Adolescents and adults at clinical high-risk for psychosis: age-related differences in attenuated positive symptoms syndrome prevalence and entanglement with basic symptoms

Gerstenberg, Miriam; Theodoridou, Anastasia; Traber‐Walker, Nina; Franscini, Maurizia; Wotruba, Diana; Metzler, Sibylle; Müller, Mario; Dvorsky, Diane; Correll, Christoph U.; Walitza, Susanne; Rössler, Wulf; Heekeren, Karsten

doi:10.1017/s0033291715002627

Cited by 26 publications

(33 citation statements)

References 36 publications

(55 reference statements)

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“…Contrary to brain morphological abnormalities observed in adults at CHR-P (Harrisberger et al, 2016;Walter et al, 2016), structural alterations have not been robustly confirmed in adolescents at CHR-P (Ziermans et al, 2009). These differences may reflect different maturational ages of the brain across these two populations or may alternatively be due to a lower true-positive rate for psychosis in paediatric CHR-P samples due to more nonspecific and overlapping phenomenologies of concurrently emerging psychiatric disorders (Gerstenberg et al, 2015(Gerstenberg et al, , 2016Kelleher et al, 2012;Schimmelmann, Michel, Martz-Irngartinger, Linder, & Schultze-Lutter, 2015).…”

Section: Discussionmentioning

confidence: 99%

Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Catalán

Pablo

Serrano

et al. 2020

Child Psychology Psychiatry

119

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Background: The clinical high-risk state for psychosis (CHR-P) paradigm has facilitated the implementation of psychosis prevention into clinical practice; however, advancements in adolescent CHR-P populations are less established. Methods: We performed a PRISMA/MOOSE-compliant systematic review of the Web of Science database, from inception until 7 October 2019, to identify original studies conducted in CHR-P children and adolescents (mean age <18 years). Findings were systematically appraised around core themes: detection, prognosis and intervention. We performed meta-analyses (employing Q statistics and I 2 test) regarding the proportion of CHR-P subgroups, the prevalence of baseline comorbid mental disorders, the risk of psychosis onset and the type of interventions received at baseline. Quality assessment and publication bias were also analysed. Results: Eighty-seven articles were included (n = 4,667 CHR-P individuals). Quality of studies ranged from 3.5 to 8 (median 5.5) on a modified Newcastle-Ottawa scale. Detection: Individuals were aged 15.6 AE 1.2 years (51.5% males), mostly (83%) presenting with attenuated positive psychotic symptoms. CHR-P psychometric accuracy improved when caregivers served as additional informants. Comorbid mood (46.4%) and anxiety (31.4%) disorders were highly prevalent. Functioning and cognition were impaired. Neurobiological studies were inconclusive. Prognosis: Risk for psychosis was 10.4% (95%CI: 5.8%-18.1%) at 6 months, 20% (95% CI: 15%-26%) at 12 months, 23% (95%CI: 18%-29%) at 24 months and 23.3% (95%CI: 17.3%-30.7%) at ≥36 months. Interventions: There was not enough evidence to recommend one specific treatment (including cognitive behavioural therapy) over the others (including control conditions) to prevent the transition to psychosis in this population. Randomised controlled trials suggested that family interventions, cognitive remediation and fish oil supplementation may improve cognition, symptoms and functioning. At baseline, 30% of CHR-P adolescents were prescribed antipsychotics and 60% received psychotherapy. Conclusions: It is possible to detect and formulate a group-level prognosis in adolescents at risk for psychosis. Future interventional research is required.

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Section: Discussionmentioning

confidence: 99%

Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Catalán

Pablo

Serrano

et al. 2020

Child Psychology Psychiatry

119

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“…Previous studies reported that the prevalence of CHR in the clinician-referred samples was 32-42% [33][34][35], which were roughly consistent with each other. While the detection rate in samples of help-seeking individuals ranged from 4.2-80%, which differed from site to site [10,[39][40][41]. As for the general population (primarily focused on young adults and adolescences), the annual incidence of new cases of CHR was estimated to be 1/10 000 [33], and the prevalence was reported to range from 0.3-2.4% [31,37,38].…”

Section: Discussionmentioning

confidence: 99%

Screening of the College Students at Clinical High Risk for Psychosis in China: A Multicenter Epidemiological Study

Long

Liu

et al. 2020

Preprint

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Background To investigate a 3-stage screening procedure and explore the clinical features of subjects at Clinical High Risk (CHR) for psychosis in a representative sample of Chinese college students. Methods An epidemiological survey of the prevalence of CHR syndrome in Chinese college students that was selected by stratified random sampling from Shanghai, Nanjing and Nanchang cities was done followed a 3-stage procedure. Participants was initially screened with the Prodromal Questionnaire-brief version (PQ-B), and whose distress score of PQ-B exceeded 24 would be invited to a telephone assessment using the subscale for positive symptoms of the Scale of Prodromal Symptoms (SOPS)/Structured Interview for Prodromal Syndromes (SIPS). Lastly, participants who scored 3 or higher in any item of the subscale would be administered with the SIPS interview conducted by trained researchers to confirm the diagnosis of CHR syndrome. Results 23 063 college students completed the survey during September 2017 to October 2018. 72 students were diagnosed as CHR subjects, and the detection rate in the total sample was 0.3%. The peak age range for the first diagnosis of CHR was 17 to 20 years. 13 and 46 were set as the cut-off points of PQ-B total score and distress score to balance the greatest sensitivity and specificity. Binary logistic regression revealed that 5 items in PQ-B showed significant distinction for detecting CHR subjects. Conclusions The 3-stage screening method can be utilized in the detection of CHR subjects for psychosis in general population, during which delusional ideas, perceptual abnormalities and suspiciousness deserve great attention.

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“…Thereby, age was positively correlated to suspiciousness and female sex to unusual perceptual experiences; educational level was positively correlated to unusual thought content and negatively to perceptual abnormalities. These findings are partly surprising and might reflect some sample bias, because it is commonly assumed that age and education will show an inverse correlation with symptom severity or symptom prevalence (Gerstenberg, Theodoridou, Traber‐Walker, et al, ; Ruhrmann et al, ).…”

Section: Introductionmentioning

confidence: 99%

Influence of demographic characteristics on attenuated positive psychotic symptoms in a young, help‐seeking, at‐risk population

Theodoridou

Hengartner

Dvorsky

et al. 2017

Early Intervention Psych

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Adolescents and adults at clinical high-risk for psychosis: age-related differences in attenuated positive symptoms syndrome prevalence and entanglement with basic symptoms

Cited by 26 publications

References 36 publications

Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Screening of the College Students at Clinical High Risk for Psychosis in China: A Multicenter Epidemiological Study

Influence of demographic characteristics on attenuated positive psychotic symptoms in a young, help‐seeking, at‐risk population

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