The identification of people who are at risk of developing psychosis is central to the development of early intervention and prevention strategies for schizophrenia. There is a world-wide movement in the study of populations at the prodromal stage led by researchers in the United States, Australia, England, Canada, Germany, and Switzerland. It is important to understand the biopsychosocial processes that occur during the clinical high risk (CHR) phase. The North American Prodrome Longitudinal Study (NAPLS) has identified key clinical characteristics and predictors of CHR youth using a comprehensive assessment package encompassing psychosocial, biological, neuropsychological, and genetic components. This is critical because it informs development of early interventions for prevention of brain damage. However, the NAPLS study is limited to the North American subjects. The purpose of this project is to broaden the existing prodrome to psychosis study to populations in a different cultural and genetic pool to examine the important cultural differences in the manifestations of the symptoms and the predictors of the illness. The overall goal of this application is to design and initiate a sustainable CHR to psychosis longitudinal program of research in a low-middle income country. Specifically, we attempt to: 1. Assess potential research needs of the Shanghai Mental Health Center [SMHC], a World Health Organization designated researcher center for mental health, and 2. Help develop a program of research on the progression of schizophrenia from prodrome to psychosis. The preliminary study contains four major components: a) clinical assessment of prodromal subjects. For this aim, the Structured Interview for Prodromal Syndromes and Scale of Prodromal Symptoms (SIPS/SOPS) will be translated into the language of the subjects and subsequently validated;b) neurocognitive assessment with the MATRICS battery, c) stigma, and d) electrophysiological assessment using event related potentials. In addition, blood samples will be collected and stored for future analyses. Gender effects will be examined across the above aims. The study goals are consistent with the guidelines of the FOA Brain Disorders in the Developing World: Research Across the Lifespan (R21, PAR-11-031).

Public Health Relevance

This R21 application proposes to establish a collaborative research program between investigators from the Shanghai Mental Health Center (SMHC), a World Health Organization designated center for research and training in mental health, and the Beth Israel Deaconess Medical Center (BIDMC),a Harvard Medical School Department of Psychiatry, Boston, U.S.A. This application will benefit the U.S. public health by expanding prodrome to psychosis studies to different racial/ethnic groups by initiating the first prodrome to psychosis longitudinal program of research in a low-middle income country;a program that will complement the ongoing prodrome study in the U.S. This application will benefit individuals from different cultural groups who are at risk for psychosis through early identification and early intervention. This application will thus lay a foundation for subsequent grant proposal submissions dedicated to examining the influence of culture, environment and genetics in the development of psychosis among CHR patients among different racial/ethnic groups and will help build sustainable research.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-BDCN-Z (50))
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Morris, Sarah E
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Florida Agricultural and Mechanical University
Schools of Arts and Sciences
United States
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Zhang, Tianhong; Li, Huijun; Woodberry, Kristen A et al. (2014) Prodromal psychosis detection in a counseling center population in China: an epidemiological and clinical study. Schizophr Res 152:391-9
Walder, Deborah J; Holtzman, Carrie W; Addington, Jean et al. (2013) Sexual dimorphisms and prediction of conversion in the NAPLS psychosis prodrome. Schizophr Res 144:43-50