The prodromal phase of schizophrenia is considered to begin with early subtle changes in behavior and continue until the onset of psychosis. The proposed study is designed to prospectively characterize the prodromal phase of schizophrenia and determine the accuracy with which prodromal symptoms predict schizophrenia. This information, which is not currently available, is essential for establishing effective intervention programs. From a research perspective, since not all individuals displaying putative prodromal symptoms will actually develop schizophrenia, such subjects constitute a new type of population at risk for schizophrenia, referred to here as clinical high risk (CHR). One hundred and twenty CHR patients, 60 normal controls and 60 psychiatric controls diagnosed with attention deficit hyperactivity disorder (included to evaluate specificity), will participate in the proposed five year study. All subjects will be between the ages of 14-21 years. High risk patients will be divided into two groups of 60 patients each: the CHR group, that will consist of patients characterized by social deficits, increasing school difficulties, and odd behaviors; and the CHR+P group, consisting of CHR patients who have also begun to display a range of attenuated positive symptoms. All high-risk patients will be recruited from the Recognition and Prevention of Psychological Problems (RAPP) Clinic. It has been operational for approximately a year and a half under the direction of the investigator and provides treatment to adolescents and young adults considered to be in the prodromal phases of schizophrenia. All study participants will be assessed at base and during regular follow ups, on clinical and neurocognitive characteristics thought most likely to define the prodrome, according to the literature and the pilot work already completed in the RAPP clinic. A number of clinicians and researchers have recently proposed that if treatment were to begin during the prodrome, progression to psychosis might be prevented or, at minimum, delayed and severity reduced. However, the prodrome is currently a retrospective concept that has not as yet been prospectively validated. The overall goal of this project is to assess and prospectively follow adolescents in all four subject groups to establish the sensitivity, specificity and predictive validity of the selected prodromal characteristics. This is expected to provide an evidential base that will lead to a variety of phase-specific interventions throughout the prodrome.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH061523-03
Application #
6539102
Study Section
Special Emphasis Panel (ZRG1-BBBP-5 (01))
Program Officer
Heinssen, Robert K
Project Start
2000-05-01
Project End
2003-04-30
Budget Start
2002-05-01
Budget End
2003-04-30
Support Year
3
Fiscal Year
2002
Total Cost
$355,500
Indirect Cost
Name
Long Island Jewish Medical Center
Department
Type
DUNS #
City
New Hyde Park
State
NY
Country
United States
Zip Code
11040
Velthorst, Eva; Meyer, Eric C; Giuliano, Anthony J et al. (2018) Neurocognitive profiles in the prodrome to psychosis in NAPLS-1. Schizophr Res :
Velthorst, Eva; Zinberg, Jamie; Addington, Jean et al. (2018) Potentially important periods of change in the development of social and role functioning in youth at clinical high risk for psychosis. Dev Psychopathol 30:39-47
Tso, Ivy F; Taylor, Stephan F; Grove, Tyler B et al. (2017) Factor analysis of the Scale of Prodromal Symptoms: data from the Early Detection and Intervention for the Prevention of Psychosis Program. Early Interv Psychiatry 11:14-22
McLaughlin, Danielle; Carrión, Ricardo E; Auther, Andrea M et al. (2016) Functional Capacity Assessed by the Map Task in Individuals at Clinical High-Risk for Psychosis. Schizophr Bull 42:1234-42
Carrión, Ricardo E; Demmin, Docia; Auther, Andrea M et al. (2016) Duration of attenuated positive and negative symptoms in individuals at clinical high risk: Associations with risk of conversion to psychosis and functional outcome. J Psychiatr Res 81:95-101
Carrión, Ricardo E; Cornblatt, Barbara A; Burton, Cynthia Z et al. (2016) Personalized Prediction of Psychosis: External Validation of the NAPLS-2 Psychosis Risk Calculator With the EDIPPP Project. Am J Psychiatry 173:989-996
Auther, A M; Cadenhead, K S; Carrión, R E et al. (2015) Alcohol confounds relationship between cannabis misuse and psychosis conversion in a high-risk sample. Acta Psychiatr Scand 132:60-8
Carrión, Ricardo E; Cornblatt, Barbara A; McLaughlin, Danielle et al. (2015) Contributions of early cortical processing and reading ability to functional status in individuals at clinical high risk for psychosis. Schizophr Res 164:1-7
Webb, Jadon R; Addington, Jean; Perkins, Diana O et al. (2015) Specificity of Incident Diagnostic Outcomes in Patients at Clinical High Risk for Psychosis. Schizophr Bull 41:1066-75
McFarlane, William R; Levin, Bruce; Travis, Lori et al. (2015) Clinical and functional outcomes after 2 years in the early detection and intervention for the prevention of psychosis multisite effectiveness trial. Schizophr Bull 41:30-43

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