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Towards a Psychosis Risk Blood Diagnostic for Persons Experiencing High-Risk Symptoms: Preliminary Results From the NAPLS Project
Open accessAbstract
INTRODUCTION: A barrier to preventative treatments for psychosis is the absence of accurate identification of persons at highest risk. A blood test that could substantially increase diagnostic accuracy would enhance development of psychosis prevention interventions. METHODS: The North American Prodrome Longitudinal Study project is a multisite endeavor that aims to better understand predictors and mechanisms for the development of psychosis. In this study, we measured expression of plasma analytes reflecting inflammation, oxidative stress, hormones, and metabolism. A "greedy algorithm" selected analytes that best distinguished persons with clinical high-risk symptoms who developed psychosis (CHR-P; n = 32) from unaffected comparison (UC) subjects (n = 35) and from those who did not develop psychosis during a 2-year follow-up (CHR-NP; n = 40). RESULTS: The classifier included 15 analytes (selected from 117), with an area under the receiver operating curve for CHR-P vs UC of 0.91 and CHR-P vs CHR-NP of 0.88. Randomly scrambled group membership followed by reconstructions of the entire classifier method yielded consistently weak classifiers, indicating that the true classifier is highly unlikely to be a chance occurrence. Such randomization methods robustly imply the assays contain consistent information distinguishing the groups which was not obscured by the data normalization method and was revealed by classifier construction. These results support the hypothesis that inflammation, oxidative stress, and dysregulation of hypothalamic-pituitary axes may be prominent in the earliest stages of psychosis. CONCLUSION: If confirmed in other groups of persons at elevated risk of psychosis, a multiplex blood assay has the potential for high clinical utility.
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“In addition, biochemical 140,141 , imaging 52,142,143 , and electrophysiological measurements 144 may help segregating patients into higher- and lower-risk groups.”
From Developmental timing and critical windows for the treatment of psychiatric disorders (2016) · cites this paper as [141]
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“These markers are not included in the 15 of the 117 studied biomarkers that formed a classifi er distinguishing people with high clinical risk of schizophrenia who developed psychosis from those who did not [10].”
BackgroundCadenhead, K. S., & Mirzakhanian, H. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15060789 · Cited by 6
“A number of promising biomarkers have been identified that predict risk for psychosis in youths at clinical high risk and provide insight into early neuropathological mechanisms (Figure 3), including elevated levels of salivary cortisol (6), elevated markers of inflammation and oxidative stress (7), accelerated loss o…”
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Han, Y. L., Sulaiman, W. S. W., Badayai, A. R. A., & Nor, H. A. M. (2023) · Frontiers in Child and Adolescent Psychiatry · doi:10.3389/frcha.2023.1221933 · Cited by 6
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“Evidence exists for multiple biomarker abnor malities in CHR. 2 , 4 , 5 , 15 – 17 CHR youth show deficits in neurocognition, 15 regional cortical gray matter, 16 event related potentials (ERP), 5 , 17 as well as higher polygenic risk scores, 18 inflammatory markers 2 and cortisol, 4 relative to comparison subjects.”
Self-citationRethinking Immunity and Cognition in Clinical High Risk for Psychosis
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Karanikas, E. (2022) · Neuroscience Letters · doi:10.1016/j.neulet.2022.137011 · Cited by 5
Идентификация биомаркеров шизофрении с помощью методов масс-спектрометрии (обзор литературы)
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“Group differences in MMN amplitudes and associations with future clinical outcomes, 28 as well as characteristics of baseline salivary cortisol, 112 blood analytes, 94,118 and gray matter 60,61 in the NAPLS-2 sample have been described previously.”
Self-citationA greedy regression algorithm with coarse weights offers novel advantages
Jeffries, C. D., Ford, J. R., Tilson, J. L., Perkins, D. O., Bost, D. M., Filer, D. L., & Wilhelmsen, K. C. (2022) · Scientific Reports · doi:10.1038/s41598-022-09415-2 · Cited by 4
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Data analysis strategies for the Accelerating Medicines Partnership® Schizophrenia Program
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Interaction between peripheral and central immune markers in clinical high risk for psychosis
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“The study showed that the blood levels of several in-terleukins including IL-8 were positively correlated with the severity of positive symptoms (i.e., delusional ideas), poor attention, and dysphoric mood (characteristic of general symptom severity) (Perkins et al., 2015).”
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“The classification perfor mance of using this single behavioral task was also comparable as models using multiple biological parameters (AUC: 0.91) 68 and multiple eye-tracking tasks (Accuracy: 88%).”
InfluentialIs Sleep Health a Potential Pathway to Global Mental Health?
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“Little work has been done to examine dysregulation across the blood-based proteome (Karanikas et al., 2017; Kelsven et al., 2020, Perkins et al., 2015).”
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“Plasma was harvested, aliquoted and then frozen at – 80 ◦ C (Perkins et al., 2015).”
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The Gordian knot of the immune-redox systems’ interactions in psychosis
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Are social theories still relevant in current psychiatric practice?
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Neurodevelopmental Theories of Schizophrenia: Twenty‐First Century Perspectives
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“Further, recent studies employing measures of biological (e.g., MRI, blood assays; Koutsouleris et al., 2009; Perkins et al., 2014) and social/environmental factors (e.”
Proteomic Studies of Psychiatric Disorders
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Cortisol and cytokines in early psychosis, do they correlate? A scoping review
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Metadata
- Authors
- Perkins, D. O., Jeffries, C. D., Addington, J., Bearden, C. E., Cadenhead, K. S., Cannon, T. D., Cornblatt, B. A., Mathalon, D. H., McGlashan, T. H., Seidman, L. J., Tsuang, M. T., Walker, E. F., Woods, S. W., & Heinssen, R.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- University of Calgary (CA)
- University of California, Los Angeles (US)
- University of California San Diego (US)
- Yale University (US)
- Zucker Hillside Hospital (US)
- University of California, San Francisco (US)
- Beth Israel Deaconess Medical Center (US)
- Emory University (US)
- National Institute of Mental Health (US)
- Corresponding author
- Perkins, Diana O.
- Jeffries, Clark D.
- ORCID
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-08-06
- Volume
- 41
- Issue
- 2
- Pages
- 419-428
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC4332942
- OpenAlex
- W2144107861
- Cited by
- 238
- References
- 60
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 16 · 2023: 28 · 2022: 14 · 2021: 15 · 2020: 25 · 2019: 22 · 2018: 17 · 2017: 20 · 2016: 32 · 2015: 19 · 2014: 7
- FWCI
- 19.85
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Schizophrenia Bulletin (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- UNC Libraries
- Funders
- National Institute of Mental Health (U01MH081928, U01MH066160, U01MH082022, U01MH076989, U01MH081984, U01MH0818902, U01MH081857, U01MH082004, U01MH081944, P50MH066286, U01MH081988)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- psychosis risk, clinical high risk for psychosis
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Hypothalamo-Hypophyseal System, Inflammation, Male, Pituitary-Adrenal System, Psychotic Disorders, Oxidative Stress, Risk Assessment, Young Adult, Prodromal Symptoms
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