Objective:To test effectiveness of the Early Detection, Intervention, and Prevention of Psychosis Program in preventing the onset of severe psychosis and improving functioning in a national sample of at-risk youth.Methods:In a risk-based allocation study design, 337 youth (age 12–25) at risk of psychosis were assigned to treatment groups based on severity of positive symptoms. Those at clinically higher risk (CHR) or having an early first episode of psychosis (EFEP) were assigned to receive Family-aided Assertive Community Treatment (FACT); those at clinically lower risk (CLR) were assigned to receive community care. Between-groups differences on outcome variables were adjusted statistically according to regression-discontinuity procedures and evaluated using the Global Test Procedure that combined all symptom and functional measures.Results:A total of 337 young people (mean age: 16.6) were assigned to the treatment group (CHR + EFEP, n = 250) or comparison group (CLR, n = 87). On the primary variable, positive symptoms, after 2 years FACT, were superior to community care (2 df, p < .0001) for both CHR (p = .0034) and EFEP (p < .0001) subgroups. Rates of conversion (6.3% CHR vs 2.3% CLR) and first negative event (25% CHR vs 22% CLR) were low but did not differ. FACT was superior in the Global Test (p = .0007; p = .024 for CHR and p = .0002 for EFEP, vs CLR) and in improvement in participation in work and school (p = .025).Conclusion:FACT is effective in improving positive, negative, disorganized and general symptoms, Global Assessment of Functioning, work and school participation and global outcome in youth at risk for, or experiencing very early, psychosis.

SUMMARYIn four series of experiments Merino ewes were exposed to ambient temperatures of about 44 °C and water vapour pressure of 33 mmHg for 9 h daily, and to 32 °C and 18 mmHg for the remaining 15 h daily, during the middle third, the final third or the final two-thirds of pregnancy. Birth weight and the weight of the placenta were considerably reduced by the treatments and the reductions were considerably more than could be accounted for by the partial loss of appetite produced by heating.There was a close inverse relationship between birth weight and the elevated rectal temperature of heated ewes in several series; but the absence of foetal dwarfing in ewes with elevated rectal temperatures due to daily heating for only 9 h at 44 °C indicates that the elevated rectal temperature of the ewe is not the main cause of dwarfing.Contrary to previous suggestions, the dwarfed lambs were not proportional miniatures, for the head components, the body lengths, the kidneys and adrenal glands were disproportionately large in heated lambs, while the liver, thyroid and thymus glands and the biceps femoris muscle were disproportionately small, and the ratio of secondary to primary wool fibres was very much reduced. There were cavities in the white matter of the cerebral hemispheres of heat-dwarfed lambs.The hypothesis that foetal dwarfing is due to stunting of the placenta was examined, but conflicting evidence was obtained in the different series. However, it appears that under some circumstances a heat-stunted placenta is capable of considerable growth in the absence of heating during the final third of pregnancy, when the placenta is normally shrinking, and that placental shrinkage in late pregnancy may be greatly accelerated by the application of heat.Neither thyroxine nor a preparation of ovine growth hormone, injected into heated ewes, prevented foetal dwarfing; the injections of growth hormone appeared to increase foetal mortality.

Whereas previous research on environmental factors implicated in the intergenerational transmission of depression has tended to focus on the role of parenting quality (e.g., harshness), the current study sought to assess whether structural aspects of families may contribute to depression-relevant affective and immune processes in youth. Specifically, the present study examined the role of family routines in linking parental depressive symptoms to youth emotion regulation, a depression-relevant marker of low-grade inflammation, and depressive symptoms in youth. 261 parent-adolescent dyads reported on their own depressive symptoms, family routines, and youth’s emotion regulation abilities. In addition, peripheral blood was drawn from youth to assess levels of the proinflammatory cytokine interleukin 6 (IL-6). Path analyses provided support for a model in which parental depressive symptoms related to fewer family routines, which in turn were associated with higher IL-6 and depressive symptoms in youth as well as marginally associated with worse youth emotion regulation. Moreover, family routines were found to statistically account for part of the association between parent- and youth- depressive symptoms. Together, these results suggest that family routines may represent an additional facet of the family environment that can potentially contribute to the intergenerational transmission of depressive symptoms.

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