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Before the onset of frank psychosis
Published in Kathy J Aitchison, Karena Meehan, Robin M Murray, First Episode Psychosis, 2021
Kathy J Aitchison, Karena Meehan, Robin M Murray
An alternative approach as proposed by Yung and McGorry is to consider such prodromal periods as those of ‘at risk mental state’.51 This ensures that there is the possibility that not all such ‘at risk’ periods inevitably progress to the development of frank psychosis. It also allows for any one individual potentially to experience a number of such episodes of ‘at risk mental state’ and on occasion to recover from these, depending on the interplay of various other factors known to increase the probability of a psychotic episode (such as life events, family stress). The designation of specific criteria to identify such an at risk state might include: a definite change in social functioning from a baseline levelthe presence of particular symptomatology such as change in perception, ideas of reference or delusional mood orschizotypal personality disorder19
Disorders
Published in Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson, Pocket Prescriber Psychiatry, 2019
Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson
Currently, it is impossible to predict for certain who will develop schizophrenia. However, in the At Risk Mental State (ARMS), there are attenuated psychotic symptoms (Sx), which are predictive of a 20%–30% rate of full psychosis within 2 yr. The Comprehensive Assessment of At Risk Mental State (CAARMS) is used in the National Health Service (NHS) and Australia to identify ARMS. PACE (Personal Assessment and Crisis Evaluation) or COPS (Criteria of Prodromal Symptoms) are other scoring systems used to identify ARMS.
Blood brain barrier permeability increases with age in individuals with 22q11.2 deletion syndrome
Published in The World Journal of Biological Psychiatry, 2022
Michal Taler, Ehud Mekori–Domachevsky, Elfi Vergaelen, Stephan Claes, Yaffa Serur, Shira Dar, Yael Levy-Shraga, Abraham Weizman, Ann Swillen, Doron Gothelf
The structured The Mini-International Neuropsychiatric Interview (M.I.N.I.) plus neuropsychiatric interview (Sheehan et al. 1998) was administered to all participants by trained clinicians to diagnose current or past psychiatric disorders according to DSM-IV criteria. To assess the presence of schizophrenia and other psychotic disorders section B and section C of the SCID were also administered by a trained clinician. Secondly, a comprehensive assessment of at-risk mental state (CAARMS) (Yung et al. 2005) was performed to assess attenuated psychotic symptoms in people at ultra-high risk (UHR) of developing psychosis. Based on this standardised interview adults with 22q11.2DS were divided into a group of ultra-high risk, meaning having developed psychosis-like symptoms with a significant impact on functioning, or a group of low-risk individuals, meaning not having developed significant psychosis-like symptoms. A significant level of psychosis-like symptoms was based on the frequency and intensity of these symptoms according to the criteria of the CAARMS. Psychotic symptoms in the psychotic group were assessed using the PANSS.
Subjective experience of social cognition in young people at Ultra-High Risk of psychosis: a 2-year longitudinal study
Published in Nordic Journal of Psychiatry, 2021
Lorenzo Pelizza, Michele Poletti, Silvia Azzali, Sara Garlassi, Ilaria Scazza, Federica Paterlini, Luigi Rocco Chiri, Simona Pupo, Andrea Raballo
In addition to the above mentioned alterations in socio-cognitive domains as measured using neuropsychological test batteries, our results further show a broader impairment also in subjective experience of social cognition both in prodromal and rising phase of psychosis, suggesting that these self-perceived deficits in socio-cognitive functions could represent an early clinical feature that marks the progression towards the onset of a full-blown psychotic episode. However, the potential role of social cognition alterations in transition to psychosis still remains controversial [11]. As in the present study, some findings supported no difference in baseline socio-cognitive functions between UHR converters and non-converters [24–28]. In contrast, other authors found more severe impairments in baseline social cognition in UHR converter than in non-converter [15,21]. In this respect, different methodologies in the assessment of social cognition and in the definition of the ‘at-risk mental state’ condition could explain a part of these divergent findings.
Clinical, genetic, and brain imaging predictors of risk for bipolar disorder in high-risk individuals
Published in Expert Review of Molecular Diagnostics, 2020
Luca Steardo Jr, Mirko Manchia, Bernardo Carpiniello, Claudia Pisanu, Luca Steardo, Alessio Squassina
Identifying at-risk populations and targeting them promptly before the illness onset is crucial in BD [8]. The term ‘at-risk mental state’ (ARMS) has been proposed to describe this population [9]. ARMS includes all those clinical presentations of subthreshold symptomatology that can evolve in the acute phase of illness. This concept has been first applied to healthy individuals at risk of psychosis, such as relatives (mainly first-degree) of patients affected by schizophrenia. The identification of ARMS might serve to plan an adequate therapeutic strategy. At present, there is considerable interest in exploring if these concepts and strategies can be translated from psychosis to other severe mental disorders, especially BD. While the term ‘prodromal’ indicates a sub-syndromic stage that anticipates the effective illness onset [6,10,11], and therefore can only be used retrospectively, the term ‘high-risk’ (HR) denotes prospectively a set of subthreshold symptoms in individuals who later could transit toward the overt disease. Ultra-high risk (UHR) concerns those HR individuals presenting with sub-threshold mood symptoms. To address early intervention, clinicians need to be able to identify the earliest manifestations of a subthreshold presentation and/or other risk markers of BD. Moreover, they need to predict diagnostic transitions, e.g. to a first manic episode.