UHR Research

Ultra High Risk Research

Leaders

Prof Alison Yung and Dr Barnaby Nelson

Members

A/Prof Paul Amminger, Connie Markulev, Dr Suzie Lavoie, Jaymee Ryan, Emily Li, Marija Strmota, Amber Williams, Anneliese Spiteri-Staines

Collaborators

Prof Stephen Wood; Dr Ashleigh Lin; Dr Andrew Thompson

Key Achievements

  • Completion of a long-term follow-up study of PACE research participants (‘PACE 400’). Various papers based on this study are published and in preparation.
  • Completion of a prospective study of basic self disturbance in the ultra high risk population, resulting in published and in press papers.
  • Completion of a study of borderline personality disorder in the ultra high risk population, resulting in a paper.
  • Collaborations with the University of Rome, University of Birmingham and the Institute of Psychiatry, London, resulting in published and in press papers.
  • Presentations by PACE research members at a number of conferences (e.g., ASPR, SIRS, WPA, ICOSR).
  • Prof Yung was awarded the Richard Wyatt Award “awarded to an individual who has made a remarkable contribution to the area of early intervention.” Presented at the International Early Psychosis Association conference, Amsterdam, December 2010.
  • Dr Nelson received an NHMRC Career Development Fellowship to pursue further research in this area.

Current Research Projects

  • Neurapro: A multicentre RCT of omega-3 fatty acids and cognitive behavioural case management for symptomatic patients at ultra high risk for early progression to schizophrenia and other psychotic disorders.

The primary aim of this international RCT is to assess whether omega-3 fatty acids, in addition to cognitive behavioural case management, reduces the incidence of first episode psychosis in an ultra high risk cohort.

The study is currently in the recruitment phase.

  • Rates of psychosis onset in a high risk population (“Late PACE”)

This NHMRC funded study is a long term follow up study of PACE research participants originally seen between 2002-2006 (n = 226). Various outcomes – including clinical, functional, neurocognitive and neurostructural variables – will be assessed.

The study is currently in the recruitment phase.

  • The European Union Gene Environment Interaction in Psychosis Study (EU-GEI)

This is a multisite study led by the Institute of Psychiatry, London and the University of Maastricht examining gene-environment interactions in the onset of psychosis.

The study has recently been submitted to the Human Research Ethics Committee.

  • Trauma, stress reactivity and prediction of outcome in an ultra high risk for psychosis population

This study, embedded in the Neurapro study, aims to examine the prevalence of trauma in the ultra high risk population and the relationship between trauma and stress reactivity in the prediction of outcome, including onset of psychotic disorder.

The study is currently in the recruitment phase.

  • Social cognition and social functioning in young people at risk of developing psychosis

To investigate social cognitive ability and level of social functioning in the UHR population and to compare this to controls and first episode psychosis patients.

The study has finished recruitment and is in the write up phase. 30 UHR patients, 30 controls and 38 FEP patients were recruited.

  • Pilot evaluation of at-risk criteria for bipolar disorder (BARPS)

This study aims to prospectively validate a set of 'at-risk criteria' for the development of bipolar affective disorder (BPAD) in a young help-seeking population. The primary aim is to generate data on conversion rates to BPAD, with the secondary aim being to comprehensively describe the 'at-risk' population (e.g. psychopathology, functioning, substance use, quality of life, temperament and comorbidity) in order to understand their clinical needs.

This study is in the data analysis and paper production phase.

  • Electroencephalography (EEG) study: Effect of Omega-3 Fatty Acid Supplementation on the Generation of the Mismatch Negativity in People At Ultra-High Risk for Psychosis.

In the context of the Neurapro study, the brain activity of individuals at ultra-high risk for psychosis is measured. Indeed, we have good reasons to believe that omega-3 fatty acid treatment could improve some EEG component or prevent them from deteriorating.

Other projects:

  • A medical file audit using a case-control methodology to retrospectively assess clinical characteristics of UHR patients who transition to psychosis versus those who do not. Papers from this study are currently in preparation.
  • Analysis of the staging model of psychiatric disorders using data collected in the ‘PACE 400’ study has been completed and a paper is in preparation.