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Early Interv Psychiatry. 2017 Aug 3. doi: 10.1111/eip.12473. [Epub ahead of print]

Changes in symptom content from a clinical high-risk state to conversion to psychosis.

Author information

1
Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
2
Department of Neuroscience, Faculty of Science, University of Calgary, Calgary, Alberta, Canada.
3
Department of Psychiatry, University of California at San Diego, La Jolla, California.
4
Department of Psychology, Yale University, New Haven, Connecticut.
5
Department of Psychiatry, Zucker Hillside Hospital, Long Island, New York.
6
Department of Psychiatry, Yale University, New Haven, Connecticut.
7
Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina.
8
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
9
Departments of Psychology and Psychiatry, Emory University, Atlanta, Georgia.
10
Department of Psychiatry & Biobehavioral Sciences and Psychology, University of California at Los Angeles, Los Angeles, California.
11
Department of Psychiatry, University of California at San Francisco and SFVA Medical Center, San Francisco, California.

Abstract

AIM:

There is an interest in the transition to psychosis for those at clinical high risk of developing psychosis. This transition is typically determined by a change in severity of the attenuated symptoms as they reach a psychotic level. However, any concomitant change in the content of such symptoms has not been examined. The current study aimed to examine potential qualitative changes in the symptom content from a clinical high-risk state to a first episode of psychosis.

METHODS:

Sixty-seven individuals, who had been identified as meeting the attenuated psychotic syndrome based on the Structured Interview of Psychosis-Risk Syndromes and who later developed a full-blown psychosis were included in the study. Comprehensive clinical vignettes were written and raters were trained using the Content of Attenuated Psychotic Symptoms codebook to code for the presence of specific symptom content found within the attenuated psychotic symptoms of unusual thought content, suspicious ideas, grandiose ideas and perceptual abnormalities.

RESULTS:

Two main changes in symptom content from baseline to conversion were observed. First, content that was vague and lacked intensity progressed to being more specific, concrete and severe. Second, new symptoms appeared whose onset occurred for the first time at conversion.

CONCLUSION:

A change in symptom content should be monitored by clinicians, as changes in content may be indications of a possible transition to psychosis.

KEYWORDS:

content analysis; converters; symptom appearance; symptom progression

PMID:
28771938
PMCID:
PMC5797503
[Available on 2019-02-03]
DOI:
10.1111/eip.12473

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