Frequency and correlates of DSM-5 attenuated psychosis syndrome in a sample of adolescent inpatients with nonpsychotic psychiatric disorders

Miriam Gerstenberg, Marta Hauser, Aseel Al-Jadiri, Eva M. Sheridan, Taishiro Kishimoto, Yehonatan Borenstein, Ditte L. Vernal, Lisa David, Ema Saito, Sara E. Landers, Morgan Carella, Sukhbir Singh, Maren Carbon, Sara Jiménez-Fernández, Michael L. Birnbaum, Andrea Auther, Ricardo E. Carrión, Barbara A. Cornblatt, John M. Kane, Susanne WalitzaChristoph U. Correll

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Abstract

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

Original languageEnglish
Pages (from-to)e1449-e1458
JournalJournal of Clinical Psychiatry
Volume76
Issue number11
DOIs
Publication statusPublished - 2015 Nov 1

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Psychotic Disorders
Psychiatry
Inpatients
Prodromal Symptoms
Mental Disorders
Hospitalized Adolescent
Odds Ratio
Confidence Intervals
Interviews
Adolescent Psychiatry
Attention Deficit and Disruptive Behavior Disorders
Brief Psychiatric Rating Scale
Conduct Disorder
Social Isolation
Personality Disorders
Major Depressive Disorder
Bipolar Disorder
Depression

ASJC Scopus subject areas

  • Psychiatry and Mental health

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Frequency and correlates of DSM-5 attenuated psychosis syndrome in a sample of adolescent inpatients with nonpsychotic psychiatric disorders. / Gerstenberg, Miriam; Hauser, Marta; Al-Jadiri, Aseel; Sheridan, Eva M.; Kishimoto, Taishiro; Borenstein, Yehonatan; Vernal, Ditte L.; David, Lisa; Saito, Ema; Landers, Sara E.; Carella, Morgan; Singh, Sukhbir; Carbon, Maren; Jiménez-Fernández, Sara; Birnbaum, Michael L.; Auther, Andrea; Carrión, Ricardo E.; Cornblatt, Barbara A.; Kane, John M.; Walitza, Susanne; Correll, Christoph U.

In: Journal of Clinical Psychiatry, Vol. 76, No. 11, 01.11.2015, p. e1449-e1458.

Research output: Contribution to journalArticle

Gerstenberg, M, Hauser, M, Al-Jadiri, A, Sheridan, EM, Kishimoto, T, Borenstein, Y, Vernal, DL, David, L, Saito, E, Landers, SE, Carella, M, Singh, S, Carbon, M, Jiménez-Fernández, S, Birnbaum, ML, Auther, A, Carrión, RE, Cornblatt, BA, Kane, JM, Walitza, S & Correll, CU 2015, 'Frequency and correlates of DSM-5 attenuated psychosis syndrome in a sample of adolescent inpatients with nonpsychotic psychiatric disorders', Journal of Clinical Psychiatry, vol. 76, no. 11, pp. e1449-e1458. https://doi.org/10.4088/JCP.14m09435
Gerstenberg, Miriam ; Hauser, Marta ; Al-Jadiri, Aseel ; Sheridan, Eva M. ; Kishimoto, Taishiro ; Borenstein, Yehonatan ; Vernal, Ditte L. ; David, Lisa ; Saito, Ema ; Landers, Sara E. ; Carella, Morgan ; Singh, Sukhbir ; Carbon, Maren ; Jiménez-Fernández, Sara ; Birnbaum, Michael L. ; Auther, Andrea ; Carrión, Ricardo E. ; Cornblatt, Barbara A. ; Kane, John M. ; Walitza, Susanne ; Correll, Christoph U. / Frequency and correlates of DSM-5 attenuated psychosis syndrome in a sample of adolescent inpatients with nonpsychotic psychiatric disorders. In: Journal of Clinical Psychiatry. 2015 ; Vol. 76, No. 11. pp. e1449-e1458.
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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.

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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

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