Christina Wenneberg

​​​​MD, Clinical assistant

​Project description

As a forerunner for psychosis is seen what is called the initial psychosis prodrome - accompanied by a gradual deterioration in psychosocial functioning and the development of clinical symptomatology. Intervention in this prodromal phase might delay or even prevent overt disease, and so a set of criteria has been developed in order to identify subjects at UHR (ultra-high risk of psychosis). 

These criteria (Comprehensive Assessment of at-Risk Mental States - CAARMS) require loss of function as well as either a genetic predisposition or the presence of sub threshold psychotic symptoms. Using the CAARMS criteria it has proven possible to identify UHR subjects, of which approximately 30% develop a psychotic episode within 1-2 years. 

The search for relevant biomarkers seems significant in the detection of UHR subjects, and for monitoring the subsequent treatment effect, and thereby delaying or preventing psychotic episodes. Disturbances in function of the neurotransmitter glutamate are suspected to be involved in the pathophysiology of schizophrenia. Disturbed glutamatergic levels in UHR subjects have been shown. 

An aim of this study is to detect differences in glutamate levels in UHR subjects compared with healthy controls, and to investigate whether the increased levels of glutamate in UHR subjects are predictors of long-term outcome. Cognitive deficits in schizophrenia are present prior to the onset of psychosis, and may be linked to perturbed glutamate function.  A connection has been found between glutamatergic levels and cognitive functioning, and it is plausible that an effect on glutamatergic levels will be seen in UHR subjects following cognitive remediation therapy (CRT). As a forerunner for psychosis is seen what is called the initial psychosis prodrome - accompanied by a gradual deterioration in psychosocial functioning and the development of clinical symptomatology. 

Intervention in this prodromal phase might delay or even prevent overt disease, and so a set of criteria has been developed in order to identify subjects at UHR (ultra-high risk of psychosis). These criteria (Comprehensive Assessment of at-Risk Mental States - CAARMS) require loss of function as well as either a genetic predisposition or the presence of sub threshold psychotic symptoms. 

Using the CAARMS criteria it has proven possible to identify UHR subjects, of which approximately 30% develop a psychotic episode within 1-2 years.The search for relevant biomarkers seems significant in the detection of UHR subjects, and for monitoring the subsequent treatment effect, and thereby delaying or preventing psychotic episodes. Disturbances in function of the neurotransmitter glutamate are suspected to be involved in the pathophysiology of schizophrenia. Disturbed glutamatergic levels in UHR subjects have been shown. An aim of this study is to detect differences in glutamate levels in UHR subjects compared with healthy controls, and to investigate whether the increased levels of glutamate in UHR subjects are predictors of long-term outcome. Cognitive deficits in schizophrenia are present prior to the onset of psychosis, and may be linked to perturbed glutamate function.  

A connection has been found between glutamatergic levels and cognitive functioning, and it is plausible that an effect on glutamatergic levels will be seen in UHR subjects following cognitive remediation therapy. ​

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