Early Psychosis Prevention and Intervention Centre long‐term follow‐up study of first‐episode psychosis: methodology and baseline characteristics

Henry, Lisa; Harris, Meredith; Amminger, G. Paul; Yuen, Hok Pan; Harrigan, Susy; Lambert, Martin; Conus, Philippe; Schwartz, Orli; Prosser, A.; Farrelly, Simone; Purcell, Rosemary; Herrman, Helen; Jackson, Henry J.; McGorry, Patrick D.

doi:10.1111/j.1751-7893.2007.00008.x

Cited by 41 publications

(30 citation statements)

References 68 publications

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“…36 If participants did not consent to a face-to-face assessment, they were asked if they would consent to a brief telephone or written assessment, enabling a minimal set of clinical and functional outcome data to be collected. The interview consisted of a battery of psychopathological and neuropsychological assessments.…”

Section: Methodsmentioning

confidence: 99%

Sexual Trauma Increases the Risk of Developing Psychosis in an Ultra High-Risk “Prodromal” Population

Thompson

Nelson

Yuen

et al. 2013

Schizophrenia Bulletin

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112

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Studies indicate a high prevalence of childhood trauma in patient cohorts with established psychotic disorder and in those at risk of developing psychosis. A causal link between childhood trauma and development of psychosis has been proposed. We aimed to examine the association between experience of childhood trauma and the development of a psychotic disorder in a large "Ultra High Risk" (UHR) for psychosis cohort. The data were collected as part of a longitudinal cohort study of all UHR patients recruited to research studies at the Personal Assessment and Clinical Evaluation clinic between 1993 and 2006. Baseline data were collected at recruitment to these studies. The participants completed a comprehensive followup assessment battery (mean time to follow-up 7.5 years, range 2.4-14.9 years), which included the Childhood Trauma Questionnaire (CTQ), a self-report questionnaire that assesses experience of childhood trauma. The outcome of interest was transition to a psychotic disorder during the follow-up period. Data were available on 233 individuals. Total CTQ trauma score was not associated with transition to psychosis. Of the individual trauma types, only sexual abuse was associated with transition to psychosis (P = .02). The association remained when adjusting for potential confounding factors. Those with high sexual abuse scores were estimated to have a transition risk 2-4 times that of those with low scores. The findings suggest that sexual trauma may be an important contributing factor in development of psychosis for some individuals.

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Section: Methodsmentioning

confidence: 99%

Sexual Trauma Increases the Risk of Developing Psychosis in an Ultra High-Risk “Prodromal” Population

Thompson

Nelson

Yuen

et al. 2013

Schizophrenia Bulletin

Self Cite

112

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“…Because cognition is a robust predictor of functioning, some studies have examined the differential impact of cognition and negative symptoms on outcome. Interestingly, negative symptoms can make a separate, non-overlapping contribution to the prediction of functioning, beyond the joint contribution with cognition (Henry et al, 2007; Milev, 2005; Peña et al, 2012). In addition, a meta-analysis that focused primarily on studies of chronic patients indicated that negative symptoms mediated the relationship between neurocognition and functional outcome (Ventura et al, 2009a).…”

Section: Introductionmentioning

confidence: 99%

Negative symptoms and functioning during the first year after a recent onset of schizophrenia and 8years later

Ventura¹,

Subotnik²,

Gitlin³

et al. 2015

Schizophrenia Research

129

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Background Understanding the longitudinal course of negative symptoms, especially in relationship to functioning, in the early phase of schizophrenia is crucial to developing intervention approaches. The course of negative symptoms and daily functioning was examined over a one-year period following a recent onset of schizophrenia and at an 8-year follow-up point. Methods The study included 149 recent-onset schizophrenia patients who had a mean age of 23.7 (SD=4.4) years and mean education of 12.9 (SD=2.2) years. Negative symptom (BPRS and SANS) and functional outcome (SCORS) assessments were conducted frequently by trained raters. Results After antipsychotic medication stabilization, negative symptoms during the first outpatient year were moderately stable (BPRS ICC=0.64 and SANS ICC=0.66). Despite this overall moderate stability, 24% of patients experienced at least one period of negative symptoms exacerbation. Furthermore, entry level of negative symptoms was significantly associated with poor social functioning (r =−.34, p < .01) and work/school functioning (r =−.25, p < .05) at 12 months, and with negative symptoms at the 8-year follow-up (r =.29, p <.05). Discussion Early negative symptoms are fairly stable during the first outpatient year, are predictors of daily functioning at 12 months, and predict negative symptoms 8 years later. Despite the high levels of stability, negative symptoms did fluctuate in a subsample of patients. These findings suggest that negative symptoms may be an important early course target for intervention aimed at promoting recovery.

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“…Ironically, however, the at-risk/UHR concept has shown the nexus is finite yet fluid. Subthreshold or early symptoms of psychosis are often non-specific and do not necessarily lead to schizophrenia, with nearly half of patients with FEP failing to meet diagnostic criteria for schizophrenia or schizophreniform disorder 9. The potential to progress to a full range of psychotic disorders, including psychotic mood disorder, has long been recognised by the UHR approach, with its target being psychosis and not merely schizophrenia.…”

Section: Challenges and Confusions: Uhr And Need For Carementioning

confidence: 99%

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

McGorry

Mei

2018

Evid Based Mental Health

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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.

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Early Psychosis Prevention and Intervention Centre long‐term follow‐up study of first‐episode psychosis: methodology and baseline characteristics

Abstract: Aim: This paper reports the rationale, methodology and baseline characteristics of a large long-term follow-up study of first-episode psychosis from a geographically defined catchment area.

Cited by 41 publications

References 68 publications

Sexual Trauma Increases the Risk of Developing Psychosis in an Ultra High-Risk “Prodromal” Population

Sexual Trauma Increases the Risk of Developing Psychosis in an Ultra High-Risk “Prodromal” Population

Negative symptoms and functioning during the first year after a recent onset of schizophrenia and 8years later

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

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