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1

Ruas Resende, M. B., F. Agostinho, R. Nogueira, D. Cotovio, F. A. Silva, and R. Lousada. "Ultra-High-Risk that do not transition to psychosis. What happens?" European Psychiatry 67, S1 (2024): S737. http://dx.doi.org/10.1192/j.eurpsy.2024.1533.

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IntroductionSpeaking prospectively we use the concept of “at risk mental state” (ARMS) to describe the state in which a person has a heightened risk of developing a psychotic disorder. Young people who are experiencing ARMS can be more precisely defined as being at ultra-high-risk of psychosis using a specific set of criteria known as the UHR criteria.ObjectivesTo clarify the concept of ultra-high-risk individuals and to characterize the clinical and functional characteristics and general psychopathology of those individuals that do not transition to psychosis during the follow-up period.Metho
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Richter, Anja, Evangelos Vassos, Matthew J. Kempton, et al. "S175. CLINICAL OUTCOMES IN PEOPLE AT HIGH RISK FOR PSYCHOSIS RELATED TO INTERACTIONS BETWEEN POLYGENIC RISK SCORES AND CHILDHOOD ADVERSITY." Schizophrenia Bulletin 46, Supplement_1 (2020): S104. http://dx.doi.org/10.1093/schbul/sbaa031.241.

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Abstract Background Genetic vulnerability to psychosis is polygenic, involving multiple genes with small individual effects (Psychiatric Genomics Consortium (PGC), 2014). The risk of psychosis is also related to environmental factors, such as childhood trauma (Lardinois et al, 2011). Although the onset of psychosis is thought to result from the interaction of genetic and environmental risk factors (Walker & Diforio, 1997), the extent to which the influence of childhood trauma depends on genetic susceptibility remains unclear. We sought to address this issue in a large prospective study of
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Omelchenko, M. "Premorbid of depressive youth at clinical high-risk for psychosis." European Psychiatry 65, S1 (2022): S683. http://dx.doi.org/10.1192/j.eurpsy.2022.1757.

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Introduction Early detection of psychosis is a promising area in preventive psychiatry. The use of early intervention can prevent the first episode psychosis and improve outcomes. Objectives Identification of premorbid features of depressive patients at clinical high risk for psychosis (CHR) comparing with depressive patients without CHR in order to improve early recognition of the psychotic process. Methods 219 young depressive in-patients with CHR criteria for SOPS with attenuated positive and attenuated negative symptoms and 52 young depressive in-patients without CHR were examined. Presenc
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Fusar-Poli, Paolo. "The Clinical High-Risk State for Psychosis (CHR-P), Version II." Schizophrenia Bulletin 43, no. 1 (2017): 44–47. http://dx.doi.org/10.1093/schbul/sbw158.

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Cleusix, Martine, Ines Khadimallah, Elodie Toffel, et al. "S69. CLINICAL HIGH RISK STATE: STRATIFICATION BASED ON CLINICAL PROFILE AND REDOX STATUS." Schizophrenia Bulletin 46, Supplement_1 (2020): S60. http://dx.doi.org/10.1093/schbul/sbaa031.135.

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Abstract Background The Clinical High Risk state (CHR) concept was implemented to promote the early detection of young help-seeking patients with higher risk of psychotic transition. This category is based on specific clinical criteria (EPA, 2015) and require narrow frequency/duration ratings of subclinical positive psychotic symptoms to allow its definition. Prevalence of CHR “category” appears nevertheless rare in help-seeking young people and the rate of psychotic transition of CHR state is lower than predicted by early studies. Therefore, the binary outcome of transition to psychosis propo
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Omelchenko, M. A. "Clinical High Risk Psychosis: Issues of Diagnostics and Therapy." Psychiatry 18, no. 2 (2020): 82–91. http://dx.doi.org/10.30629/2618-6667-2020-18-2-82-91.

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The aim of the review: the analysis of modern Russian and foreign literature dedicated to the problem of determining diagnostic criteria for clinical high risk of psychosis (CHR-P) and outlining the therapeutic approaches based on the pathogenic mechanisms of their development. Material and method: the publications found by searching queries for keywords in Russian and English in the MEDLINE/PubMed and eLIBRARY databases for the time period from 2010 to 2020 were then analyzed. Conclusion: the review presents a modern definition of the CHR-P group, along with a clarification of individual diag
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Debbané, Martin, George Salaminios, Pablo Cascone, and Marco Armando. "Mentalizing the Clinical High-Risk for Psychosis Model: A Staged Intervention Framework." Psychodynamic Psychiatry 52, no. 4 (2024): 512–41. https://doi.org/10.1521/pdps.2024.52.4.512.

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This article seeks to further specify how the mentalization-based approach may inform clinical intervention before the onset of psychosis, that is, during the stage of clinical high-risk for psychosis (CHR-P). We first review the concept of CHR-P, as well as the research evidence of the impact of early intervention. Next, we present evidence for the centrality of mentalizing as a process that may mitigate the risk for psychosis. We then review some of the key contributions in the psychoanalytical and phenomenological traditions concerning the centrality of core self disturbances in psychosis,
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Lepock, Jennifer R., Romina Mizrahi, Michele Korostil, R. Michael Bagby, Elizabeth W. Pang, and Michael Kiang. "Event-Related Potentials in the Clinical High-Risk (CHR) State for Psychosis: A Systematic Review." Clinical EEG and Neuroscience 49, no. 4 (2018): 215–25. http://dx.doi.org/10.1177/1550059418755212.

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There is emerging evidence that identification and treatment of individuals in the prodromal or clinical high-risk (CHR) state for psychosis can reduce the probability that they will develop a psychotic disorder. Event-related brain potentials (ERPs) are a noninvasive neurophysiological technique that holds promise for improving our understanding of neurocognitive processes underlying the CHR state. We aimed to systematically review the current literature on cognitive ERP studies of the CHR population, in order to summarize and synthesize the results, and their implications for our understandi
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Poletti, Michele. "Early Intervention Services for youth at Clinical High-Risk for Psychosis: The Reggio Emilia At-Risk Mental State (ReARMS) experience." RIVISTA SPERIMENTALE DI FRENIATRIA 146, no. 3 (2022): 61–80. http://dx.doi.org/10.3280/rsf2022-003004.

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Between 2012-2017, 300 individuals completed the baseline assessment, 205 of them met criteria for CHR-P or First-Episode Psychosis, and 154 accepted the enrolment in the ReARMS for treatment and follow-up. Empirical contributions based on the ReARMS dataset involved the structure of assessment and intervention, the Italian validation of ad-hoc instruments of assessment, clinical features of enrolled individuals (anhedonia, aberrant salience, suicidality and metacognition) and longitudinal trajectories in terms of outcome and response to treatments. age between adolescence and young adulthood,
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Oliver, Dominic, Giulia Spada, Joaquim Radua, Philip McGuire, and Paolo Fusar-Poli. "M136. PSYCHOSIS POLYRISK SCORE (PPS): IMPROVING DETECTION OF INDIVIDUALS AT-RISK AND PREDICTION OF CLINICAL OUTCOMES." Schizophrenia Bulletin 46, Supplement_1 (2020): S187. http://dx.doi.org/10.1093/schbul/sbaa030.448.

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Abstract Background Primary prevention in Clinical High Risk for psychosis (CHR-P) can ameliorate the course of psychotic disorders. Further advancements of knowledge have been slowed by the standstill of the field, which is mostly attributed to its epidemiological weakness. This underlies the limited identification power for at-risk individuals and the relatively modest ability of CHR-P interviews to rule-in a state of risk for psychosis. One potential avenue for improving identification of individuals at risk for psychosis is a Psychosis Polyrisk Score (PPS) integrating genetic and non-genet
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Kotlicka-Antczak, Magdalena, Michał S. Karbownik, Konrad Stawiski, et al. "Short clinically-based prediction model to forecast transition to psychosis in individuals at clinical high risk state." European Psychiatry 58 (March 11, 2019): 72–79. http://dx.doi.org/10.1016/j.eurpsy.2019.02.007.

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AbstractObjective:The predictive accuracy of the Clinical High Risk criteria for Psychosis (CHR-P) regarding the future development of the disorder remains suboptimal. It is therefore necessary to incorporate refined risk estimation tools which can be applied at the individual subject level. The aim of the study was to develop an easy-to use, short refined risk estimation tool to predict the development of psychosis in a new CHR-P cohort recruited in European country with less established early detection services.Methods:A cohort of 105 CHR-P individuals was assessed with the Comprehensive Ass
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Skuhareuskaya, M., and O. Skugarevsky. "Predictors of transition to psychosis in individuals at clinical high-risk for psychosis." European Psychiatry 41, S1 (2017): s838. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1651.

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ObjectiveClinical high risk (CHR) for psychosis state is characterized by presence of potentially prodromal for schizophrenia symptoms. The aim of this study was to assess the predictors of transition to first psychotic episode.MethodsThe study included 123 CHR subjects. All the subjects were characterized by the presence of one of the group of criteria: (1) UHR criteria, (2) basic symptoms criteria and (3) negative symptoms and formal thought disorders (FTD). The presence of FTD in clinical high-risk individuals was assessed with methods of experimental pathopsychology. The mean length of fol
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Zhen, Mao, Qijing Bo, Qing Tian, Fang Dong, Xianbin Li, and Chuanyue Wang. "T37. PREPULSE INHIBITION IN UNAFFECTED SIBLINGS OF SCHIZOPHRENIA AND CLINICAL-HIGH RISK WITHOUT FAMILY HISTORY OF PSYCHOSIS." Schizophrenia Bulletin 46, Supplement_1 (2020): S245—S246. http://dx.doi.org/10.1093/schbul/sbaa029.597.

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Abstract Background It is reported that prepulse inhibition (PPI) deficiency of startle reflex in schizophrenia is associated with positive symptoms and is hereditary. In this study, the perceived spatial separation (PSS) induced-prepulse inhibition paradigm based on the priority effect effectively was used to explore PPI levels of genetically high-risk (GHR) of schizophrenia and clinical high risk (CHR) without family history of psychosis Methods We examined startle magnitude and PPI in38 CHR (No family history of psychosis), 28 GHR (Siblings or children of schizophrenia), and 44 healthy cont
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Wei, Yanyan, Xiaochen Tang, Tingyu Zhang, et al. "Reduced temporal activation during a verbal fluency test in clinical high risk of psychosis: a functional near-infrared spectroscopy-based study." General Psychiatry 35, no. 2 (2022): e100702. http://dx.doi.org/10.1136/gpsych-2021-100702.

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BackgroundClinical high risk (CHR) of psychosis is a state in which positive symptoms cause the subjects distress but do not approach a severity level that fulfils the criteria for a psychotic episode. CHR exhibits cognitive deficits; however, the underlying neurobiological mechanisms remain unclear. This study aimed to investigate whether brain activation measured by the levels of oxygenated hemoglobin (oxy-Hb) in CHR subjects could be correlated with cognitive deficits.MethodsFifty-eight CHR individuals who fulfilled the criteria for attenuated positive syndrome as specified in the Structure
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Kim, Ahra, Minji Ha, Taekwan Kim, et al. "Triple-Network Dysconnectivity in Patients With First-Episode Psychosis and Individuals at Clinical High Risk for Psychosis." Psychiatry Investigation 19, no. 12 (2022): 1037–45. http://dx.doi.org/10.30773/pi.2022.0091.

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Objective In the triple-network model, the salience network (SN) plays a crucial role in switching between the default-mode network (DMN) and the central executive network (CEN). Aberrant patterns of triple-network connectivity have been reported in schizophrenia patients, while findings have been less consistent for patients in the early stages of psychotic disorders. Thus, the present study examined the connectivity among the SN, DMN, and CEN in first-episode psychosis (FEP) patients and individuals at clinical high risk (CHR) for psychosis.Methods Thirty-nine patients with FEP, 78 patients
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Salazar de Pablo, Gonzalo, Scott W. Woods, Georgia Drymonitou, Héctor de Diego, and Paolo Fusar-Poli. "Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis." Brain Sciences 11, no. 11 (2021): 1544. http://dx.doi.org/10.3390/brainsci11111544.

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(1) The consistency and magnitude of the prevalence of Clinical High-Risk for Psychosis (CHR-P) individuals are undetermined, limiting efficient detection of cases. We aimed to evaluate the prevalence of CHR-P individuals systematically assessed in the general population or clinical samples. (2) PRISMA/MOOSE-compliant (PROSPERO: CRD42020168672) meta-analysis of multiple databases until 21/01/21: a random-effects model meta-analysis, heterogeneity analysis, publication bias and quality assessment, sensitivity analysis—according to the gold-standard CHR-P and pre-screening instruments—leave-one-
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Wadell, Paula. "62.2 Evidence-Based Treatment for Clinical High-Risk State for Psychosis (CHR-P) Syndromes." Journal of the American Academy of Child & Adolescent Psychiatry 61, no. 10 (2022): S84. http://dx.doi.org/10.1016/j.jaac.2022.07.351.

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Menefee, Elizabeth. "62.1 Epidemiology and Diagnosis of Clinical High-Risk State for Psychosis (CHR-P) Syndromes." Journal of the American Academy of Child & Adolescent Psychiatry 61, no. 10 (2022): S84. http://dx.doi.org/10.1016/j.jaac.2022.07.350.

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Worthington, Michelle, Jean Addington, Carrie Bearden, et al. "T116. PREDICTION OF REMISSION IN NON-CONVERTING INDIVIDUALS AT CLINICAL HIGH RISK FOR PSYCHOSIS." Schizophrenia Bulletin 46, Supplement_1 (2020): S274—S275. http://dx.doi.org/10.1093/schbul/sbaa029.676.

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Abstract Background The clinical high-risk period before a first episode of psychosis (CHR-P) has been widely studied in the past 30 years with the goal of understanding the development of psychosis. Despite the progress in understanding what factors are associated with conversion to psychosis from the CHR-P state, less attention has been paid to the individuals who do not transition to psychosis. It is estimated that approximately 75–80% of individuals do not go on to convert to psychosis from the CHR-P state and this group should not simply be characterized as the inverse of conversion. To d
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Guo, Joyce Y., Tara A. Niendam, Andrea M. Auther, et al. "Predicting psychosis risk using a specific measure of cognitive control: a 12-month longitudinal study." Psychological Medicine 50, no. 13 (2019): 2230–39. http://dx.doi.org/10.1017/s0033291719002332.

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AbstractBackgroundIdentifying risk factors of individuals in a clinical-high-risk state for psychosis are vital to prevention and early intervention efforts. Among prodromal abnormalities, cognitive functioning has shown intermediate levels of impairment in CHR relative to first-episode psychosis and healthy controls, highlighting a potential role as a risk factor for transition to psychosis and other negative clinical outcomes. The current study used the AX-CPT, a brief 15-min computerized task, to determine whether cognitive control impairments in CHR at baseline could predict clinical statu
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Hu, Yegang, Jun Wu, YuJiao Cao, et al. "Abnormal neural oscillations in clinical high risk for psychosis: a magnetoencephalography method study." General Psychiatry 35, no. 2 (2022): e100712. http://dx.doi.org/10.1136/gpsych-2021-100712.

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BackgroundNeural oscillations directly reflect the rhythmic changes of brain activities during the resting state or while performing specific tasks. Abnormal neural oscillations have been discovered in patients with schizophrenia. However, there is limited evidence available on abnormal spontaneous neural oscillations in clinical high risk for psychosis (CHR-P). The brain signals recorded by the magnetoencephalography (MEG) technique are not to be disrupted by the skull and scalp.MethodsIn this study, we applied the MEG technique to record the resting-state neural activities in CHR-P. This was
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De Micheli, Andrea, Albertine van Lawick van Pabst, Enass Yossef, Philip McGuire, and Paolo Fusar-Poli. "S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE." Schizophrenia Bulletin 46, Supplement_1 (2020): S94—S95. http://dx.doi.org/10.1093/schbul/sbaa031.220.

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Abstract Background There is converging evidence that youths at clinical high risk (CHR) are not only likely to develop the first episode of psychosis but also to develop poor physical outcomes. Some physical health risk factors - such as smoking - have been shown to increase the probability of a frank onset of psychosis in those at risk. A meta-analysis conducted in psychotic patients confirmed that daily tobacco use is associated with an increased risk of psychosis. A significant association between any attenuated psychotic symptoms (that characterize CHR state) and cigarette smoking has bee
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Andreou, Christina, and Stefan Borgwardt. "Structural and functional imaging markers for susceptibility to psychosis." Molecular Psychiatry 25, no. 11 (2020): 2773–85. http://dx.doi.org/10.1038/s41380-020-0679-7.

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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, wit
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Breitborde, Nicholas J. K., Hossam Guirgis, Walter Stearns, et al. "The Ohio State University Early Psychosis Intervention Center (EPICENTER) step-based care programme for individuals at clinical high risk for psychosis: study protocol for an observational study." BMJ Open 10, no. 1 (2020): e034031. http://dx.doi.org/10.1136/bmjopen-2019-034031.

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IntroductionIn October 2018, the Substance Abuse and Mental Health Services Administration funded 21 sites throughout the USA to develop, implement and evaluate specialised care programmes for individuals at clinical high risk for developing a psychotic disorder (CHR-P). Per the funding requirements, such programmes were required to provide ‘step-based care’—a model in which individuals are initially provided with low-intensity, non-psychosis-specific and more benign (ie, least side effects) interventions and only progress onto higher-intensity, psychosis-specific interventions with a greater
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Carrión, R. E., D. McLaughlin, A. M. Auther, R. Olsen, C. U. Correll, and B. A. Cornblatt. "The impact of psychosis on the course of cognition: a prospective, nested case-control study in individuals at clinical high-risk for psychosis." Psychological Medicine 45, no. 15 (2015): 3341–54. http://dx.doi.org/10.1017/s0033291715001233.

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BackgroundAlthough cognitive deficits in patients with schizophrenia are rooted early in development, the impact of psychosis on the course of cognitive functioning remains unclear. In this study a nested case-control design was used to examine the relationship between emerging psychosis and the course of cognition in individuals ascertained as clinical high-risk (CHR) who developed psychosis during the study (CHR + T).MethodFifteen CHR + T subjects were administered a neurocognitive battery at baseline and post-psychosis onset (8.04 months, s.d. = 10.26). CHR + T subjects were matched on a ca
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Khoury, Rita, and Henry A. Nasrallah. "Inflammatory biomarkers in individuals at clinical high risk for psychosis (CHR-P): State or trait?" Schizophrenia Research 199 (September 2018): 31–38. http://dx.doi.org/10.1016/j.schres.2018.04.017.

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Modinos, Gemma, Anja Richter, Alice Egerton, et al. "Interactions between hippocampal activity and striatal dopamine in people at clinical high risk for psychosis: relationship to adverse outcomes." Neuropsychopharmacology 46, no. 8 (2021): 1468–74. http://dx.doi.org/10.1038/s41386-021-01019-0.

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AbstractPreclinical models propose that increased hippocampal activity drives subcortical dopaminergic dysfunction and leads to psychosis-like symptoms and behaviors. Here, we used multimodal neuroimaging to examine the relationship between hippocampal regional cerebral blood flow (rCBF) and striatal dopamine synthesis capacity in people at clinical high risk (CHR) for psychosis and investigated its association with subsequent clinical and functional outcomes. Ninety-five participants (67 CHR and 28 healthy controls) underwent arterial spin labeling MRI and 18F-DOPA PET imaging at baseline. CH
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Millman, Zachary B., James M. Gold, Vijay A. Mittal, and Jason Schiffman. "The Critical Need for Help-Seeking Controls in Clinical High-Risk Research." Clinical Psychological Science 7, no. 6 (2019): 1171–89. http://dx.doi.org/10.1177/2167702619855660.

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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, hin
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Franscini, M., N. Traber-Walker, F. Probst, M. Gerstenberg, and S. Walitza. "Early detection and intervention of psychosis in children and adolescents in Zurich, Switzerland: Clinical Data from 2017-2022." European Psychiatry 66, S1 (2023): S1075—S1076. http://dx.doi.org/10.1192/j.eurpsy.2023.2284.

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IntroductionThe construct of a clinical high-risk (CHR) state of psychosis has been established to describe potentially prodromal symptoms which typically appear during adolescence and young adulthood. This is a very sensitive developmental period and the clinical high risk (CHR) is associated with increased functional impairment. To address the specialities in the care for this patient population a specialized outpatient care unit for early intervention in psychosis at the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, of the University Züric
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Ciarleglio, Adam J., Gary Brucato, Michael D. Masucci, et al. "A predictive model for conversion to psychosis in clinical high-risk patients." Psychological Medicine 49, no. 07 (2018): 1128–37. http://dx.doi.org/10.1017/s003329171800171x.

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AbstractBackgroundThe authors developed a practical and clinically useful model to predict the risk of psychosis that utilizes clinical characteristics empirically demonstrated to be strong predictors of conversion to psychosis in clinical high-risk (CHR) individuals. The model is based upon the Structured Interview for Psychosis Risk Syndromes (SIPS) and accompanying clinical interview, and yields scores indicating one's risk of conversion.MethodsBaseline data, including demographic and clinical characteristics measured by the SIPS, were obtained on 199 CHR individuals seeking evaluation in t
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Panikratova, Y., E. Abdullina, I. Lebedeva, M. Omelchenko, D. Tikhonov, and V. Kaleda. "Brain functional connectivity and local coherence in non-converters with clinical high risk for psychosis." European Psychiatry 66, S1 (2023): S612—S613. http://dx.doi.org/10.1192/j.eurpsy.2023.1277.

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IntroductionInvestigation of resilience mechanisms in patients with clinical high risk for psychosis (CHR) may inform clinical practice for the development of early intervention programs. Resilience mechanisms in CHR who did not transit to psychosis for a long period of observation may be more pronounced than in CHR converters.ObjectivesWe aimed to compare CHR who did not convert to psychosis for 7.3 ± 1.7 years, patients with first-episode psychosis (FEP), and healthy controls (HC) in terms of brain functional connectivity and local coherence.MethodsTwenty-seven CHR (mean age 27.5 ± 3.1), 24
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Bortoletto, Riccardo, Marco Garzitto, Fabiana Piscitelli, et al. "The Endocannabinoid Activity Remodulation for Psychosis Liability in Youth (EARLY) Study: An Open-Label Feasibility Trial of Ultramicronized-Palmitoylethanolamide Oral Supplementation in Clinical High-Risk State for Psychosis." Brain Sciences 14, no. 12 (2024): 1230. https://doi.org/10.3390/brainsci14121230.

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To date, no psychotropic medication has shown to effectively halt progression to psychosis among individuals at Clinical High-Risk for psychosis (CHR), fueling the search for novel therapeutic agents. Recent evidence supports Palmitoylethanolamide (PEA) signaling as a potential psychosis biomarker, also indicating a therapeutic role for its supplementation in the treatment of psychotic disorders. Nonetheless, the effect of sustained PEA intake in CHR subjects has never been explored so far. We will assess the feasibility of enrolling 20 CHR young adults presenting with attenuated psychotic sym
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Haining, Kate, Gina Brunner, Ruchika Gajwani, et al. "S64. COGNITIVE IMPAIRMENTS AND PREDICTION OF FUNCTIONAL OUTCOME IN INDIVIDUALS AT CLINICAL HIGH-RISK FOR PSYCHOSIS." Schizophrenia Bulletin 46, Supplement_1 (2020): S57—S58. http://dx.doi.org/10.1093/schbul/sbaa031.130.

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Abstract Background Research in individuals at clinical-high risk for psychosis (CHR-P) has focused on developing algorithms to predict transition to psychosis. However, it is becoming increasingly important to address other outcomes, such as the level of functioning of CHR-P participants. To address this important question, this study investigated the relationship between baseline cognitive performance and functional outcome between 6–12 months in a sample of CHR-P individuals using a machine-learning approach to identify features that are predictive of long-term functional impairments. Metho
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Fusar-Poli, Paolo, Matteo Rocchetti, Alberto Sardella, et al. "Disorder, not just state of risk: Meta-analysis of functioning and quality of life in people at high risk of psychosis." British Journal of Psychiatry 207, no. 3 (2015): 198–206. http://dx.doi.org/10.1192/bjp.bp.114.157115.

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BackgroundThe nosology of the psychosis high-risk state is controversial. Traditionally conceived as an ‘at risk’ state for the development of psychotic disorders, it is also conceptualised as a clinical syndrome associated with functional impairment.AimsTo investigate meta-analytically the functional status of patients at high clinical risk for psychosis and its association with longitudinal outcomes.MethodThree meta-analyses compared level of functioning (n = 3012) and quality of life (QoL) (n = 945) between a high-risk group, a healthy control group and group with psychosis, and baseline fu
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Ifrah, Chloe, Shaynna N. Herrera, Steven M. Silverstein, et al. "The Relationship between Clinical and Psychophysical Assessments of Visual Perceptual Disturbances in Individuals at Clinical High Risk for Psychosis: A Preliminary Study." Brain Sciences 14, no. 8 (2024): 819. http://dx.doi.org/10.3390/brainsci14080819.

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This study investigated relations between a measure of early-stage visual function and self-reported visual anomalies in individuals at clinical high risk for psychosis (CHR-P). Eleven individuals at CHR identified via the Structured Interview for Psychosis-Risk Syndromes (SIPS) were recruited from a CHR-P research program in NYC. The sample was ~36% female, ranging from 16 to 33 years old (M = 23.90, SD = 6.14). Participants completed a contrast sensitivity task on an iPad with five spatial frequencies (0.41–13 cycles/degree) and completed the self-report Audio-Visual Abnormalities Questionna
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Tomyshev, A. S., I. Lebedeva, A. Dudina, P. Menshchikov, D. Kupriyanov, and M. Omelchenko. "Reduced resting-state gamma-band power correlate with unaltered glutamate + glutamine levels in patients at clinical-high risk of psychosis." European Psychiatry 67, S1 (2024): S615. http://dx.doi.org/10.1192/j.eurpsy.2024.1280.

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IntroductionThere is growing evidence of excitation / inhibition (E/I) balance abnormalities in schizophrenia, which might be associated with abnormal gamma frequency oscillations and glutamate concentrations. However, to the best of our knowledge, only one multimodal study have examined such associations between EEG and metabolite characteristics in patients at clinical-high risk of psychosis (CHR) so far.ObjectivesWe aimed to investigate potential associations between GLX (glutamate + glutamine) levels and resting-state gamma-band power in CHR individuals and healthy controls (HC).MethodsTwe
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Collin, Guusje, Alfonso Nieto-Castanon, Martha Shenton, et al. "S147. FUNCTIONAL BRAIN CONNECTIVITY DATA IMPROVE CLINICAL OUTCOME PREDICTION IN YOUTH AT RISK FOR PSYCHOSIS." Schizophrenia Bulletin 46, Supplement_1 (2020): S92. http://dx.doi.org/10.1093/schbul/sbaa031.213.

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Abstract Background Improved outcome prediction in individuals at high risk for psychosis may facilitate targeted early intervention. Studies suggest that improved outcome prediction may be achieved through the use of neurocognitive or neuroimaging data, on their own or in addition to clinical data. This study examines whether adding resting-state functional connectivity data to validated clinical predictors of psychosis improve outcome prediction in the prodromal stage. Methods This study involves 137 adolescents and young adults at Clinical High Risk (CHR) for psychosis from the Shanghai At
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Mongan, David, Melanie Föcking, Colm Healy, et al. "T21. DEVELOPMENT OF PROTEOMIC PREDICTION MODELS FOR OUTCOMES IN THE CLINICAL HIGH RISK STATE AND PSYCHOTIC EXPERIENCES IN ADOLESCENCE: MACHINE LEARNING ANALYSES IN TWO NESTED CASE-CONTROL STUDIES." Schizophrenia Bulletin 46, Supplement_1 (2020): S238—S239. http://dx.doi.org/10.1093/schbul/sbaa029.581.

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Abstract Background Individuals at clinical high risk (CHR) of psychosis have an approximately 20% probability of developing psychosis within 2 years, as well as an associated risk of non-psychotic disorders and functional impairment. People with subclinical psychotic experiences (PEs) are also at risk of future psychotic and non-psychotic disorders and decreased functioning. It is difficult to accurately predict outcomes in individuals at risk of psychosis on the basis of symptoms alone. Biomarkers for accurate prediction of outcomes could inform the clinical management of this group. Methods
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Neuner, L. M., L. Hahn, J. Kambeitz, et al. "Exploring Associations between Grey Matter Volume and Clinical High-Risk for Psychosis: A Transdiagnostic Study Utilizing the NAPLS-2 Risk Calculator in the PRONIA Cohort." European Psychiatry 67, S1 (2024): S271—S272. http://dx.doi.org/10.1192/j.eurpsy.2024.572.

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Introduction The clinical high-risk state for psychosis (CHR) is associated with alterations in grey matter volume (GMV) in various regions such as the hippocampus (Vissink et al. BP:GOS 2022; 2(2) 147-152). Within the scope of the North American Prodrome Longitudinal Study (NAPLS-2; Cannon et al. AM J Psychiatry 2016; 173(10), 980-988), a publicly available risk calculator based on clinical variables was developed to assess the likelihood of individuals to transition to psychosis within a 2-year period.Objectives In the current study, we aim to examine the association between GMV and NAPLS-2
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Zajac, Jennifer. "62.3 An Innovative Intensive Outpatient Program for Adolescents With Clinical High-Risk State for Psychosis (CHR-P) Syndromes." Journal of the American Academy of Child & Adolescent Psychiatry 61, no. 10 (2022): S84. http://dx.doi.org/10.1016/j.jaac.2022.07.352.

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DeVylder, J. E., S. Ben-David, S. A. Schobel, D. Kimhy, D. Malaspina, and C. M. Corcoran. "Temporal association of stress sensitivity and symptoms in individuals at clinical high risk for psychosis." Psychological Medicine 43, no. 2 (2012): 259–68. http://dx.doi.org/10.1017/s0033291712001262.

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BackgroundIncreased sensitivity and exposure to stress are associated with psychotic symptoms in schizophrenia and its risk states, but little is known about the co-evolution of stress sensitivity and exposure with positive and other symptoms in a clinical high-risk (CHR) cohort.MethodA combined cross-sectional and longitudinal design was used to examine the associations over time of stress sensitivity and exposure (i.e. life events) with ‘prodromal’ symptoms in a cohort of 65 CHR patients assessed quarterly for up to 4 years, and at baseline in 24 healthy controls similar in age and gender.Re
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Graham-Sullivan, Patricia C. "62.4 Prevention and Therapy Approaches to Clinical High-Risk State for Psychosis (CHR-P) in an Intensive Outpatient Program." Journal of the American Academy of Child & Adolescent Psychiatry 61, no. 10 (2022): S84. http://dx.doi.org/10.1016/j.jaac.2022.07.353.

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Oliver, D., M. Kotlicka-Antczak, A. Minichino, G. Spada, P. McGuire, and P. Fusar-Poli. "Meta-analytical prognostic accuracy of the Comprehensive Assessment of at Risk Mental States (CAARMS): The need for refined prediction." European Psychiatry 49 (2018): 62–68. http://dx.doi.org/10.1016/j.eurpsy.2017.10.001.

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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
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Popovic, D., C. Weyer, A. Ruef, et al. "Neuroinflammation in Recent Onset Mental Health Disorders – Developing Multi-level Signatures of Early-stage Depression and Psychosis in Young Adults." European Psychiatry 67, S1 (2024): S45—S47. http://dx.doi.org/10.1192/j.eurpsy.2024.147.

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IntroductionAn early and comprehensive neurobiological characterization of severe mental disorders could elucidate mechanistic pathways, aid the development of novel therapeutics, and therefore enable timely and targeted intervention in at-risk youth and young adults. Therefore, we present an unsupervised transdiagnostic machine learning approach to investigate shared and distinct patterns of early-stage depressive and psychotic disorders on multiple clinical and neurobiological levels.ObjectivesTo derive multi-level neurobiological and clinical signatures of early-stage affective and psychoti
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Azis, Matilda, Gregory P. Strauss, Elaine Walker, William Revelle, Richard Zinbarg, and Vijay Mittal. "Factor Analysis of Negative Symptom Items in the Structured Interview for Prodromal Syndromes." Schizophrenia Bulletin 45, no. 5 (2018): 1042–50. http://dx.doi.org/10.1093/schbul/sby177.

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Abstract Background Negative symptoms occur early in the clinical high risk (CHR) state and indicate increased risk of conversion to psychotic disorder and poor functional outcome. However, while the negative symptom domain has shown to be parsimoniously explained by a 2-factor construct in schizophrenia, there has yet to be an established factor structure of negative symptoms in CHR. Methods 214 individuals meeting the Structured Interview for Psychosis-Risk Syndromes (SIPS) criteria for CHR were recruited through 3 active research programs in the United States. Exploratory Factor Analysis wa
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Hasmi, Laila, Lotta-Katrin Pries, Margreet ten Have, et al. "What makes the psychosis ‘clinical high risk’ state risky: psychosis itself or the co-presence of a non-psychotic disorder?" Epidemiology and Psychiatric Sciences 30 (2021). http://dx.doi.org/10.1017/s204579602100041x.

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Abstract Aims Although attenuated psychotic symptoms in the psychosis clinical high-risk state (CHR-P) almost always occur in the context of a non-psychotic disorder (NPD), NPD is considered an undesired ‘comorbidity’ epiphenomenon rather than an integral part of CHR-P itself. Prospective work, however, indicates that much more of the clinical psychosis incidence is attributable to prior mood and drug use disorders than to psychosis clinical high-risk states per se. In order to examine this conundrum, we analysed to what degree the ‘risk’ in CHR-P is indexed by co-present NPD rather than atten
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Haining, Kate, Ruchika Gajwani, Joachim Gross, et al. "Characterising cognitive heterogeneity in individuals at clinical high-risk for psychosis: a cluster analysis with clinical and functional outcome prediction." European Archives of Psychiatry and Clinical Neuroscience, August 16, 2021. http://dx.doi.org/10.1007/s00406-021-01315-2.

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AbstractSchizophrenia is characterised by cognitive impairments that are already present during early stages, including in the clinical high-risk for psychosis (CHR-P) state and first-episode psychosis (FEP). Moreover, data suggest the presence of distinct cognitive subtypes during early-stage psychosis, with evidence for spared vs. impaired cognitive profiles that may be differentially associated with symptomatic and functional outcomes. Using cluster analysis, we sought to determine whether cognitive subgroups were associated with clinical and functional outcomes in CHR-P individuals. Data w
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Oliver, Dominic, Maite Arribas, Joaquim Radua, et al. "Prognostic accuracy and clinical utility of psychometric instruments for individuals at clinical high-risk of psychosis: a systematic review and meta-analysis." Molecular Psychiatry, June 3, 2022. http://dx.doi.org/10.1038/s41380-022-01611-w.

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AbstractAccurate prognostication of individuals at clinical high-risk for psychosis (CHR-P) is an essential initial step for effective primary indicated prevention. We aimed to summarise the prognostic accuracy and clinical utility of CHR-P assessments for primary indicated psychosis prevention. Web of Knowledge databases were searched until 1st January 2022 for longitudinal studies following-up individuals undergoing a psychometric or diagnostic CHR-P assessment, reporting transition to psychotic disorders in both those who meet CHR-P criteria (CHR-P + ) or not (CHR-P−). Prognostic accuracy m
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Tikka, Sai Krishna, Barikar C. Malathesh, Mamidipalli Sai Spoorthy, et al. "Identification of youth at clinical high‐risk for psychosis: A community‐based study from India." Early Intervention in Psychiatry, May 28, 2024. http://dx.doi.org/10.1111/eip.13581.

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AbstractAimA two‐stage process, wherein self‐report screening precedes the structured interview, is suggested for identifying individuals at clinical high‐risk for psychosis (CHR‐P) in community samples. Aim of this study was to screen a community youth sample from India for CHR‐P using the two‐stage method. Specific objectives were to assess concordant validity of the self‐report measure and predictive validity of the two‐stage method.MethodsBased on probability sampling, 2025 youth aged 15–24 years were recruited from one rural and one urban area of Telangana, a Telugu‐speaking state in Indi
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Baldwin, Helen, Joaquim Radua, Mathilde Antoniades, et al. "Neuroanatomical heterogeneity and homogeneity in individuals at clinical high risk for psychosis." Translational Psychiatry 12, no. 1 (2022). http://dx.doi.org/10.1038/s41398-022-02057-y.

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AbstractIndividuals at Clinical High Risk for Psychosis (CHR-P) demonstrate heterogeneity in clinical profiles and outcome features. However, the extent of neuroanatomical heterogeneity in the CHR-P state is largely undetermined. We aimed to quantify the neuroanatomical heterogeneity in structural magnetic resonance imaging measures of cortical surface area (SA), cortical thickness (CT), subcortical volume (SV), and intracranial volume (ICV) in CHR-P individuals compared with healthy controls (HC), and in relation to subsequent transition to a first episode of psychosis. The ENIGMA CHR-P conso
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