Neurodevelopmental predictors of treatment response in schizophrenia and bipolar disorder

Treatment resistance is a major challenge in psychiatric disorders. Early detection of potential future resistance would improve prognosis by reducing the delay to appropriate treatment adjustment and recovery. Here, we sought to determine whether neurodevelopmental markers can predict therapeutic r...

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Bibliographic Details
Published in:Psychological medicine Vol. 54; no. 13; pp. 3655 - 3666
Main Authors: Iftimovici, Anton, Krebs, Emma, Dalfin, William, Legrand, Adrien, Scoriels, Linda, Martinez, Gilles, Bendjemaa, Narjes, Duchesnay, Edouard, Chaumette, Boris, Krebs, Marie-Odile
Format: Journal Article
Language:English
Published: England Cambridge University Press 01.10.2024
Cambridge University Press (CUP)
Subjects:
Age
Antipsychotics
Autism
Bipolar disorder
Computer Science
Disease
Disorders
Dyslexia
Encopresis
Enuresis
Epilepsy
Hospitalization
Hyperactivity
Mathematics
Medical prognosis
Medical treatment
Mental disorders
Neurodevelopmental disorders
Neurological complications
Original
Patients
Psychotropic drugs
Rehabilitation
Resistance
Schizophrenia
Sex education
Statistics
Subjectivity
Therapy
Treatment resistance
Urinary incontinence
France
bipolar disorder
schizophrenia
neurodevelopment
neurological soft signs
treatment response
age at onset of disease
ISSN:0033-2917, 1469-8978, 1469-8978
Online Access:Get full text
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Summary:Treatment resistance is a major challenge in psychiatric disorders. Early detection of potential future resistance would improve prognosis by reducing the delay to appropriate treatment adjustment and recovery. Here, we sought to determine whether neurodevelopmental markers can predict therapeutic response. Healthy controls ( = 236), patients with schizophrenia ( = 280) or bipolar disorder ( = 78) with a known therapeutic outcome, were retrospectively included. Age, sex, education, early developmental abnormalities (obstetric complications, height, weight, and head circumference at birth, hyperactivity, dyslexia, epilepsy, enuresis, encopresis), neurological soft signs (NSS), and ages at first subjective impairment, clinical symptoms, treatment, and hospitalization, were recorded. A supervised algorithm leveraged NSS and age at first clinical signs to classify between resistance and response in schizophrenia. Developmental abnormalities were more frequent in schizophrenia and bipolar disorder than in controls. NSS significantly differed between controls, responsive, and resistant participants with schizophrenia (5.5 ± 3.0, 7.0 ± 4.0, 15.0 ± 6.0 respectively, = 3 × 10 ) and bipolar disorder (5.5 ± 3.0, 8.3 ± 3.0, 12.5 ± 6.0 respectively, < 1 × 10 ). In schizophrenia, but not in bipolar disorder, age at first subjective impairment was three years lower, and age at first clinical signs two years lower, in resistant than responsive subjects ( = 2 × 10 and = 9 × 10 , respectively). Age at first clinical signs and NSS accurately predicted treatment response in schizophrenia (area-under-curve: 77 ± 8%, = 1 × 10 ). Neurodevelopmental features such as NSS and age of clinical onset provide a means to identify patients who may require rapid treatment adaptation.
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ISSN:0033-2917
1469-8978
1469-8978
DOI:10.1017/S0033291724001776