Schizophrenia and Disorders with Psychotic Features
Conditions
Keywords
Psychosis, Psychotic disorders, Schizophrenia
Brief summary
KaSP is a multimodal observational study with the goal of clarifying underlying mechanisms that cause psychotic disorders, such as schizophrenia. Participants with psychotic symptoms are recruited early after first contact with health care, within 4 weeks of starting anti-psychotic medication, and are compared to controls without psychiatric diagnoses on several measures.
Detailed description
KaSP aims to recruit 120 patients sparsely medicated or drug-naive first episode psychosis (FEP) individuals, along with 80 healthy controls. Participants undergo the following assessments and measurements: * Clinical assessment * Cognitive testing * Lab results from cerebrospinal fluid, blood, urine, saliva and skin biopsy * Brain imaging using Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) * Pre-Pulse Inhibition (PPI) (a test to evaluate the startle response) * Measures of arterial stiffness and amount of vascular narrowing Participants with psychosis are invited back for repeat measurements at 1,5 and 5 years after study enrollment. Controls may be invited back at 1,5 years for repeat of some of the assessments.
Interventions
None listed
Sponsors
Centre for Psychiatry Research, Region Stockholm, Sweden
Karolinska Institutet
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
For FEP: * Diagnosis as assessed using DSM-IV of one of the following: schizophrenia, schizophreniform psychosis, psychosis not otherwise specified (NOS), brief psychosis, schizoaffective syndrome, delusional disorder * First exposure to anti-psychotic medication less than 4 weeks prior to inclusion
Exclusion criteria
For FEP: \- Other dominant psychiatric illness deemed to be related to current psychotic symptoms For HC: * A history of diagnosis of a major psychiatric disorder, including substance use disorders. * Family history of psychotic disorders in first degree relatives. For all: * Evidence based on medical history, clinical signs, MRI or laboratory tests of clinically significant somatic disorder, or previous disorder with brain engagement (e.g. tumour, neuroinflammatory disease, epilepsy) or significant brain trauma. * Exposure to an effective radiation dose of 25 mSv during the past year. * Pregnancy, lactating or breastfeeding (women). * Meets diagnostic criteria of substance use disorder (excluding nicotine dependence) as assessed using DSM-IV or as determined using repeated positive urine screens during the course of the study. * Metallic object in the eye, or ferro/electromagnetic implants. History of claustrophobic anxiety during MRI. * Symptoms of severe bacterial, fungal, or viral infection (including upper respiratory tract infection), with systemic effects as detected by e.g. fever, within 7 days prior to inclusion. * Treatment with any antihemostatic medication within 2 weeks of lumbar puncture and arterial line placement of either the baseline or 1 year follow-up. * Blood donation (1 unit or more) within 90 days prior to Screening, plasma donation from 1 week prior to Screening, and platelet donation from 6 weeks prior to inclusion. * Other unspecified reasons that, in the opinion of the Investigator or the Sponsor, make the participant unsuitable for enrollment. This may include very high symptom severity or signs of aggressiveness and hostility.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Kynurenic acid (KYNA) in FEP compared to HC | Baseline measure | KYNA are measured in CSF and blood samples |
| Cytokines in FEP compared to HC | Baseline measure | Cytokines are measured in CSF and blood samples |
| Microglial activation in FEP compared to HC | Baseline measure | Group comparison of binding of the PET ligand \[11C\]PBR-28 |
| Dopamine receptors in FEP compared to HC | Baseline measure | Group comparison of binding of the PET-ligand \[11C\]FLB457 |
| Infectious risk factors in FEP and subsequent relation to clinical outcome | Registry data in childhood, measurement at baseline, registry data through study completion (with an expected average of 7 years of follow up) | Registry data on previous infections, along with infectious agents measured in CSF and blood. Long term clinical outcome is measured through registry data, by drug-dispensation as well as in-and outpatient care for both somatic and psychiatric disorders. |
Countries
Sweden
Contacts
Primary ContactCarl M Sellgren, MD, PhD
Backup ContactLena Lundberg
Outcome results
None listed