Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-19T09:29:37.477Z Has data issue: false hasContentIssue false
  • English
  • Français

Longitudinal symptom network structure in first-episode psychosis: a possible marker for remission

Published online by Cambridge University Press:  16 February 2021

Yan Hong Piao ,
Je-Yeon Yun ,
Thong Ba Nguyen ,
Woo-Sung Kim ,
Jing Sui ,
Nam-In Kang ,
Keon-Hak Lee ,
Seunghyong Ryu ,
Sung-Wan Kim  and
Bong Ju Lee
...Show all authors
Yan Hong Piao
Affiliation:
Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
Je-Yeon Yun
Affiliation:
Seoul National University Hospital, Seoul, Republic of Korea Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
Thong Ba Nguyen
Affiliation:
Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
Woo-Sung Kim
Affiliation:
Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
Jing Sui
Affiliation:
Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China University of Chinese Academy of Sciences, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Beijing 100049, China
Nam-In Kang
Affiliation:
Department of Psychiatry, Maeumsarang Hospital, Wanju, Jeollabuk-do, Korea
Keon-Hak Lee
Affiliation:
Department of Psychiatry, Maeumsarang Hospital, Wanju, Jeollabuk-do, Korea
Seunghyong Ryu
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
Sung-Wan Kim
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
Bong Ju Lee
Affiliation:
Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
Jung Jin Kim
Affiliation:
Department of Psychiatry, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
Je-Chun Yu
Affiliation:
Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Republic of Korea
Kyu Young Lee
Affiliation:
Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Republic of Korea
Seung-Hee Won
Affiliation:
Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Republic of Korea
Seung-Hwan Lee
Affiliation:
Department of Psychiatry, Inje University College of Medicine, Goyang, Republic of Korea
Seung-Hyun Kim
Affiliation:
Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Republic of Korea
Shi Hyun Kang
Affiliation:
Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
Euitae Kim
Affiliation:
Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Young Chul Chung*
Affiliation:
Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
*
Author for correspondence: Young Chul Chung, E-mail: chungyc@jbnu.ac.kr
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Network approach has been applied to a wide variety of psychiatric disorders. The aim of the present study was to identify network structures of remitters and non-remitters in patients with first-episode psychosis (FEP) at baseline and the 6-month follow-up.

Methods

Participants (n = 252) from the Korean Early Psychosis Study (KEPS) were enrolled. They were classified as remitters or non-remitters using Andreasen's criteria. We estimated network structure with 10 symptoms (three symptoms from the Positive and Negative Syndrome Scale, one depressive symptom, and six symptoms related to schema and rumination) as nodes using a Gaussian graphical model. Global and local network metrics were compared within and between the networks over time.

Results

Global network metrics did not differ between the remitters and non-remitters at baseline or 6 months. However, the network structure and nodal strengths associated with positive-self and positive-others scores changed significantly in the remitters over time. Unique central symptoms for remitters and non-remitters were cognitive brooding and negative-self, respectively. The correlation stability coefficients for nodal strength were within the acceptable range.

Conclusion

Our findings indicate that network structure and some nodal strengths were more flexible in remitters. Negative-self could be an important target for therapeutic intervention.

Keywords

First-episode psychosisnetwork analysispredictionremission
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 14 , October 2022 , pp. 3193 - 3201
Check for updates
Copyright
Copyright © The Author(s) 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, D., Addington, J., & Schissel, B. (1990). A depression rating scale for schizophrenics. Schizophrenia Research, 3, 247–251.CrossRefGoogle ScholarPubMed
Alvarez-Jimenez, M., Gleeson, J., Henry, L., Harrigan, S., Harris, M., Amminger, G., … Jackson, H. (2011). Prediction of a single psychotic episode: A 7.5-year, prospective study in first-episode psychosis. Schizophrenia Research, 125, 236–246.CrossRefGoogle ScholarPubMed
Andreasen, N. C., Carpenter, W. T. Jr, Kane, J. M., Lasser, R. A., Marder, S. R., & Weinberger, D. R. (2005). Remission in schizophrenia: Proposed criteria and rationale for consensus. American Journal of Psychiatry 162, 441–449.CrossRefGoogle ScholarPubMed
Barrat, A., Barthelemy, M., Pastor-Satorras, R., & Vespignani, A. (2004). The architecture of complex weighted networks. Proceedings of the National Academy of Sciences, 101, 3747–3752.CrossRefGoogle ScholarPubMed
Boccaletti, S., Latora, V., Moreno, Y., Chavez, M., & Hwang, D.-U. (2006). Complex networks: Structure and dynamics. Physics Reports, 424, 175–308.CrossRefGoogle Scholar
Bos, E. H., & De Jonge, P. (2014). “Critical slowing down in depression” is a great idea that still needs empirical proof. Proceedings of the National Academy of Sciences of the USA, 111, E878.CrossRefGoogle ScholarPubMed
Bringmann, L. F., Elmer, T., Epskamp, S., Krause, R. W., Schoch, D., Wichers, M., … Snippe, E. What do centrality measures measure in psychological networks?. Journal of Abnormal Psychology, 128(8), 892–903. doi: 10.1037/abn0000446.CrossRefGoogle Scholar
Christensen, A. P. (2018). Networktoolbox: Methods and measures for brain, cognitive, and psychometric network analysis in R. The R Journal, 10, 422.CrossRefGoogle Scholar
Cui, Y., Kim, S.-W., Lee, B. J., Kim, J. J., Yu, J.-C., Lee, K. Y., … Kang, S. H. (2019). Negative schema and rumination as mediators of the relationship between childhood trauma and recent suicidal ideation in patients with early psychosis. The Journal of Clinical Psychiatry, 80, 17m12088.CrossRefGoogle ScholarPubMed
Emsley, R., Rabinowitz, J., Medori, R., & Group, E. P. G. W. (2007). Remission in early psychosis: Rates, predictors, and clinical and functional outcome correlates. Schizophrenia Research, 89, 129–139.CrossRefGoogle ScholarPubMed
Epskamp, S., Borsboom, D., & Fried, E. I. (2018). Estimating psychological networks and their accuracy: A tutorial paper. Behavior Research Methods, 50, 195–212.CrossRefGoogle ScholarPubMed
Epskamp, S., Costantini, G., Haslbeck, J., Cramer, A., Waldorp, L., Schmittmann, V., & Borsboom, D. (2019). Qgraph: Graph plotting methods, psychometric data visualization and graphical model estimation (Version 1.6. 1).Google Scholar
Esfahlani, F. Z., Sayama, H., Visser, K. F., & Strauss, G. P. (2017). Sensitivity of the positive and negative syndrome scale (PANSS) in detecting treatment effects via network analysis. Innovations in Clinical Neuroscience, 14, 59.Google ScholarPubMed
Esfahlani, F. Z., Visser, K., Strauss, G. P., & Sayama, H. (2018). A network-based classification framework for predicting treatment response of schizophrenia patients. Expert Systems with Applications, 109, 152–161.CrossRefGoogle Scholar
Fowler, D., Freeman, D., Smith, B., Kuipers, E., Bebbington, P., Bashforth, H., … Dunn, G. (2006). The Brief Core Schema Scales (BCSS): Psychometric properties and associations with paranoia and grandiosity in non-clinical and psychosis samples. Psychological Medicine, 36, 749–759.CrossRefGoogle ScholarPubMed
Fowler, D., Hodgekins, J., Garety, P., Freeman, D., Kuipers, E., Dunn, G., … Bebbington, P. E. (2012). Negative cognition, depressed mood, and paranoia: A longitudinal pathway analysis using structural equation modeling. Schizophrenia Bulletin, 38, 1063–1073.CrossRefGoogle ScholarPubMed
Friedman, J., Hastie, T., & Tibshirani, R. (2008). Sparse inverse covariance estimation with the graphical lasso. Biostatistics (Oxford, England), 9, 432–441.CrossRefGoogle ScholarPubMed
Friis, S., Melle, I., Johannessen, J. O., Røssberg, J. I., Barder, H. E., Evensen, J. H., … Langeveld, J. (2016). Early predictors of ten-year course in first-episode psychosis. Psychiatric Services, 67, 438–443.CrossRefGoogle ScholarPubMed
Fruchterman, T. M., & Reingold, E. M. (1991). Graph drawing by force-directed placement. Software: Practice and Experience, 21, 1129–1164.Google Scholar
Glück, T. M., Knefel, M., & Lueger-Schuster, B. (2017). A network analysis of anger, shame, proposed ICD-11 post-traumatic stress disorder, and different types of childhood trauma in foster care settings in a sample of adult survivors. European Journal of Psychotraumatology, 8, 1372543.CrossRefGoogle Scholar
Hartley, S., Haddock, G., e Sa, D. V., Emsley, R., & Barrowclough, C. (2014). An experience sampling study of worry and rumination in psychosis. Psychological Medicine, 44, 1605.CrossRefGoogle ScholarPubMed
Heeren, A., & McNally, R. J. (2016). An integrative network approach to social anxiety disorder: The complex dynamic interplay among attentional bias for threat, attentional control, and symptoms. Journal of Anxiety Disorders, 42, 95–104.CrossRefGoogle ScholarPubMed
Honaker, J., King, G., & Blackwell, M. (2011). Amelia II: A program for missing data. Journal of Statistical Software, 45, 1–47.CrossRefGoogle Scholar
Isvoranu, A.-M., Borsboom, D., van Os, J., & Guloksuz, S. (2016a). A network approach to environmental impact in psychotic disorder: Brief theoretical framework. Schizophrenia Bulletin, 42, 870–873.CrossRefGoogle ScholarPubMed
Isvoranu, A.-M., van Borkulo, C. D., Boyette, L.-L., Wigman, J. T., Vinkers, C. H., Borsboom, D., & Investigators, G. (2016b). A network approach to psychosis: Pathways between childhood trauma and psychotic symptoms. Schizophrenia Bulletin, 43, 187–196.CrossRefGoogle ScholarPubMed
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261–276.CrossRefGoogle ScholarPubMed
Kilcommons, A., & Morrison, A. (2005). Relationships between trauma and psychosis: An exploration of cognitive and dissociative factors. Acta Psychiatrica Scandinavica, 112, 351–359.CrossRefGoogle ScholarPubMed
Kim, S.-W., Lee, B. J., Kim, J. J., Yu, J.-C., Lee, K. Y., Won, S.-H., … Chung, Y.-C. (2017). Design and methodology of the Korean early psychosis cohort study. Psychiatry Investigation, 14, 93.CrossRefGoogle ScholarPubMed
Kim, J.-H., Piao, Y., Kim, W.-S., Park, J.-J., Kang, N.-I., Lee, K.-H., & Chung, Y.-C. (2019). The development of the Brooding Scale. Psychiatry Investigation, 16, 443.CrossRefGoogle ScholarPubMed
Kim, Y.-K., Won, S.-D., Lee, K.-M., Choi, H.-S., Jang, H.-S., Lee, B.-H., & Han, C.-S. (2005). A study on the reliability and validity of the Korean version of the Calgary Depression Scale for Schizophrenia (K-CDSS). Journal of Korean Neuropsychiatric Association, 44, 446–455.Google Scholar
Lauritzen, S. L., & Wermuth, N. (1989). Graphical models for associations between variables, some of which are qualitative and some quantitative. The Annals of Statistics, 17, 31–57.Google Scholar
Levine, S. Z., & Leucht, S. (2016). Identifying a system of predominant negative symptoms: Network analysis of three randomized clinical trials. Schizophrenia Research, 178, 17–22.CrossRefGoogle ScholarPubMed
Liu, H., Lafferty, J., & Wasserman, L. (2009). The nonparanormal: Semiparametric estimation of high dimensional undirected graphs. Journal of Machine Learning Research, 10, 2295–2328.Google Scholar
Murphy, J., McBride, O., Fried, E., & Shevlin, M. (2018). Distress, impairment and the extended psychosis phenotype: A network analysis of psychotic experiences in a US general population sample. Schizophrenia Bulletin, 44, 768–777.CrossRefGoogle Scholar
Newman, M. E., & Girvan, M. (2004). Finding and evaluating community structure in networks. Physical Review E, 69, 026113.CrossRefGoogle ScholarPubMed
Opsahl, T., Agneessens, F., & Skvoretz, J. (2010). Node centrality in weighted networks: Generalizing degree and shortest paths. Social Networks, 32, 245–251.CrossRefGoogle Scholar
Terluin, B., de Boer, M. R., & de Vet, H. C. (2016). Differences in connection strength between mental symptoms might be explained by differences in variance: Reanalysis of network data did not confirm staging. PLoS ONE, 11, e0155205.CrossRefGoogle Scholar
Thomas, N., Ribaux, D., & Phillips, L. J. (2014). Rumination, depressive symptoms and awareness of illness in schizophrenia. Behavioural and Cognitive Psychotherapy, 42, 143.CrossRefGoogle ScholarPubMed
Van Borkulo, C. D., Borsboom, D., Epskamp, S., Blanken, T. F., Boschloo, L., Schoevers, R. A., & Waldorp, L. J. (2014). A new method for constructing networks from binary data. Scientific reports, 4, 1–10.Google ScholarPubMed
van Borkulo, C., Boschloo, L., Borsboom, D., Penninx, B. W., Waldorp, L. J., & Schoevers, R. A. (2015). Association of symptom network structure with the course of depression. JAMA Psychiatry, 72, 1219–1226.CrossRefGoogle Scholar
Van Borkulo, C. D., Boschloo, L., Kossakowski, J., Tio, P., Schoevers, R. A., Borsboom, D., … Waldorp, L. J. (2017). Comparing network structures on three aspects: A permutation test. Manuscript Submitted for Publication, 10. doi:10.13140/RG.2.2.29455.38569.Google Scholar
van Borkulo, C., Epskamp, S., & Milner, A. (2016). Package network comparison test. (https://cran.r-project.org).Google Scholar
van Rooijen, G., Isvoranu, A.-M., Kruijt, O. H., van Borkulo, C. D., Meijer, C. J., Wigman, J. T., … Cahn, W. (2018). A state-independent network of depressive, negative and positive symptoms in male patients with schizophrenia spectrum disorders. Schizophrenia Research, 193, 232–239.CrossRefGoogle ScholarPubMed
van Rooijen, R., Ploeger, A., & Kret, M. E. (2017). The dot-probe task to measure emotional attention: A suitable measure in comparative studies? Psychonomic Bulletin & Review, 24, 1686–1717.CrossRefGoogle ScholarPubMed
Wigman, J. T., de Vos, S., Wichers, M., van Os, J., & Bartels-Velthuis, A. A. (2017). A transdiagnostic network approach to psychosis. Schizophrenia Bulletin, 43, 122–132.CrossRefGoogle ScholarPubMed
Wright, A. G., & Simms, L. J. (2016). Stability and fluctuation of personality disorder features in daily life. Journal of Abnormal Psychology, 125, 641.CrossRefGoogle ScholarPubMed
Yanos, P. T., Roe, D., Markus, K., & Lysaker, P. H. (2008). Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders. Psychiatric Services, 59, 1437–1442.CrossRefGoogle ScholarPubMed
Yi, J. S., Ahn, Y. M., Shin, H. K., An, S. K., Joo, Y. H., Kim, S. H., … Lee, J. Y. (2001). Reliability and validity of the Korean version of the Positive and Negative Syndrome Scale. Journal of Korean Neuropsychiatric Association, 40, 1090–1105.Google Scholar
Zhang, X.-F., Ou-Yang, L., & Yan, H. (2017). Incorporating prior information into differential network analysis using non-paranormal graphical models. Bioinformatics (Oxford, England), 33, 2436–2445.CrossRefGoogle ScholarPubMed
Supplementary material: File

Piao et al. supplementary material

Piao et al. supplementary material

Download Piao et al. supplementary material(File)
File 1.1 MB