Lifetime psychiatric diagnoses among adolescents with severe conduct problems - A register-based follow-up study.

Background: Both delinquency and out-of-home care (OOHC) are associated with a wide spectrum of psychiatric disorders. Reform schools (RS) are Finnish OOHC institutions for adolescents with severe conduct problems.

Objective: We investigated the prevalence of psychiatric diagnoses among individuals with a history of RS placement.

Severe conduct problems in adolescence and risk of schizophrenia in early adulthood.

Aim: Reform school (RS) is a foster care institution for adolescents with severe conduct problems. Both instability of early rearing environment and severe conduct problems in adolescence may associate with later psychotic disorders. We studied whether the risk of schizophrenia in adulthood is elevated in RS adolescents, and whether it is related to the age at first foster care placement or placement instability.

Adult criminality among former residential school adolescents.

Background: There is evidence from around the world that disruptive behaviour during adolescence is associated with increased risk of later criminality. Outcomes for young people placed in the Finnish residential school because of severe conduct problems are not known.

Aims: Our aims were to investigate criminality after leaving a residential school placement during adolescence, and to compare trends in criminality between four successive graduate cohorts (1991, 1996, 2001 and 2006).

Evaluation of verbal list learning as a predictor of psychosis.

Aim: We explored whether cognitive performance, and verbal learning in particular, predicts psychosis or psychiatric hospitalizations among unselected first-admission adolescent patients in general psychiatric care.

Methods: Up to 152 adolescents aged 15-18 were interviewed with the SIPS, tested with a cognitive test battery in the beginning of their psychiatric treatment, and followed for a maximum of 9 years (median 4.5 years).

Adolescents in a residential school for behavior disorders have an elevated mortality risk in young adulthood.

Background: Conduct problems during adolescence are associated with an elevated mortality risk. This study investigated the mortality rate, causes of death, and changes over time in a Finnish residential school (RS) population.

Methods: All adolescents (N = 885, M/F = 594/291, age mean 15.

Predicting psychosis and psychiatric hospital care among adolescent psychiatric patients with the Prodromal Questionnaire.

The Prodromal Questionnaire (PQ) identifies psychiatric help-seekers in need of clinical interviews to diagnose psychosis risk. However, some providers use the PQ alone to identify risk. Therefore, we tested its predictive utility among 731 adolescent psychiatric help-seekers, with a 3-9-year register-based follow-up.

Predicting psychosis in a general adolescent psychiatric sample.

Introduction: Current psychosis risk criteria have often been studied on a pre-selected population at specialized clinics. We investigated whether the Structured Interview for Prodromal Syndromes (SIPS) is a useful tool for psychosis risk screening among adolescents in general psychiatric care.

Methods: 161 adolescents aged 15-18 with first admission to adolescent psychiatric services in Helsinki were interviewed with the SIPS to ascertain Clinical High-Risk (CHR) state.

Clinical high-risk state does not predict later psychosis in a delinquent adolescent population.

Aim: Adolescents with severe disruptive behaviour have an elevated risk for adult psychosis. We investigated whether the Structured Interview for Prodromal Syndromes (SIPS) is a useful psychosis risk-screening tool for adolescents with disruptive behaviour.

Method: Fifty-three adolescents residing in a reform school due to severe behavioural problems were interviewed with SIPS to ascertain clinical high-risk (CHR) state.

Low verbal ability predicts later violence in adolescent boys with serious conduct problems.

Background: Delinquent adolescents are a known high-risk group for later criminality. Cognitive deficits correlate with adult criminality, and specific cognitive deficits might predict later criminality in the high-risk adolescents.

Aims: This study aimed to explore the neuropsychological performance and predictors of adult criminal offending in adolescents with severe behavioural problems.

Prodromal psychosis screening in adolescent psychiatry clinics.

Background: Research has identified a syndrome conferring ultra-high risk (UHR) for psychosis, although UHR interviews require intensive staff training, time and patient burden. Previously, we developed the Prodromal Questionnaire (PQ) to screen more efficiently for UHR syndromes.

Aims: This study examined the concurrent validity of the PQ against UHR status and preliminary predictive validity for later psychotic disorder.

Alexithymia is common among adolescents with severe disruptive behavior.

This study aimed to examine alexithymic features and associations between alexithymia and psychiatric symptoms among adolescents living in a closed institution because of severe behavioral problems. Forty-seven adolescents (29 boys and 18 girls) aged 15 to 18 years completed the 20-item Toronto Alexithymia Scale (TAS-20) Questionnaire and the Youth Self-Report, whereas their foster parents completed the Child Behavior Checklist. The TAS-20 scores of the participants were compared with those of an extensive population sample (N = 6000) matched by age and birth year.

[Risk symptoms of psychosis in the young].

Early intervention may postpone or even prevent the onset of psychosis and relieve symptom-related anxiety. Support and follow-up observation requires up-to-date knowledge of the nature of the risk symptoms of psychosis and of the therapy of the person having symptoms within the healthcare system. Healthcare professionals should be aware of the limitations of present research information in order to assess the correct magnitude of the risk of psychosis.

The relationship between psychotic-like symptoms and neurocognitive performance in a general adolescent psychiatric sample.

Introduction: The current criteria for detecting a Clinical High-Risk (CHR) state for psychosis do not address cognitive impairment. A first step for identifying cognitive markers of psychosis risk would be to determine which aspects of neurocognitive performance are related with more severe psychotic-like symptoms. This study assessed cognitive impairment associated with prodromal symptoms in adolescents receiving public psychiatric treatment.

Efficiency of working memory encoding in twins discordant for schizophrenia.

It has been proposed that patients with schizophrenia and some of their relatives suffer from reduced neurocognitive efficiency, increasing their sensitivity to experimental task demands. The present study evaluated such a possibility during performance of a working memory task by schizophrenia patients and their co-twins along with a healthy control sample. Electrophysiological data were obtained from sets of nine twin pairs (monozygotic and dizygotic pairs collapsed) discordant for a diagnosis of schizophrenia and from nine matched healthy control twin pairs, during administration of a variable-load spatial working memory task.

Lack of association between neuropsychological performance and level of psychosis-proneness in an adolescent psychiatric sample.

Studies of the prodromal stage of schizophrenia show that the late prepsychotic phase is associated with mild neuropsychological deficits that parallel those of schizophrenia. However, it is still unclear whether this association is present across the whole range of symptoms of psychosis-proneness, or specific to the extreme groups. In this study, the linear associations between dimensions of psychosis-proneness (as measured by the 92-item Prodromal Questionnaire) and performance on 20 neuropsychological measures were assessed in a group of 71 nonpsychotic adolescent psychiatric patients.

Abnormally high EEG alpha synchrony during working memory maintenance in twins discordant for schizophrenia.

Background: The present analyses aimed to test the prediction that schizophrenia patients and their non-schizophrenic co-twins would display reduced efficiency of the neurocognitive mechanisms subserving active maintenance of spatial information in working memory.

Methods: Upper alpha frequency band EEG event-related desynchronization and synchronization (ERD/ERS) were calculated as percent changes in power relative to an inter-trial baseline across 4 memory loads in a spatial delayed-response task.

Results: During the delay, the diagnostic groups showed equivalent ERD/ERS activity over posterior scalp regions at the lowest memory load; however, as memory load increased, patients, and to an intermediate degree, their non-schizophrenic co-twins (monozygotic and dizygotic pairs collapsed together), showed significantly greater increases in ERD/ERS amplitude as compared with controls.

The relationship between performance and fMRI signal during working memory in patients with schizophrenia, unaffected co-twins, and control subjects.

While behavioral research shows working memory impairments in schizophrenics and their relatives, functional neuroimaging studies of patients and healthy controls show conflicting findings of hypo- and hyperactivation, possibly indicating different relationships between physiological activity and performance. In a between-subjects regression analysis of fMRI activation and performance, low performance was associated with relatively lower activation in patients than controls, while higher performance was associated with higher activation in patients than controls in DLPFC and parietal cortex, but not occipital cortex, with unaffected twins of schizophrenics being intermediate between the groups. Accordingly, this supports the idea that both hyper and hypoactivation may be possible along a continuum of behavioral performance in a way consistent with a neural inefficiency model.

Inherited auditory-cortical dysfunction in twin pairs discordant for schizophrenia.

Background: Information on the inheritance of neurophysiological abnormalities might help elucidate the molecular genetic basis of schizophrenia. We used magnetoencephalography (MEG) and electroencephalography (EEG) to investigate the inheritance of auditory-cortical deficiencies in twin pairs discordant for schizophrenia.

Methods: Auditory EEG/MEG responses to frequent standard and occasional deviant tones were measured in mono- and dizygotic (MZ and DZ) twin pairs discordant for schizophrenia and demographically matched healthy twin pairs, recruited from a total population cohort.

Spatial working memory as an endophenotype for schizophrenia.

Background: Spatial working memory impairments are among the neurocognitive deficits that may mark genetic predisposition toward schizophrenia. We previously reported that impairment on the spatial span subtask of the Wechsler Adult Intelligence Scale-Revised increased in a dose-dependent manner with increasing genetic predisposition toward schizophrenia in a sample of discordant twins; however, it remains to be determined whether these deficits reflect difficulties with encoding, maintenance, manipulation, time-tagging of visual spatial information, storage capacity, or complex motor response.

Methods: We developed a spatial delayed response task in which memory set size was parametrically varied, holding constant manipulation and decision processes.