Georg, Haussleiter, Ida S., Douzenis, Athanasios, Michopoulos, Ioannis, Ferentinos, Panagiotis, Smyrnis, Nikolaos, Mantonakis, Leonidas, Nemes, Zsofia, Gonda, Xenia, Vajda, Dora, Juhasz, Anita, Shrivastava, Amresh, Waddington, John, Pompili, Maurizio, Comparelli, Anna, Corigliano, Valentina, Rancans, Elmars, Navickas, Alvydas, Hilbig, Jan, Bukelskis, Laurynas, Stevovic, Lidija Injac, Vodopic, Sanja, Esan, Oluyomi, Oladele, Oluremi, Osunbote, Christopher, Rybakowski, Janusz K., Wojciak, Pawel, Domowicz, Klaudia, Figueira, Maria Luisa, Linhares, Ludgero, Crawford, Joana, Panfil, Anca-Livia, Smirnova, Daria, Izmailova, Olga, Lecic-Tosevski, Dusica, Temmingh, Henk, Howells, Fleur, Bobes, Julio, Garcia-Portilla, Maria Paz, Garcia-Alvarez, Leticia, Erzin, Gamze, Karadag, Hasan, De Sousa, Avinash, Bendre, Anuja, Hoschl, Cyril, Bredicean, Cristina, Papava, Ion, Vukovic, Olivera, Pejuskovic, Bojana, Russell, Vincent, Athanasiadis, Loukas, Konsta, Anastasia, Stein, Dan, Berk, Michael, Dean, Olivia, Tandon, Rajiv, Kasper, Siegfried, and De Hert, Marc

Abstract

Introduction A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. Methods Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. Results Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. Discussion This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time., Funding Agencies|NHMRC Senior Principal Research FellowshipNational Health and Medical Research Council of Australia [APP1059660, APP1156072]

Published
2019
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19. Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study

Author

Fountoulakis, Konstantinos N, Dragioti, Elena, Theofilidis, Antonis T, Wikilund, Tobias, Atmatzidis, Xenefon, Nimatoudis, Ioannis, Thys, Erik, Wampers, Martien, Hranov, Luchezar, Hristova, Trayana, Aptalidis, Daniil, Milev, Roumen, Iftene, Filicia, Spaniel, Filip, Knytl, Pavel, Furstova, Petra, From, Tiina, Karlsson, Henry, Walta, Maija, Salokangas, Raimo KR, Azorin, Jean-Michel, Bouniard, Justine, Montant, Julie, Juckel, Georg, Haussleiter, Ida S, Douzenis, Athanasios, Michopoulos, Ioannis, Ferentinos, Panagiotis, Smyrnis, Nikolaos, Mantonakis, Leonidas, Nemes, Zsophia, Gonda, Xenia, Vajda, Dora, Juhasz, Anita, Shrivastava, Amresh, Waddington, John, Pompili, Maurizio, Comparelli, Anna, Corigliano, Valentina, Rancans, Elmars, Navickas, Alvydas, Hilbig, Jan, Bukelskis, Laurynas, Injac Stevovic, Lidija, Vodopic, Sanja, Esan, Oluyomi, Oladele, Oluremi, Osunbote, Christopher, Rybakowski, Janusz K, Wojciak, Pawel, Domowicz, Klaudia, Figueira, Maria Luisa, Linhares, Ludgero, Crawford, Joana, Panfil, Anca-Livia, Smirnova, Daria, Izmailova, Olga, Lecic-Tosevski, Dusica, Temmingh, Henk, Howells, Fleur, Bobes, Julio, Garcia-Portilla, Maria Paz, García-Alvarez, Leticia, Erzin, Gamze, Karadaǧ, Hasan, De Sousa, Avinash, Bendre, Anuja, Hoschl, Cyril, Bredicean, Cristina, Papava, Ion, Vukovic, Olivera, Pejuskovic, Bojana, Russell, Vincent, Athanasiadis, Loukas, Konsta, Anastasia, Stein, Dan, Berk, Michael, Dean, Olivia, Tandon, Rajiv, Kasper, Siegfried, De Hert, Marc, Fountoulakis, Konstantinos N, Dragioti, Elena, Theofilidis, Antonis T, Wikilund, Tobias, Atmatzidis, Xenefon, Nimatoudis, Ioannis, Thys, Erik, Wampers, Martien, Hranov, Luchezar, Hristova, Trayana, Aptalidis, Daniil, Milev, Roumen, Iftene, Filicia, Spaniel, Filip, Knytl, Pavel, Furstova, Petra, From, Tiina, Karlsson, Henry, Walta, Maija, Salokangas, Raimo KR, Azorin, Jean-Michel, Bouniard, Justine, Montant, Julie, Juckel, Georg, Haussleiter, Ida S, Douzenis, Athanasios, Michopoulos, Ioannis, Ferentinos, Panagiotis, Smyrnis, Nikolaos, Mantonakis, Leonidas, Nemes, Zsophia, Gonda, Xenia, Vajda, Dora, Juhasz, Anita, Shrivastava, Amresh, Waddington, John, Pompili, Maurizio, Comparelli, Anna, Corigliano, Valentina, Rancans, Elmars, Navickas, Alvydas, Hilbig, Jan, Bukelskis, Laurynas, Injac Stevovic, Lidija, Vodopic, Sanja, Esan, Oluyomi, Oladele, Oluremi, Osunbote, Christopher, Rybakowski, Janusz K, Wojciak, Pawel, Domowicz, Klaudia, Figueira, Maria Luisa, Linhares, Ludgero, Crawford, Joana, Panfil, Anca-Livia, Smirnova, Daria, Izmailova, Olga, Lecic-Tosevski, Dusica, Temmingh, Henk, Howells, Fleur, Bobes, Julio, Garcia-Portilla, Maria Paz, García-Alvarez, Leticia, Erzin, Gamze, Karadaǧ, Hasan, De Sousa, Avinash, Bendre, Anuja, Hoschl, Cyril, Bredicean, Cristina, Papava, Ion, Vukovic, Olivera, Pejuskovic, Bojana, Russell, Vincent, Athanasiadis, Loukas, Konsta, Anastasia, Stein, Dan, Berk, Michael, Dean, Olivia, Tandon, Rajiv, Kasper, Siegfried, and De Hert, Marc

Published
2019

20. Staging of Schizophrenia With the Use of PANSS: An International Multi-Center Study

Author

Fountoulakis, Konstantinos N, primary, Dragioti, Elena, additional, Theofilidis, Antonis T, additional, Wikilund, Tobias, additional, Atmatzidis, Xenofon, additional, Nimatoudis, Ioannis, additional, Thys, Erik, additional, Wampers, Martien, additional, Hranov, Luchezar, additional, Hristova, Trayana, additional, Aptalidis, Daniil, additional, Milev, Roumen, additional, Iftene, Felicia, additional, Spaniel, Filip, additional, Knytl, Pavel, additional, Furstova, Petra, additional, From, Tiina, additional, Karlsson, Henry, additional, Walta, Maija, additional, Salokangas, Raimo K R, additional, Azorin, Jean-Michel, additional, Bouniard, Justine, additional, Montant, Julie, additional, Juckel, Georg, additional, Haussleiter, Ida S, additional, Douzenis, Athanasios, additional, Michopoulos, Ioannis, additional, Ferentinos, Panagiotis, additional, Smyrnis, Nikolaos, additional, Mantonakis, Leonidas, additional, Nemes, Zsófia, additional, Gonda, Xenia, additional, Vajda, Dora, additional, Juhasz, Anita, additional, Shrivastava, Amresh, additional, Waddington, John, additional, Pompili, Maurizio, additional, Comparelli, Anna, additional, Corigliano, Valentina, additional, Rancans, Elmars, additional, Navickas, Alvydas, additional, Hilbig, Jan, additional, Bukelskis, Laurynas, additional, Injac Stevovic, Lidija, additional, Vodopic, Sanja, additional, Esan, Oluyomi, additional, Oladele, Oluremi, additional, Osunbote, Christopher, additional, Rybakowski, Janusz Κ, additional, Wojciak, Pawel, additional, Domowicz, Klaudia, additional, Figueira, Maria Luisa, additional, Linhares, Ludgero, additional, Crawford, Joana, additional, Panfil, Anca-Livia, additional, Smirnova, Daria, additional, Izmailova, Olga, additional, Lecic-Tosevski, Dusica, additional, Temmingh, Henk, additional, Howells, Fleur, additional, Bobes, Julio, additional, Garcia-Portilla, Maria Paz, additional, García-Alvarez, Leticia, additional, Erzin, Gamze, additional, Karadağ, Hasan, additional, De Sousa, Avinash, additional, Bendre, Anuja, additional, Hoschl, Cyril, additional, Bredicean, Cristina, additional, Papava, Ion, additional, Vukovic, Olivera, additional, Pejuskovic, Bojana, additional, Russell, Vincent, additional, Athanasiadis, Loukas, additional, Konsta, Anastasia, additional, Stein, Dan, additional, Berk, Michael, additional, Dean, Olivia, additional, Tandon, Rajiv, additional, Kasper, Siegfried, additional, and De Hert., Marc, additional

Published
2019
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21. Modeling psychological function in patients with schizophrenia with the PANSS: an international multi-center study

Author

Fountoulakis, Konstantinos N., Dragioti, Elena, Theofilidis, Antonis T., Wiklund, Tobias, Atmatzidis, Xenofon, Nimatoudis, Ioannis, Thys, Erik, Wampers, Martien, Hranov, Luchezar, Hristova, Trayana, Aptalidis, Daniil, Milev, Roumen, Iftene, Felicia, Spaniel, Filip, Knytl, Pavel, Furstova, Petra, From, Tiina, Karlsson, Henry, Walta, Maija, Salokangas, Raimo K.R., Azorin, Jean-Michel, Bouniard, Justine, Montant, Julie, Juckel, Georg, Haussleiter, Ida S., Douzenis, Athanasios, Michopoulos, Ioannis, Ferentinos, Panagiotis, Smyrnis, Nikolaos, Mantonakis, Leonidas, Nemes, Zsófia, Gonda, Xenia, Vajda, Dora, Juhasz, Anita, Shrivastava, Amresh, Waddington, John, Pompili, Maurizio, Comparelli, Anna, Corigliano, Valentina, Rancans, Elmars, Navickas, Alvydas, Hilbig, Jan, Bukelskis, Laurynas, Stevovic, Lidija I., Vodopic, Sanja, Esan, Oluyomi, Oladele, Oluremi, Osunbote, Christopher, Rybakowski, Janusz K., Wojciak, Pawel, Domowicz, Klaudia, Figueira, Maria L., Linhares, Ludgero, Crawford, Joana, Panfil, Anca-Livia, Smirnova, Daria, Izmailova, Olga, Lecic-Tosevski, Dusica, Temmingh, Henk, Howells, Fleur, Bobes, Julio, Garcia-Portilla, Maria P., García-Alvarez, Leticia, Erzin, Gamze, Karadağ, Hasan, De Sousa, Avinash, Bendre, Anuja, Hoschl, Cyril, Bredicean, Cristina, Papava, Ion, Vukovic, Olivera, Pejuskovic, Bojana, Russell, Vincent, Athanasiadis, Loukas, Konsta, Anastasia, Stein, Dan, Berk, Michael, Dean, Olivia, Tandon, Rajiv, Kasper, Siegfried, and De Hert, Marc

Abstract

AbstractBackgroundThe aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model.MethodsTwenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed.ResultsThe results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage.ConclusionsThe current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.

Published
2021
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22. Kraepelin and Bleuler were right: disorganised thinking and poverty of emotions, not delusions or hallucinations, are primary in psychoses.

Author

Salokangas, Raimo K. R., From, Tiina, Ilonen, Tuula, Luutonen, Sinikka, Heinimaa, Markus, Armio, Reetta-Liina, Laurikainen, Heikki, Walta, Maija, Tuominen, Lauri, and Hietala, Jarmo

Subjects
DELUSIONS, PSYCHOSES, MARITAL status, AFFECTIVE disorders, HALLUCINATIONS, NEUROPSYCHOLOGICAL tests
Abstract

In psychotic patients, functional outcome is associated with several clinical, neuropsychological and developmental factors. In a prospective study design, we aimed to predict functional outcome in patients with first-episode psychosis (FEP) and clinical high risk to psychosis (CHR) by sociodemographic, clinical, neuropsychological and premorbid factors, as well as by follow-up symptomatology. Altogether, 130 FEP and 60 CHR patients were recruited and their Global Assessment of Functioning (GAF) was assessed at baseline (T0) and when nine months (T1) and 18 months (T2) was elapsed from baseline examination. Sum of follow-up GAFT1 and GAFT2 (F-GAF) was predicted by background characteristics and factorised dimensions of the Structured Interview for Prodromal Syndromes (SIPS) symptoms, Premorbid Adjustment Scale (PAS), Trauma and Distress Scale items and neuropsychological tests, and by psychotic, depression and anxiety symptoms at T1 and T2. F-GAF was predicted by PAS Sociability and School Performance, SIPS Disorganised Thinking, work and marital status in FEP patients. In CHR patients, only SIPS Emotional Poverty predicted significantly F-GAF. In them, follow-up Depression/Anxiety symptomatology is associated strongly with poor F-GAF. The effects of PAS Sociability and School Performance on F-GAF were mediated via SIPS Emotional Poverty in both FEP and CHR patients. In patients with FEP, poor premorbid adjustment, Disorganised Thinking, poor baseline work status and single marital status predict poor follow-up functioning. In both FEP and CHR patients, the effect of premorbid adjustment on follow-up functioning is mediated via Emotional Poverty. In patients with CHR, basic disturbances are affective disorders. [ABSTRACT FROM AUTHOR]

Published
2021
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24. Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia: an international multicenter study.

Author

Fountoulakis KN, Dragioti E, Theofilidis AT, Wiklund T, Atmatzidis X, Nimatoudis I, Thys E, Wampers M, Hranov L, Hristova T, Aptalidis D, Milev R, Iftene F, Spaniel F, Knytl P, Furstova P, From T, Karlsson H, Walta M, Salokangas RKR, Azorin JM, Bouniard J, Montant J, Juckel G, Haussleiter IS, Douzenis A, Michopoulos I, Ferentinos P, Smyrnis N, Mantonakis L, Nemes Z, Gonda X, Vajda D, Juhasz A, Shrivastava A, Waddington J, Pompili M, Comparelli A, Corigliano V, Rancans E, Navickas A, Hilbig J, Bukelskis L, Stevovic LI, Vodopic S, Esan O, Oladele O, Osunbote C, Rybakowski JK, Wojciak P, Domowicz K, Figueira ML, Linhares L, Crawford J, Panfil AL, Smirnova D, Izmailova O, Lecic-Tosevski D, Temmingh H, Howells F, Bobes J, Garcia-Portilla MP, García-Alvarez L, Erzin G, Karadağ H, De Sousa A, Bendre A, Hoschl C, Bredicean C, Papava I, Vukovic O, Pejuskovic B, Russell V, Athanasiadis L, Konsta A, Fountoulakis NK, Stein D, Berk M, Dean O, Tandon R, Kasper S, and De Hert M

Subjects
Humans, Female, Male, Age of Onset, Diagnostic and Statistical Manual of Mental Disorders, Schizophrenia diagnosis, Schizophrenia epidemiology
Abstract

Background: The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia., Methods: Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 ± 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects., Results: There was a 3-year later age at onset for females ( P  < .001) and lower rates of negative symptoms ( P  < .01) and higher depression/anxiety measures ( P  < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages ( P  = .001). No significant effects were found concerning duration of illness., Discussion: Our results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.

Published
2022
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25. [The prognosis of lung cancer continues to be poor--treatment outcome within The Hospital District of Southwest Finland in 2004 to 2011].

Author

Salomaa ER and Walta M

Subjects
Female, Finland epidemiology, Humans, Male, Prognosis, Survival Rate, Lung Neoplasms epidemiology, Lung Neoplasms therapy
Abstract

Background: The survival of lung cancer patients is still poor; 10-15% are alive five years after diagnosis., Material and Methods: We evaluated 1 542 patients with new lung cancer diagnosis in 2004-2011., Results: The one-, two- and five-year survival rate was 37.3%, 23.3% and 10.5%, respectively. The prognosis of women was better. There were no changes over the 8 years in the number or age of patients, the share of women, the histology, the number of operated patients or survival., Conclusions: Compared with earlier Finnish studies the short-term prognosis seems to be little better.

Published
2015

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