Establishing a clinical high‐risk program in Tunisia, North Africa: A pilot study in early detection and identification

2021 ◽  
Author(s):  
Joseph Ventura ◽  
Lamia Jouini ◽  
Amina Aissa ◽  
Amine Larnaout ◽  
Rahma Nefzi ◽  
...  
Keyword(s):  
Pilot Study ◽  
High Risk ◽  
Early Detection ◽  
North Africa ◽  
Clinical High Risk ◽  
Detection And Identification

scholarly journals Systemic Therapy for Youth at Clinical High Risk for Psychosis: A Pilot Study

2017 ◽  
Vol 8 ◽  
Author(s):  
Jingyu Shi ◽  
Lu Wang ◽  
Yuhong Yao ◽  
Chenyu Zhan ◽  
Na Su ◽  
...  
Keyword(s):  
Pilot Study ◽  
High Risk ◽  
Systemic Therapy ◽  
Clinical High Risk

scholarly journals A pilot study of cognitive training in clinical high risk for psychosis: Initial evidence of cognitive benefit

2014 ◽  
Vol 157 (1-3) ◽  
pp. 314-316 ◽  
Author(s):  
Christine I. Hooker ◽  
Emily E. Carol ◽  
T.J. Eisenstein ◽  
Hong Yin ◽  
Sarah Hope Lincoln ◽  
...  
Keyword(s):  
Pilot Study ◽  
High Risk ◽  
Cognitive Training ◽  
Clinical High Risk ◽  
Cognitive Benefit

scholarly journals Structural and functional imaging markers for susceptibility to psychosis

2020 ◽  
Vol 25 (11) ◽  
pp. 2773-2785 ◽  
Author(s):  
Christina Andreou ◽  
Stefan Borgwardt
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Functional Neuroimaging ◽  
Clinical High Risk ◽  
Multicenter Studies ◽  
Clinical Criteria ◽  
Clinical Applicability ◽  
Prognostic Utility ◽  
Neuroimaging Biomarkers ◽  
Imaging Markers

Abstract The introduction of clinical criteria for the operationalization of psychosis high risk provided a basis for early detection and treatment of vulnerable individuals. However, about two-thirds of people meeting clinical high-risk (CHR) criteria will never develop a psychotic disorder. In the effort to increase prognostic precision, structural and functional neuroimaging have received growing attention as a potentially useful resource in the prediction of psychotic transition in CHR patients. The present review summarizes current research on neuroimaging biomarkers in the CHR state, with a particular focus on their prognostic utility and limitations. Large, multimodal/multicenter studies are warranted to address issues important for clinical applicability such as generalizability and replicability, standardization of clinical definitions and neuroimaging methods, and consideration of contextual factors (e.g., age, comorbidity).

scholarly journals Abnormal relationships between local and global brain measures in subjects at clinical high risk for psychosis: a pilot study

2017 ◽  
Vol 12 (4) ◽  
pp. 974-988 ◽  
Author(s):  
Jun Konishi ◽  
Elisabetta C. del Re ◽  
Sylvain Bouix ◽  
Gabriëlla A. M. Blokland ◽  
Raquelle Mesholam-Gately ◽  
...  
Keyword(s):  
Pilot Study ◽  
High Risk ◽  
Clinical High Risk ◽  
Global Brain

scholarly journals T160. HIGH-RESOLUTION WHOLE BRAIN MR SPECTROSCOPIC IMAGING IN YOUTHS AT CLINICAL HIGH RISK FOR PSYCHOSIS: A PILOT STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S292-S292
Author(s):  
Paul Klauser ◽  
Antoine Klauser ◽  
Martine Cleusix ◽  
Jean-Baptiste Ledoux ◽  
Kerstin von Plessen ◽  
...  
Keyword(s):  
White Matter ◽  
Pilot Study ◽  
High Risk ◽  
High Resolution ◽  
Three Dimension ◽  
Clinical High Risk ◽  
Subcortical Structures ◽  
Whole Brain ◽  
Psychosis Risk ◽  
Mrsi Data

Abstract Background In general, MR spectroscopy (MRS) studies report alterations of both glutamatergic indices and NAA not only in first episode psychosis and established schizophrenia but also in high risk populations, suggesting that altered excitatory neurotransmission and loss of neuronal integrity are early pathophysiological processes. However, interpretation of these findings is limited by the region-of-interest approach of current MRS techniques, limiting the measurement of metabolites to delimited cerebral volumes, selected by a priori hypotheses. In that context, we developed and implemented a new technique including specific MR sequence and data reconstruction that allows for whole brain high-resolution MRS imaging (MRSI) in two or three dimensions. The results enable the mapping of main metabolites in all brain regions (cortex, white matter, deep grey matter) of youths at clinical high risk for psychosis (CHR-P). Methods An FID-MRSI (Henning et al. NMR Biomed 2009) sequence with a 3D phase encoding accelerated by compressed-sensing was implemented on a 3T Prisma fit MRI (Siemens, Erlangen, Germany). The echo time (TE) was 0.65 ms, repetition time (TR) was 355 ms and the flip angle 35 degree. FID was acquired with 4 kHz bandwidth. The size of the excited Volume of Interest (VOI) was (A/P-R/L-H/F) 210 mm by 160 mm by 95 mm with a matrix of 42 x 32 x 20 resulting in 5 mm isotropic resolution. After reconstruction (Klauser A et al. Magn Reson Med. 2018), 3D MRSI data were quantified with LCModel to produce 3D metabolite maps. Concentration for total N-acetyl aspartate (tNAA), total creatinine (tCre), choline-containing compounds (Cho), myo-inositol (Ins), glutamate and glutamine (Glx) were calculated in every single voxel. A T1-weighted MPRAGE anatomical scan was acquired for positioning of the 3D MRSI and for the segmentation of the brain. For each participant, brain tissue was segmented into gray and white matter. Cerebral lobes and deep grey mater structures were also delineated using Freesurfer software package. CHR-P individuals were recruited in the service of child and adolescent psychiatry and in the service of general psychiatry, department of psychiatry at Lausanne university hospital. They were help-seeking adolescents and young adults aged between 14 and 35, who presented a psychosis-risk syndrome or basic symptoms as assessed by the Structured Interview for Psychosis-Risk Syndromes (SIPS) and the Schizophrenia Proneness Instrument, Adult (SPI-A) or Child & Youth version (SPI-CY). Healthy controls matched for age and sex were recruited in the general population. Results Three-dimension MRSI provides spatial specificity by allowing main metabolites (i.e., tNAA, tCre, Cho, Ins and Glx) to be reliably mapped in the volume of the entire brain. The resulting contrast allows the recognition of brain compartments and subcortical structures. Individual brain segments, cerebral lobes and subcortical structures were registered to 3D MRSI data and the mean concentration in each structure was computed to allow group comparisons between CHR-P and HC. Discussion In general, there is a strong need to develop new tools for the identification and stratification of CHR-P populations. Alterations of gross brain anatomy are relatively late events but early and subtle neurochemical changes and especially those reflecting oxidative stress and concomitant synaptic remodeling are promising candidates. This pilot study illustrates the potential of three-dimension MRSI to detect such alterations in the whole brain and with a good spatial resolution.

Pilot study of cognitive remediation therapy on cognition in young people at clinical high risk of psychosis

2015 ◽  
Vol 225 (1-2) ◽  
pp. 93-98 ◽  
Author(s):  
Danijela Piskulic ◽  
Mariapaola Barbato ◽  
Lu Liu ◽  
Jean Addington
Keyword(s):  
Pilot Study ◽  
High Risk ◽  
Young People ◽  
Cognitive Remediation ◽  
Clinical High Risk ◽  
Cognitive Remediation Therapy

Early detection of psychosis: finding those at clinical high risk

2008 ◽  
Vol 2 (3) ◽  
pp. 147-153 ◽  
Author(s):  
Jean Addington ◽  
Irvin Epstein ◽  
Andrea Reynolds ◽  
Ivana Furimsky ◽  
Laura Rudy ◽  
...  
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Clinical High Risk

EPA guidance on the early detection of clinical high risk states of psychoses

2015 ◽  
Vol 30 (3) ◽  
pp. 405-416 ◽  
Author(s):  
F. Schultze-Lutter ◽  
C. Michel ◽  
S.J. Schmidt ◽  
B.G. Schimmelmann ◽  
N.P. Maric ◽  
...  
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Meta Analysis ◽  
Functional Decline ◽  
Evidence Based ◽  
Clinical High Risk ◽  
Conversion Rates ◽  
Co Morbidity ◽  
Ultra High Risk ◽  
Cognitive Disturbances

AbstractThe aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rates to psychosis in non-overlapping samples meeting any at least any one of the main CHR criteria: ultra-high risk (UHR) and/or basic symptoms criteria. Further, effects of potential moderators (different UHR criteria definitions, single UHR criteria and age) on conversion rates were examined. Conversion rates in the identified 42 samples with altogether more than 4000 CHR patients who had mainly been identified by UHR criteria and/or the basic symptom criterion ‘cognitive disturbances’ (COGDIS) showed considerable heterogeneity. While UHR criteria and COGDIS were related to similar conversion rates until 2-year follow-up, conversion rates of COGDIS were significantly higher thereafter. Differences in onset and frequency requirements of symptomatic UHR criteria or in their different consideration of functional decline, substance use and co-morbidity did not seem to impact on conversion rates. The ‘genetic risk and functional decline’ UHR criterion was rarely met and only showed an insignificant pooled sample effect. However, age significantly affected UHR conversion rates with lower rates in children and adolescents. Although more research into potential sources of heterogeneity in conversion rates is needed to facilitate improvement of CHR criteria, six evidence-based recommendations for an early detection of psychosis were developed as a basis for the EPA guidance on early intervention in CHR states.

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