Predicting Psychosis: Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk

doi:10.1016/J.YPSY.2012.07.042

Home
/
Papers
/
Predicting Psychosis: Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk

Journal Article•DOI•

Predicting Psychosis: Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk

01 Jan 2013-Yearbook of Psychiatry and Applied Mental Health-Vol. 2013, pp 111-112

About: This article is published in Yearbook of Psychiatry and Applied Mental Health.The article was published on 2013-01-01. It has received 560 citations till now.

...read moreread less

Citations

PDF

Open Access

More filters

Journal Article•DOI•

The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review

[...]

Paolo Fusar-Poli, Stefan Borgwardt¹, Andreas Bechdolf, Jean Addington, Anita Riecher-Rössler, Frauke Schultze-Lutter, Matcheri S. Keshavan, Stephen J. Wood¹, Stephan Ruhrmann, Larry J. Seidman, Lucia Valmaggia, Tyrone D. Cannon, Eva Velthorst, Lieuwe de Haan, Barbara A. Cornblatt, Ilaria Bonoldi, Max Birchwood, Thomas H. McGlashan, William T. Carpenter, Patrick D. McGorry, Joachim Klosterkötter, Philip McGuire, Alison R. Yung - Show less +19 more•Institutions (1)

King's College London¹

01 Jan 2013-JAMA Psychiatry

TL;DR: The relatively new field of HR research in psychosis has the potential to shed light on the development of major psychotic disorders and to alter their course and provides a rationale for service provision to those in need of help who could not previously access it.

...read moreread less

Abstract: Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.

...read moreread less

1,213 citations

Journal Article•DOI•

Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders

[...]

Cherrie Galletly¹, David J. Castle², Frances Dark, Verity Humberstone, Assen Jablensky³, Eoin Killackey², Jayashri Kulkarni⁴, Patrick D. McGorry², Olav Nielssen⁵, Nga Tran² - Show less +6 more•Institutions (5)

University of Adelaide¹, University of Melbourne², University of Western Australia³, Monash University, Clayton campus⁴, University of Sydney⁵

01 May 2016-Australian and New Zealand Journal of Psychiatry

TL;DR: This guideline takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function, and uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care.

...read moreread less

Abstract: Objectives:This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encou...

...read moreread less

641 citations

Cites methods from "Predicting Psychosis: Meta-analysis..."

...A 2012 meta-analysis (Fusar-Poli et al., 2012) showed that among people identified as being at high risk of psychosis, rates of transition to psychosis were 22% at 1 year and 36% at 3 years....
[...]

Journal Article•DOI•

Comorbid Depressive and Anxiety Disorders in 509 Individuals With an At-Risk Mental State: Impact on Psychopathology and Transition to Psychosis

[...]

Paolo Fusar-Poli¹, Barnaby Nelson², Lucia Valmaggia¹, Alison R. Yung², Philip McGuire¹ - Show less +1 more•Institutions (2)

South London and Maudsley NHS Foundation Trust¹, University of Melbourne²

01 Jan 2014-Schizophrenia Bulletin

TL;DR: The ARMS patients are characterized by high prevalence of anxiety and depressive disorders in addition to their attenuated psychotic symptoms, which may reflect core emotional dysregulation processes and delusional mood in prodromal psychosis.

...read moreread less

Abstract: Background: The current diagnostic system for subjects at enhanced clinical risk of psychosis allows concurrent comorbid diagnoses of anxiety and depressive disorders. Their impact on the presenting high-risk psychopathology, functioning, and transition outcomes has not been widely researched. Methods: In a large sample of subjects with an At-Risk Mental State (ARMS, n = 509), we estimated the prevalence of DSM/SCID anxiety or depressive disorders and their impact on psychopathology, functioning, and psychosis transition. A meta-analytical review of the literature complemented the analysis. Results: About 73% of ARMS subjects had a comorbid axis I diagnosis in addition to the “at-risk” signs and symptoms. About 40% of ARMS subjects had a comorbid diagnosis of depressive disorder while anxiety disorders were less frequent (8%). The meta-analysis conducted in 1683 high-risk subjects confirmed that baseline prevalence of comorbid depressive and anxiety disorders is respectively 41% and 15%. At a psychopathological level, comorbid diagnoses of anxiety or depression were associated with higher suicidality or self-harm behaviors, disorganized/odd/stigmatizing behavior, and avolition/apathy. Comorbid anxiety and depressive diagnoses were also associated with impaired global functioning but had no effect on risk of transition to frank psychosis. Meta-regression analyses confirmed no effect of baseline anxiety and/or depressive comorbid diagnoses on transition to psychosis. Conclusions: The ARMS patients are characterized by high prevalence of anxiety and depressive disorders in addition to their attenuated psychotic symptoms. These symptoms may reflect core emotional dysregulation processes and delusional mood in prodromal psychosis. Anxiety and depressive symptoms are likely to impact the ongoing psychopathology, the global functioning, and the overall longitudinal outcome of these patients.

...read moreread less

520 citations

Cites background from "Predicting Psychosis: Meta-analysis..."

...Studies were included if they: (1) were reported in an original article in a peer-reviewed journal, (2) involved subjects at high risk for psychosis defined according to established international criteria,1 (3) had reported the proportion of high-risk subjects with longitudinal transition to psychosis, (4) had evaluated comorbid anxiety and depressive disorders at baseline....
[...]
...APS, Attenuated Psychosis Syndrome; BLIP, Brief Limited Intermittent Psychotic episode; GRD, Genetic Risk and Deterioration syndrome; Mixed, a mixture of the above subgroups. found no direct support towards transition risk enrichment by depressive or anxiety comorbidities, our results cannot exclude the possibility that the initial selection of high-risk subjects is based in part on inclusion of those with common mental disorders and psychotic experiences, and that these as a group have poorer prognosis compared to those with common mental disorders without psychotic experiences and those with psychotic experiences without anxiety and/or depression....
[...]
...Intermittent Psychotic episode, BLIP), (3) trait vulnerability (schizotypal personality disorder or a first-degree...
[...]
...Univariate Cox-Regression Analysis of the ARMS Sample (n = 509) Variable Level Valid Transition to Psychosis HR 95% CI Pn n % Gender Male 253 41 16.21 1.199 0.764 - 1.883 0.430 Females 256 35 13.67 0.834 0.531 - 1.309 0.429 ARMS group APS 360 47 13.06 1.163 0.941 - 1.403 0.057 GRD 28 1 3.57 0.266 0.037 - 1.925 0.190 BLIP 29 9 31.03 2.753 1.347 - 5.624 0.005 Mixed 92 19 20.65 1.744 1.023 - 2.971 0.041 Comorbidity None 134 19 14.18 0.745 0.415 - 1.370 0.355 Anxiety 39 6 15.38 1.089 0.473 - 2.508 0.842 Depression 134 17 12.69 0.849 0.494 - 1.457 0.552 Depression and anxiety 71 9 12.68 0.787 0.392 - 1.580 0.501 Others 131 25 19.08 1.375 0.685 - 2.760 0.370 Note: HR, hazards ratio; APS, Attenuated Psychosis Syndrome; BLIP, Brief Limited Intermittent Psychotic episode; GRD, Genetic Risk and Deterioration syndrome; Mixed, a mixture of the above subgroups; ARMS, At-Risk Mental State. experiential field, leading to delusion formation and aberrant interpretation of reality....
[...]
...Age Years 20 (17.7–23.7) Gender Males 257 (49.7) Females 256 (50.3) ARMS subgroup APS 360 (70.7) BLIP 29 (5.7) GRD 28 (5.5) Mixed 92 (18.1) Comorbidities None 134 (26.3) Anxiety 39 (7.7) Depression 134 (26.3) Depression and anxiety 71 (13.9) Others 131 (25.7) GAF 58 (50.3–64) CAARMS Unusual thought content Severity 3 (3–5) Frequency 3 (3–4) Perceptual abnormalities Severity 3 (2–4) Frequency 2 (1–3) Disorganized speech Severity 2 (0–3) Frequency 2 (0–4) Note: ARMS, At-Risk Mental State; CAARMS, Comprehensive Assessment of the At-Risk Mental State; GAF, Global Assessment of Functioning; APS, Attenuated Psychosis Syndrome; BLIP, Brief Limited Intermittent Psychotic episode; GRD, Genetic Risk and Deterioration syndrome; Mixed, a mixture of the above subgroups....
[...]

Journal Article•DOI•

Does coaching work? A meta-analysis on the effects of coaching on individual level outcomes in an organizational context

[...]

Tim Theeboom¹, Bianca Beersma, A.E.M. van Vianen¹•Institutions (1)

University of Amsterdam¹

02 Jan 2014-The Journal of Positive Psychology

TL;DR: In this paper, a meta-analysis on the effectiveness of coaching within an organizational context is presented, showing that coaching has significant positive effects on all outcomes with effect sizes ranging from g = 0.43 (coping) to g= 0.74 (goal-directed self-regulation).

...read moreread less

Abstract: Whereas coaching is very popular as a management tool, research on coaching effectiveness is lagging behind. Moreover, the studies on coaching that are currently available have focused on a large variety of processes and outcome measures and generally lack a firm theoretical foundation. With the meta-analysis presented in this article, we aim to shed light on the effectiveness of coaching within an organizational context. We address the question whether coaching has an effect on five both theoretically and practically relevant individual-level outcome categories: performance/skills, well-being, coping, work attitudes, and goal-directed self-regulation. The results show that coaching has significant positive effects on all outcomes with effect sizes ranging from g = 0.43 (coping) to g = 0.74 (goal-directed self-regulation). These findings indicate that coaching is, overall, an effective intervention in organizations.

...read moreread less

477 citations

Cites methods from "Predicting Psychosis: Meta-analysis..."

...First, following the example of Fusar-Poli et al. (2012), we conducted subgroup analyses for sets of studies that were different in terms of study design (mixed designs vs. withinsubject designs)....
[...]

Journal Article•DOI•

Imaging Patients with Psychosis and a Mouse Model Establishes a Spreading Pattern of Hippocampal Dysfunction and Implicates Glutamate as a Driver

[...]

Scott A. Schobel¹, Nashid H. Chaudhury, Usman A. Khan¹, Usman A. Khan², Beatriz Paniagua³, Martin Styner³, Iris Asllani¹, Benjamin P. Inbar, Cheryl Corcoran¹, Jeffrey A. Lieberman¹, Holly Moore¹, Scott A. Small¹ - Show less +8 more•Institutions (3)

Columbia University Medical Center¹, State University of New York System², University of North Carolina at Chapel Hill³

10 Apr 2013-Neuron

TL;DR: MRI tools show that hippocampal hypermetabolism leads to atrophy in psychotic disorder and suggest glutamate as a pathogenic driver and parallel in vivo experiments showed that glutamate drives both neuroimaging abnormalities.

...read moreread less

452 citations

Cites background from "Predicting Psychosis: Meta-analysis..."

...Previous studies have shown that about 30%of this enriched group of subjects with prodromal symptoms progress to psychosis (Fusar-Poli et al., 2012)....
[...]
...Previous studies have shown that about 30%of this enriched group of subjects with prodromal symptoms progress to psychosis (Fusar-Poli et al., 2012)....
[...]

1
2
3
4
…
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112

Collapse

References

PDF

Open Access

More filters

Journal Article•DOI•

Predicting Psychosis: Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk

[...]

Paolo Fusar-Poli¹, Ilaria Bonoldi, Alison R. Yung, Stefan Borgwardt¹, Matthew J. Kempton, Lucia Valmaggia, Francesco Barale, Edgardo Caverzasi, Philip McGuire - Show less +5 more•Institutions (1)

King's College London¹

05 Mar 2012-Archives of General Psychiatry

TL;DR: The state of clinical high risk is associated with a very high risk of developing psychosis within the first 3 years of clinical presentation, and the risk progressively increases across this period.

...read moreread less

Abstract: Context A substantial proportion of people at clinical high risk of psychosis will develop a psychotic disorder over time. However, the risk of transition to psychosis varies between centers, and some recent work suggests that the risk of transition may be declining. Objective To quantitatively examine the literature to date reporting the transition risk to psychosis in subjects at clinical high risk. Data Sources The electronic databases were searched until January 2011. All studies reporting transition risks in patients at clinical high risk were retrieved. Study Selection Twenty-seven studies met the inclusion criteria, comprising a total of 2502 patients. Data Extraction Transition risks, as well as demographic, clinical, and methodologic variables, were extracted from each publication or obtained directly from its authors. Data Synthesis There was a consistent transition risk, independent of the psychometric instruments used, of 18% after 6 months of follow-up, 22% after 1 year, 29% after 2 years, and 36% after 3 years. Significant moderators accounting for heterogeneity across studies and influencing the transition risks were the age of participants, publication year, treatments received, and diagnostic criteria used. There was no publication bias, and a sensitivity analysis confirmed the robustness of the core findings. Conclusions The state of clinical high risk is associated with a very high risk of developing psychosis within the first 3 years of clinical presentation, and the risk progressively increases across this period. The transition risk varies with the age of the patient, the nature of the treatment provided, and the way the syndrome and transition to psychosis are defined.

...read moreread less

1,159 citations

Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk

[...]

Paolo Fusar-Poli, Ilaria Bonoldi, Alison R. Yung, Stefan Borgwardt, Matthew J. Kempton, Lucia Valmaggia, Francesco Barale, Edgardo Caverzasi, Philip McGuire - Show less +5 more

01 Jan 2016

TL;DR: In this article, the authors examined the literature to date reporting the transition risk to psychosis in subjects at clinical high risk and found that there was a consistent transition risk, independent of the psychometric instruments used, of 18% after 6 months of follow-up, 22% after 1 year, 29% after 2 years and 36% after 3 years.

...read moreread less

Abstract: Context: A substantial proportion of people at clinical high risk of psychosis will develop a psychotic disorder over time. However, the risk of transition to psychosis varies between centers, and some recent work suggests that the risk of transition may be declining. Objective: To quantitatively examine the literature to date reporting the transition risk to psychosis in subjects at clinical high risk. Data Sources: The electronic databases were searched until January 2011. All studies reporting transition risks in patients at clinical high risk were retrieved. Study Selection: Twenty-seven studies met the inclusion criteria, comprising a total of 2502 patients. Data Extraction: Transition risks, as well as demographic, clinical, and methodologic variables, were extracted from each publication or obtained directly from its authors. Data Synthesis: There was a consistent transition risk, independent of the psychometric instruments used, of 18% after 6 months of follow-up, 22% after 1 year, 29% after 2 years, and 36% after 3 years. Significant moderators accounting for heterogeneity across studies and influencing the transition risks were the age of participants, publication year, treatments received, and diagnostic criteria used. There was no publication bias, and a sensitivity analysis confirmed the robustness of the core findings. Conclusions: The state of clinical high risk is associated with a very high risk of developing psychosis within the first 3 years of clinical presentation, and the risk progressively increases across this period. The transition risk varies with the age of the patient, the nature of the treatment provided, and the way the syndrome and transition to psychosis are defined.

...read moreread less

584 citations