children and adolescents

By Marco Armando, M. Pontillo, F. Crescenzo, L. Mazzone, E. Monducci, N. L. Cascio, Ornella Santonastaso, Maria Laura Pucciarini, B. Schimmelmann, F. Schultze-Lutter. 2015

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article i nfo Objective:The validity of currentultra-high risk(UHR) criteriaisunder-examined inhelp-seeking minors, partic- ularly, inchildren below theage of 12years.Thus, thepresent study investigatedpredictors of one-year outcome in children and adolescents (CAD) with UHR status. Method: Thirty-five children and adolescents (age 9-17 years) meeting UHR criteria according to the Structured Interviewfor Psychosis-Risk Syndromeswere followed-upfor 12 months.Regressionanalyseswere employedto detect baseline predictors of conversion to psychosis and of outcome of non-converters (remission and persis- tence of UHR versus conversion). Results: At one-year follow-up, 20% of patients had developed schizophrenia, 25.7% had remitted from their UHR status that, consequently, had persisted in 54.3%. No patient had fully remitted from mental disorders, even if UHR status was not maintained. Conversion was best predicted by any transient psychotic symptom and a disor- ganized communication score. No prediction model for outcome beyond conversion was identified. Conclusions: Our findings provide the first evidence for the predictive utility of UHR criteria in CAD in terms of brief intermittent psychotic symptoms (BIPS) when accompanied by signs of cognitive impairment, i.e. disorga- nized communication. However, because attenuated psychotic symptoms (APS) related to thought content and perceptionwereindicativeofnon-conversionat1-yearfollow-up,theiruseinearlydetectionofpsychosisinCAD needs furtherstudy. Overall, the need for more in-depth studies into developmental peculiarities in the early de- tection and treatment of psychoses with an onset of illness in childhood and early adolescence was further highlighted.

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