# Exploring the interconnections between baseline symptoms in ultra-high risk youth who did and did not transition to psychosis over three years: A network analysis comparison

## TL;DR

This study compares symptom networks in youth at ultra-high risk for psychosis who later transitioned versus those who did not, finding similar baseline symptom relationships.

## Contribution

The study introduces network analysis to explore baseline symptom interconnections in UHR youth, revealing patterns relevant to psychosis transition.

## Key findings

- Transitioned and non-transitioned UHR youth had similar symptom network structures and global connectivity.
- Impaired cognitive functioning connected multiple symptoms, suggesting its clinical relevance.
- Unusual thought content had minimal interactions with other symptoms despite traditional associations with transition.

## Abstract

In the ultra-high risk for psychosis (UHR) field, it is unknown whether understanding symptom relationships, beyond symptom severity alone, may hold prognostic value and inform preventive care. In this study, network analysis was performed to examine the interconnections between baseline symptoms in UHR youth who did and did not transition to psychosis over three years.

In a sample selected from the UHR1000+ cohort, positive and basic symptoms were assessed using the Comprehensive Assessment of At-Risk Mental States. Network analyses and network comparison tests were performed.

195 UHR youth transitioned to psychosis within three years and 346 did not. The two groups did not differ in the network structure, global strength (i.e., the overall level of connectivity between symptoms), or centrality of symptoms (i.e., their importance within networks). The transitioned group was characterized by unusual thought content not being connected to other symptoms; however, its centrality between networks was comparable. Across networks, impaired cognitive functioning connected disorganized speech to impaired emotional functioning, motor functioning, and tolerance to normal stress. Impaired bodily sensation connected perceptual abnormalities to other symptoms.

The networks of youth who transitioned and who did not transition were similar, indicating similar baseline symptom relationships. Across groups, unusual thought content, despite being traditionally associated with transition, had little to no interactions with other symptoms. Clinical manifestations that may need attention include impaired cognitive functioning, which connected several symptoms, and impaired bodily sensation. Future research using time series data may support progress toward individualized care.