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Prävalenz, Belastungsgrad und Hilfesuch-Verhalten von Personen mit Risikokriterien für die Entwicklung einer Psychose - eine Allgemeinbevölkerungsbasierte Studie

English title Prevalence and burden of at-risk criteria of psychosis and help-seeking behaviour: a population survey
Applicant Schultze-Lutter Frauke
Number 135381
Funding scheme Project funding (Div. I-III)
Research institution Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie Universitäre Psychiatrische Dienste Bern
Institution of higher education University of Berne - BE
Main discipline Mental Disorders, Psychosomatic Diseases
Start/End 01.09.2011 - 30.06.2014
Approved amount 227'038.00
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Keywords (6)

Epidemiology; Mental Disorders; Psychosis; At-Risk Mental State; Early Detection; Pathways-to-care

Lay Summary (English)

Lead
Lay summary

Early detection and treatment of persons with first signs of emerging psychosis is currently regarded the most promising strategy to reduce the enormous disability and costs associated with psychotic disorders. To this, two complementary sets of at-risk criteria are currently used: (1) ‘ultra high risk’ criteria including attenuated psychotic symptoms, brief limited intermittent psychotic symptoms and a combination of a genetic risk factor and a recent persistent significant decline in functioning and (2) the basic symptom criteria ‘cognitive-perceptive basic symptoms’ and ‘cognitive disturbances’. These, however, have as yet only been studied in selected samples of help-seeking at-risk persons that must be assumed a non-representative minority of the at-risk population. Thus, one of the main questions regarding the clinical validity of at-risk criteria is still unanswered: Do current at-risk criteria reflect behaviours so common among adolescents and young adults that a valid distinction between ill and non-ill persons is difficult?

To answer this question, the aims of this study are to assess (1) the 3-month prevalence of persons fulfilling at least one at-risk criterion in a sample of 2’750 persons from the general population of the Canton Bern (age 16 to 40), (2) their co-morbidity, psychosocial functioning and quality of life , and (3) rate and predictors of help-seeking in participants with at-risk criteria. Assessments will be carried out by trained psychologist on the telephone.

The findings of this study will be of high value for the development of future early detection strategies. (1) If at-risk criteria at population level are rather frequent phenomena of no clinical significance, screening procedures based on these criteria but also awareness and information campaigns might do more harm than good by pathologising non-clinical experiences and, consequently, by bringing persons into (potentially harmful) treatment who would not have sought help without these screenings or campaigns. In this case, at-risk criteria have to be improved, e.g., by the inclusion of severe distress or disability as an obligatory criterion. (2) On the other hand, if the prevalence of at-risk criteria was low and their presence distressing or disabling, encouraging help-seeking would be mandatory. Thereby, knowledge of variables facilitating and hindering help-seeking is important for the development of awareness and information campaigns. Yet, one way or the other, persons at risk of developing psychosis will greatly profit from the results of this study.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Age matters in the prevalence and clinical significance of ultra-high-risk for psychosis symptoms and criteria in the general population: Findings from the BEAR and BEARS-kid studies.
Schimmelmann BG, Michel C, Martz-Irngartinger A, Linder C, Schultze-Lutter F (2015), Age matters in the prevalence and clinical significance of ultra-high-risk for psychosis symptoms and criteria in the general population: Findings from the BEAR and BEARS-kid studies., in World Psychiatry, 14(2), 189-197.
Reliability of telephone assessments of at-risk criteria of psychosis: A comparison to face-to-face interviews
Michel Chantal, Schimmelmann Benno G, Kupferschmid Stephan, Siegwart Marcel, Schultze-Lutter Frauke (2014), Reliability of telephone assessments of at-risk criteria of psychosis: A comparison to face-to-face interviews, in Schizophrenia Research, 153(1-3), 251-253.
Prevalence and Clinical Significance of DSM-5-Attenuated Psychosis Syndrome in Adolescents and Young Adults in the General Population: The Bern Epidemiological At-Risk (BEAR) Study.
Schultze-Lutter Frauke, Michel Chantal, Ruhrmann Stephan, Schimmelmann Benno G (2013), Prevalence and Clinical Significance of DSM-5-Attenuated Psychosis Syndrome in Adolescents and Young Adults in the General Population: The Bern Epidemiological At-Risk (BEAR) Study., in Schizophrenia Bulletin, 40(6), 1499-1508.
Demographic and clinical characteristics of diagnosed and non-diagnosed psychotic disorders in the community.
Michel Chantal, Schimmelmann Benno G., Schultze-Lutter Frauke, Demographic and clinical characteristics of diagnosed and non-diagnosed psychotic disorders in the community., in Early Intervention in Psychiatry.

Collaboration

Group / person Country
Types of collaboration
Uniklinik Köln, Klinik für Psychiatrie und Psychotherapie, Prof. Dr. med. Stephan Ruhrmann Germany (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Insitut für Sozial- und Präventivmedizin der Universität Bern, Abteilung für Gesundheitsforschung Switzerland (Europe)
- Research Infrastructure

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
The 10th International Conference on Early Intervention in Mental Health Poster Demographic and Clinical Characteristics and Non-Diagnosed Psychotic Disorder in the Community 19.10.2016 Mailand, Italy Schultze-Lutter Frauke; Michel Chantal; Schimmelmann Benno Graf;
The 10th International Conference on Early Intervention in Mental Health Talk given at a conference Basic Symptoms in the General Population and their Association with Age 19.10.2016 Mailand, Italy Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
The 10th International Conference on Early Intervention in Mental Health Poster Prevalence of clinical high risk criteria of psychosis in the community: results from the BEAR study 19.10.2016 Mailand, Italy Schultze-Lutter Frauke; Michel Chantal;
The 10th International Conference on Early Intervention in Mental Health Poster Help-seeking for Mental Problems in the General Population: Results on the Treatment Gap from a Telephone Survey 19.10.2016 Mailand, Italy Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
The 10th International Conference on Early Intervention in Mental Health Poster Impact of age on the prevalence and clinical significance of attenuated psychotic symptoms in 8- to 40-year olds of the general population 19.10.2016 Mailand, Italy Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
SGPP Jahreskongress 2016 Poster lterseinflüsse auf Geschlechtsunterschiede in der Prävalenz und klinischen Relevanz von Ultra-High-Risk Symptomen und Kriterien in der Berner Allgemeinbevölkerung 17.08.2016 Basel, Switzerland Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
SGPP Jahreskongress 2016 Talk given at a conference Age effects in the clinical significance of symptoms used in detecting clinical high risk für psy-chosis 17.08.2016 Basel, Switzerland Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
SGPP Jahreskongress 2016 Poster Hilfesuche für psychische Beschwerden-Ergebnisse einer epidemiologischen Erhebung im Kan-ton Bern 17.08.2016 Basel, Switzerland Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
24th Biennial Meeting of the International Society for the Study of Behavioural Development Poster Age effects on the clinical significance of attenuated psychotic symptoms: a general population study 10.07.2016 Vilnius, Lithuania Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
5th European Conference on Schizophrenia Research (ECSR) Poster Prevalence of clinical high risk states of psychosis in the Swiss general population between 16 and 40 years 24.09.2015 Berlin, Germany Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
5th European Conference on Schizophrenia Research (ECSR) Talk given at a conference Impact of age on the prevalence and clinical significance of risk-symptoms in 8- to 40-year-olds of the general population 24.09.2015 Berlin, Germany Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
23rd European Congress of Psychiatry Talk given at a conference Prevalence of At-Risk Criteria of Psychosis in Children and Adolescents, and in Young Adults: Results from Two Swiss Community Samples 28.03.2015 Wien, Austria Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal; Linder Caroline;
XXXIV. DGKJP-Kongress 2015 Talk given at a conference Alterseffekte in der Prävalenz von Risikosymptomen für eine Psychose in der Allgemeinbevölkerung 04.03.2015 München, Germany Schimmelmann Benno Graf; Linder Caroline; Michel Chantal; Schultze-Lutter Frauke;
9th International Conference on Early Psychosis Talk given at a conference Prevalence of At-Risk Criteria of Psychosis in Children and Adolescents, and in Young Adults: Results from Two Swiss Community Samples 17.11.2014 Tokyo, Japan Michel Chantal; Schultze-Lutter Frauke; Linder Caroline; Schimmelmann Benno Graf;
9th International Conference on Early Psychosis Talk given at a conference Prevalence and Significance of Psychosis-Risk Criteria and Symptoms outside Specialized Eally Detection Services 17.11.2014 Tokyo, Japan Schultze-Lutter Frauke;
17th EPA Section Meeting, Epidemiology & Social Psychiatry Talk given at a conference Association of attenuated psychotic symptoms with current mental disorders, quality of life and help-seeking behaviour : results from a Swiss general population sample 21.05.2014 Ulm, Germany Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
17th EPA Section Meeting, Epidemiology & Social Psychiatry Talk given at a conference Prevalence of at-risk criteria of psychosis in the Swiss general population between 8 and 40 years 21.05.2014 Ulm, Germany Schultze-Lutter Frauke; Michel Chantal; Schimmelmann Benno Graf;
4th Biennial Schizophrenia International Research Society Conference Poster Help-seeking behaviour and at-risk criteria of psychosis in the general population: preliminary results from a telephone survey. 05.04.2014 Florenz, Italy Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
4th Biennial Schizophrenia International Research Society Conference Poster The course of at-risk symptoms of psychosis in the general population: 2-year follow-up of the Bern Epidemiological At-Risk (BEAR) study 05.04.2014 Florenz, Italy Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke; Linder Caroline;
4th Biennial Schizophrenia International Research Society Conference Poster Mental health literacy on psychosis and depression: Do labeling and causal attribution affect treatment recommendations? 05.04.2014 Florenz, Italy Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
4th Biennial Schizophrenia International Research Society Conference Poster Attitudes towards patients with psychosis and depression in the general population: Effects of labeling 05.04.2014 Florenz, Italy Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
4th Biennial Schizophrenia International Research Society Conference Poster Mental health literacy: Design of and response to an add-on questionnaire study to a population survey 05.04.2014 Florenz, Italy Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
4th Biennial Schizophrenia International Research Society Conference Poster Prevalence of at-risk criteria of psychosis in children and adolescents, and in young adults: Results from two swiss community samples 05.04.2014 Florenz, Italy Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
4th Biennial Schizophrenia International Research Society Conference Poster Mental health literacy: Is psychosis as well recognized as depression? 05.04.2014 Florenz, Italy Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
22nd European Congress of Psychiatry Poster Axis-I disorders and at-risk criteria of psychosis in the general population: preliminary results from a telephone survey 01.03.2014 München, Germany Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
22nd European Congress of Psychiatry Poster At-risk criteria of psychosis and help-seeking behaviour in the general population: preliminary results from a telephone survey 01.03.2014 München, Germany Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
22nd European Congress of Psychiatry Poster Axis-I disorders and at-risk criteria of psychosis in the general population: preliminary results from a telephone survey 01.03.2014 München, Germany Schultze-Lutter Frauke; Michel Chantal; Schimmelmann Benno Graf;
22nd European Congress of Psychiatry Poster Prevalence of at-risk criteria of psychosis in the Swiss general population between 8 and 40 years. 01.03.2014 München, Germany Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
22nd European Congress of Psychiatry Poster Prevalence and burden of at-risk criteria of psychosis and help-seeking behaviour: design and response of a population survey 01.03.2014 München, Germany Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
22nd European Congress of Psychiatry Poster Prevalence of at-risk criteria of psychosis in the Swiss general population between 8 and 40 years 01.03.2014 München, Germany Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
22nd European Congress of Psychiatry Poster At-risk criteria of psychosis and help-seeking behaviour in the general population: preliminary re-sults from a telephone survey 01.03.2014 München, Germany Schultze-Lutter Frauke; Michel Chantal; Schimmelmann Benno Graf;
22nd European Congress of Psychiatry Poster Prevalence and burden of at-risk criteria of psychosis and help-seeking behaviour: design and response of a population survey 01.03.2014 München, Germany Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
SGKJPP & SGPP Jahreskongress 2013 Poster Psychose-Risikokriterien und Hilfesuchverhalten in der Allgemeinbevölkerung 11.09.2013 Montreux, Switzerland Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
SGKJPP & SGPP Jahreskongress 2013 Poster Einstellungen der Allgemeinbevölkerung gegenüber Patienten mit Psychose oder Depression: Effekte der Mental Health Literacy 11.09.2013 Montreux, Switzerland Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
SGKJPP & SGPP Jahreskongress 2013 Poster Psychose-Risikokriterien und Lebensqualität in der Allgemeinbevölkerung: Resultate einer Telefonstudie 11.09.2013 Montreux, Switzerland Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
SGKJPP & SGPP Jahreskongress 2013 Poster „Mental Health Literacy“ zu Psychose und Depression in der Allgemeinbevölkerung 11.09.2013 Montreux, Switzerland Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
SGKJPP & SGPP Jahreskongress 2013 Poster Prävalenz und Belastung von Psychose-Risikokriterien und Hilfesuchverhalten in der Allgemeinbevölkerung: Design und Teilnehmerrate 11.09.2013 Montreux, Switzerland Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
SGKJPP & SGPP Jahreskongress 2013 Poster Achse-I-Störungen und Psychoserisikokriterien in der Allgemeinbevölkerung: Resultate einer Telefonstudie 11.09.2013 Montreux, Switzerland Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
XIV. International Congress of the IFPF Talk given at a conference Prevalence of at-risk criteria of psychosis in young adults of the general population. In Symposium: Youth mental health 05.06.2013 Leipzig, Germany Schultze-Lutter Frauke;
XIV. International Congress oft he IFPF Poster At-risk Symptoms of Psychosis and Help-Seeking Behavior in the general Population 05.06.2013 Leipzig, Germany Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
14th International Congress on Schizophrenia Research (ICOSR) Poster Association of at-risk Criteria with current Mental Disorders, Quality of Life, and Help-Seeking Behavior: Results from a telephone Survey of young Adults from the Swiss General Population 21.04.2013 Orlando, United States of America Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
14th International Congress on Schizophrenia Research (ICOSR) Poster Help-Seeking Behavior in Young Adults from the Swiss General Population Reporting Attenuated Psychotic Symptoms 21.04.2013 Orlando, United States of America Schultze-Lutter Frauke; Michel Chantal; Schimmelmann Benno Graf;
14th International Congress on Schizophrenia Research (ICOSR) Poster Prevalence of at-Risk Criteria of Psychosis in the Swiss general Population between 8 and 40 years 21.04.2013 Orlando, United States of America Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
XXXIII. DGKJP Kongress 2013 Talk given at a conference "Mental Health Literacy" zu Psychose und Depression in der Allgemeinbevölkerung 06.03.2013 Rostock, Germany Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
XXXIII. DGKJP Kongress 2013 Poster Achse-I-Störungen und Psychoserisikokriterien in der Allgemeinbevölkerung: Resultate einer Telefonstudie 06.03.2013 Rostock, Germany Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
XXXIII. DGKJP Kongress 2013 Poster Prävalenz von Risikosymptomen in der Allgemeinbevölkerung: Resultate einer Telefonstudie 06.03.2013 Rostock, Germany Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
XXXIII. DGKJP Kongress 2013 Talk given at a conference "Mental health literacy" bei Psychose und Depression: Haben Labeling und Ursachenzuschreibung eine Auswirkung auf Behandlungsempfehlungen? 06.03.2013 Rostock, Germany Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
XXXIII. DGKJP Kongress 2013 Poster Psychose-Risikokriterien und Lebensqualität in der Allgemeinbevölkerung: Resultat einer Telefonstudie 06.03.2013 Rostock, Germany Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
XXXIII. DGKJP Kongress 2013 Poster Prävalenz und Belastung von Psychose-Risikokriterien und Hilfesuchverhalten in der Allgemeinbevölkerung: Design und Teilnehmerrate 06.03.2013 Rostock, Germany Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
Kongress der deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) Poster Achse-I-Störungen und Psychoserisikokriterein in der Allgemeinbevölkerung: Vorläufige Resultate einer Telefonstudie 21.11.2012 Berlin, Germany Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
Kongress der deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) Poster Prävalenz von Risikosymptomen in der Allgemeinbevölkerung. Vorläufige Resultate einer Telefonstudie 21.11.2012 Berlin, Germany Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
8th International Conference on Early Psychosis (IEPA) Poster Axis-I disorders and at-risk criteria of psychosis in the general population: Preliminary results from a telephone survey 11.10.2012 San Francisco, United States of America Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
8th International Conference on Early Psychosis (IEPA) Poster Mental health literacy on psychosis and depression: Do labeling and casual attribution affect treatment recommendations? 11.10.2012 San Francisco, United States of America Schultze-Lutter Frauke; Michel Chantal; Schimmelmann Benno Graf;
8th International Conference on Early Psychosis (IEPA) Poster At risk criteria of psychosis and help-seeking behaviour in the general population: Preliminary results from a telephone survey 11.10.2012 San Francisco, United States of America Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
8th International Conference on Early Psychosis (IEPA) Poster At-risk criteria of psychosis and quality of life in the general population: Preliminary results from a telephone survey 11.10.2012 San Francisco, United States of America Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
8th International Conference on Early Psychosis (IEPA) Poster Prevalence and burden of at-risk criteria of psychosis and help-seeking behavior: Design and response of a population survey 11.10.2012 San Francisco, United States of America Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
8th International Conference on Early Psychosis (IEPA) Talk given at a conference Prevalence of at-risk criteria of psychosis in the general population: Preliminary results form a telephone survey 11.10.2012 San Francisco, United States of America Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
8th International Conference on Early Psychosis (IEPA) Poster Mental health literacy: Is psychosis as well recognized as depression? 11.10.2012 San Francisco, United States of America Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
8th International Conference on Early Psychosis (IEPA) Talk given at a conference Association of attenuated psychotic symptoms with current mental disorders, quality of life and help-seeking behavior: results from a Swiss general population sample. 11.10.2012 San Francisco, United States of America Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
8th International Conference on Early Psychosis (IEPA) Poster Attitudes towards patients with psychosis and depression in the general population: Effects of labeling 11.10.2012 San Francisco, United States of America Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
SGPP- Jahreskongress 2012 Talk given at a conference Wege in die Behandlung für Beschwerden im Kanton Bern. 12.09.2012 Interlaken, Switzerland Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
SGPP - Jahreskongress 2012 Talk given at a conference Bedeutung und Prävalenz von Risikosymptomen in jungen Erwachsenen aus dem Kanton Bern 12.09.2012 Interlaken, Switzerland Michel Chantal; Schultze-Lutter Frauke; Schimmelmann Benno Graf;
SGKJPP Jahreskongress 2012 Talk given at a conference Epidemiologische Studie: Risikokriterien für Psychosen in der allgemeinen Bevölkerung 30.08.2012 Zürich, Switzerland Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
2012 Biennial Meeting 3rd Biennial Schizophrenia International Research Conference Poster At-risk 20 criteria of psychosis and help-seeking behavior in the general population: preliminary results from a telephone survey 14.04.2012 Florenz, Italy Michel Chantal; Schimmelmann Benno Graf; Schultze-Lutter Frauke;
2012 Biennial Meeting 3rd Biennial Schizophrenia International Research Conference Poster Prevalence of at-risk criteria of psychosis in the general population: preliminary results from a telephone survey 12.04.2012 Florenz, Italy Schimmelmann Benno Graf; Michel Chantal; Schultze-Lutter Frauke;
2012 Biennial Meeting 3rd Biennial Schizophrenia International Research Conference Poster Prevalence and burden of at-risk criteria of psychosis and help-seeking behaviour: design and response of a population survey 12.04.2012 Florenz, Italy Schultze-Lutter Frauke; Michel Chantal; Schimmelmann Benno Graf;
2012 Biennial Meeting 3rd Biennial Schizophrenia International Research Conference Poster At-risk criteria of psychosis and quality of life in the general population: preliminary results from a telephone survey 12.04.2012 Florenz, Italy Schultze-Lutter Frauke; Michel Chantal; Schimmelmann Benno Graf;
2012 Biennial Meeting 3rd Biennial Schizophrenia International Research Conference Poster Mental health literacy: are psychoses catching up with depression? 12.04.2012 Florenz, Italy Schultze-Lutter Frauke; Schimmelmann Benno Graf; Michel Chantal;
2012 Biennial Meeting 3rd Biennial Schizophrenia International Research Conference Poster Psychopathological significance of at-risk criteria of psychosis in the general population: preliminary results from a telephone survey 12.04.2012 Florenz, Italy Schimmelmann Benno Graf; Schultze-Lutter Frauke; Michel Chantal;
16th SOPSI Congress of Psychiatry Talk given at a conference Prevalence of at-risk criteria of psychosis: interim results of a representative population survey 14.02.2012 Rom, Italy Schultze-Lutter Frauke; Schimmelmann Benno Graf;


Awards

Title Year
Erster Posterpreis am SGKJPP & SGPP Jahreskongress 2013 2013
Erster Posterpreis am XXXIII. DGKJP Kongress in Rostock 2013 2013

Associated projects

Number Title Start Funding scheme
139238 Quantitative near-infrared spectrophotometry and imaging: A proposal for a frequency domain near infrared spectrophotometer and imager, an ISS Imagent™ 01.12.2011 R'EQUIP
144100 Früherkennung von Psychosen im Kindes- und Jugendalter: Evaluation der Risikokriterien 01.09.2013 Project funding (Div. I-III)

Abstract

Background: Early detection and treatment of persons with first signs of emerging psychosis is currently regarded the most promising strategy to reduce the enormous disability and costs associated with this disease. For an early detection of psychosis, two complementary sets of at-risk criteria are currently used: (1) ‘ultra high risk’ criteria including attenuated psychotic symptoms, brief limited intermittent psychotic symptoms and a combination of a genetic risk factor and a recent persistent significant decline in functioning and (2) the basic symptom criteria ‘cognitive-perceptive basic symptoms’ and ‘cognitive disturbances’. To date, prevention research in psychosis has only been carried out in selected samples of help-seeking at-risk persons that must be assumed a non-representative minority of the at-risk population. Thus, one of the main questions regarding the clinical validity of at-risk criteria is still unanswered, i.e., whether the at-risk criteria reflect behaviours so common among adolescents and young adults that a valid distinction between ill and non-ill persons is difficult. Based on findings of epidemiological studies of psychosis-like experiences (PLEs), it has been argued, however, that at-risk criteria might indeed be common, non-pathologic phenomena. Yet, PLEs only partially - if at all - resemble at-risk criteria of psychosis. Working hypothesis and specific aims: The aims of this study are to assess (1) the 3-month prevalence of persons fulfilling at least one at-risk criterion in the general population (GP, age segment with greatest risk of psychoses, i.e., age 16 to 40), (2) their co-morbidity, psychosocial functioning and quality of life (QoL), and (3) rate and predictors of help-seeking in participants with at-risk criteria. Drawing on results of a study reporting prevalence rates of subthreshold PLEs resembling APS and own data on the 6-month prevalence of basic symptoms in a smaller GP adolescent sample, the main working hypothesis is to find a prevalence rate of ‘at least one at-risk criterion’ of 9% at most. A 2% deviation from this prevalence will be detectable with a 95% power at a=5%. The potential predictors of help-seeking are number and severity of at-risk symptoms, sociodemographic variables, axis-I co-morbidity, psychosocial functioning, QoL and current somatic health; their predictive accuracy will be assessed by multivariate logistic regression analysis.Methods: A random GP sample of the Canton Bern stratified by urbanisation, age and gender will be recruited. We expect a rate of persons with valid phone numbers of 80% and, of these, a response rate of 70%, consisting of 95% fulfilling the inclusion criteria and 5% fulfilling the exclusion criteria (life-time diagnosis of psychosis or insufficient language skills in German, English or French). Based on the calculated target sample size of 2’750 for the main hypothesis, a random sample of 5’170 contact details will be provided by the Agency for Informatics and Organisation of the Canton Bern (KAIO). Information letters will be sent to potential participants. Within 4 weeks, people will be contacted and interviewed by phone supported by ‘Computer Assisted Telephone Interviewing’ (CATI). Assessments as well as interviewing techniques will be extensively trained before the study. A lottery incentive will be used to increase response rate.Feasibility studies: The first feasibility of this design has been empirically tested by the applicants in the Canton Bern in August/September 2009 (N=102). Beside an appropriate response rate of 70%, the information letter and the incentive (lottery) were well received. Most importantly, no participant felt uncomfortable with the questions or was distressed by the interview. Furthermore, all participants signalled willingness to participate in future similar studies or follow-ups. A second feasibility study of the validity of telephone-assessed symptoms (N=40) showed that the assessment of at-risk criteria on the telephone and in face-to-face interviews lead to comparable results.Expected value: Early detection of psychoses is already widely applied in clinical and research settings both in Switzerland as well as internationally. The findings of this study will be of high value for the development of future early detection strategies. (1) If at-risk criteria at population level were rather frequent phenomena of no clinical significance (i.e., not associated with co-morbid mental disorders, poor social functioning and QoL), screening procedures based on these criteria but also awareness and information campaigns might do more harm than good by pathologising non-clinical experiences and, consequently, by bringing persons into (potentially harmful) treatment who would not have sought help without these screenings or campaigns. In this case, at-risk criteria have to be improved, e.g., by the inclusion of severe distress or disability as an obligatory criterion. (2) On the other hand, if the prevalence of at-risk criteria was low and their presence distressing or disabling, encouraging help-seeking would be mandatory. Thereby, knowledge of variables facilitating and hindering help-seeking is important for the development of awareness and information campaigns. Yet, one way or the other, persons at risk of developing psychosis will greatly profit from the results of this study.
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