The empirical success of the Clinical High Risk for Psychosis (CHR-P) paradigm is determined by the concurrent integration of efficient detection of cases at-risk, accurate prognosis, and effective preventive treatment within specialized clinical services. The characteristics of the CHR-P services are relatively under-investigated. A Pan-London Network for psychosis prevention (PNP) was created across urban CHR-P services. These services were surveyed to collect the following: description of the service and catchment area, outreach, service users, interventions, and outcomes. The results were analyzed with descriptive statistics and Kaplan Meier failure function. The PNP included five CHR-P services across two NHS Trusts: Outreach and Support In South-London (OASIS) in Lambeth and Southwark, OASIS in Croydon and Lewisham, Tower Hamlets Early Detection Service (THEDS), City & Hackney At-Risk Mental State Service (HEADS UP) and Newham Early Intervention Service (NEIS). The PNP serves a total population of 2,318,515 Londoners (830,889; age, 16-35 years), with a yearly recruitment capacity of 220 CHR-P individuals (age, 22.55 years). Standalone teams (OASIS and THEDS) are more established and successful than teams that share their resources with other mental health services (HEADS UP, NEIS). Characteristics of the catchment areas, outreach and service users, differ across PNP services; all of them offer psychotherapy to prevent psychosis. The PNP is supporting several CHR-P translational research projects. The PNP is the largest CHR-P clinical network in the UK; it represents a reference benchmark for implementing detection, prognosis, and care in the real-world clinical routine, as well as for translating research innovations into practice.
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http://dx.doi.org/10.3389/fpsyt.2019.00707 | DOI Listing |
Psychiatr Serv
January 2025
Department of Psychiatry (all authors), University of Pittsburgh School of Medicine, and Department of Psychology (Bylsma), University of Pittsburgh, Pittsburgh.
A national and global focus on expanding identification and treatment of youths who are at clinical high risk for psychosis (CHR-P) highlights an urgent need to develop clinical services for this population; however, questions remain regarding program structures and treatment approaches in CHR-P clinics. The authors of this Open Forum expand on previous recommendations and argue that a focus on enhancing developmentally informed care should serve as a central principle for structuring macrolevel service policies and programs as well as person-specific treatment approaches. The authors discuss developmental considerations in program planning and service provision and offer recommendations for providers and other stakeholders to enhance developmentally informed care for individuals at CHR-P.
View Article and Find Full Text PDFBMC Psychiatry
January 2025
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Bergische Landstraße 2, Düsseldorf, 40629, Germany.
Background: Childhood adversities and traumata (CAT) increase the risk for various mental disorders, including the clinical high-risk of psychosis (CHR-P) state and its main comorbidities, i.e., depression, and social phobia.
View Article and Find Full Text PDFChild Adolesc Ment Health
February 2025
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Background: Despite evidence suggesting that age moderates the response to preventative treatment for those at clinical high risk of psychosis (CHR-P), no meta-analysis has assessed the effectiveness of preventative interventions for CHR-P children and adolescents. Our aim was to synthesise evidence assessing preventative interventions on a wide range of mental health outcomes for CHR-P children and adolescents.
Method: A systematic search was conducted on Ovid MEDLINE, Pubmed, APA PsycInfo and Web of Science until June 2024 (PROSPERO: CRD42023406696).
Br J Psychiatry
December 2024
School of Public Policy and Department of Sociology, University of California, Riverside, USA.
Schizophr Bull Open
January 2024
School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK.
Clinical high-risk for psychosis (CHR-P) individuals are typically recruited from clinical services but the clinical and functional outcomes of community-recruited CHR-P individuals remain largely unclear. The Youth Mental Health Risk and Resilience Study (YouR-Study) obtained a community sample of CHR-P individuals through an online-screening approach and followed-up these individuals for a period of up to 3 years to determine transition rates, persistence of attenuated psychotic symptoms (APS) and functional outcomes. Baseline data were obtained from = 144 CHR-P participants, = 51 participants who met online cutoff criteria but not CHR-P criteria (CHR-Ns), and = 58 healthy controls.
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