RSS-Feed abonnieren
DOI: 10.1055/s-0042-115568
Early Intervention in Psychosis and Bipolar Disorder in Children and Adolescents – Reflections on Lambert, Niehaus and Correll
Publikationsverlauf
Publikationsdatum:
13. Oktober 2016 (online)
![](https://www.thieme-connect.de/media/pharmaco/201606/lookinside/thumbnails/2016-07-0592_10-1055-s-0042-115568-1.jpg)
The early detection and intervention in psychoses and bipolar disorders have made good progress within the past years. Lambert et al. [1] provide a comprehensive review on the similarities and differences of the early detection and intervention of these disorders with a focus on pharmacological interventions in children and adolescents.
The authors face and name the fundamental problem that many studies in fact include adolescents yet, mostly, only a few patients age 16–18 years and, only in a few studies, patients below the age of 16 years. In this context, the reader must carefully consider the actual age range and the number of minors in each study, especially since most authors inaccurately generalize their findings to “youth”, “adolescents”, or “youngsters” in their conclusions. The same speech confusion exists concerning the definition of clinical high-risk (CHR) criteria [2] [3]. Therefore, it is commendable that Lambert et al. [1] started their review with a precise definition of CHR criteria. The authors of this comment avoid the word “prodromal” in the context of CHR research in order to emphasize the fact that, at the time CHR symptoms occur, the rate of conversion to the full-blown disorder is only about 30%, while “prodromal” should only be used when the full-blown disorder already occurred to describe the CHR state in retrospect [4].
-
References
- 1 Lambert M, Niehaus V, Correll CU. Pharmacotherapy in children and adolescent at clinical-high risk for psychosis and bipolar disorder. Pharmacopsychiatry 2016. 49: 229-244
- 2 Schultze-Lutter F, Schimmelmann BG, Ruhrmann S. The near Babylonian speech confusion in early detection of psychosis. Schizophr Bull 2011; 37: 653-655
- 3 Schultze-Lutter F, Schimmelmann BG, Ruhrmann S. et al. ‘A rose is a rose is a rose’, but at-risk criteria differ. Psychopathology 2013; 46: 75-87
- 4 Schimmelmann BG, Schultze-Lutter F. Early detection and intervention of psychosis in children and adolescents: urgent need for studies. Eur Child Adolesc Psychiatry 2012; 21: 239-241
- 5 Schultze-Lutter F, Michel C, Schmidt SJ. et al. EPA guidance on the early detection of clinical high risk states of psychoses. Eur Psychiatry 2015; 30: 405-416
- 6 Schmidt SJ, Schultze-Lutter F, Schimmelmann BG. et al. EPA guidance on the early intervention in clinical high risk states of psychoses. Eur Psychiatry 2015; 30: 388-404
- 7 Schultze-Lutter F, Michel C, Ruhrmann S. et al. Prevalence and clinical significance of DSM-5-attenuated psychosis syndrome in adolescents and young adults in the general population: the Bern Epidemiological At-Risk (BEAR) study. Schizophr Bull 2014; 40: 1499-1508
- 8 Schimmelmann BG, Michel C, Martz-Irngartinger A. et al. Age matters in the prevalence and clinical significance of ultra-high-risk for psychosis symptoms and criteria in the general population: findings from the BEAR and BEARS-kid studies. World Psychiatry 2015; 14: 189-197
- 9 Schimmelmann BG, Walger P, Schultze-Lutter F. The significance of at-risk symptoms for psychosis in children and adolescents. Can J Psychiatry 2013; 58: 32-40
- 10 Hlastala SA, McClellan J. Phenomenology and diagnostic stability of youths with atypical psychotic symptoms. J Child Adolesc Psychopharmacol 2005; 15: 497-509
- 11 Legenbauer T, Hübner J, Pinnow M et al. Proper emotion recognition, dysfunctional emotion regulation. The mystery of affective dysregulation in adolescent psychiatric inpatients. Z Kinder Jugendpsychiatr Psychother 44: [in press]