Skip to main content
Erschienen in: neuropsychiatrie 1/2016

01.03.2016 | original article

The role of vulnerability factors in individuals with an at-risk mental state of psychosis

verfasst von: Martina Papmeyer, Irène Würsch, Erich Studerus, Rolf-Dieter Stieglitz, Prof. Dr. med. Anita Riecher-Rössler

Erschienen in: neuropsychiatrie | Ausgabe 1/2016

Einloggen, um Zugang zu erhalten

Summary

Background

Several indicators of heightened vulnerability to psychosis and relevant stressors have been identified. However, it has rarely been studied prospectively to what extent these vulnerability factors are in fact more frequently present in individuals with an at-risk mental state for psychosis. Moreover, it remains unknown whether any of these contribute to the prediction of psychosis onset in at-risk mental state individuals.

Methods

There were 28 healthy controls, 86 first-episode psychosis patients and 127 at-risk mental state individuals recruited within the Basel “Früherkennung von Psychosen” project. Relative frequencies of selected vulnerability factors for psychosis were compared between healthy controls, psychosis patients, those at-risk mental state individuals with subsequent psychosis onset (n = 31) and those without subsequent psychosis onset (n = 55). Survival analyses were applied to determine associations between time to transition to psychosis and vulnerability factors in all 127 at-risk mental state individuals.

Results

The vulnerability factors/indicators such as “difficulties during school education or vocational training”, “difficulties during employment”, “being single”, “difficulties with intimate relationships” and “being burdened with specific stressful situations” were more commonly found in the at-risk mental state and first-episode psychosis group than in healthy controls.

Conclusions

At-risk mental state and first-episode psychosis individuals more frequently present with vulnerability factors. Individual vulnerability factors appear, however, not to be predictive for an onset of psychosis.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat McGrath J, Saha S, Welham J, El Saadi O, MacCauley C, Chant D. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Med. 2004;2:13.CrossRefPubMedPubMedCentral McGrath J, Saha S, Welham J, El Saadi O, MacCauley C, Chant D. A systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Med. 2004;2:13.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Os J van, Rutten BP, Poulton R. Gene-environment interactions in schizophrenia: review of epidemiological findings and future directions. Schizophr Bull. 2008;34(6):1066–82.CrossRefPubMedPubMedCentral Os J van, Rutten BP, Poulton R. Gene-environment interactions in schizophrenia: review of epidemiological findings and future directions. Schizophr Bull. 2008;34(6):1066–82.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Os J van, Kenis G, Rutten BP. The environment and schizophrenia. Nature. 7321;2010(468):203–12. Os J van, Kenis G, Rutten BP. The environment and schizophrenia. Nature. 7321;2010(468):203–12.
4.
Zurück zum Zitat Zubin J, Spring B. Vulnerability–a new view of schizophrenia. J Abnorm Psychol. 1977;86(2):103–26.CrossRefPubMed Zubin J, Spring B. Vulnerability–a new view of schizophrenia. J Abnorm Psychol. 1977;86(2):103–26.CrossRefPubMed
5.
Zurück zum Zitat Nuechterlein KH, Dawson ME, Ventura J, Gitlin M, Subotnik KL, Snyder KS, et al. The vulnerability/stress model of schizophrenic relapse: a longitudinal study. Acta Psychiatr Scand. 1994;382:58–64.CrossRef Nuechterlein KH, Dawson ME, Ventura J, Gitlin M, Subotnik KL, Snyder KS, et al. The vulnerability/stress model of schizophrenic relapse: a longitudinal study. Acta Psychiatr Scand. 1994;382:58–64.CrossRef
6.
Zurück zum Zitat Myin-Germeys I, Os J van. Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clin Psychol Rev. 2007;27(4):409–24.CrossRefPubMed Myin-Germeys I, Os J van. Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clin Psychol Rev. 2007;27(4):409–24.CrossRefPubMed
8.
Zurück zum Zitat Cannon M, Clarke MC. Risk for schizophrenia–broadening the concepts, pushing back the boundaries. Schizophr Res. 2005;79(1):5–13.CrossRefPubMed Cannon M, Clarke MC. Risk for schizophrenia–broadening the concepts, pushing back the boundaries. Schizophr Res. 2005;79(1):5–13.CrossRefPubMed
9.
Zurück zum Zitat European Network of National Networks studying Gene-Environment Interactions in Schizophrenia. Identifying gene-environment interactions in schizophrenia: contemporary challenges for integrated, large-scale investigations. Schizophr Bull. 2014;40(4):729–36.CrossRef European Network of National Networks studying Gene-Environment Interactions in Schizophrenia. Identifying gene-environment interactions in schizophrenia: contemporary challenges for integrated, large-scale investigations. Schizophr Bull. 2014;40(4):729–36.CrossRef
10.
Zurück zum Zitat Pruessner M, Iyer SN, Faridi K, Joober R, Malla AK. Stress and protective factors in individuals at ultra-high risk for psychosis, first episode psychosis and healthy controls. Schizophr Res. 2011;129(1):29–35.CrossRefPubMed Pruessner M, Iyer SN, Faridi K, Joober R, Malla AK. Stress and protective factors in individuals at ultra-high risk for psychosis, first episode psychosis and healthy controls. Schizophr Res. 2011;129(1):29–35.CrossRefPubMed
11.
Zurück zum Zitat Riecher-Rössler A, Gschwandtner U, Borgwardt S, Aston J, Pflüger M, Rössler W. Early detection and treatment of schizophrenia: how early? Acta Psychiatr Scand 2006(429):73–80. Riecher-Rössler A, Gschwandtner U, Borgwardt S, Aston J, Pflüger M, Rössler W. Early detection and treatment of schizophrenia: how early? Acta Psychiatr Scand 2006(429):73–80.
12.
Zurück zum Zitat Addington J, Penn D, Woods SW, Addington D, Perkins DO. Social functioning in individuals at clinical high risk for psychosis. Schizophr Res 2008;99(1–3):119–24.CrossRefPubMedPubMedCentral Addington J, Penn D, Woods SW, Addington D, Perkins DO. Social functioning in individuals at clinical high risk for psychosis. Schizophr Res 2008;99(1–3):119–24.CrossRefPubMedPubMedCentral
13.
14.
Zurück zum Zitat Lencz T, Smith CW, Auther A, Correll CU, Cornblatt B. Nonspecific and attenuated negative symptoms in patients at clinical high-risk for schizophrenia. Schizophr Res. 2004;68(1):37–48.CrossRefPubMed Lencz T, Smith CW, Auther A, Correll CU, Cornblatt B. Nonspecific and attenuated negative symptoms in patients at clinical high-risk for schizophrenia. Schizophr Res. 2004;68(1):37–48.CrossRefPubMed
15.
Zurück zum Zitat Isohanni I, Jarvelin MR, Nieminen P, Jones P, Rantakallio P, Jokelainen J, et al. School performance as a predictor of psychiatric hospitalization in adult life. A 28-year follow-up in the Northern Finland 1966 Birth Cohort. Psychol Med. 1998;28(4):967–74.CrossRefPubMed Isohanni I, Jarvelin MR, Nieminen P, Jones P, Rantakallio P, Jokelainen J, et al. School performance as a predictor of psychiatric hospitalization in adult life. A 28-year follow-up in the Northern Finland 1966 Birth Cohort. Psychol Med. 1998;28(4):967–74.CrossRefPubMed
16.
Zurück zum Zitat Byrne M, Agerbo E, Eaton WW, Mortensen PB. Parental socio-economic status and risk of first admission with schizophrenia- a Danish national register based study. Soc Psych Psych Epid. 2004;39(2):87–96.CrossRef Byrne M, Agerbo E, Eaton WW, Mortensen PB. Parental socio-economic status and risk of first admission with schizophrenia- a Danish national register based study. Soc Psych Psych Epid. 2004;39(2):87–96.CrossRef
17.
Zurück zum Zitat Hui C, Morcillo C, Russo DA, Stochl J, Shelley GF, Painter M, et al. Psychiatric morbidity, functioning and quality of life in young people at clinical high risk for psychosis. Schizophr Res 2013;148(1–3):175–80.CrossRefPubMedPubMedCentral Hui C, Morcillo C, Russo DA, Stochl J, Shelley GF, Painter M, et al. Psychiatric morbidity, functioning and quality of life in young people at clinical high risk for psychosis. Schizophr Res 2013;148(1–3):175–80.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Kirkbride JB, Stochl J, Zimbron J, Crane CM, Metastasio A, Aguilar E, et al. Social and spatial heterogeneity in psychosis proneness in a multilevel case-prodrome-control study. Acta Psychiatr Scand. 2015;132(4):283–92.CrossRefPubMedPubMedCentral Kirkbride JB, Stochl J, Zimbron J, Crane CM, Metastasio A, Aguilar E, et al. Social and spatial heterogeneity in psychosis proneness in a multilevel case-prodrome-control study. Acta Psychiatr Scand. 2015;132(4):283–92.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Ben-David S, Birnbaum ML, Eilenberg ME, DeVylder JE, Gill KE, Schienle J, et al. The subjective experience of youths at clinically high risk of psychosis: a qualitative study. Psychiatr Serv. 2014;65(12):1499–501.CrossRefPubMedPubMedCentral Ben-David S, Birnbaum ML, Eilenberg ME, DeVylder JE, Gill KE, Schienle J, et al. The subjective experience of youths at clinically high risk of psychosis: a qualitative study. Psychiatr Serv. 2014;65(12):1499–501.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Niemi LT, Suvisaari JM, Tuulio-Henriksson A, Lonnqvist JK. Childhood developmental abnormalities in schizophrenia: evidence from high-risk studies. Schizophr Res 2003;60(2–3):239–58. Niemi LT, Suvisaari JM, Tuulio-Henriksson A, Lonnqvist JK. Childhood developmental abnormalities in schizophrenia: evidence from high-risk studies. Schizophr Res 2003;60(2–3):239–58.
21.
Zurück zum Zitat Murray RM, Grech A, Philips P, Johnson S. The relationship between substance abuse and schizophrenia. In: Murray R JP, Susser E, Os J van, Cannon M, editors. The Epidemiology of Schizophrenia. Cambridge: Cambridge University Press; 2003. pp. 317–42. Murray RM, Grech A, Philips P, Johnson S. The relationship between substance abuse and schizophrenia. In: Murray R JP, Susser E, Os J van, Cannon M, editors. The Epidemiology of Schizophrenia. Cambridge: Cambridge University Press; 2003. pp. 317–42.
22.
Zurück zum Zitat Morrison AP, French P, Lewis SW, Roberts M, Raja S, Neil ST, et al. Psychological factors in people at ultra-high risk of psychosis: comparisons with non-patients and associations with symptoms. Psychol Med. 2006;36(10):1395–404.CrossRefPubMed Morrison AP, French P, Lewis SW, Roberts M, Raja S, Neil ST, et al. Psychological factors in people at ultra-high risk of psychosis: comparisons with non-patients and associations with symptoms. Psychol Med. 2006;36(10):1395–404.CrossRefPubMed
23.
Zurück zum Zitat Riecher-Rössler A, Gschwandtner U, Aston J, Borgwardt S, Drewe M, Fuhr P, et al. The Basel early-detection-of-psychosis (FEPSY)-study–design and preliminary results. Acta Psychiatr Scand. 2007;115(2):114–25.CrossRefPubMed Riecher-Rössler A, Gschwandtner U, Aston J, Borgwardt S, Drewe M, Fuhr P, et al. The Basel early-detection-of-psychosis (FEPSY)-study–design and preliminary results. Acta Psychiatr Scand. 2007;115(2):114–25.CrossRefPubMed
24.
Zurück zum Zitat Riecher-Rössler A, Aston J, Ventura J, Merlo M, Borgwardt S, Gschwandtner U, et al. [The Basel Screening Instrument for Psychosis (BSIP): development, structure, reliability and validity]. Fortschr Neurol Psychiatr. 2008;76(4):207–16.CrossRefPubMed Riecher-Rössler A, Aston J, Ventura J, Merlo M, Borgwardt S, Gschwandtner U, et al. [The Basel Screening Instrument for Psychosis (BSIP): development, structure, reliability and validity]. Fortschr Neurol Psychiatr. 2008;76(4):207–16.CrossRefPubMed
25.
Zurück zum Zitat American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-III-R. 3 ed. Washington, DC: American Psychiatric Association; 1987. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-III-R. 3 ed. Washington, DC: American Psychiatric Association; 1987.
26.
Zurück zum Zitat Yung AR, Phillips LJ, McGorry PD, McFarlane CA, Francey S, Harrigan S, et al. Prediction of psychosis. A step towards indicated prevention of schizophrenia. Br J Psychiatry. 1998;172(33):14–20. Yung AR, Phillips LJ, McGorry PD, McFarlane CA, Francey S, Harrigan S, et al. Prediction of psychosis. A step towards indicated prevention of schizophrenia. Br J Psychiatry. 1998;172(33):14–20.
27.
Zurück zum Zitat Riecher-Rössler A, Ackermann T, Uttinger M, Ittig S, Koranyi S, Rapp C, et al. [The Basel Interview for Psychosis (BIP): structure, reliability and validity]. Fortschr Neurol Psychiatr. 2015;83(2):99–108.CrossRefPubMed Riecher-Rössler A, Ackermann T, Uttinger M, Ittig S, Koranyi S, Rapp C, et al. [The Basel Interview for Psychosis (BIP): structure, reliability and validity]. Fortschr Neurol Psychiatr. 2015;83(2):99–108.CrossRefPubMed
28.
Zurück zum Zitat Lukoff D, Nuechterlein KH, Ventura J. Manual for the expanded brief psychiatric rating scale. Schizophr Bull. 1986;12:594–602. Lukoff D, Nuechterlein KH, Ventura J. Manual for the expanded brief psychiatric rating scale. Schizophr Bull. 1986;12:594–602.
29.
Zurück zum Zitat Graham JW, Olchowski AE, Gilreath TD. How many imputations are really needed? Some practical clarifications of multiple imputation theory. Prev Sci. 2007;8(3):206–13.CrossRefPubMed Graham JW, Olchowski AE, Gilreath TD. How many imputations are really needed? Some practical clarifications of multiple imputation theory. Prev Sci. 2007;8(3):206–13.CrossRefPubMed
30.
Zurück zum Zitat Bora E, Murray RM. Meta-analysis of cognitive deficits in ultra-high risk to psychosis and first-episode psychosis: do the cognitive deficits progress over, or after, the onset of psychosis? Schizophr Bull. 2014;40(4):744–55.CrossRefPubMedPubMedCentral Bora E, Murray RM. Meta-analysis of cognitive deficits in ultra-high risk to psychosis and first-episode psychosis: do the cognitive deficits progress over, or after, the onset of psychosis? Schizophr Bull. 2014;40(4):744–55.CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Pflueger MO, Gschwandtner U, Stieglitz RD, Riecher-Rössler A. Neuropsychological deficits in individuals with an at risk mental state for psychosis—working memory as a potential trait marker. Schizophr Res. 2007;97(1–3):14–24.CrossRefPubMed Pflueger MO, Gschwandtner U, Stieglitz RD, Riecher-Rössler A. Neuropsychological deficits in individuals with an at risk mental state for psychosis—working memory as a potential trait marker. Schizophr Res. 2007;97(1–3):14–24.CrossRefPubMed
32.
Zurück zum Zitat Rajji TK, Miranda D, Mulsant BH. Cognition, function, and disability in patients with schizophrenia: a review of longitudinal studies. Can J Psychiatry. 2014;59(1):13–7.PubMedPubMedCentral Rajji TK, Miranda D, Mulsant BH. Cognition, function, and disability in patients with schizophrenia: a review of longitudinal studies. Can J Psychiatry. 2014;59(1):13–7.PubMedPubMedCentral
33.
Zurück zum Zitat Os J van, Driessen G, Gunther N, Delespaul P. Neighbourhood variation in incidence of schizophrenia. Evidence for person-environment interaction. Br J Psychiatry. 2000;176:243–8.CrossRefPubMed Os J van, Driessen G, Gunther N, Delespaul P. Neighbourhood variation in incidence of schizophrenia. Evidence for person-environment interaction. Br J Psychiatry. 2000;176:243–8.CrossRefPubMed
34.
Zurück zum Zitat Cornblatt BA, Carrion RE, Addington J, Seidman L, Walker EF, Cannon TD, et al. Risk factors for psychosis: impaired social and role functioning. Schizophr Bull. 2012;38(6):1247–57.CrossRefPubMedPubMedCentral Cornblatt BA, Carrion RE, Addington J, Seidman L, Walker EF, Cannon TD, et al. Risk factors for psychosis: impaired social and role functioning. Schizophr Bull. 2012;38(6):1247–57.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Norman RM, Malla AK. A prospective study of daily stressors and symptomatology in schizophrenic patients. Soc Psych Psych Epid. 1994;29(6):244–9.CrossRef Norman RM, Malla AK. A prospective study of daily stressors and symptomatology in schizophrenic patients. Soc Psych Psych Epid. 1994;29(6):244–9.CrossRef
36.
Zurück zum Zitat Tessner KD, Mittal V, Walker EF. Longitudinal study of stressful life events and daily stressors among adolescents at high risk for psychotic disorders. Schizophr Bull. 2011;37(2):432–41.CrossRefPubMedPubMedCentral Tessner KD, Mittal V, Walker EF. Longitudinal study of stressful life events and daily stressors among adolescents at high risk for psychotic disorders. Schizophr Bull. 2011;37(2):432–41.CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Cannon M, Caspi A, Moffitt TE, Harrington H, Taylor A, Murray RM, et al. Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort. Arch Gen Psychiatry. 2002;59(5):449–56.CrossRefPubMed Cannon M, Caspi A, Moffitt TE, Harrington H, Taylor A, Murray RM, et al. Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort. Arch Gen Psychiatry. 2002;59(5):449–56.CrossRefPubMed
38.
Zurück zum Zitat Dragt S, Nieman DH, Veltman D, Becker HE, Fliert R van de, Haan L de, et al. Environmental factors and social adjustment as predictors of a first psychosis in subjects at ultra high risk. Schizophr Res. 2011;125(1):69–76.CrossRefPubMed Dragt S, Nieman DH, Veltman D, Becker HE, Fliert R van de, Haan L de, et al. Environmental factors and social adjustment as predictors of a first psychosis in subjects at ultra high risk. Schizophr Res. 2011;125(1):69–76.CrossRefPubMed
39.
Zurück zum Zitat Castine MR, Meador-Woodruff JH, Dalack GW. The role of life events in onset and recurrent episodes of schizophrenia and schizoaffective disorder. J Psychiatr Res. 1998;32(5):283–8.CrossRefPubMed Castine MR, Meador-Woodruff JH, Dalack GW. The role of life events in onset and recurrent episodes of schizophrenia and schizoaffective disorder. J Psychiatr Res. 1998;32(5):283–8.CrossRefPubMed
40.
Zurück zum Zitat Cannon TD, Cadenhead K, Cornblatt B, Woods SW, Addington J, Walker E, et al. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry. 2008;65(1):28–37.CrossRefPubMedPubMedCentral Cannon TD, Cadenhead K, Cornblatt B, Woods SW, Addington J, Walker E, et al. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry. 2008;65(1):28–37.CrossRefPubMedPubMedCentral
Metadaten
Titel
The role of vulnerability factors in individuals with an at-risk mental state of psychosis
verfasst von
Martina Papmeyer
Irène Würsch
Erich Studerus
Rolf-Dieter Stieglitz
Prof. Dr. med. Anita Riecher-Rössler
Publikationsdatum
01.03.2016
Verlag
Springer Vienna
Erschienen in
neuropsychiatrie / Ausgabe 1/2016
Print ISSN: 0948-6259
Elektronische ISSN: 2194-1327
DOI
https://doi.org/10.1007/s40211-016-0179-9

Weitere Artikel der Ausgabe 1/2016

neuropsychiatrie 1/2016 Zur Ausgabe

bericht aus dem ögkjp-vorstand

Bericht aus dem Vorstand der ÖGKJP