Impairment in Social Functioning differentiates youth meeting Ultra-High Risk for psychosis criteria from other mental health help-seekers: A validation of the Italian version of the Global Functioning: Social and Global Functioning: Role scales

Cascio, Nella Lo; Curto, Martina; Pasqualetti, Patrizio; Lindau, Juliana Fortes; Girardi, Nicoletta; Saba, Riccardo; Brandizzi, Martina; Monducci, Elena; Masillo, Alice; Colafrancesco, Giada; Solfanelli, Andrea; Crescenzo, Franco De; Kotzalidis, Georgios D.; Cotesta, Dario; Ferrara, Mauro; Vicari, Stefano; Girardi, Paolo; Auther, Andrea M.; Cornblatt, Barbara A.; Correll, Christoph U.; Nastro, Paolo Fiori

doi:10.1016/j.psychres.2017.04.008

Cited by 14 publications

(12 citation statements)

References 36 publications

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“…Nevertheless, our results support previous evidence that APS status is associated with marked functional impairment (21,81,82). This finding is particularly relevant because functional impairment can be helpful to differentiate youth meeting CHR-P from other help-seeking individuals (83).…”

Section: Discussionsupporting

confidence: 90%

DSM-5 Attenuated Psychosis Syndrome in Adolescents Hospitalized With Non-psychotic Psychiatric Disorders

et al. 2020

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Introduction: Although attenuated psychotic symptoms often occur for the first time during adolescence, studies focusing on adolescents are scarce. Attenuated psychotic symptoms form the criteria to identify individuals at increased clinical risk of developing psychosis. The study of individuals with these symptoms has led to the release of the DSM-5 diagnosis of Attenuated Psychosis Syndrome (APS) as a condition for further research. We aimed to characterize and compare hospitalized adolescents with DSM-5-APS diagnosis vs. hospitalized adolescents without a DSM-5-APS diagnosis. Methods: Interviewing help-seeking, hospitalized adolescents (aged 12-18 years) and their caregivers independently with established research instruments, we (1) evaluated the presence of APS among non-psychotic adolescents, (2) characterized and compared APS and non-APS individuals regarding sociodemographic, illness and intervention characteristics, (3) correlated psychopathology with levels of functioning and severity of illness and (4) investigated the influence of individual clinical, functional and comorbidity variables on the likelihood of participants to be diagnosed with APS. Results: Among 248 consecutively recruited adolescents (age=15.4 ± 1.5 years, females = 69.6%) with non-psychotic psychiatric disorders, 65 (26.2%) fulfilled APS criteria and 183 (73.8%) did not fulfill them. Adolescents with APS had higher number Salazar de Pablo et al. DSM-5 Attenuated Psychosis Syndrome in Adolescents of psychiatric disorders than non-APS adolescents (3.5 vs. 2.4, p < 0.001; Cohen's d = 0.77), particularly, disruptive behavior disorders (Cramer's V = 0.16), personality disorder traits (Cramer's V = 0.26), anxiety disorders (Cramer's V = 0.15), and eating disorders (Cramer's V = 0.16). Adolescents with APS scored higher on positive (Cohen's d = 1.5), negative (Cohen's d = 0.55), disorganized (Cohen's d = 0.51), and general symptoms (Cohen's d = 0.84), and were more severely ill (Cohen's d = 1.0) and functionally impaired (Cohen's d = 0.31). Negative symptoms were associated with lower functional levels (Pearson ρ = −0.17 to −0.20; p = 0.014 to 0.031). Global illness severity was associated with higher positive, negative, and general symptoms (Pearson ρ = 0.22 to 0.46; p = 0.04 to p < 0.001). APS status was independently associated with perceptual abnormalities (OR = 2.0; 95% CI = 1.6-2.5, p < 0.001), number of psychiatric diagnoses (OR = 1.5; 95% CI = 1.2-2.0, p = 0.002), and impaired stress tolerance (OR = 1.4; 95% CI = 1.1-1.7, p = 0.002) (r 2 = 0.315, p < 0.001). Conclusions: A considerable number of adolescents hospitalized with non-psychotic psychiatric disorders meet DSM-5-APS criteria. These help-seeking adolescents have more comorbid disorders and more severe symptoms, functional impairment, and severity of illness than non-APS adolescents. Thus, they warrant high intensity clinical care.

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Section: Discussionsupporting

confidence: 90%

DSM-5 Attenuated Psychosis Syndrome in Adolescents Hospitalized With Non-psychotic Psychiatric Disorders

et al. 2020

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“…Altogether, 72 studies employed the SIPS/SOPS, 19 the CAARMS, 6 the BSABS, 3 the SPI‐CY and 4 the PANSS (10 studies used more than one instrument). The proportion of individuals meeting CHR‐P criteria was 16%–36% in mental health settings (Koren et al, 2019, Lo Cascio et al, 2017), including 23.6% in adolescent inpatient settings (Gerstenberg et al, 2015) and 13% in nonhelp‐seeking adolescents with disruptive behaviours (Manninen et al, 2014). From a psychometric perspective, four studies focused on the validation of CHR‐P assessment scales in adolescents across different languages (Fux, Walger, Schimmelmann, & Schultze‐Lutter, 2013; Kline et al, 2012; Pelizza, Azzali, et al, 2019; Thompson, Kline, Reeves, Pitts, & Schiffman, 2013).…”

Section: Resultsmentioning

confidence: 99%

Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Catalán

Pablo

Serrano

et al. 2020

Child Psychology Psychiatry

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Background: The clinical high-risk state for psychosis (CHR-P) paradigm has facilitated the implementation of psychosis prevention into clinical practice; however, advancements in adolescent CHR-P populations are less established. Methods: We performed a PRISMA/MOOSE-compliant systematic review of the Web of Science database, from inception until 7 October 2019, to identify original studies conducted in CHR-P children and adolescents (mean age <18 years). Findings were systematically appraised around core themes: detection, prognosis and intervention. We performed meta-analyses (employing Q statistics and I 2 test) regarding the proportion of CHR-P subgroups, the prevalence of baseline comorbid mental disorders, the risk of psychosis onset and the type of interventions received at baseline. Quality assessment and publication bias were also analysed. Results: Eighty-seven articles were included (n = 4,667 CHR-P individuals). Quality of studies ranged from 3.5 to 8 (median 5.5) on a modified Newcastle-Ottawa scale. Detection: Individuals were aged 15.6 AE 1.2 years (51.5% males), mostly (83%) presenting with attenuated positive psychotic symptoms. CHR-P psychometric accuracy improved when caregivers served as additional informants. Comorbid mood (46.4%) and anxiety (31.4%) disorders were highly prevalent. Functioning and cognition were impaired. Neurobiological studies were inconclusive. Prognosis: Risk for psychosis was 10.4% (95%CI: 5.8%-18.1%) at 6 months, 20% (95% CI: 15%-26%) at 12 months, 23% (95%CI: 18%-29%) at 24 months and 23.3% (95%CI: 17.3%-30.7%) at ≥36 months. Interventions: There was not enough evidence to recommend one specific treatment (including cognitive behavioural therapy) over the others (including control conditions) to prevent the transition to psychosis in this population. Randomised controlled trials suggested that family interventions, cognitive remediation and fish oil supplementation may improve cognition, symptoms and functioning. At baseline, 30% of CHR-P adolescents were prescribed antipsychotics and 60% received psychotherapy. Conclusions: It is possible to detect and formulate a group-level prognosis in adolescents at risk for psychosis. Future interventional research is required.

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“…While about 200-fold higher than the 2year risk of about 0.1% in adolescents and young adults, this level of prediction accuracy is still not optimal for the development and implementation of preventive interventions. Psychosis risk prediction improves when factors such as neurocognitive function (10)(11)(12), language patterns (13,14), decline in social functioning (11,12,15), severity of specific symptoms (11,(16)(17)(18)(19), stressful events, and trauma history (11,20) are considered. In previous work, we developed a psychosis risk prediction model that included such clinical and historical variables.…”

Section: Discussionmentioning

confidence: 99%

Polygenic Risk Score Contribution to Psychosis Prediction in a Target Population of Persons at Clinical High Risk

Perkins

Loohuis

Barbee

et al. 2020

AJP

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Objective: The 2-year risk of psychosis in persons who meet research criteria for a high-risk syndrome is about 15%-25%; improvements in risk prediction accuracy would benefit the development and implementation of preventive interventions. The authors sought to assess polygenic risk score (PRS) prediction of subsequent psychosis in persons at high risk and to determine the impact of adding the PRS to a previously validated psychosis risk calculator. Methods: Persons meeting research criteria for psychosis high risk (N=764) and unaffected individuals (N=279) were followed for up to 2 years. The PRS was based on the latest schizophrenia and bipolar genome-wide association studies. Variables in the psychosis risk calculator included stressful life events, trauma, disordered thought content, verbal learning, information processing speed, and family history of psychosis.

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Impairment in Social Functioning differentiates youth meeting Ultra-High Risk for psychosis criteria from other mental health help-seekers: A validation of the Italian version of the Global Functioning: Social and Global Functioning: Role scales

Cited by 14 publications

References 36 publications

DSM-5 Attenuated Psychosis Syndrome in Adolescents Hospitalized With Non-psychotic Psychiatric Disorders

DSM-5 Attenuated Psychosis Syndrome in Adolescents Hospitalized With Non-psychotic Psychiatric Disorders

Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Polygenic Risk Score Contribution to Psychosis Prediction in a Target Population of Persons at Clinical High Risk

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