Schizophrenia is amongst the most expensive disorders in terms of quality of life and societal cost. Based on current treatments more than 30% of schizophrenia subjects are resistant to treatments including non-clozapine antipsychotic treatment. While earlier intervention is associated with better outcome in psychosis there is little evidence on which to predict individual patient response. This is an important gap in our knowledge because predictors of outcome would allow clinicians to use appropriate treatments sooner and reduce time spent unwell. Our own recent research has identified a set of blood proteins, belonging to the complement and coagulation pathways, to be altered in early psychosis. These proteins modulate inflammation in the body and regulate turn-over of synapses in the brain. We have found that these proteins are altered in the blood of young people;
at age 11 – before they develop psychotic experiences
who transition from being clinical high-risk (CHR) to having a psychotic disorder (PD)
who have a good outcome following their first episode of psychosis (FEP)
These findings are novel. Significant questions remain;
In the CHR;
How do peripheral complement protein markers change over time in young people at clinical high-risk of psychotic disorder?
Are these longitudinal patterns associated with important clinical outcomes (transition to psychotic disorder; severity of psychotic symptoms; and general functioning).
In the FEP;
Can we confirm baseline complement protein dysregulation among individuals with FEP who have good versus poor clinical outcomes in response to treatment?
Are these associations replicable in naturalistic studies reflective of ‘real-world’ clinical practice?
Our study
We will use well-established methods and blood samples from unique, large, internationally collected cohorts to study the complement protein changes in the context of early psychosis presentations from CHR, to FEP. We will use cross-sectional and longitudinal approaches and include validation samples