Baseline Differences in Clinical Symptomatology Between Ultra High Risk Subjects With and Without a Transition to Psychosis

Velthorst, Eva; Nieman, Dorien H.; Becker, Hiske E.; Fliert, Reinaud van de; Dingemans, Peter; Klaassen, Rianne; Haan, Lieuwe de; Amelsvoort, Thérèse van; Linszen, Don

doi:10.1016/j.schres.2010.02.1022

Cited by 63 publications

(89 citation statements)

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“…High comorbidity rates with affective disorders in help-seeking individuals meeting UHR criteria have consistently been reported in the literature (Velthorst et al, 2009;Addington et al, 2011; for a meta-analysis see Fusar-Poli et al (2014a, 2014b, 2014c). In part, this may be due to a selection bias which is enriching the risk of psychosis, as UHR samples have in most cases been recruited in a clinical context (Fusar-Poli et al, 2014b).…”

Section: Discussionmentioning

confidence: 92%

Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?

Falkenberg

Valmaggia

Byrnes

et al. 2015

Psychiatry Research

115

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Section: Discussionmentioning

confidence: 92%

Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?

Falkenberg

Valmaggia

Byrnes

et al. 2015

Psychiatry Research

115

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“…Moreover, the recommendations did not adopt the recent addition of an obligate functional decline criterion to the symptomatic UHR criteria, as our analyses did not support the presumption that it would improve prediction of psychosis in helpseeking samples. The addition had been put forward on the basis of consistent reports of significantly lower functioning in converters in group mean comparisons and the frequent inclusion of functional deficits in prediction models [14,17,21,30,39,62,92,93,119,121,129,136]. However, such group mean-based results seem to fail to translate into an improved prediction in practice, highlighting the general need for more translational research on predictors using, for example, existing norms or clearly defined and tested cut-offs [67,101].…”

Section: Discussionmentioning

confidence: 99%

EPA guidance on the early detection of clinical high risk states of psychoses

et al. 2015

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The aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rates to psychosis in non-overlapping samples meeting any at least any one of the main CHR criteria: ultra-high risk (UHR) and/or basic symptoms criteria. Further, effects of potential moderators (different UHR criteria definitions, single UHR criteria and age) on conversion rates were examined. Conversion rates in the identified 42 samples with altogether more than 4000 CHR patients who had mainly been identified by UHR criteria and/or the basic symptom criterion 'cognitive disturbances' (COGDIS) showed considerable heterogeneity. While UHR criteria and COGDIS were related to similar conversion rates until 2-year follow-up, conversion rates of COGDIS were significantly higher thereafter. Differences in onset and frequency requirements of symptomatic UHR criteria or in their different consideration of functional decline, substance use and co-morbidity did not seem to impact on conversion rates. The 'genetic risk and functional decline' UHR criterion was rarely met and only showed an insignificant pooled sample effect. However, age significantly affected UHR conversion rates with lower rates in children and adolescents. Although more research into potential sources of heterogeneity in conversion rates is needed to facilitate improvement of CHR criteria, six evidence-based recommendations for an early detection of psychosis were developed as a basis for the EPA guidance on early intervention in CHR states.

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“…On the other hand, many of the features assessed by HA are seen in UHR individuals as maladaptive coping strategies (eg., avoidance, passivity), which are associated with higher levels of negative symptoms, depression and anxiety in this population (Lee et al, 2011b). Also, Lee et al (2011b), consider that individuals who relied on avoidant coping strategies are more likely to avoid social interactions; social withdrawal is the most commonly reported symptom in UHR individuals (Lencz et al, 2004) and is related to the transition from the UHR state to psychosis (Cannon et al, 2008;McGlashan et al, 2007;Velthorst et al, 2009).…”

Section: Discussionmentioning

confidence: 99%