scholarly journals Treatment Precedes Positive Symptoms in North American Adolescent and Young Adult Clinical High Risk Cohort

2016 ◽  
Vol 47 (1) ◽  
pp. 69-78 ◽  
Author(s):  
Kristen A. Woodberry ◽  
Larry J. Seidman ◽  
Caitlin Bryant ◽  
Jean Addington ◽  
Carrie E. Bearden ◽  
...  
Keyword(s):  
Young Adult ◽  
High Risk ◽  
North American ◽  
Adolescent And Young Adult ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
High Risk Cohort

scholarly journals Longitudinal outcome of attenuated positive symptoms, negative symptoms, functioning and remission in people at clinical high risk for psychosis: a meta-analysis

2021 ◽  
Vol 36 ◽  
pp. 100909
Author(s):  
Gonzalo Salazar de Pablo ◽  
Filippo Besana ◽  
Vincenzo Arienti ◽  
Ana Catalan ◽  
Julio Vaquerizo-Serrano ◽  
...  
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Longitudinal Outcome

Delay discounting in youth at clinical high-risk for psychosis and adults with schizophrenia

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Lisa A. Bartolomeo ◽  
Hannah C. Chapman ◽  
Ian M. Raugh ◽  
Gregory P. Strauss
Keyword(s):  
High Risk ◽  
Delay Discounting ◽  
Negative Symptoms ◽  
Chronic Phase ◽  
Reward Processing ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Symptom Scale ◽  
Processing Mechanism ◽  
Value Representation

Abstract Background Schizophrenia (SZ) is typically preceded by a prodromal (i.e. pre-illness) period characterized by attenuated positive symptoms and declining functional outcome. Negative symptoms are prominent among individuals at clinical high-risk (CHR) for psychosis (i.e. those with prodromal syndromes) and highly predictive of conversion to illness. Mechanisms underlying negative symptoms in the CHR population are unclear. Two studies were conducted to evaluate whether abnormalities in a reward processing mechanism thought to be core to negative symptoms in SZ, value representation, also exist in CHR individuals and whether they are associated with negative symptoms transphasically. Methods Study 1 included 33 individuals in the chronic phase of illness who have been diagnosed with schizophrenia or schizoaffective disorder (SZ) and 40 healthy controls (CN). Study 2 included 37 CHR participants and 45 CN. In both studies, participants completed the delay discounting (DD) task as a measure of value representation and the Brief Negative Symptom Scale was rated to measure negative symptoms. Results Results indicated that patients with SZ had steeper discounting rates than CN, indicating impairments in value representation. However, CHR participants were unimpaired on the DD task. In both studies, steeper discounting was associated with greater severity of negative symptoms. Conclusions These findings suggest that deficits in value representation are associated with negative symptoms transphasically.

The neurobiology of suicide in psychosis: A systematic review

2020 ◽  
Vol 34 (8) ◽  
pp. 811-819 ◽  
Author(s):  
Ragy R Girgis
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
General Population ◽  
Lifetime Risk ◽  
First Year ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Severe Problem ◽  
Work Done ◽  
The Relationship

The lifetime risk of dying by suicide in schizophrenia and related psychoses has been estimated to be approximately between 5% and 7%, though some have estimated that the number is closer to 10%. The highest risk for suicide occurs within the first year after presentation, when patients have a 12 times greater risk of dying by suicide than the general population, or a 60% higher risk compared with patients in other phases of psychosis, although the risk continues for many years. Some 31% of all deaths in first and early episode samples are due to suicide. Studies in individuals at clinical high-risk for psychosis (CHR) or with attenuated positive symptoms also demonstrate that suicidality is common and problematic in these individuals. Therefore, suicide in psychosis is a particularly severe problem. In order to develop interventions aimed at reducing the risk of suicide in psychotic individuals, it will be critical to understand the neurobiology of suicide in psychosis. In this paper, I report on the results of a systematic review of the work done to date on the neurobiology of suicide in psychosis and on suicidality in the CHR period. I will also identify gaps in knowledge and discuss future strategies for studying the neurobiology of suicidality in psychosis that may help to disentangle the links between suicide and psychosis and, by doing so, allow us to gain a greater understanding of the relationship between suicide and psychosis, which is critical for developing interventions aimed at reducing the risk of suicide in psychotic individuals.

Right amygdala volume in adolescent and young adult offspring from families at high risk for developing alcoholism

2001 ◽  
Vol 49 (11) ◽  
pp. 894-905 ◽  
Author(s):  
Shirley Y Hill ◽  
Michael D De Bellis ◽  
Matcheri S Keshavan ◽  
Lisa Lowers ◽  
Sa Shen ◽  
...  
Keyword(s):  
Young Adult ◽  
High Risk ◽  
Adolescent And Young Adult ◽  
Adult Offspring ◽  
Amygdala Volume

Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model: Evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis

2017 ◽  
Vol 45 ◽  
pp. 27-35 ◽  
Author(s):  
M.P. Hengartner ◽  
K. Heekeren ◽  
D. Dvorsky ◽  
S. Walitza ◽  
W. Rössler ◽  
...  
Keyword(s):  
High Risk ◽  
Prediction Model ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Predictive Accuracy ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Verbal Iq ◽  
Basic Symptoms ◽  
Ultra High Risk

AbstractBackground:The aim of this study was to critically examine the prognostic validity of various clinical high-risk (CHR) criteria alone and in combination with additional clinical characteristics.Methods:A total of 188 CHR positive persons from the region of Zurich, Switzerland (mean age 20.5 years; 60.2% male), meeting ultra high-risk (UHR) and/or basic symptoms (BS) criteria, were followed over three years. The test battery included the Structured Interview for Prodromal Syndromes (SIPS), verbal IQ and many other screening tools. Conversion to psychosis was defined according to ICD-10 criteria for schizophrenia (F20) or brief psychotic disorder (F23).Results:Altogether n = 24 persons developed manifest psychosis within three years and according to Kaplan–Meier survival analysis, the projected conversion rate was 17.5%. The predictive accuracy of UHR was statistically significant but poor (area under the curve [AUC] = 0.65, P < .05), whereas BS did not predict psychosis beyond mere chance (AUC = 0.52, P = .730). Sensitivity and specificity were 0.83 and 0.47 for UHR, and 0.96 and 0.09 for BS. UHR plus BS achieved an AUC = 0.66, with sensitivity and specificity of 0.75 and 0.56. In comparison, baseline antipsychotic medication yielded a predictive accuracy of AUC = 0.62 (sensitivity = 0.42; specificity = 0.82). A multivariable prediction model comprising continuous measures of positive symptoms and verbal IQ achieved a substantially improved prognostic accuracy (AUC = 0.85; sensitivity = 0.86; specificity = 0.85; positive predictive value = 0.54; negative predictive value = 0.97).Conclusions:We showed that BS have no predictive accuracy beyond chance, while UHR criteria poorly predict conversion to psychosis. Combining BS with UHR criteria did not improve the predictive accuracy of UHR alone. In contrast, dimensional measures of both positive symptoms and verbal IQ showed excellent prognostic validity. A critical re-thinking of binary at-risk criteria is necessary in order to improve the prognosis of psychotic disorders.

scholarly journals Lab-Based and Self-Reported Indices of Fitness Show Lowered Fitness and Insight into Fitness in Individuals at Clinical High Risk for Psychosis

2020 ◽  
Author(s):  
Katherine S. F. Damme ◽  
Richard P. Sloan ◽  
Matthew N. Bartels ◽  
Alara Ozsan ◽  
Luz H. Ospina ◽  
...  
Keyword(s):  
High Risk ◽  
Healthy Volunteers ◽  
Negative Symptoms ◽  
Population Characteristics ◽  
Self Report ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Laboratory Findings ◽  
Exercise Interventions ◽  
Intensity Of Exercise

AbstractIntroductionExercise is a promising intervention for clinical high-risk for psychosis (CHR) populations, who have attenuated positive symptoms, but evidence suggests that these youth may require tailored exercise interventions. Presently, the scope of the problem is unknown, as these youth may not be reliable reporters on fitness. This issue is compounded by the fact that there have been no investigations that utilized a formal fitness assessment in this critical population. The present study aims to determine the level of fitness in CHR youth with lab-based measures, test how effectively self-report measures characterize objective fitness indices, and explore clinical factors that may be interrupting reliable self-report-an important tool if these interventions are to be taken to scale.MethodsForty CHR individuals completed an exercise survey and lab-based indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed lab indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness.ResultsCHR youth showed greater BMI and lower VO2max compared to healthy volunteers. In the CHR group, abstract self-report items (perceived fitness) did not reflect lab indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with laboratory-based fitness measurements. Exploratory analyses suggested that positive symptoms involving grandiosity, and negative symptoms such as avolition, correlated with discrepancy between self-perception and laboratory findings of fitness.DiscussionResults suggest that CHR individuals are less objectively fit than matched controls, and that it will be important to consider unique population characteristics when weighing self-report data.

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