Potentially important periods of change in the development of social and role functioning in youth at clinical high risk for psychosis / Eva VELTHORST in Development and Psychopathology, 30-1 (February 2018)  

Public ISBD [article]  inDevelopment and Psychopathology > 30-1 (February 2018) . - p.39-47 Titre : Potentially important periods of change in the development of social and role functioning in youth at clinical high risk for psychosis Type de document : Texte imprimé et/ou numérique Auteurs : Eva VELTHORST, Auteur ; Jamie ZINBERG, Auteur ; Jean ADDINGTON, Auteur ; Kristin S. CADENHEAD, Auteur ; Tyrone D. CANNON, Auteur ; Ricardo E. CARRIÓN, Auteur ; Andrea M. AUTHER, Auteur ; Barbara A. CORNBLATT, Auteur ; Thomas H. MCGLASHAN, Auteur ; Daniel H. MATHALON, Auteur ; Diana O. PERKINS, Auteur ; Larry J. SEIDMAN, Auteur ; Ming T. TSUANG, Auteur ; Elaine F. WALKER, Auteur ; Scott W. WOODS, Auteur ; Abraham REICHENBERG, Auteur ; Carrie E. BEARDEN, Auteur Article en page(s) : p.39-47 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : The developmental course of daily functioning prior to first psychosis-onset remains poorly understood. This study explored age-related periods of change in social and role functioning. The longitudinal study included youth (aged 12–23, mean follow-up years = 1.19) at clinical high risk (CHR) for psychosis (converters [CHR-C], n = 83; nonconverters [CHR-NC], n = 275) and a healthy control group (n = 164). Mixed-model analyses were performed to determine age-related differences in social and role functioning. We limited our analyses to functioning before psychosis conversion; thus, data of CHR-C participants gathered after psychosis onset were excluded. In controls, social and role functioning improved over time. From at least age 12, functioning in CHR was poorer than in controls, and this lag persisted over time. Between ages 15 and 18, social functioning in CHR-C stagnated and diverged from that of CHR-NC, who continued to improve (p = .001). Subsequently, CHR-C lagged behind in improvement between ages 21 and 23, further distinguishing them from CHR-NC (p < .001). A similar period of stagnation was apparent for role functioning, but to a lesser extent (p = .007). The results remained consistent when we accounted for the time to conversion. Our findings suggest that CHR-C start lagging behind CHR-NC in social and role functioning in adolescence, followed by a period of further stagnation in adulthood. En ligne : https://doi.org/10.1017/S0954579417000451 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=335 [article] Potentially important periods of change in the development of social and role functioning in youth at clinical high risk for psychosis [Texte imprimé et/ou numérique] / Eva VELTHORST, Auteur ; Jamie ZINBERG, Auteur ; Jean ADDINGTON, Auteur ; Kristin S. CADENHEAD, Auteur ; Tyrone D. CANNON, Auteur ; Ricardo E. CARRIÓN, Auteur ; Andrea M. AUTHER, Auteur ; Barbara A. CORNBLATT, Auteur ; Thomas H. MCGLASHAN, Auteur ; Daniel H. MATHALON, Auteur ; Diana O. PERKINS, Auteur ; Larry J. SEIDMAN, Auteur ; Ming T. TSUANG, Auteur ; Elaine F. WALKER, Auteur ; Scott W. WOODS, Auteur ; Abraham REICHENBERG, Auteur ; Carrie E. BEARDEN, Auteur . - p.39-47. Langues : Anglais (eng) in Development and Psychopathology > 30-1 (February 2018) . - p.39-47 Index. décimale : PER Périodiques Résumé : The developmental course of daily functioning prior to first psychosis-onset remains poorly understood. This study explored age-related periods of change in social and role functioning. The longitudinal study included youth (aged 12–23, mean follow-up years = 1.19) at clinical high risk (CHR) for psychosis (converters [CHR-C], n = 83; nonconverters [CHR-NC], n = 275) and a healthy control group (n = 164). Mixed-model analyses were performed to determine age-related differences in social and role functioning. We limited our analyses to functioning before psychosis conversion; thus, data of CHR-C participants gathered after psychosis onset were excluded. In controls, social and role functioning improved over time. From at least age 12, functioning in CHR was poorer than in controls, and this lag persisted over time. Between ages 15 and 18, social functioning in CHR-C stagnated and diverged from that of CHR-NC, who continued to improve (p = .001). Subsequently, CHR-C lagged behind in improvement between ages 21 and 23, further distinguishing them from CHR-NC (p < .001). A similar period of stagnation was apparent for role functioning, but to a lesser extent (p = .007). The results remained consistent when we accounted for the time to conversion. Our findings suggest that CHR-C start lagging behind CHR-NC in social and role functioning in adolescence, followed by a period of further stagnation in adulthood. En ligne : https://doi.org/10.1017/S0954579417000451 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=335

Research in people with psychosis risk syndrome: a review of the current evidence and future directions / Christoph U. CORRELL in Journal of Child Psychology and Psychiatry, 51-4 (April 2010)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 51-4 (April 2010) . - p.390-431 Titre : Research in people with psychosis risk syndrome: a review of the current evidence and future directions Type de document : Texte imprimé et/ou numérique Auteurs : Christoph U. CORRELL, Auteur ; Marta HAUSER, Auteur ; Andrea M. AUTHER, Auteur ; Barbara A. CORNBLATT, Auteur Année de publication : 2010 Article en page(s) : p.390-431 Langues : Anglais (eng) Mots-clés : Schizophrenia psychosis risk-syndrome prodrome early-recognition early-intervention biomarker DSM-V Index. décimale : PER Périodiques Résumé : After decades of research, schizophrenia and related psychotic disorders are still among the most debilitating disorders in medicine. The chronic illness course in most individuals, greater treatment responsiveness during the first episode, progressive gray matter decline during early disease stages, and retrospective accounts of 'prodromal' or early illness signs and symptoms formed the basis for research on the psychosis risk syndrome (PRS), known variably as 'clinical high risk' (CHR), or 'ultra-high risk' (UHR), or 'prodromal'. The pioneering era of research on PRS focused on the development and validation of specific assessment tools and the delineation of high risk criteria. This was followed by the examination of conversion rates in psychosis risk cohorts followed naturalistically, identification of predictors of conversion to psychosis, and investigation of interventions able to abort or delay the development of full psychosis. Despite initially encouraging results concerning the predictive validity of PRS criteria, recent findings of declining conversion rates demonstrate the need for further investigations. Results from intervention studies, mostly involving second-generation antipsychotics and cognitive behavioral therapy, are encouraging, but are currently still insufficient to make treatment recommendations for this early, relatively non-specific illness phase. The next phase of research on PRS, just now beginning, has moved to larger, 'multisite' projects to increase generalizability and to ensure that sufficiently large samples at true risk for psychosis are included. Emphasis in these emerging studies is on: 1) identification of biomarkers for conversion to psychosis; 2) examination of non-antipsychotic, neuroprotective and low-risk pharmacologic and non-pharmacologic interventions; 3) testing of potentially phase-specific interventions; 4) examination of the relationship between treatment response during PRS and prognosis for the course of illness; 5) follow-up of patients who developed schizophrenia despite early interventions and comparison of illness trajectories with patients who did not receive early interventions; 6) characterization of individuals with outcomes other than schizophrenia-spectrum disorders, such as bipolar disorder and remission from PRS, including false positive cases; and 7) assessment of meaningful social and role functioning outcomes. While the research conducted to date has already yielded crucial information, the translation of the concept of a clinically identifiable PRS into clinical practice does not seem justified at this point. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2010.02235.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=989 [article] Research in people with psychosis risk syndrome: a review of the current evidence and future directions [Texte imprimé et/ou numérique] / Christoph U. CORRELL, Auteur ; Marta HAUSER, Auteur ; Andrea M. AUTHER, Auteur ; Barbara A. CORNBLATT, Auteur . - 2010 . - p.390-431. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 51-4 (April 2010) . - p.390-431 Mots-clés : Schizophrenia psychosis risk-syndrome prodrome early-recognition early-intervention biomarker DSM-V Index. décimale : PER Périodiques Résumé : After decades of research, schizophrenia and related psychotic disorders are still among the most debilitating disorders in medicine. The chronic illness course in most individuals, greater treatment responsiveness during the first episode, progressive gray matter decline during early disease stages, and retrospective accounts of 'prodromal' or early illness signs and symptoms formed the basis for research on the psychosis risk syndrome (PRS), known variably as 'clinical high risk' (CHR), or 'ultra-high risk' (UHR), or 'prodromal'. The pioneering era of research on PRS focused on the development and validation of specific assessment tools and the delineation of high risk criteria. This was followed by the examination of conversion rates in psychosis risk cohorts followed naturalistically, identification of predictors of conversion to psychosis, and investigation of interventions able to abort or delay the development of full psychosis. Despite initially encouraging results concerning the predictive validity of PRS criteria, recent findings of declining conversion rates demonstrate the need for further investigations. Results from intervention studies, mostly involving second-generation antipsychotics and cognitive behavioral therapy, are encouraging, but are currently still insufficient to make treatment recommendations for this early, relatively non-specific illness phase. The next phase of research on PRS, just now beginning, has moved to larger, 'multisite' projects to increase generalizability and to ensure that sufficiently large samples at true risk for psychosis are included. Emphasis in these emerging studies is on: 1) identification of biomarkers for conversion to psychosis; 2) examination of non-antipsychotic, neuroprotective and low-risk pharmacologic and non-pharmacologic interventions; 3) testing of potentially phase-specific interventions; 4) examination of the relationship between treatment response during PRS and prognosis for the course of illness; 5) follow-up of patients who developed schizophrenia despite early interventions and comparison of illness trajectories with patients who did not receive early interventions; 6) characterization of individuals with outcomes other than schizophrenia-spectrum disorders, such as bipolar disorder and remission from PRS, including false positive cases; and 7) assessment of meaningful social and role functioning outcomes. While the research conducted to date has already yielded crucial information, the translation of the concept of a clinically identifiable PRS into clinical practice does not seem justified at this point. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2010.02235.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=989

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