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Ultra-high risk for psychosis

M van der Gaag, H Ising, J Lokkerbol, F Smit
Diagnoses have heterogeneous outcomes, varying from good to extremely poor. There is a need to single out an ultra-high-risk group of individuals who have illnesses that might well end unfavourably or who might later develop serious psychopathology.<br/> AIM: To devise a screening instrument that can identify a group of individuals who run a very high risk of developing a first-episode psychosis, and to create a type of intervention that can modify the course of the illness.<br/> METHOD: We developed a short screening instrument (PQ-16) and were able to ascertain its predictive value...
2016: Tijdschrift Voor Psychiatrie
M Pruessner, L Bechard-Evans, S Pira, R Joober, D L Collins, J C Pruessner, A K Malla
BACKGROUND: Altered hypothalamus-pituitary-adrenal (HPA) axis function and reduced hippocampal volume (HV) are established correlates of stress vulnerability. We have previously shown an attenuated cortisol awakening response (CAR) and associations with HV specifically in male first-episode psychosis patients. Findings in individuals at ultra-high risk (UHR) for psychosis regarding these neurobiological markers are inconsistent, and assessment of their interplay, accounting for sex differences, could explain incongruent results...
October 24, 2016: Psychological Medicine
Tina Gupta, Steven M Silverstein, Jessica A Bernard, Brian P Keane, Thomas V Papathomas, Andrea Pelletier-Baldelli, Derek J Dean, Raeana E Newberry, Ivanka Ristanovic, Vijay A Mittal
Patients with psychosis exhibit a reduced susceptibility to depth inversion illusions (DII) in which a physically concave surface is perceived as convex (e.g., the hollow mask illusion). Here, we examined the extent to which lessened susceptibility to DII characterized youth at ultra high risk (UHR) for psychosis. In this study, 44 UHR participants and 29 healthy controls judged the apparent convexity of face-like human masks, two of which were concave and the other convex. One of the concave masks was painted with realistic texture to enhance the illusion; the other was shown without such texture...
2016: NeuroImage: Clinical
Nikolai Albert, Louise Birkedal Glenthøj, Marianne Melau, Heidi Jensen, Carsten Hjorthøj, Merete Nordentoft
BACKGROUND: Previous studies report that 20% to 30% of those initially diagnosed with schizotypal disorder go on to develop a psychotic disorder (predominantly schizophrenia). Schizotypal disorder share some traits of those used to identify patients at ultra-high risk for psychosis. METHOD: As part of a randomized clinical trial testing the effect of prolonged specialized early intervention, we recruited 83 participants diagnosed with a schizotypal disorder. Participants were recruited 18 months into their two-year treatment program, and follow-up interviews were conducted three and a half year later...
October 16, 2016: Schizophrenia Research
Huai-Hsuan Tseng, Jonathan P Roiser, Gemma Modinos, Irina Falkenberg, Carly Samson, Philip McGuire, Paul Allen
Emotional processing dysfunction is widely reported in patients with chronic schizophrenia and first-episode psychosis (FEP), and has been linked to functional abnormalities of corticolimbic regions. However, corticolimbic dysfunction is less studied in people at ultra-high risk for psychosis (UHR), particularly during processing prosodic voices. We examined corticolimbic response during an emotion recognition task in 18 UHR participants and compared them with 18 FEP patients and 21 healthy controls (HC). Emotional recognition accuracy and corticolimbic response were measured during functional magnetic resonance imaging (fMRI) using emotional dynamic facial and prosodic voice stimuli...
2016: NeuroImage: Clinical
Cali F Bartholomeusz, Vanessa L Cropley, Cassandra Wannan, Maria Di Biase, Patrick D McGorry, Christos Pantelis
OBJECTIVE: This review critically examines the structural neuroimaging evidence in psychotic illness, with a focus on longitudinal imaging across the first-episode psychosis and ultra-high-risk of psychosis illness stages. METHODS: A thorough search of the literature involving specifically longitudinal neuroimaging in early illness stages of psychosis was conducted. The evidence supporting abnormalities in brain morphology and altered neurodevelopmental trajectories is discussed in the context of a clinical staging model...
October 12, 2016: Australian and New Zealand Journal of Psychiatry
(no author information available yet)
Reports an error in "Psychosis-Predictive Value of Self-Reported Schizotypy in a Clinical High-Risk Sample" by Rahel Flückiger, Stephan Ruhrmann, Martin Debbané, Chantal Michel, Daniela Hubl, Benno G. Schimmelmann, Joachim Klosterkötter and Frauke Schultze-Lutter (Journal of Abnormal Psychology, Advanced Online Publication, Sep 1, 2016, np). In the article, there was an error in the Author Note. The affiliation of Daniela Hubl was incorrectly listed as "University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern...
October 2016: Journal of Abnormal Psychology
Maude Schneider, Marco Armando, Maria Pontillo, Stefano Vicari, Martin Debbané, Frauke Schultze-Lutter, Stephan Eliez
The 22q11.2 deletion syndrome (22q11DS) is characterized by high rates of psychotic symptoms and schizophrenia, making this condition a promising human model for studying risk factors for psychosis. We explored the predictive value of ultra high risk (UHR) criteria in a sample of patients with 22q11DS. We also examined the additional contribution of socio-demographic, clinical and cognitive variables to predict transition to psychosis within a mean interval of 32.5 ± 17.6 months after initial assessment...
October 2016: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
Sanne de Wit, Tim B Ziermans, M Nieuwenhuis, Patricia F Schothorst, Herman van Engeland, René S Kahn, Sarah Durston, Hugo G Schnack
An important focus of studies of individuals at ultra-high risk (UHR) for psychosis has been to identify biomarkers to predict which individuals will transition to psychosis. However, the majority of individuals will prove to be resilient and go on to experience remission of their symptoms and function well. The aim of this study was to investigate the possibility of using structural MRI measures collected in UHR adolescents at baseline to quantitatively predict their long-term clinical outcome and level of functioning...
October 4, 2016: Human Brain Mapping
A Schmidt, M Antoniades, P Allen, A Egerton, C A Chaddock, S Borgwardt, P Fusar-Poli, J P Roiser, O Howes, P McGuire
BACKGROUND: Impairments in the attribution of salience are thought to be fundamental to the development of psychotic symptoms and the onset of psychotic disorders. The aim of the present study was to explore longitudinal alterations in salience processing in ultra-high-risk subjects for psychosis. METHOD: A total of 23 ultra-high-risk subjects and 13 healthy controls underwent functional magnetic resonance imaging at two time points (mean interval of 17 months) while performing the Salience Attribution Test to assess neural responses to task-relevant (adaptive salience) and task-irrelevant (aberrant salience) stimulus features...
October 4, 2016: Psychological Medicine
Irina Falkenberg, Isabel Valli, Marie Raffin, Matthew R Broome, Paolo Fusar-Poli, Pall Matthiasson, Marco Picchioni, Philip McGuire
BACKGROUND: Clinical outcomes in people identified as at ultra-high risk (UHR) for psychosis are remarkably heterogeneous, and are difficult to predict on the basis of the presenting clinical features. Individuals at UHR are at risk of poor functional outcome regardless of development of psychotic disorder. The aim of the present study was to assess whether there is a relationship between functional neuroimaging measures at presentation and functional outcome as measured by the GAF three years after scanning...
September 29, 2016: Schizophrenia Research
Mark Drakesmith, Anirban Dutt, Leon Fonville, Stanley Zammit, Abraham Reichenberg, C John Evans, Philip McGuire, Glyn Lewis, Derek K Jones, Anthony S David
BACKGROUND: Grey matter (GM) abnormalities are robust features of schizophrenia and of people at ultra high-risk for psychosis. However the extent to which neuroanatomical alterations are evident in non-clinical subjects with isolated psychotic experiences is less clear. METHODS: Individuals (mean age 20 years) with (n = 123) or without (n = 125) psychotic experiences (PEs) were identified from a population-based cohort. All underwent T1-weighted structural, diffusion and quantitative T1 relaxometry MRI, to characterise GM macrostructure, microstructure and myelination respectively...
2016: NeuroImage: Clinical
Anders L Dannevang, Lasse Randers, Matthias Gondan, Kristine Krakauer, Dorte Nordholm, Merete Nordentoft
AIM: Deterioration in premorbid adjustment is related to ultra-high risk (UHR) individuals developing psychosis, but it has not been examined how UHR individuals' development differs compared to healthy controls. This study investigates differences in premorbid adjustment between UHR individuals and a healthy control group. METHOD: A total of 48 UHR individuals and 50 healthy controls matched on group level for age, gender and parents' socio-economic status were included in the study...
September 29, 2016: Early Intervention in Psychiatry
Sanne de Wit, Lara M Wierenga, Bob Oranje, Tim B Ziermans, Patricia F Schothorst, Herman van Engeland, René S Kahn, Sarah Durston
BACKGROUND: The main focus of studies of individuals at ultra-high risk for psychosis (UHR) has been on identifying brain changes in those individuals who will develop psychosis. However, longitudinal studies have shown that up to half of UHR individuals are resilient, with symptomatic remission and good functioning at follow-up. Yet little is known about brain development in resilient individuals. Therefore, the aim of this study was to investigate differences in brain development between resilient and non-resilient individuals...
2016: NeuroImage: Clinical
S R Clark, B T Baune, K O Schubert, S Lavoie, S Smesny, S M Rice, M R Schäfer, F Benninger, M Feucht, C M Klier, P D McGorry, G P Amminger
Current criteria identifying patients with ultra-high risk of psychosis (UHR) have low specificity, and less than one-third of UHR cases experience transition to psychosis within 3 years of initial assessment. We explored whether a Bayesian probabilistic multimodal model, combining baseline historical and clinical risk factors with biomarkers (oxidative stress, cell membrane fatty acids, resting quantitative electroencephalography (qEEG)), could improve this specificity. We analyzed data of a UHR cohort (n=40) with a 1-year transition rate of 28%...
2016: Translational Psychiatry
Simona Caldani, Maria Pia Bucci, Jean-Charles Lamy, Magali Seassau, Narjes Bendjemaa, Rémi Gadel, Raphael Gaillard, Marie-Odile Krebs, Isabelle Amado
Schizophrenia is a neurodevelopmental disease with cognitive and motor impairments. Motor dysfunctions, such as eye movements or Neurological Soft Signs (NSS), are proposed as endophenotypic markers. Antisaccade (AS) and memory-guided saccades (MGS), two markers of inhibitory control mechanism, are altered in both patients with schizophrenia and their relatives, although these tools may have different sensitivities. Recently, emphasis has been put on identifying markers predictive of psychosis transition in subjects with ultra-high-risk psychosis in order to develop targeted prevention...
September 14, 2016: Schizophrenia Research
E I Rasskazova, M A Omel'chenko, A O Rumyantsev, V G Kaleda
AIM: To determine characteristics of cognitive insight and its relationship with the severity and dynamics of symptoms in patients with ultra-high risk for schizophrenia during treatment. MATERIAL AND METHODS: The study included 76 young patients with subpsychotic symptoms corresponding to criteria of ultra-high risk for psychosis and 55 healthy subjects. Patients were examined using psychopathological analysis and a battery of psychological tests. RESULTS AND CONCLUSION: Cognitive insight, although not linked to objective indicators of ultra-high risk for schizophrenia, predicts a decline in both total score of SOPS, and in the Positive symptoms subscale during the treatment of patients with personality disorders...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
D Leguay
This article attempts to identify and put into perspective the different approaches that could globally prevent the suffering induced by schizophrenia, from the detection of early psychosis to the impact on individual and family functioning and emotional health. Schizophrenia causes, at the community level, a number of difficult consequences and associated costs, which likely could be reduced if specific strategies, already known and documented internationally, were applied. Two areas not explored in this article: the role of medication and the issue of suicide prevention...
September 9, 2016: L'Encéphale
W Veling, J Counotte, R Pot-Kolder, J van Os, M van der Gaag
BACKGROUND: Childhood trauma is associated with higher risk for mental disorders, including psychosis. Heightened sensitivity to social stress may be a mechanism. This virtual reality study tested the effect of childhood trauma on level of paranoid ideations and distress in response to social stress, in interaction with psychosis liability and level of social stress exposure. METHOD: Seventy-five individuals with higher psychosis liability (55 with recent onset psychotic disorder and 20 at ultra-high risk for psychosis) and 95 individuals with lower psychosis liability (42 siblings and 53 controls) were exposed to a virtual café in five experiments with 0-3 social stressors (crowded, other ethnicity and hostility)...
September 13, 2016: Psychological Medicine
Murray G Tucker, Sebastian Kekulawala, Michelle Kent, Sam Mostafa, Richard Harvey
BACKGROUND: The high prevalence of comorbid illicit drug use in persons with chronic psychotic illness represents a strong determinant of psychotic relapse and rehospitalization. Epidemiological studies indicate changing patterns of illicit drug use in Australia, which are concerning because of increased use of crystal methamphetamine, also known as "ice." An important complication of habitual use of crystal methamphetamine is the development of a dose-dependent acute psychotic reaction...
2016: Journal of Medical Case Reports
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