, Volume 30, Issue 1, pp 18–26 | Cite as

The role of vulnerability factors in individuals with an at-risk mental state of psychosis

  • Martina Papmeyer
  • Irène Würsch
  • Erich Studerus
  • Rolf-Dieter Stieglitz
  • Anita Riecher-Rössler
original article



Several indicators of heightened vulnerability to psychosis and relevant stressors have been identified. However, it has rarely been studied prospectively to what extent these vulnerability factors are in fact more frequently present in individuals with an at-risk mental state for psychosis. Moreover, it remains unknown whether any of these contribute to the prediction of psychosis onset in at-risk mental state individuals.


There were 28 healthy controls, 86 first-episode psychosis patients and 127 at-risk mental state individuals recruited within the Basel “Früherkennung von Psychosen” project. Relative frequencies of selected vulnerability factors for psychosis were compared between healthy controls, psychosis patients, those at-risk mental state individuals with subsequent psychosis onset (n = 31) and those without subsequent psychosis onset (n = 55). Survival analyses were applied to determine associations between time to transition to psychosis and vulnerability factors in all 127 at-risk mental state individuals.


The vulnerability factors/indicators such as “difficulties during school education or vocational training”, “difficulties during employment”, “being single”, “difficulties with intimate relationships” and “being burdened with specific stressful situations” were more commonly found in the at-risk mental state and first-episode psychosis group than in healthy controls.


At-risk mental state and first-episode psychosis individuals more frequently present with vulnerability factors. Individual vulnerability factors appear, however, not to be predictive for an onset of psychosis.


Psychosis Risk Predictors Risk factors Risk assessment 

Die Bedeutung von Vulnerabilitätsfaktoren bei Personen mit einem Risikostatus für eine Psychose



Verschiedene Indikatoren für eine erhöhte Vulnerabilität für Psychosen und relevante Stressoren sind identifiziert worden. Bislang wurde jedoch nicht ausreichend untersucht, ob diese Vulnerabilitätsfaktoren auch häufiger bei Personen mit einem Risikostatus für eine Psychose und ersterkrankten Psychose-Patienten vorliegen. Zudem ist unklar, ob sie zur Prädiktion einer psychotischen Dekompensation bei Personen mit einem Psychoserisiko-Status beitragen.


Achtundzwanzig gesunde Kontrollen, 86 ersterkrankte Psychose-Patienten und 127 Personen mit einem Psychoserisiko-Status wurden innerhalb des Basler Projektes ‚Früherkennung von Psychosen‘ rekrutiert. Die relativen Häufigkeiten ausgewählter Vulnerabilitätsfaktoren für Psychose wurden zwischen gesunden Kontrollen, Psychose-Patienten, jenen Risikopatienten mit späterer Psychose-Entwicklung (n = 31) und jenen ohne Psychose-Entwicklung (n = 55) verglichen. Survival-Analysen wurden verwendet, um Assoziationen zwischen der Zeit bis zu einer psychotischen Dekompensation und Vulnerabilitätsfaktoren in allen 127 Probanden mit Psychoserisiko-Status zu bestimmen.


Die Vulnerabilitätsfaktoren/-indikatoren „Schwierigkeiten während der Schul- oder Berufsausbildung“, „Schwierigkeiten während der Arbeit“, „alleinstehend sein“, „Schwierigkeiten bei intimen Beziehungen“ und „sich belastet fühlen durch stressige Situationen“, waren häufiger bei den Psychoserisiko-Patienten und den ersterkrankten Psychose-Patienten vorhanden als bei gesunden Kontrollen.


Psychoserisiko-Patienten und ersterkrankte Psychose-Patienten weisen häufiger Vulnerabilitätsfaktoren/-indikatoren auf. Einzeln scheinen diese jedoch nicht prädiktiv für eine psychotische Dekompensation zu sein.


Psychose Risiko Prädiktoren Risikofaktoren Risikobewertung 



We thank all patients and volunteers who participated in the study as well as the referring specialists. This work was supported by the Swiss National Science Foundation (grant numbers 3200-057216.99, 3200-0572216.99, PBBSB-106936 and 3232BO-119382), the Nora van Meeuwen-Haefliger Stiftung, Basel (CH) and by unconditional grants from the Novartis Foundation, Bristol-Myers Squibb, GmbH (CH), Eli Lilly SA (CH), AstraZeneca AG (CH), Janssen-Cilag AG (CH) and Sanofi-Synthelabo AG (CH).

Compliance with ethical standards

Conflict of interest

The authors declare that there are no actual or potential conflicts of interest in relation to this article.

Supplementary material

40211_2016_179_MOESM1_ESM.docx (22 kb)
(DOC 22 kb)


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Martina Papmeyer
    • 1
    • 2
  • Irène Würsch
    • 1
  • Erich Studerus
    • 1
  • Rolf-Dieter Stieglitz
    • 1
  • Anita Riecher-Rössler
    • 1
  1. 1.Center for Gender Research and Early DetectionUniversity of Basel Psychiatric ClinicsBaselSwitzerland
  2. 2.Translational Research Center, University Hospital of PsychiatryUniversity of BernBern 60Switzerland

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