PRE-PSYCH · The Prelude to Psychosis: Brain network analysis in emerging schizophrenia

The Prelude to Psychosis: Brain network analysis in emerging schizophrenia

Schizophrenia, in its most typical form, is characterized by recurrent episodes of psychosis interspersed with periods of (partial) remission. During a psychotic episode, people experience hallucinations, delusions, thought problems, and/or behavioral disturbances. The first episode of psychosis tends to manifest in adolescence or early adulthood and this is when schizophrenia is usually diagnosed. However, research has shown that changes in behavior and functioning precede the first psychotic episode. Early signs of impending psychosis include feelings of (mild) suspiciousness, social withdrawal, or a drop in school or job performance. These warning signs suggest that the underlying brain disturbance is already ongoing in the so-called prodromal phase, which is the period of imminent risk for psychosis. This project aimed to advance our understanding of what happens in the brain during this 'prelude to psychosis'. This project is important for society because mental illness is among the leading cause of disability for adolescents and young adults. Mental disorders give rise to a broad cost to society through reduced adult productivity and increased healthcare costs. By clarifying what happens in the brain as psychosis first develops, this project aims to contribute to the development of early detection and intervention strategies for serious mental illness. Intervening early in emerging psychotic illness is important on a personal level because it may mitigate the effects of the illness for youth who are vulnerable to psychosis and on a societal level by curbing rising mental healthcare costs. The conclusions of the action are that at-risk youth exhibit abnormalities in the brain's functional organization, and that abnormalities in the organization and connectivity of functional brain networks predict subsequent conversion to psychosis. Moreover, we were able to replicate our findings that brain network disturbances predate illness onset in an independent dataset of children with a familial risk for psychosis. In this dataset, functional brain network disturbances were associated with behavioral precursors of future psychopathology, including internalizing problems. These findings suggest that early interventions that target these networks may help avert the progression from early behavioral problems to mental illness in at-risk youth.

Data: CORDIS, © European Union