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
Coping Strategies Mediate the Effect of Stressful Life Events on Schizotypal Traits and Psychotic Symptoms in 22q11.2 Deletion Syndrome.
Marco Armando,Corrado Sandini,Maelle Chambaz,Marie Schaer,Maude Schneider,Maude Schneider,Stephan Eliez +6 more
TL;DR: The correlation between SLE, emotional coping strategies, schizotypal personality traits, subthreshold psychotic symptoms, and pituitary volume in a sample of healthy controls compared with 59 individuals with 22q11DS was explored to confirm the central role of stress and coping in the pathogenesis of psychosis.
Journal ArticleDOI
Latent Profile Analysis and Conversion to Psychosis: Characterizing Subgroups to Enhance Risk Prediction.
Kristin M. Healey,David L. Penn,David L. Penn,Diana O. Perkins,Scott W. Woods,Richard S.E. Keefe,Jean Addington +6 more
TL;DR: Results support a subgroup approach to research, assessment, and treatment of help-seeking individuals and suggest Class 3 may be an early risk stage of developing schizophrenia.
Journal ArticleDOI
Trauma and psychosis symptoms in a sample of help-seeking youth
Emily Kline,Zachary B. Millman,Danielle Denenny,Camille Wilson,Elizabeth Thompson,Caroline Demro,Kay Martel Connors,Kristin Bussell,Gloria Reeves,Jason Schiffman +9 more
TL;DR: Investigation of the association of trauma with psychosis and psychosis-risk symptoms among patients with early indications of psychosis as well as in a comparison group receiving mental health services for non-psychosis concerns found an association between violent traumas and heightened suspiciousness.
Journal ArticleDOI
Neurocognitive function as a possible marker for remission from clinical high risk for psychosis
Tae Young Lee,Ye Seul Shin,Na Young Shin,Sung Nyun Kim,Joon Hwan Jang,Do Hyung Kang,Jun Soo Kwon +6 more
TL;DR: CHR nonconverters who later remit from an initial prodromal state do not show reduced neurocognitive functioning compared with healthy controls at baseline, and an advanced research diagnostic criterion for a CHR state that considers neuroc cognitive functions is needed to more precisely predict which patients will develop psychosis.
Journal ArticleDOI
Dynamic ElecTronic hEalth reCord deTection (DETECT) of individuals at risk of a first episode of psychosis: a case-control development and validation study.
Lars Lau Raket,Lars Lau Raket,Jörn Jaskolowski,Bruce J Kinon,Jens Christian Brasen,Linus Jönsson,Linus Jönsson,Allan Wehnert,Paolo Fusar-Poli +8 more
TL;DR: A novel recurrent neural network model was developed to predict the risk of FEP 1 year before the index date by employing demographics and medical events dynamically collected in the EHR as part of clinical routine to detect individuals at risk of developing a FEP in primary and secondary care.
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.