Subtyping first-episode psychosis based on longitudinal symptom trajectories using machine learning

Abstract Clinical course after first episode psychosis (FEP) is heterogeneous. Subgrouping and predicting longitudinal symptom trajectories after FEP may help develop personalized treatment approaches. We utilized k-means clustering to identify clusters of 411 FEP patients based on longitudinal posi...

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Main Authors: Yanan Liu, Sara Jalali, Ridha Joober, Martin Lepage, Srividya Iyer, Jai Shah, David Benrimoh
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:npj Mental Health Research
Online Access:https://doi.org/10.1038/s44184-025-00129-7
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author Yanan Liu
Sara Jalali
Ridha Joober
Martin Lepage
Srividya Iyer
Jai Shah
David Benrimoh
author_facet Yanan Liu
Sara Jalali
Ridha Joober
Martin Lepage
Srividya Iyer
Jai Shah
David Benrimoh
author_sort Yanan Liu
collection DOAJ
description Abstract Clinical course after first episode psychosis (FEP) is heterogeneous. Subgrouping and predicting longitudinal symptom trajectories after FEP may help develop personalized treatment approaches. We utilized k-means clustering to identify clusters of 411 FEP patients based on longitudinal positive and negative symptoms. Three clusters were identified. Cluster 1 exhibits lower positive and negative symptoms (LS), lower antipsychotic dose, and relatively higher affective psychosis; Cluster 2 shows lower positive symptoms, persistent negative symptoms (LPPN), and intermediate antipsychotic doses; Cluster 3 presents persistently high levels of both positive and negative symptoms (PPNS), and higher antipsychotic doses. We predicted cluster membership (AUC of 0.74) using ridge logistic regression on baseline data. Key predictors included lower levels of apathy, affective flattening, and anhedonia/asociality in the LS cluster, compared to the LPPN cluster. Hallucination severity, positive thought disorder and manic hostility predicted PPNS. These results help parse the FEP trajectory heterogeneity and may facilitate the development of personalized treatments.
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institution Kabale University
issn 2731-4251
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series npj Mental Health Research
spelling doaj-art-c5bcc232d991457aab9f88bc431ecbd92025-08-20T03:53:46ZengNature Portfolionpj Mental Health Research2731-42512025-05-014111010.1038/s44184-025-00129-7Subtyping first-episode psychosis based on longitudinal symptom trajectories using machine learningYanan Liu0Sara Jalali1Ridha Joober2Martin Lepage3Srividya Iyer4Jai Shah5David Benrimoh6Montreal Neurological Institute, McGill UniversityDouglas Research CentreDouglas Research CentreDouglas Research CentreDouglas Research CentreDouglas Research CentreDouglas Research CentreAbstract Clinical course after first episode psychosis (FEP) is heterogeneous. Subgrouping and predicting longitudinal symptom trajectories after FEP may help develop personalized treatment approaches. We utilized k-means clustering to identify clusters of 411 FEP patients based on longitudinal positive and negative symptoms. Three clusters were identified. Cluster 1 exhibits lower positive and negative symptoms (LS), lower antipsychotic dose, and relatively higher affective psychosis; Cluster 2 shows lower positive symptoms, persistent negative symptoms (LPPN), and intermediate antipsychotic doses; Cluster 3 presents persistently high levels of both positive and negative symptoms (PPNS), and higher antipsychotic doses. We predicted cluster membership (AUC of 0.74) using ridge logistic regression on baseline data. Key predictors included lower levels of apathy, affective flattening, and anhedonia/asociality in the LS cluster, compared to the LPPN cluster. Hallucination severity, positive thought disorder and manic hostility predicted PPNS. These results help parse the FEP trajectory heterogeneity and may facilitate the development of personalized treatments.https://doi.org/10.1038/s44184-025-00129-7
spellingShingle Yanan Liu
Sara Jalali
Ridha Joober
Martin Lepage
Srividya Iyer
Jai Shah
David Benrimoh
Subtyping first-episode psychosis based on longitudinal symptom trajectories using machine learning
npj Mental Health Research
title Subtyping first-episode psychosis based on longitudinal symptom trajectories using machine learning
title_full Subtyping first-episode psychosis based on longitudinal symptom trajectories using machine learning
title_fullStr Subtyping first-episode psychosis based on longitudinal symptom trajectories using machine learning
title_full_unstemmed Subtyping first-episode psychosis based on longitudinal symptom trajectories using machine learning
title_short Subtyping first-episode psychosis based on longitudinal symptom trajectories using machine learning
title_sort subtyping first episode psychosis based on longitudinal symptom trajectories using machine learning
url https://doi.org/10.1038/s44184-025-00129-7
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