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Extracting spurious messages from noise and risk of schizophrenia-spectrum disorders in a prodromal population

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut

MAURICIO TOHEN, MD

Lilly Research Laboratories, Indianapolis, Indiana

ADRIAN PREDA, MD

Department of Psychiatry, University of California at Irvine, California

ALAN BREIER, MD

Lilly Research Laboratories, Indianapolis, Indiana

JILL GLIST, MS

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA

JEAN ADDINGTON, PhD

Department of Psychiatry, University of Calgary, Alberta, Canada

DIANA O. PERKINS, MD

Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina

THOMAS H. McGLASHAN, MD

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA

Correspondence: Dr Ralph Hoffman, Yale–New Haven Psychiatric Hospital, 184 Liberty Street LV108, New Haven, CT 06519, USA. Tel: +1 (203) 688 9734; fax: +1 (203) 688 -9709; email: ralph.hoffman{at}yale.edu

Declaration of interest This was an investigator-initiated study supported by Eli Lilly & Co. (T.H.M.). A.B. and M.T. are employed by Eli Lilly, S.W.W., R.E.H., T.H.M. and D.O.P. have received support from Eli Lilly previously.

Atendency to extract spurious, message-like meaning from meaningless noise was assessed as a risk factor leading to shizophrenia-spectrum disorders by assessing word length of speech illusions elicited by multispeaker babble in 43 people with prodromal symptoms. These individuals were randomised to olanzapine v. placebo groups during year 1 followed by no pharmacological treatment for those with no disorder conversion during year 2. A time-dependent Cox regression analysis of conversion to schizophrenia-spectrum disorder revealed a significant interaction between condition (olanzapine v. no drug) and length of speech illusion, with the latter strongly predicting subsequent conversion during medication-free intervals but not during olanzapine treatment.

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