Prediction of Early Symptom Remission in Two Independent Samples of First-Episode Psychosis Patients Using Machine Learning

Research output: Contribution to journalJournal articleResearchpeer-review

  • Rigas F. Soldatos
  • Micah Cearns
  • Costas Kollias
  • Lida Alkisti Xenaki
  • Pentagiotissa Stefanatou
  • Irene Ralli
  • Stefanos Dimitrakopoulos
  • Alex Hatzimanolis
  • Ioannis Kosteletos
  • Ilias I. Vlachos
  • Mirjana Selakovic
  • Stefania Foteli
  • Nikolaos Nianiakas
  • Leonidas Mantonakis
  • Theoni F. Triantafyllou
  • Aggeliki Ntigridaki
  • Vanessa Ermiliou
  • Marina Voulgaraki
  • Evaggelia Psarra
  • Mikkel E. Sørensen
  • Kirsten B. Bojesen
  • Karen Tangmose
  • Anne M. Sigvard
  • Karen S. Ambrosen
  • Toni Meritt
  • Warda Syeda
  • Nikolaos Koutsouleris
  • Christos Pantelis
  • Nikos Stefanis

BACKGROUND: Validated clinical prediction models of short-term remission in psychosis are lacking. Our aim was to develop a clinical prediction model aimed at predicting 4-6-week remission following a first episode of psychosis. METHOD: Baseline clinical data from the Athens First Episode Research Study was used to develop a Support Vector Machine prediction model of 4-week symptom remission in first-episode psychosis patients using repeated nested cross-validation. This model was further tested to predict 6-week remission in a sample of two independent, consecutive Danish first-episode cohorts. RESULTS: Of the 179 participants in Athens, 120 were male with an average age of 25.8 years and average duration of untreated psychosis of 32.8 weeks. 62.9% were antipsychotic-naïve. Fifty-seven percent attained remission after 4 weeks. In the Danish cohort, 31% attained remission. Eleven clinical scale items were selected in the Athens 4-week remission cohort. These included the Duration of Untreated Psychosis, Personal and Social Performance Scale, Global Assessment of Functioning and eight items from the Positive and Negative Syndrome Scale. This model significantly predicted 4-week remission status (area under the receiver operator characteristic curve (ROC-AUC) = 71.45, P < .0001). It also predicted 6-week remission status in the Danish cohort (ROC-AUC = 67.74, P < .0001), demonstrating reliability. CONCLUSIONS: Using items from common and validated clinical scales, our model significantly predicted early remission in patients with first-episode psychosis. Although replicated in an independent cohort, forward testing between machine learning models and clinicians' assessment should be undertaken to evaluate the possible utility as a routine clinical tool.

Original languageEnglish
JournalSchizophrenia Bulletin
Volume48
Issue number1
Pages (from-to)122-133
Number of pages12
ISSN0586-7614
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© The Author(s) 2021. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.All rights reserved. For permissions, please email: journals.permissions@oup.com.

    Research areas

  • first-episode/psychosis, machine learning, prediction, psychopathology, psychosis, remission, schizophrenia

ID: 313653694