scholarly journals Young people at ultra high risk for psychosis: research from the PACE clinic

2011 ◽  
Vol 33 (suppl 2) ◽  
pp. s143-s160 ◽  
Author(s):  
Alison R. Yung ◽  
Barnaby Nelson
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Psychotic Disorders ◽  
Omega 3 ◽  
Prodromal Phase ◽  
Risk Criteria ◽  
Current Controversy ◽  
Ultra High Risk ◽  
Risk Approach ◽  
Attenuated Psychosis Syndrome

Over the last fifteen years, attempts have been made to prospectively identify individuals in the prodromal phase of schizophrenia and other psychotic disorders. The ultra high risk approach, based on a combination of known trait and state risk factors, has been the main strategy used. The validation of the ultra high risk criteria allowed for predictive research in this population in an attempt to identify clinical, neurocognitive and neurobiological risk factors for psychosis onset. It also led to a series of intervention studies in this population, which have included the use of low dose antipsychotic medication, cognitive therapy, and omega-3 fatty acids. Although there is moderate evidence for the effectiveness of specific intervention strategies in this population, the most effective type and duration of intervention is yet to be determined. A current controversy in the field is whether to include an adaption of the ultra high risk criteria (the attenuated psychosis syndrome) in the next version of the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition).

scholarly journals 210. NEURAPRO: A Multi-center RCT of Omega-3 Polyunsaturated Fatty Acids Versus Placebo in Young People at Ultra-High Risk of Psychotic Disorders: Medium-Term Outcome

2017 ◽  
Vol 43 (suppl_1) ◽  
pp. S107-S107 ◽  
Author(s):  
Barnaby Nelson ◽  
G. Paul Amminger ◽  
Connie Markulev ◽  
Hok Pan Yuen ◽  
Suzie Lavoie ◽  
...  
Keyword(s):  
Fatty Acids ◽  
High Risk ◽  
Young People ◽  
Polyunsaturated Fatty Acids ◽  
Psychotic Disorders ◽  
Omega 3 ◽  
Medium Term ◽  
Term Outcome ◽  
Ultra High Risk

Detecting the first signs of emerging psychosis

2019 ◽  
pp. 57-72
Author(s):  
Frauke Schultze-Lutter
Keyword(s):  
Information Processing ◽  
High Risk ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Prodromal Phase ◽  
Risk Detection ◽  
Ultra High Risk ◽  
Positive Symptoms Of Psychosis ◽  
Insight Into

Psychotic disorders are costly and debilitating illnesses. Their prodromal phase usually lasts several years and offers opportunities for indicated prevention. Currently, two risk-detection approaches, developed in adult samples, are typically followed: ultra-high risk (UHR) criteria, developed to predict first-episode psychoses within 12 months; and basic symptom (BS) criteria, aimed at the earliest possible detection of emerging psychoses. The main UHR criterion is defined by attenuated psychotic symptoms, which resemble positive symptoms of psychosis except that some insight into their abnormal nature remains. In contrast, BS criteria include subtle disturbances in information processing, experienced immediately with full insight. Various studies have indicated that using a combination of both approaches might increase sensitivity and support the development of a timely, change-sensitive, and stratified risk-detection method. However, since age might play an important role, both the UHR and BS approach might be less psychosis-predictive and less clinically relevant in children and adolescents.

scholarly journals Prevalence and clinical relevance of interview-assessed psychosis-risk symptoms in the young adult community

2017 ◽  
Vol 48 (7) ◽  
pp. 1167-1178 ◽  
Author(s):  
Frauke Schultze-Lutter ◽  
Chantal Michel ◽  
Stephan Ruhrmann ◽  
Benno G. Schimmelmann
Keyword(s):  
Risk Factors ◽  
Young Adult ◽  
High Risk ◽  
Clinical Relevance ◽  
Community Sample ◽  
Clinical Samples ◽  
Basic Symptoms ◽  
Risk Criteria ◽  
Psychosis Risk ◽  
Ultra High Risk

AbstractBackgroundAn efficient indicated prevention of psychotic disorders requires valid risk criteria that work in both clinical and community samples. Yet, ultra-high risk and basic symptom criteria were recently recommended for use in clinical samples only. Their use in the community was discouraged for lack of knowledge about their prevalence, clinical relevance and risk factors in non-clinical, community settings when validly assessed with the same instruments used in the clinic.MethodsUsing semi-structured telephone interviews with established psychosis-risk instruments, we studied the prevalence of psychosis-risk symptoms and criteria, their clinical relevance (using presence of a non-psychotic mental disorder or of functional deficits as proxy measures) and their risk factors in a random, representative young adult community sample (N=2683; age 16–40 years; response rate: 63.4%).ResultsThe point-prevalence of psychosis-risk symptoms was 13.8%. As these mostly occurred too infrequent to meet frequency requirements of psychosis-risk criteria, only 2.4% of participants met psychosis-risk criteria. A stepwise relationship underlay the association of ultra-high risk and basic symptoms with proxy measures of clinical relevance, this being most significant when both occurred together. In line with models of their formation, basic symptoms were selectively associated with age, ultra-high risk symptoms with traumatic events and lifetime substance misuse.ConclusionsPsychosis-risk criteria were uncommon, indicating little risk of falsely labelling individuals from the community at-risk for psychosis. Besides, both psychosis-risk symptoms and criteria seem to possess sufficient clinical relevance to warrant their broader attention in clinical practice, especially if ultra-high risk and basic symptoms occur together.

scholarly journals Neurocognition and Social Cognition— Possibilities for Diagnosis and Treatment in Ultra-High Risk for Psychosis State

2021 ◽  
Vol 12 ◽  
Author(s):  
Katarzyna Rek-Owodziń ◽  
Ernest Tyburski ◽  
Katarzyna Waszczuk ◽  
Jerzy Samochowiec ◽  
Monika Mak
Keyword(s):  
Social Cognition ◽  
High Risk ◽  
Healthcare Workers ◽  
Conceptual Analysis ◽  
Psychotic Disorders ◽  
Treatment Options ◽  
Psychotic Symptoms ◽  
Early Interventions ◽  
Prodromal Phase ◽  
Ultra High Risk

In recent decades, clinicians have developed the construct of ultra-high risk (UHR) for psychosis to characterize the prodromal phase of psychosis or classify people with weakly expressed psychotic symptoms. In this conceptual analysis, we have gathered up-to-date data about the clinical picture of neurocognition and social cognition in people at UHR for psychosis. We also discuss treatment options. A well-chosen therapeutic approach can help to deal with difficulties and delay or even prevent the development of full-blown psychotic disorders in the UHR group. Despite much evidence supporting the benefits of therapy, early interventions are still not as widely used as they should be. Thus, a better understanding of the UHR state is very important for all healthcare workers.

scholarly journals Predictors of treatment response in young people at ultra-high risk for psychosis who received long-chain omega-3 fatty acids

2015 ◽  
Vol 5 (1) ◽  
pp. e495-e495 ◽  
Author(s):  
G P Amminger ◽  
A Mechelli ◽  
S Rice ◽  
S-W Kim ◽  
C M Klier ◽  
...  
Keyword(s):  
Fatty Acids ◽  
High Risk ◽  
Young People ◽  
Treatment Response ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Ultra High Risk ◽  
Long Chain

Ultra-high-risk paradigm: lessons learnt and new directions

2018 ◽  
Vol 21 (4) ◽  
pp. 131-133 ◽  
Author(s):  
Patrick D McGorry ◽  
Cristina Mei
Keyword(s):  
High Risk ◽  
Mental Disorders ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Evidence Base ◽  
Ultra High Risk ◽  
Underlying Mechanisms ◽  
Staging Model ◽  
Definition Of ◽  
New Generation

Within the embryonic early psychosis field in the early 1990s, the conceptualisation and definition of an at-risk or ultra-high-risk (UHR) mental state for psychosis was a breakthrough which transformed the clinical and research landscape in psychiatry. Twenty-five years later, we have a new evidence base that has illuminated the neurobiology of the onset phase of psychotic disorder, delivered Cochrane level 1 evidence showing that the onset of full-threshold sustained psychotic disorder can be at least delayed, and is paving the way to a new generation of transdiagnostic research. Here, we document the contribution of the UHR approach to understanding the underlying mechanisms of psychosis onset as well as the long-term outcomes. Particularly, we highlight that psychosis onset can be delayed in those meeting UHR criteria and that these criteria have a higher valence for subsequent psychotic disorders and some valence for persistent non-psychotic syndromes. Critiques have helped to identify some of the limitations of this paradigm, which are acknowledged. These include evidence that psychotic disorders can emerge more acutely and from other, as yet undefined, precursor states. Rather than defending, or alternatively questioning the value of, the UHR approach, we propose a broader, transdiagnostic staging model that is consistent with the pluripotent and variably comorbid trajectories for mental disorders. This approach moves beyond psychosis to capture a wider range of subthreshold symptoms and full-threshold disorders, thus enhancing prediction for the emergence and progression of a range of mental disorders, as well as providing new avenues for early intervention and prevention.

scholarly journals S150. EMOTIONAL BEHAVIOUR IN HIGH-RISK AND FIRST-EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S93-S93
Author(s):  
Irina Falkenberg ◽  
Huai-Hsuan Tseng ◽  
Gemma Modinos ◽  
Barbara Wild ◽  
Philip McGuire ◽  
...  
Keyword(s):  
High Risk ◽  
Emotion Recognition ◽  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
First Episode ◽  
Healthy Controls ◽  
Emotional Faces ◽  
Facial Movements ◽  
Episode Psychosis ◽  
Ultra High Risk

Abstract Background Studies indicate that people with schizophrenia and first-episode psychosis experience deficits in their ability to accurately detect and display emotions through facial expressions, and that functioning and symptoms are associated with these deficits. This study aims to examine how emotion recognition and facial emotion expression are related to functioning and symptoms in a sample of individuals at ultra-high risk, first-episode psychosis and healthy controls. Methods During fMRI, we combined the presentation of emotional faces with the instruction to react with facial movements predetermined and assigned. 18 patients with first-episode psychosis (FEP), 18 individuals at ultra high risk of psychosis (UHR) and 22 healthy controls (HCs) were examined while viewing happy, sad, or neutral faces and were instructed to simultaneously move the corners of their mouths either (a). upwards or (b). downwards, or (c). to refrain from movement. The subjects’ facial movements were recorded with an MR-compatible video camera. Results Neurofunctional and behavioral response to emotional faces were measured. Analyses have only recently commenced and are ongoing. Full results of the clinical and functional impact of behavioral and neuroimaging results will be presented at the meeting. Discussion Increased knowledge about abnormalities in emotion recognition and behaviour as well as their neural correlates and their impact on clinical measures and functional outcome can inform the development of novel treatment approaches to improve social skills early in the course of schizophrenia and psychotic disorders.

scholarly journals Gender Differences in Individuals at High-Risk of Psychosis: A Comprehensive Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Ana Barajas ◽  
Susana Ochoa ◽  
Jordi E. Obiols ◽  
Lluís Lalucat-Jo
Keyword(s):  
Gender Differences ◽  
High Risk ◽  
Social Functioning ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Control Variable ◽  
Prodromal Phase ◽  
Men And Women ◽  
Conversion Rates ◽  
High Risk Populations

Introduction. To date, few studies have focused on the characterization of clinical phenomenology regarding gender in population at high-risk of psychosis. This paper is an attempt to summarize the findings found in the scientific literature regarding gender differences in high-risk populations, taking into account parameters studied in populations with schizophrenia and other psychotic disorders, such as incidence, clinical expression, duration of untreated illness (DUI), social functioning, and cognitive impairment prior to full-blown psychosis development.Method. Studies were systematically searched in PubMed. Studies using gender variable as a control variable were excluded. 12 studies met inclusion criteria.Results. Most of the studies found a differential pattern between women and men as regards clinical, social, and cognitive variables in the prodromal phase, with worse performance in men except in cognitive functioning (more severe negative symptoms, worse social functioning, and longer DUI in men). Similar conversion rates over time were found between men and women.Conclusions. Many of the studies analyzed suggest that differences between men and women in the expression of psychosis extend across a continuum, from the subclinical forms of illness to the debut of psychosis. However, the small number of studies and their significant methodological and clinical limitations do not allow for firm conclusions.

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