Recovery From an At-Risk State: Clinical and Functional Outcomes of Putatively Prodromal Youth Who Do Not Develop Psychosis

Abstract

Nonconverting CHR cases represented a heterogeneous group. Given that nonconverted subjects who remitted symptomatically also presented initially with less severe prodromal symptomatology and showed a distinct normative trajectory of both symptoms and psychosocial functioning over time, it may be possible to refine the CHR criteria to reduce the number of "false positive" cases by eliminating those who present with less severe attenuated positive symptoms or show early improvements in terms of symptoms or functioning.

Predictors of functional outcome in individuals at high clinical risk for psychosis at six years follow-up

“…Although available treatment may reduce the risk of psychosis onset (Stafford et al, 2013), their impact on longterm functional outcomes remains unclear, with previous evidence indicating that non-converting individuals may remain at a lower level of functioning than matched healthy comparisons (Addington et al, 2011). Moreover, where functional status of HR individuals at follow-up has been studied, most have focused on short-term periods (up to 24 months) (Jalbrzikowski et al, 2013;Niendam et al, 2007;Bearden et al, 2011;Eslami et al, 2011;Sabb et al, 2010;Salokangas et al, 2014;Schlosser et al, 2012). To our knowledge there is no consensus regarding the definition of long-term observation period in the HR subjects, in this manuscript we have adopted a definition of long term follow-up of more than five years.…”

“…While a lot of effort has been made to identify predictors of conversion (Fusar-Poli et al, 2011, 2014c) so far not enough is known about the possible predictors of functional outcome. Evidence suggests that negative symptoms (Salokangas et al, 2014;Schlosser et al, 2012;Velthorst et al, 2013;Valmaggia et al, 2013;Demjaha et al, 2012), mood/anxiety symptoms (Salokangas et al, 2014;Velthorst et al, 2013) and motor disturbances (Carrion et al, 2013), as well as positive (Salokangas et al, 2014), and disorganized (Salokangas et al, 2014;Eslami et al, 2011;Carrion et al, 2013;Demjaha et al, 2012) symptoms at baseline predict the functional outcome at follow-up. The presence of formal thought content disorders (Bearden et al, 2011) and basic symptoms (Salokangas et al, 2014) showed also a predictive action.…”

Şizofreni ve Diğer Psikozlarda Risk Sendromları ve Risk Belirlenmesinde Kullanılan Ölçekler

“…Aralarındaki farklılaşma şizofreniye çevrilmeyen prodrom belirtilerinin prodrom olmaktan çıkıp risk grubu olarak değerlendirilmesi, kesişme ise şizofreniye çevrilen belirtilerin hem risk grubu hem de prodrom olarak nitelenmesi şeklindedir. Halen yüksek riskli gurup ile şizofreni prodromu arasında geniş bir üst üste binme durumu varsa da yüksek riskli gruplar şizofreni geliştirme riskinin ötesinde ve şizofreninin önlenmesinin ötesinde genel olarak psikoza çevrilme oranını azalmasını ifade eder 34 .…”

“…Bununla birlikte psikoz risk sendromu tarafından belirlenen bireylerin önemli bir kısmında şizofreni gelişmez 34 . Psikotik bozukluk geliştirenlerin ise ancak yarısı şizofreniye çevirir 35 .…”

Beyond “Cold” Cognition: Exploring Cognitive Control of Emotion as a Risk Factor for Psychosis

“…Neurocognitive and clinical markers tend to have low predictive power for transition to a psychotic disorder [3,10], and transition rates are relatively low-only 18-36 % of CHR individuals develop a psychotic disorder within 2-3 years [7]. Moreover, CHR individuals who do not develop psychosis but continue to meet high-risk criteria have substantial ongoing clinical and functional impairment [15][16][17][18][19]. Indeed, multiple studies have highlighted the diagnostic heterogeneity of CHR samples [16,20], particularly in the context of mood dysregulation; recent estimates indicate that more than 70 % of CHR individuals have comorbid depression and/or anxiety [16].…”