Targeted treatment for depression could benefit patients with psychosis


Date:
August 17, 2020
Source:
University of Birmingham
Summary:
Patients with early onset psychosis may benefit from treatment
for depression, including with anti-depressants alongside other
medication, new research shows.



FULL STORY ========================================================================== Patients with early onset psychosis may benefit from treatment for
depression, including with anti-depressants alongside other medication,
new research shows.


========================================================================== According to scientists at the University of Birmingham's Institute
for Mental Health, depression may be an intrinsic part of early phase
psychotic disorders that should be treated together with other more
prominent symptoms to improve patient outcomes.

Depression is often identified alongside psychotic disorders such as schizophrenia in the early stages of the disorder, but is not currently routinely treated. In a new study, published in Schizophrenia Bulletin,
the researchers set out to find out more about the associations between depression and psychosis, and particularly whether there were similarities
in brain structure that could help future diagnostic pathways at an
early stage.

Data was gathered from 1700 patients as part of the PRONIA study, a
largescale European study which uses machine learning to find ways to
predict how people with recent onset psychosis might recover.

The team used demographic and clinical data along with detailed symptom measures and neuroimaging information from a structural MRI scan from participants with recent onset psychosis and recent onset depression. They interrogated the data using machine learning software to try to find out whether it was possible to identify a subgroup of patients with distinct symptoms of both depression and psychosis.

Their results showed that, in fact, there was little difference in either
the patients' depressive symptoms or in the structural brain changes in patients with depression, with and without psychosis. This shows that
there is no subgroup of patients with both depression and psychosis,
but rather that depression may be an intrinsic part of a majority of
patients' psychosis.

The team argue their findings show that treatments focused on depression
may well be an effective additional first-line treatment for psychosis,
to be given alongside regular interventions.

Professsor Rachel Upthegrove, of the University of Birmingham's Institute
for Mental Health, led the study. She says: "Our results suggest that depression is absolutely inherent in early phases of schizophrenia and so
may one of the most important factors that we can target with treatments.

"We know that depression in patients with schizophrenia frequently
leads to poorer outcomes, and so understanding how treatment such as antidepressant might be used to improve these outcomes could be a big
step forward." Paris Lalousis, a Priestly PhD Fellow at the University of Birmingham and the University of Melbourne, contributed to the study. He
says: "Machine learning is a tool that has the potential to help solve
the diagnostic and treatment conundrums that the complexity of mental
health disorders present, and analyses using multimodal data are needed
to advance the field. Our results show that using a principled approach
and both psychopathological and biological factors can shed light
into the experiences of patients with depression in early psychosis."
The team has already embarked on a clinical trial to test the approach
in patients. The ADEPP trial will test people in the first stages of
psychosis who take anti-depressants alongside anti-psychotic drugs. The
trial will assess over a six month period whether the anti-depressants
have an effect on the patients' ability to recover from their psychosis.


========================================================================== Story Source: Materials provided by University_of_Birmingham. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Nikolaos Koutsouleris, Stephen J Wood, Eva Meisenzahl, Raimo K R
Salokangas, Frauke Schultze-Lutter, Stephan Ruhrmann, Christos
Pantelis, Rebekka Lencer, Joseph Kambeitz, Stefan Borgwardt,
Paolo Brambilla, Alessandro Bertolino, Lana Kambeitz-llankovic,
Nora Penzel, Theresa Haidl, Marian Surman, Dominic B Dwyer,
Anne Ruef, Marlene Rosen, Alexandra Stainton, Renate Reniers,
Mirabel Pelton, Mariam Iqbal, Sian Lowri Griffiths, Katharine
Chisholm, Pavan Mallikarjun, Paris Lalousis, Rachel Upthegrove. The
Psychopathology and Neuroanatomical Markers of Depression in Early
Psychosis. Schizophrenia Bulletin, 2020; DOI: 10.1093/schbul/sbaa094 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200817123038.htm

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