BACKGROUND: Validated clinical prediction models of short-term remission in psychosis are lacking. Our aim was to develop a clinical prediction model aimed at predicting 4-6-week remission following a first episode of psychosis. METHOD: Baseline clinical data from the Athens First Episode Research Study was used to develop a Support Vector Machine prediction model of 4-week symptom remission in first-episode psychosis patients using repeated nested cross-validation. This model was further tested to predict 6-week remission in a sample of two independent, consecutive Danish first-episode cohorts. RESULTS: Of the 179 participants in Athens, 120 were male with an average age of 25.8 years and average duration of untreated psychosis of 32.8 weeks. 62.9% were antipsychotic-naïve. Fifty-seven percent attained remission after 4 weeks. In the Danish cohort, 31% attained remission. Eleven clinical scale items were selected in the Athens 4-week remission cohort. These included the Duration of Untreated Psychosis, Personal and Social Performance Scale, Global Assessment of Functioning and eight items from the Positive and Negative Syndrome Scale. This model significantly predicted 4-week remission status (area under the receiver operator characteristic curve (ROC-AUC) = 71.45, P < .0001). It also predicted 6-week remission status in the Danish cohort (ROC-AUC = 67.74, P < .0001), demonstrating reliability. CONCLUSIONS: Using items from common and validated clinical scales, our model significantly predicted early remission in patients with first-episode psychosis. Although replicated in an independent cohort, forward testing between machine learning models and clinicians' assessment should be undertaken to evaluate the possible utility as a routine clinical tool.
BACKGROUND: Validated clinical prediction models of short-term remission in psychosis are lacking. Our aim was to develop a clinical prediction model aimed at predicting 4-6-week remission following a first episode of psychosis. METHOD: Baseline clinical data from the Athens First Episode Research Study was used to develop a Support Vector Machine prediction model of 4-week symptom remission in first-episode psychosis patients using repeated nested cross-validation. This model was further tested to predict 6-week remission in a sample of two independent, consecutive Danish first-episode cohorts. RESULTS: Of the 179 participants in Athens, 120 were male with an average age of 25.8 years and average duration of untreated psychosis of 32.8 weeks. 62.9% were antipsychotic-naïve. Fifty-seven percent attained remission after 4 weeks. In the Danish cohort, 31% attained remission. Eleven clinical scale items were selected in the Athens 4-week remission cohort. These included the Duration of Untreated Psychosis, Personal and Social Performance Scale, Global Assessment of Functioning and eight items from the Positive and Negative Syndrome Scale. This model significantly predicted 4-week remission status (area under the receiver operator characteristic curve (ROC-AUC) = 71.45, P < .0001). It also predicted 6-week remission status in the Danish cohort (ROC-AUC = 67.74, P < .0001), demonstrating reliability. CONCLUSIONS: Using items from common and validated clinical scales, our model significantly predicted early remission in patients with first-episode psychosis. Although replicated in an independent cohort, forward testing between machine learning models and clinicians' assessment should be undertaken to evaluate the possible utility as a routine clinical tool.
Authors: K Allott; D Fraguas; C F Bartholomeusz; C M Díaz-Caneja; C Wannan; E M Parrish; G P Amminger; C Pantelis; C Arango; P D McGorry; M Rapado-Castro Journal: Psychol Med Date: 2017-11-27 Impact factor: 7.723
Authors: Samuel P Leighton; Rachel Upthegrove; Rajeev Krishnadas; Michael E Benros; Matthew R Broome; Georgios V Gkoutos; Peter F Liddle; Swaran P Singh; Linda Everard; Peter B Jones; David Fowler; Vimal Sharma; Nicholas Freemantle; Rune H B Christensen; Nikolai Albert; Merete Nordentoft; Matthias Schwannauer; Jonathan Cavanagh; Andrew I Gumley; Max Birchwood; Pavan K Mallikarjun Journal: Lancet Digit Health Date: 2019-09-12
Authors: Alexandra Talpalaru; Nikhil Bhagwat; Gabriel A Devenyi; Martin Lepage; M Mallar Chakravarty Journal: Schizophr Res Date: 2019-08-24 Impact factor: 4.939
Authors: Anthony S David; Nicholas Bedford; Ben Wiffen; James Gilleen Journal: Philos Trans R Soc Lond B Biol Sci Date: 2012-05-19 Impact factor: 6.237
Authors: Richard Dinga; Andre F Marquand; Dick J Veltman; Aartjan T F Beekman; Robert A Schoevers; Albert M van Hemert; Brenda W J H Penninx; Lianne Schmaal Journal: Transl Psychiatry Date: 2018-11-05 Impact factor: 6.222