Basic symptoms and psychotic symptoms: Their relationships in the at risk mental states, first episode and multi-episode schizophrenia

2014 ◽  
Vol 55 (4) ◽  
pp. 785-791 ◽  
Author(s):  
Anna Comparelli ◽  
Antonella De Carolis ◽  
Emanuele Emili ◽  
Silvia Rigucci ◽  
Ilaria Falcone ◽  
...  
Keyword(s):  
At Risk ◽  
Mental States ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Basic Symptoms ◽  
At Risk Mental States

Increased serum interleukin-6 levels in early stages of psychosis: Associations with at-risk mental states and the severity of psychotic symptoms

2014 ◽  
Vol 41 ◽  
pp. 23-32 ◽  
Author(s):  
Alexander Stojanovic ◽  
Lourdes Martorell ◽  
Itziar Montalvo ◽  
Laura Ortega ◽  
Rosa Monseny ◽  
...  
Keyword(s):  
At Risk ◽  
Interleukin 6 ◽  
Mental States ◽  
Psychotic Symptoms ◽  
Early Stages ◽  
At Risk Mental States

scholarly journals Identification of young people at risk of psychosis

2006 ◽  
Vol 12 (4) ◽  
pp. 249-255 ◽  
Author(s):  
Sophie Parker ◽  
Shôn Lewis
Keyword(s):  
At Risk ◽  
Mental States ◽  
Psychotic Symptoms ◽  
Significant Efficacy ◽  
Mental Health Settings ◽  
Seeking Help ◽  
Operational Criteria ◽  
Threshold Criteria ◽  
At Risk Mental States

Operational criteria for detecting prodromal, or at-risk, mental states have been developed largely on the basis of individuals seeking help for attenuated or brief, self-limiting symptoms that do not meet threshold criteria for psychotic disorder. These individuals present largely to primary care and other non-specialist mental health settings. Follow-up studies have confirmed that 15–40% will make the transition to full psychosis within 12 months. Cognitive therapy alone or in combination with low-dose atypical antipsychotics has been shown to be efficacious in reducing or delaying the transition to psychosis, as well as in ameliorating the severity of non-psychotic symptoms and distress. Antipsychotic medication alone has not shown significant efficacy, but results are suggestive of some advantage from drug treatment. Further work is needed to clarify the relative merits of these interventions.

scholarly journals Meta-analytical prognostic accuracy of the Comprehensive Assessment of at Risk Mental States (CAARMS): The need for refined prediction

2018 ◽  
Vol 49 ◽  
pp. 62-68 ◽  
Author(s):  
D. Oliver ◽  
M. Kotlicka-Antczak ◽  
A. Minichino ◽  
G. Spada ◽  
P. McGuire ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Meta Analysis ◽  
Mental States ◽  
Comprehensive Assessment ◽  
Sensitivity Analyses ◽  
First Episode ◽  
Index Test ◽  
Prognostic Accuracy ◽  
At Risk Mental States

AbstractPrimary indicated prevention is reliant on accurate tools to predict the onset of psychosis. The gold standard assessment for detecting individuals at clinical high risk (CHR-P) for psychosis in the UK and many other countries is the Comprehensive Assessment for At Risk Mental States (CAARMS). While the prognostic accuracy of CHR-P instruments has been assessed in general, this is the first study to specifically analyse that of the CAARMS. As such, the CAARMS was used as the index test, with the reference index being psychosis onset within 2 years. Six independent studies were analysed using MIDAS (STATA 14), with a total of 1876 help-seeking subjects referred to high risk services (CHR-P+: n = 892; CHR-P–: n = 984). Area under the curve (AUC), summary receiver operating characteristic curves (SROC), quality assessment, likelihood ratios, and probability modified plots were computed, along with sensitivity analyses and meta-regressions. The current meta-analysis confirmed that the 2-year prognostic accuracy of the CAARMS is only acceptable (AUC = 0.79 95% CI: 0.75–0.83) and not outstanding as previously reported. In particular, specificity was poor. Sensitivity of the CAARMS is inferior compared to the SIPS, while specificity is comparably low. However, due to the difficulties in performing these types of studies, power in this meta-analysis was low. These results indicate that refining and improving the prognostic accuracy of the CAARMS should be the mainstream area of research for the next era. Avenues of prediction improvement are critically discussed and presented to better benefit patients and improve outcomes of first episode psychosis.

Risk factors for transition to first episode psychosis among individuals with ‘at-risk mental states’

2004 ◽  
Vol 71 (2-3) ◽  
pp. 227-237 ◽  
Author(s):  
Oliver Mason ◽  
Mike Startup ◽  
Sean Halpin ◽  
Ulrich Schall ◽  
Agatha Conrad ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Mental States ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
At Risk Mental States

scholarly journals Clinical features of adolescents diagnosed with eating disorders and at risk for psychosis

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Martina Maria Mensi ◽  
Chiara Rogantini ◽  
Renata Nacinovich ◽  
Anna Riva ◽  
Livio Provenzi ◽  
...  
Keyword(s):  
At Risk ◽  
Eating Disorders ◽  
Social Functioning ◽  
Psychological Symptoms ◽  
Mental States ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Psychological Features ◽  
At Risk Mental States

Abstract Background. The presence of subthreshold psychotic symptoms in adolescents with eating disorders is poorly described. This study provides a detailed characterization of adolescents affected by eating disorders in the absence or presence of subthreshold psychotic symptoms, taking into account a wide set of sociodemographic, psychological, and clinical variables. Methods. Ninety-four adolescents diagnosed with eating disorders were interviewed, focusing on clinical anamnesis and sociodemographic data collection. The Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to assess the presence (HR+) or absence (HR−) of subthreshold psychosis. The clinicians completed a questionnaire on eating disorders severity, whereas patients provided self-report measures of global social functioning and psychological symptoms associated with eating disorders. Results. Attenuated psychotic symptoms were highly frequent (84% of subjects). HR+ patients experienced more frequently purging behaviors and dysmorphophobia and received a greater amount of antipsychotic drugs. Compared to HR− counterparts, HR+ patients reported higher eating disorders severity and psychological symptoms (i.e., ineffectiveness, interpersonal and affective problems) associated with eating disorders. Finally, a significant correlation between global social functioning and eating disorders severity emerged only for HR− subjects. Conclusions. These descriptive data are warranted to identify a potential psychotic core in eating disorders, mainly concerning body image and weight as well as specific psychological features. The availability of reliable and valid markers of risk can further increase our capacity to detect the early emergence of psychosis in adolescents with eating disorders, whose outcome might be worsened by the presence of psychotic symptoms.

scholarly journals Anxiety sensitivity dimensions in young individuals with at-risk-mental states

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Andrea Pozza ◽  
Anna Meneghelli ◽  
Maria Meliante ◽  
Luisa Amato ◽  
Davide Dèttore
Keyword(s):  
At Risk ◽  
Anxiety Sensitivity ◽  
Mental States ◽  
First Episode ◽  
Sensitivity Index ◽  
Significance Level ◽  
Social Concerns ◽  
Penn State ◽  
State Worry ◽  
At Risk Mental States

Anxiety Sensitivity (AS) is a transdiagnostic risk factor involved in the development and maintenance of different psychopathological conditions including anxiety disorders and psychosis. It consists of Physical Concerns (e.g., the belief that palpitations lead to a cardiac arrest), Social Concerns (the belief that observable anxiety reactions will elicit social rejection), and Cognitive Concerns (the belief that cognitive difficulties lead to mental incapacitation). No study investigated whether specific AS dimensions are related to At-Risk Mental States (ARMS). This study compared AS dimensions between young individuals with ARMS, patients after a recently occurred First-Episode Psychosis (FEP) and matched community controls. Based on models of ARMS and previous evidence, it was hypothesized that ARMS individuals have higher physical, social and cognitive concerns than FEP patients and controls. Thirty individuals with ARMS and 30 with FEP and 30 controls recruited from the general population completed the Anxiety Sensitivity Index-3 (ASI-3) and Penn State Worry Questionnaire. ARMS and FEP individuals had higher scores than controls on ASI-3 Cognitive Concerns [F(2,87)= 11.48, p<.001]. Individuals with ARMS had higher ASI-3 Physical Concerns scores than FEP patients [F(2,87)= 5.10, p<.01] and at a marginal significance level than controls. No between-group difference was found on Social Concerns. Higher ASI-3 Physical Concerns scores [B = -.324, Wald’s χ2(1) = 8.29, p < .01] and psychiatric comorbidities [B = -2.726, Wald’s χ2(1) = 9.33, p < .01] were significantly related to ARMS than FEP. Higher ASI-3 Social Concerns scores were related to FEP, despite at a marginal significance level [B =.213, Wald’s χ2(1) = 3.79, p = .052]. Interventions for AS Cognitive/Physical Concerns could be incorporated in the treatment of ARMS. A replication of the findings is required. Future longitudinal studies should examine whether Cognitive Concerns predict development of FEP in ARMS to improve early detection and prevention strategies.

scholarly journals A retrospective case-control service evaluation of CAARMS scores of patients with autism in York EIP, compared to age matched controls

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S59-S60
Author(s):  
Daniel Whitney ◽  
Stephen Wright
Keyword(s):  
At Risk ◽  
Statistical Significance ◽  
Mental States ◽  
Autism Spectrum ◽  
Mean Difference ◽  
Autism Spectrum Conditions ◽  
First Episode ◽  
Retrospective Case ◽  
Significant Difference ◽  
Early Intervention In Psychosis

AimsStudies show the prevalence of Autism Spectrum Conditions in Early Intervention in Psychosis (EIP) populations is 3.6-3.7%, compared to approximately 1-1.5% in the general population. The CAARMS (Comprehensive Assessment of At Risk Mental States) is a national tool used by EIP services as a screening tool to bring patients into services and stratify their symptoms to determine what pathway may be most appropriate (First Episode Psychosis pathway (FEP) or At Risk Mental State pathway (ARMS)). As far as we are aware the CAARMS has not been validated in an autistic population. It is our view that several of the questions in the CAARMS may be interpreted differently by people with autism, thus affecting the scores. The aim of this evaluation was to identify whether CAARMS scores differ between patients diagnosed with autism and matched controls in York EIP.MethodFrom their mental health records, we identified all patients in the service with a diagnosis of autism. We then compared the CAARMS scores, at the time of referral, to those of age matched controls (matched by being in the age range 16-30) without an autism diagnosis, using continuous sampling by date of referral.Result14 patients in the service had a diagnosis of autism and had completed a CAARMS. CAARMS domains are all scored between 0 and 6 (indicating increasing severity or frequency). Compared to the age matched controls, autistic patients had a higher mean difference in their scores for ‘Non-Bizarre Ideas’ (mean difference of 0.86 for severity and 0.57 for frequency) and ‘Disorganised Speech’ (mean difference of 0.28 for severity and 0.57 for frequency). These results did not reach statistical significance which was unsurprising given the sample size. The gender split between groups was similar.ConclusionOur evaluation suggests a difference in CAARMS scores between patients in our service with a diagnosis of autism and those without. A larger study would be needed to confirm a statistically significant difference and multicentre results would be needed as evidence of generalisability. However, if such a difference were confirmed it might question the validity of CAARMS in autistic patients or suggest that modifications, perhaps in the form of reasonable adjustments to the questions or scoring, were needed to increase the validity in this population. We would suggest that spending extra time checking the patient has understood the intended meaning of the questions in the CAARMS may increase validity, particularly in the ‘Non-Bizarre Ideas’ domain.

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