John wiley sons wpa series early detection and management of mental disorders2005

Early Detection and Management of Mental Disorders Early Detection and Management of Mental Disorders Edited by Mario Maj University of Naples, Italy Juan Jose´ Lo´pez-Ibor Complutense University of Madrid, Spain Norman Sartorius University of Geneva, Switzerland Mitsumoto Sato Tohuko University School of Medicine, Sendai, Japan Ahmed Okasha Ain Shams University, Cairo, Egypt Copyright u 2005 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex PO19 8SQ, England Telephone (+44) 1243 779777 Email (for orders and customer service enquiries): cs-books@wiley.co.uk Visit our Home Page on www.wileyeurope.com or www.wiley.com All Rights Reserved No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except under the terms of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London W1T 4LP, UK, without the permission in writing of the Publisher Requests to the Publisher should be addressed to the Permissions Department, John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex PO19 8SQ, England, or emailed to permreq@wiley.co.uk, or faxed to (+44) 1243 770620 Designations used by companies to distinguish their products are often claimed as trademarks All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners The Publisher is not associated with any product or vendor mentioned in this book This publication is designed to provide accurate and authoritative information in regard to the subject matter covered It is sold on the understanding that the Publisher is not engaged in rendering professional services If professional advice or other expert assistance is required, the services of a competent professional should be sought Other Wiley Editorial Offices John Wiley & Sons Inc., 111 River Street, Hoboken, NJ 07030, USA Jossey-Bass, 989 Market Street, San Francisco, CA 94103-1741, USA Wiley-VCH Verlag GmbH, Boschstr 12, D-69469 Weinheim, Germany John Wiley & Sons Australia Ltd, 33 Park Road, Milton, Queensland 4064, Australia John Wiley & Sons (Asia) Pte Ltd, Clementi Loop #02-01, Jin Xing Distripark, Singapore 129809 John Wiley & Sons Canada Ltd, 22 Worcester Road, Etobicoke, Ontario, Canada M9W 1L1 Wiley also publishes its books in a variety of electronic formats Some content that appears in print may not be available in electronic books Library of Congress Cataloging-in-Publication Data Early detection and management of mental disorders / edited by Mario Maj [et al.] p ; cm Includes bibliographical references and index ISBN 0-470-01083-5 (alk paper) Mental illness – Diagnosis Mental illness – Treatment Psychiatry I Maj, Mario, 1953– [DNLM: Mental Disorders – diagnosis Early Diagnosis WM 141 E12 2005] RC469.E217 2005 616.89–dc22 2004055349 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0-470-01083-5 Typeset in 10/12pt Palatino by Dobbie Typesetting Ltd, Tavistock, Devon Printed and bound in Great Britain by This book is printed on acid-free paper responsibly manufactured from sustainable forestry in which at least two trees are planted for each one used for paper production Contents List of Contributors Preface Chapter ix Prodromal Symptoms and Early Detection of Schizophrenia Heinz Haăfner and Kurt Maurer Chapter The Management of Early Psychosis Patrick McGorry, Jane Edwards and Alison Yung Chapter Children of Persons with Schizophrenia: An Overview of Empirical Research Allan F Mirsky and Adrienne K Elliott Chapter vii Detection and Management of Bipolar Disorder in Children and Adolescents Elizabeth Weller, Roomana Sheikh, Joon Kang and Ronald Weller 51 111 135 Chapter Detecting the Risk for Affective Spectrum Disorders in the Children of Bipolar Parents 163 Gabriele Masi, Hagop S Akiskal and Kareen Akiskal Chapter The ‘‘Difficult’’ Child: Main Underlying Syndromes and Differential Diagnosis 185 Sam Tyano and Iris Manor Chapter Precursors, Prodromes and Early Detection of Eating Disorders Regina C Casper Chapter Precursors, Early Detection and Prevention of Anxiety Disorders Dan J Stein, Soraya Seedat, Paul Carey and Brian Harvey 211 231 vi _ Chapter Chapter 10 Index CONTENTS Early Recognition and Management of Depression in Primary Care Andre Tylee and Paul Walters 249 The Prodromes and Early Detection of Alzheimer’s Disease Michael Zaudig 277 295 List of Contributors Hagop S Akiskal International Mood Center, Department of Psychiatry, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA Kareen Akiskal International Mood Center, Department of Psychiatry, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA Paul Carey Medical Research Council Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg 7505, Cape Town, South Africa Regina C Casper Department of Psychiatry and Behavioral Sciences, Stanford University Medical School, 401 Quarry Road, Stanford, CA 94305-5723, USA Jane Edwards Early Psychosis Prevention and Intervention Centre, Department of Psychiatry, University of Melbourne, Locked Bag 10, Parkville, 3052 Victoria, Australia Adrienne K Elliott National Institute of Mental Health, Section on Clinical and Experimental Neuropsychology, Suite 203-B, 5415 West Cedar Lane, MSC 2615, Bethesda, MD 20892-2615, USA Heinz Haăfner Schizophrenia Research Unit, Central Institute of Mental Health, J5, D-68159 Mannheim, Germany Brian Harvey School of Pharmacy, Division of Pharmacology, North West University, Private Bag X6001, Potchefstroom 2520, South Africa Joon Kang Department of Child and Adolescent Psychiatry, Children’s Hospital of Philadelphia, 34th & Civic Center Blvd, Philadelphia, PA 19104, USA Iris Manor Israel Geha Psychiatric Hospital, PO Box 102, 49100 Petach-Tikvah, Gabriele Masi IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, University of Pisa, Via Dei Giacinti 2, 56018 Calambrone (Pisa), Italy viii _ CONTRIBUTORS Kurt Maurer Schizophrenia Research Unit, Central Institute of Mental Health, J5, D-68159 Mannheim, Germany Patrick McGorry Early Psychosis Prevention and Intervention Centre, Department of Psychiatry, University of Melbourne, Locked Bag 10, Parkville, 3052 Victoria, Australia Allan F Mirsky National Institute of Mental Health, Section on Clinical and Experimental Neuropsychology, Suite 203-B, 5415 West Cedar Lane, MSC 2615, Bethesda, MD 20892-2615, USA Soraya Seedat Medical Research Council Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg 7505, Cape Town, South Africa Roomana Sheikh Department of Child and Adolescent Psychiatry, Drexel University College of Medicine, Eppi, 3200 Henry Avenue, Philadelphia, PA 19129, USA Dan J Stein Medical Research Council Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg 7505, Cape Town, South Africa Sam Tyano Israel Geha Psychiatric Hospital, PO Box 102, 49100 Petach-Tikvah, Andre Tylee Health Services Research Department, Section of Primary Care Mental Health, Institute of Psychiatry, King’s College, De Crespigny Park, London SE5 8AF, UK Paul Walters Health Services Research Department, Section of Primary Care Mental Health, Institute of Psychiatry, King’s College, De Crespigny Park, London SE5 8AF, UK Elizabeth Weller Department of Child and Adolescent Psychiatry, Children’s Hospital of Philadelphia, 34th & Civic Center Blvd, Philadelphia, PA 19104, USA Ronald Weller Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 2nd Floor, Philadelphia, PA 19104, USA Alison Yung Early Psychosis Prevention and Intervention Centre, Department of Psychiatry, University of Melbourne, Locked Bag 10, Parkville, 3052 Victoria, Australia Michael Zaudig Windach Hospital and Institute for Neurobehavioral Research and Therapy, Schuătzenstraòe 16, 86949 Windach, Germany Preface A common theme in the recent literature on most mental disorders is that they often remain undetected and untreated for quite a long time, not rarely for several years, after the occurrence of their first manifestations For some disorders – namely bipolar disorder, schizophrenia and some anxiety disorders – clinical research has directly documented the average interval between their onset and the time of their diagnosis and the start of appropriate treatment For depressive disorders, a different way to document the same phenomenon has been the finding that a high proportion of cases are missed by general practitioners, although part of them are recognized in subsequent consultations For other conditions – especially eating disorders and some anxiety disorders – the main focus has been on the multiple barriers to help seeking, which often delay recognition and treatment In the case of Alzheimer’s disease, neuropsychological and biological research has been decisive in documenting the latency between the first manifestations of the disease and the clinical diagnosis The argument underlying this vast and diverse body of literature has been that an early diagnosis and management of the various disorders may be essential in improving their course and outcome and in reducing or even preventing their social consequences This hypothesis has received up to now only a partial empirical support for most of the above-mentioned disorders, but represents a major focus of research for virtually all of them Moreover, it has been repeatedly pointed out that the reconstruction of the early phases of development of mental disorders may contribute significantly to the elucidation of their etiopathogenesis and, in the case of some of them, may allow devising prevention programmes Early detection and management of a mental disorder implies the availability of a thorough description of the prodromal manifestations of the disorder, the existence of assessment and screening instruments with a satisfactory sensitivity and specificity, the feasibility of screening programmes in the general population or in vulnerable groups, the successful engagement of a significant proportion of the subjects found to be at high risk, and the availability of validated programmes of intervention focused on the early phases of the disorder All these elements are currently being developed for most of the above-mentioned mental disorders, and are already part of clinical practice in several contexts for some of them (notably schizophrenia) 292 27 McKelvey R., Bergman H., Stern J (1999) Lack of prognostic significance of SPECT abnormalities in elderly subjects with a mild memory loss Can J Neurol 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35 36 37 38 39 40 41 42 43 EARLY DETECTION AND MANAGEMENT OF MENTAL DISORDERS EARLY DETECTION OF ALZHEIMER’S DISEASE 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 293 Price J.L., Ko A.I., Wade M.J., Tsou S.K., McKell D.W., Morris J.C (2001) Neuron number in the entorhinal cortex and CA I in preclinical Alzheimer disease Arch Neurol., 58, 1395–1402 Goldman W.P., Price J.L., Storandt M., Grant E.A., McKeel D.W., Rubin E.H., Morris J.C (2001) Absence of cognitive impairment or decline in preclinical Alzheimer’s disease Neurology, 56, 361–367 Price J.L., Morris J.C (1999) Tangles and plaques in non-demented aging and preclinical Alzheimer’s disease Ann Neurol., 45, 358–368 Collie A., Maruff P., Shafiq-Antonacci R., Smith M., Hallup M., Schofield R.P., Maslers C.C., Currie J (2001) Memory decline in healthy older people Implication for identifying mild cognitive impairment Neurology, 56, 1533–1538 Bookheimer S.Y., Strojwas M.H., Cohen M.S., Saunders A.M., Pericak-Vance M.A., Mazziota 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subjective cognitive dysfunction The Rotterdam Scan Study Neurology, 56, 1539–1545 Hampel H., Buerger K., Zinkowski R., Teipel S.J., Goernitz A., Andreasen N., Sjoegren M., DeBernardis J., Kerkman D., Ichiguro K., et al (2004) Measurement of phosphorylated tau epitopes in the differential diagnoses of Alzheimer’s disease A comparative cerebrospinal fluid study Arch Gen Psychiatry, 61, 95–102 Sunderland T., Wolozin B., Galasko D (1999) Longitudinal stability of CSF tau levels in Alzheimer patients Biol Psychiatry, 46, 750–755 Galasko D (1999) Cerebrospinal fluid opens a window on Alzheimer’s disease Arch Neurol., 56, 655–656 Okamura N., Arai H., Maroyama M., Iguchi M., Mazui T., Tanji H., Seki T., Hirai H., Chiba H., Itoh M., et al (2002) Combined analysis of CSF tau levels and [(123)I] iodoamphetamine SPECT in mild cognitive impairment: implications for a novel predictor of Alzheimer’s disease Am J Psychiatry, 159, 474–476 294 61 Kantarci K., Xu Y., Shiung M.M (2002) Comparative diagnostic utility of different MR modalities in mild cognitive impairment and Alzheimer’s disease J Dem Geriatr Cogn Dis., 14, 198–207 DeSanti S., DeLion M.J., Rusinek H., Convit A., Tarshik C.Y., Roche A., Tsui W.H., Kandil E., Boppana M., Daisly K., et al (2001) Hippocampal formation glucose metabolism and volume losses in MCI and AD Neurobiol Aging, 22, 529–539 Kennedy A.M., Frackowiak R.S., Newman S.K (1995) Deficits in cerebral glucose metabolism demonstrated by positron emission tomography in individuals at risk of familial Alzheimer’s disease Neurosci Lett., 186, 17–20 Kordower J.H., Chu Y., Stebbins G.T., Dekosky S.T., Cochran E.J., Bennet D., Mufson E.J (2001) Loss and atrophy of layer II entorhinal cortex neurons in elderly people with mild cognitive impairment Neurology, 49, 202–213 Du A.T., Schuff N., Amend D., Laakso M.P., Hsu Y.Y., Jagust W.J., Yaffe K., Kramer J.H., Reed B., Norman D., et al (2001) Magnetic resonance imaging of the entorhinal cortex and hippocampus in mild cognitive impairment and Alzheimer’s disease J Neurol Neurosurg Psychiatry, 71, 441–447 Robins E., Guze S (1970) Establishment of diagnostic validity in psychiatric illnesses: its application to schizophrenia Am J Psychiatry, 126, 983–987 62 63 64 65 66 EARLY DETECTION AND MANAGEMENT OF MENTAL DISORDERS Index ABC first-episode sample 21, 23, 33 ABC Schizophrenia Study 5–6, 15, 17–19, 25, 38 academic functioning 167 N-acetyl-aspartate (NAA) 177 activities of daily living (ADL) 284–5 acute psychosis 60 Adolescent Dissociative Experience Scale (ADES) 188 adolescents grandiose delusions 139 of parents with bipolar disorder 163 sexuality in 140 ADS-IS 285 Affective Disorders and Schizophrenia for School Age Children (KSADS) 146 affective spectrum disorders in children of bipolar parents 163–84 age-associated cognitive decline (AACD) 279, 285, 287 aggression 63, 79–80, 101–2, 140 agoraphobia 234–5 alcohol abuse 25, 75 Alzheimer’s disease 277–95 asymptomatic 285–6 pathogenesis 288 preclinical 278, 285–6 presymptomatic 286 American Psychiatric Association 87 amisulpride 86 amphetamines 93 anastrophae Angie/Andy Cartoon Trauma Scale (ACTS) 188 anorexia nervosa (AN) childhood activity level 214 denial of illness 221 dieting exposure 214 differential diagnosis 222 eating problems in early childhood 216–17 family interaction, environment and psychopathology 215–16 in childhood 222 overview 211–12 personality features 214–15 physical activity 216 precursors 213–16, 223–5 premorbid body weight 213–14 prodromes 216 psychological traits 214–15 significant weight loss 216 anticholinergic medication 96 antidepressants 63, 84–5, 148, 165, 261–2 compliance 262 antimanic agents 84 antipsychotic-free period 72–3 antipsychotic therapy 101 antipsychotics 63, 83–4, 96 choice of 86 continuation of 88 dosage 86–7 in bipolar disorder in children and adolescents 152 principles in use in early psychosis 85 side effects 84, 96 anxiety disorders 141, 165, 231–48 childhood 240 position and prospects 241 prevention 239–41 screening 238–9 see also generalized anxiety disorder Anxiety Screening Questionnaire 239 APOE-e allele 286–7, 291 apokalypse Early Detection and Management of Mental Disorders Edited by Mario Maj, Juan Jose´ Lo´pez-Ibor, Norman Sartorius, Mitsumoto Sato and Ahmed Okasha &2005 John Wiley & Sons Ltd ISBN 0-470-01083-5 296 apophany aripiprazole 86 Asperger’s syndrome 198–9 at-risk mental states (ARMS) 58–63 attention deficit/hyperactivity disorder (ADHD) 140–1, 165, 167–70, 176, 188–9, 197–200, 202 and mania 144 clinical picture 190–2 comorbidity with 142 differential diagnosis 197–201 in early childhood 200–1 early childhood 190–1, 200–1 educational aspect 192 elementary school childrem 191–2 epidemiology 189–90 follow-up studies 195 prevalence 189–90 social aspect 192 attention deviance in children of persons with schizophrenia 124–5 attenuated psychotic symptoms 60 behavioural checklists 187 behavioural disorders 185, 197, 205 behavioural inhibition (BI) 237 development of 238 early identification in children 238 Beigel–Murphy Scale 146 benzodiazepines 73, 84–5, 96, 101 biological markers in mild cognitive impairment (MCI) 288–9 bipolar disorder adolescent-onset 143 adult-onset 143 child-onset 143 childhood-onset 168 diagnosis of pre-pubertal 142 differences between adult-, adolescent- and child-onset 141–3 differences in phenomenology related to age of onset 143 early-onset 165 environmental factors 173–4 environmental stressors 165 epidemiology 135 familial transmission 173 lifetime prevalence 137 onset of 165 sub-syndromal 137, 173, 175 symptoms 23 INDEX type I or II 137, 140, 142, 164, 171, 175–6 DSM-IV criteria 142 lifetime prevalence 138 vulnerability, temperamental features 174–5 see also bipolar disorder in children and adolescents bipolar disorder in children and adolescents 135–62, 196–7 antipsychotics in 152 carbamazepine in 151 combination treatments 151 comorbidity in 143–5 diagnostic assessment 146–7 diagnostic criteria 136, 138 differential diagnosis 143–5 electroconvulsive therapy (ECT) 153 epidemiological studies 137 internet resources 154–5 lithium in 149–50 long-term outcome 145–6 management of 147–55 manic/hypomanic phase 138 misdiagnosis 135–6 pharmacological treatment 148–52 prescribing practices 136 prevalence rates 137 prodromal symptoms 141 psychotherapy in 153 sub-syndromal 138 sub-threshold forms 137–8 support groups 153–4 topiramate in 152 treatment methods 138 treatment practices for teenagers and prepubescent children 136 underdiagnosis 135–6 valproate in 150–1 bipolar offspring affective spectrum disorders in children of 163–84 neurobiological aspects 177 psychopathology 166, 178–9 treatment implications 177–8 bipolar probands, first-degree relatives 166 bipolar spectrum disorders in children, awareness of 163 bipolarity juvenile 171–3 INDEX prodromal features 167 prospective follow-up studies 171–3 Bonn Scale for the Assessment of Basic Symptoms (BSABS) 30–1 prodromal symptoms 30 prognostic accuracy 30 brain imaging anomalies in children of persons with schizophrenia 123–4 brain morphology at prodromal stage of schizophrenia 14 brief limited intermittent positive symptoms (BLIPS) 8, 25, 29, 32, 58, 60 Brief Symptom Inventory-18 (BSI) 239 bulimia nervosa (BN) age at menarche 218 binge eating 217 family interaction, environment and psychopathology 218–19 food deprivation 217 identifying in young women 222–3 overview 211–12 personality characteristics 218 precursors 213, 217–19, 223–5 premorbid body weight 217 rumination 217–18 Cambridge Cognitive Examination (CAMCOG) 284 Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) 278, 284 cannabis 93 carbamazepine in bipolar disorder in children and adolescents 151 catastrophae catatonic syndrome 24 Chapman scales 29 Child and Adolescent Bipolar Foundation (CABF) 154 Child and Adolescent Treatment and Prevention Intervention Research Branch 142 Child Behavior Checklist (CBCL) 146, 170, 176–7, 188 Child Dissociative Checklist (CDC) 188 childhood, anxiety disorders 240 Childhood Depression Rating Scale – Revised (CDRS-R) 188 childhood-onset bipolar disorder 168 childhood-onset psychosis 197–8 297 children awareness of bipolar spectrum disorders 163 prodromal manifestation in 168 children of persons with schizophrenia 111–33 attention deviance 124–5 brain imaging anomalies 123–4 cognitive markers 124–5 family variables 121–2 genetic diathesis 113 genetic testing 126 high-risk indicators 119–25 high-risk studies 114–16 interventions 125–7 IQ in 123 linkage and association studies 113–14 motor dysfunctions 123 obstetric complications 122–3 personality variables 121 social skills 120–1 summary of findings 125 twin studies 117–19 Children’s Interview for Psychiatric Syndromes (ChIPS) 146 Children’s Perceptual Alteration Scale (CPAS) 188 Children’s PTSD Inventory (CPTSDI) 188 cholinesterase inhibitors 290 Clinical Dementia Rating (CDR) 284 Clinical Global Assessment Scale (CGAS) 152 Clinical Global Impression (CGI) improvement score 178 Clinician-Administered PTSD Scale for Children (CAPS-C) 188 clozapine 83, 87 cognitive–behavioural therapy (CBT) 87, 91, 234, 240, 263 cognitive decline within normal neuropsychological limits 286 cognitive disorders, spectrum of 280 cognitive function 75 cognitive impairment 277–8, 280 cognitive markers in children of persons with schizophrenia 124–5 cognitive strategies 91 cognitively impaired non-demented (CIND) subjects 287 298 Colombo interview technique 73 comorbidity 141, 166 in attention deficit/hyperactivity disorder (ADHD) 142 in bipolar disorder in children and adolescents 143–5 Comprehensive Assessment of At-Risk Mental States (CAARMS) 31, 60 computed tomography (CT) 13, 82–3, 96 conduct disorder (CD) 168, 193, 196–7 DSM-III-R diagnostic criteria 144–5 Conners’ Continuous Performance Test 188 Conners’ Rating Scale 188 Conrad’s model of early course of schizophrenia 2–5 Continuous Performance Test (CPT) 119 Copenhagen High-Risk Project 114, 120 corticotropin releasing hormone (CRH) 237–8 counselling for depression 262–3 creatine (Cr) 177 CSF-CBF index 289 CSF tau values 288–9 cyclothymia 137, 140, 166–7, 178 Defeat Depression Campaign 254, 260 delayed treatment, potential risks of 11 delusions 18 dementia praecox 113 depression 84, 165, 171, 235, 249–75 bottom-up approaches 259–60 case-finding instruments 255 clinical guidelines 256–8 comparison of prodromal symptoms 19 cost-utility of screening 256 counselling for 262–3 diagnosis 253 early management in primary care 261–6 early recognition in primary care 250–61 enhancing management in primary care 264–6 epidemiology 249–50 factors affecting early recognition in primary care 251–4 GP attitudes to 254 GP factors influencing early recognition 253–4 INDEX implementation of guidelines 258 improving early recognition 254–61 in children and adolescents 250 in early illness course as prognostic indicator of later course 21 in offspring of bipolar parents 166 in preschool children 175 increasing public awareness 260–1 outcome issues 259 patient factors influencing early recognition 251 patient presentation in clinical interview 251–2 postpsychotic 21 primary care programme 260 prodromal 21 psychoeducation 264 psychological therapies 262–3 risk factor for AD 280 screening 239, 255–6 self-help 264 somatized symptoms 252 stepped-care approach 259–60, 265 stigma and early recognition 253 symptom attribution 252–3 ten most frequent initial symptoms 20 ten most frequent symptoms in early course 20 top-down approaches 254–5 Depression and Bipolar Support Alliance (DBSA) 154 Depression Attitude Questionnaire (DAQ) 254 depressive symptoms as prodromal signs of schizophrenia 18–19 Determinants of Outcome of Severe Mental Disorders (DOSMED) 23 deviant behaviour 206 Diagnostic Interview for Children and Adolescents, Revised (DICA-R) 146 Diagnostic Interview Schedule for Children (DISC) 146 diathesis–stress model 111 differential diagnosis in attention deficit/hyperactivity disorder (ADHD) 197–201 in bipolar disorder in children and adolescents 143–5 in early childhood, attention deficit/ hyperactivity disorder (ADHD) 200–1 INDEX ‘‘difficult’’ child 185–210 assessment 187–8 bio-psycho-social model 206 emotional level 186 equilibrium 204 integrative–dynamic model 202–5 prognosis 201–2 secondary organic disorder 200 time motif in development 203 tolerance line 186 use of term 185–7, 205 Disability Assessment Schedule (DAS) score 21 disinhibition disruptive behaviour 141, 168–70 DNA trinucleotide repeat sequences 165 Docherty et al.’s model of early course of schizophrenia 3–5 donepezil 290 drug abuse 25, 75, 82, 93 drug screen 82 DSM-II-R, psychiatric illness 252 DSM-III bipolar disorder 136 psychiatric disorders 172 DSM-III-R bipolar disorder 136 conduct disorder 144–5 prodromal symptoms 37 DSM-IV ADHD 189 axis I diagnosis 174 axis I disorders 167 bipolar disorder 142, 151, 166 brief psychotic disorder 59 eating disorders 221 hypomania 142 mania 138, 141–2 mental disorder 170 post-traumatic stress disorder (PTSD) 194 psychotic disorder criteria 63 DSM-IV TR, major depressive disorder 136 duration of untreated illness (DUI) 8–15 duration of untreated psychosis (DUP) 2, 8–15 and illness course and outcome 13–15 dysthymia 167 299 Early Psychosis Prevention and Intervention Centre (EPPIC) 65, 68, 97, 99 Early Recognition Inventory (ERIraos) 28, 34–6 additional modules 35–6 further risk factors 36 preoccupation with mysterious things 36 symptom list 35 Eating Attitudes Test (EAT 40 or EAT 26) 222 eating disorders 211–29 DSM-IV 221 early detection 220–3 information about precursors 219–20 overview 211–12 precursors as risk factors 212–13 prevention and intervention protocols 219–20 screening 222–3 see also anorexia nervosa (AN); bulimia nervosa (BN) education 63, 73, 88–9 electrocardiogram 83 electroconvulsive therapy (ECT) in bipolar disorder in children and adolescents 153 electroencephalogram (EEG) 83 emotional aspects 90 emotional support 90 ethical standards for medical research 63 event-related potentials (ERPs) 123 Eyeberg Child Behavior Inventory 188 family engagement 69 Family Environment Scale (FES) 173 family needs and capabilities in homebased treatment 93 family relationship 80 family support 69, 73, 88–90 family variables in children of persons with schizophrenia 121–2 first-episode psychosis 59–60 aims of treatment 64–5 assessment 72 context for management 64–6 crisis prevention 66–7 education 89 300 first-episode psychosis (cont.) hospital admission 92 inpatient care 98 intervention in acute phase 64–5 investigations 82 negative symptoms 75 neurodegenerative effect 11–12 programmes 55 psychological interventions 90–1 psychosocial aspects 88 psychosocial issues 96 Fould’s model of early course of schizophrenia 5–6 functional magnetic resonance imaging (fMRI) 286 gabapentin 151 galantamine 290 Genain sisters 111–12, 118 General Behavior Inventory 137 General Health Questionnaire (GHQ) 239 generalized anxiety disorder, see also anxiety disorders generalized anxiety disorder (GAD) 231–2 early detection 232 psychiatric morbidity 232 psychobiology 232 treatment of 232 genetic diathesis in development of schizophrenia 118 genetic testing for children of persons with schizophrenia 126 Global Assessment of Functioning (GAF) 29, 141 Global Deterioration Scale (GDS) 284–5 GOS criteria 222 grandiose children 139 grandiose delusions 140 Haăfner group instruments 32–6 hallucinations 18 Hamilton Depression Rating Scale 188 Hampshire Depression Project 257–8 high-risk patients 101 Hillside Recognition and Prevention Project 126–7 home-based treatment checklist for initiation 94 INDEX containment 93 crisis and acute phase 95 family needs and capabilities in 93 in early psychosis 92–7 outcomes 97 physical investigations 96 psychosocial issues 96 treating team 94–5 treatment package 95 hospital admission addressing concerns 98–9 criteria for 97–8 favourable environment 100–1 need for 97 observation 103 restraint 103 seclusion 103 Hospital Anxiety and Depression Scale (HADS) 239 hostility 63 hyperorexia nervosa 221 hypersexuality in children 139–40 hypomania 138 DSM-IV diagnostic criteria 142 hypomanic symptoms 23 hypothalamic–pituitary–adrenal (HPA) axis function 237 hysteria ICD-10 33, 189, 249 Primary Health Care mental health guidelines 257 Impulsive Nonconformity Scale 29 informed consent 64 inpatient care in first-episode psychosis 98 models of 99–100 treatment in early psychosis 97–104 insomnia 140 internet resources in bipolar disorder in children and adolescents 154–5 interpersonal therapy (IPT) 263 Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS) 19, 32–4 test–retest design 33 Interview Schedule for Children (ISC) 146 IQ in children of persons with schizophrenia 123 INDEX performance 176 verbal 176 irritability 140 Israeli High-Risk Study 115–16, 122–4 Jerusalem Infant Development Study 117 K10/K6 239 Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) 187 lability 178 laboratory assessment 147 lamotrigine 151 Liddle’s three-factor model 12 Liebowitz Social Anxiety Scale (LSAS) 237 lithium and lithium resistance 138 in bipolar disorder in children and adolescents 149–50 responders 166 McGlashan group instruments 31–2 McGorry group instruments 31 Magical Ideation Scale 29 magnetic resonance imaging (MRI) 13, 27, 82–3, 96, 177 magnetic resonance spectroscopy (MRS) 177 major depression 136–7, 167, 178 clinical profile 195–6 in children and adolescents 195–6 mania 84, 138, 140 and attention deficit/hyperactivity disorder (ADHD) 144 DSM-IV criteria for 141–2 in children 148 juvenile 165 phenotypic system of classifying 141–2 subsyndromal 175–6 tracking severity and course of target symptoms 146 Mania Rating Scale 146 manic adolescents 139 manic children 139 manic symptoms 23 masturbation 140 301 medication 63 adherence 85–6 failure to respond 87 management 96 noncompliance 86 route of administration 85–6 memantine 290 memory complaints 287 memory training programmes 290 Mendelian inheritance, deviations in bipolar disorder 165 mental health legislation 80 mental health skills training and education 261 mild cognitive impairment (MCI) 277, 285 as harbinger of AD 279 assessment 281–4 basic critieria to identify those likely to decline to dementia (AD) 278–9 biological markers 288–9 classification 277–9 definition 277–9 diagnostic borders 280–1 differential diagnosis 279–80 domains to be assessed for diagnosis 284 follow-up studies 281–2 gold standard for diagnostic validity 290 instruments for identification 283 management 290 neuroimaging 289 neuropathology 289 observer scales 283 prevalence 279 progression to AD 291 rates of conversion to AD 281 screening instruments 284 screening tests 283 terminology 277–9 Mini-Social Phobia Inventory (SPIN) 237 Minnesota Multiphasic Personality Inventory (MMPI) 115, 121 mood disorders in children and adolescents 195 risk for 165–8 mood stabilizers 85, 148 mood swings 171 302 motor agitation 175 motor dysfunctions in children of persons with schizophrenia 123 multifamily psychoeducational groups (MPFGs) 153 N-acetyl-aspartate (NAA) 177 NAA/CR ratio 177 National Alliance for the Mentally Ill (NAMI) 154–5 National Comorbidity Survey 235 National Institute for Clinical Excellence (NICE) 54, 263 National Institute for Mental Health Epidemiological Catchment Area study 252 National Institute for Mental Health in England (NIMHE) 260 National Institute of Mental Health (NIMH) 155 Developmental Psychopathology and Prevention Research Branch 142 negative predictive power (NPP) 27 Netherlands 170 neurasthenia neurobiological aspects in bipolar offspring 177 neurobiological markers in obsessive– compulsive disorder (OCD) 234 neuroleptics 24 neuroprotective drug strategies 63 neuropsychological assessment 188 neuropsychological deficits 83 neurotic defence mechanisms New York High-Risk Project 116–17, 119–21, 124 NIMH Israeli High-Risk Study 115–16, 122–4 nonverbal learning disabilities (NLD) syndrome 176 obsessive–compulsive disorder (OCD) 233–4 childhood-onset 233 early detection 233 family interventions 233 neurobiological markers 234 prevalence 233 obsessive–compulsive reactions obstetric complications in children of persons with schizophrenia 122–3 INDEX ODD/CD 202 olanzapine 86 onset of psychiatric disorders 62 onset of psychosis 72 oppositional defiant disorder (ODD) 188, 193, 196–8 organic syndromes 199–200 overextension PACE Clinic 58, 61, 69 paediatric neuropsychiatric disorders associated with streptococcus (PANDAS) 233 panic disorder 234–5 early detection of 234 prevention 235 risk factors for onset 234 patient support 73, 90, 97, 153–4 see also family support; support groups PDD-NOS 199 Pediatric Emotional Distress Scale (PEDS) 188 Perceptual Aberration Scale 29 Personal Assessment and Clinical Evaluation (PACE) Clinic 58, 61, 69 personality variables in children of persons with schizophrenia 121 pervasive developmental disorders (PDD) 198–9 phenotypic system of classifying juvenile mania 141–2 physical disorders producing psychiatric symptoms 200 positive predictive power (PPP) 27 positron emission tomography (PET) 84 post-traumatic stress disorder (PTSD) 188, 193–6, 198, 202, 235–7 DSM-IV category of 194 pharmacotherapy 236 psychotherapeutic intervention 236 risk factors 236 prediction of bipolar disorder, psychopathology 175–7 prepulse inhibition 114 Present State Examination (PSE) Prevention through Risk Identification, Management and Education (PRIME) Research Clinic 31 Primary Care Evaluation of Mental Disorders (PRIME-MD) 239 INDEX primary care programme for depression 260 problem-solving therapy 263 prodromal manifestation in children 168 prodromal symptoms 1–49 bipolar disorder in children and adolescents 141 Bonn Scale for the Assessment of Basic Symptoms (BSABS) 30 severity assessment 31–2 psychoeducation in depression 264 in early psychosis 69 psychoeducational interventions 177–8 psychological therapies in depression 262–3 psychopathology, prediction of bipolar disorder 175–7 psychosis (early) acute phase 53 aims of assessment 71 approaches to treatment 52, 54–5 biomedical investigations 81–3 challenges for clinicians 51–2 childhood-onset 197–8 choice of treatment setting 92 close-in strategy 56–7 comorbidity 68, 75–6 comparison with chronic psychotic illness 52 crisis management 66 critical period 53 current clinical guidelines for prepsychotic phase 62 current issues for research 104 definition of onset 59 development of 111 diagnosis 71–2 duration of untreated psychosis (DUP) 64 early prognostic indicators engagement of patients 70–1 false positive rate 57 first-episode programmes 55 help-seeking and recognition 67–8 hospital admission 92 insight 74–5 intervention research 61 interviewing young people 73 link between genetic factors and subsequent development 112 303 management of 51–109 medication in acute phase 83–8 mental state examination 74–5 mobile detection and engagement 68 models of care 65–6 multiple-gate screening 57 neglect and death 81 obstacles to early detection and treatment 67 obstacles to pre-psychotic intervention 57 onset criteria 59 phases of illness 53–4 potential advantages of pre-psychotic intervention 56 preliminary assessment 72 premorbid phase 55 pre-psychotic phase 55–64 prodromal period 53 proneness 29 psychological interventions 91 psychosis phase 74 psychosocial function assessment 76 recognition of problem by GPs 68 recovery process 53–4 recurrence 54 referral 68 research guidelines for treatment strategies 63–4 secondary morbidity 76 special features 52 staging 53 symptoms 72 transition to recovery phase 103–4 ultra-high risk (IHR) for 28, 38 use of term 53 see also first-episode psychosis; homebased treatment psychosocial functioning 138 psychostimulants 198 psychotherapy in bipolar disorder in children and adolescents 153 interventions in bipolar offspring 177–8 psychotic disorders, peak onset 65 psychotic disorganization psychotic episodes duration or severity 12 304 psychotic episodes (cont.) hypothesis of neurotoxicity 11–13 see also first-episode psychosis psychotic symptoms, onset of quantitative trait locus (QTL) analysis 114 quetiapine 86 racing thoughts 139 randomized controlled trial (RCT) 61 rating scales 187–8 Receiver Operating Characteristic Analysis (ROC Analyse) 27 reconstruction of illness onset and early course 6–8 restlessness 175 restricted consciousness Retrospective Assessment of the Onset of Schizophrenia (IRAOS) Revised Child Behavior Checklist (RCBP) 188 risk assessment in early psychosis 76–81 risperidone 61, 86, 152 rivastigmine 290 Rotterdam Scan Study 288 Royal Park Multidiagnostic Instrument for Psychosis (RP-MIP) 31, 37 Scale of Prodromal Symptoms (SOPS) 31 Schedule for Affective Disorders and Schizophrenia for School-Aged Children and Adolescents, Epidemiological Version (K-SADS-E) 136 schizophrenia ABC study aetiology 114, 120, 128 age and gender as risk factors 22–3 antistigma and information campaigns 27 as heritable disorder 119 assessing prodromal symptoms and impairment in early course of 15–26 assessing prodromal symptoms before psychotic relapses 16–17 awareness programmes 27 brain morphology at prodromal stage 14 INDEX comparison of prodromal symptoms 19 depressive symptoms as prodromal signs of 18–19 descriptive diagnosis 67 diagnosis 33 diagnostic classification of unspecific symptoms 26 diagnostic criteria 18 diagnostic efficiency and predictive power of prodromal symptoms 37 diagnostic tests, strategies to improve predictive accuracy 28–9 disability in 56 duration of prodromal stage 23, 38 duration of psychotic episode 38 earlier onset in men 23 earliest psychotic symptoms 17–18 early course of 7–8 early detection 1–49 early functional impairment and social consequences 21–2 false positives 28 five-year social outcome 22 further syndromes of prodromal phase 23–4 genetic diathesis 119 heterogeneous course 12–13 indicators of prognostic accuracy 27–8 instruments for assessing onset and early course 27–36 lists of prodromal features 24–5 optimal standard of care 66 premature onset of pre-psychotic (prodromal) stage 25 premorbid indicators 112 premorbid personality traits 25–6 prephases pre-psychotic phase 55 prodromal signs 112 prodromal stage 7–8 prognostic indicators 22 prospective assessments 26 psychological indicator of vulnerability to 26 psychotic symptoms 39 residual symptoms as prodromal signs 15–17 sequence of first-ever onset of symptoms 18 INDEX social course 22 spectrum disorders 59, 111, 113 stage models of early course 2–6 symptom dimensions 12 ten most frequent earliest signs 17 ten most frequent initial symptoms 20 ten most frequent symptoms in early course 20 trait factors 28–9 transition from premorbid risk status to prodromal stage 26 validating DSM-III prodromal symptoms 37–8 with and without depressive episodes 21 see also ABC Schizophrenia Study; children of persons with schizophrenia and specific aspects and instruments Schizophrenia Proneness Scale 121 schizophrenogenic family 120 schizophrenogenic life experience 120 schizophrenogenic mother 120 selective serotonin reuptake inhibitor (SSRI) medication 60, 232, 261–2 self-harm 101–2 self-help in depression 264 serious emotional disturbance (SED) 148 sexuality in adolescents 140 SIDAM Score (SISCO) 284 sleep, decreased need for 140 SNAP-IV 188 Social Anhedonia Scale 29 social anxiety disorder (SAD) 237–8 comorbid disorders 237 potentially modifiable risks 238 screening 237 social functioning 167 social skills in children of persons with schizophrenia 120–1 social support 97 somatization 251–2 specific preventive intervention (SPI) 61 SSRIs 60, 232, 261–2 stealing 139 stress-vulnerability model 62 structural equation modelling technique (SEM) 4–5 Structured Interview for Prodromal Syndromes (SIPS) 31 305 Structured Interview for the Assessment of Dementia (SIDAM) 278, 282, 284 subjective cognitive complaints, not only memory 288 subjective cognitive impairment 286–8 subjective memory complaints 287–8 substance use/abuse 25, 75, 82, 93, 143–4, 235 suicide and risk of 63, 77–9, 102, 178 support groups, in bipolar disorder in children and adolescents 153–4 temazepam 96 temperamental features, bipolar disorder vulnerability 174–5 temperamental moodiness 171 terminale Test of Variables of Attention (TOVA) 188 thought disorder 18 topiramate in bipolar disorder in children and adolescents 152 trait and state risk factors 60 Trauma Symptom Checklist for Children (TSCC) 188 treatment resistance 87 trema tricyclic antidepressants 261–2 twin studies, children of persons with schizophrenia 117–19 ultra-high risk (UHR) for psychosis 28, 38 ultra-high risk (UHR) studies 58–61 ultra-high-risk (UHR) probands 13 ultra-rapid cycling 171 unintentional harm to others 81 unipolar depression 136 US Preventive Services Task Force (USPSTF) 255–6 valproate in bipolar disorder in children and adolescents 150–2 victimization by others 81 violence 79–80, 101–2 Washington University Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) 146 white matter lesions (WML) 288 306 WHO Collaborative Study of Psychiatric Disorders in General Medical Settings 249 WHO Study of Psychological Problems in General Health Care 251 Wisconsin Card Sorting Test (WCST) 117, 119 INDEX World Psychiatric Association 261 YMRS scores 155 Youth Access Team (YAT) 68–9 ziprasidone 86 .. .Early Detection and Management of Mental Disorders Early Detection and Management of Mental Disorders Edited by Mario Maj University of Naples, Italy Juan Jose´ Lo´pez-Ibor... understanding of the early course of schizophrenia: _ EARLY DETECTION AND MANAGEMENT OF MENTAL DISORDERS There are many reasons for wanting to know more about the period of onset of schizophrenic... Mitsumoto Sato and Ahmed Okasha &2005 John Wiley & Sons Ltd ISBN 0-470-01083-5 2 _ EARLY DETECTION AND MANAGEMENT OF MENTAL DISORDERS was seen by Sullivan as a hierarchical sequence of neurotic