Speech Illusions in People at Clinical High Risk for Psychosis Linked to Clinical Outcome

Author:

Hird Emily J1ORCID,Ohmuro Noriyuki123,Allen Paul14,Moseley Peter5ORCID,Kempton Matthew J1,Modinos Gemma1ORCID,Sachs Gabriele6ORCID,van der Gaag Mark789,de Haan Lieuwe1011,Gadelha Ary12,Bressan Rodrigo12,Barrantes-Vidal Neus13ORCID,Ruhrmann Stephan14,Catalan Ana115ORCID,McGuire Philip16,Valmaggia Lucia R17,Kempton Matthew J16,Calem Maria16,Tognin Stefania16,Modinos Gemma16,de Haan Lieuwe1011,van der Gaag Mark189,Velthorst Eva1019,Kraan Tamar C10,van Dam Daniella S10,Burger Nadine9,Nelson Barnaby20,McGorry Patrick20,Paul Amminger Günter20,Pantelis Christos20,Politis Athena20,Goodall Joanne20,Riecher-Rössler Anita21,Borgwardt Stefan21,Rapp Charlotte21,Ittig Sarah21,Studerus Erich21,Smieskova Renata21,Bressan Rodrigo12,Gadelha Ary12,Brietzke Elisa22,Asevedo Graccielle12,Asevedo Elson12,Zugman Andre12,Barrantes-Vidal Neus13,Domínguez-Martínez Tecelli23,Torrecilla Pilar24,Kwapil Thomas R25,Monsonet Manel24,Hinojosa Lídia24,Kazes Mathilde26,Daban Claire26,Bourgin Julie26,Gay Olivier26,Mam-Lam-Fook Célia26,Krebs Marie-Odile26,Nordholm Dorte27,Randers Lasse27,Krakauer Kristine27,Glenthøj Louise27,Glenthøj Birte28,Nordentoft Merete27,Ruhrmann Stephan14,Gebhard Dominika14,Arnhold Julia29,Klosterkötter Joachim14,Sachs Gabriele6,Lasser Iris6,Winklbaur Bernadette6,Delespaul Philippe A3031,Rutten Bart P30,van Os1 Jim30,McGuire Philip1,

Affiliation:

1. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London , London , UK

2. Department of Psychiatry, Tohoku University Hospital , Sendai, Miyagi , Japan

3. Department of Psychiatry, Osaki Citizen Hospital , Osaki , Japan

4. School of Psychology, Whitelands College, University of Roehampton , Holybourne Ave, London, SW15 4JD , UK

5. Psychology Department, Northumbria University , College Lane, Newcastle-Upon-Tyne, NE1 8ST , UK

6. Department of Psychiatry and Psychotherapy, Medical University of Vienna , Vienna , Austria

7. Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology, VU University , van der Boechorststraat 1, 1081 BT Amsterdam , The Netherlands

8. EMGO Institute for Health and Care Research, VU University , van der Boechorststraat 1, 1081 BT Amsterdam , The Netherlands

9. Department of Psychosis Research, Parnassia Psychiatric Institute , Zoutkeetsingel 40, 2512 HN The Hague , The Netherlands

10. Department Early Psychosis, AMC, Academic Psychiatric Centre , Meibergdreef 5, 1105 AZ Amsterdam , The Netherlands

11. Arkin , Amsterdam , The Netherlands

12. LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP , São Paulo , Brazil

13. Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM) , Barcelona , Spain

14. Department of Psychiatry and Psychotherapy, University of Cologne , Cologne , Germany

15. Psychiatry Department, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Centro de Investigación en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III , Plaza de Cruces 12, 48903 Barakaldo, Bizkaia , Spain

16. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , De Crespigny Park, Denmark 458 Hill, London, SE5 8AF , UK

17. Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , De Crespigny Park, Denmark Hill, 456, London, SE5 8AF , UK

18. Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology and EMGO Institute for Health and Care Research , VU University, van der Boechorststraat 1, 1081 BT Amsterdam , The Netherlands

19. Department of Psychiatry, Icahn School of Medicine at Mount Sinai , 1425 Madison Ave, New York, NY 10029 , USA

20. Centre for Youth Mental Health, University of Melbourne , 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052 , Australia

21. University Psychiatric Hospital , Wilhelm Klein-Strasse 27, CH-4002 Basel , Switzerland

22. Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP , São Paulo , Brazil

23. CONACYT-Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (México) , Mexico City , Mexico

24. Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona) , Barcelona , Spain

25. Department of Psychology, University of Illinois at Urbana-Champaign , IL , USA

26. University Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service HospitaloUniversitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris , France

27. Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen , Copenhagen , Denmark

28. Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen , Glostrup , Denmark

29. Psyberlin , Berlin , Germany

30. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre , PO Box 616, 6200 MD 464 Maastricht , The Netherlands

31. Mondriaan Mental Health Trust , PO Box 4436 CX Heerlen , The Netherlands

Abstract

Abstract Background and hypothesis Around 20% of people at clinical high risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions [SIs]) in noise in CHR participants and examined whether this was associated with adverse clinical outcomes. Study design At baseline, 344 CHR participants and 67 healthy controls were presented with a computerized white noise task and asked whether they heard speech, and whether speech was neutral, affective, or whether they were uncertain about its valence. After 2 years, we assessed whether participants transitioned to psychosis, or remitted from the CHR state, and their functioning. Study results CHR participants had a lower sensitivity to the task. Logistic regression revealed that a bias towards hearing targets in stimuli was associated with remission status (OR = 0.21, P = 042). Conversely, hearing SIs with uncertain valence at baseline was associated with reduced likelihood of remission (OR = 7.72. P = .007). When we assessed only participants who did not take antipsychotic medication at baseline, the association between hearing SIs with uncertain valence at baseline and remission likelihood remained (OR = 7.61, P = .043) and this variable was additionally associated with a greater likelihood of transition to psychosis (OR = 5.34, P = .029). Conclusions In CHR individuals, a tendency to hear speech in noise, and uncertainty about the affective valence of this speech, is associated with adverse outcomes. This task could be used in a battery of cognitive markers to stratify CHR participants according to subsequent outcomes.

Funder

European Network of National Schizophrenia Networks Studying Gene Environment Interactions

European Community’s Seventh Framework Programme

Medical Research Council Fellowship

Innovación e Universidades to N Barrantes-Vidal

Publisher

Oxford University Press (OUP)

Subject

Psychiatry and Mental health

Reference53 articles.

1. Clinical outcomes in individuals at clinical high risk of psychosis who do not transition to psychosis: a meta-analysis;de Pablo;Epidemiol Psychiatr Sci.,2022

2. Prediction of functional outcome in individuals at clinical high risk for psychosis;Carrión;JAMA Psychiatry.,2013

3. Brain development in adolescents at ultra-high risk for psychosis: longitudinal changes related to resilience.;de Wit;Neuroimage Clin.,2016

4. Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states;Yung;Aust N Z J Psychiatry.,2005

5. Onset and early course as determinants of the further course of schizophrenia;Häfner;Acta Psychiatr Scand Suppl.,2000

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