Prognosis of Brief Psychotic Episodes

Fusar‐Poli, Paolo; Cappucciati, Marco; Bonoldi, Ilaria; Hui, Christy Lai Ming; Rutigliano, Grazia; Ståhl, Daniel; Borgwardt, Stefan; Politi, Pierluigi; Mishara, Aaron L.; Lawrie, Stephen M.; Carpenter, William T.; McGuire, Philip

doi:10.1001/jamapsychiatry.2015.2313

Cited by 146 publications

(149 citation statements)

References 63 publications

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“…Firstly, this state is the closest antecedent of psychosis by definition, with onset of the disorder occurring from within a few months of ultra-high-risk diagnosis 110 . Indeed, some ultra-highrisk individuals already present with severe symptoms, including short-lived psychotic episodes 111,112 , affective symptoms 113 and impaired functioning 114 . Secondly, the ultra-high-risk state is intrinsically heterogeneous 10,115 , including different subgroups 115 and varying diagnostic operationalizations 116 .…”

Section: Discussionmentioning

confidence: 99%

What causes psychosis? An umbrella review of risk and protective factors

et al. 2018

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Psychosis is a heterogeneous psychiatric condition for which a multitude of risk and protective factors have been suggested. This umbrella review aimed to classify the strength of evidence for the associations between each factor and psychotic disorders whilst controlling for several biases. The Web of Knowledge database was searched to identify systematic reviews and meta-analyses of observational studies which examined associations between socio-demographic, parental, perinatal, later factors or antecedents and psychotic disorders, and which included a comparison group of healthy controls, published from 1965 to January 31, 2017. The literature search and data extraction followed PRISMA and MOOSE guidelines. The association between each factor and ICD or DSM diagnoses of non-organic psychotic disorders was graded into convincing, highly suggestive, suggestive, weak, or non-significant according to a standardized classification based on: number of psychotic cases, random-effects p value, largest study 95% confidence interval, heterogeneity between studies, 95% prediction interval, small study effect, and excess significance bias. In order to assess evidence for temporality of association, we also conducted sensitivity analyses restricted to data from prospective studies. Fifty-five meta-analyses or systematic reviews were included in the umbrella review, corresponding to 683 individual studies and 170 putative risk or protective factors for psychotic disorders. Only the ultra-high-risk state for psychosis (odds ratio, OR59.32, 95% CI: 4.91-17.72) and Black-Caribbean ethnicity in England (OR54.87, 95% CI: 3.96-6.00) showed convincing evidence of association. Six factors were highly suggestive (ethnic minority in low ethnic density area, second generation immigrants, trait anhedonia, premorbid IQ, minor physical anomalies, and olfactory identification ability), and nine were suggestive (urbanicity, ethnic minority in high ethnic density area, first generation immigrants, North-African immigrants in Europe, winter/spring season of birth in Northern hemisphere, childhood social withdrawal, childhood trauma, Toxoplasma gondii IgG, and non-right handedness). When only prospective studies were considered, the evidence was convincing for ultra-high-risk state and suggestive for urbanicity only. In summary, this umbrella review found several factors to be associated with psychotic disorders with different levels of evidence. These risk or protective factors represent a starting point for further etiopathological research and for the improvement of the prediction of psychosis.

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Section: Discussionmentioning

confidence: 99%

What causes psychosis? An umbrella review of risk and protective factors

et al. 2018

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“…23 At 5-year, about half of them developed psychosis, 23 in line with the meta-analytical prognostic outcomes observed in these groups. 25 The study further elucidated the course of the BLIPS, with recurrent episodes in 11% of cases. Recurrent episodes were associated with an increased risk of psychosis (hazard ratio [HR] 3.98).…”

Section: Contributions Of This Special Issuementioning

confidence: 98%

The Clinical High-Risk State for Psychosis (CHR-P), Version II

Fusar‐Poli

2017

SCHBUL

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The Clinical High-Risk state for psychosis (CHR-P) paradigm was introduced about 2 decades ago. Over this period of time accumulating knowledge has been gained. Conceptual advancements involve new knowledge into risk enrichment and the impact of recruitment strategies, specificity for prediction of psychotic and nonpsychotic mental disorders and heterogeneity of psychosis risk among the different CHR-P subgroups. The current special issue advances current knowledge on deconstructing the CHR-P paradigm across its 3 subgroups: genetic risk, attenuated psychotic symptoms, and short-lived and remitting psychotic episodes. A conceptual revision of the paradigm (Version II) is suggested and supported by 3 original studies published in this special issue.

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“…Each episode was precipitated by an erotomanic delusion or delusions of persecution in the workplace that followed shortly after the psychiatrist decided to taper her antipsychotic medications. [20][21][22] .…”

Section: Powell 1998mentioning

confidence: 99%

“…Psychosis can resolve without treatment in some of these patients 21,25 . Longitudinal studies conducted before the advent of neuroleptics remind us that these numbers are large enough to not be dismissed 26 .…”

Section: Powell 1998mentioning

confidence: 99%

Inefficient Neural Self-Stabilization: A theory of spontaneous resolutions and recurrent relapses in psychosis

Palaniyappan

2018

Preprint

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Prognosis of Brief Psychotic Episodes

Cited by 146 publications

References 63 publications

What causes psychosis? An umbrella review of risk and protective factors

What causes psychosis? An umbrella review of risk and protective factors

The Clinical High-Risk State for Psychosis (CHR-P), Version II

Inefficient Neural Self-Stabilization: A theory of spontaneous resolutions and recurrent relapses in psychosis

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