Staines L., Gajwani R., Gross J., Gumley A.I., Lawrie S.M., Schwannauer M., Schultze-Lutter F., Uhlhaas P.J.
Institute for Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom; Royal College of Surgeons in Ireland, Dublin, Ireland; Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Muenster, Germany; Department of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom; Department of Clinical Psychology, University of Edinburgh, Edinburgh, United Kingdom; Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
Introduction: Duration of risk symptoms (DUR) in people at clinical high risk for psychosis (CHR-P) has been related to poorer clinical outcomes, such as reduced functioning, but it is currently unclear how different symptoms emerge as well as their link with cognitive deficits. To address these questions, we examined the duration of basic symptoms (BS) and attenuated psychotic symptoms (APS) in a sample of CHR-P participants to test the hypothesis that BS precede the manifestation of APS. As a secondary objective, we investigated the relationship between DUR, functioning and neuropsychological deficits. Methods: Data from 134 CHR-P participants were assessed with the Comprehensive Assessment of At-Risk Mental State and the Schizophrenia Proneness Interview, Adult Version. Global, role and social functioning and neurocognition were assessed and compared to a sample of healthy controls (n = 57). Results: In CHR-P participants who reported both APS and BS, onset of BS and APS was not significantly related. When divided into short and long BS duration (> 8 years), CHR-P participants with a longer duration of BS showed evidence for an onset of BS preceding APS (n = 8, p = 0.003). However, in the short BS duration group, APS showed evidence of preceding BS (n = 56, p = 0.020). Finally, there were no significant effects of DUR on cognition or functioning measures. Conclusion: The present findings do not support the view that APS constitute a secondary phenomenon to BS. Moreover, our data could also not confirm that DUR has a significant effect on functioning and cognitive deficits. These findings are discussed in the context of current theories regarding emerging psychosis and the importance of DUR. © 2021, The Author(s).
Attenuated psychotic symptoms; Basic symptoms; Clinical high risk for psychosis; Cognition; Duration; Psychosis
Publisher: BioMed Central Ltd
Volume 21, Issue 1, Art No 339, Page – , Page Count
Journal Link: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85109767851&doi=10.1186%2fs12888-021-03267-2&partnerID=40&md5=93b5f94a1cb7b2211aee1b664b157978
Type: All Open Access, Gold, Green
Norman, R.M.G., Malla, A.K., Duration of untreated psychosis: a critical examination of the concept and its importance (2001) Psychol Med, 31 (3), pp. 381-400; Marshall, M., Lewis, S., Lockwood, A., Drake, R., Jones, P., Croudace, T., Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review (2005) Arch Gen Psychiatry, 62 (9), pp. 975-983; Jonas, K.G., Fochtmann, L.J., Perlman, G., Tian, Y., Kane, J.M., Bromet, E.J., Lead-Time Bias Confounds Association Between Duration of Untreated Psychosis and Illness Course in Schizophrenia (2020) Am J Psychiatry, , http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2019.19030324, cited 2020 May 4, Available from; Rosengard, R.J., Malla, A., Mustafa, S., Iyer, S.N., Joober, R., Bodnar, M., Lepage, M., Shah, J.L., Association of pre-onset Subthreshold Psychotic Symptoms with Longitudinal Outcomes during Treatment of a first episode of psychosis (2019) JAMA Psychiatry, 76 (1), pp. 61-70; Malla, A.K., Norman, R.M.G., Manchanda, R., Ahmed, M.R., Scholten, D., Harricharan, R., Cortese, L., Takhar, J., One year outcome in first episode psychosis: influence of DUP and other predictors (2002) Schizophr Res, 54 (3), pp. 231-242; Zhang, T.H., Xu, L., Tang, Y., Cui, H., Tang, X., Wei, Y., Relationship between duration of untreated prodromal symptoms and symptomatic and functional recovery (2018) Eur Arch Psychiatry Clin Neurosci, 269 (8), pp. 871-877. , [cited 2019 Jan 28]; Available from; Carrión, R.E., Demmin, D., Auther, A.M., McLaughlin, D., Olsen, R., Lencz, T., Correll, C.U., Cornblatt, B.A., Duration of attenuated positive and negative symptoms in individuals at clinical high risk: associations with risk of conversion to psychosis and functional outcome (2016) J Psychiatr Res, 81, pp. 95-101; Nelson, B., Yuen, H.P., Lin, A., Wood, S.J., McGorry, P.D., Hartmann, J.A., Further examination of the reducing transition rate in ultra high risk for psychosis samples: the possible role of earlier intervention (2016) Schizophr Res, 174 (1-3), pp. 43-49; Zhang, T.H., Xu, L., Tang, Y., Cui, H., Wei, Y., Wang, J., Tang, X.C., Wang, J.J., Duration of untreated prodromal symptoms in a Chinese sample at a high risk for psychosis: demographic, clinical, and outcome (2018) Psychol Med, 48 (8), pp. 1274-1281; Fusar-Poli, P., Meneghelli, A., Valmaggia, L., Allen, P., Galvan, F., McGuire, P., Cocchi, A., Duration of untreated prodromal symptoms and 12-month functional outcome of individuals at risk of psychosis (2009) Br J Psychiatry, 194 (2), pp. 181-182; Chon, M.-W., Lee, T.Y., Kim, S.N., Huh, M.J., Park, H.Y., Lee, C.R., Shin, N.Y., Kwon, J.S., Factors contributing to the duration of untreated prodromal positive symptoms in individuals at ultra-high risk for psychosis (2015) Schizophr Res, 162 (1), pp. 64-66; Yung, A.R., Yung, A.R., Pan Yuen, H., Mcgorry, P.D., Phillips, L.J., Kelly, D., Dell’olio, M., Buckby, J., Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states (2005) Aust N Z J Psychiatry, 39 (11-12), pp. 964-971; Schultze-Lutter, F., Addington, J., Ruhrmann, S., Klosterkötter, J., (2007) Schizophrenia Proneness Instrument, Adult version, p. 97. , Giovanni Fioriti Editore s.r.l, Roma; Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Riecher-Rössler, A., Schultze-Lutter, F., Keshavan, M., Yung, A., The psychosis high-risk state (2013) JAMA Psychiatry., 70 (1), pp. 107-120; Schultze-Lutter, F., Klosterkötter, J., Ruhrmann, S., Improving the clinical prediction of psychosis by combining ultra-high risk criteria and cognitive basic symptoms (2014) Schizophr Res, 154 (1), pp. 100-106; Ruhrmann, S., Schultze-Lutter, F., Salokangas, R.K.R., Heinimaa, M., Linszen, D., Dingemans, P., Birchwood, M., Klosterkötter, J., Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European prediction of psychosis study (2010) Arch Gen Psychiatry, 67 (3), pp. 241-251; Youn, S., Phillips, L.J., Amminger, G.P., Berger, G., Chen, E.Y.H., de Haan, L., Hartmann, J.A., Nelson, B., Basic symptoms in young people at ultra-high risk of psychosis: association with clinical characteristics and outcomes (2020) Schizophr Res, 216, pp. 255-261; Schultze-Lutter, F., Michel, C., Ruhrmann, S., Schimmelmann, B.G., Prevalence and clinical relevance of interview-assessed psychosis-risk symptoms in the young adult community (2018) Psychol Med, 48 (7), pp. 1167-1178; Schultze-Lutter, F., Debbané, M., Theodoridou, A., Wood, S.J., Raballo, A., Michel, C., (2016); Huber, G., Gross, G., The concept of basic symptoms in schizophrenic and schizoaffective psychoses (1989) Recenti Prog Med, 80 (12), pp. 646-652. , COI: 1:STN:280:DyaK3c7ptlejtA%3D%3D, PID: 2697899; Schultze-Lutter, F., Ruhrmann, S., Berning, J., Maier, W., Klosterkötter, J., Basic symptoms and ultrahigh risk criteria: symptom development in the initial prodromal state (2010) Schizophr Bull, 36 (1), pp. 182-191; Schultze-Lutter, F., Rahman, J., Ruhrmann, S., Michel, C., Schimmelmann, B.G., Maier, W., Klosterkötter, J., Duration of unspecific prodromal and clinical high risk states, and early help-seeking in first-admission psychosis patients (2015) Soc Psychiatry Psychiatr Epidemiol, 50 (12), pp. 1831-1841; Uhlhaas, P.J., Gajwani, R., Gross, J., Gumley, A.I., Lawrie, S.M., Schwannauer, M., (2017); McDonald, M., Christoforidou, E., Van Rijsbergen, N., Gajwani, R., Gross, J., Gumley, A.I., Using online screening in the general population to detect participants at clinical high-risk for psychosis (2019) Schizophr Bull, 45 (3), pp. 600-609; Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E., The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10 (1998) J Clin Psychiatry, 59, pp. 22-33. , quiz 34–57; Cornblatt, B.A., Auther, A.M., Niendam, T., Smith, C.W., Zinberg, J., Bearden, C.E., Cannon, T.D., Preliminary findings for two new measures of social and role functioning in the prodromal phase of schizophrenia (2007) Schizophr Bull, 33 (3), pp. 688-702; Keefe, R.S.E., Goldberg, T.E., Harvey, P.D., Gold, J.M., Poe, M.P., Coughenour, L., The brief assessment of cognition in schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery (2004) Schizophr Res, 68 (2-3), pp. 283-297; Moore, T.M., Reise, S.P., Gur, R.E., Hakonarson, H., Gur, R.C., Psychometric properties of the Penn computerized neurocognitive battery (2015) Neuropsychology., 29 (2), pp. 235-246; (2019) R: A language and environment for statistical computing, , https://www.R-project.org/, R Foundation for Statistical Computing, Vienna: Available from: https://www.R-project.org/; Fusar-Poli, P., Rutigliano, G., Stahl, D., Schmidt, A., Ramella-Cravaro, V., Hitesh, S., Deconstructing pretest risk enrichment to optimize prediction of psychosis in individuals at clinical high risk (2016) JAMA Psychiatry., 73 (12), pp. 1260-1267; Fusar-Poli, P., Schultze-Lutter, F., Cappucciati, M., Rutigliano, G., Bonoldi, I., Stahl, D., Borgwardt, S., McGuire, P., The dark side of the moon: meta-analytical impact of recruitment strategies on risk enrichment in the clinical high risk state for psychosis (2016) Schizophr Bull, 42 (3), pp. 732-743; Haining, K., Matrunola, C., Mitchell, L., Gajwani, R., Gross, J., Gumley, A.I., Neuropsychological deficits in participants at clinical high risk for psychosis recruited from the community: Relationships to functioning and clinical symptoms (2020) Psychol Med, 50 (1), pp. 77-85. , https://doi.org/10.1017/S0033291718003975, Epub 2019 Mar 13; Rapp, C., Studerus, E., Bugra, H., Aston, J., Tamagni, C., Walter, A., Pflueger, M., Riecher-Rössler, A., Duration of untreated psychosis and cognitive functioning (2013) Schizophr Res, 145 (1-3), pp. 43-49; Mills, J.G., Fusar-Poli, P., Morgan, C., Azis, M., McGuire, P., People meeting ultra high risk for psychosis criteria in the community (2017) World Psychiatry, 16 (3), pp. 322-323
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