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The Mapping Individual Routes of Risk and Resilience (Mirorr) study


- candidate number26511
- NTR NumberNTR6350
- ISRCTNISRCTN no longer applicable
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR19-jan-2017
- Secondary IDsNL52974 (ccmo) 2015/159 (metc)
- Public TitleThe Mapping Individual Routes of Risk and Resilience (Mirorr) study
- Scientific TitleThe Mapping Individual Routes of Risk and Resilience (Mirorr) study
- ACRONYMMIRORR
- hypothesisWith the Mirorr study, we aim to investigate the hypothesis of dynamic symptom networks as the basis of psychopathology in general and psychosis in particular. Furthermore, we aim to investigate the additional hypothesis of symptom networks as the driving force of progression of illness through successive clinical stages. Taking a broader, multidimensional and developmental approach, we will examine how symptoms of multiple domains influence each other over time and across diagnostic boundaries, in interaction with environmental factors. We hypothesize that characteristics of these networks can predict illness course and outcome within a clinical staging model.
- Healt Condition(s) or Problem(s) studiedPsychosis
- Inclusion criteriaIn order to be eligible to participate in the study, subjects must meet all of the following criteria: 1) age between 18 and 35 years, 2) read and speak Dutch fluently, 3) capable of following the research procedures, 4) provide Informed Consent. In addition, participants of subsample 1 should not be in clinical care for mental health at the moment of screening. In contrast, participants of subsample 2-4 should currently be in clinical care for mental health. In addition, participants of subsample 2 should have mild, non-psychotic psychopathology, as evidenced by a score below 6 on the Prodromal Questionnaire (PQ), participants of subsample 3 should have mild psychopathology including subclinical psychotic symptoms, as evidenced by a score of or above 6 on the PQ, but are not at ultra-high risk (UHR) for psychosis, as indexed by the Comprehensive Assessment of At Risk Mental States (CAARMS). Finally, participants of subsample 4 should be at UHR for psychosis, as indexed by the CAARMS.
- Exclusion criteriaExclusions criteria are: 1) a history of or current psychotic episode, according to the Diagnostic and Statistical manual of Mental Disorders-IV (DSM-IV) criteria; 2) significant hearing or visual problems impairments; 3) pregnancy, as stated on a general health questionnaire.
- mec approval receivedyes
- multicenter trialno
- randomisedno
- group[default]
- Type[default]
- Studytypeobservational
- planned startdate 1-aug-2015
- planned closingdate1-aug-2019
- Target number of participants175
- Interventions-
- Primary outcomeNetwork parameters from symptom networks will be linked to (progression through) clinical stage, functioning and need for care. Progression through clinical stages will be assessed with the Prodromal Questionaire, the Community assessment of Psychotic Experiences, the Comprehensive Assessment of At Risk Mental States, the Symptom Check List (SCL-90), and the Schedules for Clinical Assessment in Neuropsychiatry, short version. Social functioning will be assessed using the Groningse Vragenlijst voor Sociaal Gedrag and the Flourishing Scale. Need for care will be assessed using self-reported information on care use. Additionally, need for care will be assessed by linking data from the psychiatric case registry to our sample when approved by the participant (as stated on the informed consent form). Specifically, the frequency and type of care use throughout the study period will be obtained.
- Secondary outcome-
- TimepointsThis study combines idiographic (within-person) and nomothetic (between-person) observational study designs. The nomothetic aspect of the study is captured by questionnaire and interview data at baseline and three yearly follow measurement waves. The idiographic aspect is captured by diary assessment at baseline and the first follow-up wave. During the diary periods, participants will complete a diary questionnaire daily for a period of 90 days on their smartphone.
- Trial web site-
- statusopen: patient inclusion
- CONTACT FOR PUBLIC QUERIES J.T.W. Wigman
- CONTACT for SCIENTIFIC QUERIES J.T.W. Wigman
- Sponsor/Initiator University Medical Center Groningen (UMCG)
- Funding
(Source(s) of Monetary or Material Support)
NWO
- Publications-
- Brief summaryBackground: Psychotic disorders are among the most severe mental disorders in terms of individual and societal impact. Our current ability to predict the course and outcome of early psychotic symptoms is limited, hampering timely intervention and treatment. To improve our understanding of the development of psychosis, a different approach to psychopathology may be fruitful. We propose to re-conceptualize psychopathology according to a network perspective, where symptoms act as a dynamic, interconnected system , impacting on each other over time and across diagnostic boundaries and forming symptom networks. Adopting this network approach, the Mapping Individual Routes of Risk and Resilience (Mirorr) study aims to determine whether characteristics of symptom networks can predict illness course and outcome of early psychotic symptoms.

Methods: The sample of the Mirorr study consists of N=100 participants in the age range of 18-35 years old, divided into four subgroups (N=4x25) with increasing levels of psychopathological severity, that represent successive stages of clinical progression. Individuals representing the lowest stage come from the general population and have a psychometric risk of psychotic experiences, whereas individuals representing the highest stage are help-seeking and at ultra-high risk for psychosis. At baseline and 1-year follow-up, participants report their day-to-day symptoms, affective states and experiences for three consecutive months in short, daily questionnaires on their smartphone. In addition, symptomatology, functioning, psychopathological severity and need for care will be assessed at three annual follow-up assessments by means of questionnaires and diagnostic interviews. The diary questionnaires will be used to map individual networks of symptoms, experiences and emotions. Network parameters, including the strength and directionality of symptom connections and centrality indices, will be estimated. Subsequently, these parameters will be linked to individual differences in and within-individual progression through clinical stage.

Discussion: This study will empirically investigate dynamic symptom network as predictors of illness course and outcome of early psychotic symptoms in the context of a clinical staging model. The results will assist in improving and fine-tuning dynamic models of psychopathology, stimulating both clinical (in terms of both diagnostics and intervention) and scientific progress.
- Main changes (audit trail)
- RECORD19-jan-2017 - 1-jun-2017


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