Childhood behaviour, psychotic symptoms and psychosis onset in young people at high risk of schizophrenia: early findings from the Edinburgh High Risk Study

2002 ◽  
Vol 32 (1) ◽  
pp. 173-179 ◽  
Author(s):  
P. M. MILLER ◽  
M. BYRNE ◽  
A. HODGES ◽  
S. M. LAWRIE ◽  
E. C. JOHNSTONE
Keyword(s):  
At Risk ◽  
High Risk ◽  
Young People ◽  
Child Behavior ◽  
Aggressive Behaviour ◽  
Child Behavior Checklist ◽  
Somatic Symptoms ◽  
Study Groups ◽  
Psychotic Symptoms ◽  
Neurodevelopmental Abnormalities

Background. Several studies suggest that many patients with schizophrenia have pre-morbid neurodevelopmental abnormalities. This study examines how behavioural abnormalities are associated with mild psychotic symptoms and later schizophrenic illness.Methods. Maternal ratings on the Child Behavior Checklist (CBCL) of the early behaviour of 155 subjects were obtained at entry to the Edinburgh study of people at high risk of schizophrenia. These maternal ratings were compared in those with and without psychotic symptoms and used to predict the later onset of psychosis.Results. The CBCL syndrome scores for the children prior to age 13 did not distinguish any of the study groups at entry to the study. In the ratings made for the subjects when aged from 13 to 16, delinquent behaviour and ‘other problems’ were weakly associated with these symptoms. However, with the exception of somatic symptoms and thought problems, the age 13–16 scales were significant predictors of later schizophrenic illness. This was true also for some of the ratings prior to age 13.Conclusions. Various behaviours, in particular, withdrawn and delinquent–aggressive behaviour in adolescents at risk of schizophrenia may predict later onset of the illness. These behaviours, however, are far less predictive of isolated psychotic symptoms prior to psychosis onset.

scholarly journals Sexuality in Ultra-High Risk for Psychosis and First-Episode Psychosis. A Systematic Review of Literature

2021 ◽  
Vol 12 ◽  
Author(s):  
Giacomo Ciocca ◽  
Tommaso B. Jannini ◽  
Michele Ribolsi ◽  
Rodolfo Rossi ◽  
Cinzia Niolu ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Young People ◽  
First Episode Psychosis ◽  
Sexual Life ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Episode Psychosis ◽  
Ultra High Risk

A considerable body of literature reports that individuals with psychotic disorders often suffer from sexual dysfunctions (SDs), with these representing a major unmet need. Long-term antipsychotic drug treatment may be the main cause for SDs in psychotic patients, through a plethora of different mechanisms, including prolactin dyscrasia, histamine-mediated sedation, and serotonin-induced sexual demotivation. However, a few pieces of evidence treat sexuality in patients at risk or the onset of psychosis. For this purpose, we systematically reviewed literature of the last 10 years in order to investigate sexuality in ultra-high risk (UHR) for psychosis and first-episode psychosis (FEP). We included in our review 34 articles fitting our research criteria on SDs in UHR and FEP. Evidence of SDs in the transition from UHR to FEP emerges through the selected studies. In FEP, sexuality is affected by the severity of the psychotic symptoms and, in some cases, by the iatrogenic effects of psychopharmacological treatment. Further experimental and clinical studies should systematically investigate the role of sexual functioning in the transition from UHR to FEP and, consequently, clarify whether or not SDs could be considered a possible marker for the onset of psychosis in at-risk populations. Moreover, psychiatrists and clinical psychologists should take into consideration the role of sexual life in young people with prodromal mental symptoms or at the onset of psychosis. Focusing on a thorough sexual evaluation might be a major challenge that could break down barriers of mental health promotion among young people with schizophrenia-spectrum disorders and therefore achieve better clinical outcomes.

scholarly journals The reality of at risk mental state services: a response to recent criticisms

2019 ◽  
pp. 1-7 ◽  
Author(s):  
Alison R. Yung ◽  
Stephen J. Wood ◽  
Ashok Malla ◽  
Barnaby Nelson ◽  
Patrick McGorry ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Psychotic Disorder ◽  
Mental State ◽  
Help Seeking ◽  
Psychotic Symptoms ◽  
Ultra High Risk ◽  
Psychological Medicine ◽  
Poor Outcomes ◽  
At Risk Mental State

AbstractBackgroundIn the 1990s criteria were developed to detect individuals at high and imminent risk of developing a psychotic disorder. These are known as the at risk mental state, ultra high risk or clinical high risk criteria. Individuals meeting these criteria are symptomatic and help-seeking. Services for such individuals are now found worldwide. Recently Psychological Medicine published two articles that criticise these services and suggest that they should be dismantled or restructured. One paper also provides recommendations on how ARMS services should be operate.MethodsIn this paper we draw on the existing literature in the field and present the perspective of some ARMS clinicians and researchers.ResultsMany of the critics' arguments are refuted. Most of the recommendations included in the Moritz et al. paper are already occurring.ConclusionsARMS services provide management of current problems, treatment to reduce risk of onset of psychotic disorder and monitoring of mental state, including attenuated psychotic symptoms. These symptoms are associated with a range of poor outcomes. It is important to assess them and track their trajectory over time. A new approach to detection of ARMS individuals can be considered that harnesses broad youth mental health services, such as headspace in Australia, Jigsaw in Ireland and ACCESS Open Minds in Canada. Attention should also be paid to the physical health of ARMS individuals. Far from needing to be dismantled we feel that the ARMS approach has much to offer to improve the health of young people.

Examining High-Risk Children for Learning Problems in the Health Care Setting

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 398-404
Author(s):  
James A. Blackman ◽  
Julie Bretthauer
Keyword(s):  
At Risk ◽  
High Risk ◽  
Child Behavior Checklist ◽  
Standardized Test ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
High Risk Group ◽  
Learning Problems ◽  
High Risk Children

The validity of the Pediatric Evaluation of Educational Readiness (PEER) in evaluating high-risk 5-year-old children who passed developmental screenings through age 30 months was assessed by comparing it with a battery of standardized psychoeducational tests. High-risk children who "failed" the PEER scored significantly below those who "passed" the PEER on tests of verbal, perceptual-motor, and preacademic skills. Furthermore, scores on the PEER of the high-risk group were significantly below those of a normal comparison group. When the standardized test battery was used as the true indicator of developmental concerns, the sensitivity of the PEER averaged 0.60; specificity averaged 0.88. The overall hit rate was 78%. False-positive rate was 27%, the false-negative rate, 20%. Observations of behavior, including attention and activity, correlated at the .63 level (P < .001) with those made independently by a psychometrist. The correlation of these observations to ratings of behavior by parents on the Child Behavior Checklist was .32 (P < .001). It is concluded that the PEER distinguishes between groups of children at risk and not at risk for learning problems; however, in individual cases, the PEER and the standardized test agreed that a child had problems only 60% of the time. Thus two out of five children who may have problems would be missed by the PEER. The observations of behavior feature of the PEER seemed to be a reliable measure and to have some relationship to concerns indicated by parents. With the health history and physical examination, the PEER can assist in the developmental surveillance of children known to be at risk for learning problems. However, based on this study, it cannot be recommended for screening of general populations.

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

2006 ◽  
Vol 40 (5) ◽  
pp. 414-420 ◽  
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.

scholarly journals Predicting schizophrenia: findings from the Edinburgh High-Risk Study

2005 ◽  
Vol 186 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Eve C. Johnstone ◽  
Klaus P. Ebmeier ◽  
Patrick Miller ◽  
David G. C. Owens ◽  
Stephen M. Lawrie
Keyword(s):  
Young Adults ◽  
High Risk ◽  
Young People ◽  
Risk Group ◽  
High Risk Group ◽  
Psychotic Symptoms ◽  
Control Group ◽  
Well Control ◽  
Group A ◽  
A Prospective Study

BackgroundThe hypothesis that schizophrenia is neurodevelopmental was investigated in a prospective study of young people with a postulated 10–15% risk for the development of schizophrenia.AimsTo determine premorbid variables distinguishing high-risk people who will go on to develop schizophrenia from those who will not.MethodA high-risk sample of 163 young adults with two relatives with schizophrenia was recruited. They and 36 controls were serially examined. Baseline measures were compared between those who did develop schizophrenia, a well control group, a well high-risk group and high-risk participants with partial or isolated psychotic symptoms.ResultsOf those at high risk, 20 developed schizophrenia within 2½ years. More experienced isolated or partial psychotic symptoms. Those who developed schizophrenia differed from those who did not on social anxiety, withdrawal and other schizotypal features. The whole high-risk sample differed from the control group on developmental and neuropsychological variables.ConclusionsThe genetic component of schizophrenia affects many more individuals than will develop the illness, and partial impairment can be found in them. Highly significant predictors of the development of schizophrenia are detectable years before onset.

scholarly journals Schizotypal components in people at high risk of developing schizophrenia: early findings from the Edinburgh High-Risk Study

2002 ◽  
Vol 180 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Patrick Miller ◽  
Majella Byrne ◽  
Ann Hodges ◽  
Stephen M. Lawrie ◽  
David G. Cunningham Owens ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Principal Components ◽  
Social Withdrawal ◽  
Risk Groups ◽  
Structured Interview ◽  
Psychotic Symptoms ◽  
Emotional Dysfunction ◽  
State Examination

BackgroundThe study of high-risk groups and the development of schizophrenia.AimsTo investigate further schizotypy, measured by the Structured Interview for Schizotypy (SIS), and to examine relationships between schizotypal components, psychotic symptoms on the Present State Examination (PSE) and subsequent schizophrenia.MethodThe SIS and PSE were administered on entry. Schizophrenia onsets were recorded during follow-up.ResultsThe SIS yielded four principal components labelled social withdrawal, psychotic symptoms, socio-emotional dysfunction and odd behaviour. On entry, these differentiated between controls, subjects at risk for schizophrenia with and without symptoms and patients with schizophrenia. Seven of 78 subjects at risk developed schizophrenia within 39 months. This was best predicted by combining the four SIS components.ConclusionsSchizotypy is heterogeneous and may become psychosis, particularly if several of its components are present. As psychosis develops, odd behaviour gives way to psychotic symptoms and social function deteriorates.

A Social and Psychiatric Survey of Unemployment among Young People

1984 ◽  
Vol 18 (2) ◽  
pp. 135-143 ◽  
Author(s):  
Robert Finlay-Jones ◽  
Bob Eckhardt
Keyword(s):  
At Risk ◽  
High Risk ◽  
Young People ◽  
Psychiatric Disorder ◽  
Men And Women ◽  
The Difference

Unemployment raised the odds of having a psychiatric disorder by a factor of six in this sample of 401 young single people. The effect of unemployment was borne by men and women equally, since the difference between the sexes was preserved in the proportion who had a psychiatric disorder. Those particularly at risk for psychiatric disorder were men who were dismissed, who could not borrow money readily, and who had large debts. Women at high risk were those who resigned, and who could not borrow money readily.

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