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Clinical high risk for psychosis in childhood and adolescence: findings from the 2-year follow-up of the ReARMS project

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Abstract

The clinical significance and the prognostic value of clinical high risk (CHR) for psychosis, while substantially corroborated in adults, remains less firmly established in children and early adolescents. This follow-up study, developed within the Reggio Emilia At Risk Mental States project, is meant to contribute to the reduction of such lacuna, and has two main aims: (1) to characterize the clinical profile of help seekers [stratified in non-CHR, CHR and first episode psychosis (FEP)] referred to child–adolescent mental health services; and (2) to monitor the cumulative transition rate from CHR to FEP in adolescents at the follow-up of 12 and 24 months. 112 adolescents (aged 13–18 years) were assessed with the Comprehensive Assessment of At-Risk Mental States and the Schizophrenia Proneness Instrument, Child and Youth version. 51 subjects met CHR criteria (45.5% of the sample) and 33 subjects met FEP criteria (29.5%) at baseline. The criterial transition rate from CHR to FEP was 7% over 12 months and 13% over 24 months; higher rates of cumulative transition were detected when also functional transition (indexed by the consensual introduction of antipsychotic medication by the treating clinical staff) was considered. The identification of CHR for psychosis in help-seeking adolescents is feasible and clinically relevant. Studies conducted in real world, publicly funded components of the national health system, should take into consideration not only criterial, psychometric transition, but also functional equivalents of transition.

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Funding

This research did not receive any specific grant from any funding agency, commercial or not-for-profit sector. The ReARMS project is partly financed through a special regional fund: “Progetto Esordi Psicotici della Regione Emilia Romagna”.

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Authors and Affiliations

  1. Department of Mental Health and Pathological Addiction, AUSL-IRCSS di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia (RE), Italy

    Michele Poletti, Lorenzo Pelizza, Silvia Azzali, Federica Paterlini, Sara Garlassi & Ilaria Scazza

  2. Department of Mental Health and Pathological Addiction, AUSL di Bologna, Bologna, Italy

    Luigi Rocco Chiri

  3. Cmed Polyspecialistic Diagnostic and Therapeutic Centre, Rome, Italy

    Eva Gebhardt

  4. Intensive Care Unit, Anesthesia and Resuscitation Service, Guastalla Civil Hospital, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy

    Simona Pupo

  5. Department of Psychology, Childhood and Development Research Group, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Raballo Andrea

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  1. Michele Poletti
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  2. Lorenzo Pelizza
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Correspondence to Lorenzo Pelizza.

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Poletti, M., Pelizza, L., Azzali, S. et al. Clinical high risk for psychosis in childhood and adolescence: findings from the 2-year follow-up of the ReARMS project. Eur Child Adolesc Psychiatry 28, 957–971 (2019). https://doi.org/10.1007/s00787-018-1262-5

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