Biomarkers/Biotypes, Course of Early Psychosis and Specialty Services (BICEPS)
Kareem Hamada (1,5), Ananya Saluja (1), Pegah Seif (1), Gautami Shashidhar (1), Walid Yassine (1), Victor Zeng (1), Paulo Lizano (1), Rosco Brady (1),Brett Clementz (2,) Elliot Gershon (3), Sarah Keedy (3), Godfrey Pearlson (4), Dost Ongur (5), Eve Lewandowsky (5), Carol Tamminga (6), Matcheri Keshavan (1)
(1) Beth Israel Deaconess Medical Center, Boston, MA
(2) University of Georgia, Athens, GA
(3) University of Chicago, Chicago, IL
(4) Yale University, New Haven, CT
(5) McLean Hospital, Boston MA
(6) University of Texas Southwestern Medical Center, Dallas, TX
Background: Psychotic disorders are highly heterogeneous in the early stages, ranging from early full recovery to treatment resistance and functional decline from onset. This heterogeneity limits accurate and effective prediction of remission and recovery. The ability to predict outcomes on an individual level for those with Early Psychosis (EP) would be valuable for treatment planning and for tailoring psychosocial and pharmacological interventions.
Methods: We leverage the biomarker-based categorization (EEG, eye tracking, neurocognition, blood/DNA collection, digital phenotyping) of a cross-diagnostic sample of psychosis (Biotypes) developed, replicated and validated by our Bipolar-Schizophrenia Network for Intermediate Phenotypes consortium (BSNIP). We have 5 active EP sites, each enrolling ~16 patients/year (total 80/year), aiming for 320 EP patients (< 3 years from onset: schizophrenia, schizoaffective disorder, bipolar disorder, schizophreniform disorder, delusional disorder, major depressive disorder with psychosis, and psychosis NOS) over the first 4 years of funding. With 25% attrition, we expect 240 completers. Current enrollments: Boston: 18; Hartford: 14; Chicago: 13; Dallas: 11; Georgia: 5. All EP cases are tested with BSNIP biomarker assessments at baseline, with clinical and cognition assessments are repeated at 1, 6 and 12 months.
Results: We are still collecting data from the BICEPS study. However, we will briefly present data from our previous studies that support the rationale for this study; a) our data from Pittsburgh show that distinct trajectories of psychosis outcomes can be identified during 1 year follow-up in EP patients; and b) data from the BSNIP study show that biotypes 1, 2 and 3, characterized in mid-late course psychosis patients can be identified in EP patients as well.
Conclusions: Our goal is to identify multivariate biomarkers/Biotypes predictors of clinical and functional outcomes in EP patients treated in coordinated specialty care clinics. Such data could help develop a predictive algorithm and calculator for clinical use in EP.