TY - JOUR
T1 - Prediction of Early Symptom Remission in Two Independent Samples of First-Episode Psychosis Patients Using Machine Learning
AU - Soldatos, Rigas F.
AU - Cearns, Micah
AU - Nielsen, Mette Ø.
AU - Kollias, Costas
AU - Xenaki, Lida Alkisti
AU - Stefanatou, Pentagiotissa
AU - Ralli, Irene
AU - Dimitrakopoulos, Stefanos
AU - Hatzimanolis, Alex
AU - Kosteletos, Ioannis
AU - Vlachos, Ilias I.
AU - Selakovic, Mirjana
AU - Foteli, Stefania
AU - Nianiakas, Nikolaos
AU - Mantonakis, Leonidas
AU - Triantafyllou, Theoni F.
AU - Ntigridaki, Aggeliki
AU - Ermiliou, Vanessa
AU - Voulgaraki, Marina
AU - Psarra, Evaggelia
AU - Sørensen, Mikkel E.
AU - Bojesen, Kirsten B.
AU - Tangmose, Karen
AU - Sigvard, Anne M.
AU - Ambrosen, Karen S.
AU - Meritt, Toni
AU - Syeda, Warda
AU - Glenthøj, Birte Y.
AU - Koutsouleris, Nikolaos
AU - Pantelis, Christos
AU - Ebdrup, Bjørn H.
AU - Stefanis, Nikos
N1 - Publisher Copyright:
© The Author(s) 2021. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.All rights reserved. For permissions, please email: [email protected].
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - first-episode/psychosis
KW - machine learning
KW - prediction
KW - psychopathology
KW - psychosis
KW - remission
KW - schizophrenia
U2 - 10.1093/schbul/sbab107
DO - 10.1093/schbul/sbab107
M3 - Journal article
C2 - 34535800
AN - SCOPUS:85120073214
VL - 48
SP - 122
EP - 133
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
SN - 0586-7614
IS - 1
ER -