scholarly journals S69. CLINICAL HIGH RISK STATE: STRATIFICATION BASED ON CLINICAL PROFILE AND REDOX STATUS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S60-S60
Author(s):  
Martine Cleusix ◽  
Ines Khadimallah ◽  
Elodie Toffel ◽  
Paul Klauser ◽  
Kim Q Do ◽  
...  
Keyword(s):  
High Risk ◽  
Psychosocial Functioning ◽  
Help Seeking ◽  
Verbal Learning ◽  
Self Esteem ◽  
Cognitive Outcomes ◽  
Clinical Profile ◽  
Clinical High Risk ◽  
Basic Symptoms ◽  
The Impact

Abstract Background The Clinical High Risk state (CHR) concept was implemented to promote the early detection of young help-seeking patients with higher risk of psychotic transition. This category is based on specific clinical criteria (EPA, 2015) and require narrow frequency/duration ratings of subclinical positive psychotic symptoms to allow its definition. Prevalence of CHR “category” appears nevertheless rare in help-seeking young people and the rate of psychotic transition of CHR state is lower than predicted by early studies. Therefore, the binary outcome of transition to psychosis proposed by the “CHR model” actually fails to be an efficient marker to stratify, in neurobiological studies, people with different psychopathological trajectories, notably those who develop psychosis from those who do not. In order to rely on a vulnerability model for schizophrenic psychosis more sensitive to psychosocial functioning and negative dimension, we study prospectively with three years of follow-up a population of help-seekers addressed for clinical suspicion of prodromal state of psychosis. We aimed here to identify subgroups of patients in a sample of subclinical psychotic states using psychological and cognitive outcomes as profiling criteria, focusing not only on transition but also on psychosocial functioning as main outcome. Methods A total of 32 help-seeking adolescents and young adults aged 14 to 35 were referred by health care providers for a specialized evaluation in case of suspicion of a prodromal psychotic state and/or detected by the French version of the Prodromal Questionnaire (PQ-16; cut-off 6/16). Their CHR status was assessed by the Structured Interview for Psychosis-Risk Syndromes (SIPS) and the Schizophrenia Proneness Instrument, Adult (SPI-A). Individuals included in the study presented either a CHR status, a subclinical CHR status or negative symptomatology. All subjects performed an additional neuropsychological battery and blood test for redox markers (Glutathione Peroxidase (GPx) and Glutathione Reductase (GR) activities) (Xin et al, 2016). Based on their clinical profile, we made a stratification of the patients using a Principal Component Analysis. Results Cognitive and psychological outcome stratification of all help-seekers revealed two subgroups (called group1 and group2) of patients with distinct profiles. Individuals in group1 (n=18) had greater levels of basic symptoms and general symptomatology. On the other hand, in group2 (n=14), individuals showed a weaker self-esteem and a lower rate of “living independently”. Cognitive scores for speed processing, attention, verbal learning and social cognition were significantly lower in group2 compared to group1. In addition, these cognitive outcomes were negatively correlated with negative symptoms only in group2. Analysis of redox markers revealed a positive correlation between GPx and GR activities in group1, a correlation disrupted in group2. Discussion Stratification of a cohort of young help-seekers with suspicion of prodromal psychosis, regardless of their CHR status, allowed us to distinguish two subgroups with different clinical profiles: group1 with higher levels of basic symptoms and general symptomatology, and group2 with weaker self-esteem, less autonomy and poorer neurocognition. In addition, analysis of redox markers revealed a redox dysregulation in patients with poorer cognitive profile. Considering the impact of neurocognitive impairment on functioning, special focus to patients of group2 is needed, mostly in clinical practice. Moreover, they might benefit of supplementation with antioxidant compounds such as NAC, which may improve cognitive deficits (Conus et al, 2018).

The Effects of Grouping, Self Esteem, and Locus of Control on Microcomputer Performance and Help Seeking by Mildly Handicapped Students

1987 ◽  
Vol 3 (4) ◽  
pp. 443-460 ◽  
Author(s):  
Merith A. Cosden ◽  
Judy P. English
Keyword(s):  
Locus Of Control ◽  
Problem Solving ◽  
Help Seeking ◽  
Personal Characteristics ◽  
Self Esteem ◽  
Problem Solving Skills ◽  
Math Problem Solving ◽  
Performance Accuracy ◽  
Instructional Literature ◽  
The Impact

The impact of grouping, learning handicap, locus of control, and self esteem on students' performance on a math problem-solving program was assessed in two studies. Outcome measures included: 1) the level of difficulty at which students selected to work, 2) use of a program help command, and 3) response accuracy with and without help. Despite indication from the non-computer instructional literature that grouping would facilitate problem-solving skills for some students, neither problem selections nor performance accuracy varied as a function of group configuration. Personal characteristics influenced problem selections, help seeking, and accuracy in anticipated directions but not consistently. More consistent patterns were noted as a function of initial student competency in math.

Basic symptoms and gray matter volumes of patients at clinical high risk for psychosis

2020 ◽  
pp. 1-9 ◽  
Author(s):  
Daniela Hubl ◽  
Chantal Michel ◽  
Frauke Schultze-Lutter ◽  
Martinus Hauf ◽  
Benno G. Schimmelmann ◽  
...  
Keyword(s):  
High Risk ◽  
Gray Matter ◽  
First Episode ◽  
Clinical High Risk ◽  
Significant Group ◽  
Basic Symptoms ◽  
Conversion Rates ◽  
Episode Psychosis ◽  
Ultra High Risk ◽  
Gray Matter Volumes

Abstract Background Clinical high-risk (CHR) for psychosis is indicated by ultra-high risk (UHR) and basic symptom (BS) criteria; however, conversion rates are highest when both UHR and BS criteria are fulfilled (UHR&BS). While BSs are considered the most immediate expression of neurobiological aberrations underlying the development of psychosis, research on neurobiological correlates of BS is scarce. Methods We investigated gray matter volumes (GMV) of 20 regions of interest (ROI) previously associated with UHR criteria in 90 patients from the Bern early detection service: clinical controls (CC), first-episode psychosis (FEP), UHR, BS and UHR&BS. We expected lowest GMV in FEP and UHR&BS, and highest volume in CC with UHR and BS in-between. Results Significantly, lower GMV was detected in FEP and UHR&BS patients relative to CC with no other significant between-group differences. When ROIs were analyzed separately, seven showed a significant group effect (FDR corrected), with five (inferior parietal, medial orbitofrontal, lateral occipital, middle temporal, precuneus) showing significantly lower GM volume in the FEP and/or UHR&BS groups than in the CC group (Bonferroni corrected). In the CHR group, only COGDIS scores correlated negatively with cortical volumes. Conclusions This is the first study to demonstrate that patients who fulfill both UHR and BS criteria – a population that has been associated with higher conversion rates – exhibit more severe GMV reductions relative to those who satisfy BS or UHR criteria alone. This result was mediated by the BS in the UHR&BS group, as only the severity of BS was linked to GMV reductions.

scholarly journals Evaluating the impact of cannabis use on thalamic connectivity in youth at clinical high risk of psychosis

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Lisa Buchy ◽  
Tyrone D. Cannon ◽  
Alan Anticevic ◽  
Kristina Lyngberg ◽  
Kristin S. Cadenhead ◽  
...  
Keyword(s):  
High Risk ◽  
Cannabis Use ◽  
Clinical High Risk ◽  
The Impact

scholarly journals Two-year follow-up of a Chinese sample at clinical high risk for psychosis: timeline of symptoms, help-seeking and conversion

2016 ◽  
Vol 26 (3) ◽  
pp. 287-298 ◽  
Author(s):  
T. H. Zhang ◽  
H. J. Li ◽  
K. A. Woodberry ◽  
L. H. Xu ◽  
Y. Y. Tang ◽  
...  
Keyword(s):  
High Risk ◽  
Symptom Onset ◽  
Help Seeking ◽  
Cox Regression ◽  
Clinical Population ◽  
Psychotic Symptoms ◽  
Clinical High Risk ◽  
Chinese Sample ◽  
Over Time

Background.Chinese psychiatrists have gradually started to focus on those who are deemed to be at ‘clinical high-risk (CHR)’ for psychosis; however, it is still unknown how often those individuals identified as CHR from a different country background than previously studied would transition to psychosis. The objectives of this study are to examine baseline characteristics and the timing of symptom onset, help-seeking, or transition to psychosis over a 2-year period in China.Method.The presence of CHR was determined with the Structured Interview for Prodromal Syndromes (SIPS) at the participants' first visit to the mental health services. A total of 86 (of 117) CHR participants completed the clinical follow-up of at least 2 years (73.5%). Conversion was determined using the criteria of presence of psychotic symptoms (in SIPS). Analyses examined baseline demographic and clinical predictors of psychosis and trajectory of symptoms over time. Survival analysis (Kaplan–Meier) methods along with Log-rank tests were performed to illustrate the relationship of baseline data to either conversion or non-conversion over time. Cox regression was performed to identify baseline predictors of conversion by the 2-year follow-up.Results.In total 25 (29.1%) of 86 completers transitioned to a psychotic disorder over the course of follow-up. Among the CHR sample, the mean time between attenuated symptom onset and professional help-seeking was about 4 months on average, and converters developed fully psychotic symptoms about 12 months after symptom onset. Compared with those CHR participants whose risk syndromes remitted over the course of the study, converters had significantly longer delays (p = 0.029) for their first visit to a professional in search of help. At baseline assessment, the conversion subgroup was younger, had poorer functioning, higher total SIPS positive symptom scores, longer duration of untreated prodromal symptoms, and were more often given psychosis-related diagnoses and subsequently prescribed antipsychotics in the clinic.Conclusions.Chinese CHR identified primarily by a novel clinical screening approach had a 2-year transition rate comparable with those of specialised help-seeking samples world-wide. Early clinical intervention with this functionally deteriorating clinical population who are suffering from attenuated psychotic symptoms, is a next step in applying the CHR construct in China.

scholarly journals F116. HELP-SEEKING BARRIERS FOR YOUTH AT CLINICAL HIGH RISK OF DEVELOPING PSYCHOSIS: BY DEMOGRAPHIC INFORMATION

2019 ◽  
Vol 45 (Supplement_2) ◽  
pp. S298-S298
Author(s):  
Emily He ◽  
Cikylie Brooks ◽  
Nadine Gardner ◽  
Huijun Li
Keyword(s):  
High Risk ◽  
Help Seeking ◽  
Clinical High Risk ◽  
Demographic Information

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 Self-esteem and Symptoms in Individuals at Clinical High Risk for Psychosis

2018 ◽  
Vol 206 (6) ◽  
pp. 433-438
Author(s):  
Caridad Benavides ◽  
Gary Brucato ◽  
David Kimhy
Keyword(s):  
High Risk ◽  
Self Esteem ◽  
Clinical High Risk

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 Long-term Efficacy and Tolerability of Perospirone for Young Help-seeking People at Clinical High Risk: a Preliminary Open Trial

2013 ◽  
Vol 11 (3) ◽  
pp. 132-136 ◽  
Author(s):  
Naohisa Tsujino ◽  
Takahiro Nemoto ◽  
Keiko Morita ◽  
Naoyuki Katagiri ◽  
Shinya Ito ◽  
...  
Keyword(s):  
High Risk ◽  
Help Seeking ◽  
Open Trial ◽  
Clinical High Risk ◽  
Term Efficacy

scholarly journals Clinical and functional ultra-long-term outcome of patients with a clinical high risk (CHR) for psychosis

2019 ◽  
Vol 62 ◽  
pp. 30-37 ◽  
Author(s):  
Katharina Beck ◽  
Erich Studerus ◽  
Christina Andreou ◽  
Laura Egloff ◽  
Letizia Leanza ◽  
...  
Keyword(s):  
High Risk ◽  
Psychosocial Functioning ◽  
Original Sample ◽  
Clinical High Risk ◽  
Term Outcome ◽  
Risk Status ◽  
Long Term Outcome ◽  
Long Term Follow Up

Abstract Background: Few studies have followed up patients with a clinical high risk (CHR) for psychosis for more than 2–3 years. We aimed to investigate the rates and baseline predictors for remission from CHR and transition to psychosis over a follow-up period of up to 16 years. Additionally, we examined the clinical and functional long-term outcome of CHR patients who did not transition. Methods: We analyzed the long-term course of CHR patients that had been included in the longitudinal studies “Früherkennung von Psychosen” (FePsy) or “Bruderholz” (BHS). Those patients who had not transitioned to psychosis during the initial follow-up periods (2/5 years), were invited for additional follow-ups. Results: Originally, 255 CHR patients had been included. Of these, 47 had transitioned to psychosis during the initial follow-ups. Thus, 208 were contacted for the long-term follow-up, of which 72 (34.6%) participated. From the original sample of 255, 26%, 31%, 35%, and 38% were estimated to have transitioned after 3, 5, 10, and 16 years, respectively, and 51% had remitted from their high risk status at the latest follow-up. Better psychosocial functioning at baseline was associated with a higher rate of remission. Of the 72 CHR patients re-assessed at long-term follow-up, 60 had not transitioned, but only 28% of those were fully recovered clinically and functionally. Conclusions: Our study shows the need for follow-ups and clinical attention longer than the usual 2–3 years as there are several CHR patients with later transitions and only a minority of CHR those without transition fully recovers.

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