Age effects on clinical outcome in subjects clinically at-risk of psychosis
Poster A32, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron
Stephan Ruhrmann1, Chantal Michel2, Raimo K.R. Salokangas,3, Dorien Nieman4, Frauke Schultze-Lutter2; 1Department of Psychiatry and Psychotherapy University of Cologne, 2University Hospital of Child and Adolescent Psychiatry and Psychotherapy University of Bern, 3Department of Psychiatry, University of Turku, Turku, Finland, 4Department of Psychiatry, Academic Medical Centre, Amsterdam, The Netherlands
Background: Several reasons have been considered for explaining the heterogeneity of conversion rates across different studies on clinical high risk (CHR) states. As the transitory phase from early adolescence to adulthood is associated numerous biological, cognitive and social changes, the age structure of different cohorts may contribute to this variance. Methods: (1) A meta-analysis on prediction studies was performed for the European Psychiatric Association (EPA; http://www.europsy.net/publications/guidance-papers/), finally including 45 studies. Categories for age distribution included: almost entirely minors (≤18 years; CAD), almost entirely adults (minimum age 18 years or mean >18 with lower sd only spanning ≥18 years; ADULT), ≥50% minors (median or mean age ≤18 years or mean ≤18 with upper sd still spanning ≤18 years; YOUTH). (2) Data of the European Prediction of Psychosis Study (EPOS; 16 to 35 yrs) were analyzed with regard to relationships between age and conversion as well as functioning. Results: The EPA meta-analysis demonstrated a clear age effect with markedly lower conversion rates in minors and young adolescents. In line with that, no age effect on conversion was observed in EPOS, however, differential age-dependent effects of psychopathology on functioning became apparent. Discussion: In line with a recent study published after completion of the EPA meta-analysis, age composition of samples seems to be an important source of heterogeneity. Thus, CHR criteria should be used in children and early adolescents, but only with utmost care. Persistence of certain risk related symptoms may impact functioning in adult CHR subjects.
Topic Area: Diagnosis and Phenomenology