PMID- 32402605
OWN - NLM
STAT- MEDLINE
DCOM- 20210617
LR  - 20231114
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Print)
IS  - 0920-9964 (Linking)
VI  - 227
DP  - 2021 Jan
TI  - Counterpoint. Early intervention for psychosis risk syndromes: Minimizing risk 
      and maximizing benefit.
PG  - 10-17
LID - S0920-9964(20)30227-9 [pii]
LID - 10.1016/j.schres.2020.04.020 [doi]
AB  - BACKGROUND: Malhi et al. in this issue critique the clinical high risk (CHR) 
      syndrome for psychosis. METHOD: Response to points of critique. RESULTS: We agree 
      that inconsistency in CHR nomenclature should be minimized. We respectfully 
      disagree on other points. In our view: a) individuals with CHR and their families 
      need help, using existing interventions, even though we do not yet fully 
      understand disease mechanisms; b) substantial progress has been made in 
      identification of biomarkers; c) symptoms used to identify CHR are specific to 
      psychotic illnesses; d) CHR diagnosis is not "extremely difficult"; e) the 
      pattern of progression, although heterogenous, is discernible; f) "psychosis-like 
      symptoms" are common but are not used to identify CHR; and g) on the point 
      described as 'the real risk,' CHR diagnosis does not frequently cause harmful 
      stigma. DISCUSSION: Malhi et al.'s arguments do not fairly characterize progress 
      in the CHR field nor efforts to minimize stigma. That said, much work remains in 
      areas of consistent nomenclature, mechanisms of disease, dissecting 
      heterogeneity, and biomarkers. With regard to what the authors term the "real 
      risk" of stigma associated with a CHR "label," however, our view is that avoiding 
      words like "risk" and "psychosis" reinforces the stigma that both they and we 
      mean to oppose. Moreover, patients and their families benefit from being given a 
      term that describes what is happening to them.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Woods, Scott W
AU  - Woods SW
AD  - Department of Psychiatry, Yale University, New Haven, CT, USA. Electronic 
      address: scott.woods@yale.edu.
FAU - Bearden, Carrie E
AU  - Bearden CE
AD  - Department of Psychiatry and Biobehavioral Sciences, Semel Institute for 
      Neuroscience and Human Behavior, University of California, Los Angeles, USA; 
      Department Psychology, Semel Institute for Neuroscience and Human Behavior, 
      University of California, Los Angeles, USA.
FAU - Sabb, Fred W
AU  - Sabb FW
AD  - Lewis Center for Neuroimaging, University of Oregon, Eugene, USA.
FAU - Stone, William S
AU  - Stone WS
AD  - Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical 
      Center, Boston, MA, USA; Shanghai Mental Health Center, Shanghai Jiaotong 
      University School of Medicine, China.
FAU - Torous, John
AU  - Torous J
AD  - Department of Psychiatry, Harvard Medical School, Beth Israel Deaconess Medical 
      Center, Boston, MA, USA.
FAU - Cornblatt, Barbara A
AU  - Cornblatt BA
AD  - Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
FAU - Perkins, Diana O
AU  - Perkins DO
AD  - Department of Psychiatry, University of North Carolina, Chapel Hill, USA.
FAU - Cadenhead, Kristin S
AU  - Cadenhead KS
AD  - Department of Psychiatry, University of California, San Diego, USA.
FAU - Addington, Jean
AU  - Addington J
AD  - Department of Psychiatry, University of Calgary, Alberta, Canada.
FAU - Powers, Albert R 3rd
AU  - Powers AR 3rd
AD  - Department of Psychiatry, Yale University, New Haven, CT, USA; Department of 
      Psychology, Yale University, New Haven, CT, USA.
FAU - Mathalon, Daniel H
AU  - Mathalon DH
AD  - Department of Psychiatry, University of California, San Francisco, USA.
FAU - Calkins, Monica E
AU  - Calkins ME
AD  - Department of Psychiatry, University of Pennsylvania, Philadelphia, USA.
FAU - Wolf, Daniel H
AU  - Wolf DH
AD  - Department of Psychiatry, University of Pennsylvania, Philadelphia, USA.
FAU - Corcoran, Cheryl M
AU  - Corcoran CM
AD  - Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 
      USA.
FAU - Horton, Leslie E
AU  - Horton LE
AD  - Department of Psychiatry, University of Pittsburgh, PA, USA.
FAU - Mittal, Vijay A
AU  - Mittal VA
AD  - Department of Psychology, Northwestern University, Evanston, IL, USA; Department 
      of Psychology, Northwestern University, Chicago, IL, USA.
FAU - Schiffman, Jason
AU  - Schiffman J
AD  - Department of Psychology, University of Maryland, Baltimore County, USA.
FAU - Ellman, Lauren M
AU  - Ellman LM
AD  - Department of Psychology, Temple University, Philadelphia, PA, USA.
FAU - Strauss, Gregory P
AU  - Strauss GP
AD  - Department of Psychology, University of Georgia, Athens, GA, USA.
FAU - Mamah, Daniel
AU  - Mamah D
AD  - Department of Psychiatry, Washington University in Saint Louis, MO, USA.
FAU - Choi, Jimmy
AU  - Choi J
AD  - Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, CT, 
      USA.
FAU - Pearlson, Godfrey D
AU  - Pearlson GD
AD  - Department of Psychiatry, Yale University, New Haven, CT, USA; Olin 
      Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, CT, USA.
FAU - Shah, Jai L
AU  - Shah JL
AD  - Department of Psychiatry, McGill University, Montreal, Canada.
FAU - Fusar-Poli, Paolo
AU  - Fusar-Poli P
AD  - Department of Psychosis Studies, King's College London, UK; Department of 
      Behavioral Sciences, University of Pavia, Pavia, Italy.
FAU - Arango, Celso
AU  - Arango C
AD  - Dept. of Child and Adolescent Psychiatry, Universidad Complutense de Madrid, 
      Spain.
FAU - Perez, Jesus
AU  - Perez J
AD  - Department of Psychiatry, University of Cambridge, UK.
FAU - Koutsouleris, Nikolaos
AU  - Koutsouleris N
AD  - Department of Psychiatry, Ludwig Maximilian University of Munich, Germany.
FAU - Wang, Jijun
AU  - Wang J
AD  - Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 
      China.
FAU - Kwon, Jun Soo
AU  - Kwon JS
AD  - Department of Psychiatry, Seoul National University College of Medicine, South 
      Korea.
FAU - Walsh, Barbara C
AU  - Walsh BC
AD  - Department of Psychiatry, Yale University, New Haven, CT, USA.
FAU - McGlashan, Thomas H
AU  - McGlashan TH
AD  - Department of Psychiatry, Yale University, New Haven, CT, USA.
FAU - Hyman, Steven E
AU  - Hyman SE
AD  - Broad Institute of MIT and Harvard, Cambridge, MA, USA.
FAU - Gur, Raquel E
AU  - Gur RE
AD  - Department of Psychiatry, University of Pennsylvania, Philadelphia, USA.
FAU - Cannon, Tyrone D
AU  - Cannon TD
AD  - Department of Psychiatry, Yale University, New Haven, CT, USA; Department of 
      Psychology, Yale University, New Haven, CT, USA.
FAU - Kane, John M
AU  - Kane JM
AD  - Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
FAU - Anticevic, Alan
AU  - Anticevic A
AD  - Department of Psychiatry, Yale University, New Haven, CT, USA; Department of 
      Psychology, Yale University, New Haven, CT, USA.
LA  - eng
GR  - R01 MH111448/MH/NIMH NIH HHS/United States
GR  - U01 MH081902/MH/NIMH NIH HHS/United States
GR  - R01 MH105178/MH/NIMH NIH HHS/United States
GR  - K23 MH115252/MH/NIMH NIH HHS/United States
GR  - R01 MH105084/MH/NIMH NIH HHS/United States
GR  - WT_/Wellcome Trust/United Kingdom
GR  - R01 MH116039/MH/NIMH NIH HHS/United States
GR  - R01 MH113533/MH/NIMH NIH HHS/United States
GR  - U01 MH081928/MH/NIMH NIH HHS/United States
GR  - R01 MH112613/MH/NIMH NIH HHS/United States
GR  - R33 MH111850/MH/NIMH NIH HHS/United States
GR  - U01 MH082022/MH/NIMH NIH HHS/United States
GR  - U01 MH081984/MH/NIMH NIH HHS/United States
GR  - R01 MH115332/MH/NIMH NIH HHS/United States
GR  - R01 MH112612/MH/NIMH NIH HHS/United States
GR  - UL1 TR001863/TR/NCATS NIH HHS/United States
GR  - R34 MH110506/MH/NIMH NIH HHS/United States
GR  - R01 MH113565/MH/NIMH NIH HHS/United States
GR  - R01 MH120088/MH/NIMH NIH HHS/United States
GR  - R01 MH112189/MH/NIMH NIH HHS/United States
GR  - U01 MH076989/MH/NIMH NIH HHS/United States
GR  - R01 MH121095/MH/NIMH NIH HHS/United States
GR  - R01 MH107558/MH/NIMH NIH HHS/United States
GR  - R01 MH107250/MH/NIMH NIH HHS/United States
GR  - K23 MH116130/MH/NIMH NIH HHS/United States
GR  - R01 MH112545/MH/NIMH NIH HHS/United States
GR  - R01 MH115000/MH/NIMH NIH HHS/United States
GR  - R01 MH119219/MH/NIMH NIH HHS/United States
GR  - R21 MH119438/MH/NIMH NIH HHS/United States
GR  - U01 MH081857/MH/NIMH NIH HHS/United States
GR  - U01 MH082004/MH/NIMH NIH HHS/United States
GR  - R01 MH105243/MH/NIMH NIH HHS/United States
GR  - U01 MH081944/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20200510
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
SB  - IM
CON - Schizophr Res. PMID: 32527679
MH  - Humans
MH  - *Psychotic Disorders/diagnosis/therapy
MH  - Social Stigma
MH  - Syndrome
PMC - PMC8218020
MID - NIHMS1593100
OTO - NOTNLM
OT  - Autonomy
OT  - Beneficence
OT  - Biomarkers
OT  - Clinical high risk (CHR)
OT  - Psychosis
OT  - Stigma
EDAT- 2020/05/14 06:00
MHDA- 2021/06/22 06:00
PMCR- 2022/01/01
CRDT- 2020/05/14 06:00
PHST- 2020/03/09 00:00 [received]
PHST- 2020/04/16 00:00 [revised]
PHST- 2020/04/16 00:00 [accepted]
PHST- 2020/05/14 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/05/14 06:00 [entrez]
PHST- 2022/01/01 00:00 [pmc-release]
AID - S0920-9964(20)30227-9 [pii]
AID - 10.1016/j.schres.2020.04.020 [doi]
PST - ppublish
SO  - Schizophr Res. 2021 Jan;227:10-17. doi: 10.1016/j.schres.2020.04.020. Epub 2020 
      May 10.