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Duration of prodromal phase and severity of volumetric abnormalities in first-episode psychosis^*

King’s College London, Institute of Psychiatry, London

PAOLA DAZZAN, MBChB, MSc, MRCPsych and KEVIN MORGAN, PhD

Brain Mapping Unit, University of Cambridge

CRAIG MORGAN, PhD and XAVIER CHITNIS, MSc

King’s College London, Institute of Psychiatry, London

JOHN SUCKLING, PhD

Department of Psychiatry, University of Cambridge

PAUL FEARON, MBChB, MSc, MRCPsych

King’s College London, Institute of Psychiatry, London

PETER B. JONES, MBChB, PhD, MRCPsych

Department of Psychiatry, University of Cambridge

JULIAN LEFF, MBChB, PhD, FRCPsych, ROBIN M. MURRAY, MBChB, MPhil, FRCPsych and PHILIP K. McGUIRE, MBChB, MD, PhD, MRCPsych

King’s College London, Institute of Psychiatry, London, UK

Correspondence: Dr Paola Dazzan, PO Box 63, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF. Email: Paola.Dazzan{at}iop.kcl.ac.uk

Declaration of interest None. Funding detailed in Acknowledgements.

^* Preliminary analysis of these data was presented in abstract form at the XIII Biennial Winter Workshop on Schizophrenia, Davos, Switzerland, 2006.

Background First-episode psychosis is typically preceded by a prodrome in which there is deterioration in global and social functioning.

Aims To examine whether the duration ofthe prodromal phase influences grey and white matter volumes at the onset of psychosis.

Methods Eighty-two people were scanned using magnetic resonance imaging when they developed a first episode of psychosis. The duration of the prodromal phase was estimated from detailed interviews and medical records. Voxel-based morphometry was used to assess neuroanatomical abnormalities.

Results A long prodromal phase was associated with smaller grey matter volumes in the cingulate, frontal and left insular cortex, and with less white matter volume bilaterally in the superior longitudinal and uncinate fasciculi and the cingulum.

Conclusions The severity of volumetric abnormalities in first-episode psychosis was greater in those with a long prodrome.