This week brings a possible new test for early psychosis, the latest salvo in the battle over marijuana, and answers to more questions about ketamine.
Early Skin Reaction to Niacin May Predict Psychosis Risk
A novel study in The Journal of Clinical Psychiatry has found that the efficiency of a person’s skin flushing response to niacin could serve as a sensitive biomarker for early psychosis. The research, conducted in Shanghai, tracked 98 individuals at clinical high risk (CHR) for psychosis over three years, comparing them to 54 patients with first-episode psychosis (FEP) and 61 healthy controls (HC).
The team introduced a new variable — “response efficiency” — to assess how quickly and strongly the skin reacts to niacin, a compound known to trigger flushing. While previous studies focused on the degree of redness (or attenuation), this study found that slower, weaker responses were more predictive of future psychosis.
CHR individuals whose skin responded less efficiently to low doses of niacin were significantly more likely to develop psychosis within the follow-up period. This efficiency measure outperformed traditional intensity scores in forecasting outcomes. Among CHR participants, 23 (23.5%) converted to psychosis, and their response patterns more closely resembled those of FEP patients than HCs.
Notably, this is the first large-scale study to validate NSFR efficiency as a predictive tool. The results suggest that both the intensity and the timing of the flush may reveal underlying biological changes related to early psychosis risk.
Researchers recommend refining the test using AI-driven image analysis to improve accuracy and support early intervention. While promising, they caution that further validation and standardization are needed before the method can be adopted in clinical practice.
IN OTHER PSYCHIATRY AND NEUROLOGY NEWS
- Readers write in to The Primary Care Companion for CNS Disorders to discuss the potential complications of extended marijuana use.
- A JCP commentary also tries to answer three lingering questions regarding ketamine, which relate to suicidality during administration, patients with substance use disorders, and REMS monitoring.
- A PCC case study looks at a report that highlights the challenges of managing bipolar disorder in the context of an incidental diagnosis of papillary thyroid carcinoma.
- Original research in JCP reveals that adolescents experiencing their first episode of bipolar or major depressive disorder show lower levels of Klotho and higher levels of MMP-9, suggesting a potential biological signature for early affective disorders.
- And don’t forget to catch the latest in our ongoing series, “Emerging Approaches in Schizophrenia.”
