Prevention of psychosis

Question 1

Is there a higher prevalence of psychotic symptoms or incidence of schizophrenia

Answer 1

Higher prevalence of psychotic symptoms (100x more)

Question 2

What is the paranoia hierarchy

Answer 2

Pyramid, wide to specific:

• Social evaluative concerns (fears of rejection, thoughts that world is potentially dangerous)
• Ideas of reference (people talking about you, being watched)
• Mild threat (people trying to cause minor distress)
• Moderate threat (people going out of your way to get to you)
• Severe threat (people trying to cause significant harm)

Question 3

Why is prevention of psychosis important?

Answer 3

• There is no clear cause of psychoses
• Moderate results of evidence based interventions
• Psychoses (almost always) develop gradually
• Reduce Duration Untreated Psychosis (DUP)

Question 4

How to prevent/ delay psychoses

Answer 4

• Maintain social functioning (relationships, friendships, study / work, other social roles)
• Improve quality of life
• Reduction of stigmatisation and traumatisation
• Improve access to mental health care

Reduce distress/ suffering from extraordinary experiences

Question 5

What are the different stages of the development of psychosis

Answer 5

Premorbid phase
Prodromal phase
Psychotic phase
Recovery phase

Question 6

What are the criteria for the At Risk Mental State (ARMS)

Answer 6

• Young (14-35)
• Decline in social functioning
• Seeking help in mental health care
• Psychosis-like experiences (with distress)
• PQ-16

It is not a diagnosis. But odds of developing it really high (1247)
It does predict psychosis

Question 7

What is meant with CBTuhr?

Answer 7

It is Cognitive Behavioral Therapy for subjects at Ultrahigh risk

Question 8

What is the profile of someone that meets the ARMS prognostic profile

Answer 8

• Subliclinical psychotic symptoms with distress
• Decline in social functioning
• Unhelpful cognitive biases/ tendencies, and survival strategies
• Distressed, help seeking
• Fear of going mad / losing control

Question 9

If someone meets these criteria (ARMS) what is advised for them to keep doing?

Answer 9

• Talk to loved ones about experiences
• Maintain social activity
• Maintain a good sleep pattern and healthy life-style
• be wise with certain types of drugs
• Don’t worry too much
• Don’t get too involved w/ things that scare you