Relapse of Psychosis: Prediction and Prevention

Relapse of Psychosis: Prediction and Prevention

Relapse is a common problem in the management of patients with psychosis. Besides being associated with functional and social impairments, relapse can also lead to issues such as hospitalization and severe financial burden. Even with maintenance medication treatment, relapse has been found to occur in around 40% of recovered patients. The need for markers to predict relapse and methods to prevent relapse is thus of great importance in informing practice.


Current projects:

  • Cognitive deterioration and its underlying neurobiological basis as a predictor:
    Our group previously found in the Relapse Prevention Study (RPS project) that patients who eventually relapse often display neurocognitive decline (especially in the visual working memory domain) in the months prior to relapse. We aim to replicate this in a one-year prospective follow-up study and explore the underlying neurobiological basis of this deterioration using fMRI.
  • In-vivo dopaminergic activity as a predictor of relapse after medication discontinuation:
    Likelihood of relapse after medication discontinuation is high, with local RCT data previously showing 1-year relapse rates being significantly higher in the discontinuation group (79%) than the maintenance group (41%). Currently, little is known about the predictors of relapse among patients who have discontinued medication. This study aims to examine the role of in-vivo striatal dopaminergic activity (as monitored by PET radiotracer) in predicting relapse in remitted patients who have stopped medication.
  • Effectiveness of mindfulness intervention in preventing relapse:
    A key precipitating factor of psychotic relapse is stress. We therefore believe that the exploration of non-pharmacological interventions that modulate stress is important. This is a single-blind, 12-month RCT to examine the effectiveness of mindfulness intervention in preventing relapse.
Dr. Christy LM Hui (Lead)
Prof. Eric YH Chen
Dr. Edwin HM Lee
Dr. Sherry KW Chan
Dr. WC Chang
Dr. YN Suen