Schizophrenia is amongst the most expensive disorders in terms of quality of life and societal cost. While early intervention is known to be associated with improved outcome there is little information on predictors of patient outcome following antipsychotic drug treatment. Based on current treatments more than 30% of schizophrenia subjects are resistant to antipsychotic treatment. We seek to identify, for the first time, discriminative plasma protein biomarkers of patient outcomes following standard first line antipsychotic treatment.
We and others have implicated the complement pathway and other plasma proteins in psychosis. The complement pathway generally is upregulated in individuals; at age 11, before these individuals develop psychotic disorder at age 18 [English et al, 2018]. in subjects at Ultra High Risk (UHR) for psychosis who go on to transition to psychotic disorder in the European Union Gene Environment Interaction (EUGEI) Study (see our preliminary data).
And we now have preliminary data indicating that the complement pathway maybe upregulated in the first episode of psychosis (FEP) in subjects who have a poor outcome following antipsychotic treatment (see our preliminary data).
Based on these findings, including this directly relevant preliminary data, we hypothesise that upregulation of the complement pathway is associated with poor outcome following antipsychotic drug treatment. We will test this hypothesis. We will also test other implicated pathways and proteins
Our proposed study: In FEP baseline plasma samples we will examine the relationship between levels of these complement plasma proteins (and other identified protein) and clinical outcome and function. We will undertake this study in a). the OPTIMISE FEP sample and b). we will validate using the PSYScan FEP sample (EC Framework 7). This data will be integrated with other neuroimaging and genomic data to provide the most predictive model of outcome following antipsychotic drug treatment in FEP.
