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
Clinical-learning versus machine-learning for transdiagnostic prediction of psychosis onset in individuals at-risk
Paolo Fusar-Poli,Dominic Stringer,Alice M. S. Durieux,Grazia Rutigliano,Ilaria Bonoldi,Andrea De Micheli,Daniel Stahl +6 more
TL;DR: The development of prognostic models on the basis of a priori clinical knowledge, large samples and adequate events per variable is a robust clinical prediction method to forecast psychosis onset in patients at-risk, and is comparable to machine-learning methods, which are more difficult to interpret and implement.
Journal ArticleDOI
Transient Patterns of Functional Dysconnectivity in Clinical High Risk and Early Illness Schizophrenia Individuals Compared with Healthy Controls.
Eva Mennigen,Eva Mennigen,Susanna L. Fryer,Susanna L. Fryer,Barnaly Rashid,Eswar Damaraju,Yuhui Du,Yuhui Du,Rachel Loewy,Barbara K. Stuart,Vince D. Calhoun,Vince D. Calhoun,Daniel H. Mathalon,Daniel H. Mathalon +13 more
TL;DR: Overall, HC individuals showed significant changes of connectivity between states that were absent or altered in ESZ patients and CHR individuals, underscoring the likelihood that abnormalities are present not only in static FNC but also in dFNC, in individuals at CHR for schizophrenia.
Posted ContentDOI
Large-scale brain network dynamics provide a measure of psychosis and anxiety in 22q11.2 deletion syndrome
Daniela Zöller,Corrado Sandini,Fikret Isik Karahanoglu,Maria Carmela Padula,Maria Carmela Padula,Marie Schaer,Stephan Eliez,D. Van De Ville +7 more
TL;DR: The results confirm that the dynamic nature of brain network activation contains essential function to develop clinically relevant imaging markers of psychosis vulnerability.
Journal ArticleDOI
Interventions and Transition in Youth at Risk of Psychosis: A Systematic Review and Meta-Analyses.
TL;DR: This systematic review and pairwise meta-analyses demonstrated a reduced risk for transition favoring CBT at 12 and 18 months and no interventions were significantly more effective at reducing transition compared with all other interventions in the NMAs.
Journal ArticleDOI
Ten-year audit of clients presenting to a specialised service for young people experiencing or at increased risk for psychosis
Agatha M. Conrad,Terry J. Lewin,Ketrina A. Sly,Ulrich Schall,Sean A. Halpin,Mick Hunter,Vaughan J. Carr +6 more
TL;DR: Whether or not UHR clients transition to psychosis, they displayed high rates of comorbid depression and anxiety at service presentation, with half receiving ongoing treatment from PAS, viewed as largely consistent with those reported elsewhere.
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.