Abstract
Primary prevention in individuals at Clinical High Risk for psychosis (CHR-P) can ameliorate the course of psychotic disorders. Further advancements of knowledge have been slowed by the standstill of the field, which is mostly attributed to its epidemiological weakness. The latter, in turn, underlies the limited identification power of at-risk individuals and the relatively modest ability of CHR-P interviews to rule-in a state of risk for psychosis. In the first part, this perspective review discusses these limitations and traces a new approach to overcome them. Theoretical concepts to support a Psychosis Polyrisk Score (PPS) integrating genetic and non-genetic risk and protective factors for psychosis are presented. The PPS hinges on recent findings indicating that risk enrichment in CHR-P samples is accounted for by the accumulation of non-genetic factors such as: parental and sociodemographic risk factors, perinatal risk factors, later risk factors, and antecedents. In the second part of this perspective review we present a prototype of a PPS encompassing core predictors beyond genetics. The PPS prototype may be piloted in the next generation of CHR-P research and combined with genetic information to refine the detection of individuals at-risk of psychosis and the prediction of their outcomes, and ultimately advance clinical research in this field.
| Original language | English |
|---|---|
| Article number | 174 |
| Journal | Frontiers in Psychiatry |
| Volume | 10 |
| Issue number | MAR |
| DOIs | |
| Publication status | Published - 2019 |
Bibliographical note
Funding Information:This study was supported by the King’s College London Confidence in Concept award from the Medical Research Council (MRC) (MC_PC_16048) to PF-P. This study also represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funders had no influence on the design, collection, analysis and interpretation of the data, writing of the report and decision to submit this article for publication.
Funding Information:
We declare no conflict of interest in relation to the current manuscript. All the figures presented are original and not previously published. DO is supported by the UK Medical Research Council (MR/N013700/1) and King’s College London member of the MRC Doctoral Training Partnership in Biomedical Sciences.
Publisher Copyright:
Copyright © 2019 Oliver, Radua, Reichenberg, Uher and Fusar-Poli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
ASJC Scopus Subject Areas
- Psychiatry and Mental health
