A critique of the "ultra-high risk" and "transition" paradigm

World Psychiatry : Official Journal of the World Psychiatric Association (WPA)
Jim van Os, Sinan Guloksuz

Abstract

The transdiagnostic expression of psychotic experiences in common mental disorder (anxiety/depression/substance use disorder) is associated with a poorer prognosis, and a small minority of people may indeed develop a clinical picture that meets criteria for schizophrenia. However, it appears neither useful nor valid to observe early states of multidimensional psychopathology in young people through the "schizo"-prism, and apply misleadingly simple, unnecessary and inefficient binary concepts of "risk" and "transition". A review of the "ultra-high risk" (UHR) or "clinical high risk" (CHR) literature indicates that UHR/CHR samples are highly heterogeneous and represent individuals diagnosed with common mental disorder (anxiety/depression/substance use disorder) and a degree of psychotic experiences. Epidemiological research has shown that psychotic experiences are a (possibly non-causal) marker of the severity of multidimensional psychopathology, driving poor outcome, yet notions of "risk" and "transition" in UHR/CHR research are restrictively defined on the basis of positive psychotic phenomena alone, ignoring how baseline differences in multidimensional psychopathology may differentially impact course and outcome. The concepts ...Continue Reading

References

Jan 1, 1970·The American Journal of Psychiatry·E Robins, S B Guze
Jun 6, 1981·British Medical Journal·G Rose
Jan 1, 1996·Schizophrenia Bulletin·A R Yung, P D McGorry
Oct 26, 2000·The Journal of Nervous and Mental Disease·A S Kablinger, A M Freeman
Dec 14, 2005·The Australian and New Zealand Journal of Psychiatry·Alison R YungJoe Buckby
Sep 12, 2006·European Child & Adolescent Psychiatry·Andor E SimonDaniel Umbricht
Nov 28, 2007·The Medical Journal of Australia·Patrick D McGorryJohn Moran
Jan 9, 2008·Archives of General Psychiatry·Tyrone D CannonRobert Heinssen
Feb 12, 2009·Journal of the Royal Society of Medicine·Richard SmithHeather Kinlaw
Jul 26, 2011·Schizophrenia Research·Andor E SimonLieuwe de Haan
Sep 13, 2011·Schizophrenia Research·Judith RietdijkMark van der Gaag
Sep 29, 2011·Early Intervention in Psychiatry·Catherine MarshallRobert B Zipursky
Apr 14, 2012·The British Journal of Psychiatry : the Journal of Mental Science·Ian KelleherMary Cannon
Jun 15, 2012·The Australian and New Zealand Journal of Psychiatry·Andrew Amos
Jun 22, 2012·The International Journal of Neuropsychopharmacology·Camilo de la Fuente-SandovalAriel Graff-Guerrero
Nov 10, 2012·Acta Psychiatrica Scandinavica·P Fusar-Poli, J Van Os
Sep 6, 2013·JAMA Psychiatry·Ricardo E CarriónBarbara A Cornblatt
Nov 15, 2013·Early Intervention in Psychiatry·Jean AddingtonKristin S Cadenhead
Dec 10, 2013·European Psychiatry : the Journal of the Association of European Psychiatrists·R K R SalokangasUNKNOWN EPOS group
Jul 19, 2014·Biological Psychiatry·Tyrone D CannonUNKNOWN North American Prodrome Longitudinal Study Consortium
Mar 5, 2015·European Psychiatry : the Journal of the Association of European Psychiatrists·F Schultze-LutterJ Klosterkötter
Mar 10, 2015·European Psychiatry : the Journal of the Association of European Psychiatrists·S J SchmidtS Ruhrmann
Jun 15, 2015·Psychiatry Research·Irina FalkenbergPaolo Fusar-Poli
Nov 1, 2012·Perspectives on Psychological Science : a Journal of the Association for Psychological Science

❮ Previous
Next ❯

Citations

Jul 19, 2018·Early Intervention in Psychiatry·David PeraltaAnita Riecher-Rössler
Jan 15, 2018·Psychological Medicine·Tais Silveira MoriyamaRodrigo Affonseca Bressan
Oct 26, 2018·Evidence-based Mental Health·Patrick D McGorry, Cristina Mei
Oct 5, 2018·Evidence-based Mental Health·Sinan Guloksuz, Jim van Os
Oct 20, 2018·Schizophrenia Bulletin·Andrea RaballoWilliam T Carpenter
Dec 27, 2018·Psychological Medicine·Olesya AjnakinaRobin M Murray
Jun 20, 2019·Frontiers in Psychiatry·Marco ArmandoMartin Debbané
Dec 29, 2019·Early Intervention in Psychiatry·Clare HowieCiaran Mulholland
Feb 19, 2020·Molecular Psychiatry·Christina Andreou, Stefan Borgwardt
Apr 28, 2020·Early Intervention in Psychiatry·Matilda AzisVijay A Mittal
May 19, 2020·Early Intervention in Psychiatry·Eduardo Fonseca-PedreroJulio Bobes
Jun 24, 2020·Early Intervention in Psychiatry·Victoria C PattersonRudolf Uher
Feb 14, 2020·Journal of Autism and Developmental Disorders·E H HorwitzC A Hartman
Sep 16, 2020·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Sinan Guloksuz, Jim van Os
Jun 2, 2018·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Christoph U CorrellJohn M Kane
Nov 17, 2019·European Child & Adolescent Psychiatry·Martin K RimvallPia Jeppesen
Sep 19, 2020·Early Intervention in Psychiatry·Hella JanssenFloortje Scheepers
Sep 14, 2018·Frontiers in Psychology·David M Lydon-Staley, Danielle S Bassett
Sep 15, 2018·Psychological Medicine·TianHong ZhangUNKNOWN SHARP (ShangHai At Risk for Psychosis) Study Group
Apr 1, 2020·International Journal of Mental Health Systems·Marco ColizziMirella Ruggeri
Apr 3, 2020·Psychological Medicine·Peter ZacharKenneth S Kendler
Apr 3, 2020·The American Journal of Psychiatry·René S Kahn
Jul 20, 2020·Social Psychiatry and Psychiatric Epidemiology·Patrick D McGorryAlison Yung
Jun 2, 2018·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Patrick D McGorryBarnaby Nelson
Jun 29, 2017·Schizophrenia Bulletin·Jason Schiffman
Oct 5, 2018·Frontiers in Psychiatry·Frauke Schultze-LutterAnastasia Theodoridou

❮ Previous
Next ❯

Related Concepts

Related Feeds

Alcohol Use Disorder

Alcohol use disorder involves a pattern of alcohol consumption that includes compulsive use and a loss of control over intake of alcohol. The impact on physical health, socioeconomic factors, and psychiatric health is profound. Find the latest research on alcohol use disorder here.

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here