title: Predictors of schizophrenia spectrum disorders in early-onset first episodes of psychosis: a support vector machine model.
abstract: Identifying early-onset schizophrenia spectrum disorders (SSD) at a very early stage remains challenging. To assess the diagnostic predictive value of multiple types of data at the emergence of early-onset first-episode psychosis (FEP), various support vector machine (SVM) classifiers were developed. The data were from a 2-year, prospective, longitudinal study of 81 patients (age 9-17 years) with early-onset FEP and a stable diagnosis during follow-up and 42 age- and sex-matched healthy controls (HC). The input was different combinations of baseline clinical, neuropsychological, magnetic resonance imaging brain volumetric and biochemical data, and the output was the diagnosis at follow-up (SSD vs. non-SSD, SSD vs. HC, and non-SSD vs. HC). Enhanced recursive feature elimination was performed for the SSD vs. non-SSD classifier to select and rank the input variables with the highest predictive value for a diagnostic outcome of SSD. After validation with a test set and considering all baseline variables together, the SSD vs. non-SSD, SSD vs. HC and non-SSD vs. HC classifiers achieved an accuracy of 0.81, 0.99 and 0.99, respectively. Regarding the SSD vs. non-SSD classifier, a combination of baseline clinical variables (severity of negative, disorganized symptoms and hallucinations or poor insight) and neuropsychological variables (impaired attention, motor coordination, and global cognition) showed the highest predictive value for a diagnostic outcome of SSD. Neuroimaging and biochemical variables at baseline did not add to the predictive value. Thus, comprehensive clinical/cognitive assessment remains the most reliable approach for differential diagnosis during early-onset FEP. SVMs may constitute promising multivariate tools in the search for predictors of diagnostic outcome in FEP.
authors.affiliation: Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón. School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Ibiza 43, 28009, Madrid, Spain, lpina.iisgm@gmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Pina-Camacho
authors.forename: Juan
authors.initials: J
authors.lastname: Garcia-Prieto
authors.forename: Mara
authors.initials: M
authors.lastname: Parellada
authors.forename: Josefina
authors.initials: J
authors.lastname: Castro-Fornieles
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gonzalez-Pinto
authors.forename: Igor
authors.initials: I
authors.lastname: Bombin
authors.forename: Montserrat
authors.initials: M
authors.lastname: Graell
authors.forename: Beatriz
authors.initials: B
authors.lastname: Paya
authors.forename: Marta
authors.initials: M
authors.lastname: Rapado-Castro
authors.forename: Joost
authors.initials: J
authors.lastname: Janssen
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Baeza
authors.forename: Francisco
authors.initials: F
authors.lastname: Del Pozo
authors.forename: Manuel
authors.initials: M
authors.lastname: Desco
authors.forename: Celso
authors.initials: C
authors.lastname: Arango
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000523:psychology; D005260:Female; D006212:Hallucinations; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000175:diagnosis*; D012559:Schizophrenia / Q000175:diagnosis*; D060388:Support Vector Machine
references.citation: Schizophr Res. 2011 Mar;126(1-3):77-80
references.pmid: 20965697
references.citation: Br J Psychiatry. 2010 Feb;196(2):92-5
references.pmid: 20118450
references.citation: Psychiatry Res. 2011 Jan 30;185(1-2):72-7
references.pmid: 20580840
references.citation: Neurosci Biobehav Rev. 2010 Jul;34(8):1207-22
references.pmid: 20144653
references.citation: Science. 2010 Mar 19;327(5972):1437
references.pmid: 20299556
references.citation: Schizophr Bull. 2005 Oct;31(4):962-77
references.pmid: 15958818
references.citation: Eur Child Adolesc Psychiatry. 2013 Dec;22(12):733-44
references.pmid: 22930323
references.citation: Front Hum Neurosci. 2010 Oct 26;4:189
references.pmid: 21103008
references.citation: Mol Psychiatry. 2012 Dec;17(12):1174-9
references.pmid: 22869033
references.citation: Anal Chem. 2011 Jun 1;83(11):4258-65
references.pmid: 21517122
references.citation: PLoS One. 2012;7(12):e50698
references.pmid: 23236384
references.citation: Lancet. 2011 Jun 18;377(9783):2093-102
references.pmid: 21652063
references.citation: J Am Acad Child Adolesc Psychiatry. 1997 Jul;36(7):980-8
references.pmid: 9204677
references.citation: Int Rev Psychiatry. 2009;21(4):336-56
references.pmid: 20374148
references.citation: Schizophr Bull. 2014 Mar;40 Suppl 2:S138-46
references.pmid: 24371326
references.citation: Am J Psychiatry. 2002 Jul;159(7):1080-92
references.pmid: 12091183
references.citation: J Neural Transm (Vienna). 2007;114(4):505-12
references.pmid: 16897595
references.citation: Psychol Med. 2013 Dec;43(12):2547-62
references.pmid: 23507081
references.citation: Schizophr Bull. 2009 Sep;35(5):1022-9
references.pmid: 18495643
references.citation: J Child Psychol Psychiatry. 2011 Oct;52(10):1089-98
references.pmid: 21770939
references.citation: Can J Psychiatry. 2000 Oct;45(8):710-6
references.pmid: 11086553
references.citation: Neuroimage. 2014 Jan 1;84:299-306
references.pmid: 24004694
references.citation: J Digit Imaging. 2009 Apr;22(2):136-48
references.pmid: 18712567
references.citation: Br J Psychiatry. 2000 Sep;177:233-40
references.pmid: 11040884
references.citation: Rev Psiquiatr Salud Ment. 2013 Apr-Jun;6(2):80-5
references.pmid: 23084798
references.citation: Continuum (Minneap Minn). 2013 Apr;19(2 Dementia):325-38
references.pmid: 23558480
references.citation: J Child Adolesc Psychopharmacol. 2008 Oct;18(5):475-90
references.pmid: 18928412
references.citation: Hum Brain Mapp. 2012 Sep;33(9):2104-24
references.pmid: 22887825
references.citation: BMC Psychiatry. 2011 Jan 28;11:18
references.pmid: 21276242
references.citation: Schizophr Bull. 2007 Jul;33(4):912-20
references.pmid: 17567627
references.citation: World Psychiatry. 2011 Feb;10(1):19-31
references.pmid: 21379347
references.citation: Schizophr Bull. 2005 Jul;31(3):639-49
references.pmid: 15976012
references.citation: J Child Adolesc Psychopharmacol. 2008 Aug;18(4):327-36
references.pmid: 18759642
references.citation: Psychol Med. 2012 May;42(5):1037-47
references.pmid: 22059690
references.citation: Med Biol Eng Comput. 2010 Feb;48(2):177-84
references.pmid: 19924461
references.citation: Neuroimage Clin. 2014 Apr 13;4:687-94
references.pmid: 24936420
references.citation: Schizophr Res. 2006 Sep;86(1-3):110-7
references.pmid: 16765029
references.citation: Schizophr Res. 2009 Sep;113(2-3):167-75
references.pmid: 19450952
references.citation: Schizophr Bull. 2012 Nov;38(6):1200-15
references.pmid: 21576280
references.citation: J Clin Psychiatry. 2005 Oct;66(10):1239-46
references.pmid: 16259537
references.citation: BMC Psychiatry. 2011 Feb 14;11:26
references.pmid: 21320302
references.citation: Neurosci Biobehav Rev. 2012 Apr;36(4):1140-52
references.pmid: 22305994
references.citation: Schizophr Res. 2007 Mar;91(1-3):226-37
references.pmid: 17267179
references.citation: Schizophr Bull. 2012 May;38(3):475-85
references.pmid: 20841326
references.citation: J Am Acad Child Adolesc Psychiatry. 2002 Jul;41(7):791-8
references.pmid: 12108803
references.citation: Arch Gen Psychiatry. 2000 Jun;57(6):593-600
references.pmid: 10839338
references.citation: Arch Gen Psychiatry. 2009 Jul;66(7):700-12
references.pmid: 19581561
references.citation: Am J Psychiatry. 2000 Oct;157(10):1652-9
references.pmid: 11007720