Clinical high risk for psychosis in childhood and adolescence: findings from the 2-year follow-up of the ReARMS project

Michele Poletti, Lorenzo Pelizza, Silvia Azzali, Federica Paterlini, Sara Garlassi, Ilaria Scazza, Luigi Rocco Chiri, Eva Gebhardt, Simona Pupo, Raballo Andrea

Research output: Contribution to journalArticle

Abstract

The clinical significance and the prognostic value of clinical high risk (CHR) for psychosis, while substantially corroborated in adults, remains less firmly established in children and early adolescents. This follow-up study, developed within the Reggio Emilia At Risk Mental States project, is meant to contribute to the reduction of such lacuna, and has two main aims: (1) to characterize the clinical profile of help seekers [stratified in non-CHR, CHR and first episode psychosis (FEP)] referred to child–adolescent mental health services; and (2) to monitor the cumulative transition rate from CHR to FEP in adolescents at the follow-up of 12 and 24 months. 112 adolescents (aged 13–18 years) were assessed with the Comprehensive Assessment of At-Risk Mental States and the Schizophrenia Proneness Instrument, Child and Youth version. 51 subjects met CHR criteria (45.5% of the sample) and 33 subjects met FEP criteria (29.5%) at baseline. The criterial transition rate from CHR to FEP was 7% over 12 months and 13% over 24 months; higher rates of cumulative transition were detected when also functional transition (indexed by the consensual introduction of antipsychotic medication by the treating clinical staff) was considered. The identification of CHR for psychosis in help-seeking adolescents is feasible and clinically relevant. Studies conducted in real world, publicly funded components of the national health system, should take into consideration not only criterial, psychometric transition, but also functional equivalents of transition.

Original languageEnglish
JournalEuropean Child and Adolescent Psychiatry
DOIs
Publication statusAccepted/In press - Jan 1 2018
Externally publishedYes

Keywords

  • Attenuated psychosis syndrome
  • Basic symptoms
  • Clinical high risk
  • Criterial transition
  • Functional transition
  • Ultrahigh risk

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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  • Cite this

    Poletti, M., Pelizza, L., Azzali, S., Paterlini, F., Garlassi, S., Scazza, I., Chiri, L. R., Gebhardt, E., Pupo, S., & Andrea, R. (Accepted/In press). Clinical high risk for psychosis in childhood and adolescence: findings from the 2-year follow-up of the ReARMS project. European Child and Adolescent Psychiatry. https://doi.org/10.1007/s00787-018-1262-5