Family Perception and 6-Month Symptomatic and Functioning Outcomes in Young Adolescents at Clinical High Risk for Psychosis in a General Population in China

Abstract

Background and AimsGiven the difficulty of treating schizophrenia and other forms of psychosis, researchers have shifted focus to early detection and intervention of individuals at clinical high risk (CHR) for psychosis. Previous studies have shown that elements in family functioning could predict symptom outcome in CHR individuals. However, associations between self reported family functioning and symptom or functioning outcome of CHR individuals was rarely reported. Our study aimed to investigate the characteristics and the role of family functioning in the development of CHR individuals among young adolescents.MethodsA sample of 32 CHR individuals was recruited from 2800 university students. The characteristics of family perception were evaluated by both Family Assessment Device (FAD) and Family cohesion and adaptability evaluation Scale II (FACES II). 6 month follow up data was available with 25 of the recruited CHR individuals. Baseline socio-demographic characteristics and family functioning were compared between CHR and control group. We also measured the associations between different dimensions of perceived family functioning and both severity of prodromal symptoms and global functioning at baseline and 6-month follow up.ResultsCHR individuals showed more maladaptive family functioning compared to control in nearly all of the dimensions of FAD and FACES II except for Affective Involvement. Better Problem Solving and Affective Responsiveness predicted less severe positive and negative symptoms respectively. Family cohesion and adaptability were not only correlated with the baseline severity of general symptoms, but also positively associated with the general and disorganized symptom outcome.ConclusionsThis study contributed preliminary evidence towards the associations between family perception and symptom outcome of CHR individuals. It also provided evidence for the importance of family interventions on CHR individuals.

Screening of the College Students at Clinical High Risk for Psychosis in China: A Multicenter Epidemiological Study

“…Therefore, the sample in the present study was representative for Chinese college students. Although the detection rate reported in our study was lower than 1.1% reported in a single-centered study conducted in Chinese college students [38], but was generally in line with other studies of this kind mentioned above.…”

“…Detection of CHR samples in both the clinical [10,[33][34][35][36] and non-clinical settings [31,37,38] had caught great attention across the world, while the detection rate of CHR subjects in those studies varied greatly. Previous studies reported that the prevalence of CHR in the clinician-referred samples was 32-42% [33][34][35], which were roughly consistent with each other.…”

“…While the detection rate in samples of help-seeking individuals ranged from 4.2-80%, which differed from site to site [10,[39][40][41]. As for the general population (primarily focused on young adults and adolescences), the annual incidence of new cases of CHR was estimated to be 1/10 000 [33], and the prevalence was reported to range from 0.3-2.4% [31,37,38]. The diagnostic instruments were considered to be a great factor contributing to the inconsistency of the detection rate.…”

Screening of the College Students at Clinical High Risk for Psychosis in China: A Multicenter Epidemiological Study

“…While the detection rate in samples of help-seeking individuals ranged from 4.2% to 80%, which differed from site to site [10,[39][40][41]. As for the general population (primarily focused on young adults and adolescences), the annual incidence of new cases of CHR was estimated to be 1/10 000 [33], and the prevalence was reported to range from 0.3% to 2.4% [31,37,38]. The diagnostic instruments were considered to be a great factor contributing to the inconsistency of the detection rate.…”

Psychosis risk screening in different populations using the Prodromal Questionnaire: A systematic review

“…However, in our review of the broader screening literature, symptom thresholds that have been validated in more enriched samples are commonly being adopted in less UHR-prevalent populations. In a non-help-seeking population, for example, a distress score of ≥9 may be the most appropriate for the PQ-16, a figure higher than the ≥6 used in all 3 identified studies conducted in this population (Chen et al, 2013;Suna, Wang, Shi, & Zhao, 2015;Wang et al, 2015). Adopting thresholds appropriate for more enriched populations may increase false positives, reducing screening efficiency.…”