The psychosis prodrome in adolescent patients viewed through the lens of DSM-IV

被引:108
作者
Meyer, SE
Bearden, CE
Lux, SR
Gordon, JL
Johnson, JK
O'Brien, MP
Niendam, TA
Loewy, RL
Ventura, J
Cannon, TD
机构
[1] Univ Calif Los Angeles, NPIH, Div Child & Adolescent Psychiat, Los Angeles, CA 90024 USA
[2] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA
关键词
D O I
10.1089/cap.2005.15.434
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective: Recently developed research criteria have made it possible to identify adolescents at imminent risk for psychosis. However, the array of symptomatology in these patients is broad and has not yet been systematically characterized using established diagnostic and assessment tools. Method: The authors characterized 24 adolescent research participants at the UCLA Center for the Assessment and Prevention of Prodromal States (CAPPS) using structured interviews for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, (DSM-IV), the Child Behavior Checklist (CBCL), and information regarding psychiatric treatment histories. Two composite cases are also presented. Results: The most common DSM-IV diagnosis at study entry was major depression, followed by anxiety disorder not otherwise specified (NOS), and social phobia. Most participants met criteria for at least one subthreshold condition, including obsessive-compulsive disorder (OCD), psychosis, mania or hypomania, and generalized anxiety. CBCL data revealed high rates of affective disturbance and broad-ranging symptomatology, as did participants' diagnostic and treatment histories. Conclusions: Consistent with retrospective studies of patients with first-episode psychosis, findings revealed frequent mood and anxiety disturbance during the prodromal phase of illness. The DSM-IV does not offer a clear framework for describing the widespread subthreshold symptomatology that characterizes putatively prodromal patients. The authors consider whether the psychosis prodrome merits designation as a recognized clinical entity.
引用
收藏
页码:434 / 451
页数:18
相关论文
共 32 条
[1]  
Achenbach T.M, 2000, ASEBA PRESCHOOL FORM
[2]  
ANDREASEN NC, 1992, ARCH GEN PSYCHIAT, V49, P615
[3]  
ANDREASEN NC, 1977, ARCH GEN PSYCHIAT, V34, P1229
[4]  
[Anonymous], 1996, User Guide for the Structural Clinical Interview for DSM-IV Axis I Disorders
[5]   Early and late neurodevelopmental influences in the prodrome to schizophrenia, contributions of genes, environment, and their interactions [J].
Cannon, TD ;
van Erp, TGM ;
Bearden, CE ;
Loewy, R ;
Thompson, P ;
Toga, AW ;
Huttunen, MO ;
Keshavan, MS ;
Seidman, LJ ;
Tsuang, MT .
SCHIZOPHRENIA BULLETIN, 2003, 29 (04) :653-669
[6]   MEASUREMENT OF PREMORBID ADJUSTMENT IN CHRONIC-SCHIZOPHRENIA [J].
CANNONSPOOR, HE ;
POTKIN, SG ;
WYATT, RJ .
SCHIZOPHRENIA BULLETIN, 1982, 8 (03) :470-484
[7]  
CHAMBERS WJ, 1985, ARCH GEN PSYCHIAT, V42, P696
[8]   The stress cascade and schizophrenia: Etiology and onset [J].
Corcoran, C ;
Walker, E ;
Huot, R ;
Mittal, V ;
Tessner, K ;
Kestler, L ;
Malaspina, D .
SCHIZOPHRENIA BULLETIN, 2003, 29 (04) :671-692
[9]   The schizophrenia prodrome: treatment and high-risk perspectives [J].
Cornblatt, B ;
Lencz, T ;
Obuchowski, M .
SCHIZOPHRENIA RESEARCH, 2002, 54 (1-2) :177-186
[10]   The schizophrenia prodrome revisited: A neurodevelopmental perspective [J].
Cornblatt, BA ;
Lencz, T ;
Smith, CW ;
Correll, CU ;
Auther, AM ;
Nakayama, E .
SCHIZOPHRENIA BULLETIN, 2003, 29 (04) :633-651