Treating young individuals at clinical high risk for psychosis
Article first published online: 23 SEP 2011
© 2011 Blackwell Publishing Asia Pty Ltd
Early Intervention in Psychiatry
Volume 6, Issue 1, pages 60–68, February 2012
How to Cite
Marshall, C., Addington, J., Epstein, I., Liu, L., Deighton, S. and Zipursky, R. B. (2012), Treating young individuals at clinical high risk for psychosis. Early Intervention in Psychiatry, 6: 60–68. doi: 10.1111/j.1751-7893.2011.00299.x
- Issue published online: 24 JAN 2012
- Article first published online: 23 SEP 2011
- Received 2 February 2011; accepted 10 July 2011
- treatment outcome
Background: Typically, studies investigating those at clinical high risk for psychosis have focused on predictors of conversion and treatments that might prevent conversion to full-blown psychosis. Few studies have followed those who do not go on to develop a psychotic illness.
Methods: Participants were 48 young people who were at risk for developing psychosis based on the Structured Interview for Prodromal Symptoms criteria and participated in a treatment programme where they were offered up to 6 months of psychosocial treatment and psychiatric management. Attenuated psychotic symptoms, negative symptoms, depression, anxiety, social functioning, alcohol and drug use, and meta-cognitive beliefs were assessed at baseline, 6, 12 and 18 months. Personality characteristics were assessed at baseline. Medication use was tracked and psychiatric visits were logged over the 18-month study period.
Results: On average, participants attended 12 sessions of psychosocial treatment and had one meeting with the psychiatrist every 6 months. Only 24% were ever prescribed any psychotropic medications, and antipsychotics were not used. Significant improvements were found over time in attenuated positive symptoms, negative symptoms, depression, anxiety, meta-cognitions and social functioning with most improvement occurring in the first 6 months. There was no change in the level of substance use. For personality assessment, participants generally scored high on neuroticism and openness and had low scores on extraversion, agreeableness and conscientiousness.
Conclusion: With minimal treatment and no antipsychotics, young people who present as being at risk for developing a psychotic disorder demonstrate clinical improvement over time. However, a few continued to have the liability of ongoing attenuated psychotic symptoms.