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Prognostic Accuracy of DSM-5 Attenuated Psychotic Symptoms in Adolescents: Prospective Real-World 5-year Cohort Study

Published online by Cambridge University Press:  01 September 2022

M. Iorio ,
C. Coci ,
E. Ballante ,
P. Fusar-Poli ,
R. Borgatti  and
M. Mensi
M. Iorio
Affiliation:
University of Pavia, Department Of Brain And Behavioural Sciences, Pavia, Italy
C. Coci*
Affiliation:
University of Pavia, Department Of Brain And Behavioural Sciences, Pavia, Italy
E. Ballante
Affiliation:
Università di Pavia e Bio data Center IRCCS Fondazione Mondino, Dipartimento Di Matematica, Pavia, Italy
P. Fusar-Poli
Affiliation:
Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Psychosis Studies, London, United Kingdom
R. Borgatti
Affiliation:
University of Pavia, Department Of Brain And Behavioural Sciences, Pavia, Italy Fondazione Mondino - Istituto Neurologico Nazionale IRCCS, Child Neuropsychiatry, Pavia, Italy
M. Mensi
Affiliation:
University of Pavia, Department Of Brain And Behavioural Sciences, Pavia, Italy Fondazione Mondino - Istituto Neurologico Nazionale IRCCS, Child Neuropsychiatry, Pavia, Italy
*
*Corresponding author.

Abstract

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Introduction

There is limited research in adolescent at risk for psychosis. The new criteria of Attenuated Psychosis Syndrome (APS) of Diagnostic and Statistical Manual of Mental Disorders- 5 (DSM-5) have not been validated.

Objectives

The aims of this study were to: 1) characterize adolescent’s profile with APS (DSM-5 APS) compared to adolescents with early onset psychosis (EOP) and with other psychiatric disorders (non-APS); 2) to estimate their long-term risk of transition to psychosis and prognostic accuracy of DSM-5 APS.

Methods

243 adolescents, aged 12-17, were included (October 2012- July 2019) and dived in three sub-groups (110 DSM-5 APS, 31 EOP, 102 non-APS). All underwent a comprehensive assessment evaluating: sociodemographic characteristics, family and personal history of any DSM-5 psychiatric disorders, psychopathological assessment and level of functioning. An annual follow-up evaluation was carried out (up to 7 years) including a clinical interview to investigate DSM-5 criteria for transition to psychosis.

Results

DSM-5 APS adolescents had on average higher comorbid disorders (2.3) and intermediate psychopathological and functioning profile between non-APS/EOP. The cumulative risk of transition at 1,2,3, 4-5 years was 13%, 17%, 24.2%, 26.8% and 26.8% in DSM-5 APS group, 0%, 0%, 3.2%, 3.2% and 3.2% in the non-APS. The 5-year prognostic accuracy of the DSM-5 APS in adolescent was adequate (Area Under the Curve=0.77) with high sensitivity (91.3%) and suboptimal specificity (63.2%).

Conclusions

The DSM-5 APS diagnosis can be used to detect help-seeking adolescents at risk of psychosis and predict their long-term outcomes, leading the way to new preventive approaches.

Disclosure

The authors declare that they do not have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstrac.

Keywords

PsychosisAdolescentsAttenuated Psychosis SyndromeAt risk of psychosis adolescents outcome
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S194 - S195
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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