Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?. Issue 3 (30th August 2015)

• Record Type: Journal Article
• Authors: Falkenberg, Irina; Valmaggia, Lucia; Byrnes, Majella; Frascarelli, Marianna; Jones, Ceri; Rocchetti, Matteo; Straube, Benjamin; Badger, Steven; McGuire, Philip; Fusar-Poli, Paolo
• Is Part Of: Psychiatry research. Volume 228:Issue 3(2015)
• Page Start: 808
• Page End: 815
• Publication Date: 2015-08-30
• Subjects: Ultra-high risk (UHR) -- Psychosis -- Help-seeking -- Psychosocial functioning -- Transition; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2015.05.018
• Languages: English
• ISSNs: 0165-1781

Abstract

Abstract: In addition to attenuated psychotic symptoms, individuals at high clinical risk of developing psychosis display a wide range of psychopathological features. Some of these may be subjectively perceived as more troubling than others and may therefore be more likely to trigger help-seeking behavior. We aimed at investigating the nature and prevalence of symptoms subjectively considered most distressing by high-risk individuals at the time of their presentation to early recognition services and to determine their impact on baseline and longitudinal functional and clinical outcomes. The clinical records of 221 clients meeting ultra-high risk (UHR) criteria and receiving care at a specialized early intervention service ("Outreach and Support in South London") between 2001 and 2011 were reviewed. Main outcome measures were reason to seek help as subjectively reported by the clients, comorbid DSM-IV SCID diagnoses, transition to psychosis, psychosocial functioning at baseline and after a median follow-up period of 4.5 years. Affective symptoms, i.e., depression and/or anxiety, were the most commonly reported subjective reasons to seek help (47.1%). Sub-threshold psychotic symptoms were reported by 39.8%. There was no significant association between subjective complaints at presentation and transition to psychosis. However, the group reporting affective symptoms as their main subjective reason to seek help at baseline had a significantly poorer longitudinal outcome in psychosocial functioning relative to the group reporting sub-threshold psychotic symptoms. Assessment of subjective complaints in UHR individuals at initial presentation may help to identify predictors of future functional outcome and tailor treatments accordingly. Highlights: Affective symptoms were the main subjective complaint in UHR people. Subjective complaints at presentation did not predict transition to psychosis. Subjective complaints for affective symptoms predicted poor functional outcomes.