Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States

Yung, Alison R.; Yuen, Hok Pan; McGorry, Patrick D.; Phillips, Lisa; Kelly, Daniel P.; Dell'Olio, Margaret; Francey, Shona; Cosgrave, Elizabeth; Killackey, Eóin; Stanford, Carrie; Godfrey, Katherine; Buckby, Joe

doi:10.1111/j.1440-1614.2005.01714.x

Cited by 549 publications

(621 citation statements)

References 16 publications

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“…Patients' inclusion criteria were age between 14 and 40 years old and IQ ≥ 75. ARMS criteria were established by the Comprehensive Assessment of At‐Risk Mental States (CAARMS; 37) and/or the Schizophrenia Proneness Instrument‐Adult version (SPI‐A; 38). FEP patients met DSM‐IV‐TR criteria for any psychotic disorder or affective disorder with psychotic symptoms as established by the Structured Clinical Interview for DSM‐IV (SCID‐I; 39).…”

Section: Methodsmentioning

confidence: 99%

The role of stress‐regulation genes in moderating the association of stress and daily‐life psychotic experiences

Cristóbal-Narváez

Sheinbaum

Myin-Germeys

et al. 2017

Acta Psychiatr Scand

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ObjectiveThe interaction of single nucleotide polymorphisms with both distal and proximal environmental factors across the extended psychosis phenotype is understudied. This study examined (i) the interaction of relevant SNPs with both early‐life adversity and proximal (momentary) stress on psychotic experiences (PEs) in an extended psychosis sample; and (ii) differences between early‐psychosis and non‐clinical groups for these interactions.MethodsTwo hundred and forty‐two non‐clinical and 96 early‐psychosis participants were prompted randomly eight times daily for 1 week to complete assessments of current experiences, including PEs and stress. Participants also reported on childhood trauma and were genotyped for 10 SNPs on COMT, RGS4, BDNF, FKBP5, and OXTR genes.ResultsUnlike genetic variants, distal and proximal stressors were associated with PEs in both samples and were more strongly associated with PEs in the early‐psychosis than in the non‐clinical group. The RGS4 TA and FKBP5 CATT haplotypes interacted with distal stress, whereas the A allele of OXTR (rs2254298) interacted with proximal stress, increasing momentary levels of PEs in the early‐psychosis group. No interactions emerged with COMT or BDNF variants.ConclusionIndividual differences in relevant stress‐regulation systems interact with both distal and proximal psychosocial stressors in shaping the daily‐life manifestation of PEs across the psychosis continuum.

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Section: Methodsmentioning

confidence: 99%

The role of stress‐regulation genes in moderating the association of stress and daily‐life psychotic experiences

Cristóbal-Narváez

Sheinbaum

Myin-Germeys

et al. 2017

Acta Psychiatr Scand

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“…Future studies should focus on subclinical psychotic symptoms in at-risk groups and HCs to cover the full range of the psychosis spectrum using other rating scales such as the Comprehensive Assessment of At-Risk Mental States (CAARMS) or the Structured Interview for Prodromal Syndromes (SIPS). 64,65 In addition, the relationship between salience, value and reward prediction signals is still a matter of intense debate. 3,53,66 However, our task design focused only on reward anticipation.…”

Section: Discussionmentioning

confidence: 99%

Ventral Striatal Dysfunction and Symptom Expression in Individuals With Schizotypal Personality Traits and Early Psychosis

Kirschner

Hager

Muff

et al. 2016

SCHBUL

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Striatal abnormalities play a crucial role in the pathophysiology of schizophrenia. Growing evidence suggests an association between aberrant striatal activity during reward anticipation and symptom dimensions in schizophrenia. However, it is not clear whether this holds across the psychosis continuum. The aim of the present study was to investigate alterations of ventral striatal activation during reward anticipation and its relationship to symptom expression in persons with schizotypal personality traits (SPT) and first-episode psychosis. Twenty-six individuals with high SPT, 26 patients with non-affective first-episode psychosis (including 13 with brief psychotic disorder (FEP-BPD) and 13 with first-episode schizophrenia [FEP-SZ]) and 25 healthy controls underwent event-related functional magnetic resonance imaging while performing a variant of the Monetary Incentive Delay task. Ventral striatal activation was positively correlated with total symptom severity, in particular with levels of positive symptoms. This association was observed across the psychosis continuum and within each subgroup. Patients with FEP-SZ showed the strongest elevation of striatal activation during reward anticipation, although symptom levels did not differ between groups in the psychosis continuum. While our results provide evidence that variance in striatal activation is mainly explained by dimensional symptom expression, patients with schizophrenia show an additional dysregulation of striatal activation. Trans-diagnostic approaches are promising in order to disentangle dimensional and categorical neural mechanisms in the psychosis continuum.

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“…With the BSIP, a rating of the at-risk mental state as well as the transition criteria can be done, according to Yung et al [36]. The BSIP was developed based on these criteria around the same time as the Comprehensive Assessment of At-Risk Mental States (CAARMS) [41], using the same criteria, there is one difference in that a low-risk category with unspecific prodromal signs is also included.…”

Section: Setting and Recruitmentmentioning

confidence: 99%

Help-seeking and pathways to care in the early stages of psychosis

Fridgen

Aston

Gschwandtner

et al. 2012

Soc Psychiatry Psychiatr Epidemiol

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Purpose Delay in the treatment of a first psychotic episode can have a negative influence on the future course of the disease. In this context, it is important to examine pathways to care to understand factors contributing to delay in access to adequate care. Methods Using the Basel Interview for Psychosis, we examined the help-seeking behaviour of 61 individuals with an at-risk mental state for psychosis and 37 patients with a first episode of psychosis in a low threshold health care system as part of the Basel early detection of psychosis study. Results The median duration of untreated illness was 3.4 years, of untreated psychosis 12 months. Eighty-six percent of all individuals sought help of some kind before reaching our specialised early detection outpatient clinic, with a mean number of help-seeking contacts of 1.5 prior to referral. The most frequent first help-seeking contacts were family members or relatives n = 24 (26.7 %), close friends n = 17 (17.9 %), psychiatrists in private practice n = 13 (14.4 %) or general practitioners n = 11 (12.2 %). Most patients consulted other health professionals in the early course of the illness before reaching our specialised service; help-seeking with non-medical institutions was rare. Women had more help-seeking contacts than men before contact with our early detection clinic. Conclusions Family, close friends and medical professionals play an important role in help-seeking leading to specialised psychiatric care. Men seek help less often; specific strategies for encouraging young, at-risk men to seek help should be developed.

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Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States

Cited by 549 publications

References 16 publications

The role of stress‐regulation genes in moderating the association of stress and daily‐life psychotic experiences

The role of stress‐regulation genes in moderating the association of stress and daily‐life psychotic experiences

Ventral Striatal Dysfunction and Symptom Expression in Individuals With Schizotypal Personality Traits and Early Psychosis

Help-seeking and pathways to care in the early stages of psychosis

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