The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review
Paolo Fusar-Poli,Stefan Borgwardt,Andreas Bechdolf,Jean Addington,Anita Riecher-Rössler,Frauke Schultze-Lutter,Matcheri S. Keshavan,Stephen J. Wood,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 +22 more
TLDR
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.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 more
Citations
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Journal ArticleDOI
Neuropsychological deficits in participants at clinical high risk for psychosis recruited from the community: relationships to functioning and clinical symptoms.
Kate Haining,Claire Matrunola,Lucy Mitchell,Ruchika Gajwani,Joachim Gross,Andrew Gumley,Stephen M. Lawrie,Matthias Schwannauer,Frauke Schultze-Lutter,Peter J. Uhlhaas +9 more
TL;DR: The current data obtained from a community sample of CHR-participants highlight the importance of dysfunctions in motor and processing speed and emotion recognition RT, suggesting that neurocognitive impairments are an important aspect of sub-threshold psychotic experiences and a possible target for therapeutic interventions.
Journal ArticleDOI
Neurodegenerative Aspects in Vulnerability to Schizophrenia Spectrum Disorders
TL;DR: Whether detrimental to neurodevelopment or tissue-destructive, or an acceleration of neurotoxic pathways, the notion of neurodegeneration in the pathophysiology of schizophrenia spectrum and psychotic disorders continues to gather momentum.
Book ChapterDOI
Early Detection and Intervention in Psychosis
TL;DR: As this volume shows, early detection of and intervention in psychosis is a rapidly evolving and highly promising field of psychiatry.
Journal ArticleDOI
Classifying risk status of non-clinical adolescents using psychometric indicators for psychosis spectrum disorders
Eduardo Fonseca-Pedrero,Diane C. Gooding,Javier Ortuño-Sierra,Madeline J. Pflum,Mercedes Paino,José Muñiz +5 more
TL;DR: It is indicated that different latent classes of early individuals at risk can be empirically defined in adolescent community samples using psychometric indicators for psychosis spectrum disorders.
Journal ArticleDOI
Clinical outcomes in individuals at clinical high risk of psychosis who do not transition to psychosis: a meta-analysis
Gonzalo Salazar de Pablo,L. Soardo,A. Cabras,J. Pereira,S. Kaur,Filippo Besana,Vincenzo Arienti,Francesco Coronelli,Jae Il Shin,Marco Solmi,Natalia Petros,André F. Carvalho,Philip McGuire,Paolo Fusar-Poli +13 more
TL;DR: Clinical outcomes improve in CHR-P individuals not transitioning to psychosis but only less than half remit over time, with sustained clinical attention needed in the longer term to monitor these outcomes.
References
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BookDOI
Reducing risks for mental disorders: Frontiers for preventive intervention research.
TL;DR: This study provides a targeted definition of prevention and a conceptual framework that emphasizes risk reduction and presents a focused research agenda, with recommendations on how to develop effective intervention programs, create a cadre of prevention researchers, and improve coordination among federal agencies.
Journal ArticleDOI
A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder
TL;DR: There is evidence, however, that transitory developmental expression of psychosis (psychosis proneness) may become abnormally persistent and subsequently clinically relevant (impairment), depending on the degree of environmental risk the person is additionally exposed to.
Journal ArticleDOI
Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States
Alison R. Yung,Hok Pan Yuen,Patrick D. McGorry,Lisa J. Phillips,D. Kelly,Margaret Dell'Olio,Shona M. Francey,Elizabeth Cosgrave,Eoin Killackey,Carrie Stanford,Katherine Godfrey,Joe A. Buckby +11 more
TL;DR: The CAARMS instrument provides a useful platform for monitoring sub threshold psychotic symptoms for worsening into full-threshold psychotic disorder and has good to excellent reliability.
Journal ArticleDOI
Prodromal Assessment With the Structured Interview for Prodromal Syndromes and the Scale of Prodromal Symptoms: Predictive Validity, Interrater Reliability, and Training to Reliability
Tandy J. Miller,Thomas H. McGlashan,Joanna Lifshey Rosen,Kristen Cadenhead,Joseph Ventura,William R. McFarlane,Diana O. Perkins,Godfrey D. Pearlson,Scott W. Woods +8 more
TL;DR: Data is presented suggesting that excellent interrater reliability can be established for diagnosis in a day-and-a-half-long training workshop and on the Structured Interview for Prodromal Syndromes and the Scale of ProDromal Symptoms.
Journal ArticleDOI
Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison.
Christos Pantelis,Christos Pantelis,Dennis Velakoulis,Dennis Velakoulis,Patrick D. McGorry,Stephen J. Wood,Stephen J. Wood,John Suckling,Lisa J. Phillips,Alison R. Yung,Edward T. Bullmore,Warrick J. Brewer,Warrick J. Brewer,Bridget Soulsby,Bridget Soulsby,Patricia Desmond,Philip McGuire +16 more
TL;DR: Some of the grey-matter abnormalities associated with psychotic disorders predate the onset of frank symptoms, whereas others appear in association with their first expression.