Predicting Psychotic Relapse Using Speech-Based Early Detection

Condition(s) studied

Study summary

Psychotic disorders, including schizophrenia and affective psychosis, are severe mental health conditions marked by recurrent episodes that contribute to long-term disability. Relapses, characterized by the re-emergence of psychotic symptoms after remission, are a critical factor in the progression of these disorders, increasing risks such as suicide, cognitive impairment, and unemployment. This study aims to develop a novel, speech-based digital model to predict relapses in individuals with psychosis. Building on previous research into language abnormalities in schizophrenia, the study will employ a longitudinal design across Early Psychosis Intervention (EPI) clinics in Ontario and Quebec to advance relapse prediction

Eligibility

Primary outcome measure(s)

• Likelihood of relapse estimated using Speech-NLP Metrics — Monthly, up to 24 months
  This primary outcome will assess the ability of speech-based NLP metrics (coherence, connectedness, and complexity) to predict impending relapses in psychosis. Monthly speech samples will be analyzed to determine if changes in these metrics can distinguish timepoints preceding relapses from those not followed by relapse, with the aim of predicting relapses up to four weeks in advance. The likelihood of relapse is a numerical probabilistic estimate without any units. Outcome definition: Occurrence of relapse (i.e., psychiatric hospitalization, an increase in the level of psychiatric care, or substantial clinical deterioration \>1wk that requires \>25% increase in Defined Daily Dose equivalents of antipsychotics)
• Generalization of Speech-Based Relapse Prediction Models Across Languages and Genders — Monthly, up to 24 months
  This outcome will assess whether the speech-based relapse prediction models are valid and perform equally well across different languages (English and French) and genders (male and female). The study will evaluate how sociodemographic factors such as language and sex impact the predictive accuracy of the models. NLP metrics (coherence, connectedness, complexity) will be correlated with clinical outcomes, and model performance will be compared across linguistic and gender subgroups to ensure generalizability.

Trial sites (3)

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