A clinical staging model for early intervention youth mental health services.

Transformational reforms in mental health services are providing more young Australians who experience mental health problems with access to high-quality care. However, the current diagnostic approach has low utility in the early stages of illness, causing uncertainty among clinicians in regard to matching clients' needs with safe and effective interventions. The authors propose a clinical staging model that has the potential to better match illness stage to intervention.

The predictive validity of bipolar at-risk (prodromal) criteria in help-seeking adolescents and young adults: a prospective study.

Objectives: There are no established tools to identify individuals at risk for developing bipolar disorder. We developed a set of ultra-high-risk criteria for bipolar disorder [bipolar at-risk (BAR)]. The primary aim of the present study was to determine the predictive validity of the BAR criteria.

Safety and privacy outcomes from a moderated online social therapy for young people with first-episode psychosis.

Objective: Internet-based treatments for early psychosis offer considerable promise, but safety and security need to be established. This study pilot tested Horyzons, a novel online treatment application that integrates purpose-built moderated social networking with psychoeducation for recovery from early psychosis.

Methods: Safety, privacy, and security were evaluated during a one-month single-group trial with 20 young consumers recovering from early psychosis who were recruited in Melbourne, Australia.

Demographic and clinical characteristics of young people seeking help at youth mental health services: baseline findings of the Transitions Study.

Aim: The Transitions Study was designed to establish a cohort of young people (12-25 years) seeking help for mental health problems, in order to longitudinally explore and refine a clinical staging model of the development and progression of mental disorders. This paper presents the baseline demographic and clinical characteristics of the cohort, particularly the nature and severity of psychopathology.

Method: All eligible young people attending one of four headspace clinical services were invited to participate, and completed a battery of self-report and interviewer-administered measures of psychopathology and functional impairment at baseline, which will be repeated at the annual follow up.

Vascular endothelial growth factor and brain-derived neurotrophic factor in quetiapine treated first-episode psychosis.

Objective. It has been suggested that atypical antipsychotics confer their effects via brain-derived neurotrophic factor (BDNF). We investigated the effect of quetiapine on serum levels of BDNF and vascular endothelial growth factor (VEGF) in drug-naive first-episode psychosis subjects.

Sulcogyral pattern and sulcal count of the orbitofrontal cortex in individuals at ultra high risk for psychosis.

Three types of orbitofrontal cortex (OFC) sulcogyral patterns have been identified in the general population. The distribution of these three types has been found to be altered in individuals at genetic risk of psychosis, and in patients with first episode psychosis (FEP) and chronic schizophrenia. This study aims at establishing whether altered OFC sulcogyral patterns were present in a large cohort of individuals at ultra high risk (UHR) for psychosis.

Emotion recognition as a predictor of transition to a psychotic disorder in ultra-high risk participants.

Aims: Recent research has shown emotion recognition to be impaired in individuals at ultra-high risk (UHR) for developing a psychotic disorder compared to healthy controls. This longitudinal study aimed to examine whether disturbed emotion recognition measured in UHR participants at baseline predicts transition to a psychotic disorder within 12months.

Methods: Thirty-seven UHR participants aged 13-22years participated in the study.

Altered depth of the olfactory sulcus in ultra high-risk individuals and patients with psychotic disorders.

A shallow olfactory sulcus has been reported in schizophrenia, possibly reflecting abnormal forebrain development during early gestation. However, it remains unclear whether this anomaly exists prior to the onset of psychosis and/or differs according to illness stage. In the current study, magnetic resonance imaging was used to investigate the length and depth of the olfactory sulcus in 135 ultra high-risk (UHR) individuals [of whom 52 later developed psychosis (UHR-P) and 83 did not (UHR-NP)], 162 patients with first-episode psychosis (FEP), 89 patients with chronic schizophrenia, and 87 healthy controls.

Delayed sleep onset in depressed young people.

Background: The circadian abnormality of delayed sleep phase has been suggested to characterise a subgroup of depressed young adults with different risk factors and course of illness. We aim to assess the prevalence and factors, particularly substance use, associated with such delay in a large help-seeking cohort of young people with mental health problems.

Methods: From a consecutively recruited sample of 802 help-seeking young people, 305 (38%) had at least moderate depressive symptoms (QIDS-C16 >10), sleep data and did not have a chronic severe mental illness.

headspace - Australia's innovation in youth mental health: who are the clients and why are they presenting?

Objectives: To provide the first national profile of the characteristics of young people (aged 12-25 years) accessing headspace centre services - the Australian Government's innovation in youth mental health service delivery - and investigate whether headspace is providing early service access for adolescents and young adults with emerging mental health problems.

Design And Participants: Census of all young people accessing a headspace centre across the national network of 55 centres comprising a total of 21 274 headspace clients between 1 January and 30 June 2013.

Main Outcome Measures: Reason for presentation, Kessler Psychological Distress Scale, stage of illness, diagnosis, functioning.

Treated incidence and baseline characteristics of substance induced psychosis in a Norwegian catchment area.

Background: Substance misuse is a well-recognized co-morbidity to psychosis and has been linked to poor prognostic outcomes in patients. Researchers have yet to investigate the difference in rates and characteristics between first-episode Substance Induced Psychosis (SIP) and primary psychosis. We aimed at comparing patients with SIP to primary psychosis patients with or without substance misuse at baseline.

Testing a model of the relationship between childhood sexual abuse and psychosis in a first-episode psychosis group: the role of hallucinations and delusions, posttraumatic intrusions, and selective attention.

Several theories suggest that posttraumatic intrusive symptoms are central to the relationship between childhood trauma (CT) and hallucinations and delusions in psychosis. Biased selective attention has been implicated as a cognitive process underlying posttraumatic intrusions. The current study sought to test theories of the relationship between childhood sexual abuse (CSA), hallucinations and delusions, posttraumatic intrusions, and selective attention in first-episode psychosis (FEP).

Therapy contamination as a measure of therapist treatment adherence in a trial of cognitive behaviour therapy versus befriending for psychosis.

Background: High quality randomized controlled trials (RCT) of psychotherapeutic interventions should ensure that the therapy being tested is what is actually delivered. However, contamination of one therapy into the other, a critical component of treatment adherence, is seldom measured in psychotherapy trials of psychosis.

Aims: The aim of the study was to determine whether a purpose-designed measure, the ACE Treatment Integrity Measure (ATIM) could detect therapy contaminations within a controlled trial of cognitive behavioural therapy (CBT) versus Befriending for first-episode psychosis and to compare the ATIM to a more traditional adherence measure, the Cognitive Therapy Scale (CTS).

Clinical staging: a necessary step in the development of improved animal models of mood disturbance?

Recently, it has been suggested that the clinical staging approach be considered a serious alternative framework for conceptualising mood related psychopathology. The fundamental difference between clinical staging and the now dominant categorical diagnostic framework is that the entire illness trajectory becomes relevant, as opposed to simply the end-stage. The concept of disease trajectory has significant implications for animal models of psychopathology, and particularly for animal models of depression.

Public health significance of bipolar disorder: implications for early intervention and prevention.

Objectives: Early intervention and preventive strategies have become major targets of research and service development in psychiatry over the last few years. Compared to schizophrenia, bipolar disorder (BD) has received limited attention in this regard. In this paper, we review the available literature in order to explore the public health significance of BD and the extent to which this may justify the development of early intervention strategies for this disorder.

Predictors of substance use reduction in an epidemiological first-episode psychosis cohort.

Aim: To assess the predictors of a significant decrease or cessation of substance use (SU) in a treated epidemiological cohort of first-episode psychosis (FEP) patients.

Method: Participants were FEP patients of the Early Psychosis Prevention and Intervention Centre in Australia. Patients' medical files were reviewed using a standardized file audit.

Omega-3 fatty acid supplementation in adolescents with borderline personality disorder and ultra-high risk criteria for psychosis: a post hoc subgroup analysis of a double-blind, randomized controlled trial.

Objective: To investigate whether long-chain omega-3 (n-3) polyunsaturated fatty acids (PUFAs) improve functioning and psychiatric symptoms in young people with borderline personality disorder (BPD) who also meet ultra-high risk criteria for psychosis.

Methods: We conducted a post hoc subgroup analysis of a double-blind, randomized controlled trial. Fifteen adolescents with BPD (mean age 16.

A randomized controlled trial of vocational intervention for young people with first-episode psychosis: method.

Aim: Young people who are experiencing first-episode psychosis (FEP) are at increased risk of being unemployed compared to either their same age peers in the general population, or those with other mental illnesses. Significant research has been conducted examining employment interventions for those with chronic psychotic illness. This has yielded strong results in favour of an intervention called individual placement and support (IPS).

Effect of omega-3 fatty acids for indicated prevention of young patients at risk for psychosis: when do they begin to be effective?

The results of a recent double-blind, randomized, placebo-controlled trial performed in 81 young patients at ultra-high risk for psychosis indicated that a 12-week intervention of 1.2g/day of ω-3 polyunsaturated fatty acids (PUFA) significantly reduced the risk of transition to psychosis and improved positive, negative and general symptoms as well as functioning. The aim of this post-hoc analysis was to determine at which time point ω-3 PUFAs start to significantly differ from placebo in improving psychopathology and functioning in young people at risk of developing psychosis.