2025
The impact of Duration of Untreated Psychosis on functioning and quality of life over one year of Coordinated Specialty Care (CSC)
Hazan H, Tayfur S, Zhou B, Li F, Gibbs-Dean T, Karmani S, Kline E, Ferrara M, Corbera S, Riley S, Sykes L, Tek C, Keshavan M, Srihari V. The impact of Duration of Untreated Psychosis on functioning and quality of life over one year of Coordinated Specialty Care (CSC). PLOS ONE 2025, 20: e0312740. PMID: 39928579, PMCID: PMC11809850, DOI: 10.1371/journal.pone.0312740.Peer-Reviewed Original ResearchConceptsCoordinated specialty careQuality of lifeDuration of untreated psychosisDUP groupWorld Health OrganizationYear of coordinated specialty careGeneralized linear modelConfidence intervalsBinary outcomesGlobal functioningDuration of untreated psychosis groupSymptom severityUntreated psychosisSpecialty careCSC programsImpact of duration of untreated psychosisFunctional gainsModel repeated measuresMixed model repeated measuresOdds ratioNo significant differenceLogit link functionStatus improvementContinuous outcomesSocial functioningMeasurement properties of instruments to assess insight in psychosis: A systematic review protocol
Hazan H, Funaro M, Srihari V. Measurement properties of instruments to assess insight in psychosis: A systematic review protocol. PLOS ONE 2025, 20: e0316447. PMID: 39854417, PMCID: PMC11759350, DOI: 10.1371/journal.pone.0316447.Peer-Reviewed Original ResearchMeSH KeywordsHumansPsychometricsPsychotic DisordersReproducibility of ResultsSchizophreniaSystematic Reviews as TopicConceptsMeasurement properties of instrumentsProperties of instrumentsSystematic reviewCOSMIN Risk of Bias checklistRisk of Bias checklistMeasurement propertiesMeasure methodological qualityMeta-Analysis ProtocolsSynthesize current evidenceSystematic review protocolPreferred Reporting ItemsClinical practicePeer-reviewed journalsStrength of evidenceSemi-structured interviewsBias checklistImprove careMental illnessMethodological qualityReporting ItemsPatient awarenessPRISMA-PReview protocolGRADE approachSelf-reportInsight and suicidality in first-episode psychosis: The mediating role of depression
Tayfur S, Song Z, Li F, Hazan H, Gibbs-Dean T, Purushothaman D, Karmani S, Terashima J, Tek C, Srihari V. Insight and suicidality in first-episode psychosis: The mediating role of depression. Schizophrenia Research 2025, 275: 189-195. PMID: 39754935, DOI: 10.1016/j.schres.2024.12.013.Peer-Reviewed Original ResearchConceptsFirst-episode psychosisPredictors of suicideCoordinated specialty careTreatment of depressionPersistence of depressionEffects of depressionSuicide attemptsMediation analysisPrevent suicideDepressionSuicideImpact suicidePsychosisTargeted interventionsLongitudinal cohort studyEarly treatment stageParticipantsSignificant predictorsImproving clinical outcomesRegression analysisSpecialty careClinical outcomesCohort studyRelationshipMonths
2024
TimelinePTC: Development of a unified interface for pathways to care collection, visualization, and collaboration in first episode psychosis
Mathis W, Ferrara M, Cahill J, Karmani S, Tayfur S, Srihari V. TimelinePTC: Development of a unified interface for pathways to care collection, visualization, and collaboration in first episode psychosis. PLOS ONE 2024, 19: e0302116. PMID: 39028697, PMCID: PMC11259254, DOI: 10.1371/journal.pone.0302116.Peer-Reviewed Original ResearchMeSH KeywordsCooperative BehaviorData CollectionHumansInternetPsychotic DisordersUser-Computer InterfaceConceptsPathways to CareDuration of untreated psychosisManual transcription errorsDevelopment of targeted interventionsReduce duration of untreated psychosisHealthcare accessibility researchReal-time data entryImprove patient outcomesEpisode psychosisCare pathwaysPatient journeyHealthcare contextPatient outcomesPaper-basedConversion of collected dataFEP treatmentData collection processNew HavenData collection methodsData entryTranscription errorsUntreated psychosisOpen-source codebaseData collectionWeb-based toolThe impact of early detection (ED) campaigns on care presentations: Beyond DUP reduction
Hazan H, Ferrara M, Riley S, Li F, Zhou B, Kline E, Gibbs-Dean T, Karmani S, Tayfur S, Tek C, Keshavan M, Srihari V. The impact of early detection (ED) campaigns on care presentations: Beyond DUP reduction. Schizophrenia Research 2024, 264: 457-461. PMID: 38266513, PMCID: PMC10923115, DOI: 10.1016/j.schres.2024.01.022.Peer-Reviewed Original ResearchMeSH KeywordsEarly DiagnosisHospitalizationHumansPsychotic DisordersSchizophrenic PsychologyTime FactorsConceptsCoordinated specialty careDuration of untreated psychosisImpact of early detectionEarly detectionEarly detection campaignsSpecialty careAdjustment scoresCampaign yearDetection campaignsMediation analysisEffects of EDRegression modelsCareUntreated psychosisPositive symptomsGAFPatientsSalutary effects
2023
The effect of duration of untreated psychosis (DUP) on the risk for hospitalization after admission to a first episode service
Ferrara M, Guloksuz S, Hazan H, Li F, Tek C, Sykes L, Riley S, Keshavan M, Srihari V. The effect of duration of untreated psychosis (DUP) on the risk for hospitalization after admission to a first episode service. Schizophrenia Research 2023, 260: 198-204. PMID: 37688984, DOI: 10.1016/j.schres.2023.08.005.Peer-Reviewed Original ResearchConceptsFirst-episode psychosis servicesLength of stayUntreated psychosisPsychiatric hospitalizationFirst-episode servicesDuration of hospitalizationIncidence rate ratiosNon-affective psychosisNew Haven areaPoisson regression modelsPatient characteristicsHospitalization ratesRecent onsetMedical recordsHospitalizationEffect of durationNegative binomial regressionSpecialized treatmentPsychosisRate ratioBinomial regressionAdmissionDUPEnrollmentFirst yearAberrant Hierarchical Prediction Errors Are Associated With Transition to Psychosis: A Computational Single-Trial Analysis of the Mismatch Negativity
Hauke D, Charlton C, Schmidt A, Griffiths J, Woods S, Ford J, Srihari V, Roth V, Diaconescu A, Mathalon D. Aberrant Hierarchical Prediction Errors Are Associated With Transition to Psychosis: A Computational Single-Trial Analysis of the Mismatch Negativity. Biological Psychiatry Cognitive Neuroscience And Neuroimaging 2023, 8: 1176-1185. PMID: 37536567, DOI: 10.1016/j.bpsc.2023.07.011.Peer-Reviewed Original ResearchConceptsPrecision-weighted prediction errorsHealthy control participantsCourse of schizophreniaCHR-P individualsLower-level precision-weighted prediction errorsControl participantsLow-level sensoryPredictive coding accountMismatch negativity paradigmHierarchical Gaussian FilterPrediction errorEarly psychosisSingle-trial analysisClinical high riskDouble deviantsMismatch negativityComputational mechanismsElectroencephalography amplitudeFuture psychosisComputational modelSchizophreniaPsychosisIndividualsParticipantsSensor spaceSampling from different populations: Sociodemographic, clinical, and functional differences between samples of first episode psychosis individuals and clinical high-risk individuals who progressed to psychosis
Hagler M, Ferrara M, Yoviene Sykes L, Li F, Addington J, Bearden C, Cadenhead K, Cannon T, Cornblatt B, Perkins D, Mathalon D, Seidman L, Tsuang M, Walker E, Powers A, Allen A, Srihari V, Woods S. Sampling from different populations: Sociodemographic, clinical, and functional differences between samples of first episode psychosis individuals and clinical high-risk individuals who progressed to psychosis. Schizophrenia Research 2023, 255: 239-245. PMID: 37028205, PMCID: PMC10207144, DOI: 10.1016/j.schres.2023.03.047.Peer-Reviewed Original ResearchMeSH KeywordsHumansLongitudinal StudiesNorth AmericaProdromal SymptomsProtective FactorsPsychotic DisordersConceptsFirst-episode psychosis servicesClinical high riskClinical high-risk individualsEarly detectionFirst-episode psychosis individualsRecent psychiatric hospitalizationCourse of illnessHigh-risk individualsAttenuated positive symptomsCHR researchGeographic catchmentSyndromal psychosisPsychosis individualsPsychiatric hospitalizationEarly intervention effortsHigh riskPsychosis servicesPositive symptomsGlobal functioningClinical resourcesProtective factorsDifferent populationsFE participantsGeneralizability of findingsFES program
2022
DUP redux: Observations vs. experiments in early intervention (invited commentary on Nkire et al.)
Srihari V, Li F. DUP redux: Observations vs. experiments in early intervention (invited commentary on Nkire et al.). Schizophrenia Research 2022, 251: 46-48. PMID: 36565532, DOI: 10.1016/j.schres.2022.12.006.Peer-Reviewed Original ResearchReducing Delay From Referral to Admission at a U.S. First-Episode Psychosis Service: A Quality Improvement Initiative
Ferrara M, Gallagher K, Yoviene Sykes LA, Markovich P, Li F, Pollard JM, Imetovski S, Cahill J, Guloksuz S, Srihari VH. Reducing Delay From Referral to Admission at a U.S. First-Episode Psychosis Service: A Quality Improvement Initiative. Psychiatric Services 2022, 73: 1416-1419. PMID: 35652190, PMCID: PMC9715806, DOI: 10.1176/appi.ps.202100374.Peer-Reviewed Original ResearchMeSH KeywordsEarly DiagnosisHospitalizationHumansPsychotic DisordersQuality ImprovementReferral and ConsultationConceptsFirst-episode psychosis servicesConfirmation of eligibilityEarly detection campaignsProportion of admissionsSpecialty care servicesQuality improvement interventionsQuality improvement initiativesLonger DUPMedian delayPoor outcomeUntreated psychosisTreatment accessPsychosis onsetPsychosis servicesCSC servicesCare servicesImprovement interventionsAdmissionImprovement initiativesDetection campaignsInterventionGreater vulnerabilityReferralPsychosisEarly Intervention Services for Schizophrenia: Looking Back and Looking Ahead
Srihari VH, Keshavan MS. Early Intervention Services for Schizophrenia: Looking Back and Looking Ahead. Schizophrenia Bulletin 2022, 48: 544-550. PMID: 35373302, PMCID: PMC9077409, DOI: 10.1093/schbul/sbac024.Peer-Reviewed Original ResearchToward an expanded and personalized approach to coordinated specialty care in early course psychoses
Keshavan MS, Ongur D, Srihari VH. Toward an expanded and personalized approach to coordinated specialty care in early course psychoses. Schizophrenia Research 2022, 241: 119-121. PMID: 35121436, DOI: 10.1016/j.schres.2022.01.016.Peer-Reviewed Original ResearchTiming of cannabis exposure relative to prodrome and psychosis onset in a community-based first episode psychosis sample
Kline ER, Ferrara M, Li F, D'Souza DC, Keshavan M, Srihari VH. Timing of cannabis exposure relative to prodrome and psychosis onset in a community-based first episode psychosis sample. Journal Of Psychiatric Research 2022, 147: 248-253. PMID: 35066293, PMCID: PMC8882157, DOI: 10.1016/j.jpsychires.2022.01.039.Peer-Reviewed Original ResearchConceptsCannabis exposurePublic health significancePsychosis onsetPsychotic disordersHealth significanceFirst-episode psychosis samplePsychosis sampleFirst exposureFirst-episode psychosis servicesWorse premorbid functioningAdverse prognostic factorAssociation of ageImpact of cannabisPsychosis PreventionSymptom onsetPrognostic factorsOverall incidenceEarly psychosis sampleConsecutive admissionsOverall burdenPsychotic illnessPsychosis servicesPsychosis symptomsGreater severityYounger age
2021
First help-seeking attempt before and after psychosis onset: measures of delay and aversive pathways to care
Ferrara M, Guloksuz S, Mathis WS, Li F, Lin IH, Syed S, Gallagher K, Shah J, Kline E, Tek C, Keshavan M, Srihari VH. First help-seeking attempt before and after psychosis onset: measures of delay and aversive pathways to care. Social Psychiatry And Psychiatric Epidemiology 2021, 56: 1359-1369. PMID: 33948678, PMCID: PMC8319102, DOI: 10.1007/s00127-021-02090-0.Peer-Reviewed Original ResearchConceptsPsychosis onsetNon-affective psychosisPsychosis risk syndromeEarly detection effortsAversive eventsAversive pathwaysProdromal sampleClinical characteristicsAntipsychotic treatmentEffective treatmentSociodemographic characteristicsSpecialized treatmentPsychosisProdromeOnsetTreatmentStructured interviewsOverall functioningFamily membersMeasures of delayEpisodesNew HavenSemi-structured interviewsHelp seekersPathwayTaking the next step: Improving care transitions from a first‐episode psychosis service
Gallagher K, Ferrara M, Pollard J, Sykes L, Li F, Imetovski S, Cahill J, Mathis W, Srihari VH. Taking the next step: Improving care transitions from a first‐episode psychosis service. Early Intervention In Psychiatry 2021, 16: 91-96. PMID: 35029048, DOI: 10.1111/eip.13127.Peer-Reviewed Original ResearchConceptsFirst-episode servicesQuality improvement approachQI approachExact testFirst-episode psychosis servicesUnknown treatment statusRecent-onset psychosisFisher's exact testDischarge planning processStudy-Act cyclesDischarge planningCare transitionsCare 3Onset psychosisDisposition planningPsychosis servicesTreatment statusFunctional gainsPatient engagementQI phasePlan-DoPatientsDisposition outcomesTransfer statusMonthsNeural cell‐derived plasma exosome protein abnormalities implicate mitochondrial impairment in first episodes of psychosis
Goetzl EJ, Srihari VH, Guloksuz S, Ferrara M, Tek C, Heninger GR. Neural cell‐derived plasma exosome protein abnormalities implicate mitochondrial impairment in first episodes of psychosis. The FASEB Journal 2021, 35: e21339. PMID: 33454965, DOI: 10.1096/fj.202002519r.Peer-Reviewed Original ResearchConceptsNeuron-derived extracellular vesiclesFunctional proteinsMitochondrial functional proteinsMitochondrial protein mitofusin 2Extracellular vesiclesMitochondrial ATP synthaseMitochondrial ATP synthase activityATP synthase activityTranscription factor AMitochondrial proteinsATP synthaseMyosin VICyclophilin DConversion of NADHMitofusin 2EV contentExosome markersPeptide humaninProteinMitochondrial impairmentSynthase activityProtein levelsFactor AMitochondriaVesiclesEstablishing the Early Psychosis Intervention Clinic, New Orleans (EPIC-NOLA): Sustainability Challenges Threaten Clinical Success.
Weiss A, Chaudhry S, Cahill JD, Srihari VH. Establishing the Early Psychosis Intervention Clinic, New Orleans (EPIC-NOLA): Sustainability Challenges Threaten Clinical Success. Journal Of Health Care For The Poor And Underserved 2021, 32: 8-17. PMID: 33678676, DOI: 10.1353/hpu.2021.0003.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Care FacilitiesEarly Intervention, EducationalHumansMedicineNew OrleansPsychotic Disorders
2020
Natural History, Not Lead Time
Srihari VH, Guloksuz S, Friis S. Natural History, Not Lead Time. American Journal Of Psychiatry 2020, 177: 1185-1185. PMID: 33256447, PMCID: PMC7968614, DOI: 10.1176/appi.ajp.2020.20040402.Peer-Reviewed Original ResearchDecreased mitochondrial electron transport proteins and increased complement mediators in plasma neural-derived exosomes of early psychosis
Goetzl EJ, Srihari VH, Guloksuz S, Ferrara M, Tek C, Heninger GR. Decreased mitochondrial electron transport proteins and increased complement mediators in plasma neural-derived exosomes of early psychosis. Translational Psychiatry 2020, 10: 361. PMID: 33106473, PMCID: PMC7588411, DOI: 10.1038/s41398-020-01046-3.Peer-Reviewed Original ResearchMeSH KeywordsAstrocytesComplement System ProteinsElectron TransportExosomesHumansPsychotic DisordersEarly Intervention for Psychosis in the United States: Tailoring Services to Improve Care for Women
Ferrara M, Srihari VH. Early Intervention for Psychosis in the United States: Tailoring Services to Improve Care for Women. Psychiatric Services 2020, 72: 5-6. PMID: 32966169, DOI: 10.1176/appi.ps.202000205.Peer-Reviewed Original Research
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