Follow-up of subjects labelled with putative pre-psychotic states: Viewed from a transdiagnostic clinical high-at-risk mental state (CHARMS) paradigm

BackgroundMany research groups have attempted to predict which individuals with an at-risk mental state (ARMS) for psychosis will later develop a psychotic disorder. However, it is difficult to predict the course and outcome based on individual symptoms scores.MethodData from 318 ARMS individuals from two specialized services for ARMS subjects were analysed using latent class cluster analysis (LCCA). The score on the Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to explore the number, size and symptom profiles of latent classes.ResultsLCCA produced four high-risk classes, censored after 2 years of follow-up: class 1 (mild) had the lowest transition risk (4.9%). Subjects in this group had the lowest scores on all the CAARMS items, they were younger, more likely to be students and had the highest Global Assessment of Functioning (GAF) score. Subjects in class 2 (moderate) had a transition risk of 10.9%, scored moderately on all CAARMS items and were more likely to be in employment. Those in class 3 (moderate–severe) had a transition risk of 11.4% and scored moderately severe on the CAARMS. Subjects in class 4 (severe) had the highest transition risk (41.2%), they scored highest on the CAARMS, had the lowest GAF score and were more likely to be unemployed. Overall, class 4 was best distinguished from the other classes on the alogia, avolition/apathy, anhedonia, social isolation and impaired role functioning.ConclusionsThe different classes of symptoms were associated with significant differences in the risk of transition at 2 years of follow-up. Symptomatic clustering predicts prognosis better than individual symptoms.

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S201. Correlates of Neurocognitive Functions in Patients With At-Risk Mental State: A 6-Month Follow-Up Study

Biological Psychiatry ◽

10.1016/j.biopsych.2018.02.1093 ◽

2018 ◽

Vol 83 (9) ◽

pp. S425-S426

Author(s):

Kenji Sanada ◽

Sonia Ruiz de Azúa ◽

Shinichiro Nakajima ◽

Susana Alberich Mesa ◽

Akihito Hirata ◽

...

Keyword(s):

At Risk ◽

Mental State ◽

Follow Up Study ◽

Neurocognitive Functions ◽

At Risk Mental State

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A naturalistic longitudinal study of at-risk mental state with a 2.4year follow-up at a specialized clinic setting in Japan

Schizophrenia Research ◽

10.1016/j.schres.2014.06.013 ◽

2014 ◽

Vol 158 (1-3) ◽

pp. 32-38 ◽

Cited By ~ 31

Author(s):

Masahiro Katsura ◽

Noriyuki Ohmuro ◽

Chika Obara ◽

Tatsuo Kikuchi ◽

Fumiaki Ito ◽

...

Keyword(s):

At Risk ◽

Longitudinal Study ◽

Mental State ◽

Clinic Setting ◽

At Risk Mental State

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A FOLLOW-UP OF FUNCTIONING IN AT-RISK MENTAL STATE

Schizophrenia Research ◽

10.1016/s0920-9964(14)70773-x ◽

2014 ◽

Vol 153 ◽

pp. S271

Author(s):

Justine Xue ◽

Lye Yin Poon ◽

Helen Lee ◽

Swapna Verma

Keyword(s):

At Risk ◽

Mental State ◽

At Risk Mental State

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Transition to Psychosis: 6-Month follow-up of a Chinese High-Risk Group in Hong Kong

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2006.01817.x ◽

2006 ◽

Vol 40 (5) ◽

pp. 414-420 ◽

Cited By ~ 25

Author(s):

May M.L. Lam ◽

Se-Fong Hung ◽

Eric Y.H. Chen

Keyword(s):

At Risk ◽

High Risk ◽

Mental State ◽

Functional Decline ◽

High Risk Group ◽

Psychotic Symptoms ◽

Syndrome Scale ◽

History Of ◽

At Risk Mental State

Objectives: The identification of individuals at high risk of becoming psychotic within the near future creates opportunities for early intervention before the onset of psychosis. This study sets out to identify a group of symptomatic young people in a Chinese population with the high likelihood of transition to psychosis within a follow-up period of 6 months, and to determine the rate of transition to psychosis in this group. Method: Symptomatic individuals with a family history of psychotic disorder, subthreshold psychotic symptoms or brief transient psychotic symptoms were identified using the operationalized criteria of an ‘At Risk Mental State’. The individuals were prospectively assessed monthly on a measure of psychopathology for 6 months. Results: Eighteen out of 62 individuals (29%) made the transition to frank psychosis within a 6 month follow-up period, with the majority occurring within 3 months. In addition, significant differences were found in the intake Positive and Negative Syndrome Scale, Comprehensive Assessment of ‘At Risk Mental State’ and Global Assessment of Functioning scores between the group that ultimately became psychotic and the group that did not. Conclusion: The period of the highest risk of transition to psychosis was within the 3 months after the study began. Thus, distressed youths in our outpatient clinic, who meet the high-risk criteria should be monitored most closely in the initial 3 months, particularly those individuals with high levels of psychopathology and functional decline.

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Long-term rates of remission and late psychotic transition of individuals at risk for psychosis

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2105 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S186-S186 ◽

Cited By ~ 2

Author(s):

K. Beck ◽

C. Andreou ◽

E. Studerus ◽

L. Egloff ◽

U. Heitz ◽

...

Keyword(s):

At Risk ◽

Mental State ◽

Research Field ◽

Initial Assessment ◽

Psychotic Symptoms ◽

Term Outcome ◽

Long Term Outcome ◽

At Risk Mental State

IntroductionIn the growing research field of early psychosis detection in patients with an at risk mental state (ARMS), most studies focus on the transition to frank psychosis. However, the majority of ARMS patients do not go on to develop frank psychosis and reported transition rates are declining. Little is known about the long-term outcome of these non-transitioned patients (ARMS-NT).ObjectivesTo investigate in preliminary analyses the long-term outcome of ARMS-NT patients with respect to persistence of ARMS signs and symptoms and the rates of late psychotic transition.MethodsThe ongoing study “FePsy-BHS-NT” follows up ARMS-NT without transition during at least the first two years for up to 15 years after their initial assessment. ARMS status is ascertained with the Basel Screening Instrument for Psychosis (BSIP). ARMS remission is defined as the absence of attenuated psychotic symptoms or brief limited intermittent psychotic symptoms for at least 12 consecutive months.ResultsIn this preliminary sample of 51 ARMS-NT, the majority of patients (70.6%) have remitted from their at risk mental state, 13.7% remain at risk and 15.7% have made a late psychotic transition during the course of long-term follow up (median = 5.75, range 4–11 years after initial assessment).ConclusionsThe considerable rates of ARMS persistence and late psychotic transition indicate that longer follow-up durations than commonly recommended should be contemplated in ARMS patients. Potential predictors of favorable long-term clinical outcome, as well as psychosocial, neurocognitive and other outcomes of ARMS-NT patients will be further evaluated in the present study.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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195 – Six-month follow-up of Japanese high risk (“at-risk mental state”) group in Sendai: Preliminary findings

Schizophrenia Research ◽

10.1016/j.schres.2007.12.262 ◽

2008 ◽

Vol 98 ◽

pp. 113-114 ◽

Cited By ~ 2

Author(s):

T. Miyakoshi ◽

K. Matsumoto ◽

F. Ito ◽

A. Sakuma ◽

M. Katsura ◽

...

Keyword(s):

At Risk ◽

High Risk ◽

Mental State ◽

State Group ◽

At Risk Mental State

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Features of Duration Mismatch Negativity Around the Onset of Overt Psychotic Disorders: A Longitudinal Study

Cerebral Cortex ◽

10.1093/cercor/bhaa364 ◽

2020 ◽

Author(s):

Takahiro Tateno ◽

Yuko Higuchi ◽

Suguru Nakajima ◽

Daiki Sasabayashi ◽

Mihoko Nakamura ◽

...

Keyword(s):

At Risk ◽

Mental State ◽

Mismatch Negativity ◽

Psychotic Disorders ◽

Transition Period ◽

Oddball Paradigm ◽

Auditory Oddball ◽

Not At Risk ◽

At Risk Mental State

Abstract Reduced amplitude of duration mismatch negativity (dMMN) has been reported in psychotic disorders and at-risk mental state (ARMS); however, few longitudinal MMN studies have examined the amplitude changes during the course of psychosis. We compared dMMN amplitude between ARMS individuals with later psychosis onset and those without, and we longitudinally examined potential dMMN changes around psychosis onset. Thirty-nine ARMS subjects and 22 healthy controls participated in this study. Of the 39 ARMS subjects, 11 transitioned to psychosis (at-risk mental state with later psychosis onset [ARMS-P]) during follow-up and 28 did not (at-risk mental state without later psychosis onset [ARMS-NP]). dMMN was measured twice using an auditory oddball paradigm with a mean interval of 2 years. Follow-up dMMN data were available for all but four ARMS-P subjects. dMMN amplitude at baseline was smaller in ARMS-P subjects compared with control and ARMS-NP subjects. Additionally, ARMS-P subjects displayed a longitudinal decline in dMMN amplitude, which was not present in control and ARMS-P subjects. We also observed a progressive decline in dMMN amplitude during the transition period, suggesting dynamic brain changes associated with the psychosis onset. Our findings implicate dMMN amplitude as a biological predictor of future psychosis onset in high-risk individuals, which may be used for early detection and intervention of psychosis.

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