scholarly journals Early Detection of Psychosis: Recent Updates from Clinical High-Risk Research

2015 ◽  
Vol 2 (2) ◽  
pp. 90-101 ◽  
Author(s):  
Ariel Schvarcz ◽  
Carrie E. Bearden
2020 ◽  
Vol 25 (11) ◽  
pp. 2773-2785 ◽  
Author(s):  
Christina Andreou ◽  
Stefan Borgwardt

Abstract The introduction of clinical criteria for the operationalization of psychosis high risk provided a basis for early detection and treatment of vulnerable individuals. However, about two-thirds of people meeting clinical high-risk (CHR) criteria will never develop a psychotic disorder. In the effort to increase prognostic precision, structural and functional neuroimaging have received growing attention as a potentially useful resource in the prediction of psychotic transition in CHR patients. The present review summarizes current research on neuroimaging biomarkers in the CHR state, with a particular focus on their prognostic utility and limitations. Large, multimodal/multicenter studies are warranted to address issues important for clinical applicability such as generalizability and replicability, standardization of clinical definitions and neuroimaging methods, and consideration of contextual factors (e.g., age, comorbidity).


2019 ◽  
Vol 7 (6) ◽  
pp. 1171-1189 ◽  
Author(s):  
Zachary B. Millman ◽  
James M. Gold ◽  
Vijay A. Mittal ◽  
Jason Schiffman

Despite rapidly growing knowledge of the clinical high-risk (CHR) state for psychosis, the vast majority of case-control studies have relied on healthy volunteers as a reference point for drawing inferences about the CHR construct. Researchers have long recognized that results generated from this design are limited by significant interpretive concerns, yet little attention has been given to how these concerns affect the growing field of CHR research. We argue that overreliance on healthy control participants in CHR research threatens the validity of inferences concerning group differences, hinders advances in understanding the development of psychosis, and limits clinical progress. We suggest that the combined use of healthy and help-seeking (i.e., psychiatric) controls is a necessary step for the next generation of CHR research. We then evaluate methods for help-seeking control studies, identify the available CHR studies that have used such designs, discuss select findings in this literature, and offer recommendations for research.


2019 ◽  
Vol 151 ◽  
pp. 109450
Author(s):  
Steffen Moritz ◽  
Burghard Andresen ◽  
Mary Sengutta

2008 ◽  
Vol 2 (3) ◽  
pp. 147-153 ◽  
Author(s):  
Jean Addington ◽  
Irvin Epstein ◽  
Andrea Reynolds ◽  
Ivana Furimsky ◽  
Laura Rudy ◽  
...  

2015 ◽  
Vol 30 (3) ◽  
pp. 405-416 ◽  
Author(s):  
F. Schultze-Lutter ◽  
C. Michel ◽  
S.J. Schmidt ◽  
B.G. Schimmelmann ◽  
N.P. Maric ◽  
...  

AbstractThe aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rates to psychosis in non-overlapping samples meeting any at least any one of the main CHR criteria: ultra-high risk (UHR) and/or basic symptoms criteria. Further, effects of potential moderators (different UHR criteria definitions, single UHR criteria and age) on conversion rates were examined. Conversion rates in the identified 42 samples with altogether more than 4000 CHR patients who had mainly been identified by UHR criteria and/or the basic symptom criterion ‘cognitive disturbances’ (COGDIS) showed considerable heterogeneity. While UHR criteria and COGDIS were related to similar conversion rates until 2-year follow-up, conversion rates of COGDIS were significantly higher thereafter. Differences in onset and frequency requirements of symptomatic UHR criteria or in their different consideration of functional decline, substance use and co-morbidity did not seem to impact on conversion rates. The ‘genetic risk and functional decline’ UHR criterion was rarely met and only showed an insignificant pooled sample effect. However, age significantly affected UHR conversion rates with lower rates in children and adolescents. Although more research into potential sources of heterogeneity in conversion rates is needed to facilitate improvement of CHR criteria, six evidence-based recommendations for an early detection of psychosis were developed as a basis for the EPA guidance on early intervention in CHR states.


Endoscopy ◽  
2006 ◽  
Vol 38 (11) ◽  
Author(s):  
A Qasim ◽  
T Tajjudin ◽  
B Zaman ◽  
D Maguire ◽  
J Geoghegan ◽  
...  

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