Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis

Gemma Modinos; Matthew J. Kempton; Stefania Tognin; Maria Calem; Lilla Porffy; Mathilde Antoniades; Ava Mason; Matilda Azis; Paul Allen; Barnaby Nelson; Patrick McGorry; Christos Pantelis; Anita Riecher-Rossler; Stefan Borgwardt; Rodrigo Bressan; Neus Barrantes-Vidal; Marie-Odile Krebs; Merete Nordentoft; Birte Glenthoj; Stephan Ruhrmann; Gabriele Sachs; Bart Rutten; Jim van Os; Lieuwe de Haan; Eva Velthorst; Mark van der Gaag; Lucia R. Valmaggia; Philip McGuire; Philip McGuire; Matthew J. Kempton; Gemma Modinos; Lieuwe de Haan; Tamar C. Kraan; Daniella S. van Dam; Nadine Burger; G. Paul Amminger; Athena Politis; Joanne Goodall; Charlotte Rapp; Philippe A. Delespaul; EU-GEI High Risk Study Group

doi:10.1001/jamapsychiatry.2019.3501

Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis

Gemma Modinos^*, Matthew J. Kempton, Stefania Tognin, Maria Calem, Lilla Porffy, Mathilde Antoniades, Ava Mason, Matilda Azis, Paul Allen, Barnaby Nelson, Patrick McGorry, Christos Pantelis, Anita Riecher-Rossler, Stefan Borgwardt, Rodrigo Bressan, Neus Barrantes-Vidal, Marie-Odile Krebs, Merete Nordentoft, Birte Glenthoj, Stephan RuhrmannGabriele Sachs, Bart Rutten, Jim van Os, Lieuwe de Haan, Eva Velthorst, Mark van der Gaag, Lucia R. Valmaggia, Philip McGuire, Philip McGuire, Matthew J. Kempton, Gemma Modinos, Lieuwe de Haan, Tamar C. Kraan, Daniella S. van Dam, Nadine Burger, G. Paul Amminger, Athena Politis, Joanne Goodall, Charlotte Rapp, Philippe A. Delespaul, EU-GEI High Risk Study Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

This case-control study analyzes emotion recognition and neuroimaging data as well as clinical and functional outcomes for individuals at risk for transition to psychosis and those without psychiatric or neurological disorders.

Question Is altered emotion recognition associated with adverse clinical and functional outcomes in people at clinical high risk for psychosis? Findings In this case-control study of 213 individuals at clinical high risk for psychosis and 52 healthy participants, abnormalities in the recognition of negative emotion at baseline were associated with neuroanatomical alterations in the medial prefrontal cortex and hippocampus and with a low level of functioning at a 12-month follow-up. Meaning This study found that, in people with high risk for developing psychosis, functional outcomes are associated with the degree to which their emotion processing is altered.

Importance The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. Objective To examine the association between alterations in emotion processing and regional gray matter volumes in individuals at clinical high risk (CHR) for psychosis, and the association with subsequent clinical outcomes. Design, Setting, and Participants This naturalistic case-control study with clinical follow-up at 12 months was conducted from July 1, 2010, to August 31, 2016, and collected data from 9 psychosis early detection centers (Amsterdam, Basel, Cologne, Copenhagen, London, Melbourne, Paris, The Hague, and Vienna). Participants (213 individuals at CHR and 52 healthy controls) were enrolled in the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) project. Data were analyzed from October 1, 2018, to April 24, 2019. Main Measures and Outcomes Emotion recognition was assessed with the Degraded Facial Affect Recognition Task. Three-Tesla magnetic resonance imaging scans were acquired from all participants, and gray matter volume was measured in regions of interest (medial prefrontal cortex, amygdala, hippocampus, and insula). Clinical outcomes at 12 months were evaluated for transition to psychosis using the Comprehensive Assessment of At-Risk Mental States criteria, and the level of overall functioning was measured through the Global Assessment of Functioning [GAF] scale. Results A total of 213 individuals at CHR (105 women [49.3%]; mean [SD] age, 22.9 [4.7] years) and 52 healthy controls (25 women [48.1%]; mean [SD] age, 23.3 [4.0] years) were included in the study at baseline. At the follow-up within 2 years of baseline, 44 individuals at CHR (20.7%) had developed psychosis and 169 (79.3%) had not. Of the individuals at CHR reinterviewed with the GAF, 39 (30.0%) showed good overall functioning (GAF score, >= 65), whereas 91 (70.0%) had poor overall functioning (GAF score,

Original language	English
Pages (from-to)	190-200
Number of pages	11
Journal	JAMA Psychiatry
Volume	77
Issue number	2
DOIs	https://doi.org/10.1001/jamapsychiatry.2019.3501
Publication status	Published - Feb 2020

Keywords

ULTRA-HIGH RISK
GRAY-MATTER VOLUME
SOCIAL COGNITION
PREFRONTAL CORTEX
NEUTRAL FACES
FEARFUL FACES
SCHIZOPHRENIA
RECOGNITION
ONSET
METAANALYSIS

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Modinos, G., Kempton, M. J., Tognin, S., Calem, M., Porffy, L., Antoniades, M., Mason, A., Azis, M., Allen, P., Nelson, B., McGorry, P., Pantelis, C., Riecher-Rossler, A., Borgwardt, S., Bressan, R., Barrantes-Vidal, N., Krebs, M.-O., Nordentoft, M., Glenthoj, B., ... EU-GEI High Risk Study Group (2020). Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis. JAMA Psychiatry, 77(2), 190-200. https://doi.org/10.1001/jamapsychiatry.2019.3501

@article{87cf5c8aba494e5e8d1168f533f9e563,

title = "Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis",

abstract = "This case-control study analyzes emotion recognition and neuroimaging data as well as clinical and functional outcomes for individuals at risk for transition to psychosis and those without psychiatric or neurological disorders.Question Is altered emotion recognition associated with adverse clinical and functional outcomes in people at clinical high risk for psychosis? Findings In this case-control study of 213 individuals at clinical high risk for psychosis and 52 healthy participants, abnormalities in the recognition of negative emotion at baseline were associated with neuroanatomical alterations in the medial prefrontal cortex and hippocampus and with a low level of functioning at a 12-month follow-up. Meaning This study found that, in people with high risk for developing psychosis, functional outcomes are associated with the degree to which their emotion processing is altered.Importance The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. Objective To examine the association between alterations in emotion processing and regional gray matter volumes in individuals at clinical high risk (CHR) for psychosis, and the association with subsequent clinical outcomes. Design, Setting, and Participants This naturalistic case-control study with clinical follow-up at 12 months was conducted from July 1, 2010, to August 31, 2016, and collected data from 9 psychosis early detection centers (Amsterdam, Basel, Cologne, Copenhagen, London, Melbourne, Paris, The Hague, and Vienna). Participants (213 individuals at CHR and 52 healthy controls) were enrolled in the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) project. Data were analyzed from October 1, 2018, to April 24, 2019. Main Measures and Outcomes Emotion recognition was assessed with the Degraded Facial Affect Recognition Task. Three-Tesla magnetic resonance imaging scans were acquired from all participants, and gray matter volume was measured in regions of interest (medial prefrontal cortex, amygdala, hippocampus, and insula). Clinical outcomes at 12 months were evaluated for transition to psychosis using the Comprehensive Assessment of At-Risk Mental States criteria, and the level of overall functioning was measured through the Global Assessment of Functioning [GAF] scale. Results A total of 213 individuals at CHR (105 women [49.3%]; mean [SD] age, 22.9 [4.7] years) and 52 healthy controls (25 women [48.1%]; mean [SD] age, 23.3 [4.0] years) were included in the study at baseline. At the follow-up within 2 years of baseline, 44 individuals at CHR (20.7%) had developed psychosis and 169 (79.3%) had not. Of the individuals at CHR reinterviewed with the GAF, 39 (30.0%) showed good overall functioning (GAF score, >= 65), whereas 91 (70.0%) had poor overall functioning (GAF score,",

keywords = "ULTRA-HIGH RISK, GRAY-MATTER VOLUME, SOCIAL COGNITION, PREFRONTAL CORTEX, NEUTRAL FACES, FEARFUL FACES, SCHIZOPHRENIA, RECOGNITION, ONSET, METAANALYSIS",

author = "Gemma Modinos and Kempton, {Matthew J.} and Stefania Tognin and Maria Calem and Lilla Porffy and Mathilde Antoniades and Ava Mason and Matilda Azis and Paul Allen and Barnaby Nelson and Patrick McGorry and Christos Pantelis and Anita Riecher-Rossler and Stefan Borgwardt and Rodrigo Bressan and Neus Barrantes-Vidal and Marie-Odile Krebs and Merete Nordentoft and Birte Glenthoj and Stephan Ruhrmann and Gabriele Sachs and Bart Rutten and {van Os}, Jim and {de Haan}, Lieuwe and Eva Velthorst and {van der Gaag}, Mark and Valmaggia, {Lucia R.} and Philip McGuire and Philip McGuire and Kempton, {Matthew J.} and Gemma Modinos and {de Haan}, Lieuwe and Kraan, {Tamar C.} and {van Dam}, {Daniella S.} and Nadine Burger and Amminger, {G. Paul} and Athena Politis and Joanne Goodall and Charlotte Rapp and Delespaul, {Philippe A.} and {EU-GEI High Risk Study Group}",

note = "Funding Information: reported holding 2 patents issued (AU 2015203289; 9884034) and 2 pending (CA2773031; 15/844444). Dr Pantelis reported receiving grants from Australian National Health & Medical Research Council during the conduct of the study; grants from Lundbeck Foundation, personal fees from Lundbeck and Australia Pty Ltd; and personal fees from Lundbeck and Australia Pty Ltd outside the submitted work. Dr Riecher-R{\"o}ssler reported receiving personal fees from Lundbeck and personal fees from Angelini Pharma outside the submitted work. Dr Bressan reported receiving grants from Funda{\c c}{\~a}o de Amparo {\`a} Pesquisa do Estado de S{\~a}o Paulo, The Brazilian National Council for Scientific and Technological Development, European Research Council, and Medical Research Council UK during the conduct of the study; personal fees and nonfinancial support from Janssen; personal fees from Pfizer; and personal fees from Sanofi-Aventis outside the submitted work. Dr Krebs reported receiving grants PHRC 07-118 (ICAAR study) from the French Health Ministry during the conduct of the study; participating on the boards of Roche and Janssen; and receiving financial support from Janssen, Otsuka Lundbeck Alliance, and EIsai for conference or dissemination initiatives. Dr Glenth{\o}j reported being the leader of Lundbeck Foundation Centre of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research; receiving grants from Medical Research Council and the Lundbeck Foundation during the conduct of the study; and receiving grants from The Lundbeck Foundation and H. Lundbeck A/S outside the submitted work. Dr Ruhrmann reported receiving grants from the European Community during the conduct of the study and personal fees from Boehringer Ingelheim outside the submitted work. Dr Sachs reported receiving grants from European Community Seventh Framework Program during the conduct of the study and personal fees from Lundbeck and Janssen-Cilag outside the submitted work. Dr Rutten reported receiving grants from European Union during the conduct of the study. No other disclosures were reported. Funding Information: National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community Seventh Framework Programme. Additional financial support was obtained from the Institut National de la Sant{\'e} et de la Recherche M{\'e}dicale (recurrent funding and fellowships) and by Fondation Pierre Deniker. The study received grant 08-MNP-007 from the French government Agence Nationale de la Recherche and grant AOM-07-118 (Influence of Cannabis Psychopathological Outcome in At-risk Mental State [ICAAR study]) from the French Health Ministry Programme Hospitalier de Recherche Clinique. The Sainte-Anne Hospital Center promoted the study. Dr Kempton was supported by a Medical Research Council Fellowship grant MR/ J008915/1. Dr Pantelis was supported by Australia's National Health and Medical Research Council Senior Principal Research Fellowship (ID: 628386 & 1105825) and by grant R246-2016-3237 from the Lundbeck Foundation. Dr Barrantes-Vidal was supported by the Ministerio de Ciencia, Innovaci{\'o}n e Universidades (PSI2017-87512-C2-1-R), and the Generalitat de Catalunya (2017SGR1612 and ICREA Academia Award). Dr Modinos was supported by a Sir Henry Dale Fellowship #202397/Z/16/Z, jointly funded by The Wellcome Trust and the Royal Society. Publisher Copyright: {\textcopyright} 2019 American Medical Association. All rights reserved.",

year = "2020",

month = feb,

doi = "10.1001/jamapsychiatry.2019.3501",

language = "English",

volume = "77",

pages = "190--200",

journal = "JAMA Psychiatry",

issn = "2168-622X",

publisher = "American Medical Association",

number = "2",

}

Modinos, G, Kempton, MJ, Tognin, S, Calem, M, Porffy, L, Antoniades, M, Mason, A, Azis, M, Allen, P, Nelson, B, McGorry, P, Pantelis, C, Riecher-Rossler, A, Borgwardt, S, Bressan, R, Barrantes-Vidal, N, Krebs, M-O, Nordentoft, M, Glenthoj, B, Ruhrmann, S, Sachs, G, Rutten, B, van Os, J, de Haan, L, Velthorst, E, van der Gaag, M, Valmaggia, LR, McGuire, P, McGuire, P, Kempton, MJ, Modinos, G, de Haan, L, Kraan, TC, van Dam, DS, Burger, N, Amminger, GP, Politis, A, Goodall, J, Rapp, C, Delespaul, PA & EU-GEI High Risk Study Group 2020, 'Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis', JAMA Psychiatry, vol. 77, no. 2, pp. 190-200. https://doi.org/10.1001/jamapsychiatry.2019.3501

TY - JOUR

T1 - Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis

AU - Modinos, Gemma

AU - Kempton, Matthew J.

AU - Tognin, Stefania

AU - Calem, Maria

AU - Porffy, Lilla

AU - Antoniades, Mathilde

AU - Mason, Ava

AU - Azis, Matilda

AU - Allen, Paul

AU - Nelson, Barnaby

AU - McGorry, Patrick

AU - Pantelis, Christos

AU - Riecher-Rossler, Anita

AU - Borgwardt, Stefan

AU - Bressan, Rodrigo

AU - Barrantes-Vidal, Neus

AU - Krebs, Marie-Odile

AU - Nordentoft, Merete

AU - Glenthoj, Birte

AU - Ruhrmann, Stephan

AU - Sachs, Gabriele

AU - Rutten, Bart

AU - van Os, Jim

AU - de Haan, Lieuwe

AU - Velthorst, Eva

AU - van der Gaag, Mark

AU - Valmaggia, Lucia R.

AU - McGuire, Philip

AU - Kempton, Matthew J.

AU - Modinos, Gemma

AU - de Haan, Lieuwe

AU - Kraan, Tamar C.

AU - van Dam, Daniella S.

AU - Burger, Nadine

AU - Amminger, G. Paul

AU - Politis, Athena

AU - Goodall, Joanne

AU - Rapp, Charlotte

AU - Delespaul, Philippe A.

AU - EU-GEI High Risk Study Group

N1 - Funding Information: reported holding 2 patents issued (AU 2015203289; 9884034) and 2 pending (CA2773031; 15/844444). Dr Pantelis reported receiving grants from Australian National Health & Medical Research Council during the conduct of the study; grants from Lundbeck Foundation, personal fees from Lundbeck and Australia Pty Ltd; and personal fees from Lundbeck and Australia Pty Ltd outside the submitted work. Dr Riecher-Rössler reported receiving personal fees from Lundbeck and personal fees from Angelini Pharma outside the submitted work. Dr Bressan reported receiving grants from Fundação de Amparo à Pesquisa do Estado de São Paulo, The Brazilian National Council for Scientific and Technological Development, European Research Council, and Medical Research Council UK during the conduct of the study; personal fees and nonfinancial support from Janssen; personal fees from Pfizer; and personal fees from Sanofi-Aventis outside the submitted work. Dr Krebs reported receiving grants PHRC 07-118 (ICAAR study) from the French Health Ministry during the conduct of the study; participating on the boards of Roche and Janssen; and receiving financial support from Janssen, Otsuka Lundbeck Alliance, and EIsai for conference or dissemination initiatives. Dr Glenthøj reported being the leader of Lundbeck Foundation Centre of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research; receiving grants from Medical Research Council and the Lundbeck Foundation during the conduct of the study; and receiving grants from The Lundbeck Foundation and H. Lundbeck A/S outside the submitted work. Dr Ruhrmann reported receiving grants from the European Community during the conduct of the study and personal fees from Boehringer Ingelheim outside the submitted work. Dr Sachs reported receiving grants from European Community Seventh Framework Program during the conduct of the study and personal fees from Lundbeck and Janssen-Cilag outside the submitted work. Dr Rutten reported receiving grants from European Union during the conduct of the study. No other disclosures were reported. Funding Information: National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community Seventh Framework Programme. Additional financial support was obtained from the Institut National de la Santé et de la Recherche Médicale (recurrent funding and fellowships) and by Fondation Pierre Deniker. The study received grant 08-MNP-007 from the French government Agence Nationale de la Recherche and grant AOM-07-118 (Influence of Cannabis Psychopathological Outcome in At-risk Mental State [ICAAR study]) from the French Health Ministry Programme Hospitalier de Recherche Clinique. The Sainte-Anne Hospital Center promoted the study. Dr Kempton was supported by a Medical Research Council Fellowship grant MR/ J008915/1. Dr Pantelis was supported by Australia's National Health and Medical Research Council Senior Principal Research Fellowship (ID: 628386 & 1105825) and by grant R246-2016-3237 from the Lundbeck Foundation. Dr Barrantes-Vidal was supported by the Ministerio de Ciencia, Innovación e Universidades (PSI2017-87512-C2-1-R), and the Generalitat de Catalunya (2017SGR1612 and ICREA Academia Award). Dr Modinos was supported by a Sir Henry Dale Fellowship #202397/Z/16/Z, jointly funded by The Wellcome Trust and the Royal Society. Publisher Copyright: © 2019 American Medical Association. All rights reserved.

PY - 2020/2

Y1 - 2020/2

N2 - This case-control study analyzes emotion recognition and neuroimaging data as well as clinical and functional outcomes for individuals at risk for transition to psychosis and those without psychiatric or neurological disorders.Question Is altered emotion recognition associated with adverse clinical and functional outcomes in people at clinical high risk for psychosis? Findings In this case-control study of 213 individuals at clinical high risk for psychosis and 52 healthy participants, abnormalities in the recognition of negative emotion at baseline were associated with neuroanatomical alterations in the medial prefrontal cortex and hippocampus and with a low level of functioning at a 12-month follow-up. Meaning This study found that, in people with high risk for developing psychosis, functional outcomes are associated with the degree to which their emotion processing is altered.Importance The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. Objective To examine the association between alterations in emotion processing and regional gray matter volumes in individuals at clinical high risk (CHR) for psychosis, and the association with subsequent clinical outcomes. Design, Setting, and Participants This naturalistic case-control study with clinical follow-up at 12 months was conducted from July 1, 2010, to August 31, 2016, and collected data from 9 psychosis early detection centers (Amsterdam, Basel, Cologne, Copenhagen, London, Melbourne, Paris, The Hague, and Vienna). Participants (213 individuals at CHR and 52 healthy controls) were enrolled in the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) project. Data were analyzed from October 1, 2018, to April 24, 2019. Main Measures and Outcomes Emotion recognition was assessed with the Degraded Facial Affect Recognition Task. Three-Tesla magnetic resonance imaging scans were acquired from all participants, and gray matter volume was measured in regions of interest (medial prefrontal cortex, amygdala, hippocampus, and insula). Clinical outcomes at 12 months were evaluated for transition to psychosis using the Comprehensive Assessment of At-Risk Mental States criteria, and the level of overall functioning was measured through the Global Assessment of Functioning [GAF] scale. Results A total of 213 individuals at CHR (105 women [49.3%]; mean [SD] age, 22.9 [4.7] years) and 52 healthy controls (25 women [48.1%]; mean [SD] age, 23.3 [4.0] years) were included in the study at baseline. At the follow-up within 2 years of baseline, 44 individuals at CHR (20.7%) had developed psychosis and 169 (79.3%) had not. Of the individuals at CHR reinterviewed with the GAF, 39 (30.0%) showed good overall functioning (GAF score, >= 65), whereas 91 (70.0%) had poor overall functioning (GAF score,

AB - This case-control study analyzes emotion recognition and neuroimaging data as well as clinical and functional outcomes for individuals at risk for transition to psychosis and those without psychiatric or neurological disorders.Question Is altered emotion recognition associated with adverse clinical and functional outcomes in people at clinical high risk for psychosis? Findings In this case-control study of 213 individuals at clinical high risk for psychosis and 52 healthy participants, abnormalities in the recognition of negative emotion at baseline were associated with neuroanatomical alterations in the medial prefrontal cortex and hippocampus and with a low level of functioning at a 12-month follow-up. Meaning This study found that, in people with high risk for developing psychosis, functional outcomes are associated with the degree to which their emotion processing is altered.Importance The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. Objective To examine the association between alterations in emotion processing and regional gray matter volumes in individuals at clinical high risk (CHR) for psychosis, and the association with subsequent clinical outcomes. Design, Setting, and Participants This naturalistic case-control study with clinical follow-up at 12 months was conducted from July 1, 2010, to August 31, 2016, and collected data from 9 psychosis early detection centers (Amsterdam, Basel, Cologne, Copenhagen, London, Melbourne, Paris, The Hague, and Vienna). Participants (213 individuals at CHR and 52 healthy controls) were enrolled in the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) project. Data were analyzed from October 1, 2018, to April 24, 2019. Main Measures and Outcomes Emotion recognition was assessed with the Degraded Facial Affect Recognition Task. Three-Tesla magnetic resonance imaging scans were acquired from all participants, and gray matter volume was measured in regions of interest (medial prefrontal cortex, amygdala, hippocampus, and insula). Clinical outcomes at 12 months were evaluated for transition to psychosis using the Comprehensive Assessment of At-Risk Mental States criteria, and the level of overall functioning was measured through the Global Assessment of Functioning [GAF] scale. Results A total of 213 individuals at CHR (105 women [49.3%]; mean [SD] age, 22.9 [4.7] years) and 52 healthy controls (25 women [48.1%]; mean [SD] age, 23.3 [4.0] years) were included in the study at baseline. At the follow-up within 2 years of baseline, 44 individuals at CHR (20.7%) had developed psychosis and 169 (79.3%) had not. Of the individuals at CHR reinterviewed with the GAF, 39 (30.0%) showed good overall functioning (GAF score, >= 65), whereas 91 (70.0%) had poor overall functioning (GAF score,

KW - ULTRA-HIGH RISK

KW - GRAY-MATTER VOLUME

KW - SOCIAL COGNITION

KW - PREFRONTAL CORTEX

KW - NEUTRAL FACES

KW - FEARFUL FACES

KW - SCHIZOPHRENIA

KW - RECOGNITION

KW - ONSET

KW - METAANALYSIS

U2 - 10.1001/jamapsychiatry.2019.3501

DO - 10.1001/jamapsychiatry.2019.3501

M3 - Article

C2 - 31722018

SN - 2168-622X

VL - 77

SP - 190

EP - 200

JO - JAMA Psychiatry

JF - JAMA Psychiatry

IS - 2

ER -

Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis

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