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Ultra-high risk for psychosis

Anastasia Theodoridou
Early detection of psychosis: evidence and perspectives Abstract. Early detection of psychosis, in the sense of preventing psychosis, has become increasingly important in recent years. Especially psychopathological approaches are promising and are reflected in the attenuated and transient positive symptoms ("ultra high risk" criteria) and the basic symptom criterion "cognitive disturbances". According to the recommendation of the European Psychiatric Association (EPA), both risk-criteria sets are currently the most well-tested diagnostic criteria for a psychosis risk syndrome...
June 2018: Therapeutische Umschau. Revue Thérapeutique
Simon Rice, Andrea Polari, Andrew Thompson, Jessica Hartmann, Patrick McGorry, Barnaby Nelson
AIM: To examine reasons for referral to a specialist ultra-high risk (UHR) for psychosis clinic and whether these reasons are associated with risk for subsequent transition to psychosis. METHODS: Data for 127 patients referred to the Personal Assessment and Crisis Evaluation clinic were collected by medical record audit. Time to transition to psychosis was calculated from date of referral to time at which the young person was judged by their treating team to be experiencing onset of first episode psychosis...
June 6, 2018: Early Intervention in Psychiatry
Ying He, Tomasz Kosciolek, Jinsong Tang, Yao Zhou, Zongchang Li, Xiaoqian Ma, Qiyun Zhu, Ning Yuan, Liu Yuan, Chunwang Li, Ke Jin, Rob Knight, Ming T Tsuang, Xiaogang Chen
BACKGROUND: The microbiota-gut-brain axis and membrane dysfunction in the brain has attracted increasing attention in the field of psychiatric research. However, the possible interactive role of gut microbiota and brain function in the prodromal stage of schizophrenia has not been studied yet. METHODS: To explore this, we collected fecal samples and performed Magnetic Resonance Spectroscopy (MRS) scans in 81 high risk (HR) subjects, 19 ultra-high risk (UHR) subjects and 69 health controls (HC)...
June 2, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Vlatka Boričević Maršanić, Josipa Jukić, Mia Flander
The onset of psychosis is typically preceded by a prodromal phase that is characterised by the emergence of "attenuated" psychotic symptoms. This phase is described as ultra-high risk (UHR) or at-risk mental state (ARMS) of psychosis. Criteria have been established for identifying these young people who are at clinical high risk. People at ultra-high risk (UHR) of psychosis have about 30% chance of developing the illness within two years. This category was introduced with the goal of developing treatments for prevention of psychotic disorders...
June 2018: Psychiatria Danubina
Vinita Jagannath, Miriam Gerstenberg, Susanne Walitza, Maurizia Franscini, Karsten Heekeren, Wulf Rössler, Anastasia Theodoridou, Edna Grünblatt
Little is known about valid predictive markers for functional outcomes in an at-risk for psychosis population. In a cohort of 185 individuals (age: 13-35 years) at high risk (HR) and ultra-high risk (UHR), we assessed pan-NRG1 mRNA levels across good functional status (GFS) and poor functional status (PFS) at baseline, and good functional outcome (GFO) and poor functional outcome (PFO) at 12-month follow-up. NRG1 mRNA levels were significantly higher in individuals with PFO than individuals with GFO at 12-month follow-up...
May 17, 2018: Psychiatry Research
Andrea Raballo, Elena Monducci, Mauro Ferrara, Paolo Fiori Nastro, Claudia Dario
Trait-like anomalies of subjective experience (aka, Basic Self-disturbance or Self-disorder, SD) have been empirically identified as schizophrenia-specific markers of vulnerability in several clinical and genetic high-risk populations. However, such specificity is still to be tested in developmental years, where emerging psychopathology is less crystallized and diagnostic boundaries more blurred. Thus, the current study explores the distribution of SD in adolescent help-seekers (age range 14 to 18) and tests the specificity of SD with respect to the severity of their diagnostic staging (Early Onset schizophrenia-spectrum psychosis [EOP], ultra high-risk [UHR] and clinical help-seeking controls [CHSC])...
May 24, 2018: Schizophrenia Research
Zixu Yang, Keane Lim, Max Lam, Richard Keefe, Jimmy Lee
INTRODUCTION: The Positive and Negative Syndrome Scale (PANSS), a comprehensive psychopathology assessment scale used in the evaluation of psychopathology in schizophrenia, is also often used in the Ultra-High-Risk (UHR) population. This paper examined the dimensional structure of the PANSS in a UHR sample. METHODS: A total of 168 individuals assessed to be at UHR for psychosis on the Comprehensive Assessment of At-Risk Mental States (CAARMS) were evaluated on the PANSS, Calgary Depression Scale for Schizophrenia (CDSS), Beck Anxiety Inventory (BAI), Brief Assessment of Cognition in Schizophrenia (BACS), and Global Assessment of Functioning (GAF)...
May 24, 2018: Schizophrenia Research
Ingvild Aase, Kristiina Kompus, Jens Gisselgård, Inge Joa, Jan O Johannessen, Kolbjørn Brønnick
Objectives: Impaired attention and language functions are common in psychosis, but have been less explored in subjects with ultra-high risk for psychosis (UHR). The aim of the study was to investigate differences in language lateralization and auditory attention in UHR subjects compared to healthy controls with a dichotic listening paradigm. In addition, symptoms from The Structural Interview for Prodromal Syndromes (SIPS) were explored in relation to performance on dichotic listening. Methods: The UHR subjects ( n = 46, female = 28, mean age = 17...
2018: Frontiers in Psychology
Valentina Deriu, Marie Rose Moro, Laelia Benoit
AIM: Over the past 20 years, early management of psychosis has become both a research and policy priority. In Western countries, psychotic disorders appear more prevalent in migrant and minority ethnic groups than in native or dominant groups. Moreover, disparities exist in health conditions and access to care among immigrants and minority ethnic groups, compared with native-born and majority groups. Appropriate early detection tools are necessary for the different groups. METHODS: This systematic review provides a synthesis of the assessment and discussion of transcultural issues in ultra-high-risk (UHR) cohorts...
April 30, 2018: Early Intervention in Psychiatry
Lorenzo Pelizza, Federica Paterlini, Silvia Azzali, Sara Garlassi, Ilaria Scazza, Simona Pupo, Magenta Simmons, Barnaby Nelson, Andrea Raballo
AIM: The Comprehensive Assessment of At-Risk Mental States (CAARMS) was specifically developed to assess and detect young people at ultra-high risk (UHR) of developing psychosis. The current study was undertaken to test the reliability and validity of the authorized Italian version of the CAARMS (CAARMS-ITA) in a help-seeking population. METHODS: Psychometric properties of the CAARMS-ITA were established using a sample of 223 Italian adolescents and young adults aged between 13 and 35 years, who were divided into 3 groups according to the CAARMS criteria: UHR-negative individuals (UHR [-]; n = 64), UHR-positive (UHR [+]; n = 55) and individuals with a first-episode psychosis (FEP; n = 104)...
April 26, 2018: Early Intervention in Psychiatry
Oussama Kebir, Boris Chaumette, Marie-Odile Krebs
Conversion to psychosis is a longitudinal process during which several epigenetic changes have been described. We tested the hypothesis that epigenetic variability in the methylomes of ultra-high risk (UHR) individuals may contribute to the risk of conversion. We studied a longitudinal cohort of UHR individuals (n = 39) and compared two groups (converters, n = 14 vs. non-converters, n = 25). A longitudinal methylomic study was conducted using Infinium HumanMethylation450 BeadChip covering half a million cytosine-phosphate-guanine (CpG) sites across the human genome from whole-blood samples...
April 26, 2018: Translational Psychiatry
Ran-Ran Li, Hai-Long Lyu, Feng Liu, Nan Lian, Ren-Rong Wu, Jing-Ping Zhao, Wen-Bin Guo
AIMS: Evidence of altered structural and functional connectivity in the frontal-occipital network is associated with cognitive deficits in patients with schizophrenia. However, the altered patterns of functional connectivity strength (FCS) in individuals with ultra-high risk (UHR) for psychosis remain unknown. In this study, whole-brain FCS was assessed to examine the altered patterns of FCS in UHR subjects. METHODS: A total of 34 UHR subjects and 37 age- and sex-matched healthy controls were enrolled to undergo resting-state functional magnetic resonance imaging...
April 24, 2018: CNS Neuroscience & Therapeutics
Phillip Grant, Aisha Judith Leila Munk, Juergen Hennig
BACKGROUND: While individuals at ultra-risk for schizophrenia are characterized by high negative/disorganised but low positive schizotypy, schizophrenia patients are usually high in all three schizotypy facets. Thus, avoiding increases in positive schizotypy in ultra-high risk individuals may constitute of form of schizophrenia-prevention. A possible method of reducing positive schizotypy could be Positive-Psychological intervention (PI). METHODS: We present results from 2 independent studies, including a 12-month follow-up from study 1, using an easy-to-perform intervention based on Positive Psychology to reduce positive schizotypy...
April 13, 2018: Schizophrenia Research
Jie Yin Yee, Tih-Shih Lee, Jimmy Lee
Background: Identifying biomarkers to enrich prognostication and risk predictions in individuals at high risk of developing psychosis will enable stratified early intervention efforts. Brain-derived neurotrophic factor (BDNF) has been widely studied in schizophrenia and in first-episode psychosis with promising results. The aim of this study was to examine the levels of serum BDNF between healthy controls and individuals with ultra-high risk of psychosis (UHR). Methods: A sample of 106 healthy controls and 105 UHR individuals from the Longitudinal Youth at Risk Study was included in this study...
March 23, 2018: International Journal of Neuropsychopharmacology
Elfi Vergaelen, Carmen Schiweck, Kristof Van Steeland, Jacqueline Counotte, Wim Veling, Ann Swillen, Hemmo Drexhage, Stephan Claes
BACKGROUND: A growing body of evidence supports a role for immune alterations in Schizophrenia Spectrum Disorders (SSD). A high prevalence (25-40%) of SSD has been found in patients with 22q11.2 deletion syndrome (22q11.2DS), which is known for T-cell deficits due to thymus hypoplasia. This study is the first to explore the association between the T-cell subsets and psychotic symptoms in adults with 22q11.2DS. METHODS: 34 individuals (aged 19-38 yrs.) with 22q11...
May 2018: Brain, Behavior, and Immunity
Jack Cotter, Sandra Bucci, Richard J Drake, Alison R Yung, Rebekah Carney, Dawn Edge
AIM: Many young people at ultra-high risk (UHR) of developing psychosis exhibit marked and persistent impairments in social and occupational functioning. We aimed to explore UHR patients' subjective experiences of these difficulties and their causes. METHODS: We conducted semi-structured interviews with 20 UHR individuals recruited from Early Detection and Intervention Teams in Northwest England. Topics covered included how participants spent their time, their interpersonal relationships, academic and occupational performance, premorbid functioning and clinical treatment...
March 7, 2018: Early Intervention in Psychiatry
Henry R Cowan, Dan P McAdams, Vijay A Mittal
Cognitive theory posits that core beliefs play an active role in developing and maintaining symptoms of depression, anxiety, and psychosis. This study sought to comprehensively examine core beliefs, their dimensionality, and their relationships to depression, anxiety, and attenuated psychotic symptoms in two groups of community youth: a group at ultrahigh risk for psychosis (UHR; n = 73, M age = 18.7) and a matched healthy comparison group (HC; n = 73, M age = 18.1). UHR youth reported significantly more negative beliefs about self and others, and significantly less positive beliefs about self and others...
March 6, 2018: Development and Psychopathology
Ju-Yeon Lee, Young-Chul Chung, Jae-Min Kim, Il-Seon Shin, Jin-Sang Yoon, Sung-Wan Kim
The ability to identify students at ultra-high risk (UHR) for psychosis in school settings is crucial for enabling appropriate referral to a clinician and positive therapeutic results. The aim of this study was to examine school counselors' recognition of the diagnosis and appropriate treatment recommendations for students at UHR for psychosis. In total, 132 school counselors completed surveys, including questions relating to a vignette about a student at UHR for psychosis. In total, 12.4% of the sample provided the correct diagnosis, much lower than that for other schizophrenia spectrum disorders and non-psychotic disorders, including depressive disorder...
March 2018: Psychiatry Investigation
Sung-Wan Kim, Young-Chul Chung, Young-Shin Kang, Jae-Kyeong Kim, Ji-Eun Jang, Min Jhon, Ju-Yeon Lee, Jae-Min Kim, Il-Seon Shin, Jin-Sang Yoon
OBJECTIVE: To examine the reliability and validity of the Korean version of the 16-item Prodromal Questionnaire (KPQ-16) in non-help-seeking university students. METHODS: Among 2,246 university students participated in the initial screening, 257 subjects with KPQ-16 scores ≥4 were interviewed. The criteria for ultra-high risk (UHR) of psychosis of the Comprehensive Assessment of At-Risk Mental States (CAARMS) were the gold standard for diagnosis. An exploratory modified version of the questionnaire (mKPQ-16), to which three items from the Eppendorf Schizophrenia Inventory were added, was also used to compensate for items on thought and cognitive problems...
February 2018: Psychiatry Investigation
Andrea Polari, Suzie Lavoie, Hok-Pan Yuen, Paul Amminger, Gregor Berger, Eric Chen, Lieuwe deHaan, Jessica Hartmann, Connie Markulev, Fritha Melville, Dorien Nieman, Merete Nordentoft, Anita Riecher-Rössler, Stefan Smesny, John Stratford, Swapna Verma, Alison Yung, Patrick McGorry, Barnaby Nelson
BACKGROUND: Traditionally, research in the ultra-high risk (UHR) for psychosis population has focused on the treatment of existing symptomatology and prevention of transition to psychosis. Recently, there has been an increase in focus on outcomes in individuals who do not transition to psychosis. However, there is a lack of standardised definitions of remission, recovery, recurrence and relapse in UHR, resulting in the inability to generalise and replicate outcomes. METHOD: The aims of the current study were to develop definitions for remission, recovery, recurrence and relapse, and apply them to a UHR cohort allowing the identification of longitudinal clinical trajectories...
February 18, 2018: Schizophrenia Research
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