The role of a family history of psychosis for youth at clinical high risk of psychosis

Georgopoulos, Grace; Stowkowy, Jacqueline; Liu, Lu; Cadenhead, Kristin S.; Cannon, Tyrone D.; Cornblatt, Barbara A.; McGlashan, Thomas H.; Perkins, Diana O.; Seidman, Larry J.; Tsuang, Ming T.; Walker, Elaine F.; Woods, Scott W.; Bearden, Carrie E.; Mathalon, Daniel H.; Addington, Jean

doi:10.1111/eip.12471

Cited by 12 publications

(5 citation statements)

References 25 publications

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“…In contrast to most, but not all (Georgopoulos et al, 2019), studies comparing youth with and without family histories of psychotic disorders (Bora et al, 2014;Hemager et al, 2018), we found that youth with and without family histories of PS symptoms performed similarly on neurocognitive tests. However, after adjusting for PRS-S in the European-American subsample, we did find that FHPS status was associated with a small social cognition deficit and a small complex cognition deficit (at the trend level).…”

Section: Discussioncontrasting

confidence: 99%

Characteristics of youth with reported family history of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort

Taylor

Asabere

Calkins

et al. 2020

Schizophrenia Research

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Little is known about the impact of family history of psychosis on youth from community samples. To fill this gap, we compared youth with a first-degree relative with psychosis spectrum symptoms (i.e. family history of psychosis spectrum symptoms, FHPS) to youth without FHPS in a cross-sectional analysis of the Philadelphia Neurodevelopmental Cohort (PNC). The PNC is a racially diverse community sample of 9,498 youth ages 8-21 years, of whom 8,928 completed the Family Interview for Genetic Studies to determine FHPS status. Polygenic risk score for schizophrenia (PRS-S) was available for a subsample of 4,433 European Americans. FHPS youth (n=489) constituted 5.5% of the analytic sample. After adjusting for environmental risk factors (sociodemographic variables and traumatic stressful events), FHPS youth had lower functioning on the Children's Global Assessment Scale and elevated psychosis spectrum, mood, externalizing, and fear symptoms compared to non-FHPS youth (all p<0.001). In the European-American subsample, FHPS status was associated with poorer functioning and greater symptom burden in all four psychopathology domains (all p<0.001), even after covarying for PRS-S. Thus, ascertaining FHPS is important because it is uniquely associated with symptoms and functional impairment in community youth beyond PRS-S and the environmental risk factors we investigated. Future

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Section: Discussioncontrasting

confidence: 99%

Characteristics of youth with reported family history of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort

Taylor

Asabere

Calkins

et al. 2020

Schizophrenia Research

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“…The psychosis risk calculator variables included age at baseline, number of undesirable stressful life events (Research Interview Life Events Scale) (41), trauma history (Childhood Trauma and Abuse Scale) (42), sum of SIPS items P1 and P2 (unusual thought content and suspiciousness, respectively, rescored to range from 0 to 3, with non-prodromal severity levels rescored to 0), verbal learning (Hopkins Verbal Learning Test-Revised, sum of trials 1-3) (43), processing speed (Brief Assessment of Cognition in Schizophrenia, symbol coding test), past-year decline in social function (Global Functioning: Social) (44), and family history of psychotic disorders in first-degree relatives (Family Interview for Genetic Studies) (45,46).…”

Section: Discussionmentioning

confidence: 99%

Polygenic Risk Score Contribution to Psychosis Prediction in a Target Population of Persons at Clinical High Risk

Perkins

Loohuis

Barbee

et al. 2020

AJP

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101

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Objective: The 2-year risk of psychosis in persons who meet research criteria for a high-risk syndrome is about 15%-25%; improvements in risk prediction accuracy would benefit the development and implementation of preventive interventions. The authors sought to assess polygenic risk score (PRS) prediction of subsequent psychosis in persons at high risk and to determine the impact of adding the PRS to a previously validated psychosis risk calculator. Methods: Persons meeting research criteria for psychosis high risk (N=764) and unaffected individuals (N=279) were followed for up to 2 years. The PRS was based on the latest schizophrenia and bipolar genome-wide association studies. Variables in the psychosis risk calculator included stressful life events, trauma, disordered thought content, verbal learning, information processing speed, and family history of psychosis.

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“…This review identified four studies specifically assessing whether PR individuals perceive discrimination in the society because of their condition (Georgopoulos et al, 2019; Rusch et al, 2014a; Saleem et al, 2014; Uttinger et al, 2018) (Table 1). All of them indicate that discrimination plays an important role in the experience of a PR state.…”

Section: Resultsmentioning

confidence: 99%

“…All of them indicate that discrimination plays an important role in the experience of a PR state. Also, two have a control group, specifically comparing (i) PR individuals with and without a family history of psychosis (Georgopoulos et al, 2019) and (ii) PR individuals and healthy subjects with reference to multiple sources of stigma other than mental health such as appearance, age, gender, ethnicity, skin color, religion, disability, and sexual orientation (Saleem et al, 2014). Another study is not analytic (Uttinger et al, 2018) (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…In particular, most PR individuals report being aware of psychosis' negative image in the public opinion and the media as well as of stereotypes associated with it, preferring not to disclose their condition because of expected or previously experienced negative reactions (Uttinger et al, 2018). Moreover, perceived discrimination among PR individuals seems to be higher than that experienced by healthy peers (Saleem et al, 2014), independent of having also a family history of psychosis (Georgopoulos et al, 2019), and to positively correlate with shame about the condition, self-labeling as mentally ill, and stigma stress (Rusch et al, 2014a).…”

Section: Resultsmentioning

confidence: 99%

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Should we be concerned about stigma and discrimination in people at risk for psychosis? A systematic review

2020

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BackgroundPrevious studies have provided initial evidence that people at risk for psychosis (PR) suffer from stigma and discrimination related to their condition. However, no study has systematically reviewed stigma and discrimination associated with being at PR and the potential underlying mechanisms.MethodsThis work aimed to systematically review all studies addressing stigma and discrimination in PR people in order to assess: (1) the occurrence of this phenomenon and its different components (public, internalized, perceived, and labeling-related), (2) whether stigma affects outcomes of the PR state, and (3) whether other factors modulate stigma among PR individuals.ResultsThe reviewed studies (n = 38) widely differ in their design, methodological quality, and populations under investigation, thus limiting direct comparison of findings. However, converging evidence suggests that the general public endorses stigmatizing attitudes towards PR individuals, and that this is more frequent in people with a low educational level or with no direct experience of the PR state. PR individuals experience more internalized stigma and perceive more discrimination than healthy subjects or patients with non-psychotic disorders. Further, PR labeling is equally associated with both positive (e.g. validation and relief) and negative effects (e.g. status loss and discrimination). Moreover, stigma increases the likelihood of poor outcome, transition to full-psychosis, disengagement from services, and family stigma among PR individuals. Finally, very limited evidence awaiting replication supports the efficacy of cognitive therapies in mitigating the negative effects of stigma.ConclusionsEvidence confirms previous concerns about stigma and its negative consequences for PR individuals, thus having important public health implications.

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The role of a family history of psychosis for youth at clinical high risk of psychosis

Abstract: There is a possibility that CHR + FH individuals believe that it is more difficult for them to cope with circumstances such as abuse or potential abuse. Future research on this subject should investigate family environment and its role in conversion to psychosis among CHR + FH individuals.

Cited by 12 publications

References 25 publications

Characteristics of youth with reported family history of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort

Characteristics of youth with reported family history of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort

Polygenic Risk Score Contribution to Psychosis Prediction in a Target Population of Persons at Clinical High Risk

Should we be concerned about stigma and discrimination in people at risk for psychosis? A systematic review

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