Overview
This study will investigate neural markers in the cerebellar-cortical circuitry that predict treatment response to antipsychotics in first-episode psychosis. A total of 120 patients diagnosed with a first-episode psychotic disorder will be recruited. All subjects receive naturalistic treatment with either risperidone or aripiprazole for 12 weeks, with dosage and titration followed by standard clinical care. A comprehensive clinical and neuroimaging assessments will be performed before and after treatment.
Eligibility
Inclusion Criteria:
- Diagnosis of a first-episode psychotic disorder including: schizophrenia, schizophreniform disorder, schizoaffective disorder, brief psychotic disorder, psychotic disorder Not Otherwise Specified (NOS), bipolar disorder with psychosis, and major depressive disorder with psychosis;
- Current positive symptoms rated \> 3 (moderate) on one or more of the Brief Psychiatric Rating Scale (BPRS) psychosis items: conceptual disorganization, grandiosity, hallucinatory behavior, and unusual thought content;
- At early phase of illness as defined by having taken antipsychotic drugs for a cumulative lifetime period of 8 weeks or less;
- Age 16 to 40;
- Competent to sign informed consent.
Exclusion Criteria:
- Serious neurological or endocrine disorder or brain trauma;
- Any medical condition which requires treatment with a medication with psychotropic effects;
- Significant risk of suicidal or homicidal behavior;
- Cognitive or language limitations, or any other factor that would preclude subjects providing informed consent;
- Contraindications to antipsychotic monotherapy;
- Contraindications to MR imaging (e.g. pacemaker);
- Pregnancy by self report.
