Predicting Psychosis

Abstract

The state of clinical high risk is associated with a very high risk of developing psychosis within the first 3 years of clinical presentation, and the risk progressively increases across this period. The transition risk varies with the age of the patient, the nature of the treatment provided, and the way the syndrome and transition to psychosis are defined.

A systematic review and meta‐analysis of mental health service use in people who report psychotic experiences

“…For example, in the meta‐analysis by Kaymaz et al (2012), the incidence rate of psychosis in those with ascertained PEs was 558 per 100 000 person years of follow up (0.6% per year), compared to 159 cases per 100 000 person‐years in those without (0.2% per year). Transitions to psychosis are much higher in enriched clinical samples, for example a meta‐analysis of transition occurrence in ultra‐high risk samples suggested an overall transition risk of 36% at three years follow up (Fusar‐Poli et al, 2012). This lends support to the ultra‐high risk approach, but also is consistent with a model where PEs represent a general marker for more severe psychopathology.…”

The dynamics of psychopathological symptoms of ultra high risk for psychosis in young patients with non-psychotic mental disorders

“…По данным ряда авторов [15,19,[20][21][22][23], манифестация психоза в группе ультравысо-кого риска составляет в течение 6 мес 18% (12-25%), 1 года -22% (17-28%), 2 лет -29% (23-36%), 3 лет -32% (24-35%), более 3 лет (3 года -5 лет) -36% (30-43%). Было проведено несколько работ [24,25], касающихся ка-тамнеза пациентов из группы риска, у которых эндоген-ный психоз не манифестировал.…”

Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study

“…Within 2-3 years of presentation, a third of these ''clinically high risk (CHR) 1 '' individuals transition to psychotic illness [2]; a substantial proportion continue to experience persistent psychopathology, marked psychosocial impairment, and compromised quality of life; and only a third experience clinical remission [3]. This trajectory of persisting or worsening functional disability for the majority underscores a need for earlier intervention.…”

“…2 Our research required a new method for prospectively identifying at-risk children in the premorbid phase of illness via screening of the general population. Although family history of schizophrenia represents the most established of risk markers for the illness (*10-15 % of individuals with a first-degree relative with schizophrenia develop the disorder), a lack of family history for the majority with schizophrenia [6] renders this a limited means of identifying at-risk individuals in the population.…”

“…This review summarises CHADS findings published to date, including epidemiological findings (from the community cohorts) and psychological, cognitive, and neurobiological findings (from the selected longitudinal cohort), as well as findings 1 The CHR state is also known as the ''at-risk mental state'' (ARMS) and ''ultra-high-risk'' (UHR) state [1]. 2 Established methods (reviewed in [1]) for the identification of individuals in this prodromal phase include the complementary UHR [4] and basic symptoms [5] criteria assessed via clinical interview, with the latter possibly identifying an earlier phase of the prodromal state than UHR criteria. 3 Items assessed psychotic-like experiences (child-and caregiverreport), internalising and externalising psychopathology (emotional symptoms, peer relationship problems, conduct problems, and hyperactivity-inattention; child-and caregiver-report using the Strengths and Difficulties Questionnaire [11,12]), and delays or abnormalities in speech and/or motor milestone development (caregiver-report).…”