PMID- 25735810 OWN - NLM STAT- MEDLINE DCOM- 20160509 LR - 20220318 IS - 1778-3585 (Electronic) IS - 0924-9338 (Linking) VI - 30 IP - 3 DP - 2015 Mar TI - EPA guidance on the early detection of clinical high risk states of psychoses. PG - 405-16 LID - S0924-9338(15)00054-1 [pii] LID - 10.1016/j.eurpsy.2015.01.010 [doi] AB - The aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rates to psychosis in non-overlapping samples meeting any at least any one of the main CHR criteria: ultra-high risk (UHR) and/or basic symptoms criteria. Further, effects of potential moderators (different UHR criteria definitions, single UHR criteria and age) on conversion rates were examined. Conversion rates in the identified 42 samples with altogether more than 4000 CHR patients who had mainly been identified by UHR criteria and/or the basic symptom criterion 'cognitive disturbances' (COGDIS) showed considerable heterogeneity. While UHR criteria and COGDIS were related to similar conversion rates until 2-year follow-up, conversion rates of COGDIS were significantly higher thereafter. Differences in onset and frequency requirements of symptomatic UHR criteria or in their different consideration of functional decline, substance use and co-morbidity did not seem to impact on conversion rates. The 'genetic risk and functional decline' UHR criterion was rarely met and only showed an insignificant pooled sample effect. However, age significantly affected UHR conversion rates with lower rates in children and adolescents. Although more research into potential sources of heterogeneity in conversion rates is needed to facilitate improvement of CHR criteria, six evidence-based recommendations for an early detection of psychosis were developed as a basis for the EPA guidance on early intervention in CHR states. CI - Copyright (c) 2015 Elsevier Masson SAS. All rights reserved. FAU - Schultze-Lutter, F AU - Schultze-Lutter F AD - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. FAU - Michel, C AU - Michel C AD - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. FAU - Schmidt, S J AU - Schmidt SJ AD - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. FAU - Schimmelmann, B G AU - Schimmelmann BG AD - University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. FAU - Maric, N P AU - Maric NP AD - School of Medicine, University of Belgrade and Clinic of Psychiatry, Clinical Center of Serbia, Belgrade, Serbia. FAU - Salokangas, R K R AU - Salokangas RK AD - Department of Psychiatry, University of Turku, Turku, Finland. FAU - Riecher-Rossler, A AU - Riecher-Rossler A AD - Center for Gender Research and Early Detection, Psychiatric University Clinics Basel, Basel, Switzerland. FAU - van der Gaag, M AU - van der Gaag M AD - Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands. FAU - Nordentoft, M AU - Nordentoft M AD - Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark. FAU - Raballo, A AU - Raballo A AD - Department of Mental Health, Reggio Emilia Public Health Centre, Reggio Emilia, Italy; Regional Working Group on Early Detection of Psychosis, Emilia Romagna Regional Health Service, Bologna, Italy. FAU - Meneghelli, A AU - Meneghelli A AD - Dipartimento di Salute Mentale, Centro per l'Individuazione e l'Intervento Precoce nelle Psicosi-Programma 2000, Ospedale Niguarda Ca' Granda, Milan, Italy. FAU - Marshall, M AU - Marshall M AD - School of Medicine, University of Manchester, Manchester, UK; LANTERN Centre, Lancashire Care NHS Foundation Trust, Preston, UK. FAU - Morrison, A AU - Morrison A AD - School of Psychological Sciences, University of Manchester, Manchester, UK; Psychosis Research Unit, Greater Manchester West NHS Mental Health Trust, Manchester, UK. FAU - Ruhrmann, S AU - Ruhrmann S AD - Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany. FAU - Klosterkotter, J AU - Klosterkotter J AD - Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany. Electronic address: Joachim.klosterkotter@uk-koeln.de. LA - eng PT - Journal Article PT - Meta-Analysis DEP - 20150227 PL - England TA - Eur Psychiatry JT - European psychiatry : the journal of the Association of European Psychiatrists JID - 9111820 RN - 0 (Antipsychotic Agents) SB - IM MH - Adolescent MH - Adult MH - Antipsychotic Agents/therapeutic use MH - Child MH - Cognition Disorders/diagnosis MH - *Early Diagnosis MH - Early Medical Intervention/*statistics & numerical data MH - Female MH - Humans MH - Male MH - Mood Disorders/diagnosis/therapy MH - Practice Guidelines as Topic MH - Psychiatric Status Rating Scales MH - Psychotic Disorders/*diagnosis/*therapy MH - Risk Assessment MH - Risk Factors MH - Schizophrenia/diagnosis/therapy MH - Treatment Outcome MH - Young Adult OTO - NOTNLM OT - Attenuated psychotic symptoms (APS) OT - Children and adolescents OT - Cognitive disturbances (COGDIS) OT - Meta-analysis OT - Prevention of psychosis in Europe OT - Transient psychotic symptoms (BLIPS) EDAT- 2015/03/05 06:00 MHDA- 2016/05/10 06:00 CRDT- 2015/03/05 06:00 PHST- 2014/11/10 00:00 [received] PHST- 2015/01/29 00:00 [revised] PHST- 2015/01/29 00:00 [accepted] PHST- 2015/03/05 06:00 [entrez] PHST- 2015/03/05 06:00 [pubmed] PHST- 2016/05/10 06:00 [medline] AID - S0924-9338(15)00054-1 [pii] AID - 10.1016/j.eurpsy.2015.01.010 [doi] PST - ppublish SO - Eur Psychiatry. 2015 Mar;30(3):405-16. doi: 10.1016/j.eurpsy.2015.01.010. Epub 2015 Feb 27.