Welcome to the third PRONIA newsletter, coming this time from the University of Basel Psychiatric Hospital, Switzerland. With these yearly newsletters we hope to introduce you to the PRONIA project and keep you up to date with our progress so far, our plans for the future, and what individual members of the consortium have been up to since the last newsletter. We will also report on past meetings and give announcements of upcoming events. In addition, each newsletter will focus on one of our PRONIA team sites; this time the University of Basel Psychiatric Hospital, and our PRONIA team members here in Basel.
An introduction to the PRONIA project
The PRONIA project is a European Commission funded study with collaborators in the UK, Germany, Italy, Switzerland, Finland and Australia. The purpose of PRONIA is to develop a computerised tool which can predict the onset and course of early psychotic illness. Reliable and broadly accessible prognostic tools will significantly alleviate the burden of psychotic illness by enabling individualised risk prediction, and paving the way to the targeted prevention of psychoses. However, to date no reliable prediction tools have been developed.
Primarily, we are interested in the prediction of frank psychotic illness in individuals who are currently considered to be at risk of developing psychosis. Using a combination of different data types we hope to identify markers of risk which will allow us to predict whether an individual will develop psychosis, as well as which stage of psychotic illness they are currently in, and what their psychosocial outcomes will be.
To achieve this goal, we are collecting information on psychopathology, structural and functional neuroimaging, neuropsychological, metabolic and genomic data, as well as information on other factors that could affect outcome, such as personality, trauma, resilience and coping strategies. We collect this information from four different groups of people aged 16-40 years: those with recent onset psychosis, young people who are at-risk for psychosis, individuals with recent-onset depression, and healthy controls who have never experienced living with a mental illness. We then follow up participants at multiple time points over an 18 month period in order to monitor the development or remission of their symptoms. Finally, the data collected undergoes complex machine learning algorithms in order to develop reliable prediction tools.
The PRONIA consortium is comprised of 8 academic partners; University of Birmingham, UK, Ludwig Maximilian University Munich, Germany, University of Basel Psychiatric Hospital, Switzerland, University Hospital Cologne, Germany, University of Turku, Finland, University of Udine, Italy, University of Milan, Italy, and Melbourne Neuropsychiatry Centre, Australia; and 4 private sector partners; Dynamic Evolution, GE healthcare, GE Global Research, and ARTTIC.
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Into the 3rd year of PRONIA
The project is now in its 3rd year and all the hard work and efforts are becoming slowly visible. Not only have we recruited a total sample of over 1300 participants in total, first analyses were conducted and presented at the European Conference on Schizophrenia Research (ECSR) 2015 in Berlin and at the Schizophrenia International Research Society (SIRS) Conference 2016 in Florence.
Recently, an article about the possible causes of schizophrenia was published in the Frankfurter Rundschau, referring PRONIA.
In January 2016, the 5th Steering Committee Meeting was held in Munich, Germany. We held our 4th PRONIA General Assembly Meeting in April at the 5th Biennial Schizophrenia International Research Society Conference in Florence, Italy. Here we greeted our older members as well as welcoming some new members to our PRONIA team. More recently, the 7th PRONIA Steering Committee meeting was held in Munich in January 2017.
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The 5th Steering Committee Meeting took place in Munich in January 2016. During the Meeting the PRONIA PIs discussed the results achieved so far, as well as the future goals. The 4th General Assembly Meeting of PRONIA took place just before the Schizophrenia International Research Society (SIRS) Conference in Florence, Italy, together with the 6th Steering Committee Meeting. During the Meeting the PRONIA PI’s made several decisions. First they announced the extension of follow-up period by 18 months after T2. Reasons for the extension are a higher scientific value and an improved prediction. New follow-up time points will be at 27 and 36 months. They also agreed on a publication plan saying that one general article on PRONIA together with several methods papers should be published first. Other goals for the future are keeping the PRONIA website updated and to produce an awareness film about psychosis.
First results of MRI quality were presented at the European Conference on Schizophrenia Research (ECSR) Berlin 2015 and in Basel.
At the 7th PRONIA Steering Committee Meeting held in Munich, we heard lots of good news. Neurominer was announced to be released by the end of April 2017, the first data exports for PRONIA analyses is expected for spring/early summer 2017 and the PRONIA amendment 2 was accepted. In this amendment, the former project management company GABO:mi was terminated and new partners University of Milan and ARTTIC were included.
The next Steering Committee Meetings will be the 8th in Turku in Finland on 1-2 June 2017. The next General Assembly Meeting will take place shortly before the WPA World Congress in Berlin in October 2017.
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PRONIA @ SIRS 2016
During the 5th Biennial Schizophrenia International Research Society (SIRS) Conference, which took place from 2nd – 6th April 2016 in Florence, Italy, several young researchers from the PRONIA consortium presented their first analysis conducted on PRONIA data.
PRONIA Poster Presentations
The authors intended to determine whether schizotypy scores can be used to differentiate individuals with CHR from ROP at the single subject level and additionally which neuropsychological domains were related to schizotypal traits. Self-reported schizotypy scores using the brief form of the Wisconsin Schizotypy Scale (WSS) and data from the PRONIA neuropsychological battery of 304 participants, including 70 CHR, 65 ROP and 169 healthy controls (HC), were analyzed. The results indicated that social anhedonia items separate best between CHR and ROP patients and HC and this might be mediated by abnormalities in verbal and processing speed.
In this study it was investigated whether multivariate pattern classification using whole-brain resting-state FC facilitates the identification of individuals experiencing a ROP, as well as how these alterations relate to memory performance. Resting state fMRI images from 19 sex and gender matched HC and 19 ROP patients obtained from PRONIA were anaylsed. Results showed that the separation of ROP patients from HCs based on resting-state functional connectivity pattern classification is possible with an accuracy of 86.8%. Long range connections between the fronto-parietal regions complement previous findings indicating activations in these regions during this task.
For evaluating the mechanisms underlying functional decline and for an improved definition of targets for intervention, a more detailed analysis of the affection of the different domains of functioning and its illness-related pattern is required. Data from the “Functional Remisson of General Schizophrenia” Scale (FROGS), the “Global Functioning: Social and Role” Scale (GF S/R) and the “Global Assessment of Functioning” Scale (GAF) were analyzed for the three clinical groups CHR, ROP and ROD. Compared to healthy controls, CHR, ROP and ROD showed lower functioning scores on all scales. Among the patient groups, ROP scored significantly lower than the two other groups on the GAF as well as on the GF scales and all domains of the FROGS.
The current analysis aimed to investigating the relation of functioning and different types of (attenuated) positive symptoms as well as basic symptoms in ROP patients. Positive symptoms of ROP individuals assessed by the “Structured Interview of Prodromal Symptoms” (SIPS 5.0), basic symptoms assessed by the Schizophrenia Proneness Instrument adult version (SPI-A) and the level of functioning by the GF S/R and GAF Scale were analysed. Results indicated that particularly cognitive basic symptoms contribute significantly to the well-known functional deterioration in psychosis patients.
The aim of this study was to investigate levels of resilience in CHR patients in comparison to ROP and ROD patients. Data from the 'Resilience Scale for Adults' (RSA) for the three clinical groups CHR, ROP and ROD, as well as HC were analysed. Group comparisons revealed a significant difference between patients and HC. The latter showed higher total scores on the RSA than CHR, ROP and ROD participants. These results support the notion that lower resilience is associated with mental illness.
For the aim of early detection of psychosis, different clinical high risk (CHR) criteria have been developed. The first 76 CHR subjects included into PRONIA were considered for a first analysis of the distribution of the inclusion criteria. This preliminary analysis demonstrated a high correspondence between the PRONIA and the SIPS 5.0 definitions of UHR criteria. The proportion of individuals meeting the CAARMS criteria was considerably lower, which may be indicative of a lower sensitivity for at-risk mental states for psychosis.
To assess bullying in PRONIA, a modified, considerably shorter version of the Bully Survey was developed. Among other modifications, the PRONIA version enables a differentiation between experiences at school or within the current living situation and between onset before or after the age of 17. CHR, ROP and ROD patients reported significantly more bullying experiences than HC. Compared to HC, the CHR as well as the ROP and the ROD patients reported a significantly higher subjective burden due to the bullying experience.
Katherine Chisholm: Childhood Abuse in the Pronia dataset: A Comparison between First Episode Psychosis, Depression, Individuals at Risk of Psychosis, and Controls
The aim was to investigate how patterns of childhood abuse may differ between individuals diagnosed with a recent onset psychosis (ROP), those who meet ‘clinical high risk’ (CHR) criteria for psychosis and those diagnosed with resent onset of depression (ROD). 401 participants from age 15-40 years fulfilled the childhood trauma questionnaire about emotional, physical or sexual abuse and emotional or physical neglect. The results showed a consistent pattern of ROP reporting the highest levels of abuse across all subscales, followed by CHR participants, then ROD patients, with controls reporting the lowest levels of abuse.
Two of the PRONIA young researchers also won awards for their posters:
Poster Award Winners: Maria Urquijo (left) & Shalaila Haas (right)
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Since its release online on 26.02.2014, the PRONIA website (www.pronia.eu) counts 43.240 sessions in 151 countries; in 82 of those countries all over the world we have even had more than ten sessions per country on the PRONIA website. We update our website on a regular basis and look forward to attracting more visitors to our pages, which offer information for scientists and professionals as well as help-seekers and relatives.
In 2016, we have renewed our starting page for PRONIA. There is a new short text or teaser, to inform interested people about the project in a quick and easy way. Also, the header pictures are in a new format with three pictures changing over time.
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- Publishing the first flagship papers (concept paper, structural MRI, rs fMRI, DTI).
- PRONIA @ home is now available. An easy and convincing way of collecting data.
- The PRONIA App release is expected for summer 2017
- PRONIA scientists envisage to start with the first data analyses in summer 2017
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PRONIA’s consortium consists of 11 partners, and combined, makes up to over 100 individuals. Within this group, we come from a great range of backgrounds, including: clinical psychology, neurology, radiology, bio-engineering and psychiatry. Along-side our work on PRONIA, consortium members are working on other prestigious research projects, and presenting at conferences both nationally and internationally. Listed below are a few of our consortium members’ most recent achievements.
University of Basel Psychiatric Hospital (UPK)
Dr Claudia Lenz and Dr André Schmidt published an article about brain diffusion changes in emerging psychosis. Furthermore, Dr Lenz co-authored a review about neuroimaging in moderate MDMA use as well as a recently published review on commercial video games as a potential treatment in schizophrenia. Additionally, Laura Egloff (PhD student) presented a poster on verbal learning and memory in at-risk mental state and first episode psychosis patients at the 5th Biennial SIRS Conference (Poster T52).
The LMU Munich team is very happy about their success at the 5th Biennial Schizophrenia International Research Society Conference – SIRS 2016. They had three nominations for poster awards and Ms. Haas received the prize for Best Poster of the SIRS congress. Ms. Urquijo was awarded with one of the prizes from the Nature Partner Journals– NPJ Schizophrenia. Nikolaos Koutsouleris had a Plenary Talk on the topic “Toward Predictive Psychiatry – Prognostic and Diagnostic Applications of Pattern Recognition Methods”. Additionally their team has received grants to develop projects related to PRONIA. Dr. Lana Kambeitz-Ilankovic obtained two very important grants from the Junior Researcher Fund at the Ludwig-Maximilians-University in Munich and from the Friedric-Baur-Foundation. Dr. Joseph Kambeitz received a grant from the German Research Foundation.
The team of LMU Munich published several new papers:
University of Cologne
Prof Stefan Ruhrmann and his colleagues published several papers on psychosis:
as well as papers on schizophrenia:
Nathalie Kaiser (Research Associate), who has been working for PRONIA since October 2013, will be on maternity leave from beginning of July 2016 until July 2017. Nathalie Kaiser had an oral presentation about the early detection and intervention of psychosis at the Soul Food event back in April (http://www.fetz.org/html/aktuelles.html). During Natalie Kaiser’s maternity leave, she will be replaced by Mauro Seves (MSc Psych) who has completed an internship at the Early Recognition Centre of the University Hospital Cologne under the direction of Prof Stephan Ruhrmann, where he also absolved his master thesis. There, he got familiar with the PRONIA project and will be in charge for administrative aspects of the PRONIA project in cologne from the beginning of August 2016.
University of Udine
The group of the University of Udine/University of Milan remains stable with Prof Paolo Brambilla and his research fellows Dr Carolina Bonivento and Dr Adele Ferro. Together with Sara Piccin and further group associates, they are finalising a medical thesis of a resident in psychiatry who has helped with the recruitment. Furthermore, several analyses and manuscripts are currently underway. Unfortunately two further group associates Livia Fornasari and Monica Leskovec left their group.
Prof Paolo Brambilla and his colleagues have published some papers related to PRONIA themes:
University of Birmingham
Dr Katharine Chisholm (Research Fellow) and Professor Stephen Wood presented some of the baseline data from PRONIA at the Schizophrenia International Research Society Conference, with one of their posters nominated as a poster finalist. Dr Chisholm has been successful in gaining a travel grant to visit colleagues at Melbourne University, and funding which enabled the Birmingham PRONIA site to purchase DNA saliva collection kits. Dr Chisholm has also published 2 papers based on her PhD work which focused on promoting mental health in adolescents in the BMJ Open (http://bmjopen.bmj.com/content/6/2/e009435.abstract) and Early Intervention in Psychiatry (http://www.ncbi.nlm.nih.gov/pubmed/27168481) and a book chapter which focused on the association between autism and psychosis. Mariam Iqbal (Research Associate) has been successfully accepted onto the University of Liverpool’s Clinical Doctorate programme. We are sad to lose Mariam from the Birmingham team but are excited and happy that she was accepted onto such a competitive programme and hope to continue to work with her in the future. Alexandra Stainton (PhD student) began her PhD study on RPONIA in September, receiving the University of Birmingham Alumni Scholarship to support her studies. Additionally, Alex’s undergraduate dissertation project has recently been published in Brain and Cognition (http://www.ncbi.nlm.nih.gov/pubmed/27045450). In addition, this year the Birmingham PRONIA team has welcomed Mirabel Pelton (voluntary research assistant), Chris Day (placement student from Aston University), and Shauna Benton, Andreea Tudor, and Barry O'Mahony (MSci and MRes students at the University of Birmingham).
University of Turku
The group in Turku welcomed MSc Anna Toivonen in her team. After graduation from Åbo Akademi University (Swedish language university in Turku) she has worked as a clinical psychologist for 6 years at psychiatric hospital ward of Turku welfare division. She is now starting her PhD studies.
Psychiatric nurse Anu Ellilä returned to her private clinic and does not continue in PRONIA anymore. MD Otto Turtonen went back to the psychiatric hospital ward of Turku welfare division for the rest of 2016. He will probably come back to our team in January 2017.
There are some new articles published by the Turku team:
GABO:mi - terminated
Due to external circumstances, the former project management company GABO:mi had to be terminated as a partner of PRONIA on 30 June 2016.
University of Milan (UMIL) - new beneficiary
UMIL is our new partner in Italy since 1 May 2016. After the transfer of the PRONIA PI in Udine to the University of Milan, Prof. Paolo Brambilla, we are very happy to welcome the University of Milan as a new partner in PRONIA who will strengthen the recruitment and support PRONIA with the neuroimaging predictors and neurocognitive predictors (new lead of work package 4).
ARTTIC S.A.S. - new beneficiary
ARTTIC is the new project management partner of PRONIA since 1st of July 2016. As a project management company and consultancy service, ARTTIC ensures the overall management of the project by supporting the Coordinator. It assists the PRONIA consortium in carrying out its contractual duties, in addition to advising and guiding the participants to comply with the EU regulations and with their contractual requirements.
ARTTIC also supports the dissemination, communication and exploitation activities of the project.
Claudia Lenz: Unfortunately, Claudia will leave the PRONIA team Basel in January 2017. We would like to express our gratitude for her great work and commitment. We wish her all the best and will miss her and her expertise for sure.
Anna Walter: In April 2016, Anna decided to face new challenges and left the University of Basel Psychiatric Hospital as well as the PRONIA team. We wish her all the best with her new position as senior physician in the rehabilitation sector.
Carlos Cabral: Carlos left the LMU Munich and PRONIA in October 2016 to pursue new challenges. We are very thankful for all his efforts towards PRONIA and wish him all the best in his new position.
André Schmidt: André will be the replacement for Claudia Lenz and assume her responsibilities. Welcome to the PRONIA team, André!
Anne Ruef: Anne is taking over the tasks from Carlos Cabral, we are very happy to welcome her to PRONIA at the LMU Munich!
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Meet the Team – The University of Basel Psychiatric Hospital
Prof Dr med Stefan Borgwardt (Principal Investigator)
Stefan Borgwardt, MD PhD, is the principal investigator for PRONIA in Basel. He is senior consultant of the Diagnostic and Crisis Intervention Centre, Department of Psychiatry (UPK), Basel and Professor of Neuropsychiatry at the University of Basel. In addition, he is Visiting Professor at the Institute of Psychiatry, King’s College, London.
His research interests include structural and functional neuroimaging, pharmacology neuroimaging methods, the prodromal and early phase of psychosis, neurocognitive and genetic mechanisms in schizophrenia, and the neurofunctional mechanisms of cannabinoids and heroin. Clinical interests include prodromal and early psychosis and neuropsychiatry.
Prof Dr med Anita Riecher-Rössler (Clinical Investigator)
Anita Riecher-Rössler, MD PhD, is since 1998 Professor of Psychiatry at the University of Basel and Head of the Center for Gender Research and Early Detection at the University of Basel Psychiatric Hospital in Basel, Switzerland. She is specialized in psychiatry, psychotherapy and psychoanalysis, as well as in consultation and liaison psychiatry and in gerontopsychiatry.
Her research work is mainly in the field of schizophrenic psychoses, on the onset and early detection, but also on late onset schizophrenia and gender differences in these psychoses.
Her other research focus is on specific aspects of mental disorders in women.
Dr phil Claudia Lenz (Postdoctoral research fellow)
Claudia Lenz studied physics at the University of Basel and graduated in 2008. In 2011, she completed her Ph.D. in biophysics at the University Hospital of Basel working on MRI physics. She then was employed as a medical physicist in radiation oncology and passed the exams to become a board certified medical physicist. Currently, Claudia works as a post-doc at the University Hospital of Psychiatry in Basel. Her main interest is translational research in brain MRI to bridge the gap between basic imaging physics and clinical needs in neuropsychiatry.
Dr sc nat André Schmidt (Postdoctoral research fellow)
André Schmidt studied neuroscience at the ETH in Zurich. He completed his Ph.D. at the University Hospital of Psychiatry in Zurich working on electro-pharmacological models of psychosis with the aim to study pathophysiological mechanisms of specific symptom formation, in particular of cognitive impairments. André Schmidt has just returned from Kings College London, where he spent the last 1.5 years thanks to a Swiss National Foundation Mobility Grant. Currently, he works as a postdoctoral research fellow at the University Hospital of Psychiatry in Basel with a research focus on sophisticated connectivity analyses of resting-state and functional imaging data implicated in diverse psychiatric diseases.
Laura Egloff (MSc Psychology, PhD student)
Laura Egloff studied Cognitive Neuropsychology at the University of Basel and graduated in 2014. Currently, Laura works as a PhD student at the University of Basel Psychiatric Hospital. Her main interests are neuropsychological and brain structural alterations in emerging psychosis as well as sophisticated statistical techniques, including structural equation modelling and prediction modelling, to evaluate such alterations.
Délia Felder (Master student Psychology)
Délia Felder studies Psychology at the University of Basel and is our current PRONIA student apprentice.
Dario Berther (Civil servant)
Dario Berther is our current civil servant performing his community service at our site.
Doris Blaser (Secretary)
Doris Blaser is responsible for all administrative concerns in PRONIA.
The core team is supported by members of the Center for Gender Research and Early Detection at the University of Basel Psychiatric Hospital
Ulrike Heitz (MSc Psychology, PhD student)
Ulrike Heitz studied psychology at the University of Strasbourg, the University of Vienna and the University of Maastricht. In 2013 she graduated in Neuropsychology and in 2014 she started her PhD and advanced training in psychotherapy at the University of Basel Psychiatric Hospital. Since the beginning of 2016 she has been senior psychologist at the early detection for psychosis (FePsy) clinic in Basel.
Letizia Leanza (MSc Psychology, PhD student)
Letizia Leanza has just finished her studies in Psychology at the University of Basel and started working as a PhD student and junior psychologist at the University of Basel Psychiatric Hospital in August 2016. Letizia has already gained a lot of research experience during her master studies, which she spent at the early detection for psychosis (FePsy) center.
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