Das Kölner Früh-Erkennungs- &amp; Therapie-Zentrum für psychische Krisen (FETZ)

Schultze‐Lutter, Frauke; Picker, H.; Ruhrmann, Stephan; Klosterkötter, Joachim

doi:10.1007/s00063-008-1012-4

Cited by 15 publications

(9 citation statements)

References 33 publications

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“…There is, however, some indication that certain clinical and/or sociodemographic factors are associated with differences in the course of symptoms in the prodromal phase. [3][4][5][6][10][11][12][13][14][15][16] Therefore, 6 factors were analyzed for their influence on the proposed sequence for the following reasons: the CER study [3][4][5][6] had its focus on the development of schizophrenia; thus, it is not clear whether its results can be assigned to other psychoses. Consequently, type of first-episode psychosis at discharge was studied as a moderating variable.…”

Section: Introductionmentioning

confidence: 99%

“…Prospective early detection studies rely on help-seeking samples, yet, only a fraction of first-episode patients appear to seek help for mental problems in this early phase 12 and, thus, might introduce a selection bias in models relying on these studies. One major variable associated with help-seeking behavior not only for mental but also for any health-related problems is the sociodemographic background including level of education on leaving high school 13 ; thus level of education was studied as yet another moderating variable.…”

Section: Introductionmentioning

confidence: 99%

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Basic Symptoms and Ultrahigh Risk Criteria: Symptom Development in the Initial Prodromal State

Schultze‐Lutter

Ruhrmann

Berning

et al. 2008

Schizophrenia Bulletin

188

137

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Symptom development during the prodromal phase of psychosis was explored retrospectively in first-episode psychosis patients with special emphasis on the assumed time-related syndromic sequence of "unspecific symptoms (UN)-predictive basic symptoms (BS)-attenuated psychotic symptoms (APS)-(transient) psychotic symptoms (PS)." Onset of syndromes was defined by first occurrence of any of their respective symptoms. Group means were inspected for time differences between syndromes and influence of sociodemographic and clinical characteristics on the recalled sequence. The sequence of "UN-BS/APS-PS" was clearly supported, and both BS and, though slightly less, APS were highly sensitive. However, onset of BS and APS did not show significant time difference in the whole sample (N = 126; 90% schizophrenia), although when each symptom is considered independently, APS tended to occur later than first predictive BS. On descriptive level, about one-third each recalled an earlier, equal and later onset of BS compared with APS. Level of education showed the greatest impact on the recall of the hypothesized sequence. Thereby, those with a higher school-leaving certificate supported the assumed sequence, whereas those of low educational background retrospectively dated APS before BS. These findings rather point out recognition and recall bias inherent to the retrospective design than true group characteristics. Future long-term prospective studies will have to explore this conclusively. However, as regards the criteria, the results support the notion of BS as at least a complementary approach to the ultrahigh risk criteria, which may also allow for an earlier detection of psychosis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Basic Symptoms and Ultrahigh Risk Criteria: Symptom Development in the Initial Prodromal State

Schultze‐Lutter

Ruhrmann

Berning

et al. 2008

Schizophrenia Bulletin

188

137

View full text Add to dashboard Cite

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“…Notably, a considerable number experience improvement in psychosocial outcome following the detection of an ARMS [138]. Furthermore, many ARMS patients suffer from other nonpsychotic mental disorders, frequently depression and anxiety [105,116,139]. Thus it was not surprising that the pattern of coping, self-efficacy, and control beliefs of ARMS patients closely resembled that of depressive patients in its frequent lack of positive coping strategies, low self-efficacy, and a fatalistic externalizing bias [140].…”

Section: Clinical Significance Of the At-risk Mentalmentioning

confidence: 99%

Early Detection and Treatment of Psychosis: The Bern Child and Adolescent Psychiatric Perspective

Schultze‐Lutter

Schimmelmann

2014

Advances in Psychiatry

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Commonly conceptualized as neurodevelopmental disorders of yet poorly understood aetiology, schizophrenia and other nonorganic psychoses remain one of the most debilitating illnesses with often poor outcome despite all progress in treatment of the manifest disorder. Drawing on the frequent poor outcome of psychosis and its association with the frequently extended periods of untreated first-episode psychosis (FEP) including its prodrome, an early detection and treatment of both the FEP and the preceding at-risk mental state (ARMS) have been increasingly studied. Thereby both approaches are confronted with different problems, for example, treatment engagement in FEP and predictive accuracy in ARMS. They share, however, the problems related to the lack of understanding of developmental, that is, age-related, peculiarities and of the presentation and natural course of their cardinal symptoms in the community. Most research on early detection and intervention in FEP and ARMS is still related to clinical psychiatric samples, and little is known about symptom presentation and burden and help-seeking in the general population related to these experiences. Furthermore, in particular in the early detection of an ARMS, studies often address adolescents and young adults alike without consideration of developmental characteristics, thereby applying risk criteria that have been developed predominately in adults. Combining our earlier experiences described in this paper in child and adolescent, and general psychiatry as well as in both lines of research, that is, on early psychosis and its treatment and on the early detection of psychosis, in particular in its very early states by subjective disturbances in terms of basic symptoms, age-related developmental and epidemiological aspects have therefore been made the focus of our current studies in Bern, thus making our line of research unique.

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“…Early intervention is thought to reduce the duration of untreated psychosis and to prevent or delay transition to psychosis by attenuating the symptoms of individuals at clinical high-risk for psychosis ( 4 , 9 ). Higher levels of attenuated positive symptoms, poor social functioning, some genetic risk, e.g., having a first-degree relative with a psychotic disorder, have been so far identified as consistent predictors of conversion to psychosis ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Early Somatosensory Processing Over Time in Individuals at Risk to Develop Psychosis

et al. 2019

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Objective: Somatosensory evoked potentials (SEPs) enable the investigation of thalamocortical and early cortical processing. Previous studies reported alterations of SEPs in patients with schizophrenia as well as in individuals in the prodromal stage. Moreover, cannabis use as an environmental risk factor for the development of schizophrenia has been demonstrated to influence SEP parameters in individuals at risk to develop psychosis. The aim of this study was to explore the course of SEP changes and the impact of concomitant cannabis use in individuals at risk to develop psychosis who sought medical help.Methods: Median nerve SEPs including high-frequency oscillations (HFOs) superimposed on the primary cortical response (N20) were investigated using multichannel EEG in individuals (n = 54 at baseline) remaining at risk to develop psychosis at follow-up after 1 year (high-risk: n = 19; ultra-high-risk: n = 27) vs. subjects with conversion to psychosis (n = 8) and a healthy control group (n = 35). Longitudinal and cross-sectional analyses of SEP components as estimated by dipole source analysis were performed.Results: The longitudinal development of the N20 strength depended on cannabis use. In cannabis non-users, a greater decrease of N20 strengths over time was associated with more negative symptoms at baseline. At baseline, converters did not differ from subjects remaining at risk. At follow-up, converters showed increased low- and high-frequency activity than at-risk subjects and did not differ from controls.Conclusion: The results of this study lead to the suggestion that the deficits in early somatosensory processing in individuals at risk to develop psychosis may not represent a marker for a genetic risk for psychosis but rather reflect state-dependent factors such as negative symptoms. On the other hand, the transition to psychosis seems to represent an interstage between reduced sensory registration from the at-risk state and gating deficits in the chronic state.

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Das Kölner Früh-Erkennungs- & Therapie-Zentrum für psychische Krisen (FETZ)

Abstract: Although an early detection center is generally well received, findings indicate the necessity to develop and carry out custom-built public campaigns especially tailored to at-risk persons with migration background as well as those with lower graduation.

Cited by 15 publications

References 33 publications

Basic Symptoms and Ultrahigh Risk Criteria: Symptom Development in the Initial Prodromal State

Basic Symptoms and Ultrahigh Risk Criteria: Symptom Development in the Initial Prodromal State

Early Detection and Treatment of Psychosis: The Bern Child and Adolescent Psychiatric Perspective

Early Somatosensory Processing Over Time in Individuals at Risk to Develop Psychosis

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