Universität zu Köln

Ruhrmann, Stephan ORCID: 0000-0002-6022-2364, Schultze-Lutter, Frauke, Schmidt, Stefanie J., Kaiser, Nathalie and Klosterkotter, Joachim (2014). Prediction and prevention of psychosis: current progress and future tasks. Eur. Arch. Psych. Clin. Neurosci., 264. S. S9 - 8. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-8491

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Abstract

Prevention of psychoses has been intensively investigated within the past two decades, and particularly, prediction has been much advanced. Depending on the applied risk indicators, current criteria are associated with average, yet significantly heterogeneous transition rates of >= 30 % within 3 years, further increasing with longer follow-up periods. Risk stratification offers a promising approach to advance current prediction as it can help to reduce heterogeneity of transition rates and to identify subgroups with specific needs and response patterns, enabling a targeted intervention. It may also be suitable to improve risk enrichment. Current results suggest the future implementation of multi-step risk algorithms combining sensitive risk detection by cognitive basic symptoms (COGDIS) and ultra-high-risk (UHR) criteria with additional individual risk estimation by a prognostic index that relies on further predictors such as additional clinical indicators, functional impairment, neurocognitive deficits, and EEG and structural MRI abnormalities, but also considers resilience factors. Simply combining COGDIS and UHR criteria in a second step of risk stratification produced already a 4-year hazard rate of 0.66. With regard to prevention, two recent meta-analyses demonstrated that preventive measures enable a reduction in 12-month transition rates by 54-56 % with most favorable numbers needed to treat of 9-10. Unfortunately, psychosocial functioning, another important target of preventive efforts, did not improve. However, these results are based on a relatively small number of trials; and more methodologically sound studies and a stronger consideration of individual profiles of clinical needs by modular intervention programs are required.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ruhrmann, Stephan UNSPECIFIED orcid.org/0000-0002-6022-2364 UNSPECIFIED Schultze-Lutter, Frauke UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Stefanie J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaiser, Nathalie UNSPECIFIED UNSPECIFIED UNSPECIFIED Klosterkotter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-425125
DOI:	10.1007/s00406-014-0541-5
Journal or Publication Title:	Eur. Arch. Psych. Clin. Neurosci.
Volume:	264
Page Range:	S. S9 - 8
Date:	2014
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-8491
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Clinical Neurology; Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42512