Neurobioloigical biomarkers

Question 1

Effects of DUP

Answer 1

1. Longer DUP = poorer outcomes
   - Could be due to longer lack of treatment
   OR
   - People with worse outcomes take longer to get help= are more severe anyway

Question 2

Future of people with FEP

Answer 2

1) 90% will have some remission - hope
2) 80% will relapse in 5 years
3) 60% will stop or change their medication (risk factor for relapse)
4) Impairments present at FEP are rarely reduced
5) many already have social / vocational decline when they present

Question 3

Issues with treating FEP with antipsychoits

Answer 3

100% are treater routinely with antipsychotics but only 60% of unmediated ppl would have psychosis exacerbation in the 1st year = we are treating 40% of people who are not expected to have worse symptoms

Question 4

What are challenges in treatment?

Answer 4

What can we use to predict response and what is a good “response” to treatment?

• Assess/scan patients before treatment starts
• See patients again to establish response

What best predicts response?

These challenges stress the need for biomarkers

Question 5

What are the criteria for response?

Answer 5

• Absence or reduction of symptoms
• Minimal symptoms with mild disability
• Change from baseline measurement
• Remission (low intensity symptoms) vs Recovery (symptom free)