scholarly journals O1.1. ETRo: EVALUATION OF THE TREATMENT APPROACH “ROBIN” (STANDARDIZED MANUAL AND SMARTPHONE APP) FOR ADOLESCENTS WITH CLINICAL HIGH RISK FOR DEVELOPING A PSYCHOTIC DISORDER

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S1-S1
Author(s):  
Nina Traber-Walker ◽  
Miriam Gerstenberg ◽  
Sibylle Metzler ◽  
Claudia Bühlmann ◽  
Yolanda Blumenthal ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Treatment Approach ◽  
Combined Treatment ◽  
Smartphone Application ◽  
Clinical High Risk ◽  
Smartphone Applications ◽  
Early Intervention In Psychosis ◽  
Intervention Condition

Abstract Background The construct of a clinical high-risk (CHR) state of psychosis has been established to describe potentially prodromal symptoms which typically appear during adolescence and young adulthood. This is a very sensitive developmental period and the clinical high risk (CHR) is associated with increased functional impairment. However, there is a lack of research on age-appropriate treatment strategies for this vulnerable age group. To fill this gap, the experts from the specialized outpatient care unit for early intervention in psychosis at the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, of the University Zürich (CAPS), have developed the combined treatment program “Robin” (standardized manual and smartphone App). The therapy program is targeting at risk-symptoms and aims to improve of quality of life as well as daily functioning. The smartphone application “Robin Z” is an add-on treatment tool to support the patients between the sessions. While a number of trials with smartphone applications in therapy have shown promising effects with adult patient with psychosis, there is little known about using them in the therapy with minor patients. “Robin Z” is one of the first smartphone applications addressing adolescent patients with at risk- symptoms or full-blown psychotic symptoms. Since September 2017, the efficacy of this combined treatment approach is being evaluated with the systematic clinical intervention trial ETRo (Evaluation of the treatment approach “Robin“). The study has been registered at ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT03829527) and the study protocol has been published June 2019 in the journal “Frontiers in Psychiatry”. Methods The ETRo trial is a prospective, naturalistic, follow up study with a matched control design. Participants from a former early recognition study are included for the control condition (treatment as usual). For the intervention condition (16 weekly individual sessions + a minimum 4 family sessions), 30 help seeking CHR adolescents, aged 14–18, are being recruited. At-risk and comorbid symptoms, functioning, self-efficacy and quality of life are monitored at six time points (baseline, during the treatment period, immediately after intervention, and 6, 12, and 24 months later) and compared to the respective measures of the active control group. Results The data from a pilot investigation showed, that “Robin” was accepted by clinicians and patients. Therefore, the authors hypothesize that the “Robin” will enhance the treatment engagement. Within the first 2 years of the systematic evaluation, 18 CHR individuals (61% female, mean age 16.1) have been included in the intervention condition. In Florence, the preliminary results and their implications will be presented. This will include baseline data of the first patients in the intervention group, the intraindividual changes in symptomatology and well-being after 6 months of treatment and data about the treatment satisfaction. Discussion “Robin” is a newly developed treatment approach for adolescents at clinical high risk (CHR) of developing a psychotic disorder combining a standardized treatment manual with a smartphone application. To the best of the author’s knowledge, this is the first controlled trial to test the efficacy of a specific early psychosis treatment in combination with a smartphone application for CHR adolescents. The results of the study are of clinical importance and expected to add essential information in the fields of eMental Health as well as in prevention and early intervention in psychosis.

scholarly journals Evaluation of the Combined Treatment Approach “Robin” (Standardized Manual and Smartphone App) for Adolescents at Clinical High Risk for Psychosis

2019 ◽  
Vol 10 ◽  
Author(s):  
Nina Traber-Walker ◽  
Miriam Gerstenberg ◽  
Sibylle Metzler ◽  
Maria Raquel Joris ◽  
Markus Karr ◽  
...  
Keyword(s):  
High Risk ◽  
Treatment Approach ◽  
Combined Treatment ◽  
Smartphone App ◽  
Clinical High Risk

scholarly journals Clinical subtypes that predict conversion to psychosis: A canonical correlation analysis study from the ShangHai At Risk for Psychosis program

2019 ◽  
Vol 54 (5) ◽  
pp. 482-495 ◽  
Author(s):  
TianHong Zhang ◽  
XiaoChen Tang ◽  
HuiJun Li ◽  
Kristen A Woodberry ◽  
Emily R Kline ◽  
...  
Keyword(s):  
At Risk ◽  
Cluster Analysis ◽  
High Risk ◽  
Correlation Analysis ◽  
Canonical Correlation Analysis ◽  
Canonical Correlation ◽  
Clinical Symptoms ◽  
Structured Interview ◽  
Two Dimensions ◽  
Clinical High Risk

Objective: Since only 30% or fewer of individuals at clinical high risk convert to psychosis within 2 years, efforts are underway to refine risk identification strategies to increase their predictive power. The clinical high risk is a heterogeneous syndrome presenting with highly variable clinical symptoms and cognitive dysfunctions. This study investigated whether subtypes defined by baseline clinical and cognitive features improve the prediction of psychosis. Method: Four hundred clinical high-risk subjects from the ongoing ShangHai At Risk for Psychosis program were enrolled in a prospective cohort study. Canonical correlation analysis was applied to 289 clinical high-risk subjects with completed Structured Interview for Prodromal Syndromes and cognitive battery tests at baseline, and at least 1-year follow-up. Canonical variates were generated by canonical correlation analysis and then used for hierarchical cluster analysis to produce subtypes. Kaplan–Meier survival curves were constructed from the three subtypes to test their utility further in predicting psychosis. Results: Canonical correlation analysis determined two linear combinations: (1) negative symptom and functional deterioration-related cognitive features, and (2) Positive symptoms and emotional disorganization-related cognitive features. Cluster analysis revealed three subtypes defined by distinct and relatively homogeneous patterns along two dimensions, comprising 14.2% (subtype 1, n = 41), 37.4% (subtype 2, n = 108) and 48.4% (subtype 3, n = 140) of the sample, and each with distinctive features of clinical and cognitive performance. Those with subtype 1, which is characterized by extensive negative symptoms and cognitive deficits, appear to have the highest risk for psychosis. The conversion risk for subtypes 1–3 are 39.0%, 11.1% and 18.6%, respectively. Conclusion: Our results define important subtypes within clinical high-risk syndromes that highlight clinical symptoms and cognitive features that transcend current diagnostic boundaries. The three different subtypes reflect significant differences in clinical and cognitive characteristics as well as in the risk of conversion to psychosis.

scholarly journals Current status of postnatal depression smartphone applications available on application stores: an information quality analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e015655 ◽  
Author(s):  
Melvyn WB Zhang ◽  
Roger CM Ho ◽  
Alvona Loh ◽  
Tracey Wing ◽  
Olivia Wynne ◽  
...  
Keyword(s):  
Postnatal Depression ◽  
English Language ◽  
Information Quality ◽  
Smartphone Application ◽  
Evidence Base ◽  
Quality Analysis ◽  
Current Status ◽  
Average Score ◽  
Smartphone Applications

ObjectivesIt is the aim of the current research to identify some common functionalities of postnatal application, and to determine the quality of the information content of postnatal depression application using validated scales that have been applied for applications in other specialties.Settings and participantsTo determine the information quality of the postnatal depression smartphone applications, the two most widely used smartphone application stores, namely Apple iTunes as well as Google Android Play store, were searched between 20May and 31 May. No participants were involved. The inclusion criteria for the application were that it must have been searchable using the keywords ‘postnatal’, ‘pregnancy’, ‘perinatal’, ‘postpartum’ and ‘depression’, and must be in English language.InterventionThe Silberg Scale was used in the assessment of the information quality of the smartphone applications.Primary and secondary outcomes measureThe information quality score was the primary outcome measure.ResultsOur current results highlighted that while there is currently a myriad of applications, only 14 applications are specifically focused on postnatal depression. In addition, the majority of the currently available applications on the store have only disclosed their last date of modification as well as ownership. There remain very limited disclosures about the information of the authors, as well as the references for the information included in the application itself. The average score for the Silberg Scale for the postnatal applications we have analysed is 3.0.ConclusionsThere remains a need for healthcare professionals and developers to jointly conceptualise new applications with better information quality and evidence base.

scholarly journals Personal Beliefs about Experiences in those at Clinical High Risk for Psychosis

2014 ◽  
Vol 43 (6) ◽  
pp. 669-675 ◽  
Author(s):  
Jacqueline Stowkowy ◽  
Diana O. Perkins ◽  
Scott W. Woods ◽  
Karissa Nyman ◽  
Jean Addington
Keyword(s):  
High Risk ◽  
Negative Symptoms ◽  
Intervention Strategies ◽  
Psychotic Symptoms ◽  
Clinical High Risk ◽  
Personal Beliefs ◽  
Negative Beliefs ◽  
The Impact ◽  
Important Objective

Background: Negative beliefs about illness in early psychosis have been shown to have an unfavourable impact on one's quality of life. A shift of focus in psychosis research has been on the detection of individuals considered to be at clinical high risk (CHR) of developing psychosis. Little is known about the impact that beliefs about psychotic like experiences or attenuated psychotic symptoms may have on CHR individuals. Aim: To explore these beliefs in a large sample of young people at CHR of developing psychosis using the Personal Beliefs about Experiences Questionnaire (PBEQ). Method: Beliefs about unusual experiences were assessed in 153 CHR individuals with the PBEQ. Prodromal symptoms (measured by the SIPS) and depression (measured by the CDSS) were also assessed. Results: In CHR individuals, holding more negative beliefs was associated with increased severity in depression and negative symptoms. Higher scores on suspiciousness were associated with increased negative beliefs, and higher levels of grandiosity were associated with decreased negative beliefs. Those who later transitioned to psychosis agreed significantly more with statements concerning control over experiences (i.e. “my experiences frighten me”, “I find it difficult to cope). Conclusions: The results suggest that targeting negative beliefs and other illness related appraisals is an important objective for intervention strategies.

scholarly journals Choice of combined treatment of lung cancer and aortic valve pathologies

2015 ◽  
Vol 17 (2) ◽  
pp. 51
Author(s):  
A. M. Karaskov ◽  
O. Yu. Anikeeva ◽  
O. A. Pashkovskaya ◽  
A. B. Open
Keyword(s):  
Aortic Valve ◽  
Treatment Approach ◽  
Combined Treatment ◽  
Left Lung ◽  
Patient Specific ◽  
Surgical Interventions ◽  
Specific Complex ◽  
Hypofractionated Radiation

We present a clinical case of step-by-step treatment of a patient with a tumor of the left lung upper lobe and a pronounced aortic valvular disease. The combination of concurrent pathologies always requires a thorough selection of the treatment approach. The risks of simultaneous surgical interventions are associated with high intraoperative and early postoperative complications. The selected approach of the stepwise treatment of aortic valve replacement followed by stereotactic hypofractionated radiation therapy has demonstrated the outcomes comparable to those of radical surgery. The compensation of hemodynamic parameters and a full local response during 18-month follow-up has confirmed the appropriateness of a patient-specific complex treatment approach, with a high quality of life maintained.

scholarly journals Emotion recognition deficits as predictors of transition in individuals at clinical high risk for schizophrenia: a neurodevelopmental perspective

2015 ◽  
Vol 45 (14) ◽  
pp. 2959-2973 ◽  
Author(s):  
C. M. Corcoran ◽  
J. G. Keilp ◽  
J. Kayser ◽  
C. Klim ◽  
P. D. Butler ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Emotion Recognition ◽  
Negative Symptoms ◽  
Characteristic Curve ◽  
Classification Model ◽  
Developmental Study ◽  
Clinical High Risk ◽  
Risk Patients ◽  
Early Developmental

Background.Schizophrenia is characterized by profound and disabling deficits in the ability to recognize emotion in facial expression and tone of voice. Although these deficits are well documented in established schizophrenia using recently validated tasks, their predictive utility in at-risk populations has not been formally evaluated.Method.The Penn Emotion Recognition and Discrimination tasks, and recently developed measures of auditory emotion recognition, were administered to 49 clinical high-risk subjects prospectively followed for 2 years for schizophrenia outcome, and 31 healthy controls, and a developmental cohort of 43 individuals aged 7–26 years. Deficit in emotion recognition in at-risk subjects was compared with deficit in established schizophrenia, and with normal neurocognitive growth curves from childhood to early adulthood.Results.Deficits in emotion recognition significantly distinguished at-risk patients who transitioned to schizophrenia. By contrast, more general neurocognitive measures, such as attention vigilance or processing speed, were non-predictive. The best classification model for schizophrenia onset included both face emotion processing and negative symptoms, with accuracy of 96%, and area under the receiver-operating characteristic curve of 0.99. In a parallel developmental study, emotion recognition abilities were found to reach maturity prior to traditional age of risk for schizophrenia, suggesting they may serve as objective markers of early developmental insult.Conclusions.Profound deficits in emotion recognition exist in at-risk patients prior to schizophrenia onset. They may serve as an index of early developmental insult, and represent an effective target for early identification and remediation. Future studies investigating emotion recognition deficits at both mechanistic and predictive levels are strongly encouraged.

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