Evidence map›Paper›PMID 42805768›Full record

Observational studyBMJ mental health2026

External validation and refinement of the Psychosis Polyrisk Score to detect individuals at clinical high risk for psychosis.

Riccardo Stefanelli, Dominic Oliver, Stefano Damiani, Marika Orlandi, Umberto Provenzani, Elisa Bortolin, Margherita Rovida, Jean Addington, Luis Alameda, Celso Arango and 61 more

Registry-linked trialAbstract readMulticenter StudyObservational StudyValidation Study
In one paragraph

Observational study in BMJ mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05905003 (Accelerating Medicines Partnership® Schizophrenia Observational Study), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05905003 active not recruitingnot on this map

Accelerating Medicines Partnership® Schizophrenia Observational Study: Psychosis Risk Evaluation, Data Integration, and Computational Technologies -Data Processing, Analysis, and Coordination Center and Coordination Center

TypeobservationalSponsorBrigham and Women's HospitalRan2022 to 2027Enrolled2,617ConditionsClinical High Risk, Psychosis, Remission, Conversion
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

71 authors.

Riccardo StefanelliDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy riccardoste99@gmail.com.ORCID http://orcid.org/0000-0002-4048-9790
Dominic OliverDepartment of Psychiatry, University of Oxford, Oxford, UK.
Stefano DamianiDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Marika OrlandiDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Umberto ProvenzaniDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Elisa BortolinDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Margherita RovidaDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Jean AddingtonDepartment of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Alberta, Canada.
Luis AlamedaTiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
Celso ArangoDepartment of Child and Adolescent Psychiatry, Hospital Universitario La Paz, IdiPAZ, CIBERSAM, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Nicholas J BreitbordeDepartment of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Columbus, OH, USA.
Matthew BroomeSchool of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK.
Kristin S CadenheadDepartment of Psychiatry, University of California, San Diego, CA, USA.
Monica E CalkinsDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Ricardo E CarrionNorthwell Health, New Hyde Park, New York, USA.
Rolando I Castillo-PassiDepartment of Psychiatry, University of Chile, University of Chile, Santiago, Chile.
Yu Hai Eric ChenDepartment of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong.
Jimmy ChoiOlin Neuropsychiatry Research Center, Hartford HealthCare, Hartford, CT, USA.
Philippe ConusTiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
Barbara A CornblattDepartment of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Covadonga M Díaz-CanejaDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry and Menthal Health, Hospital General Universitario Gregorio Maranon, IiSMG, CIBERSAM, Instituo de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain.
Lauren M EllmanDepartment of Psychology & Neuroscience, Temple University, Philadelphia, PA, USA.
Pablo A GasparDepartment of Psychiatry, University of Chile, Santiago, Chile.
Carla GerberBehavioral Health Services, PeaceHealth Medical Group, Eugene, OR, USA.
Louise Birkedal GlenthøjVIRTU Research Group, Mental Health Copenhagen, University of Copenhagen, Copenhagen, Denmark.
Leslie E HortonDepartment of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Christy Lm HuiDepartment of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong.
Joseph KambeitzDepartment of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Lana Kambeitz-IlankovicDepartment of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Matcheri S KeshavanDepartment of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Minah KimDepartment of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.ORCID http://orcid.org/0000-0001-8668-0817
Sung-Wan KimDepartment of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Nikolaos KoutsoulerisDepartment of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany.
Jun Soo KwonDepartment of Psychiatry, Hanyang University College of Medicine, Seoul, Korea.
Kerstin LangbeinDepartment of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
Daniel MamahDepartment of Psychiatry, Washington University Medical School, St. Louis, MO, USA.
Daniel H MathalonDepartment of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
Vijay A MittalDepartment of Psychology, Northwestern University, Evanston, IL, USA.
Meredete NordentoftCopenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Copenhagen, Denmark.
Godfrey D PearlsonOlin Neuropsychiatry Research Center, Hartford HealthCare, Hartford, CT, USA.
Nora PenzelDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Jesus PerezCAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
Diana O PerkinsDepartment of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Albert R PowersDepartment of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Jack R RogersCentre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.
Fred W SabbPrevention Science Institute, University of Oregon, Eugene, OR, USA.
Jason SchiffmanDepartment of Psychological Science, University of California, Irvine, CA, USA.
Jai ShahDepartment of Psychiatry, McGill University, Montreal, Quebec, Canada.
Steven M SilversteinDepartment of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA.
Stefan SmesnyDepartment of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
William S StoneDepartment of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Gregory P StraussDepartment of Psychology, University of Georgia, Athens, GA, USA.
Judy L ThompsonDepartments of Psychiatry and Neuroscience, University of Rochester Medical Center, Rochester, NY, USA.
Rachel UpthegroveSchool of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK.
Swapna VermaDepartment of Psychosis, Institute of Mental Health, Singapore.
Jijun WangShanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Daniel H WolfDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
TianHong ZhangShanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Neuromodulation Center, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shangai, China.ORCID http://orcid.org/0000-0002-5379-7119
Sylvain BouixDepartment of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Quebec, Canada.
Cheryl M CorcoranDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Tina KapurDepartment of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Ofer PasternakDepartment of Psychiatry, Mass General Brigham Hospital, Harvard Medical School, Boston, MA, USA.
Carrie BeardenDepartment of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.
Rene S KahnDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
John M KaneDepartment of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Patrick D McGorryCentre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
Barnaby NelsonCentre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
Martha E ShentonDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Scott W WoodsDepartment of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Accelerating Medicines Partnership Schizophrenia (AMP SCZ)
Paolo Fusar-PoliDepartment of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

Funding

ProNET: Psychosis-Risk Outcomes NetworkU01MH124639 · NIMH · YALE UNIVERSITY · PI CARRIE E BEARDEN, JOHN M KANE · 2020 to 2026
$81.2M
Psychosis Risk Evaluation, Data Integration and Computational Technologies (PREDICT): Data Processing, Analysis, and Coordination CenterU24MH124629 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI Rene S. Kahn, Martha E. Shenton · 2020 to 2026
$32.6M
Trajectories and Predictors in the Clinical High Risk for Psychosis Population: Prediction Scientific Global Consortium (PRESCIENT)U01MH124631 · NIMH · UNIVERSITY OF MELBOURNE · PI Christopher Barnaby Nelson · 2020 to 2026
$30.4M
Randomized controlled trial of enhanced coordinated specialty care (CSC 2.0)P50MH115846 · NIMH · MCLEAN HOSPITAL · PI Dost Ongur · 2019 to 2026
$16.9M
NIMH NIH HHS P50 MH115846NIMH NIH HHS U01 MH124631NIMH NIH HHS U01 MH124639NIMH NIH HHS U24 MH124629Wellcome Trust
6 · The paper itself

Abstract

backgroundThe Psychosis Polyrisk Score (PPS) was developed to characterise exposure to environmental and developmental risk factors for psychosis. In previous studies, the PPS showed promise particularly in discriminating between individuals at clinical high risk for psychosis (CHR-P) and community controls (CC).

objectivesThis study aimed to (1) perform an external validation of the PPS model in a large independent sample and (2) refine the model using expanded predictor data.

methodsParticipants were recruited through the AMP SCZ program: n=1642 CHR-P, n=519 CC. We performed a formal external validation of the PPS original model. The model was then refined incorporating expanded predictor data (perceived loneliness, neighbourhood quality) and increasing the granularity of existing predictors (ethnicity, childhood trauma, parental severe mental illness). Next, we evaluated the refined model through repeated nested cross-validation and compared it to the original model retrained in the new dataset. Discrimination (Harrell's C-index) and calibration (intercept and slope) were used to assess model performance.

findingsThe externally validated PPS original model showed good discrimination (C=0.777, 95% CI 0.756 to 0.797) between CHR-P and CC and good calibration (intercept=0; slope=1.003) after recalibration. The refined PPS model exhibited higher internally cross-validated discrimination than the retrained original model (C=0.876, 95% CI 0.860 to 0.891 vs C=0.796, 95% CI 0.775 to 0.816), as well as good calibration performance (intercept=-0.008; slope=1.031).

conclusionsThe PPS showed good generalisability to a large, independent sample, and performance improved after model refinement. CLINICAL IMPLICATIONS: The PPS represents a potential scalable tool within stepped assessment frameworks for identifying individuals who warrant further CHR-P assessment. TRIAL REGISTRATION NUMBER: NCT05905003.

Indexed as

Psychotic DisordersAdolescentAdultFemaleHumansMaleReproducibility of ResultsRisk AssessmentRisk FactorsYoung AdultBehavioral MedicinePsychiatrySchizophrenia Spectrum and Other Psychotic Disorders

Identifiers

PMID42805768
PMCPMC13629901

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.