PMID- 25720419
OWN - NLM
STAT- MEDLINE
DCOM- 20150611
LR  - 20220129
IS  - 1423-033X (Electronic)
IS  - 0254-4962 (Linking)
VI  - 48
IP  - 2
DP  - 2015
TI  - First-rank symptoms and premorbid adjustment in young individuals at increased 
      risk of developing psychosis.
PG  - 120-6
AB  - BACKGROUND: Individuals at clinical high risk (CHR) for psychosis represent a 
      heterogeneous group with a high rate of comorbid psychiatric disorders. There is 
      little information on whether certain qualitative aspects of psychotic symptoms 
      among CHR individuals may be predictive of future psychosis. This study focused 
      on describing the prevalence of first-rank symptoms (FRS) among a sample of CHR 
      individuals and its association with future transition to psychosis and, from a 
      neurodevelopmental perspective, the level of adjustment of individuals at CHR 
      during their childhood was also analysed. SAMPLING AND METHODS: Participants 
      comprised 60 individuals at CHR (according to the Comprehensive Assessment of 
      At-Risk Mental States, CAARMS) at the time of their referral to an early 
      intervention service and 60 healthy volunteers (HVs). All subjects were assessed 
      by senior research clinicians using the Mini International Neuropsychiatric 
      Interview (MINI), and the Positive and Negative Syndrome Scale (PANSS). FRS were 
      defined according to Kurt Schneider's original classification, and information 
      was collected from PANSS, CAARMS and clinical reports. Early premorbid 
      functioning was measured using the Premorbid Adjustment Scale (PAS). We grouped 
      individuals by number and type of FRS and analysed transitions to full-blown 
      psychosis over a 2-year follow-up period. We also correlated the general social 
      and functional adjustment of these individuals during their childhood (6-11 years 
      of age) with the future development of mental states at CHR and FRS. RESULTS: 
      Over 69% of CHR individuals had more than one DSM-IV psychiatric diagnosis, 
      mainly within the affective and anxiety diagnostic spectra. At least one FRS was 
      present in 43.3% of CHR individuals, and 21.6% of these had more than one. 
      Auditory hallucinations and passivity experiences were the most commonly 
      reported. Only 10% of individuals at CHR made a transition to first-episode 
      psychosis (FEP) over 2 years and, except for passivity experiences, the presence 
      of one or more FRS was not significantly associated with the transition to FEP. 
      CHR individuals, especially those with FRS, had poorer premorbid functioning and 
      adjustment as children across educational, social and peer relationship domains 
      than HVs. However, this was not associated with FEP 2 years later. CONCLUSIONS: 
      FRS might not be indicators of psychosis alone but of different psychiatric 
      disorders. In line with the neurodevelopmental model of psychosis, individuals at 
      CHR might be exhibiting several vulnerability traits and manifestations of 
      abnormal developmental processes that might predict a future psychiatric disorder 
      and/or long-term impairment.
FAU - Morcillo, C
AU  - Morcillo C
FAU - Stochl, J
AU  - Stochl J
FAU - Russo, D A
AU  - Russo DA
FAU - Zambrana, A
AU  - Zambrana A
FAU - Ratnayake, N
AU  - Ratnayake N
FAU - Jones, P B
AU  - Jones PB
FAU - Perez, J
AU  - Perez J
LA  - eng
GR  - G0001354/MRC_/Medical Research Council/United Kingdom
GR  - RP-PG-0606-1335/DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Switzerland
TA  - Psychopathology
JT  - Psychopathology
JID - 8401537
SB  - IM
MH  - *Adaptation, Psychological
MH  - Adolescent
MH  - Adult
MH  - Anxiety/psychology
MH  - Anxiety Disorders/psychology
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Mental Health Services
MH  - Prevalence
MH  - Psychotic Disorders/*epidemiology/prevention & control/*psychology
MH  - Risk Assessment
MH  - Risk Factors
MH  - *Social Adjustment
MH  - United Kingdom
MH  - Young Adult
EDAT- 2015/02/28 06:00
MHDA- 2015/06/13 06:00
CRDT- 2015/02/28 06:00
PHST- 2014/07/22 00:00 [received]
PHST- 2014/11/10 00:00 [accepted]
PHST- 2015/02/28 06:00 [entrez]
PHST- 2015/02/28 06:00 [pubmed]
PHST- 2015/06/13 06:00 [medline]
AID - 000369859 [pii]
AID - 10.1159/000369859 [doi]
PST - ppublish
SO  - Psychopathology. 2015;48(2):120-6. doi: 10.1159/000369859.