scholarly journals E-Clinical High Risk for Psychosis: Viewpoint on Potential of Digital Innovations for Preventive Psychiatry

10.2196/14581 ◽  
2019 ◽  
Vol 6 (10) ◽  
pp. e14581 ◽  
Author(s):  
Thomas Reilly ◽  
Andrea Mechelli ◽  
Philip McGuire ◽  
Paolo Fusar-Poli ◽  
Peter J Uhlhaas
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Clinical Population ◽  
Great Promise ◽  
Clinical High Risk ◽  
Current Management ◽  
Preventive Psychiatry

E-mental health is an emerging area of research that has the potential to overcome some of the current barriers to progress in working with people at clinical high risk for psychosis (CHR-P). This article provides an overview of how e-mental health could be used in the detection, prediction, and treatment in the CHR-P population. Specifically, we evaluate e-detection, e-prediction, and e-therapeutics for this clinical population. E-mental health holds great promise to improve current management of CHR-P individuals.

scholarly journals E-Clinical High Risk for Psychosis: Viewpoint on Potential of Digital Innovations for Preventive Psychiatry (Preprint)

2019 ◽  
Author(s):  
Thomas Reilly ◽  
Andrea Mechelli ◽  
Philip McGuire ◽  
Paolo Fusar-Poli ◽  
Peter J Uhlhaas
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Clinical Population ◽  
Great Promise ◽  
Clinical High Risk ◽  
Current Management ◽  
Preventive Psychiatry

UNSTRUCTURED E-mental health is an emerging area of research that has the potential to overcome some of the current barriers to progress in working with people at clinical high risk for psychosis (CHR-P). This article provides an overview of how e-mental health could be used in the detection, prediction, and treatment in the CHR-P population. Specifically, we evaluate e-detection, e-prediction, and e-therapeutics for this clinical population. E-mental health holds great promise to improve current management of CHR-P individuals.

scholarly journals Two-year follow-up of a Chinese sample at clinical high risk for psychosis: timeline of symptoms, help-seeking and conversion

2016 ◽  
Vol 26 (3) ◽  
pp. 287-298 ◽  
Author(s):  
T. H. Zhang ◽  
H. J. Li ◽  
K. A. Woodberry ◽  
L. H. Xu ◽  
Y. Y. Tang ◽  
...  
Keyword(s):  
High Risk ◽  
Symptom Onset ◽  
Help Seeking ◽  
Cox Regression ◽  
Clinical Population ◽  
Psychotic Symptoms ◽  
Clinical High Risk ◽  
Chinese Sample ◽  
Over Time

Background.Chinese psychiatrists have gradually started to focus on those who are deemed to be at ‘clinical high-risk (CHR)’ for psychosis; however, it is still unknown how often those individuals identified as CHR from a different country background than previously studied would transition to psychosis. The objectives of this study are to examine baseline characteristics and the timing of symptom onset, help-seeking, or transition to psychosis over a 2-year period in China.Method.The presence of CHR was determined with the Structured Interview for Prodromal Syndromes (SIPS) at the participants' first visit to the mental health services. A total of 86 (of 117) CHR participants completed the clinical follow-up of at least 2 years (73.5%). Conversion was determined using the criteria of presence of psychotic symptoms (in SIPS). Analyses examined baseline demographic and clinical predictors of psychosis and trajectory of symptoms over time. Survival analysis (Kaplan–Meier) methods along with Log-rank tests were performed to illustrate the relationship of baseline data to either conversion or non-conversion over time. Cox regression was performed to identify baseline predictors of conversion by the 2-year follow-up.Results.In total 25 (29.1%) of 86 completers transitioned to a psychotic disorder over the course of follow-up. Among the CHR sample, the mean time between attenuated symptom onset and professional help-seeking was about 4 months on average, and converters developed fully psychotic symptoms about 12 months after symptom onset. Compared with those CHR participants whose risk syndromes remitted over the course of the study, converters had significantly longer delays (p = 0.029) for their first visit to a professional in search of help. At baseline assessment, the conversion subgroup was younger, had poorer functioning, higher total SIPS positive symptom scores, longer duration of untreated prodromal symptoms, and were more often given psychosis-related diagnoses and subsequently prescribed antipsychotics in the clinic.Conclusions.Chinese CHR identified primarily by a novel clinical screening approach had a 2-year transition rate comparable with those of specialised help-seeking samples world-wide. Early clinical intervention with this functionally deteriorating clinical population who are suffering from attenuated psychotic symptoms, is a next step in applying the CHR construct in China.

Mental health service use decision‐making among young adults at clinical high risk for developing psychosis

2018 ◽  
Vol 13 (5) ◽  
pp. 1050-1055 ◽  
Author(s):  
Shelly Ben‐David ◽  
Andrea Cole ◽  
Gary Brucato ◽  
Ragy R. Girgis ◽  
Michelle R. Munson
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Young Adults ◽  
Mental Health Service ◽  
High Risk ◽  
Health Service ◽  
Service Use ◽  
Mental Health Service Use ◽  
Health Service Use ◽  
Clinical High Risk

scholarly journals Self-Disorders and Clinical High Risk for Psychosis: An Empirical Study in Help-Seeking Youth Attending Community Mental Health Facilities

2016 ◽  
Vol 42 (4) ◽  
pp. 926-932 ◽  
Author(s):  
Andrea Raballo ◽  
Elena Pappagallo ◽  
Alice Dell’ Erba ◽  
Nella Lo Cascio ◽  
Martina Patane’ ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Community Mental Health ◽  
Empirical Study ◽  
Help Seeking ◽  
Health Facilities ◽  
Clinical High Risk ◽  
Mental Health Facilities

scholarly journals S27. EXAMINING DISCREPANCIES BETWEEN SELF-REPORT AND CLINICIAN-RATED ASSESSMENTS OF PSYCHOSIS RISK: DOES INTERNALIZED STIGMA MATTER?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S41-S41
Author(s):  
LeeAnn Shan ◽  
Zachary B Millman ◽  
Joseph DeLuca ◽  
Mallory J Klaunig ◽  
Pamela Rakhshan Rouhakhtar ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Structured Interview ◽  
Self Report ◽  
Internalized Stigma ◽  
Clinical High Risk ◽  
Negative Stereotypes ◽  
Psychosis Risk

Abstract Background Psychosis is one of the most highly stigmatized mental health conditions (Thornicroft et al., 2009). Compared to those with other mental health concerns, people diagnosed with schizophrenia spectrum disorders are more likely to be perceived by others as dangerous, violent, and unpredictable. As a result, they are often socially marginalized and discriminated against (Crisp et al., 2000; Martin et al., 2007). Individuals at clinical high risk (CHR) for psychosis may be at lower risk for experiencing public stigma, given that their symptoms are often less outwardly visible at this early stage of illness. However, evidence suggests that those at CHR experience high levels of self-stigma, as they may internalize negative stereotypes related to psychosis (Yang et al., 2010; Yang et al., 2015). Internalized stigma can negatively impact help-seeking behavior and has been associated with lower self-esteem and the underreporting of mental health symptoms (Corrigan, 2004; Corrigan, 2007; Saporito, Ryan, & Teachman, 2011; Rüsch, Angermeyer, & Corrigan, 2005). Despite these findings, no studies to-date have examined how internalized stigma may impact reporting of attenuated psychosis symptoms in the CHR population. The current study aims to examine whether discrepancies between self-report and clinician-rated measures of psychosis risk are associated with internalized stigma in a sample of help-seeking adolescents and young adults. We hypothesized that higher levels of self-stigma will predict inconsistencies between self-reported symptom severity and clinician-obtained diagnoses of psychosis risk. Methods Participants will include youth classified as either non-psychosis-related help-seeking controls or at clinical high risk (CHR) for psychosis, as determined by the Structured Interview for Psychosis-Risk Syndromes (SIPS; Miller et al., 2003). The SIPS is administered by trained raters and is currently considered the gold standard tool for diagnosing clinical high-risk syndromes (Thompson et al., 2018). In addition to SIPS diagnoses, psychosis risk will also be assessed using the Prime Screen – Revised (PS-R; Miller et al., 2004), a brief, 12-item self-report questionnaire designed to measure attenuated positive symptoms. Lastly, internalized stigma will be assessed using the Internalized Stigma of Mental Illness Inventory (ISMI; Ritsher, Otilingam, & Grajales, 2003), a 29-item self-report questionnaire designed to measure subjective experiences of stigma in adolescents (e.g., endorsement of negative stereotypes, social withdrawal and feelings of alienation due to mental health problems, etc.). Results Preliminary analyses demonstrate a significant interaction between Prime scores and internalized stigma in predicting SIPS diagnoses. Specifically, higher scores on the Prime were associated with increased odds of being diagnosed as CHR on the SIPS, but only for those participants who endorsed low and mean levels of stigma. For participants who endorsed high levels of stigma, there did not appear to be any relation between Prime scores and SIPS diagnoses. Discussion At the time of submission, participant recruitment is ongoing, and results and discussion will be presented on the final sample. Findings may inform efforts to improve detection and accurate diagnosis of psychosis risk syndromes in individuals at early stages of illness.

scholarly journals O10.5. CLINICAL HIGH RISK (CHR) CRITERIA IN CHILDREN AND ADOLESCENTS NOT SUSPECTED TO DEVELOP PSYCHOSIS: NO TRANSDIAGNOSTIC SEVERITY MARKER OF MENTAL HEALTH PROBLEMS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S26-S26
Author(s):  
Frauke Schultze-Lutter ◽  
Chantal Michel ◽  
Benno G Schimmelmann ◽  
Maurizia Franscini ◽  
Nina Traber-Walker ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Children And Adolescents ◽  
Mental Health Problems ◽  
Community Sample ◽  
Structured Interview ◽  
Clinical High Risk ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Increased Risk

Abstract Background Compared to adults, children and adolescents of the community more frequently report clinical high risk of psychosis (CHR) criteria. Yet, little is known about the prevalence of CHR criteria in clinical children and adolescents’ samples. Thus, we studied the prevalence of CHR criteria and symptoms in 8- to 17-year-old inpatients with disorders that have been associated with greater odds to develop psychosis in adulthood, i.e., attention-deficit hyperactivity disorder, social and specific phobia, and obsessive-compulsive disorder, eating disorders and Asperger’s disorder. Methods As part of the multicenter naturalistic Bi-national Evaluation of At-Risk Symptoms in children and adolescents (BEARS-Kid) study, 8- to 17-year-olds of the community (N=235) and 8- to 17-year-old inpatients with any one of the above main diagnoses who were not suspected to be at increased risk of psychosis (N=306) were examined for CHR symptoms and criteria with the Schizophrenia Proneness Instrument, Child & Youth version and with the Structured Interview for Psychosis-Risk Syndromes. Results At 6.4%, the prevalence rate of CHR criteria in the community sample did not significantly differ from the 8.2%-rate in the inpatient sample. CHR criteria and symptoms were generally associated with age but not with group membership. Discussion This indicates that, irrespective of their mental health status, children and adolescents present more frequently with CHR criteria compared to young adults of the community for whom a 2.4%-rate of CHR criteria had earlier been reported. Furthermore, these findings contradict assumptions that CHR criteria might be diagnostically puripotential or merely severity markers of mental illness. Yet, more research into these symptoms and their cause and meaning in children and adolescents is needed to understand their significance in this age group and to detect factors that convey their clinical relevance in adulthood.

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