ArticleSchizophrenia research2021
Incorporating cortisol into the NAPLS2 individualized risk calculator for prediction of psychosis.
Article in Schizophrenia research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 26 citations in OpenAlex.
- Decoding Psychosis Risk: Neuroanatomical Correlates of the NAPLS-2 Calculator in the PRONIA Cohort.Schizophrenia bulletin · 2026Article
- Beyond tumor biology: nursing interventions for psychological and immune health in cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Review
- Body fluid biomarkers and psychosis risk in The Accelerating Medicines Partnership® Schizophrenia Program: design considerations.Schizophrenia (Heidelberg, Germany) · 2025Article
- Data analysis strategies for the Accelerating Medicines Partnership® Schizophrenia Program.Schizophrenia (Heidelberg, Germany) · 2025Article
- Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis.Schizophrenia bulletin · 2024Article
- Unique Challenges in Biomarkers for Psychotic Disorders.Brain sciences · 2024Article
- The Translational Future of Stress Neurobiology and Psychosis Vulnerability: A Review of the Evidence.Current neuropharmacology · 2024Review
- Are We There Yet? Predicting Conversion to Psychosis Using Machine Learning.The American journal of psychiatry · 2023Article
- Psychotic disorders as a framework for precision psychiatry.Nature reviews. Neurology · 2023Review
- A redux of schizophrenia research in 2021.Schizophrenia research · 2022Article
- Cortisol Levels in Childhood Associated With Emergence of Attenuated Psychotic Symptoms in Early Adulthood.Biological psychiatry · 2022Article
- Translating RDoC to Real-World Impact in Developmental Psychopathology: A Neurodevelopmental Framework for Application of Mental Health Risk Calculators.Development and psychopathology · 2021Article
- Toward Generalizable and Transdiagnostic Tools for Psychosis Prediction: An Independent Validation and Improvement of the NAPLS-2 Risk Calculator in the Multisite PRONIA Cohort.Biological psychiatry · 2021Article
- Childhood exposure to ambient air pollution and predicting individual risk of depression onset in UK adolescents.Journal of psychiatric research · 2021Article
- Hindsight 2020: Emerging research trends in schizophrenia.Schizophrenia research · 2021Article
- Acute Physiological and Psychological Stress Response in Youth at Clinical High-Risk for Psychosis.Frontiers in psychiatry · 2021Article
- Prediction and Prevention in the Clinical High-Risk for Psychosis Paradigm: A Review of the Current Status and Recommendations for Future Directions of Inquiry.Frontiers in psychiatry · 2021Review
Corrections and comments
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Authors and funding
13 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundRisk calculators are useful tools that can help clinicians and researchers better understand an individual's risk of conversion to psychosis. The North American Prodrome Longitudinal Study (NAPLS2) Individualized Risk Calculator has good predictive accuracy but could be potentially improved by the inclusion of a biomarker. Baseline cortisol, a measure of hypothalamic-pituitary-adrenal (HPA) axis functioning that is impacted by biological vulnerability to stress and exposure to environmental stressors, has been shown to be higher among individuals at clinical high-risk for psychosis (CHRP) who eventually convert to psychosis than those who do not. We sought to determine whether the addition of baseline cortisol to the NAPLS2 risk calculator improved the performance of the risk calculator.
methodsParticipants were drawn from the NAPLS2 study. A subset of NAPLS2 participants provided salivary cortisol samples. A multivariate Cox proportional hazards regression evaluated the likelihood of an individual's eventual conversion to psychosis based on demographic and clinical variables in addition to baseline cortisol levels.
resultsA total of 417 NAPLS2 participants provided salivary cortisol and were included in the analysis. Higher levels of cortisol were predictive of conversion to psychosis in a univariate model (C-index = 0.59, HR = 21.5, p-value = 0.004). The inclusion of cortisol in the risk calculator model resulted in a statistically significant improvement in performance from the original risk calculator model (C-index = 0.78, SE = 0.028).
conclusionsSalivary cortisol is an inexpensive and non-invasive biomarker that could improve individual predictions about conversion to psychosis and treatment decisions for CHR-P individuals.
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Registered trials
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