Wearable technologies and digital phenotyping foster unique opportunities for designing novel intelligent electronic services that can address various well-being issues in patients with mental disorders (i.e., schizophrenia and bipolar disorder), thus having the potential to revolutionize psychiatry and its clinical practice. In this paper, we present e-Prevention, an innovative integrated system for medical support that facilitates effective monitoring and relapse prevention in patients with mental disorders. The technologies offered through e-Prevention include: (i) long-term continuous recording of biometric and behavioral indices through a smartwatch; (ii) video recordings of patients while being interviewed by a clinician, using a tablet; (iii) automatic and systematic storage of these data in a dedicated Cloud server and; (iv) the ability of relapse detection and prediction. This paper focuses on the description of the e-Prevention system and the methodologies developed for the identification of feature representations that correlate with and can predict psychopathology and relapses in patients with mental disorders. Specifically, we tackle the problem of relapse detection and prediction using Machine and Deep Learning techniques on all collected data. The results are promising, indicating that such predictions could be made and leading eventually to the prediction of psychopathology and the prevention of relapses.

This study examined the connection between two prominent deficits in schizophrenia: the deficit in parasympathetic regulation and the deficit in cognitive inhibitory control, within the framework of the Neurovisceral Integration Model (NIM).Thirty healthy controls and 30 patients with schizophrenia performed the internationally standardized antisaccade protocol while their electrocardiographic data were recorded. The interaction between the group, the cognitive inhibitory control as measured with error rate (ER) in the antisaccade task and parasympathetic activity as measured with the High Frequency power component of Heart Rate Variability (HF-HRV) was tested.Findings confirmed that decreased HF-HRV was specifically related to increased ER in patients with schizophrenia. In contrast, patient deficits in other oculomotor function measures such as reaction time and reaction time variability related to volitional movement control and cognitive stability respectively were not linked to the deficit in parasympathetic regulation.Our study validates the theory behind NIM proposing that cognitive inhibition has common physiological substrate with parasympathetic regulation. Future research could test this brain-heart link in other mental disorders especially those with a prominent deficit in inhibitory cognitive function.

Interleukin-1 beta (IL1β) is primarily produced by monocytes in the periphery and the brain. Yet, IL1β protein levels have to date been investigated in major depressive disorder (MDD) and antidepressant response using either plasma or serum assays although with contradictory results, while mononuclear cell assays are lacking despite their extensive use in other contexts. In this pilot study, we comparatively assessed IL1β in mononuclear lysates and plasma in depressed MDD patients over treatment and healthy controls (HC). We recruited 31 consecutive adult MDD inpatients and 25 HC matched on age, sex, and BMI. Twenty-six patients completed an 8-week follow-up under treatment. IL1β was measured in both lysates and plasma in patients at baseline (T0) and at study end (T1) as well as in HC. We calculated ΔIL1β(%) for both lysates and plasma as IL1β percent changes from T0 to T1. Seventeen patients (65.4% of completers) were responders at T1 and had lower baseline BMI than non-responders (p = 0.029). Baseline IL1β from either plasma or lysates could not efficiently discriminate between depressed patients and HC, or between responders and non-responders. However, the two response groups displayed contrasting IL1β trajectories in lysates but not in plasma assays (response group by time interactions, p = 0.005 and 0.96, respectively). ΔIL1β(%) in lysates predicted response (p = 0.025, AUC = 0.81; accuracy = 84.6%) outperforming ΔIL1β(%) in plasma (p = 0.77, AUC=0.52) and was robust to adjusting for BMI. In conclusion, ΔIL1β(%) in mononuclear lysates may be a longitudinal biomarker of antidepressant response, potentially helpful in avoiding untimely switching of antidepressants, thereby warranting further investigation.

Sensory processing deficits and altered long-range connectivity putatively underlie Multisensory Integration (MSI) deficits in Autism Spectrum Disorder (ASD). The present study set out to investigate non-social MSI stimuli and their electrophysiological correlates in young neurotypical adolescents and adolescents with ASD. We report robust MSI effects at behavioural and electrophysiological levels. Both groups demonstrated normal behavioural MSI. However, at the neurophysiological level, the ASD group showed less MSI-related reduction of the visual P100 latency, greater MSI-related slowing of the auditory P200 and an overall temporally delayed and spatially constrained onset of MSI. Given the task design and patient sample, and the age of our participants, we argue that electro-cortical indices of MSI deficits in ASD: (a) can be detected in early-adolescent ASD, (b) occur at early stages of perceptual processing, (c) can possibly be compensated by later attentional processes, (d) thus leading to normal MSI at the behavioural level.

BACKGROUND.: The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model. METHODS.: Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed. RESULTS.: The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage. CONCLUSIONS.: The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct "cores" of schizophrenia, the "Positive" and the "Negative," while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.

BACKGROUND: Patients with body dysmorphic disorder (BDD) exhibit differential attentional mechanisms compared to healthy subjects. The exact nature of this differentiation is unclear. To this end, EEG (electrophysiological) responses to prepulse inhibition (PPI: reflecting attentional modulation) and prepulse facilitation (PPF: indicating orienting activation) were recorded and analysed. The aim of this study was to compare the respective neural oscillations associated with PPI and PPF in BDD vs healthy controls. MATERIALS AND METHODS: Event-related EEG oscillations elicited by PPI and PPF (26 and 25 trials, respectively, randomly presented) were explored in a sample of patients with BDD (N = 30) vs healthy controls (N = 25). The Yale-Brown Obsessive-Compulsive Scale for BDD (BDD-YBOCS), the Body Dysmorphic Disorder Examination, the Dysmorphic Concern Questionnaire (DCQ) and the Brown Assessment of Belief Scale (BABS) were also administered. RESULTS: Analysis of the power spectrum in response to PPI and PPF revealed that the BDD patient group compared to healthy controls exhibited higher theta-1 oscillations (potentially indicative of disrupted thalamo-cortical activation) and reduced beta-1 oscillations (potentially indicative of reduced top-down-controlled processing during attentional orienting). CONCLUSION: These findings offer novel contributions with regards to the neural mechanisms underlying attention processes in BDD patients, and demonstrate the potential of event-related EEG oscillations as a tool to better understand body dysmorphic disorder.

The increasing proportion of variance in human complex traits explained by polygenic scores, along with progress in preimplantation genetic diagnosis, suggests the possibility of screening embryos for traits such as height or cognitive ability. However, the expected outcomes of embryo screening are unclear, which undermines discussion of associated ethical concerns. Here, we use theory, simulations, and real data to evaluate the potential gain of embryo screening, defined as the difference in trait value between the top-scoring embryo and the average embryo. The gain increases very slowly with the number of embryos but more rapidly with the variance explained by the score. Given current technology, the average gain due to screening would be ≈2.5 cm for height and ≈2.5 IQ points for cognitive ability. These mean values are accompanied by wide prediction intervals, and indeed, in large nuclear families, the majority of children top-scoring for height are not the tallest.

BACKGROUND: It has been suggested that the use of window functions, other than the rectangular, in the sliding window method, may be beneficial for reducing the effects of motion-related outliers in the time-series, when assessing dynamic functional connectivity (dFC) in resting-state fMRI (rs-fMRI). METHODOLOGY: Ten window functions for a wide range of window lengths (20-150 s) combined with Pearson and Kendall correlation metrics, were investigated. One hundred high quality rs-fMRI datasets from healthy controls, were used to systematically assess the effect of varying the window function and length on dFC assessment. To this end, two approaches were implemented: a) simulated outliers were added to the experimental data and b) the experimental data were divided into low and high motion subgroups. RESULTS: The presence of experimental motion-noise tended to inflate the number of dynamic connections for longer (≥100 s) wide-shaped windows, while shorter (20-30 s) narrow-shaped windows exhibited increased sensitivity in the presence of simulated outliers. Moreover, window sizes from 60 s to 90 s were mildly affected by motion-related effects. In most cases, the number of dynamic connections increased, and gradually lower frequencies were captured, with an increasing window size. CONCLUSIONS: Subject motion considerably affects the obtained dFC patterns; thus, it is preferable to perform motion artefact removal in the pre-processing stage rather than using alternative window functions to mitigate their effects. Provided that motion-noise is not excessive, the choice of a rectangular window is adequate. Finally, low frequency oscillations in functional connectivity seem to play an important role in the context of dFC assessment.

INTRODUCTION: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and to develop such a staging method. MATERIALS AND METHODS: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21±11.87 years with schizophrenia. Analysis of Covariance, Exploratory Factor Analysis (EFA), Discriminant Function Analysis (DFA) and inspection of resultant plots were performed. RESULTS: EFA returned five factors explaining 59% of the variance (Positive-Po, Negative-Ne, Excitement/Hostility-EH, Depression/Anxiety-DA and Neurocognition-Ncog). The staging model included four main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: Po; stage 2a and 2b: EH; stage 3a and 3b: DA; stage 4a and 4b: Ncog). There were no differences between sexes. The DFA developed an algorithm which correctly classified >85% of patients. DISCUSSION: This study elaborates a five-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.

Schizotypal personality traits may increase proneness to psychosis and likely index familial vulnerability to schizophrenia (SZ), implying shared genetic determinants with SZ. Here, we sought to investigate the contribution of common genetic risk variation for SZ on self-reported schizotypy in 2 ethnically homogeneous cohorts of healthy young males during compulsory military service, enrolled in the Athens Study of Proneness and Incidence of Schizophrenia (ASPIS, N = 875) and the Learning on Genetics of Schizophrenia Spectrum study (LOGOS, N = 690). A follow-up psychometric assessment was performed in a sub-sample of the ASPIS (N = 121), 18 months later at military service completion. Polygenic risk scores (PRS) for SZ were derived based on genome-wide association meta-analysis results from the Psychiatric Genomics Consortium. In the ASPIS, higher PRSSZ significantly associated with lower levels of positive (ie, perceptual distortions), disorganization and paranoid facets of schizotypy, whereas no association with negative (ie, interpersonal) facets was noted. Importantly, longitudinal data analysis in the ASPIS subsample revealed that PRSSZ was inversely associated with positive schizotypy at military induction (stressed condition) but not at follow-up (nonstressed condition), providing evidence for environmental rather than SZ-implicated genetic influences. Moreover, consistent with prior reports, PRSSZ was positively correlated with trait anxiety in the LOGOS and additionally the recruits with higher PRSSZ and trait anxiety exhibited attenuated paranoid ideation. Together, these findings do not support an etiological link between increased polygenic liability for SZ and schizotypy, suggesting that psychosocial stress or trait anxiety may impact schizotypal phenotypic expressions among healthy young adults not genetically predisposed to SZ.