Psychosocial predictors of distressing unusual experiences in adolescence: Testing the fit of an adult cognitive model of psychosis.

Background: For adults with psychosis, international guidelines recommend individual and family based cognitive behavioural therapy interventions. Recommendations are extended to children and adolescents, based on adult research. It is also recommended that psychological interventions are offered for childhood presentations of psychotic-like or Unusual Experiences (UE), in the absence of a formal diagnosis, when these are Distressing (UEDs).

Group acceptance and commitment therapy for patients and caregivers in psychosis services: Feasibility of training and a preliminary randomized controlled evaluation.

Objective: Psychological interventions reduce the impact of psychosis, but widescale implementation is problematic. We tested the feasibility of group acceptance and commitment therapy for Psychosis (G-ACTp), delivered by frontline staff, and co-facilitated by service-user experts-by-experience (SU-EbyE), for service-users and informal caregivers (ISRCTN: 68540929). We estimated recruitment/retention rates and outcome variability for future evaluation.

Improving Access to psychological therapies for people with severe mental illness (IAPT-SMI): Lessons from the South London and Maudsley psychosis demonstration site.

Implementation of evidence-based cognitive behavioural therapy for psychosis (CBTp) remains low in routine services. The United Kingdom Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) initiative aimed to address this issue. The project evaluated whether existing services could improve access to CBTp and demonstrate effectiveness using a systematic approach to therapy provision and outcome monitoring (in a similar way to the Improving Access to Psychological Therapies (IAPT) model for people with anxiety and depression).

The relationship between ethnicity and service access, treatment uptake and the incidence of psychosis among people at ultra high risk for psychosis.

Black ethnicity is associated with increased risk for psychosis in South London. This study explored the distribution of ethnicity among services users at ultra high risk for psychosis (UHR) and examined the influence of ethnicity on service access, treatment uptake and incidence of psychosis. The ethnic distribution of 228 people at UHR for psychosis, seen in an early detection clinical service over 10 years, was compared with 146 people with first episode psychosis from the same geographic region and census figures for the local population.

Coping with Unusual ExperienceS for 12-18 year olds (CUES+): a transdiagnostic randomised controlled trial of the effectiveness of cognitive therapy in reducing distress associated with unusual experiences in adolescent mental health services: study protocol for a randomised controlled trial.

Background: Childhood 'unusual experiences' (such as hearing voices that others cannot, or suspicions of being followed) are common, but can become more distressing during adolescence, especially for young people in contact with Child and Adolescent Mental Health Services (CAMHS). Unusual experiences that are distressing or have adverse life impact (UEDs) are associated with a range of current and future emotional, behavioural and mental health difficulties. Recommendations for psychological intervention are based on evidence from adult studies, with some support from small, pilot, child-specific evaluations.

Substance use and at-risk mental state for psychosis in 2102 prisoners: the case for early detection and early intervention in prison.

Aim: Prisoners exhibit high rates of substance use and mental health problems. In the present study, we sought to gain a detailed understanding of substance use amongst young prisoners to inform early detection and early intervention strategies in a prison setting.

Methods: This is a cross-sectional study of 2102 prisoners who were screened by the London Early Detection and Prevention in Prison Team (LEAP).

Family intervention in a prison environment: A systematic literature review.

Background: The prison population in England and Wales is approximately 85,000, and elevated rates of mental health difficulties have been reported among the prisoners. Despite frequent recommendations for family interventions to optimise prisoner outcomes, the evidence for its use and impact in prison remain unclear.

Aim: The aim of the study is to conduct a systematic review of published literature on family interventions in prisons.

Prison and Community Populations at Ultra-High Risk of Psychosis: Differences and Challenges for Service Provision.

Objective: The aim of the study was to explore the feasibility of expanding a community service for early detection of psychosis into a local London prison for men in the United Kingdom.

Methods: All new receptions to a local prison for men in South London were approached for routine screening. Those who met criteria for being at ultra-high-risk of psychosis were compared with a help-seeking sample from the community who met the same criteria.

The feasibility and acceptability of a brief Acceptance and Commitment Therapy (ACT) group intervention for people with psychosis: The 'ACT for life' study.

Background And Objectives: Acceptance and Commitment Therapy (ACT) is a contextual cognitive-behavioural approach with a developing evidence base for clinical and cost-effectiveness as an individually-delivered intervention to promote recovery from psychosis. ACT also lends itself to brief group delivery, potentially increasing access to therapy without inflating costs. This study examined, for the first time, the feasibility and acceptability of ACT groups for people with psychosis (G-ACTp).

Duration of untreated psychosis and need for admission in patients who engage with mental health services in the prodromal phase.

Background: It is unknown whether prodromal services improve outcomes in those who go on to develop psychosis, and whether these patients are demographically different from the overall first-episode population.

Aims: To compare sociodemographic features, duration of untreated psychosis, hospital admission and frequency of compulsory treatment in the first year after the onset of psychosis in patients who present to prodromal services with patients who did not present to services until the first episode of psychosis.

Method: We compared two groups of patients with first-episode psychosis: one who made transition after presenting in the prodromal phase and the other who had presented with a first episode.

Treating Multiple Incident Post-Traumatic Stress Disorder (PTSD) in an Inner City London Prison: The Need for an Evidence Base.

Background: Mental health problems have been found to be more prevalent in prison populations, and higher rates of post-traumatic stress disorder (PTSD) have been found in sentenced populations compared to the general population. Evidence-based treatment in the general population however has not been transferred and empirically supported into the prison system.

Aims: The aim of this manuscript is to illustrate how trauma focused work can be applied in a prison setting.

Spatial working memory ability in individuals at ultra high risk for psychosis.

The goal of this investigation was to clarify the nature of spatial working memory difficulties in individuals at ultra high risk (UHR) for psychosis. We evaluated spatial working memory and intelligence in 96 individuals at UHR for psychosis, 28 patients with first episode psychosis (FEP), and 23 healthy controls. Fourteen UHR individuals developed a psychotic disorder during follow-up.

Exploring perceptions of "wellness" in black ethnic minority individuals at risk of developing psychosis.

Background: The NICE Schizophrenia guidelines (NICE, 2009, Update) recommend that services should address cultural differences in treatment, expectations and adherence, and clients' explanatory models of illness should be better understood. Service users from Black African and Black Caribbean communities are overrepresented in psychosis services in the UK, yet there is no literature on how wellness is understood by this group.

Aims: This study explored perceptions of wellness in Black African and Black Caribbean individuals with an At Risk Mental State (ARMS) for psychosis.

Disorganization/cognitive and negative symptom dimensions in the at-risk mental state predict subsequent transition to psychosis.

Objective: The at-risk mental state (ARMS) is associated with a very high risk of psychosis, but it is difficult to predict which individuals will later develop psychosis on the basis of their presenting symptoms. We investigated psychopathological dimensions in subjects with an ARMS and examined whether particular symptom dimensions predicted subsequent transition to psychosis.

Method: The sample comprised 122 subjects (aged 16-35 years) meeting Personal Assessment and Crisis Evaluation clinic criteria for the ARMS recruited through Outreach and Support in South London, a clinical service for people with an ARMS.

Perceptions of disadvantage, ethnicity and psychosis.

Background: People from Black ethnic groups (African-Caribbean and Black African) are more prone to develop psychosis in Western countries. This excess might be explained by perceptions of disadvantage.

Aims: To investigate whether the higher incidence of psychosis in Black people is mediated by perceptions of disadvantage.

Obstetric conditions and risk of first admission with schizophrenia: a Danish national register based study.

A range of complications of pregnancy, abnormal fetal growth and development, and complications of delivery have been associated with increased risk of schizophrenia. Few studies have been able to adjust for a broad range of potential confounding factors. A national population nested case-control study based on Danish longitudinal registers was conducted to investigate the risk of schizophrenia associated with exposure to a range of obstetric events.

Indicators of fetal growth and bipolar disorder: a Danish national register-based study.

Background: Several studies have found an association between indicators of fetal growth and/or obstetric complications and schizophrenia but only a few studies have investigated the possible association between these factors and bipolar disorder. Furthermore, the results of these studies have been contradictory. The aim of this study was to investigate whether the risk of bipolar disorder is associated with exposure to indicators of fetal growth.

Association of schizophrenia and autoimmune diseases: linkage of Danish national registers.

Objective: Individuals with schizophrenia and their relatives tend to have either higher or lower than expected prevalences of autoimmune disorders, especially rheumatoid arthritis, celiac disease, autoimmune thyroid diseases, and type 1 diabetes. The purpose of the study was to estimate the association of schizophrenia with these disorders as well as a range of other autoimmune diseases in a single large epidemiologic study.

Method: The Danish Psychiatric Register, the National Patient Register, and a register with socioeconomic information were linked to form a data file that included all 7,704 persons in Denmark diagnosed with schizophrenia from 1981 to 1998 and their parents along with a sample of matched comparison subjects and their parents.

Neuropsychological performance over time in people at high risk of developing schizophrenia and controls.

Background: Neuropsychological assessments of relatives of schizophrenics have shown subtle impairments in verbal memory, executive and intellectual function, which are stable in those beyond the age of maximum risk for the disorder. We sought to: (1) determine baseline neurocognitive predictors of psychosis, and (2) compare performance over time between relatives within the age of maximum risk, and controls.

Methods: (1) and (2) were examined in 118 individuals at familial high risk of schizophrenia (HR) and 30 controls (C), using one-way analyses of variance (ANOVAs) and repeated measures analyses of covariance (ANCOVAs), controlling for intelligence quotient, time between and number of assessments, and correcting for multiple comparisons.

Higher socio-economic status of parents may increase risk for bipolar disorder in the offspring.

Background: There are conflicting data regarding the socio-economic risk factors for bipolar disorders. The aim of the present study was to explore the association between the socio-economic status of an individual or the parent and the risk for bipolar disorder.

Method: Two Danish registers were merged.

Obstetric adversity and age at first presentation with schizophrenia: evidence of a dose-response relationship.

Objective: The purpose of the study was to determine if a dose-response relationship exists between obstetric adversity and age at first presentation with schizophrenia.

Method: The Dublin Psychiatric Case Register was used to identify subjects with schizophrenia. Data on obstetric complications, social class of origin, and family history of psychiatric illness were obtained for those subjects.

Parental socio-economic status and risk of first admission with schizophrenia- a Danish national register based study.

Background: We examined the relationships between measures of parental and personal socio-economic status and risk of first admission with schizophrenia in order to identify whether low socio-economic status in cases is a consequence of the illness process or is a familial risk factor.

Methods: A national population-based nested case-control study based on Danish longitudinal registers was conducted. The sample included 7704 first admissions with ICD-8 or ICD-10 schizophrenia admitted to a psychiatric facility in Denmark between 1981 and 1998 and 192590 individually time-, age- and gender-matched population controls identified through national registers, and their parents and siblings.

Measurement of lateral preferences and schizophrenia: results of the Edinburgh High-Risk Study and methodological issues.

The assessment and measurement of handedness has varied across studies, limiting the comparability of results. Data from the Edinburgh High Risk for Schizophrenia Study were analyzed to investigate the effect of different methods of assessment and scoring of hand preferences on the prevalence of handedness type and on between-group differences in handedness. Handedness was measured using both the Edinburgh Handedness Inventory and the Annett Handedness Scale in 143 subjects at high risk for schizophrenia, 31 control subjects, and 27 patients with a first episode of schizophrenia.