Clinical and Functional Outcomes of At-Risk Mental State Among Non-Help Seeking Adolescents

Abstract

Background: At-risk mental state (ARMS) individuals are at high risk to develop psychosis. In addition to attenuated symptoms, ARMS is associated with cognitive and functional impairment. The findings are mostly based on research in help-seeking at-risk population. Our study aim was to explore prevalence rates of ARMS, comorbidities, functioning, and cognitive performance among non-help seeking adolescents. Patients and methods: Study subjects were randomly selected high school adolescents. At-risk mental state was assessed with Comprehensive Assessment of At Risk Mental States interview (CAARMS). Kiddie-Schedule for Affective Disorders and Schizophrenia examined comorbidities. Social functioning and quality of life were measured with Social and Occupational Functioning Assessment Scale (SOFAS) and KIDSCREEN 52. Cognitive performance in the domains of visual memory, verbal memory, working memory, and processing speed was assessed with a battery of cognitive tests Results: The total of 82 adolescents was enrolled, 21 of them met the ARMS criteria. No case of threshold psychotic disorder was detected in the study sample. Subthreshold mental disorders were more frequent in the ARMS+ group than in the ARMS- group (OR= 3.05; 95%CI 1.07, 8.67; p=0.03). Lower SOFAS scores were observed in the ARMS+ group compared to the ARMS- group (t= -3.888; p<.001; Cohen’s d = 0.99). In the total sample, CAARMS symptoms intensity was negatively associated with the SOFAS score (β = -.51; R2 = 0.26; p<.001). No significant differences in the KIDSCREEN-52 scores or cognitive functioning were found between the groups. Conclusion: Our findings suggest that non-help seeking adolescents with at-risk mental state have worse level of functioning compared to controls and higher rates of non-psychotic psychiatric comorbidities. Reduction in functioning is negatively associated with the severity of their subsyndromal psychotic symptoms.