Dysregulated Lipid Metabolism Precedes Onset of Psychosis

Alex M. Dickens, Partho Sen, Matthew J. Kempton, Neus Barrantes-Vidal, Conrad Iyegbe, Merete Nordentoft, Thomas Pollak, Anita Riecher-Rössler, Stephan Ruhrmann, Gabriele Sachs, Rodrigo Bressan, Marie Odile Krebs, G. Paul Amminger, Lieuwe de Haan, Mark van der Gaag, Lucia Valmaggia, Tuulia Hyötyläinen, , Matej Orešič, Philip McGuireManel Monsonet Bardaji

Research output: Contribution to journalArticleResearchpeer-review

24 Citations (Scopus)


BACKGROUND: A key clinical challenge in the management of individuals at clinical high risk for psychosis (CHR) is that it is difficult to predict their future clinical outcomes. Here, we investigated if the levels of circulating molecular lipids are related to adverse clinical outcomes in this group. METHODS: Serum lipidomic analysis was performed in 263 CHR individuals and 51 healthy control subjects, who were then clinically monitored for up to 5 years. Machine learning was used to identify lipid profiles that discriminated between CHR and control subjects, and between subgroups of CHR subjects with distinct clinical outcomes. RESULTS: At baseline, compared with control subjects, CHR subjects (independent of outcome) had higher levels of triacylglycerols with a low acyl carbon number and a double bond count, as well as higher levels of lipids in general. CHR subjects who subsequently developed psychosis (n = 50) were distinguished from those that did not (n = 213) on the basis of lipid profile at baseline using a model with an area under the receiver operating curve of 0.81 (95% confidence interval = 0.69-0.93). CHR subjects who became psychotic had lower levels of ether phospholipids than CHR individuals who did not (p < .01). CONCLUSIONS: Collectively, these data suggest that lipidomic abnormalities predate the onset of psychosis and that blood lipidomic measures may be useful in predicting which CHR individuals are most likely to develop psychosis.

Original languageAmerican English
Pages (from-to)288-297
Number of pages10
JournalBiological Psychiatry
Issue number3
Publication statusPublished - 1 Feb 2021


  • At-risk mental state
  • Clinical high risk for psychosis
  • Lipid metabolism
  • Lipidomics
  • Mass spectrometry
  • Schizophrenia
  • RISK


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