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
Pre-onset sub-threshold psychotic symptoms and cortical organization in the first episode of psychosis
Rachel Rosengard,Carolina Makowski,M. Mallar Chakravarty,Ashok Malla,Ridha Joober,Jai Shah,Martin Lepage,Martin Lepage +7 more
TL;DR: This study demonstrates that the early course of sub-threshold psychotic symptoms holds significance in predicting patterns of CT during FEP, and reveals patterns of SC that differentiated patient subgroups and patterns of cortical thinning unique to STPS- patients.
Journal ArticleDOI
Structural retinal abnormalities as potential markers for psychosis spectrum disorders
Stefan Jerotic,P Nađa Marić +1 more
TL;DR: Evidence on retinal thinning in schizophrenia and related disorders is summarized and discussed, finding that the current evidence is conflicting, owing to both the heterogeneity of the disorder, and the methodological differences of the described studies.
Book ChapterDOI
Towards an Integrated View of Early Molecular Changes Underlying Vulnerability to Social Stress in Psychosis.
TL;DR: A model wherein inflammation and oxidative stress act as a first hit, producing altered parvalbumin interneuron development, NMDAR hypofunction, microglial priming, and sensitivity to a second hit of peripubertal social stress is proposed.
Book ChapterDOI
Trends in Schizophrenia Diagnosis and Treatment
TL;DR: This review provides an overview of the concepts, methods and current status of the classification and diagnosis of schizophrenia and of the guidelines in schizophrenia treatment since the respective previous issue of Advances in Psychiatry had been published in 2009.
Journal ArticleDOI
Predictors of Outcomes in Adolescents With Clinical High Risk for Psychosis, Other Psychiatric Symptoms, and Psychosis: A Longitudinal Protocol Study.
Silvia Molteni,Eleonora Filosi,Maria Martina Mensi,Giulia Spada,Chiara Zandrini,Federica Ferro,Matteo Paoletti,Anna Pichiecchio,Ilaria Bonoldi,Umberto Balottin +9 more
TL;DR: The protocol of an innovative longitudinal cohort study of adolescents aged 12-17 will enable a better understanding of the clinical significance of CHR-P in adolescents, and shed new light on prognostic factors that can be used to refine the prediction of clinical outcomes and the implementation of preventive interventions.
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.