The Course of Risk Symptoms for Psychosis in the General Population: 2.5-year Follow-up of the Bern Epidemiological At-risk (Bear) Study

Abstract

Introduction: In clinical samples of specialized early detection services, ultra-high risk and basic symptom criteria are associated with a 2-year conversion rate of roughly 30%. Objectives/Aim: Their prevalence and course outside help-seeking samples is largely unknown and is therefore studied in the BEAR study. Methods/Results: At baseline, 25% of the young adults from the community (16-40 years) acknowledged the presence of any lifetime risk symptom, but only 3% met any risk criterion. After 2.5 years, those with any lifetime risk symptoms (RISK) and a control group (CONTROL) are re-interviewed. At the time of writing, 87 follow-ups were conducted: in 48 RISK (30% male, baseline age: 36±4 years) and in 39 CONTROL (46% male, baseline age: 36±2 years). Two RISK (4%), but no CONTROL reported the meanwhile development of first-episode psychosis. RISK were significantly more likely than CONTROL to report presence of any risk symptom within the follow-up period (41% vs. 5%). Thus, the relative risk to still report risk symptoms when these had already been reported before was 8.05 (95% CI: 2.0; 32.4). Altogether 18% met criteria for a non-psychotic current or within-follow-up axis-I disorder whose presence was unrelated to presence of atrisk phenomena at first or second interview (13% in both RISK and CONTROL). Conclusions: This indicates that risk symptoms might frequently be not just fleeting experiences but tend to persist. Thereby, they do not seem to increase the likelihood of developing any mental disorder but-should the result holdmight predispose to the development of psychotic symptoms.

Coping with Unusual ExperienceS for 12–18 year olds (CUES+): a transdiagnostic randomised controlled trial of the effectiveness of cognitive therapy in reducing distress associated with unusual experiences in adolescent mental health services: study protocol for a randomised controlled trial

“…Severity, distress and less effective coping skills predict a persisting trajectory [ 17 ]. UEDs have been associated with a range of poor mental health outcomes and intervention is indicated to reduce current distress and disability, with the potential to additionally increase resilience and reduce future mental health risk [ 12 , 13 , 18 , 19 ]. However, for younger adolescents (aged under 14 years), recent guidance suggests that the lack of specificity of UEDs as a risk factor for psychosis contraindicates explicitly preventative interventions [ 20 , 21 ].…”