Early or even preventative treatment—the goal across medical disciplines—has been hard to achieve in psychiatric illnesses, especially those involving psychosis. Psychosis involves hallucinations or delusions, symptoms that are common in schizophrenia and some other psychiatric illnesses. Typically, schizophrenia is diagnosed in late adolescence or early adulthood, but psychosis is now known to usually be preceded by a phase called the prodrome, during which patients can exhibit mild or intermittent symptoms. Increasing research is being done to better define this period to enable early diagnostic and intervention techniques. Existing research shows that only about a third of people with the current profile of prodromal symptoms will go on to develop an overt psychotic disorder, and it is very difficult to reliably predict who will and who will not.

Results from a new study, led by Diana Perkins, M.D., M.P.H., and Clark D. Jeffries, Ph.D., of the University of North Carolina Chapel Hill, as part of the North American Prodrome Longitudinal Study (an international, collaborative effort to identify the factors that contribute to the development of psychosis), suggest a panel of blood markers that could be used to identify those who are showing mild prodromal symptoms and are at highest risk of developing psychosis. The findings were published August 6th in Schizophrenia Bulletin.

Dr. Perkins and colleagues, including numerous NARSAD Grantees (see list below), analyzed blood samples from three groups of people: 32 patients showing prodromal symptoms who later developed psychosis, 40 patients showing mild symptoms who did not go on to develop psychosis and 35 healthy control subjects with no symptoms. From an initial set of 185 different molecules in the blood samples, they were able to identify 15 markers that predicted whether or not a patient would develop psychosis or not.

“The blood test included a selection of 15 measures of immune and hormonal system imbalances as well as evidence of oxidative stress,” explained Dr. Perkins. “While further research is required before this blood test could be clinically available, these results provide evidence regarding the fundamental nature of schizophrenia, and point towards novel pathways that could be targets for preventative interventions,” she said.

The test will have to be validated in other studies with larger sample sizes, but the researchers report that the multiplex blood assay, if independently replicated and integrated with studies of other classes of biomarkers, may be able to be used to predict psychosis and enable early intervention.

NARSAD Grantees involved in this research include: Ming Tsuang, M.D., Ph.D. (2010 Lieber Prizewinner for Outstanding Achievement in Schizophrenia Research and 1998 NARSAD Distinguished Investigator Grantee), of the University of California, San Diego; Daniel Mathalon, M.D., Ph.D., of the University of California, San Francisco (2007 NARSAD Independent Investigator Grantee and 2001 NARSAD Young Investigator Grantee); Tyrone Cannon, Ph.D. (2006 NARSAD Distinguished Investigator Grantee and 1997 NARSAD Independent Investigator Grantee); Carrie Bearden, Ph.D., of the University of California, Los Angeles (2005 and 2003 NARSAD Young Investigator Grantee); Scott Woods, M.D. (2005 NARSAD Distinguished Investigator Grantee and 1998 NARSAD Independent Investigator Grantee), of Yale University; Larry Seidman, Ph.D., of Massachusetts General Hospital (2004 and 1998 NARSAD Independent Investigator Grantee); Kristin Cadenhead, M.D. (1999 and 1992 NARSAD Young Investigator Grantee); Thomas McGlashan, M.D. (1997 NARSAD Distinguished Investigator Grantee); Robert Heinssen, Ph.D., of the National Institute of Mental Health (1990 NARSAD Young Investigator Grantee); and Elaine Walker, Ph.D., of Emory University (1989 NARSAD Distinguished Investigator Grantee).

Read the abstract of this research paper.

Read the press release about this research.

Read an article about this study in Science World Report.