Obstetric Complications and Polygenic Risk Score: Which Role in Predicting a Severe Short-Term Outcome in Psychosis?

Area of Science:

• Neuroscience
• Psychiatry
• Genetics

Background:

• Improving outcomes in psychosis is a significant clinical challenge.
• Obstetric complications (OCs) are explored as risk factors and outcome predictors in schizophrenia (SZ).
• Limited research exists on OCs' impact on first episode psychosis (FEP) patient outcomes.

Purpose of the Study:

• To determine if OCs predict illness course and psychopathology severity in FEP patients after two years.
• To investigate if the schizophrenia polygenic risk score (SZ-PRS) predicts FEP illness course.
• To examine potential gene-environment interactions between OCs and SZ-PRS.

Main Methods:

• A cohort of 264 FEP patients was assessed using standardized instruments.
• OCs were recorded via maternal interviews using the Lewis-Murray scale.
• Schizophrenia polygenic risk score (SZ-PRS) was calculated for each patient.

Main Results:

• 30% of patients reported at least one OC.
• Patients with OCs were more likely to have a non-remitting illness course (35.3% vs. 16.3%, p=0.014).
• No association was found between SZ-PRS and illness course, nor evidence for gene-environment interaction.

Conclusions:

• Obstetric complications are associated with poor short-term outcomes in FEP patients.
• SZ-PRS did not serve as a prognostic indicator for poor outcomes in this FEP cohort.
• OCs represent a potential predictive factor for illness trajectory in early psychosis.