Association between psychosocial interventions and aberrant salience in adolescents with early psychosis: A follow‐up study

Poletti, Michele; Pelizza, Lorenzo; Azzali, Silvia; Scazza, Ilaria; Paterlini, Federica; Garlassi, Sara; Chiri, Luigi Rocco; Pupo, Simona; Raballo, Andrea

doi:10.1111/sjop.12806

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…The PANSS is a widely used clinical interview specifically developed to assess psychosis psychopathology. It has been frequently administered also in young people with early psychosis (Pelizza et al, 2020; Poletti et al, 2022). As proposed by Shafer and Dazzi (2019), we considered the following 5 main psychopathological dimensions: ‘Disorganization’, ‘Negative Symptoms’, ‘Positive Symptoms’, ‘Resistance’ (‘Excitement‐Activity’) and ‘Affect’ (‘Depression–Anxiety’).…”

Section: Methodsmentioning

confidence: 99%

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Baseline antipsychotic prescription and short‐term outcome indicators in individuals at clinical high‐risk for psychosis: Findings from the Parma At‐Risk Mental States (PARMS) program

Pelizza

Leuci

Quattrone

et al. 2023

Early Intervention Psych

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AimThe prognostic prediction of outcomes in individuals at clinical high‐risk for psychosis (CHR‐P) is still a significant clinical challenge. Among multiple baseline variables of risk calculator models, the role of ongoing pharmacological medications has been partially neglected, despite meta‐analytical evidence of higher risk of psychosis transition associated with baseline prescription exposure to antipsychotics (AP) in CHR‐P individuals. The main aim of the current study was to test the hypothesis that ongoing AP need at baseline indexes a subgroup of CHR‐P individuals with more severe psychopathology and worse prognostic trajectories along a 1‐year follow‐up period.MethodsThis research was settled within the ‘Parma At‐Risk Mental States’ program. Baseline and 1‐year follow‐up assessment included the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). CHR‐P individuals who were taking AP medications at entry were included in the CHR‐P‐AP+ subgroup. The remaining participants were grouped as CHR‐P‐AP‐.ResultsHundred and seventy‐eight CHR‐P individuals (aged 12–25 years) were enrolled (91 CHR‐P‐AP+, 87 CHR‐P‐AP‐). Compared to CHR‐P AP‐, CHR‐P AP+ individuals had older age, greater baseline PANSS ‘Positive Symptoms’ and ‘Negative Symptoms’ factor subscores and a lower GAF score. At the end of our follow‐up, CHR‐P‐AP+ subjects showed higher rates of psychosis transition, new hospitalizations and urgent/non‐planned visits compared to CHRP‐ AP‐ individuals.ConclusionsIn agreement with increasing empirical evidence, also the results of the current study suggest that AP need is a significant prognostic variable in cohorts of CHR‐P individuals and should be included in risk calculators.

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Section: Methodsmentioning

confidence: 99%

“…administered also in young people with early psychosis Poletti et al, 2022). As proposed by Shafer and Dazzi (2019), we considered the following 5 main psychopathological dimensions: 'Disorganization', 'Negative Symptoms', 'Positive Symptoms', 'Resistance' ('Excitement-Activity') and 'Affect' ('Depression-Anxiety').…”

Section: Instrumentsmentioning

confidence: 99%

Baseline antipsychotic prescription and short‐term outcome indicators in individuals at clinical high‐risk for psychosis: Findings from the Parma At‐Risk Mental States (PARMS) program

Pelizza

Leuci

Quattrone

et al. 2023

Early Intervention Psych

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“…In addition, experience of early subclinical symptoms may exacerbate feelings of alienation and social isolation (91)(92)(93). Focusing on the relationship between negative and disorganization symptoms in the network structure, an explanatory framework may be offered by the aberrant salience model, which posits that dysregulation of the dopamine system may lead to inappropriate attention to irrelevant stimuli (58,94,95). Indeed, such dysregulation has been linked to negative symptoms (e.g., anhedonia, blunted affect), which, in turn, have been connected to cognitive deficits and disorganization (96)(97)(98).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, such dysregulation has been linked to negative symptoms (e.g., anhedonia, blunted affect), which, in turn, have been connected to cognitive deficits and disorganization (96)(97)(98). Moreover, in the aberrant salience model, positive psychotic symptoms are hypothesized to emerge after the dysregulation of the dopamine system, to make sense of the perceived world (which would otherwise appear unintelligible) (58,95,99).…”

Section: Discussionmentioning

confidence: 99%

A network analysis of anxiety, depressive, and psychotic symptoms and functioning in children and adolescents at clinical high risk for psychosis

et al. 2022

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ObjectiveYouths at clinical high risk for psychosis (CHR-P) are characterized by a high prevalence of anxiety and depressive disorders. The present study aimed at developing and analyzing a network structure of CHR-P symptom domains (i.e., positive, negative, disorganization, and general subclinical psychotic symptoms), depressive and anxiety symptoms, and general functioning.MethodsNetwork analysis was applied to data on 111 CHR-P children and adolescents (Mage = 14.1), who were assessed using the Structured Interview for Prodromal Syndromes, the Children’s Depression Inventory, the Children’s Global Assessment Scale, and the Multidimensional Anxiety Scale for Children.ResultsIn the network, negative and disorganization symptoms showed the strongest association (r = 0.71), and depressive and anxiety symptoms showed dense within-domain connections, with a main bridging role played by physical symptoms of anxiety. The positive symptom cluster was not associated with any other node. The network stability coefficient (CS) was slightly below 0.25, and observed correlations observed ranged from 0.35 to 0.71.ConclusionThe lack of association between subclinical positive symptoms and other network variables confirmed the independent nature of subclinical positive symptoms from comorbid symptoms, which were found to play a central role in the analyzed network. Complex interventions should be developed to target positive and comorbid symptoms, prioritizing those with the most significant impact on functioning and the most relevance for the young individual, through a shared decision-making process. Importantly, the results suggest that negative and disorganization symptoms, as well as depressive and anxiety symptoms, may be targeted simultaneously.

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Diagnostic shift in adolescents with first episode psychosis: findings from the 2-year follow-up of the “Parma Early Psychosis” program

Pelizza,

Plazzi,

Leuci

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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Purpose Diagnostic stability for people with First Episode Psychosis (FEP) is essential for treatment, but it remains poorly investigated, especially in adolescents and within a prospective design. The aims of this research were: (a) to examine diagnostic change in Italian adolescents with FEP treated within an “Early Intervention in Psychosis” program during a 2-year follow-up period and (b) to investigate any sociodemographic and clinical predictors at baseline. Methods At baseline, 66 adolescents with FEP was recruited. Their primary diagnosis was formulated both at baseline and at the end of follow-up. At presentation, FEP adolescents completed the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). As for diagnostic stability, the Kappa statistic was calculated. The associations of diagnostic change with baseline clinical and sociodemographic features were analyzed using a logistic model with the diagnostic shift as dependent variable. A propensity score was finally calculated based on logistic analysis results. Results 38 (57.6%) FEP adolescents changed their opening diagnosis. The highest prospective diagnostic stability was for initial diagnosis of schizophrenia (95.4%) and affective spectrum psychoses (75%). Diagnostic instability was high for opening diagnosis of psychosis not otherwise specified, brief psychosis and schizophreniform disorder (100%). The best predictors of diagnostic change were fewer years of education, shorter duration of untreated psychosis and higher baseline levels of psychiatric symptoms. Conclusion Diagnostic stability is crucial for treatment and clinical decision making. Addressing instability in FEP diagnoses is an important challenge for future diagnostic development in early psychosis, especially in adolescence.

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Association between psychosocial interventions and aberrant salience in adolescents with early psychosis: A follow‐up study

Cited by 5 publications

References 35 publications

Baseline antipsychotic prescription and short‐term outcome indicators in individuals at clinical high‐risk for psychosis: Findings from the Parma At‐Risk Mental States (PARMS) program

Baseline antipsychotic prescription and short‐term outcome indicators in individuals at clinical high‐risk for psychosis: Findings from the Parma At‐Risk Mental States (PARMS) program

A network analysis of anxiety, depressive, and psychotic symptoms and functioning in children and adolescents at clinical high risk for psychosis

Diagnostic shift in adolescents with first episode psychosis: findings from the 2-year follow-up of the “Parma Early Psychosis” program

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