Theresa Haidl1, Marlene Rosen1, Frauke Schultze-Lutter2, Dorien Nieman3, Susanne Eggers1, Markus Heinimaa4, Georg Juckel5, Andreas Heinz6, Anthony Morrison7, Don Linszen8, Raimo Salokangas4, Joachim Klosterkötter1, Max Birchwood9, Paul Patterson10, Stephan Ruhrmann11. 1. Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Str. 62, 50934 Cologne, Germany. 2. University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Effingerstrasse 14a, 3011 Bern, Switzerland; Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Bergische Landstraße 2, 40629 Düsseldorf, Germany. 3. Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam-Zuidoost, Netherlands. 4. Department of Psychiatry, University of Turku, Kiinamyllynkatu 4-8, Rakennus 11B, 20520 Turku, Finland. 5. Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Alexandrinenstraße 1, 344791 Bochum, Germany. 6. Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité, Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany. 7. School of Psychological Sciences, University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom. 8. Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam-Zuidoost, Netherlands; Department of Psychiatry and Psychology, Maastricht University, PO Box 616, 6200 MD Maastricht, Netherlands. 9. Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom. 10. Birmingham Children's Hospital, Steelhouse Ln, Birmingham B4 6NH, Birmingham, United Kingdom. 11. Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Str. 62, 50934 Cologne, Germany. Electronic address: stephan.ruhrmann@uk-koeln.de.
Abstract
OBJECTIVE: To investigate the impact of expressed emotion (EE) on the risk of developing the first psychotic episode (FEP). METHOD: The European Prediction of Psychosis Study (EPOS) investigated 245 patients who were at clinical high risk (CHR) of psychosis. The predictive value of EE alone and as a part of the multivariate EPOS model was evaluated. RESULTS: "Perceived irritability", a domain of the Level of Expressed Emotion Scale (LEE), was found to be predictive for the First Psychotic Episode (FEP), even as an individual variable. Furthermore, it was selected in the multivariate EPOS prediction model, thereby replacing two of the original predictor variables. This led to an improved revised version that enabled the identification of three significantly different risk classes with a hazard rate of up to 0.911. CONCLUSIONS: CHR subjects who perceive the most important person in their individual social environment to be limited in their stress coping skills had a higher risk of conversion to the first psychotic episode. The importance of this risk factor was further demonstrated by an improvement of risk estimation in the original EPOS predictor model. Perceiving a reference person as stress-prone and thus potentially unreliable might amplify self-experienced uncertainty and anxiety, which are often associated with the prodromal phase. Such an enforcement of stress-related processes could promote a conversion to psychosis.
OBJECTIVE: To investigate the impact of expressed emotion (EE) on the risk of developing the first psychotic episode (FEP). METHOD: The European Prediction of Psychosis Study (EPOS) investigated 245 patients who were at clinical high risk (CHR) of psychosis. The predictive value of EE alone and as a part of the multivariate EPOS model was evaluated. RESULTS: "Perceived irritability", a domain of the Level of Expressed Emotion Scale (LEE), was found to be predictive for the First Psychotic Episode (FEP), even as an individual variable. Furthermore, it was selected in the multivariate EPOS prediction model, thereby replacing two of the original predictor variables. This led to an improved revised version that enabled the identification of three significantly different risk classes with a hazard rate of up to 0.911. CONCLUSIONS:CHR subjects who perceive the most important person in their individual social environment to be limited in their stress coping skills had a higher risk of conversion to the first psychotic episode. The importance of this risk factor was further demonstrated by an improvement of risk estimation in the original EPOS predictor model. Perceiving a reference person as stress-prone and thus potentially unreliable might amplify self-experienced uncertainty and anxiety, which are often associated with the prodromal phase. Such an enforcement of stress-related processes could promote a conversion to psychosis.
Authors: Eugene N Muratov; Jürgen Bajorath; Robert P Sheridan; Igor V Tetko; Dmitry Filimonov; Vladimir Poroikov; Tudor I Oprea; Igor I Baskin; Alexandre Varnek; Adrian Roitberg; Olexandr Isayev; Stefano Curtarolo; Denis Fourches; Yoram Cohen; Alan Aspuru-Guzik; David A Winkler; Dimitris Agrafiotis; Artem Cherkasov; Alexander Tropsha Journal: Chem Soc Rev Date: 2020-05-01 Impact factor: 54.564
Authors: J Onwumere; C Bonetto; A Lasalvia; E Miglietta; A Veronese; F Bellini; M Imbesi; P Bebbington; E Kuipers; M Ruggeri Journal: Epidemiol Psychiatr Sci Date: 2019-04-10 Impact factor: 6.892