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Clinical predictors of antipsychotic treatment resistance: development and internal validation of a prognostic prediction model by the STRATA-G consortium

Abstract: Introduction Our aim was to, firstly, identify characteristics at first-episode of psychosis that are associated with later antipsychotic treatment resistance (TR) and, secondly, to develop a parsimonious prediction model for TR. Methods We combined data from ten prospective, first-episode psychosis cohorts from across Europe and categorised patients as TR or non-treatment resistant (NTR) after a mean follow up of 4.18 years (s.d. = 3.20) for secondary data analysis. We identified a list of potential predictors from clinical and demographic data recorded at first-episode. These potential predictors were entered in two models: a multivariable logistic regression to identify which were independently associated with TR and a penalised logistic regression, which performed variable selection, to produce a parsimonious prediction model. This model was internally validated using a 5-fold, 50-repeat cross-validation optimism-correction. Results Our sample consisted of N = 2216 participants of which 385 (17 %) developed TR. Younger age of psychosis onset and fewer years in education were independently associated with increased odds of developing TR. The prediction model selected 7 out of 17 variables that, when combined, could quantify the risk of being TR better than chance. These included age of onset, years in education, gender, BMI, relationship status, alcohol use, and positive symptoms. The optimism-corrected area under the curve was 0.59 (accuracy = 64 %, sensitivity = 48 %, and specificity = 76 %). Implications Our findings show that treatment resistance can be predicted, at first-episode of psychosis. Pending a model update and external validation, we demonstrate the potential value of prediction models for TR.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Schizophrenia Research, 2022, (250), 1-9

Editorial: Elsevier

 Año de publicación: 2022

Nº de páginas: 9

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.schres.2022.09.009

ISSN: 0920-9964,1573-2509

 Proyecto español: SAF2016-76046-R

Url de la publicación: https://doi.org/10.1016/j.schres.2022.09.009

Autoría

SMART, SOPHIE E.

AGBEDJRO, DEBORAH

PARDIÑAS, ANTONIO F.

AJNAKINA, OLESYA

ALAMEDA, LUIS

ANDREASSEN, OLE A.

BARNES, THOMAS R. E.

BERARDI, DOMENICO

CAMPORESI, SARA

CLEUSIX, MARTINE

CONUS, PHILIPPE

CRESPO-FACORRO, BENEDICTO

D'ANDREA, GIUSEPPE

DEMJAHA, ARSIME

DI FORTI, MARTA

DO, KIM

DOODY, GILLIAN

EAP, CHIN B.

FERCHIOU, AZIZ