{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:57:57Z","timestamp":1780379877217,"version":"3.54.1"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01 MH056584"],"award-info":[{"award-number":["R01 MH056584"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["5P20RR021938"],"award-info":[{"award-number":["5P20RR021938"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P20GM103472"],"award-info":[{"award-number":["P20GM103472"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["1R01 MH084803"],"award-info":[{"award-number":["1R01 MH084803"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000015","name":"Department of Energy","doi-asserted-by":"publisher","award":["DE-FG02-08ER64581"],"award-info":[{"award-number":["DE-FG02-08ER64581"]}],"id":[{"id":"10.13039\/100000015","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Niuvanniemi Hospital"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and hypothesis<\/jats:title>\n                  <jats:p>Neuroimaging-based machine learning (ML) algorithms have the potential to aid the clinical diagnosis of schizophrenia. However, literature on the effect of prevalent comorbidities such as substance use disorder (SUD) and antisocial personality (ASPD) on these models\u2019 performance has remained unexplored. We investigated whether the presence of SUD or ASPD affects the performance of neuroimaging-based ML models trained to discern patients with schizophrenia (SCH) from controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study design<\/jats:title>\n                  <jats:p>We trained an ML model on structural MRI data from public datasets to distinguish between SCH and controls (SCH\u2005=\u2005347, controls\u2005=\u2005341). We then investigated the model\u2019s performance in two independent samples of individuals undergoing forensic psychiatric examination: sample 1 was used for sensitivity analysis to discern ASPD (N\u2005=\u200552) from SCH (N\u2005=\u200566), and sample 2 was used for specificity analysis to discern ASPD (N\u2005=\u200526) from controls (N\u2005=\u200525). Both samples included individuals with SUD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study results<\/jats:title>\n                  <jats:p>In sample 1, 94.4% of SCH with comorbid ASPD and SUD were classified as SCH, followed by patients with SCH\u2005+\u2005SUD (78.8% classified as SCH) and patients with SCH (60.0% classified as SCH). The model failed to discern SCH without comorbidities from ASPD\u2005+\u2005SUD (AUC\u2005=\u20050.562, 95%CI\u2005=\u20050.400\u20130.723). In sample 2, the model\u2019s specificity to predict controls was 84.0%. In both samples, about half of the ASPD\u2005+\u2005SUD were misclassified as SCH. Data-driven functional characterization revealed associations between the classification as SCH and cognition-related brain regions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Altogether, ASPD and SUD appear to have effects on ML prediction performance, which potentially results from converging cognition-related brain abnormalities between SCH, ASPD, and SUD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/schbul\/sbad103","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T07:44:38Z","timestamp":1689320678000},"page":"1568-1578","source":"Crossref","is-referenced-by-count":8,"title":["Effects of Substance Use and Antisocial Personality on Neuroimaging-Based Machine Learning Prediction of Schizophrenia"],"prefix":"10.1093","volume":"49","author":[{"given":"Matias","family":"Taipale","sequence":"first","affiliation":[{"name":"Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland , Kuopio , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jari","family":"Tiihonen","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland , Kuopio , Finland"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet , Stockholm , Sweden"},{"name":"Center for Psychiatry Research, Stockholm City Council , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juuso","family":"Korhonen","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Aalto University , Espoo , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2367-9437","authenticated-orcid":false,"given":"David","family":"Popovic","sequence":"additional","affiliation":[{"name":"Max Planck Institute of Psychiatry , Munich , Germany"},{"name":"International Max Planck Research School for Translational Psychiatry (IMPRS-TP) , Munich , Germany"},{"name":"Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli","family":"Vaurio","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland , Kuopio , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7244-145X","authenticated-orcid":false,"given":"Markku","family":"L\u00e4hteenvuo","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland , Kuopio , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Lieslehto","sequence":"additional","affiliation":[{"name":"Department of Forensic Psychiatry, Niuvanniemi Hospital, 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