The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review

Paolo Fusar-Poli; Stefan Borgwardt; Andreas Bechdolf; Jean Addington; Anita Riecher-Rössler; Frauke Schultze-Lutter; Matcheri Keshavan; Stephen Wood; Stephan Ruhrmann; Larry J Seidman; Lucia Valmaggia; Tyrone Cannon; Eva Velthorst; Lieuwe De Haan; Barbara Cornblatt; Ilaria Bonoldi; Max Birchwood; Thomas McGlashan; William Carpenter; Patrick McGorry; Joachim Klosterkötter; Philip McGuire; Alison Yung

doi:10.1001/jamapsychiatry.2013.269

The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review

Paolo Fusar-Poli^*, Stefan Borgwardt, Andreas Bechdolf, Jean Addington, Anita Riecher-Rössler, Frauke Schultze-Lutter, Matcheri Keshavan, Stephen Wood, Stephan Ruhrmann, Larry J Seidman, Lucia Valmaggia, Tyrone Cannon, Eva Velthorst, Lieuwe De Haan, Barbara Cornblatt, Ilaria Bonoldi, Max Birchwood, Thomas McGlashan, William Carpenter, Patrick McGorryJoachim Klosterkötter, Philip McGuire, Alison Yung

^*Corresponding author for this work

Research output: Contribution to journal › Literature review › peer-review

1241 Citations (Scopus)

Abstract

Context: During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5.

Objective: To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain.

Data Sources: Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences.

Study Selection and Data Extraction: Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field.

Data Synthesis: Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures.

Conclusions: The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.

Original language	English
Pages (from-to)	107-120
Number of pages	14
Journal	JAMA Psychiatry
Volume	70
Issue number	1
DOIs	https://doi.org/10.1001/jamapsychiatry.2013.269
Publication status	Published - Jan 2013

Keywords

ULTRA-HIGH-RISK
MENTAL STATE
RANDOMIZED CONTROLLED-TRIAL
INITIAL PRODROMAL PHASE
MAGNETIC-RESONANCE SPECTROSCOPY
1ST-EPISODE PSYCHOSIS
1ST EPISODE PSYCHOSIS
CLINICAL HIGH-RISK
AT-RISK
BASE-LINE CHARACTERISTICS

Access to Document

10.1001/jamapsychiatry.2013.269

Cite this

Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Riecher-Rössler, A., Schultze-Lutter, F., Keshavan, M., Wood, S., Ruhrmann, S., Seidman, L. J., Valmaggia, L., Cannon, T., Velthorst, E., De Haan, L., Cornblatt, B., Bonoldi, I., Birchwood, M., McGlashan, T., Carpenter, W., ... Yung, A. (2013). The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review. JAMA Psychiatry, 70(1), 107-120. https://doi.org/10.1001/jamapsychiatry.2013.269

@article{df32915bed6d43fea2d7af44e80770e3,

title = "The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review",

abstract = "Context: During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5.Objective: To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain.Data Sources: Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences.Study Selection and Data Extraction: Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field.Data Synthesis: Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures.Conclusions: The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.",

keywords = "ULTRA-HIGH-RISK, MENTAL STATE, RANDOMIZED CONTROLLED-TRIAL, INITIAL PRODROMAL PHASE, MAGNETIC-RESONANCE SPECTROSCOPY, 1ST-EPISODE PSYCHOSIS, 1ST EPISODE PSYCHOSIS, CLINICAL HIGH-RISK, AT-RISK, BASE-LINE CHARACTERISTICS",

author = "Paolo Fusar-Poli and Stefan Borgwardt and Andreas Bechdolf and Jean Addington and Anita Riecher-R{\"o}ssler and Frauke Schultze-Lutter and Matcheri Keshavan and Stephen Wood and Stephan Ruhrmann and Seidman, {Larry J} and Lucia Valmaggia and Tyrone Cannon and Eva Velthorst and {De Haan}, Lieuwe and Barbara Cornblatt and Ilaria Bonoldi and Max Birchwood and Thomas McGlashan and William Carpenter and Patrick McGorry and Joachim Klosterk{\"o}tter and Philip McGuire and Alison Yung",

year = "2013",

month = jan,

doi = "10.1001/jamapsychiatry.2013.269",

language = "English",

volume = "70",

pages = "107--120",

journal = "JAMA Psychiatry",

issn = "2168-622X",

publisher = "American Medical Association",

number = "1",

}

Fusar-Poli, P, Borgwardt, S, Bechdolf, A, Addington, J, Riecher-Rössler, A, Schultze-Lutter, F, Keshavan, M, Wood, S, Ruhrmann, S, Seidman, LJ, Valmaggia, L, Cannon, T, Velthorst, E, De Haan, L, Cornblatt, B, Bonoldi, I, Birchwood, M, McGlashan, T, Carpenter, W, McGorry, P, Klosterkötter, J, McGuire, P & Yung, A 2013, 'The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review', JAMA Psychiatry, vol. 70, no. 1, pp. 107-120. https://doi.org/10.1001/jamapsychiatry.2013.269

TY - JOUR

T1 - The Psychosis High-Risk State

T2 - A Comprehensive State-of-the-Art Review

AU - Fusar-Poli, Paolo

AU - Borgwardt, Stefan

AU - Bechdolf, Andreas

AU - Addington, Jean

AU - Riecher-Rössler, Anita

AU - Schultze-Lutter, Frauke

AU - Keshavan, Matcheri

AU - Wood, Stephen

AU - Ruhrmann, Stephan

AU - Seidman, Larry J

AU - Valmaggia, Lucia

AU - Cannon, Tyrone

AU - Velthorst, Eva

AU - De Haan, Lieuwe

AU - Cornblatt, Barbara

AU - Bonoldi, Ilaria

AU - Birchwood, Max

AU - McGlashan, Thomas

AU - Carpenter, William

AU - McGorry, Patrick

AU - Klosterkötter, Joachim

AU - McGuire, Philip

AU - Yung, Alison

PY - 2013/1

Y1 - 2013/1

N2 - Context: During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5.Objective: To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain.Data Sources: Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences.Study Selection and Data Extraction: Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field.Data Synthesis: Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures.Conclusions: The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.

AB - Context: During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5.Objective: To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain.Data Sources: Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences.Study Selection and Data Extraction: Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field.Data Synthesis: Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures.Conclusions: The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.

KW - ULTRA-HIGH-RISK

KW - MENTAL STATE

KW - RANDOMIZED CONTROLLED-TRIAL

KW - INITIAL PRODROMAL PHASE

KW - MAGNETIC-RESONANCE SPECTROSCOPY

KW - 1ST-EPISODE PSYCHOSIS

KW - 1ST EPISODE PSYCHOSIS

KW - CLINICAL HIGH-RISK

KW - AT-RISK

KW - BASE-LINE CHARACTERISTICS

U2 - 10.1001/jamapsychiatry.2013.269

DO - 10.1001/jamapsychiatry.2013.269

M3 - Literature review

C2 - 23165428

SN - 2168-622X

VL - 70

SP - 107

EP - 120

JO - JAMA Psychiatry

JF - JAMA Psychiatry

IS - 1

ER -

The Psychosis High-Risk State: A Comprehensive State-of-the-Art Review

Abstract

Keywords

Access to Document

Fingerprint

Cite this