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An investigation of psychosis subgroups with prognostic validation and exploration of genetic underpinnings: The PsyCourse study

JAMA Feb 24, 2020

Dwyer DB, Kalman JL, Budde M, et al. - The intent of this study was to distinguish psychosis subgroups using data-driven methods and explore their illness courses over 1.5 years and polygenic scores for schizophrenia, bipolar disorder, major depression disorder, and educational achievement. Researchers performed an ongoing multisite, naturalistic, longitudinal (6-month intervals) cohort study that began in January 2012 across 18 sites. They obtained data from a referred sample of 1,223 individuals (765 in the discovery sample and 458 in the validation sample) with DSM-IV diagnoses of schizophrenia, bipolar affective disorder (I/II), schizoaffective disorder, schizophreniform disorder, and brief psychotic disorder from secondary and tertiary care sites. It was showed that psychosis subgroups were identified with distinctive clinical signatures and illness courses and specificity for a nondiagnostic genetic marker. For future psychosis taxonomies, new data-driven clinical approaches are important. The findings imply a requirement to consider short-term to medium-term service provision to restore functioning in individuals stratified into the depressive and severe psychosis subgroups.
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