Universität zu Köln

Schultze-Lutter, F., Michel, C., Schmidt, S. J., Schimmelmann, B. G., Maric, N. P., Salokangas, R. K. R., Riecher-Roessler, A., van der Gaag, M., Nordentoft, M., Raballo, A., Meneghelli, A., Marshall, M., Morrison, A., Ruhrmann, S. and Klosterkoetter, J. (2015). EPA guidance on the early detection of clinical high risk states of psychoses. Eur. Psychiat., 30 (3). S. 405 - 417. ISSY-LES-MOULINEAUX: ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER. ISSN 1778-3585

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Abstract

The aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rates to psychosis in non-overlapping samples meeting any at least any one of the main CHR criteria: ultra-high risk (UHR) and/or basic symptoms criteria. Further, effects of potential moderators (different UHR criteria definitions, single UHR criteria and age) on conversion rates were examined. Conversion rates in the identified 42 samples with altogether more than 4000 CHR patients who had mainly been identified by UHR criteria and/or the basic symptom criterion 'cognitive disturbances' (COGDIS) showed considerable heterogeneity. While UHR criteria and COGDIS were related to similar conversion rates until 2-year follow-up, conversion rates of COGDIS were significantly higher thereafter. Differences in onset and frequency requirements of symptomatic UHR criteria or in their different consideration of functional decline, substance use and co-morbidity did not seem to impact on conversion rates. The 'genetic risk and functional decline' UHR criterion was rarely met and only showed an insignificant pooled sample effect. However, age significantly affected UHR conversion rates with lower rates in children and adolescents. Although more research into potential sources of heterogeneity in conversion rates is needed to facilitate improvement of CHR criteria, six evidence-based recommendations for an early detection of psychosis were developed as a basis for the EPA guidance on early intervention in CHR states. (C) 2015 Elsevier Masson SAS. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schultze-Lutter, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Michel, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, S. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schimmelmann, B. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maric, N. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Salokangas, R. K. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Riecher-Roessler, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED van der Gaag, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nordentoft, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Raballo, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meneghelli, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Marshall, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Morrison, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruhrmann, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klosterkoetter, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-406822
DOI:	10.1016/j.eurpsy.2015.01.010
Journal or Publication Title:	Eur. Psychiat.
Volume:	30
Number:	3
Page Range:	S. 405 - 417
Date:	2015
Publisher:	ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
Place of Publication:	ISSY-LES-MOULINEAUX
ISSN:	1778-3585
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ULTRA-HIGH-RISK; CHILDHOOD-ONSET SCHIZOPHRENIA; RANDOMIZED CONTROLLED-TRIAL; EUROPEAN PSYCHIATRIC ASSOCIATION; 1ST EPISODE PSYCHOSIS; AT-RISK; FOLLOW-UP; 1ST-EPISODE PSYCHOSIS; BASE-LINE; MENTAL STATES Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40682