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 Negative psychotic symptoms and impaired role functioning predict transition outcomes in the at-risk mental state: a latent class cluster analysis study

2013 ◽  
Vol 43 (11) ◽  
pp. 2311-2325 ◽  
Author(s):  
L. R. Valmaggia ◽  
D. Stahl ◽  
A. R. Yung ◽  
B. Nelson ◽  
P. Fusar-Poli ◽  
...  
Keyword(s):  
At Risk ◽  
Cluster Analysis ◽  
Mental State ◽  
Latent Class ◽  
Mental States ◽  
Psychotic Symptoms ◽  
Role Functioning ◽  
Latent Class Cluster Analysis ◽  
At Risk Mental State

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.

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.

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

2017 ◽  
Vol 41 (S1) ◽  
pp. S186-S186 ◽  
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.

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

2008 ◽  
Vol 98 ◽  
pp. 113-114 ◽  
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

scholarly journals Identifying patients at risk of psychosis: a qualitative study of GP views in South West England

2020 ◽  
pp. bjgp20X713969
Author(s):  
Daniela Strelchuk ◽  
Nicola Wiles ◽  
Catherine Derrick ◽  
Stanley Zammit ◽  
Katrina Turner
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Patient Group ◽  
Continuity Of Care ◽  
Mental State ◽  
Psychotic Symptoms ◽  
Structured Interviews ◽  
South West ◽  
South West England ◽  
At Risk Mental State

BackgroundEarly intervention in people with an at-risk mental state for psychosis can decrease the rates of transition to psychosis. GPs play a key role in the identification of this patient group but very few studies have explored GPs’ awareness of patients who are at risk of psychosis.AimTo explore GPs’ views and experiences of identifying patients with an at-risk mental state for psychosis, and the barriers and facilitators to identification.Design and settingIn-depth semi-structured interviews were held with GPs working in South West England primary care. The interviews were conducted between March and July 2019.MethodA topic guide was used to ensure consistency across interviews. This guide was revised to incorporate a definition of the at-risk mental state for psychosis, as after conducting a few interviews it became clear that some GPs were not familiar with this construct. Interviews were audiorecorded and analysed thematically.ResultsA total of 20 GPs were interviewed. Some GPs were not familiar with the concept of being at risk of developing psychosis, and perceived that they may not have the right skills to identify this patient group. Other barriers related to patients not presenting or disclosing psychotic symptoms, and limitations imposed by scarce resources on the structure and provision of NHS services, such as lack of continuity of care and high thresholds for accessing specialised services.ConclusionIdentifying people at risk of psychosis in primary care is difficult. Provision of GP training, development of policies that support continuity of care, and improved access to specialised services could help improve the identification of this patient group.

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

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

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

2014 ◽  
Vol 158 (1-3) ◽  
pp. 32-38 ◽  
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

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

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

The Relationship Between Negative Symptoms and Cognitive Functioning in Patients with an at Risk Mental State for Psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S270-S271
Author(s):  
L. Leanza ◽  
L. Egloff ◽  
E. Studerus ◽  
C. Andreou ◽  
U. Heitz ◽  
...  
Keyword(s):  
At Risk ◽  
Cognitive Functioning ◽  
Mental State ◽  
Verbal Fluency ◽  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Clinical Impression ◽  
The Relationship ◽  
At Risk Mental State

IntroductionNegative symptoms and cognitive impairments are both present in patients with an at risk mental state (ARMS) for psychosis and negatively affect functioning and outcome. According to previous studies in patients with first-episode psychosis, negative symptoms are negatively associated with cognitive functioning while positive symptoms do not seem to be associated. Yet, little is known about the specific relationship of negative symptoms and cognitive functioning in ARMS patients.ObjectiveTo evaluate, the relationship between negative symptoms and cognitive functioning in ARMS patients.MethodsData of 154 ARMS patients were collected within the prospective Basel early detection of psychosis (FePsy) study. Negative symptoms were assessed with the SANS, positive psychotic symptoms with the BPRS, cognitive functioning with an extensive neuropsychological test battery. Multiple regressions were applied and results were controlled for age and gender.ResultsRegression analyses showed a significant, negative association between negative but not positive psychotic symptoms and cognitive functioning, showing the strongest association with verbal fluency (see Fig. 1). However, results mainly did not withstand correction for multiple testing.ConclusionsThe association found between verbal fluency and negative symptoms may be indicative of an overlap between those constructs. Finally, verbal fluency might have a strong influence on the clinical impression of negative symptoms, especially on alogia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

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