The association between migrant status and transition in an ultra-high risk for psychosis population

Purpose: Migrant status is one of the most replicated and robust risk factors for developing a psychotic disorder. This study aimed to determine whether migrant status in people identified as Ultra-High Risk for Psychosis (UHR) was associated with risk of transitioning to a full-threshold psychotic disorder. Methods: Hazard ratios for the risk of transition were calculated from five large UHR cohorts (n = 2166) and were used to conduct a meta-analysis using the generic inverse-variance method using a random-effects model. Results: 2166 UHR young people, with a mean age of 19.1 years (SD ± 4.5) were included, of whom 221 (10.7%) were first-generation migrants. A total of 357 young people transitioned to psychosis over a median follow-up time of 417 days (I.Q.R.147–756 days), representing 17.0% of the cohort. The risk of transition to a full-threshold disorder was not increased for first-generation migrants, (HR = 1.08, 95% CI 0.62–1.89); however, there was a high level of heterogeneity between studies The hazard ratio for second-generation migrants to transition to a full-threshold psychotic disorder compared to the remainder of the native-born population was 1.03 (95% CI 0.70–1.51). Conclusions: This meta-analysis did not find a statistically significant association between migrant status and an increased risk for transition to a full-threshold psychotic disorder; however, several methodological issues could explain this finding. Further research should focus on examining the risk of specific migrant groups and also ensuring that migrant populations are adequately represented within UHR clinics

Attenuation of auditory evoked potentials for hand and eye-initiated sounds

Reduction of auditory event-related potentials (ERPs) to self-initiated sounds has been considered evidence for a predictive model in which copies of motor commands suppress sensory representations of incoming stimuli. However, in studies which involve arbitrary auditory stimuli evoked by sensory-unspecific motor actions, learned associations may underlie ERP differences. Here, in a new paradigm, eye motor output generated auditory sensory input, a naïve action–sensation contingency. We measured the electroencephalogram (EEG) of 40 participants exposed to pure tones, which they produced with either a button-press or volitional saccade. We found that button-press-initiated stimuli evoked reduced amplitude compared to externally initiated stimuli for both the N1 and P2 ERP components, whereas saccade-initiated stimuli evoked intermediate attenuation at N1 and no reduction at P2. These results indicate that the motor-to-sensory mapping involved in speech production may be partly generalized to other contingencies, and that learned associations also contribute to the N1 attenuation effect

Physical health assistance in early recovery of psychosis: study protocol for a randomized controlled trial

First published 23 October 2019Aim: Young people with psychotic disorders have poorer physical health compared to their healthy peers, a state compounded by the metabolic side‐effects of antipsychotic medications. To address this, Orygen Youth Health has introduced physical health services including exercise physiologists and dieticians. These services are typically coordinated by the case manager and doctor. It is not yet known whether a treating team member dedicated to physical health will improve engagement, adherence and outcomes with these services. Hence, the protocol is presented here for a trial to evaluate the effect of including a physical health nurse in the care of young people with first‐episode psychosis. Methods: This will be a single‐blind randomized controlled trial that includes 15‐ to 24‐year‐olds with first‐episode psychosis who have just commenced (within 30 days) antipsychotic medication. The primary outcome will be the event of clinically significant weight gain (≥7% body weight). Participants will be assigned either a physical health nurse in their treating team (in addition to the case manager and doctor) for a 12‐week period, or treatment as usual (case manager and doctor). Research assessments will be conducted at baseline, 12 and 26 weeks. Activity trackers worn by participants for the study's duration will measure sleep and physical activity. Conclusion: The present study will determine whether a physical health nurse will facilitate participants in attending and engaging in physical health interventions and whether this will be associated with physical health improvements or the prevention of worsening physical health.Brian O'Donoghue, Nathan G. Mifsud, Rachel M. Tindall, Lauren Foote, Jessica A. Hartmann, Kate Obst, Magenta B. Simmons, Patrick D. McGorry Eoin Killacke