2024
Antipsychotic drugs in first-episode psychosis: a target trial emulation in the FEP-CAUSAL Collaboration
Szmulewicz A, Martínez-Alés G, Logan R, Ferrara M, Kelly C, Fredrikson D, Gago J, Conderino S, Díaz-Caneja C, Galvañ J, Thorpe L, Srihari V, Yatham L, Sarpal D, Shinn A, Arango C, Öngür D, Hernán M, Collaboration O. Antipsychotic drugs in first-episode psychosis: a target trial emulation in the FEP-CAUSAL Collaboration. American Journal Of Epidemiology 2024, 193: 1081-1087. PMID: 38576166, DOI: 10.1093/aje/kwae029.Peer-Reviewed Original ResearchFirst-episode psychosisFirst-generation agentsAntipsychotic therapyAntipsychotic drugsPsychosis onsetPsychotic disordersEpisode psychosisAripiprazolePaliperidoneRisk of hospitalizationPsychosisTarget trialsRisperidoneOlanzapineFirst-line therapyTreatment discontinuationEUFESTObservational cohortAntipsychoticsQuetiapineRandomized trialsPrimary outcomeAbsolute riskRisk differenceClinical questions
2022
Illness Phase as a Key Assessment and Intervention Window for Psychosis
Kohler C, Wolf D, Abi-Dargham A, Anticevic A, Cho Y, Fonteneau C, Gil R, Girgis R, Gray D, Grinband J, Javitch J, Kantrowitz J, Krystal J, Lieberman J, Murray J, Ranganathan M, Santamauro N, Van Snellenberg J, Tamayo Z, Group T, D'Souza D, Srihari V, Gueorguieva R, Patel P, Forselius-Bielen K, Lu J, Butler A, Fram G, Afriyie-Agyemang Y, Selloni A, Cadavid L, Gomez-Luna S, Gupta A, Radhakrishnan R, Rashid A, Aker R, Abrahim P, Nia A, Surti T, Kegeles L, Carlson M, Goldberg T, Gangwisch J, Benedict E, Govil P, Brazis S, Mayer M, de la Garrigue N, Fallon N, Baumvoll T, Abeykoon S, Perlman G, Bobchin K, Elliott M, Schmidt L, Rush S, Port A, Heffernan Z, Laney N, Kantor J, Hohing T, Gur R, Gur R, Calkins M. Illness Phase as a Key Assessment and Intervention Window for Psychosis. Biological Psychiatry Global Open Science 2022, 3: 340-350. PMID: 37519466, PMCID: PMC10382701, DOI: 10.1016/j.bpsgos.2022.05.009.Peer-Reviewed Original ResearchIllness phasePotential critical windowsPhase-specific biomarkersDopaminergic abnormalitiesFunctional outcomeSpecialty careSymptom assessmentIllness stageChronic illnessClinical assessmentIllness trajectoryNeurophysiological biomarkersFunctional abnormalitiesClinical careEarly psychosisMemory dysfunctionPsychotic disordersTreatment targetsAllostatic adaptationIntervention windowClinical programsBrain developmentCritical windowDysfunctionIllnessTiming of cannabis exposure relative to prodrome and psychosis onset in a community-based first episode psychosis sample
Kline ER, Ferrara M, Li F, D'Souza DC, Keshavan M, Srihari VH. Timing of cannabis exposure relative to prodrome and psychosis onset in a community-based first episode psychosis sample. Journal Of Psychiatric Research 2022, 147: 248-253. PMID: 35066293, PMCID: PMC8882157, DOI: 10.1016/j.jpsychires.2022.01.039.Peer-Reviewed Original ResearchConceptsCannabis exposurePublic health significancePsychosis onsetPsychotic disordersHealth significanceFirst-episode psychosis samplePsychosis sampleFirst exposureFirst-episode psychosis servicesWorse premorbid functioningAdverse prognostic factorAssociation of ageImpact of cannabisPsychosis PreventionSymptom onsetPrognostic factorsOverall incidenceEarly psychosis sampleConsecutive admissionsOverall burdenPsychotic illnessPsychosis servicesPsychosis symptomsGreater severityYounger age
2020
Cognitive Effort and Amotivation in First-Episode Psychosis
Fortgang RG, Srihari V, Cannon TD. Cognitive Effort and Amotivation in First-Episode Psychosis. Journal Of Psychopathology And Clinical Science 2020, 129: 422-431. PMID: 32162929, DOI: 10.1037/abn0000509.Peer-Reviewed Original ResearchConceptsCognitive effortFirst-episode psychosisCognitive test performanceObserved cognitive deficitsAdditional monetary incentivesCognitive remediationCognitive tasksCognitive performanceDifficult trialsNovel taskCognitive deficitsAmotivationImpaired cognitionTest performanceCore featuresDisengagementLower overall accuracyHealthy community membersMonetary incentivesCurrent studyEpisode psychosisFEP patientsPsychotic disordersReduced effortTask
2015
Too Late and Too Little: Narratives of Treatment Disconnect in Early Psychosis
van Schalkwyk GI, Davidson L, Srihari V. Too Late and Too Little: Narratives of Treatment Disconnect in Early Psychosis. Psychiatric Quarterly 2015, 86: 521-532. PMID: 25663602, PMCID: PMC5576358, DOI: 10.1007/s11126-015-9348-4.Peer-Reviewed Original ResearchConceptsFirst episode psychosis programLong-term outcomesSpecialized treatment servicesOnset of psychosisInitial contactSpecialized servicesYounger patientsSignificant morbidityPsychosis programPatient preferencesEarly treatmentEffective treatmentEarly psychosisPsychiatric careTreatment experienceTreatment prioritiesPsychotic disordersTreatment servicesPatientsInductive thematic analysisFurther treatmentTreatmentDisproportionate improvementBehavioral changesCritical periodFirst-Episode Services for Psychotic Disorders in the U.S. Public Sector: A Pragmatic Randomized Controlled Trial
Srihari VH, Tek C, Kucukgoncu S, Phutane VH, Breitborde NJ, Pollard J, Ozkan B, Saksa J, Walsh BC, Woods SW. First-Episode Services for Psychotic Disorders in the U.S. Public Sector: A Pragmatic Randomized Controlled Trial. Psychiatric Services 2015, 66: 705-712. PMID: 25639994, PMCID: PMC4490067, DOI: 10.1176/appi.ps.201400236.Peer-Reviewed Original ResearchConceptsUsual treatmentSTEP participantsCommunity mental health centerFirst-episode servicesFirst-episode psychosisMental health centersSerious mental illnessInpatient psychiatric unitAntipsychotic exposureAdditional patientsIllness onsetHospital utilizationHealth centersInpatient utilizationPsychiatric hospitalizationMAIN OUTCOMEPsychotic illnessPsychiatric unitPsychotic disordersHospitalizationEarly interventionMental illnessSpecialized treatmentPatientsTranslational research
2014
Reducing the duration of untreated psychosis and its impact in the U.S.: the STEP-ED study
Srihari VH, Tek C, Pollard J, Zimmet S, Keat J, Cahill JD, Kucukgoncu S, Walsh BC, Li F, Gueorguieva R, Levine N, Mesholam-Gately RI, Friedman-Yakoobian M, Seidman LJ, Keshavan MS, McGlashan TH, Woods SW. Reducing the duration of untreated psychosis and its impact in the U.S.: the STEP-ED study. BMC Psychiatry 2014, 14: 335. PMID: 25471062, PMCID: PMC4262386, DOI: 10.1186/s12888-014-0335-3.Peer-Reviewed Original ResearchConceptsEarly detectionEarly outcomesGeographic catchmentTIPS studyYounger patientsAppropriate patientsUntreated psychosisPsychosis onsetEffective treatmentCare providersPsychotic symptomsPublic education campaignsPsychotic disordersHelp-seeking behaviorSecondary aimComprehensive interventionPatientsIntervention servicesDUPEducation campaignsOutcomesSocial marketing approachPrimary aimTreatmentFES
2013
Automatic Auditory Processing Deficits in Schizophrenia and Clinical High-Risk Patients: Forecasting Psychosis Risk with Mismatch Negativity
Perez VB, Woods SW, Roach BJ, Ford JM, McGlashan TH, Srihari VH, Mathalon DH. Automatic Auditory Processing Deficits in Schizophrenia and Clinical High-Risk Patients: Forecasting Psychosis Risk with Mismatch Negativity. Biological Psychiatry 2013, 75: 459-469. PMID: 24050720, PMCID: PMC4028131, DOI: 10.1016/j.biopsych.2013.07.038.Peer-Reviewed Original ResearchConceptsCHR patientsHealthy control subjectsPsychosis onsetControl subjectsClinical high-risk patientsEarly illness schizophrenia patientsPsychosis riskClinical high-risk individualsHigh-risk patientsThird of patientsHigh-risk individualsCurrent clinical criteriaAuditory processing deficitsMismatch negativityNonclinical measuresAuditory devianceCox regressionClinical criteriaUnnecessary treatmentHigh riskCHR convertersPatientsPsychotic disordersSchizophrenia patientsPreventive interventionsChapter 10 Early auditory gamma-band responses in patients at clinical high risk for schizophrenia
Perez VB, Roach BJ, Woods SW, Srihari VH, McGlashan TH, Ford JM, Mathalon DH. Chapter 10 Early auditory gamma-band responses in patients at clinical high risk for schizophrenia. Supplements To Clinical Neurophysiology 2013, 62: 147-162. PMID: 24053038, PMCID: PMC4120874, DOI: 10.1016/b978-0-7020-5307-8.00010-7.Peer-Reviewed Original ResearchConceptsClinical high riskPhase-locking factorGamma-band responseAuditory gamma-band responsesCHR patientsHigh riskSchizophrenia patientsChronic schizophrenia patientsNMDA glutamate receptorsYounger schizophrenia patientsTransient gamma-band responseTrend-level reductionsNeurotransmission abnormalitiesGamma-band oscillationsYounger patientsIllness onsetProdromal symptomsPhase synchronyProdromal periodHealthy controlsPsychosis onsetPatientsPsychotic disordersCHR groupElectroencephalographic studies
2009
Public-academic partnerships: early intervention for psychotic disorders in a community mental health center.
Srihari VH, Breitborde NJ, Pollard J, Tek C, Hyman L, Frisman LK, McGlashan TH, Jacobs S, Woods SW. Public-academic partnerships: early intervention for psychotic disorders in a community mental health center. Psychiatric Services 2009, 60: 1426-8. PMID: 19880454, PMCID: PMC4469899, DOI: 10.1176/appi.ps.60.11.1426.Peer-Reviewed Original ResearchConceptsMental health centersEarly interventionHealth centersConnecticut Mental Health CenterCommunity mental health centerLong-term outcomesEarly intervention servicesYounger patientsUntreated illnessPsychotic illnessPsychotic disordersAddiction servicesSpecialized treatmentMental healthInterventionConnecticut DepartmentIllnessPatientsPsychosisPublic-Academic Partnerships: Early Intervention for Psychotic Disorders in a Community Mental Health Center
Srihari V, Breitborde N, Pollard J, Tek C, Hyman L, Frisman L, McGlashan T, Jacobs S, Woods S. Public-Academic Partnerships: Early Intervention for Psychotic Disorders in a Community Mental Health Center. Psychiatric Services 2009, 60: 1426-1428. DOI: 10.1176/ps.2009.60.11.1426.Peer-Reviewed Original Research
2006
Revisiting cycloid psychosis: A case of an acute, transient and recurring psychotic disorder
Srihari VH, Lee TS, Rohrbaugh RM, D'Souza DC. Revisiting cycloid psychosis: A case of an acute, transient and recurring psychotic disorder. Schizophrenia Research 2006, 82: 261-264. PMID: 16442782, DOI: 10.1016/j.schres.2005.11.022.Peer-Reviewed Original ResearchConceptsPsychotic disordersCycloid psychosisTransient psychotic disordersICD-10 categoriesIV-TR criteriaMinimal functional impairmentFavorable prognosisRecurrent psychosisUnknown incidenceDistinct pathophysiologyFunctional impairmentClinical attentionPsychosisDisordersFurther investigationPrognosisPathophysiologyIncidenceCasesImpairment