psychotic disorder
Conditions
Interventions
Venapunction and MRI
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
No minimum to 64 Years
Inclusion criteria
Inclusion criteria: All pregnant women and their partners: • At least 18 years old • Ability to provide informed consent • Singleton pregnancy • Biological parent of the fetus/neonate Pregnant women and their partners with at least one (future) parent with SMI: • At least one (future) parent with SMI in the mood-psychosis spectrum diagnosed before current pregnancy, i.e., schizophrenia, bipolar disorder, severe MDD (i.e., with high recurrence rate and/or hospitalizations), psychosis NOS, single psychosis
Exclusion criteria
Exclusion criteria: All pregnant women: • Contraindication for MRI (including claustrophobia, a cardiac implantable electronic device, ferromagnetic metal implants, piercing (in some cases), tattoos (in some cases)) (Ghadimi & Sapra, 2022). • Postpartum psychosis (after a prior pregnancy) • Not willing to be informed about incidental findings following MRI assessment All pregnant women and their partners: • Substance use disorder (alcohol, drugs), active < six months pre pregnancy as assessed with R4U or current addiction treatment such as methadone or buprenorphine • Not willing to be informed about neonate*s incidental findings following MRI assessment All fetuses/neonates: • Preeclampsia or fetal growth restriction at time of inclusion • Neurological illness or structural brain abnormalities • Suspected congenital anomalies or syndromes known to affect neurodevelopment • Chromosomal abnormalities • Genetic abnormalities known to impact neurodevelopment • Premature birth (< 37 weeks) Pregnant women and their partners without SMI: • A lifetime diagnosis of SMI in the mood-psychosis spectrum as assessed with the Mini-International Neuropsychiatric Interview (M.I.N.I.; Sheehan et al., 1998) • An SMI in the mood-psychosis spectrum in their first degree relatives • Use of neurotrophic medication In all (future) parents, (co)morbidity with other psychiatric diagnoses is not an exclusion criterion.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Feasibility: The percentage of (future) parents participating in all three visits using MRI assessments. The study will be considered feasible when >=30% of invited couples participates in at least one visit including MRI assessment. Differences between neurodevelopmental trajectories of fetuses/neonates from parents with vs. without severe mental illness, as measured by: - Brain volume, cortical folding, cortical thickness, and cortical surface (global measures and local regions) from T1 and T2 weighted images. - Fractional anisotrophy (FA), mean diffusivity, axial diffusivity, radial diffusivity (per fiber and voxel based) from diffusion MRI (dMRI) images. - Brain activation during resting state (per region and voxel based) from resting-state fMRI (rs-fMRI) images. - Graph theory metrics from FA (via dMRI) and rs-fMRI. - Measurements of fetal growth and development, such as: biparietal diameter (BPD), transverse cerebellar diameter (TCD), head circumference (HC), thalamus, femur length (FL), and abdominal circumference (AC), estimated fetal weight, insula depth, Sylvian fissure depth, and parietal-occipital fissures (POF) depth, using 2D and 3D fetal ultrasound. - Doppler fetal hemodynamics, such as: umbilical artery (UA), middle cerebral artery (MCA), and estimated cerebro-placental ratio (CPR). | — |
Secondary
| Measure | Time frame |
|---|---|
| - Clinical features, i.e. parental psychosis, depression, or mania diagnoses and symptoms, age of onset parental disorder, number of episodes, number of hospitalizations, GAF score - Parental bonding - Polygenic risk scores for psychiatric traits - Cortisol levels - Development of the offspring | — |
Countries
Netherlands
Contacts
Public ContactM.I. Broer
Erasmus MC, Universitair Medisch Centrum Rotterdam
Outcome results
None listed