Skip to main content

Advertisement

SpringerLink
Log in

Eye movement indices as predictors of conversion to psychosis in individuals at clinical high risk

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Eye movement abnormalities have been established as an “endophenotype” of schizophrenia. However, less is known about the possibility of these abnormalities as biomarkers for psychosis conversion among clinical high risk (CHR) populations. In the present study, 108 CHR individuals and 70 healthy controls (HC) underwent clinical assessments and eye-tracking tests, comprising fixation stability and free-viewing tasks. According to three-year follow-up outcomes, CHR participants were further stratified into CHR-converter (CHR-C; n = 21) and CHR-nonconverter (CHR-NC; n = 87) subgroups. Prediction models were constructed using Cox regression and logistic regression. The CHR-C group showed more saccades of the fixation stability test (no distractor) and a reduced saccade amplitude of the free-viewing test than HC. Moreover, the CHR-NC group exhibited excessive saccades and an increased saccade amplitude of the fixation stability test (no distractor; with distractor) compared with HC. Furthermore, two indices could effectively discriminate CHR-C from CHR-NC with an area under the receiver-operating characteristic (ROC) curve of 0.80, including the saccade number of the fixation stability test (no distractor) and the saccade amplitude of the free-viewing test. Combined with negative symptom scores of the Scale of Prodromal Symptoms, the area was 0.81. These findings support that eye movement alterations might emerge before the onset of clinically overt psychosis and could assist in predicting psychosis transition among CHR populations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Azar M, Pruessner M, Baer LH, Iyer S, Malla AK, Lepage M (2018) A study on negative and depressive symptom prevalence in individuals at ultra-high risk for psychosis. Early Interv Psychiatry 12:900–906. https://doi.org/10.1111/eip.12386

    Article  PubMed  Google Scholar 

  2. Bansal S, Robinson BM, Leonard CJ, Hahn B, Luck SJ, Gold JM (2019) Failures in top-down control in schizophrenia revealed by patterns of saccadic eye movements. J Abnorm Psychol 128:415–422. https://doi.org/10.1037/abn0000442

    Article  PubMed  PubMed Central  Google Scholar 

  3. Barton JJ, Pandita M, Thakkar K, Goff DC, Manoach DS (2008) The relation between antisaccade errors, fixation stability and prosaccade errors in schizophrenia. Exp Brain Res 186:273–282. https://doi.org/10.1007/s00221-007-1235-2

    Article  PubMed  Google Scholar 

  4. Benson PJ, Beedie SA, Shephard E, Giegling I, Rujescu D, St Clair D (2012) Simple viewing tests can detect eye movement abnormalities that distinguish schizophrenia cases from controls with exceptional accuracy. Biol Psychiatry 72:716–724. https://doi.org/10.1016/j.biopsych.2012.04.019

    Article  PubMed  Google Scholar 

  5. Caldani S, Bucci MP, Lamy JC, Seassau M, Bendjemaa N, Gadel R, Gaillard R, Krebs MO, Amado I (2017) Saccadic eye movements as markers of schizophrenia spectrum: exploration in at-risk mental states. Schizophr Res 181:30–37. https://doi.org/10.1016/j.schres.2016.09.003

    Article  PubMed  Google Scholar 

  6. Cannon TD, Chung Y, He G, Sun D, Jacobson A, van Erp TG, McEwen S, Addington J, Bearden CE, Cadenhead K, Cornblatt B, Mathalon DH, McGlashan T, Perkins D, Jeffries C, Seidman LJ, Tsuang M, Walker E, Woods SW, Heinssen R (2015) Progressive reduction in cortical thickness as psychosis develops: a multisite longitudinal neuroimaging study of youth at elevated clinical risk. Biol Psychiatry 77:147–157. https://doi.org/10.1016/j.biopsych.2014.05.023

    Article  PubMed  Google Scholar 

  7. Cannon TD, Yu C, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Heinssen R, Jeffries CD, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Kattan MW (2016) An individualized risk calculator for research in prodromal psychosis. Am J Psychiatry 173:980–988. https://doi.org/10.1176/appi.ajp.2016.15070890

    Article  PubMed  PubMed Central  Google Scholar 

  8. Cui H, Giuliano AJ, Zhang T, Xu L, Wei Y, Tang Y, Qian Z, Stone LM, Li H, Whitfield-Gabrieli S, Niznikiewicz M, Keshavan MS, Shenton ME, Wang J, Stone WS (2020) Cognitive dysfunction in a psychotropic medication-naïve, clinical high-risk sample from the shanghai-at-risk-for-psychosis (sharp) study: associations with clinical outcomes. Schizophr Res 226:138–146. https://doi.org/10.1016/j.schres.2020.06.018

    Article  PubMed  Google Scholar 

  9. Fusar-Poli P, Bonoldi I, Yung AR, Borgwardt S, Kempton MJ, Valmaggia L, Barale F, Caverzasi E, McGuire P (2012) Predicting psychosis: Meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 69:220–229. https://doi.org/10.1001/archgenpsychiatry.2011.1472

    Article  PubMed  Google Scholar 

  10. Haraldsson HM, Ettinger U, Magnusdottir BB, Sigmundsson T, Sigurdsson E, Petursson H (2008) Eye movement deficits in schizophrenia: investigation of a genetically homogenous icelandic sample. Eur Arch Psychiatry Clin Neurosci 258:373–383. https://doi.org/10.1007/s00406-008-0806-y

    Article  PubMed  Google Scholar 

  11. Helo A, Rämä P, Pannasch S, Meary D (2016) Eye movement patterns and visual attention during scene viewing in 3- to 12-month-olds. Vis Neurosci 33:E014. https://doi.org/10.1017/s0952523816000110

    Article  PubMed  Google Scholar 

  12. Hong LE, Turano KA, O’Neill HB, Hao L, Wonodi I, McMahon RP, Thaker GK (2009) Is motion perception deficit in schizophrenia a consequence of eye-tracking abnormality? Biol Psychiatry 65:1079–1085. https://doi.org/10.1016/j.biopsych.2008.10.021

    Article  PubMed  Google Scholar 

  13. Huang L, Wei W, Liu Z, Zhang T, Wang J, Xu L, Chen W, Le Meur O (2020) Effective schizophrenia recognition using discriminative eye movement features and model-metric based features. Pattern Recogn Lett 138:608–616. https://doi.org/10.1016/j.patrec.2020.09.017

    Article  Google Scholar 

  14. Huang W, Chen C, Chen X, Chen X, Gan J, Zhu X, Xu J, Zhao L, Zhou J, Yang R, Lv J, Liu X, Li H (2021) Association between global visual scanning and cognitive function in schizophrenia. Asian J Psychiatr 56:102559. https://doi.org/10.1016/j.ajp.2021.102559

    Article  PubMed  Google Scholar 

  15. Ito J, Yamane Y, Suzuki M, Maldonado P, Fujita I, Tamura H, Grün S (2017) Switch from ambient to focal processing mode explains the dynamics of free viewing eye movements. Sci Rep 7:1082. https://doi.org/10.1038/s41598-017-01076-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Kacur J, Polec J, Smolejova E, Heretik A (2020) An analysis of eye-tracking features and modelling methods for free-viewed standard stimulus: application for schizophrenia detection. IEEE J Biomed Health Inform 24:3055–3065. https://doi.org/10.1109/jbhi.2020.3002097

    Article  PubMed  Google Scholar 

  17. Kleineidam L, Frommann I, Ruhrmann S, Klosterkötter J, Brockhaus-Dumke A, Wölwer W, Gaebel W, Maier W, Wagner M, Ettinger U (2019) Antisaccade and prosaccade eye movements in individuals clinically at risk for psychosis: comparison with first-episode schizophrenia and prediction of conversion. Eur Arch Psychiatry Clin Neurosci 269:921–930. https://doi.org/10.1007/s00406-018-0973-4

    Article  PubMed  Google Scholar 

  18. Lee TY, Hwang WJ, Kim NS, Park I, Lho SK, Moon SY, Oh S, Lee J, Kim M, Woo CW, Kwon JS (2020) Prediction of psychosis: model development and internal validation of a personalized risk calculator. Psychol Med. https://doi.org/10.1017/s0033291720004675

    Article  PubMed  PubMed Central  Google Scholar 

  19. Li Z, Zhang T, Xu L, Wei Y, Cui H, Tang Y, Liu X, Qian Z, Zhang H, Liu P, Li C, Wang J (2022) Plasma metabolic alterations and potential biomarkers in individuals at clinical high risk for psychosis. Schizophr Res 239:19–28. https://doi.org/10.1016/j.schres.2021.11.011

    Article  CAS  PubMed  Google Scholar 

  20. Lieberman JA, Small SA, Girgis RR (2019) Early detection and preventive intervention in schizophrenia: from fantasy to reality. Am J Psychiatry 176:794–810. https://doi.org/10.1176/appi.ajp.2019.19080865

    Article  PubMed  Google Scholar 

  21. Macedo AF, Crossland MD, Rubin GS (2008) The effect of retinal image slip on peripheral visual acuity. J Vis 8(16):11–11. https://doi.org/10.1167/8.14.16

    Article  Google Scholar 

  22. Macpherson T, Hikida T (2019) Role of basal ganglia neurocircuitry in the pathology of psychiatric disorders. Psychiatry Clin Neurosci 73:289–301. https://doi.org/10.1111/pcn.12830

    Article  PubMed  Google Scholar 

  23. McGlashan T, Walsh B, Woods S (2010) The psychosis-risk syndrome: handbook for diagnosis and follow-up. Oxford University Press, New York

    Google Scholar 

  24. Miller TJ, McGlashan TH, Rosen JL, Cadenhead K, Cannon T, Ventura J, McFarlane W, Perkins DO, Pearlson GD, Woods SW (2003) Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophr Bull 29:703–715. https://doi.org/10.1093/oxfordjournals.schbul.a007040

    Article  PubMed  Google Scholar 

  25. Miura K, Hashimoto R, Fujimoto M, Yamamori H, Yasuda Y, Ohi K, Umeda-Yano S, Fukunaga M, Iwase M, Takeda M (2014) An integrated eye movement score as a neurophysiological marker of schizophrenia. Schizophr Res 160:228–229. https://doi.org/10.1016/j.schres.2014.10.023

    Article  PubMed  Google Scholar 

  26. Morita K, Miura K, Fujimoto M, Yamamori H, Yasuda Y, Iwase M, Kasai K, Hashimoto R (2017) Eye movement as a biomarker of schizophrenia: using an integrated eye movement score. Psychiatry Clin Neurosci 71:104–114. https://doi.org/10.1111/pcn.12460

    Article  CAS  PubMed  Google Scholar 

  27. Morita K, Miura K, Fujimoto M, Yamamori H, Yasuda Y, Kudo N, Azechi H, Okada N, Koshiyama D, Ikeda M, Kasai K, Hashimoto R (2019) Eye movement abnormalities and their association with cognitive impairments in schizophrenia. Schizophr Res 209:255–262. https://doi.org/10.1016/j.schres.2018.12.051

    Article  PubMed  Google Scholar 

  28. Mwansisya TE, Hu A, Li Y, Chen X, Wu G, Huang X, Lv D, Li Z, Liu C, Xue Z, Feng J, Liu Z (2017) Task and resting-state fmri studies in first-episode schizophrenia: a systematic review. Schizophr Res 189:9–18. https://doi.org/10.1016/j.schres.2017.02.026

    Article  PubMed  Google Scholar 

  29. Nieman D, Becker H, van de Fliert R, Plat N, Bour L, Koelman H, Klaassen M, Dingemans P, Niessen M, Linszen D (2007) Antisaccade task performance in patients at ultra high risk for developing psychosis. Schizophr Res 95:54–60. https://doi.org/10.1016/j.schres.2007.06.022

    Article  PubMed  Google Scholar 

  30. Obyedkov I, Skuhareuskaya M, Skugarevsky O, Obyedkov V, Buslauski P, Skuhareuskaya T, Waszkiewicz N (2019) Saccadic eye movements in different dimensions of schizophrenia and in clinical high-risk state for psychosis. BMC Psychiatry 19:110. https://doi.org/10.1186/s12888-019-2093-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Perkins DO, Olde Loohuis L, Barbee J, Ford J, Jeffries CD, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Mathalon DH, McGlashan TH, Seidman LJ, Tsuang M, Walker EF, Woods SW (2020) Polygenic risk score contribution to psychosis prediction in a target population of persons at clinical high risk. Am J Psychiatry 177:155–163. https://doi.org/10.1176/appi.ajp.2019.18060721

    Article  PubMed  Google Scholar 

  32. Pirdankar OH, Das VE (2016) Influence of target parameters on fixation stability in normal and strabismic monkeys. Invest Ophthalmol Vis Sci 57:1087–1095. https://doi.org/10.1167/iovs.15-17896

    Article  PubMed  PubMed Central  Google Scholar 

  33. Pretegiani E, Optican LM (2017) Eye movements in parkinson’s disease and inherited parkinsonian syndromes. Front Neurol 8:592. https://doi.org/10.3389/fneur.2017.00592

    Article  PubMed  PubMed Central  Google Scholar 

  34. Roux P, Brunet-Gouet E, Passerieux C, Ramus F (2016) Eye-tracking reveals a slowdown of social context processing during intention attribution in patients with schizophrenia. J Psychiatry Neurosci 41:E13-21. https://doi.org/10.1503/jpn.150045

    Article  PubMed  PubMed Central  Google Scholar 

  35. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC (1998) The mini-international neuropsychiatric interview (m.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for dsm-iv and icd-10. J Clin Psychiatry 59(Suppl 20):22–33 (quiz 34-57)

    PubMed  Google Scholar 

  36. Silverstein SM, Berten S, Essex B, Kovács I, Susmaras T, Little DM (2009) An fmri examination of visual integration in schizophrenia. J Integr Neurosci 8:175–202. https://doi.org/10.1142/s0219635209002113

    Article  PubMed  Google Scholar 

  37. Sprenger A, Friedrich M, Nagel M, Schmidt CS, Moritz S, Lencer R (2013) Advanced analysis of free visual exploration patterns in schizophrenia. Front Psychol 4:737. https://doi.org/10.3389/fpsyg.2013.00737

    Article  PubMed  PubMed Central  Google Scholar 

  38. Tang Y, Wang J, Zhang T, Xu L, Qian Z, Cui H, Tang X, Li H, Whitfield-Gabrieli S, Shenton ME, Seidman LJ, McCarley RW, Keshavan MS, Stone WS, Wang J, Niznikiewicz MA (2020) P300 as an index of transition to psychosis and of remission: data from a clinical high risk for psychosis study and review of literature. Schizophr Res 226:74–83. https://doi.org/10.1016/j.schres.2019.02.014

    Article  PubMed  Google Scholar 

  39. Thakkar KN, Diwadkar VA, Rolfs M (2017) Oculomotor prediction: a window into the psychotic mind. Trends Cogn Sci 21:344–356. https://doi.org/10.1016/j.tics.2017.02.001

    Article  PubMed  PubMed Central  Google Scholar 

  40. Tsitsi P, Benfatto MN, Seimyr G, Larsson O, Svenningsson P, Markaki I (2021) Fixation duration and pupil size as diagnostic tools in parkinson’s disease. J Parkinsons Dis 11:865–875. https://doi.org/10.3233/jpd-202427

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. van Tricht MJ, Nieman DH, Bour LJ, Boerée T, Koelman JH, de Haan L, Linszen DH (2010) Increased saccadic rate during smooth pursuit eye movements in patients at ultra high risk for developing a psychosis. Brain Cogn 73:215–221. https://doi.org/10.1016/j.bandc.2010.05.005

    Article  PubMed  Google Scholar 

  42. Wu G, Gan R, Li Z, Xu L, Tang X, Wei Y, Hu Y, Cui H, Li H, Tang Y, Hui L, Liu X, Li C, Wang J, Zhang T (2019) Real-world effectiveness and safety of antipsychotics in individuals at clinical high-risk for psychosis: study protocol for a prospective observational study (shanghai at risk for psychosis-phase 2). Neuropsychiatr Dis Treat 15:3541–3548. https://doi.org/10.2147/ndt.S230904

    Article  PubMed  PubMed Central  Google Scholar 

  43. Wu G, Tang X, Gan R, Zeng J, Hu Y, Xu L, Wei Y, Tang Y, Chen T, Li C, Wang J, Zhang T (2021) Temporal and time-frequency features of auditory oddball response in distinct subtypes of patients at clinical high risk for psychosis. Eur Arch Psychiatry Clin Neurosci. https://doi.org/10.1007/s00406-021-01316-1

    Article  PubMed  PubMed Central  Google Scholar 

  44. Yung AR, McGorry PD, McFarlane CA, Jackson HJ, Patton GC, Rakkar A (1996) Monitoring and care of young people at incipient risk of psychosis. Schizophr Bull 22:283–303. https://doi.org/10.1093/schbul/22.2.283

    Article  CAS  PubMed  Google Scholar 

  45. Zhang T, Li H, Tang Y, Niznikiewicz MA, Shenton ME, Keshavan MS, Stone WS, McCarley RW, Seidman LJ, Wang J (2018) Validating the predictive accuracy of the napls-2 psychosis risk calculator in a clinical high-risk sample from the sharp (shanghai at risk for psychosis) program. Am J Psychiatry 175:906–908. https://doi.org/10.1176/appi.ajp.2018.18010036

    Article  PubMed  Google Scholar 

  46. Zhang T, Li H, Woodberry KA, Seidman LJ, Zheng L, Li H, Zhao S, Tang Y, Guo Q, Lu X, Zhuo K, Qian Z, Chow A, Li C, Jiang K, Xiao Z, Wang J (2014) Prodromal psychosis detection in a counseling center population in china: an epidemiological and clinical study. Schizophr Res 152:391–399. https://doi.org/10.1016/j.schres.2013.11.039

    Article  PubMed  Google Scholar 

  47. Zhang T, Xu L, Chen Y, Wei Y, Tang X, Hu Y, Li Z, Gan R, Wu G, Cui H, Tang Y, Hui L, Li C, Wang J (2020) Conversion to psychosis in adolescents and adults: Similar proportions, different predictors. Psychol Med. https://doi.org/10.1017/s0033291720000756

    Article  PubMed  PubMed Central  Google Scholar 

  48. Zhang TH, Li HJ, Woodberry KA, Xu LH, Tang YY, Guo Q, Cui HR, Liu XH, Chow A, Li CB, Jiang KD, Xiao ZP, Seidman LJ, Wang JJ (2017) Two-year follow-up of a chinese sample at clinical high risk for psychosis: timeline of symptoms, help-seeking and conversion. Epidemiol Psychiatr Sci 26:287–298. https://doi.org/10.1017/s2045796016000184

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was supported by the Ministry of Science and Technology of China, National Key R&D Program of China (2016YFC1306800); National Natural Science Foundation of China (81671332, 81971251, 81671329, 81871050, and 62171269); Shanghai Municipal Science and Technology Major Project (2018SHZDZX01); Science and Technology Commission of Shanghai Municipality (16JC1420200, 16ZR1430500, 19410710800, 19411969100, 19441907800, 20ZR1448600, and 21S31903100); Shanghai Municipal Health Commission (202040361); Clinical Research Center at Shanghai Jiao Tong University School of Medicine (DLY201817); Shanghai Jiao Tong University Foundation (ZH2018ZDB03, ZH2018QNB19), The Clinical Research Center at Shanghai Mental Health Center (CRC2018ZD01, CRC2018ZD04, CRC2018YB01, and CRC2019ZD02), Shanghai Mental Health Center (2019-zd01); “To the youth” Psychological class for middle school students (21DZ2300400).

Author information

Author notes

  1. Lihua Xu shares the first authorship.

Authors and Affiliations

  1. Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People’s Republic of China

    Dan Zhang, Lihua Xu, Xiaochen Tang, Yegang Hu, Xu Liu, Guisen Wu, Zhenying Qian, Yingying Tang, Tianhong Zhang & Jijun Wang

  2. First Clinical Medical College of Nanjing Medical University, Nanjing, 211103, People’s Republic of China

    Yuou Xie

  3. Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, 200444, People’s Republic of China

    Zhi Liu

  4. School of Communication and Information Engineering, Shanghai University, Shanghai, 200444, People’s Republic of China

    Zhi Liu

  5. Senior Research Fellow, Labor and Worklife Program, Harvard University, Cambridge, MA, USA

    Tao Chen

  6. Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada

    Tao Chen

  7. Niacin (Shanghai) Technology Co., Ltd., Shanghai, People’s Republic of China

    Tao Chen

  8. Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, People’s Republic of China

    HaiChun Liu

  9. CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, People’s Republic of China

    Jijun Wang

  10. Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, People’s Republic of China

    Jijun Wang

Authors
  1. Dan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lihua Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuou Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiaochen Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yegang Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xu Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Guisen Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zhenying Qian
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yingying Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Zhi Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Tao Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. HaiChun Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Tianhong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Jijun Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JW, TZ, HL, TC, and ZL: designed the research project; XT and YH: were responsible for recruiting participants; GW, ZQ, and YT: conceived and supervised the clinical evaluation; DZ and XL: carried out the data collection; DZ, LX, and YX: contributed to the statistical analyses and conceptualization of the manuscript. All authors were responsible for reviewing and approving the final manuscript.

Corresponding authors

Correspondence to Tianhong Zhang or Jijun Wang.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to declare.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 26833 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, D., Xu, L., Xie, Y. et al. Eye movement indices as predictors of conversion to psychosis in individuals at clinical high risk. Eur Arch Psychiatry Clin Neurosci 273, 553–563 (2023). https://doi.org/10.1007/s00406-022-01463-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-022-01463-z

Keywords

Search

Navigation