TY - JOUR
T1 - Frequency and correlates of DSM-5 attenuated psychosis syndrome in a sample of adolescent inpatients with nonpsychotic psychiatric disorders
AU - Gerstenberg, Miriam
AU - Hauser, Marta
AU - Al-Jadiri, Aseel
AU - Sheridan, Eva M.
AU - Kishimoto, Taishiro
AU - Borenstein, Yehonatan
AU - Vernal, Ditte L.
AU - David, Lisa
AU - Saito, Ema
AU - Landers, Sara E.
AU - Carella, Morgan
AU - Singh, Sukhbir
AU - Carbon, Maren
AU - Jiménez-Fernández, Sara
AU - Birnbaum, Michael L.
AU - Auther, Andrea
AU - Carrión, Ricardo E.
AU - Cornblatt, Barbara A.
AU - Kane, John M.
AU - Walitza, Susanne
AU - Correll, Christoph U.
N1 - Funding Information:
This work was partially supported by a Swiss National Foundation Mobility Grant (IZK0Z3_147538; Dr Gerstenberg) and by the National Institute of Mental Health Advanced Center for Services and Intervention Research, The Zucker Hillside Hospital (P30MH090590).
Publisher Copyright:
© 2015 Physicians Postgraduate Press, Inc.
PY - 2015/11
Y1 - 2015/11
N2 - Objectives: DSM-5 conceptualized attenuated psychosis syndrome (APS) as self-contained rather than as a risk syndrome, including it under "Conditions for Further Study," but also as a codable/billable condition in the main section. Since many major mental disorders emerge during adolescence, we assessed the frequency and characteristics of APS in adolescent psychiatric inpatients. Methods: Consecutively recruited adolescents hospitalized for nonpsychotic disorders (September 2009-May 2013) were divided into APS youth versus non-APS youth, based on the Structured Interview of Prodromal Syndromes (SIPS) and according to DSM-5 criteria, and compared across multiple characteristics. Results: Of 89 adolescents (mean ± SD age = 15.1 ± 1.6 years), 21 (23.6%) had APS. Compared to non-APS, APS was associated with more comorbid disorders (2.7 ± 1.0 vs 2.2 ± 1.3), major depressive disorder (61.9% vs 27.9%), oppositional defiant disorder/conduct disorder (52.4% vs 25.0%), and personality disorder traits (57.1% vs 7.4%, the only diagnostic category surviving Bonferroni correction). APS youth were more severely ill, having higher SIPS total positive, negative, and general symptoms; Brief Psychiatric Rating Scale total and positive scores; depression and global illness ratings; and lower Global Assessment of Functioning (GAF). Conversely, Young Mania Rating Scale scores, suicidal behavior, prescribed psychotropic medications, and mental disorder awareness were similar between APS and non-APS groups. In multivariable analysis, lowest GAF score in the past year (odds ratio [OR] = 51.15; 95% confidence interval [CI], 2.46-2,439.0) and social isolation (OR = 27.52; 95% CI, 3.36-313.87) were independently associated with APS (r2 = 0.302, P <.0001). Although psychotic disorders were excluded, 65.2% (APS = 57.1%, non-APS = 67.7%, P =.38) received antipsychotics. Conclusion: One in 4 nonpsychotic adolescent inpatients met DSM-5 criteria for APS. APS youth were more impaired, showing a complex entanglement with a broad range of psychiatric symptoms and disorders, including depression, impulse-control, and, especially, emerging personality disorders.
AB - Objectives: DSM-5 conceptualized attenuated psychosis syndrome (APS) as self-contained rather than as a risk syndrome, including it under "Conditions for Further Study," but also as a codable/billable condition in the main section. Since many major mental disorders emerge during adolescence, we assessed the frequency and characteristics of APS in adolescent psychiatric inpatients. Methods: Consecutively recruited adolescents hospitalized for nonpsychotic disorders (September 2009-May 2013) were divided into APS youth versus non-APS youth, based on the Structured Interview of Prodromal Syndromes (SIPS) and according to DSM-5 criteria, and compared across multiple characteristics. Results: Of 89 adolescents (mean ± SD age = 15.1 ± 1.6 years), 21 (23.6%) had APS. Compared to non-APS, APS was associated with more comorbid disorders (2.7 ± 1.0 vs 2.2 ± 1.3), major depressive disorder (61.9% vs 27.9%), oppositional defiant disorder/conduct disorder (52.4% vs 25.0%), and personality disorder traits (57.1% vs 7.4%, the only diagnostic category surviving Bonferroni correction). APS youth were more severely ill, having higher SIPS total positive, negative, and general symptoms; Brief Psychiatric Rating Scale total and positive scores; depression and global illness ratings; and lower Global Assessment of Functioning (GAF). Conversely, Young Mania Rating Scale scores, suicidal behavior, prescribed psychotropic medications, and mental disorder awareness were similar between APS and non-APS groups. In multivariable analysis, lowest GAF score in the past year (odds ratio [OR] = 51.15; 95% confidence interval [CI], 2.46-2,439.0) and social isolation (OR = 27.52; 95% CI, 3.36-313.87) were independently associated with APS (r2 = 0.302, P <.0001). Although psychotic disorders were excluded, 65.2% (APS = 57.1%, non-APS = 67.7%, P =.38) received antipsychotics. Conclusion: One in 4 nonpsychotic adolescent inpatients met DSM-5 criteria for APS. APS youth were more impaired, showing a complex entanglement with a broad range of psychiatric symptoms and disorders, including depression, impulse-control, and, especially, emerging personality disorders.
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U2 - 10.4088/JCP.14m09435
DO - 10.4088/JCP.14m09435
M3 - Article
C2 - 26646040
AN - SCOPUS:84958292319
SN - 0160-6689
VL - 76
SP - e1449-e1458
JO - Diseases of the Nervous System
JF - Diseases of the Nervous System
IS - 11
ER -
