PMID- 31722018 OWN - NLM STAT- MEDLINE DCOM- 20210202 LR - 20220129 IS - 2168-6238 (Electronic) IS - 2168-622X (Print) IS - 2168-622X (Linking) VI - 77 IP - 2 DP - 2020 Feb 1 TI - Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis. PG - 190-200 LID - 10.1001/jamapsychiatry.2019.3501 [doi] AB - IMPORTANCE: The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. OBJECTIVE: To examine the association between alterations in emotion processing and regional gray matter volumes in individuals at clinical high risk (CHR) for psychosis, and the association with subsequent clinical outcomes. DESIGN, SETTING, AND PARTICIPANTS: This naturalistic case-control study with clinical follow-up at 12 months was conducted from July 1, 2010, to August 31, 2016, and collected data from 9 psychosis early detection centers (Amsterdam, Basel, Cologne, Copenhagen, London, Melbourne, Paris, The Hague, and Vienna). Participants (213 individuals at CHR and 52 healthy controls) were enrolled in the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) project. Data were analyzed from October 1, 2018, to April 24, 2019. MAIN MEASURES AND OUTCOMES: Emotion recognition was assessed with the Degraded Facial Affect Recognition Task. Three-Tesla magnetic resonance imaging scans were acquired from all participants, and gray matter volume was measured in regions of interest (medial prefrontal cortex, amygdala, hippocampus, and insula). Clinical outcomes at 12 months were evaluated for transition to psychosis using the Comprehensive Assessment of At-Risk Mental States criteria, and the level of overall functioning was measured through the Global Assessment of Functioning [GAF] scale. RESULTS: A total of 213 individuals at CHR (105 women [49.3%]; mean [SD] age, 22.9 [4.7] years) and 52 healthy controls (25 women [48.1%]; mean [SD] age, 23.3 [4.0] years) were included in the study at baseline. At the follow-up within 2 years of baseline, 44 individuals at CHR (20.7%) had developed psychosis and 169 (79.3%) had not. Of the individuals at CHR reinterviewed with the GAF, 39 (30.0%) showed good overall functioning (GAF score, >/=65), whereas 91 (70.0%) had poor overall functioning (GAF score, <65). Within the CHR sample, better anger recognition at baseline was associated with worse functional outcome (odds ratio [OR], 0.88; 95% CI, 0.78-0.99; P = .03). In individuals at CHR with a good functional outcome, positive associations were found between anger recognition and hippocampal volume (ze = 3.91; familywise error [FWE] P = .02) and between fear recognition and medial prefrontal cortex volume (z = 3.60; FWE P = .02), compared with participants with a poor outcome. The onset of psychosis was not associated with baseline emotion recognition performance (neutral OR, 0.93; 95% CI, 0.79-1.09; P = .37; happy OR, 1.03; 95% CI, 0.84-1.25; P = .81; fear OR, 0.98; 95% CI, 0.85-1.13; P = .77; anger OR, 1.00; 95% CI, 0.89-1.12; P = .96). No difference was observed in the association between performance and regional gray matter volumes in individuals at CHR who developed or did not develop psychosis (FWE P < .05). CONCLUSIONS AND RELEVANCE: In this study, poor functional outcome in individuals at CHR was found to be associated with baseline abnormalities in recognizing negative emotion. This finding has potential implications for the stratification of individuals at CHR and suggests that interventions that target socioemotional processing may improve functional outcomes. FAU - Modinos, Gemma AU - Modinos G AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. AD - Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. FAU - Kempton, Matthew J AU - Kempton MJ AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. AD - National Institute for Health Research, Biomedical Research Centre, London, United Kingdom. FAU - Tognin, Stefania AU - Tognin S AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. FAU - Calem, Maria AU - Calem M AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. FAU - Porffy, Lilla AU - Porffy L AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. FAU - Antoniades, Mathilde AU - Antoniades M AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. FAU - Mason, Ava AU - Mason A AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. FAU - Azis, Matilda AU - Azis M AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. FAU - Allen, Paul AU - Allen P AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. AD - Department of Psychology, University of Roehampton, London, United Kingdom. FAU - Nelson, Barnaby AU - Nelson B AD - Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia. AD - Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia. FAU - McGorry, Patrick AU - McGorry P AD - Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia. AD - Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia. FAU - Pantelis, Christos AU - Pantelis C AD - Center for Neuropsychiatric Schizophrenia Research, University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark. AD - Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark. AD - Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. FAU - Riecher-Rossler, Anita AU - Riecher-Rossler A AD - University of Basel Psychiatric Hospital, Basel, Switzerland. FAU - Borgwardt, Stefan AU - Borgwardt S AD - University of Basel Psychiatric Hospital, Basel, Switzerland. FAU - Bressan, Rodrigo AU - Bressan R AD - LiNC-Lab Interdisciplinar Neurociencias Clinicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de Sao Paulo-UNIFESP, Sao Paulo, Brazil. FAU - Barrantes-Vidal, Neus AU - Barrantes-Vidal N AD - Departament de Psicologia Clinica i de la Salut (Universitat Autonoma de Barcelona), Fundacio Sanitaria Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain. FAU - Krebs, Marie-Odile AU - Krebs MO AD - University of Paris, GHU-Paris, Sainte-Anne, C'JAAD, Hospitalo-Universitaire Department SHU, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France. FAU - Nordentoft, Merete AU - Nordentoft M AD - Mental Health Center Copenhagen, Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark. AD - Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark. FAU - Glenthoj, Birte AU - Glenthoj B AD - Center for Neuropsychiatric Schizophrenia Research, University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark. AD - Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark. FAU - Ruhrmann, Stephan AU - Ruhrmann S AD - Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany. FAU - Sachs, Gabriele AU - Sachs G AD - Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria. FAU - Rutten, Bart AU - Rutten B AD - School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. FAU - van Os, Jim AU - van Os J AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. AD - University Medical Centre Utrecht Brain Center, Department of Psychiatry, Utrecht University Medical Centre, Utrecht, the Netherlands. FAU - de Haan, Lieuwe AU - de Haan L AD - Early Psychosis Department, Amsterdam UMC, Amsterdam, the Netherlands. FAU - Velthorst, Eva AU - Velthorst E AD - Early Psychosis Department, Amsterdam UMC, Amsterdam, the Netherlands. AD - Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York. FAU - van der Gaag, Mark AU - van der Gaag M AD - Amsterdam Public Mental Health Research Institute, Department of Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. AD - Parnassia Psychiatric Institute, Department of Psychosis Research, The Hague, the Netherlands. FAU - Valmaggia, Lucia R AU - Valmaggia LR AD - Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, King's College London, London, United Kingdom. FAU - McGuire, Philip AU - McGuire P AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. AD - National Institute for Health Research, Biomedical Research Centre, London, United Kingdom. AD - South London and Maudsley National Health Service Foundation Trust, London, United Kingdom. CN - EU-GEI High Risk Study Group LA - eng GR - 202397/Z/16/Z/Wellcome Trust/United Kingdom GR - MR/J008915/1/MRC_/Medical Research Council/United Kingdom GR - MR/N026063/1/MRC_/Medical Research Council/United Kingdom PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't PL - United States TA - JAMA Psychiatry JT - JAMA psychiatry JID - 101589550 SB - IM MH - Brain/diagnostic imaging/*pathology MH - Case-Control Studies MH - *Emotional Intelligence MH - Emotions MH - Facial Recognition MH - Female MH - Gray Matter/diagnostic imaging/pathology/physiopathology MH - Humans MH - Magnetic Resonance Imaging MH - Male MH - Neuroimaging MH - Psychiatric Status Rating Scales MH - Psychotic Disorders/diagnostic imaging/pathology/*psychology MH - Young Adult PMC - PMC6865249 COIS- Conflict of Interest Disclosures: Dr McGorry reported holding 2 patents issued (AU 2015203289; 9884034) and 2 pending (CA2773031; 15/844444). Dr Pantelis reported receiving grants from Australian National Health & Medical Research Council during the conduct of the study; grants from Lundbeck Foundation, personal fees from Lundbeck and Australia Pty Ltd; and personal fees from Lundbeck and Australia Pty Ltd outside the submitted work. Dr Riecher-Rossler reported receiving personal fees from Lundbeck and personal fees from Angelini Pharma outside the submitted work. Dr Bressan reported receiving grants from Fundacao de Amparo a Pesquisa do Estado de Sao Paulo, The Brazilian National Council for Scientific and Technological Development, European Research Council, and Medical Research Council UK during the conduct of the study; personal fees and nonfinancial support from Janssen; personal fees from Pfizer; and personal fees from Sanofi-Aventis outside the submitted work. Dr Krebs reported receiving grants PHRC 07-118 (ICAAR study) from the French Health Ministry during the conduct of the study; participating on the boards of Roche and Janssen; and receiving financial support from Janssen, Otsuka Lundbeck Alliance, and EIsai for conference or dissemination initiatives. Dr Glenthoj reported being the leader of Lundbeck Foundation Centre of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research; receiving grants from Medical Research Council and the Lundbeck Foundation during the conduct of the study; and receiving grants from The Lundbeck Foundation and H. Lundbeck A/S outside the submitted work. Dr Ruhrmann reported receiving grants from the European Community during the conduct of the study and personal fees from Boehringer Ingelheim outside the submitted work. Dr Sachs reported receiving grants from European Community Seventh Framework Program during the conduct of the study and personal fees from Lundbeck and Janssen-Cilag outside the submitted work. Dr Rutten reported receiving grants from European Union during the conduct of the study. No other disclosures were reported. EDAT- 2019/11/14 06:00 MHDA- 2021/02/03 06:00 PMCR- 2019/11/13 CRDT- 2019/11/14 06:00 PHST- 2019/11/14 06:00 [pubmed] PHST- 2021/02/03 06:00 [medline] PHST- 2019/11/14 06:00 [entrez] PHST- 2019/11/13 00:00 [pmc-release] AID - 2755277 [pii] AID - yoi190075 [pii] AID - 10.1001/jamapsychiatry.2019.3501 [doi] PST - ppublish SO - JAMA Psychiatry. 2020 Feb 1;77(2):190-200. doi: 10.1001/jamapsychiatry.2019.3501.