Early Recognition of High Risk of Bipolar Disorder and Psychosis: An Overview of the ZInEP “Early Recognition” Study

Abstract

Early detection of persons with first signs of emerging psychosis is regarded as a promising strategy to reduce the burden of the disease. In recent years, there has been increasing interest in early detection of psychosis and bipolar disorders, with a clear need for sufficient sample sizes in prospective research. The underlying brain network disturbances in individuals at risk or with a prodrome are complex and yet not well known. This paper provides the rationale and design of a prospective longitudinal study focused on at-risk states of psychosis and bipolar disorder. The study is carried out within the context of the Zurich Program for Sustainable Development of Mental Health services (Zürcher Impulsprogramm zur Nachhaltigen Entwicklung der Psychiatrie). Persons at risk for psychosis or bipolar disorder between 13 and 35 years of age are examined by using a multi-level-approach (psychopathology, neuropsychology, genetics, electrophysiology, sociophysiology, magnetic resonance imaging, near-infrared spectroscopy). The included adolescents and young adults have four follow-ups at 6, 12, 24, and 36 months. This approach provides data for a better understanding of the relevant mechanisms involved in the onset of psychosis and bipolar disorder, which can serve as targets for future interventions. But for daily clinical practice a practicable "early recognition" approach is required. The results of this study will be useful to identify the strongest predictors and to delineate a prediction model.

Alterations in the hippocampus and thalamus in individuals at high risk for psychosis

“…For this structural MRI analysis CHR individuals and HC were recruited in two centers: In Basel, as part of the Early Detection of Psychosis research program, FePsy, at the Psychiatry Outpatient Department, University Psychiatric Clinics Basel, 41 , 42 and in Zurich, as part of a prospective study on the early recognition of psychosis 43 within the Zurich Program for Sustainable Development of Mental Health Services (ZInEP), conducted at the Psychiatric University Hospital, University of Zurich.…”

Triple Network Model Dynamically Revisited: Lower Salience Network State Switching in Pre-psychosis

“…The present study included 76 participants (29 CTR, 28 BS, 19 UHR), and was approved by the local ethics committee of Zürich. Risk groups were recruited in the Swiss region of Zürich within the context of a larger study on early psychosis recognition (Theodoridou et al, 2014). Following an initial screening, in-person diagnostic interviews were administered, and a complete project description was provided.…”

Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis

“…Participants were recruited in the region of Zürich, Switzerland, in the context of a larger study on early recognition of psychosis (for further details of study design, recruitment and inclusion criteria see Theodoridou et al, 2014;Rüsch et al, 2014b). After complete description of the study to participants, written informed consent was obtained, in case of minors including the written informed consent of their parents.…”