Blood biomarkers as an independent predictor of psychosis in at-risk mental satates for psychosis

Abstract

BACKGROUND: Psychosis is a severe mental disorder that impairs the patient’s entire behaviour and psychosocial functioning; it is characterized by delusions, hallucinations, thought and behaviour disorganization, and negative symptoms. Psychotic disorders affect a 3% of population, beginning before 25 years of age. Psychosis supposes high costs for Health Care System and a worse quality of life and life expectancy for the affected population. It is known that psychosis prognosis is related to diagnoses and treatment delay. Because of this, early intervention programmes are very important, thus improving the burdens of psychotic disorders. The problem is that, nowadays, early intervention tools detect a huge number of high risk patients which may never suffer psychotic disorders in the future. Psychotic disorders can be understood as neurodevelopment disorders, this fact is because of the evidence in new research which shows that some biomarkers can appear altered before psychosis develops. Therefore, an abnormal maturation of the brain in combination with the presence of known risk factors could interact modifying these biomarkers (BDNF, ApoE and IL-6) levels. In accordance to all of the above, more specific instruments are needed for early psychosis detection. Biomarkers are a promising path of researching. OBJECTIVE: To analyse if BDNF, ApoE and IL-6 serum levels are different between high risk of psychosis patients which develop a first episode of psychosis to those who do not. DESIGN: This project is a pilot multicentre prospective cohort study. METHOD: Blood samples collection and psychopathological interview evaluation will be done every 6 months during 3 years to patients that are considered by their physicians as at-risk mental state for psychosis (ARMS). We will follow up a cohort of 100 ARMS, monitoring biomarkers plasma levels since the beginning of the project and, the absence or presence of a first episode of psychosis (FEP) (using The Positive and Negative Syndrome Scale: PANNS). Thus, we can know if there is some relation between biomarkers blood levels and the development of a FEP