Attenuated Psychosis and the Schizophrenia Prodrome: Current Status of Risk Identification and Psychosis Prevention

Overview

Journal Neuropsychiatry (London)

Specialty Psychiatry

Date 2012 Nov 6

PMID 23125875

Citations 16

Authors

Neeraj Tandon

Jai Shah

Matcheri S Keshavan

Rajiv Tandon

Affiliations

Soon will be listed here.

Abstract

Recent efforts in the prevention of schizophrenia have focused on defining psychosis-risk syndromes and evaluating treatments that can prevent transition to psychosis in these ultra-high risk groups. In this review, different kinds of prevention approaches are enumerated and necessary conditions for a disease-prevention strategy are summarized. The broad overlap as well as the significant difference between a schizophrenia prodrome and a 'psychosis-risk syndrome' is discussed and the present status of approaches to identify individuals at increased risk for developing psychosis and schizophrenia are critically examined along with evaluations on therapeutic interventions to reduce these risks. Finally, to conclude, recommendations for current best clinical practice and key questions for the future are suggested.

Citing Articles

N-acetylcysteine during critical neurodevelopmental periods prevents behavioral and neurochemical deficits in the Poly I:C rat model of schizophrenia.

Romero-Miguel D, Casquero-Veiga M, Lamanna-Rama N, Torres-Sanchez S, MacDowell K, Garcia-Partida J Transl Psychiatry. 2024; 14(1):14.

PMID: 38191622 PMC: 10774365. DOI: 10.1038/s41398-023-02652-7.

Sampling from different populations: Sociodemographic, clinical, and functional differences between samples of first episode psychosis individuals and clinical high-risk individuals who progressed to psychosis.

Hagler M, Ferrara M, Yoviene Sykes L, Li F, Addington J, Bearden C Schizophr Res. 2023; 255:239-245.

PMID: 37028205 PMC: 10207144. DOI: 10.1016/j.schres.2023.03.047.

Subjective Cognitive Complaints in Unaffected First-Degree Relatives of Schizophrenia Patients: Relation to Cognitive Performance, Psychotic Experiences, and Social Functioning.

Baliga S, Kedare J, Mankar U, Kamath R Indian J Psychol Med. 2022; 44(2):129-136.

PMID: 35655986 PMC: 9120994. DOI: 10.1177/02537176211010504.

The Enigma of Prodromes in Hereditary Angioedema (HAE).

Leibovich-Nassi I, Reshef A Clin Rev Allergy Immunol. 2021; 61(1):15-28.

PMID: 33534063 DOI: 10.1007/s12016-021-08839-4.

Timing, Distribution, and Relationship Between Nonpsychotic and Subthreshold Psychotic Symptoms Prior to Emergence of a First Episode of Psychosis.

Cupo L, McIlwaine S, Daneault J, Malla A, Iyer S, Joober R Schizophr Bull. 2021; 47(3):604-614.

PMID: 33410487 PMC: 8759816. DOI: 10.1093/schbul/sbaa183.

References

Cannon T, Cadenhead K, Cornblatt B, Woods S, Addington J, Walker E . Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry. 2008; 65(1):28-37. PMC: 3065347. DOI: 10.1001/archgenpsychiatry.2007.3. View

Smieskova R, Fusar-Poli P, Allen P, Bendfeldt K, Stieglitz R, Drewe J . Neuroimaging predictors of transition to psychosis--a systematic review and meta-analysis. Neurosci Biobehav Rev. 2010; 34(8):1207-22. DOI: 10.1016/j.neubiorev.2010.01.016. View

Yung A, Phillips L, Yuen H, Francey S, McFarlane C, Hallgren M . Psychosis prediction: 12-month follow up of a high-risk ("prodromal") group. Schizophr Res. 2002; 60(1):21-32. DOI: 10.1016/s0920-9964(02)00167-6. View

Werbeloff N, Drukker M, Dohrenwend B, Levav I, Yoffe R, van Os J . Self-reported attenuated psychotic symptoms as forerunners of severe mental disorders later in life. Arch Gen Psychiatry. 2012; 69(5):467-75. DOI: 10.1001/archgenpsychiatry.2011.1580. View

Ziermans T, Schothorst P, Sprong M, van Engeland H . Transition and remission in adolescents at ultra-high risk for psychosis. Schizophr Res. 2010; 126(1-3):58-64. DOI: 10.1016/j.schres.2010.10.022. View

Peters B, Blaas J, de Haan L . Diffusion tensor imaging in the early phase of schizophrenia: what have we learned?. J Psychiatr Res. 2010; 44(15):993-1004. DOI: 10.1016/j.jpsychires.2010.05.003. View

Lawrie S, McIntosh A, Hall J, Owens D, Johnstone E . Brain structure and function changes during the development of schizophrenia: the evidence from studies of subjects at increased genetic risk. Schizophr Bull. 2008; 34(2):330-40. PMC: 2632417. DOI: 10.1093/schbul/sbm158. View

McGrath J, Saha S, Welham J, El Saadi O, MacCauley C, Chant D . A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Med. 2004; 2:13. PMC: 421751. DOI: 10.1186/1741-7015-2-13. View

Chapman J . The early symptoms of schizophrenia. Br J Psychiatry. 1966; 112(484):225-51. DOI: 10.1192/bjp.112.484.225. View

10.

Schultze-Lutter F, Ruhrmann S, Berning J, Maier W, Klosterkotter J . Basic symptoms and ultrahigh risk criteria: symptom development in the initial prodromal state. Schizophr Bull. 2008; 36(1):182-91. PMC: 2800137. DOI: 10.1093/schbul/sbn072. View

11.

Gill M, Donohoe G, Corvin A . What have the genomics ever done for the psychoses?. Psychol Med. 2009; 40(4):529-40. DOI: 10.1017/S0033291709991139. View

12.

Stefansson H, Ophoff R, Steinberg S, Andreassen O, Cichon S, Rujescu D . Common variants conferring risk of schizophrenia. Nature. 2009; 460(7256):744-7. PMC: 3077530. DOI: 10.1038/nature08186. View

13.

Tandon R, Keshavan M, Nasrallah H . Schizophrenia, "just the facts" what we know in 2008. 2. Epidemiology and etiology. Schizophr Res. 2008; 102(1-3):1-18. DOI: 10.1016/j.schres.2008.04.011. View

14.

Correll C, Hauser M, Auther A, Cornblatt B . Research in people with psychosis risk syndrome: a review of the current evidence and future directions. J Child Psychol Psychiatry. 2010; 51(4):390-431. PMC: 3085111. DOI: 10.1111/j.1469-7610.2010.02235.x. View

15.

Hegelstad W, Larsen T, Auestad B, Evensen J, Haahr U, Joa I . Long-term follow-up of the TIPS early detection in psychosis study: effects on 10-year outcome. Am J Psychiatry. 2012; 169(4):374-80. DOI: 10.1176/appi.ajp.2011.11030459. View

16.

Carpenter W, van Os J . Should attenuated psychosis syndrome be a DSM-5 diagnosis?. Am J Psychiatry. 2011; 168(5):460-3. DOI: 10.1176/appi.ajp.2011.10121816. View

17.

Morrison A, French P, Stewart S, Birchwood M, Fowler D, Gumley A . Early detection and intervention evaluation for people at risk of psychosis: multisite randomised controlled trial. BMJ. 2012; 344:e2233. PMC: 3320714. DOI: 10.1136/bmj.e2233. View

18.

Insel T . Rethinking schizophrenia. Nature. 2010; 468(7321):187-93. DOI: 10.1038/nature09552. View

19.

McGrath J, Lawlor D . The search for modifiable risk factors for schizophrenia. Am J Psychiatry. 2011; 168(12):1235-8. DOI: 10.1176/appi.ajp.2011.11081300. View

20.

Sun D, Phillips L, Velakoulis D, Yung A, McGorry P, Wood S . Progressive brain structural changes mapped as psychosis develops in 'at risk' individuals. Schizophr Res. 2009; 108(1-3):85-92. PMC: 2670732. DOI: 10.1016/j.schres.2008.11.026. View