Multitudinous contributors to impaired functioning in UHR for psychosis individuals. Four case studies.

Poster B92, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Adam Finkelstein1, Andrea Polari1, John Stratford1, Mel Pane1, Angelina Crea1, Emma Cartwright1, Barnaby Nelson2; 1Orygen Youth Health, PACE Clinic, Melbourne, Australia, 2Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia

The introduction of Ultra high-risk (UHR) criteria aimed to prospectively identify patients at increased risk of transitioning to a psychotic disorder. The at risk mental state (ARMS) for psychosis concept and its subsequent clinical implementation aspires to intervene earlier and achieve better outcomes for young people with emerging symptoms or with a trait vulnerability to psychotic disorder. Extensive research has investigated the UHR criteria, outlining stage specific treatment and predictors of transition to psychotic disorder. Standardised criteria to identify individuals at risk for developing psychosis have been used internationally. The current version of the UHR criteria implemented in the PACE (Personal Assessment and Crisis Evaluation) clinic in Melbourne includes a significant drop in functioning or chronic low functioning for all three UHR groups (APS, BLIPS, Trait vulnerability). Although the aim of including this deterioration or persistent low functioning requirement for all three groups was to increase enrichment for psychosis risk, compromised functioning may be present for a variety of clinical reasons, not necessarily related to emerging psychosis. The objective of this presentation is to illustrate UHR patient heterogeneity with regard to clinical factors contributing to compromised functioning in this clinical population. Four de-identified case vignettes retrieved from case management in the PACE clinic will portray the multitudinous contributing factors to impaired functioning (i.e. attenuated psychotic symptoms, depression, anxiety, socio-economic related hardship, traumatic life experiences, personality pathology), and highlight the bidirectional relationship between everyday functioning and transition risk to a psychotic disorder among individuals meeting UHR criteria.

Topic Area: Ultra High Risk / Prodromal Research

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