The prognostic significance of attenuated psychotic symptoms in help-seeking youth

H Hazan; T Spelman; G P Amminger; I Hickie; P D McGorry; L J Phillips; R Purcell; S J Wood; A R Yung; B Nelson

doi:10.1016/j.schres.2019.10.016

The prognostic significance of attenuated psychotic symptoms in help-seeking youth

Schizophr Res. 2020 Jan:215:277-283. doi: 10.1016/j.schres.2019.10.016. Epub 2019 Oct 12.

Authors

H Hazan¹, T Spelman², G P Amminger³, I Hickie⁴, P D McGorry³, L J Phillips⁵, R Purcell³, S J Wood⁶, A R Yung⁷, B Nelson⁸

Affiliations

¹ Psychology Department, University of Otago, New Zealand.
² Burnet Institute, Melbourne, Australia.
³ Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia.
⁴ Brain and Mind Research Institute, The University of Sydney, Australia.
⁵ Melbourne School of Psychological Sciences, The University of Melbourne, Australia.
⁶ Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia; School of Psychology, University of Birmingham, United Kingdom.
⁷ Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia; Institute of Brain, Behaviour and Mental Health, University of Manchester, United Kingdom.
⁸ Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Australia. Electronic address: Barnaby.Nelson@orygen.org.au.

PMID: 31615738
DOI: 10.1016/j.schres.2019.10.016

Abstract

Background: Recent findings suggest that attenuated psychotic symptoms (APS) might serve as a risk factor for general mental health impairment in help-seeking youth. The current study was designed to test this possibility by examining the prognostic significance of APS in a large cohort of help-seeking youth not selected for psychosis risk.

Method: 465 youth aged 12-25 referred to general youth mental health services were grouped as either APS + or APS- based on whether or not they met 'ultra high risk' for psychosis APS risk criteria as assessed using the Comprehensive Assessment of At Risk Mental States (CAARMS). They completed clinical assessments at baseline and at 12-month follow-up, measuring a range of psychopathology (depression, anxiety, eating disorders, general psychological distress, substance abuse) and psychosocial functioning.

Results: APS + had significantly poorer outcomes at 12-months on a range of clinical variables, even after adjusting for baseline scores and amount of treatment received. However, the APS + group showed greater improvement in functioning at follow-up compared to APS-.

Conclusion: Attenuated psychotic symptoms are a prognostic indicator of persistent transdiagnostic mental health problems and reduced response to treatment in help-seeking youth over the short term. Hence, it is critical to screen and assess attenuated psychotic symptoms at the primary and secondary mental health services level, especially given that these subclinical symptoms are rarely voluntarily reported.

Keywords: At risk mental state; Attenuated psychotic symptoms; Psychosocial outcomes; Psychotic experiences; Transdiagnostic; Youth mental health.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Behavioral Symptoms / diagnosis*
Behavioral Symptoms / physiopathology*
Behavioral Symptoms / therapy
Child
Female
Follow-Up Studies
Humans
Male
Outcome Assessment, Health Care
Patient Acceptance of Health Care
Prodromal Symptoms
Prognosis
Psychotic Disorders / diagnosis*
Psychotic Disorders / physiopathology*
Psychotic Disorders / therapy
Risk
Young Adult