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
Personalized Estimates of Brain Structural Variability in Individuals With Early Psychosis.
Mathilde Antoniades,Shalaila S. Haas,Amirhossein Modabbernia,Oleg Bykowsky,Sophia Frangou,Sophia Frangou,Stefan Borgwardt,Stefan Borgwardt,André Schmidt +8 more
TL;DR: In this paper, structural variability in early psychosis indicated heterogeneity at the level of individual profiles and encourages further large-scale examination to identify individuals that deviate markedly from normative reference data, which can assist in quantifying the degree of brain structural heterogeneity in clinical relative to healthy control.
Journal ArticleDOI
Diagnostic Categories: Provisional, Not Otherwise Classified, or Place-holder?
Journal ArticleDOI
Clinical, genetic, and brain imaging predictors of risk for bipolar disorder in high-risk individuals.
Luca Steardo,Mirko Manchia,Mirko Manchia,Bernardo Carpiniello,Claudia Pisanu,Alessio Squassina,Alessio Squassina +6 more
TL;DR: A narrative review of articles aimed at identifying clinical, genetics, molecular, and brain imaging markers of BD specifically focusing on samples of individuals at high-risk for BD supports the need for more efforts.
Journal ArticleDOI
Sensory characteristics of youth at clinical high risk for psychosis.
TL;DR: To identify and compare the sensory characteristics of young people at clinical high risk for psychosis to those of peers at clinical low risk (CLR), and to national normative data, participants were recruited from 6 US regions.
Journal ArticleDOI
Public health primary prevention implemented by clinical high-risk services for psychosis
Andrés Estradé,Gonzalo Salazar de Pablo,Alice Zanotti,Scott Wood,Helen L. Fisher,Paolo Fusar-Poli +5 more
TL;DR: In this article , the authors conducted a systematic review of clinical high risk for psychosis (CHR-P) services from inception until 14th June 2021, identifying original studies describing public health strategies: (a) service characteristics (configuration of mental health service, outreach, pathways to care); (b) universal interventions (general population); (c) selective interventions targeting CHR-P service-users or family/carers).
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.