Lecture 2: Clinical staging and E detection Flashcards
Why is ED important (Gibbs et al, 2010)
Birth cohort
Investigated impact of p———- d———- the burnden in YA and life outcome at age of __
rate of welfare depended is x higher amoug those with more than - episodes of psychiatric disorder vs no disoder, REveal need to develop targeted intervention to those with more –
Gibbs et al (2010) lasting effect of mental illness
Investigated impact of common psychiatric disorders, burden of psychiatric disorder in young adulthood and life outcomes at age 30
4
4
Psychiatric episodes
birth cohort - cohort effects the results may not generalise to other popualtions
what are the challenges to early detection?
Yung et al (1996)
Yung et al (2005)
Schultze-lutter (2014)
van os et al (2000)
psychosiss phenotype is x50 prevelent than clincal conscept
increase risk of false popstiives at risk state
Fusar-Poli et al (2012)
many never transition
Yung et al (1996) identified state/ trait and risk factors
Yung et al (2005)
thre are incopereted into the CAARMS increases probabilty of realibe detection of help seekers at high risk
Schultze-lutter (2014) patients mest UHR AND CODIS at baseline had sig increased risk of conversion HZ=0,66 @ 48 months and shorter conversion than those that only met UHR crtieria HR = .28
using UHR and COGDIS gives better prediction .
What is clinical staging - why is it useful?
McGorry et al (2006) (2013)
Helps us to undertand b m involved in t and p
McGorry (2013) - what happened previous to clinical staging?
biological markers
treatmetn and prognosis
restores the utility of diagnsos - promote early intervention and organise data into clear clinicopathiological framework
Immediate potential to improve logic and time of interventions
those with early midler stages locked out of care until present severit and chronicit that reues out the risk of overtreatment thus decreaesd damatically changes of reponse to treatment and recovery
APPROCHES TO EARLY DETECTION
family history
birth cohorts
popualtion studies