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Clinical high risk for psychosis in children and adolescents: a systematic review

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Abstract

The concept of being at risk for psychosis has been introduced both for adults and children and adolescents, but fewer studies have been conducted in the latter population. The aim of this study is to systematically review the articles associated with clinical description, interventions, outcome and other areas in children and adolescents at risk for psychosis. We searched in MEDLINE/PubMed and PsycINFO databases for articles published up to 30/06/16. Reviewed articles were prospective studies; written in English; original articles with Clinical High Risk (CHR) for psychosis samples; and mean age of samples younger than 18 years. From 103 studies initially selected, 48 met inclusion criteria and were systematically reviewed. Studies show that CHR children and adolescents present several clinical characteristics at baseline, with most attenuated positive-symptom inclusion criteria observed, reporting mostly perceptual abnormalities and suspiciousness, and presenting comorbid conditions such as depressive and anxiety disorders. CHR children and adolescents show lower general intelligence and no structural brain changes compared with controls. Original articles reviewed show rates of conversion to psychosis between 17 and 20% at 1 year follow-up and between 7 and 21% at 2 years. While 36% of patients recovered from their CHR status at 6-year follow-up, 40% still met CHR criteria. Studies in children and adolescents with CHR were conducted with different methodologies, assessments tools and small samples. It is important to conduct studies on psychopharmacological and psychological treatment, as well as replication of the few studies found.

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Acknowledgements

This study was supported by grants from the Carlos III Institute of Health, Spanish Department of Health, Instituto de Salud Carlos III (Fondo de Investigación Sanitaria PI11/1340, PI11/02684, PI15/0444 and PI15/00509), CIBERSAM Network.

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Authors and Affiliations

  1. Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Santa Rosa, 39-57, Esplugues de Llobregat, 08950, Barcelona, Spain

    Jordina Tor, Montserrat Dolz, Daniel Muñoz & Marta Pardo

  2. Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 002, Esplugues de Llobregat, 08950, Barcelona, Spain

    Jordina Tor, Montserrat Dolz, Anna Sintes, Daniel Muñoz & Marta Pardo

  3. Department of Child and Adolescent Psychiatry and Psychology, Institut Clínic of Neurosciences, Centro de Investigación Biomédica en Red de Salud Mental, Hospital Clinic Universitari of Barcelona, CIBERSAM (2014SGR489), Villarroel 170, 08036, Barcelona, Spain

    Elena de la Serna, Olga Puig, Gisela Sugranyes & Inmaculada Baeza

  4. Institut Clinic of Neurosciences, CERCA-IDIBAPS (Institut d’Investigacions Biomèdiques August Pi Sunyer), Hospital Clínic Universitari of Barcelona, Villarroel 170, 08036, Barcelona, Spain

    Elena de la Serna, Gisela Sugranyes & Inmaculada Baeza

  5. Department of Psychiatry and Psychobiology, Health Sciences Division, Centro de Investigación Biomédica en Red de Salud Mental, University of Barcelona, CIBERSAM, Villarroel 170, 08036, Barcelona, Spain

    Elena de la Serna, Gisela Sugranyes & Inmaculada Baeza

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  1. Jordina Tor
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  4. Daniel Muñoz
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  5. Marta Pardo
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  6. Elena de la Serna
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  7. Olga Puig
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  8. Gisela Sugranyes
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  9. Inmaculada Baeza
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Corresponding author

Correspondence to Inmaculada Baeza.

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Conflict of interest

Jordina Tor: Ms. Jordina Tor has received support to attend conferences from Otsuka-Lundbeck. Montserrat Dolz: Dr. Dolz has received grants from Fundación Alicia Koplowitz and Instituto de Salud Carlos III, and has received support to attend conferences or honoraria for lectures from Shire, Janssen and Osuka-Lundbeck. Anna Sintes: the author declares that she has no conflict of interest. Daniel Muñoz: Dr. Muñoz has received support to attend conferences or honoraria for lectures from Otsuka-Lundbeck and Janssen. Marta Pardo: Dr. Pardo has received support to attend conferences or honoraria for lectures from Otsuka-Lundbeck and Janssen. Elena de la Serna: the author declares that she has no conflict of interest. Olga Puig: Dr. Puig has received grants from Fundación Alicia Koplowitz and Instituto de Salud Carlos III. Gisela Sugranyes: Dr. Sugranyes has received grants from the Fundación Alicia Koplowitz and Instituto de Salud Carlos III, and has received travel support from Shire, Janssen and Adamed Pharma. Inmaculada Baeza: Dr. Baeza has received grants from Instituto de Salud Carlos III and Fundación Alicia Koplowitz, and has received support to attend conferences or honoraria for lectures from Otsuka-Lundbeck and Janssen.

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Tor, J., Dolz, M., Sintes, A. et al. Clinical high risk for psychosis in children and adolescents: a systematic review. Eur Child Adolesc Psychiatry 27, 683–700 (2018). https://doi.org/10.1007/s00787-017-1046-3

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