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Detailed clinical phenotyping and generalisability in prognostic models of functioning in at-risk populations

Published online by Cambridge University Press:  06 October 2021

Marlene Rosen
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Linda T. Betz
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Natalie Kaiser
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Nora Penzel
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany; and Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
Dominic Dwyer
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
Theresa K. Lichtenstein
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Frauke Schultze-Lutter
Affiliation:
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; and University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
Lana Kambeitz-Ilankovic
Affiliation:
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; and University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
Alessandro Bertolino
Affiliation:
Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
Stefan Borgwardt
Affiliation:
Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
Paolo Brambilla
Affiliation:
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy; and Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
Rebekka Lencer
Affiliation:
Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany; and Department of Psychiatry, University of Münster, Münster, Germany
Eva Meisenzahl
Affiliation:
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
Christos Pantelis
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, Australia
Raimo K. R. Salokangas
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland
Rachel Upthegrove
Affiliation:
Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK; and Early Intervention Service, Birmingham Womens and Childrens NHS trust, Birmingham, UK
Stephen Wood
Affiliation:
School of Psychology, University of Birmingham, UK; and Orygen, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
Stephan Ruhrmann
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Nikolaos Koutsouleris
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; and Max-Planck Institute of Psychiatry, Munich, Germany; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Joseph Kambeitz*
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
*
Correspondence: Joseph Kambeitz. Email: joseph.kambeitz@uk-koeln.de

Summary

Personalised prediction of functional outcomes is a promising approach for targeted early intervention in psychiatry. However, generalisability and resource efficiency of such prognostic models represent challenges. In the PRONIA study (German Clinical Trials Register: DRKS00005042), we demonstrate excellent generalisability of prognostic models in individuals at clinical high-risk for psychosis or with recent-onset depression, and substantial contributions of detailed clinical phenotyping, particularly to the prediction of role functioning. These results indicate that it is possible that functioning prediction models based only on clinical data could be effectively applied in diverse healthcare settings, so that neuroimaging data may not be needed at early assessment stages.

Type
Short report
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

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References

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