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01-10-2016 | Original Contribution

Attenuated psychotic and basic symptom characteristics in adolescents with ultra-high risk criteria for psychosis, other non-psychotic psychiatric disorders and early-onset psychosis

Authors: Nella Lo Cascio, Riccardo Saba, Marta Hauser, Ditte Lammers Vernal, Aseel Al-Jadiri, Yehonatan Borenstein, Eva M. Sheridan, Taishiro Kishimoto, Marco Armando, Stefano Vicari, Paolo Fiori Nastro, Paolo Girardi, Eva Gebhardt, John M. Kane, Andrea Auther, Ricardo E. Carrión, Barbara A. Cornblatt, Benno G. Schimmelmann, Frauke Schultze-Lutter, Christoph U. Correll

Published in: European Child & Adolescent Psychiatry | Issue 10/2016

Abstract

While attenuated psychotic symptoms (APS) and basic symptoms (BS) are the main current predictors of psychosis in adults, studies in adolescents are scarce. Thus, we (1) described the prevalence and severity of positive, negative, disorganization, general, and basic symptoms in adolescent patients at ultra-high risk for psychosis (UHR), with other non-psychotic psychiatric disorders (PC) and with early-onset psychosis (EOP); and (2) investigated BS criteria in relation to UHR criteria. Sixty-nine 12–18-year-old adolescents (15.3 ± 1.7 years, female = 58.0 %, UHR = 22, PC = 27, EOP = 20) were assessed with the structured interview for prodromal syndromes (SIPS) and the schizophrenia proneness instrument-child and youth version (SPI-CY). Despite similar current and past 12-month global functioning, both UHR and EOP had significantly higher SIPS total and subscale scores compared to PC, with moderate-large effect sizes. Expectedly, UHR had significantly lower SIPS positive symptom scores than EOP, but similar SIPS negative, disorganized, and general symptom scores. Compared to PC, both EOP and UHR had more severe basic thought and perception disturbances, and significantly more often met cognitive disturbances criteria (EOP = 50.0 %, UHR = 40.9 %, PC = 14.8 %). Compared to UHR, both EOP and PC significantly less often met cognitive-perceptive BS criteria (EOP = 35.0 %, UHR = 68.2 %, PC = 25.9 %). BS were significantly more prevalent in both EOP and UHR than PC, and UHR were similar to EOP in symptom domains. Given the uncertain outcome of adolescents at clinical high-risk of psychosis, future research is needed to determine whether the combined assessment of early subjective disturbances with observable APS can improve the accuracy of psychosis prediction.

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Correll CU, Hauser M, Auther AM, Cornblatt BA (2010) Research in people with psychosis risk syndrome: a review of the current evidence and future directions. J Child Psychol Psychiatry 51:390–431. doi:10.1111/j.1469-7610.2010.02235.x CrossRefPubMedPubMedCentral

Schimmelmann BG, Walger P, Schultze-Lutter F (2013) The significance of at-risk symptoms for psychosis in children and adolescents. Can J Psychiatry 58:32–40PubMed

Schimmelmann BG, Schultze-Lutter F (2012) Early detection and intervention of psychosis in children and adolescents: urgent need for studies. Eur Child Adolesc Psychiatry 21:239–241CrossRefPubMed

Schultze-Lutter F, Michel C, Schmidt SJ et al (2015) EPA guidance on the early detection of clinical high risk states of psychoses. Eur Psychiatry 30:405–416. doi:10.1016/j.eurpsy.2015.01.010 CrossRefPubMed

Yung AR, Nelson B (2013) The ultra-high risk concept—a review. Can J Psychiatry 58:5–12PubMed

Klosterkötter J, Hellmich M, Steinmeyer EM, Schultze-Lutter F (2001) Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry 58:158–164CrossRefPubMed

Schultze-Lutter F, Klosterkötter J, Picker H et al (2007) Predicting first-episode psychosis by basic symptom criteria. Clin Neuropsychiatry 4:11–22

Schultze-Lutter F (2009) Subjective symptoms of schizophrenia in research and the clinic: the basic symptom concept. Schizophr Bull 35:5–8. doi:10.1093/schbul/sbn139 CrossRefPubMedPubMedCentral

Gross G (1989) The “basic” symptoms of schizophrenia. Br J Psychiatry Suppl 21–25 (discussion 37–40)

10.

Welsh P, Tiffin PA (2012) Experience of child and adolescent mental health clinicians working within an at-risk mental state for psychosis service: a qualitative study. Early Interv Psychiatry 6:207–211. doi:10.1111/j.1751-7893.2012.00352.x CrossRefPubMed

11.

Schimmelmann BG, Michel C, Martz-Irngartinger A et al (2015) Age matters in the prevalence and clinical significance of ultra-high-risk for psychosis symptoms and criteria in the general population: findings from the BEAR and BEARS-kid studies. World Psychiatry 14:189–197. doi:10.1002/wps.20216 CrossRefPubMedPubMedCentral

12.

Gerstenberg M, Hauser M, Al-Jadiri A et al (2015) Frequency and correlates of DSM-5 attenuated psychosis syndrome in a sample of adolescent inpatients with nonpsychotic psychiatric disorders. J Clin Psychiatry 76:e1449–e1458. doi:10.4088/JCP.14m09435 CrossRefPubMed

13.

Ruhrmann S, Schultze-Lutter F, Salokangas RK et al (2010) Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European prediction of psychosis study. Arch Gen Psychiatry 67:241–251CrossRefPubMed

14.

Schultze-Lutter F, Klosterkötter J, Ruhrmann S (2014) Improving the clinical prediction of psychosis by combining ultra-high risk criteria and cognitive basic symptoms. Schizophr Res 154:100–106. doi:10.1016/j.schres.2014.02.010 CrossRefPubMed

15.

Ziermans TB, Schothorst PF, Sprong M, van Engeland H (2011) Transition and remission in adolescents at ultra-high risk for psychosis. Schizophr Res 126:58–64. doi:10.1016/j.schres.2010.10.022 CrossRefPubMed

16.

Schultze-Lutter F, Ruhrmann S, Fusar-Poli P et al (2012) Basic symptoms and the prediction of first-episode psychosis. Curr Pharm Des 18:351–357CrossRefPubMed

17.

Schultze-Lutter F, Marshall M, Koch E (2012) Schizophrenia proneness instrument, child and youth version (SPI-CY)—extended english translation. Giovanni Fioriti Editore, Rome

18.

Schultze-Lutter F, Koch E (2010) Strumento di valutazione per la propensione alla schizofrenia. Versione per bambini e adolescenti. Giovanni Fioriti Editore, Rome

19.

Koch E, Schultze-Lutter F, Schimmelmann BG, Resch F (2010) On the importance and detection of prodromal symptoms from the perspective of child and adolescent psychiatry. Clin Neuropsychiatry 7:38–48

20.

Schultze-Lutter F, Steinmeyer EM, Ruhrmann S, Klosterkötter J (2008) The dimensional structure of self-reported “prodromal” disturbances in schizophrenia. Clin Neuropsychiatry 5:140–150

21.

Fux L, Walger P, Schimmelmann BG, Schultze-Lutter F (2013) The schizophrenia proneness instrument, child and youth version (SPI-CY): practicability and discriminative validity. Schizophr Res 146:69–78. doi:10.1016/j.schres.2013.02.014 CrossRefPubMed

22.

McGlashan TH, Miller TJ, Woods SW et al (2003) Structured interview for prodromal syndromes, version 4.0. Yale School of Medicine, New Haven

23.

First MB, Spitzer R, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV disorders. American Psychiatric Press Inc., Washington

24.

Kaufman J, Birmaher B, Brent D et al (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988CrossRefPubMed

25.

Miller TJ, McGlashan TH, Rosen JL et al (2003) Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophr Bull 29:703–715CrossRefPubMed

26.

Hall RCW (1995) Global assessment of functioning: a modified scale. Psychosomatics 36:267–275CrossRefPubMed

27.

Michel C, Schimmelmann BG, Kupferschmid S et al (2014) Reliability of telephone assessments of at-risk criteria of psychosis: a comparison to face-to-face interviews. Schizophr Res 153:251–253. doi:10.1016/j.schres.2014.01.025 CrossRefPubMed

28.

Rosenthal R, Rosnow RL (1991) Essentials of behavioral research: methods and data analysis, 2nd edn. McGraw Hill, New York

29.

Meng H, Graf Schimmelmann B, Koch E et al (2009) Basic symptoms in the general population and in psychotic and non-psychotic psychiatric adolescents. Schizophr Res 111:32–38. doi:10.1016/j.schres.2009.03.001 CrossRefPubMed

30.

Resch F, Koch E, Möhler E et al (2002) Early detection of psychotic disorders in adolescents: specificity of basic symptoms in psychiatric patient samples. Psychopathology 35:259–266. doi:10.1159/000067069 CrossRefPubMed

31.

Schultze-Lutter F, Ruhrmann S, Picker H et al (2007) Basic symptoms in early psychotic and depressive disorders. Br J Psychiatry 191:s31–s37. doi:10.1192/bjp.191.51.s31 CrossRef

32.

Szily E, Kéri S (2009) Anomalous subjective experience and psychosis risk in young depressed patients. Psychopathology 42:229–235. doi:10.1159/000218520 CrossRefPubMed

33.

Cannon TD, Cadenhead K, Cornblatt B et al (2008) Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry 65:28–37CrossRefPubMedPubMedCentral

34.

Salokangas RKR, Ruhrmann S, von Reventlow HG et al (2012) Axis I diagnoses and transition to psychosis in clinical high-risk patients EPOS project: prospective follow-up of 245 clinical high-risk outpatients in four countries. Schizophr Res 138:192–197. doi:10.1016/j.schres.2012.03.008 CrossRefPubMed

35.

Woods SW, Addington J, Cadenhead KS et al (2009) Validity of the prodromal risk syndrome for first psychosis: findings from the North American prodrome longitudinal study. Schizophr Bull 35:894–908. doi:10.1093/schbul/sbp027 CrossRefPubMedPubMedCentral

36.

Fusar-Poli P, Bechdolf A, Taylor MJ et al (2013) At risk for schizophrenic or affective psychoses? A meta-analysis of DSM/ICD diagnostic outcomes in individuals at high clinical risk. Schizophr Bull 39:923–932CrossRefPubMed

37.

Schmidt SJ, Schultze-Lutter F, Schimmelmann BG et al (2015) EPA guidance on the early intervention in clinical high risk states of psychoses. Eur Psychiatry 30:388–404. doi:10.1016/j.eurpsy.2015.01.013 CrossRefPubMed

38.

Woods SW, Addington J, Bearden CE et al (2013) Psychotropic medication use in youth at high risk for psychosis: comparison of baseline data from two research cohorts 1998–2005 and 2008–2011. Schizophr Res 148:99–104. doi:10.1016/j.schres.2013.05.019 CrossRefPubMed

39.

Simon AE, Dvorsky DN, Boesch J et al (2006) Defining subjects at risk for psychosis: a comparison of two approaches. Schizophr Res 81:83–90. doi:10.1016/j.schres.2005.10.006 CrossRefPubMed

40.

Demjaha A, Valmaggia L, Stahl D et al (2012) Disorganization/cognitive and negative symptom dimensions in the at-risk mental state predict subsequent transition to psychosis. Schizophr Bull 38:351–359. doi:10.1093/schbul/sbq088 CrossRefPubMed

41.

Nelson B, Yuen HP, Wood SJ et al (2013) Long-term follow-up of a group at ultra high risk (“prodromal”) for psychosis: the PACE 400 study. JAMA Psychiatry 70:793. doi:10.1001/jamapsychiatry.2013.1270 CrossRefPubMed

42.

Riecher-Rösser A, Pflueger MO, Aston J et al (2009) Efficacy of using cognitive status in predicting psychosis: a 7-year follow-up. Biol Psychiatry 66:1023–1030. doi:10.1016/j.biopsych.2009.07.020 CrossRef

43.

Fusar-Poli P, Hobson R, Raduelli M, Balottin U (2012) Reliability and validity of the comprehensive assessment of the at risk mental state, Italian version (CAARMS-I). Curr Pharm Des 18:386–391CrossRefPubMed

44.

Yung AR, Yuen HP, McGorry PD et al (2005) Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust N Z J Psychiatry 39:964–971. doi:10.1111/j.1440-1614.2005.01714.x CrossRefPubMed

45.

Ruhrmann S, Schultze-Lutter F, Klosterkötter J (2010) Probably at-risk, but certainly ill—advocating the introduction of a psychosis spectrum disorder in DSM-V. Schizophr Res 120:23–37. doi:10.1016/j.schres.2010.03.015 CrossRefPubMed

46.

Carrión RE, Goldberg TE, McLaughlin D et al (2011) Impact of neurocognition on social and role functioning in individuals at clinical high risk for psychosis. Am J Psychiatry 168:806–813. doi:10.1176/appi.ajp.2011.10081209 CrossRefPubMedPubMedCentral

47.

Olfson M, King M, Schoenbaum M (2015) Treatment of young people with antipsychotic medications in the united states. JAMA Psychiatry 72:867–874. doi:10.1001/jamapsychiatry.2015.0500 CrossRefPubMed

48.

Olfson M, Blanco C, Wang S et al (2014) National trends in the mental health care of children, adolescents, and adults by office-based physicians. JAMA Psychiatry 71:81–90. doi:10.1001/jamapsychiatry.2013.3074 CrossRefPubMed

49.

Olfson M, Blanco C, Liu SM et al (2012) National trends in the office-based treatment of children, adolescents, and adults with antipsychotics. Arch Gen Psychiatry 69:1247–1256. doi:10.1001/archgenpsychiatry.2012.647 CrossRefPubMed

50.

Penfold RB, Stewart C, Hunkeler EM et al (2013) Use of antipsychotic medications in pediatric populations: what do the data say? Curr Psychiatry Rep 15:426. doi:10.1007/s11920-013-0426-8 CrossRefPubMedPubMedCentral

51.

Correll CU, Blader JC (2015) Antipsychotic use in youth without psychosis: a double-edged sword. JAMA Psychiatry 72:859–860CrossRefPubMed

52.

Finnerty M, Neese-Todd S, Pritam R et al (2016) Access to psychosocial services prior to starting antipsychotic treatment among medicaid-insured youth. J Am Acad Child Adolesc Psychiatry 55(69–76):e3. doi:10.1016/j.jaac.2015.09.020 PubMed

53.

Maher AR, Maglione M, Bagley S et al (2011) Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults: a systematic review and meta-analysis. JAMA 306:1359–1369. doi:10.1001/jama.2011.1360 CrossRefPubMed

54.

Stafford MR, Jackson H, Mayo-Wilson E et al (2013) Early interventions to prevent psychosis: systematic review and meta-analysis. BMJ 346:f185. doi:10.1136/bmj.f185 CrossRefPubMedPubMedCentral

55.

Correll CU (2008) Assessing and maximizing the safety and tolerability of antipsychotics used in the treatment of children and adolescents. J Clin Psychiatry 69(Suppl 4):26–36PubMed

56.

Correll CU, Manu P, Olshanskiy V et al (2009) Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA 302:1765–1773. doi:10.1001/jama.2009.1549 CrossRefPubMedPubMedCentral

57.

Galling B, Roldán A, Nielsen RE et al (2016) Type 2 diabetes mellitus in youth exposed to antipsychotics: a systematic review and meta-analysis. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2015.2923 PubMed

58.

Lindgren M, Manninen M, Kalska H et al (2014) Predicting psychosis in a general adolescent psychiatric sample. Schizophr Res 158:1–6. doi:10.1016/j.schres.2014.06.028 CrossRefPubMed

59.

Manninen M, Lindgren M, Therman S et al (2014) Clinical high-risk state does not predict later psychosis in a delinquent adolescent population. Early Interv Psychiatry 8:87–90. doi:10.1111/eip.12045 CrossRefPubMed

60.

Fusar-Poli P, Bonoldi I, Yung AR et al (2012) Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 69:220–229. doi:10.1001/archgenpsychiatry.2011.1472 CrossRefPubMed

Title: Attenuated psychotic and basic symptom characteristics in adolescents with ultra-high risk criteria for psychosis, other non-psychotic psychiatric disorders and early-onset psychosis
Authors: Nella Lo Cascio
Riccardo Saba
Marta Hauser
Ditte Lammers Vernal
Aseel Al-Jadiri
Yehonatan Borenstein
Eva M. Sheridan
Taishiro Kishimoto
Marco Armando
Stefano Vicari
Paolo Fiori Nastro
Paolo Girardi
Eva Gebhardt
John M. Kane
Andrea Auther
Ricardo E. Carrión
Barbara A. Cornblatt
Benno G. Schimmelmann
Frauke Schultze-Lutter
Christoph U. Correll
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: European Child & Adolescent Psychiatry / Issue 10/2016
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI: https://doi.org/10.1007/s00787-016-0832-7

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Attenuated psychotic and basic symptom characteristics in adolescents with ultra-high risk criteria for psychosis, other non-psychotic psychiatric disorders and early-onset psychosis

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

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