Prevalence of At-risk Criteria of Psychosis in Children and Adolescents, and in Young Adults: Results From Two Swiss Community Samples

Abstract

The prevalence and significance of APS and other risk symptoms in the general population, when assessed in the same way as in help-seeking persons, is still rather unclear. In two complimentary studies, we studied the prevalence of ultra-high risk and basic symptom criteria and symptoms assessed with the ‘Structured Interview for Psychosis-Risk Syndromes’ (SIPS) and the ‘Schizophrenia Proneness Instrument, Adult / Child and Youth version’ (SPI-A/SPI-CY) by trained psychologists in random community samples of age 8-17 and 16-40 years. At the time of writing, 1229 interviews with young adults and 55 with children/adolescents were completed. While only 2.8% of the young adults acknowledged the presence of any risk criterion, 9.1% of the children/adolescents did so. An even more pronounced age-related difference was found in the prevalence of lifetime risk phenomena: 25.2% of the young adults and 45.5% of the children/adolescents reported at least any one. Thereby, 'perceptual abnormalities/hallucinations” of the SIPS, mainly on APS level, were most frequent in both samples. While risk phenomena occurred, at least temporarily, in a quarter of young adults and even in nearly half of the children and adolescents, only a minority fulfilled the frequency and onset requirements of SIPS and SPI-A/SPI-CY – again with higher rates in children and adolescents. This highlights the importance of these additional requirements of the risk criteria, but also the need to further examine developmental peculiarities. These factors might play a crucial role in the differentiation between ill and non-ill persons and thus should be studied in more detail.

EPA guidance on the early detection of clinical high risk states of psychoses

“…This is supported by first reports on conversion rates in adolescent risk samples between age 12 and 18 [122,135], indicating that lag time to conversion might be longer and, consequently, conversion rates in the first years following initial risk assessment might be lower. Furthermore, recent studies reported high prevalence rates of (attenuated) psychotic symptoms [111], in particular of hallucinations, in children and young adolescents, which seem to decrease with age [43,44] and to remit spontaneously in about three quarters [7]. Thus, it was recently argued that the validity of current risk criteria needs to be examined in and possibly adapted to children and adolescents [23,95,99,107].…”

Clinical utility of the at-risk for psychosis state beyond transition: A multidimensional network analysis

“…First, the CHR-P individuals were younger (mean age = 14.32 years) compared to the CHR-P populations enrolled in most studies (mean age = 20.6 years [65]). Some scholars have questioned the predictive value of CHR-P criteria in younger populations [66,67]. While this is not necessarily a study limitation, it highlights the need for further research into the unique developmental characteristics of younger CHR-P individuals.…”