Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis

Background First-episode psychosis is a critical period for early interventions to reduce the risk of poor outcomes and relapse as much as possible. However, uncertainties about the long-term outcomes of symptomatology remain to be ascertained. Methods The aim of the present study was to use network...

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Autores: Gil Berrozpe, Gustavo José, Peralta Martín, Víctor, Sánchez Torres, Ana María, Moreno-Izco, Lucía, García de Jalón, Elena, Peralta, David, Janda-Galán, Lucía, Cuesta, Manuel J., SEGPEPs Group
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2023
País:España
Institución:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/53762
Acceso en línea:https://hdl.handle.net/2454/53762
Access Level:acceso abierto
Palabra clave:First-episode psychosis
Long-term
Follow-up
Psychopathology
Network analysis
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spelling Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosisGil Berrozpe, Gustavo JoséPeralta Martín, VíctorSánchez Torres, Ana MaríaMoreno-Izco, LucíaGarcía de Jalón, ElenaPeralta, DavidJanda-Galán, LucíaCuesta, Manuel J.SEGPEPs GroupFirst-episode psychosisLong-termFollow-upPsychopathologyNetwork analysisBackground First-episode psychosis is a critical period for early interventions to reduce the risk of poor outcomes and relapse as much as possible. However, uncertainties about the long-term outcomes of symptomatology remain to be ascertained. Methods The aim of the present study was to use network analysis to investigate first-episode and long-term stages of psychosis at three levels of analysis: micro, meso and macro. The sample was a cohort of 510 patients with first-episode psychoses from the SEGPEP study, who were reassessed at the long-term follow-up (n = 243). We used the Comprehensive Assessment of Symptoms and History for their assessments and lifetime outcome variables of clinical relevance. Results Our results showed a similar pattern of clustering between first episodes and long-term follow-up in seven psychopathological dimensions at the micro level, 3 and 4 dimensions at the meso level, and one at the macro level. They also revealed significant differences between first-episode and long-term network structure and centrality measures at the three levels, showing that disorganization symptoms have more influence in long-term stabilized patients. Conclusions Our findings suggest a relative clustering invariance at all levels, with the presence of two domains of disorganization as the most notorious difference over time at micro level. The severity of disorganization at the follow-up was associated with a more severe course of the psychosis. Moreover, a relative stability in global strength of the interconnections was found, even though the network structure varied significantly in the long-term follow-up. The macro level was helpful in the integration of all dimensions into a common psychopathology factor, and in unveiling the strong relationships of psychopathological dimensions with lifetime outcomes, such as negative with poor functioning, disorganization with high antipsychotic dose-years, and delusions with poor adherence to treatment. These results add evidence to the hierarchical, dimensional and longitudinal structure of psychopathological symptoms and their clinical relevance in first-episode psychoses.This work was supported by the Government of Navarra (grant 17/31 and 18/41) and the Carlos III Health Institute (FEDER Funds) from the Spanish Ministry of Economy and Competitiveness (16/02148 and 19/1698).ElsevierCiencias de la SaludOsasun ZientziakGobierno de Navarra / Nafarroako Gobernua2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2454/53762reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarrainstname:Universidad Pública de NavarraInglés© 2023 Elsevier B.V. This manuscript version is made available under the CC-BY-NC-ND 4.0.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:academica-e.unavarra.es:2454/537622026-06-17T12:41:47Z
dc.title.none.fl_str_mv Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis
title Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis
spellingShingle Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis
Gil Berrozpe, Gustavo José
First-episode psychosis
Long-term
Follow-up
Psychopathology
Network analysis
title_short Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis
title_full Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis
title_fullStr Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis
title_full_unstemmed Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis
title_sort Psychopathological networks in psychosis: changes over time and clinical relevance. A long-term cohort study of first-episode psychosis
dc.creator.none.fl_str_mv Gil Berrozpe, Gustavo José
Peralta Martín, Víctor
Sánchez Torres, Ana María
Moreno-Izco, Lucía
García de Jalón, Elena
Peralta, David
Janda-Galán, Lucía
Cuesta, Manuel J.
SEGPEPs Group
author Gil Berrozpe, Gustavo José
author_facet Gil Berrozpe, Gustavo José
Peralta Martín, Víctor
Sánchez Torres, Ana María
Moreno-Izco, Lucía
García de Jalón, Elena
Peralta, David
Janda-Galán, Lucía
Cuesta, Manuel J.
SEGPEPs Group
author_role author
author2 Peralta Martín, Víctor
Sánchez Torres, Ana María
Moreno-Izco, Lucía
García de Jalón, Elena
Peralta, David
Janda-Galán, Lucía
Cuesta, Manuel J.
SEGPEPs Group
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Ciencias de la Salud
Osasun Zientziak
Gobierno de Navarra / Nafarroako Gobernua
dc.subject.none.fl_str_mv First-episode psychosis
Long-term
Follow-up
Psychopathology
Network analysis
topic First-episode psychosis
Long-term
Follow-up
Psychopathology
Network analysis
description Background First-episode psychosis is a critical period for early interventions to reduce the risk of poor outcomes and relapse as much as possible. However, uncertainties about the long-term outcomes of symptomatology remain to be ascertained. Methods The aim of the present study was to use network analysis to investigate first-episode and long-term stages of psychosis at three levels of analysis: micro, meso and macro. The sample was a cohort of 510 patients with first-episode psychoses from the SEGPEP study, who were reassessed at the long-term follow-up (n = 243). We used the Comprehensive Assessment of Symptoms and History for their assessments and lifetime outcome variables of clinical relevance. Results Our results showed a similar pattern of clustering between first episodes and long-term follow-up in seven psychopathological dimensions at the micro level, 3 and 4 dimensions at the meso level, and one at the macro level. They also revealed significant differences between first-episode and long-term network structure and centrality measures at the three levels, showing that disorganization symptoms have more influence in long-term stabilized patients. Conclusions Our findings suggest a relative clustering invariance at all levels, with the presence of two domains of disorganization as the most notorious difference over time at micro level. The severity of disorganization at the follow-up was associated with a more severe course of the psychosis. Moreover, a relative stability in global strength of the interconnections was found, even though the network structure varied significantly in the long-term follow-up. The macro level was helpful in the integration of all dimensions into a common psychopathology factor, and in unveiling the strong relationships of psychopathological dimensions with lifetime outcomes, such as negative with poor functioning, disorganization with high antipsychotic dose-years, and delusions with poor adherence to treatment. These results add evidence to the hierarchical, dimensional and longitudinal structure of psychopathological symptoms and their clinical relevance in first-episode psychoses.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2454/53762
url https://hdl.handle.net/2454/53762
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv © 2023 Elsevier B.V. This manuscript version is made available under the CC-BY-NC-ND 4.0.
https://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv © 2023 Elsevier B.V. This manuscript version is made available under the CC-BY-NC-ND 4.0.
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
instname:Universidad Pública de Navarra
instname_str Universidad Pública de Navarra
reponame_str Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
collection Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
repository.name.fl_str_mv
repository.mail.fl_str_mv
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