The Experts below are selected from a list of 257502 Experts worldwide ranked by ideXlab platform
Barnaby Nelson - One of the best experts on this subject based on the ideXlab platform.
-
has improved treatment contributed to the declining Rate of Transition to psychosis in ultra high risk cohorts
Schizophrenia Research, 2020Co-Authors: M J C Formica, P D Mcgorry, Lisa J Phillips, Jessica A Hartmann, Alison R Yung, Stephen J Wood, Ashliegh Lin, G P Amminger, Barnaby NelsonAbstract:Abstract Background The factors contributing to declining psychotic disorder Transition Rates in ultra-high-risk populations remain unclear. We examined the contribution of longitudinal changes in standard clinical treatment (‘treatment as usual’) to this decline. Method An audit was conducted on 105 clinical files of patients who received standard care at a specialised ultra-high-risk service. The session notes of these files were quantified, allowing examination of treatment quantity, targets, psychotherapy, and medication. Differences in these aspects across patients' year of clinic entry were assessed. Variables with significant differences across years were examined using cox regression to assess their contribution to psychosis Transition Rates. Results Findings were that, as a function of patients' year of clinic entry, there were increases in: patients' number of sessions, cognitive behavioural therapy (CBT), problem and solving therapy. There was a relationship between baseline year cohort and psychosis Transition Rate, with lower Rates observed in more recent cohorts. When changes in treatment between cohorts were adjusted for, the relationship between baseline year cohort and Transition Rate disappeared. The relationship between baseline year and Transition Rate was attenuated most by increases in CBT. Conclusion Changes in standard treatment, particularly increases in CBT, may have contributed to the decline in psychosis risk observed in recent ultra-high-risk cohorts, although these variables do not fully explain this trend. Implications for clinical practice, prediction and intervention research are discussed. Future ultra-high-risk research should investigate the impact of other treatment factors, such as therapeutic alliance.
-
declining Transition Rates to psychotic disorder in ultra high risk clients investigation of a dilution effect
Schizophrenia Research, 2016Co-Authors: Jessica A Hartmann, P D Mcgorry, Alison R Yung, Stephen J Wood, Hok Pan Yuen, Ashleigh Lin, Suzie Lavoie, Barnaby NelsonAbstract:Abstract During recent years, a decrease has been noted in the Rate of Transition of ultra-high risk (UHR) clients to a psychotic disorder. Although important to the concept of the at-risk mental state, the reasons for this decline remain largely unknown. We investigated the possibility of a ‘dilution effect’ in contributing to the decline, i.e. if later UHR cohorts present with less severe clinical intake characteristics than earlier cohorts. Firstly, clinical intake characteristics of a large UHR sample (n = 397) were compared across baseline year epochs (1995–2006). Characteristics showing significant differences were included in a Cox-regression to examine if they could explain the decline in Transition Rates. Secondly, because later cohorts show lower Transition Rates, ‘more stringent’ UHR-criteria were retrospectively applied to these cohorts (post-2000, n = 219), investigating if this resulted in a higher Transition Rate. Results indicated that earlier cohorts presented with (1) a larger array of attenuated psychotic symptoms, (2) higher ratings on conceptual disorganization (formal thought disorder) and (3) a higher proportion of individuals with trait risk factor (all P Our study suggests that later UHR cohorts presented with different clinical intake characteristics than earlier cohorts. While this may have contributed to the observed decrease in Transition Rates to psychosis, it does not appear to fully account for this decline, suggesting other factors have also impacted on Transition Rates over time.
-
long term follow up of a group at ultra high risk prodromal for psychosis the pace 400 study
JAMA Psychiatry, 2013Co-Authors: Barnaby Nelson, Stephen J Wood, Hok Pan Yuen, Ashleigh Lin, Daniela Spiliotacopoulos, Annie Bruxner, Christina Broussard, Magenta Simmons, Debra L Foley, Warrick J BrewerAbstract:Importance The ultra high-risk (UHR) criteria were introduced to prospectively identify patients at high risk of psychotic disorder. Although the short-term outcome of UHR patients has been well researched, the long-term outcome is not known. Objective To assess the Rate and baseline predictors of Transition to psychotic disorder in UHR patients up to 15 years after study entry. Design Follow-up study of a cohort of UHR patients recruited to participate in research studies between 1993 and 2006. Setting The Personal Assessment and Crisis Evaluation (PACE) clinic, a specialized service for UHR patients in Melbourne, Australia. Participants Four hundred sixteen UHR patients previously seen at the PACE clinic. Main Outcomes and Measures Transition to psychotic disorder, as measured using the Comprehensive Assessment of At-Risk Mental States, Brief Psychiatric Rating Scale/Comprehensive Assessment of Symptoms and History, or state public mental health records. Results During the time to follow-up (2.4-14.9 years after presentation), 114 of the 416 participants were known to have developed a psychotic disorder. The highest risk for Transition was within the first 2 years of entry into the service, but individuals continued to be at risk up to 10 years after initial referral. The overall Rate of Transition was estimated to be 34.9% over a 10-year period (95% CI, 28.7%-40.6%). Factors associated with Transition included year of entry into the clinic, duration of symptoms before clinic entry, baseline functioning, negative symptoms, and disorders of thought content. Conclusions and Relevance The UHR patients are at long-term risk for psychotic disorder, with the highest risk in the first 2 years. Services should aim to follow up patients for at least this period, with the possibility to return for care after this time. Individuals with a long duration of symptoms and poor functioning at the time of referral may need closer monitoring. Interventions to improve functioning and detect help-seeking UHR patients earlier also may be indicated.
-
declining Transition Rate in ultra high risk prodromal services dilution or reduction of risk
Schizophrenia Bulletin, 2007Co-Authors: Alison R Yung, Lisa J Phillips, Barnaby Nelson, Hok Pan Yuen, Shona M Francey, Gregor Berger, Techieh Hung, P D McgorryAbstract:There is growing interest in the prodromal stage of psychotic disorders, with many services now providing care for these "ultra high risk" (UHR) individuals. However, a reduction in the Rate of Transition to psychosis has been suspected over the last few years. This has implications for the use of interventions in this population and for the validity of research findings. This study examined the Transition Rate in one UHR service, the Personal Assessment and Crisis Evaluation Clinic, over the years 1995-2000 and investigated possible causes for the Transition Rate reduction. There was evidence for a declining Transition Rate, with each successive year showing a Rate 0.80 times that of the preceding year. Functioning and symptom level were not responsible for the change. The decreased Transition Rate was partly explained by a reduction in the duration of symptoms of patients prior to receiving help. That is, UHR individuals are being detected and provided with care earlier than in the past. Thus, the decline in Transition Rate may be due to treatment being more effective at this very early stage of illness or it may be due to finding more false positives who were never at risk of psychosis, ie, a "dilution" effect. Given that it is not possible to distinguish between these alternatives at least phenotypically at present, perhaps it is time to rethink the role and practice of UHR clinics. Patients presenting to them need help. It may be that we need to aim to prevent a range of target syndromes.
P D Mcgorry - One of the best experts on this subject based on the ideXlab platform.
-
has improved treatment contributed to the declining Rate of Transition to psychosis in ultra high risk cohorts
Schizophrenia Research, 2020Co-Authors: M J C Formica, P D Mcgorry, Lisa J Phillips, Jessica A Hartmann, Alison R Yung, Stephen J Wood, Ashliegh Lin, G P Amminger, Barnaby NelsonAbstract:Abstract Background The factors contributing to declining psychotic disorder Transition Rates in ultra-high-risk populations remain unclear. We examined the contribution of longitudinal changes in standard clinical treatment (‘treatment as usual’) to this decline. Method An audit was conducted on 105 clinical files of patients who received standard care at a specialised ultra-high-risk service. The session notes of these files were quantified, allowing examination of treatment quantity, targets, psychotherapy, and medication. Differences in these aspects across patients' year of clinic entry were assessed. Variables with significant differences across years were examined using cox regression to assess their contribution to psychosis Transition Rates. Results Findings were that, as a function of patients' year of clinic entry, there were increases in: patients' number of sessions, cognitive behavioural therapy (CBT), problem and solving therapy. There was a relationship between baseline year cohort and psychosis Transition Rate, with lower Rates observed in more recent cohorts. When changes in treatment between cohorts were adjusted for, the relationship between baseline year cohort and Transition Rate disappeared. The relationship between baseline year and Transition Rate was attenuated most by increases in CBT. Conclusion Changes in standard treatment, particularly increases in CBT, may have contributed to the decline in psychosis risk observed in recent ultra-high-risk cohorts, although these variables do not fully explain this trend. Implications for clinical practice, prediction and intervention research are discussed. Future ultra-high-risk research should investigate the impact of other treatment factors, such as therapeutic alliance.
-
Further examination of the reducing Transition Rate in ultra high risk for psychosis samples: The possible role of earlier intervention
Schizophrenia Research, 2016Co-Authors: B Nelson, H P Yuen, A Lin, S J Wood, P D Mcgorry, J A Hartmann, A R YungAbstract:Abstract Background The Rate of Transition to psychotic disorder in ultra high risk (UHR) patients has declined in recent cohorts. The reasons for this are unclear, but may include a lead-time bias, earlier intervention, a change in clinical characteristics of cohorts, and treatment changes. Aims In this paper we examined the two possibilities related to reduction in duration of symptoms prior to clinic entry, i.e., lead-time bias and earlier intervention. Method The sample consisted of all UHR research participants seen at the PACE clinic, Melbourne between 1993 and 2006 ( N = 416), followed for a mean of 7.5 years (the ‘PACE 400’ cohort). Duration of symptoms was analysed by four baseline year time periods. Analysis of Transition Rate by duration of symptoms was restricted to more homogenous sub-samples (pre-1998 and pre-2001) in order to minimize confounding effects of change in patient characteristics or treatments. These cohorts were divided into those with a short and long duration of symptoms using a cut-point approach. Results Duration of symptoms prior to entry did not reduce significantly between 1993 and 2006 ( p = 0.10). The group with a short duration of symptoms showed lower Transition Rates and did not catch up in Transition Rate compared to the long duration of symptoms group. Discussion These data suggest that, while earlier intervention or lead-time bias do not fully account for the declining Transition Rate in UHR cohorts, it appears that earlier intervention may have exerted a stronger influence on this decline than length of follow-up period (lead-time bias).
-
declining Transition Rates to psychotic disorder in ultra high risk clients investigation of a dilution effect
Schizophrenia Research, 2016Co-Authors: Jessica A Hartmann, P D Mcgorry, Alison R Yung, Stephen J Wood, Hok Pan Yuen, Ashleigh Lin, Suzie Lavoie, Barnaby NelsonAbstract:Abstract During recent years, a decrease has been noted in the Rate of Transition of ultra-high risk (UHR) clients to a psychotic disorder. Although important to the concept of the at-risk mental state, the reasons for this decline remain largely unknown. We investigated the possibility of a ‘dilution effect’ in contributing to the decline, i.e. if later UHR cohorts present with less severe clinical intake characteristics than earlier cohorts. Firstly, clinical intake characteristics of a large UHR sample (n = 397) were compared across baseline year epochs (1995–2006). Characteristics showing significant differences were included in a Cox-regression to examine if they could explain the decline in Transition Rates. Secondly, because later cohorts show lower Transition Rates, ‘more stringent’ UHR-criteria were retrospectively applied to these cohorts (post-2000, n = 219), investigating if this resulted in a higher Transition Rate. Results indicated that earlier cohorts presented with (1) a larger array of attenuated psychotic symptoms, (2) higher ratings on conceptual disorganization (formal thought disorder) and (3) a higher proportion of individuals with trait risk factor (all P Our study suggests that later UHR cohorts presented with different clinical intake characteristics than earlier cohorts. While this may have contributed to the observed decrease in Transition Rates to psychosis, it does not appear to fully account for this decline, suggesting other factors have also impacted on Transition Rates over time.
-
declining Transition Rate in ultra high risk prodromal services dilution or reduction of risk
Schizophrenia Bulletin, 2007Co-Authors: Alison R Yung, Lisa J Phillips, Barnaby Nelson, Hok Pan Yuen, Shona M Francey, Gregor Berger, Techieh Hung, P D McgorryAbstract:There is growing interest in the prodromal stage of psychotic disorders, with many services now providing care for these "ultra high risk" (UHR) individuals. However, a reduction in the Rate of Transition to psychosis has been suspected over the last few years. This has implications for the use of interventions in this population and for the validity of research findings. This study examined the Transition Rate in one UHR service, the Personal Assessment and Crisis Evaluation Clinic, over the years 1995-2000 and investigated possible causes for the Transition Rate reduction. There was evidence for a declining Transition Rate, with each successive year showing a Rate 0.80 times that of the preceding year. Functioning and symptom level were not responsible for the change. The decreased Transition Rate was partly explained by a reduction in the duration of symptoms of patients prior to receiving help. That is, UHR individuals are being detected and provided with care earlier than in the past. Thus, the decline in Transition Rate may be due to treatment being more effective at this very early stage of illness or it may be due to finding more false positives who were never at risk of psychosis, ie, a "dilution" effect. Given that it is not possible to distinguish between these alternatives at least phenotypically at present, perhaps it is time to rethink the role and practice of UHR clinics. Patients presenting to them need help. It may be that we need to aim to prevent a range of target syndromes.
-
prediction of psychosis a step towards indicated prevention of schizophrenia
The British journal of psychiatry. Supplement, 1998Co-Authors: Alison R Yung, P D Mcgorry, Lisa J Phillips, Colleen A Mcfarlane, Shona M Francey, Susan Harrigan, George C Patton, Henry J JacksonAbstract:Background The identification of people at high risk of becoming psychotic within the near future creates opportunities for early intervention prior to the onset of psychosis to prevent or minimise later ill-health. The present study combines current knowledge about risk factors for schizophrenia with our knowledge of psychotic prodromes in an attempt to identify a group particularly vulnerable to impending psychosis. We wanted to identify people with high likelihood of Transition to psychosis within a follow-up period of 12 months, and to determine the Rate of Transition to psychosis in this group. Method Various state and trait risk factors for psychosis were used alone and in combination to operationally define a putatively high-risk group. Operationalised criteria for onset of psychosis were established. The individuals were assessed monthly on measures of psychopathology for six months. Results Eight out of 20 people made the Transition to frank psychosis within a six-month follow-up period. Follow-up of this group is still in progress, and the 12 month Transition Rate might prove to be higher still. Conclusions We have demonstRated that it is possible to identify individuals with a high likelihood of onset of psychosis within a brief follow-up period. This lays the foundation for early treatment in an attempt to prevent, delay or minimise the severity of first onset of schizophrenia.
Alison R Yung - One of the best experts on this subject based on the ideXlab platform.
-
has improved treatment contributed to the declining Rate of Transition to psychosis in ultra high risk cohorts
Schizophrenia Research, 2020Co-Authors: M J C Formica, P D Mcgorry, Lisa J Phillips, Jessica A Hartmann, Alison R Yung, Stephen J Wood, Ashliegh Lin, G P Amminger, Barnaby NelsonAbstract:Abstract Background The factors contributing to declining psychotic disorder Transition Rates in ultra-high-risk populations remain unclear. We examined the contribution of longitudinal changes in standard clinical treatment (‘treatment as usual’) to this decline. Method An audit was conducted on 105 clinical files of patients who received standard care at a specialised ultra-high-risk service. The session notes of these files were quantified, allowing examination of treatment quantity, targets, psychotherapy, and medication. Differences in these aspects across patients' year of clinic entry were assessed. Variables with significant differences across years were examined using cox regression to assess their contribution to psychosis Transition Rates. Results Findings were that, as a function of patients' year of clinic entry, there were increases in: patients' number of sessions, cognitive behavioural therapy (CBT), problem and solving therapy. There was a relationship between baseline year cohort and psychosis Transition Rate, with lower Rates observed in more recent cohorts. When changes in treatment between cohorts were adjusted for, the relationship between baseline year cohort and Transition Rate disappeared. The relationship between baseline year and Transition Rate was attenuated most by increases in CBT. Conclusion Changes in standard treatment, particularly increases in CBT, may have contributed to the decline in psychosis risk observed in recent ultra-high-risk cohorts, although these variables do not fully explain this trend. Implications for clinical practice, prediction and intervention research are discussed. Future ultra-high-risk research should investigate the impact of other treatment factors, such as therapeutic alliance.
-
declining Transition Rates to psychotic disorder in ultra high risk clients investigation of a dilution effect
Schizophrenia Research, 2016Co-Authors: Jessica A Hartmann, P D Mcgorry, Alison R Yung, Stephen J Wood, Hok Pan Yuen, Ashleigh Lin, Suzie Lavoie, Barnaby NelsonAbstract:Abstract During recent years, a decrease has been noted in the Rate of Transition of ultra-high risk (UHR) clients to a psychotic disorder. Although important to the concept of the at-risk mental state, the reasons for this decline remain largely unknown. We investigated the possibility of a ‘dilution effect’ in contributing to the decline, i.e. if later UHR cohorts present with less severe clinical intake characteristics than earlier cohorts. Firstly, clinical intake characteristics of a large UHR sample (n = 397) were compared across baseline year epochs (1995–2006). Characteristics showing significant differences were included in a Cox-regression to examine if they could explain the decline in Transition Rates. Secondly, because later cohorts show lower Transition Rates, ‘more stringent’ UHR-criteria were retrospectively applied to these cohorts (post-2000, n = 219), investigating if this resulted in a higher Transition Rate. Results indicated that earlier cohorts presented with (1) a larger array of attenuated psychotic symptoms, (2) higher ratings on conceptual disorganization (formal thought disorder) and (3) a higher proportion of individuals with trait risk factor (all P Our study suggests that later UHR cohorts presented with different clinical intake characteristics than earlier cohorts. While this may have contributed to the observed decrease in Transition Rates to psychosis, it does not appear to fully account for this decline, suggesting other factors have also impacted on Transition Rates over time.
-
declining Transition Rate in ultra high risk prodromal services dilution or reduction of risk
Schizophrenia Bulletin, 2007Co-Authors: Alison R Yung, Lisa J Phillips, Barnaby Nelson, Hok Pan Yuen, Shona M Francey, Gregor Berger, Techieh Hung, P D McgorryAbstract:There is growing interest in the prodromal stage of psychotic disorders, with many services now providing care for these "ultra high risk" (UHR) individuals. However, a reduction in the Rate of Transition to psychosis has been suspected over the last few years. This has implications for the use of interventions in this population and for the validity of research findings. This study examined the Transition Rate in one UHR service, the Personal Assessment and Crisis Evaluation Clinic, over the years 1995-2000 and investigated possible causes for the Transition Rate reduction. There was evidence for a declining Transition Rate, with each successive year showing a Rate 0.80 times that of the preceding year. Functioning and symptom level were not responsible for the change. The decreased Transition Rate was partly explained by a reduction in the duration of symptoms of patients prior to receiving help. That is, UHR individuals are being detected and provided with care earlier than in the past. Thus, the decline in Transition Rate may be due to treatment being more effective at this very early stage of illness or it may be due to finding more false positives who were never at risk of psychosis, ie, a "dilution" effect. Given that it is not possible to distinguish between these alternatives at least phenotypically at present, perhaps it is time to rethink the role and practice of UHR clinics. Patients presenting to them need help. It may be that we need to aim to prevent a range of target syndromes.
-
prediction of psychosis a step towards indicated prevention of schizophrenia
The British journal of psychiatry. Supplement, 1998Co-Authors: Alison R Yung, P D Mcgorry, Lisa J Phillips, Colleen A Mcfarlane, Shona M Francey, Susan Harrigan, George C Patton, Henry J JacksonAbstract:Background The identification of people at high risk of becoming psychotic within the near future creates opportunities for early intervention prior to the onset of psychosis to prevent or minimise later ill-health. The present study combines current knowledge about risk factors for schizophrenia with our knowledge of psychotic prodromes in an attempt to identify a group particularly vulnerable to impending psychosis. We wanted to identify people with high likelihood of Transition to psychosis within a follow-up period of 12 months, and to determine the Rate of Transition to psychosis in this group. Method Various state and trait risk factors for psychosis were used alone and in combination to operationally define a putatively high-risk group. Operationalised criteria for onset of psychosis were established. The individuals were assessed monthly on measures of psychopathology for six months. Results Eight out of 20 people made the Transition to frank psychosis within a six-month follow-up period. Follow-up of this group is still in progress, and the 12 month Transition Rate might prove to be higher still. Conclusions We have demonstRated that it is possible to identify individuals with a high likelihood of onset of psychosis within a brief follow-up period. This lays the foundation for early treatment in an attempt to prevent, delay or minimise the severity of first onset of schizophrenia.
Stephen J Wood - One of the best experts on this subject based on the ideXlab platform.
-
has improved treatment contributed to the declining Rate of Transition to psychosis in ultra high risk cohorts
Schizophrenia Research, 2020Co-Authors: M J C Formica, P D Mcgorry, Lisa J Phillips, Jessica A Hartmann, Alison R Yung, Stephen J Wood, Ashliegh Lin, G P Amminger, Barnaby NelsonAbstract:Abstract Background The factors contributing to declining psychotic disorder Transition Rates in ultra-high-risk populations remain unclear. We examined the contribution of longitudinal changes in standard clinical treatment (‘treatment as usual’) to this decline. Method An audit was conducted on 105 clinical files of patients who received standard care at a specialised ultra-high-risk service. The session notes of these files were quantified, allowing examination of treatment quantity, targets, psychotherapy, and medication. Differences in these aspects across patients' year of clinic entry were assessed. Variables with significant differences across years were examined using cox regression to assess their contribution to psychosis Transition Rates. Results Findings were that, as a function of patients' year of clinic entry, there were increases in: patients' number of sessions, cognitive behavioural therapy (CBT), problem and solving therapy. There was a relationship between baseline year cohort and psychosis Transition Rate, with lower Rates observed in more recent cohorts. When changes in treatment between cohorts were adjusted for, the relationship between baseline year cohort and Transition Rate disappeared. The relationship between baseline year and Transition Rate was attenuated most by increases in CBT. Conclusion Changes in standard treatment, particularly increases in CBT, may have contributed to the decline in psychosis risk observed in recent ultra-high-risk cohorts, although these variables do not fully explain this trend. Implications for clinical practice, prediction and intervention research are discussed. Future ultra-high-risk research should investigate the impact of other treatment factors, such as therapeutic alliance.
-
declining Transition Rates to psychotic disorder in ultra high risk clients investigation of a dilution effect
Schizophrenia Research, 2016Co-Authors: Jessica A Hartmann, P D Mcgorry, Alison R Yung, Stephen J Wood, Hok Pan Yuen, Ashleigh Lin, Suzie Lavoie, Barnaby NelsonAbstract:Abstract During recent years, a decrease has been noted in the Rate of Transition of ultra-high risk (UHR) clients to a psychotic disorder. Although important to the concept of the at-risk mental state, the reasons for this decline remain largely unknown. We investigated the possibility of a ‘dilution effect’ in contributing to the decline, i.e. if later UHR cohorts present with less severe clinical intake characteristics than earlier cohorts. Firstly, clinical intake characteristics of a large UHR sample (n = 397) were compared across baseline year epochs (1995–2006). Characteristics showing significant differences were included in a Cox-regression to examine if they could explain the decline in Transition Rates. Secondly, because later cohorts show lower Transition Rates, ‘more stringent’ UHR-criteria were retrospectively applied to these cohorts (post-2000, n = 219), investigating if this resulted in a higher Transition Rate. Results indicated that earlier cohorts presented with (1) a larger array of attenuated psychotic symptoms, (2) higher ratings on conceptual disorganization (formal thought disorder) and (3) a higher proportion of individuals with trait risk factor (all P Our study suggests that later UHR cohorts presented with different clinical intake characteristics than earlier cohorts. While this may have contributed to the observed decrease in Transition Rates to psychosis, it does not appear to fully account for this decline, suggesting other factors have also impacted on Transition Rates over time.
-
long term follow up of a group at ultra high risk prodromal for psychosis the pace 400 study
JAMA Psychiatry, 2013Co-Authors: Barnaby Nelson, Stephen J Wood, Hok Pan Yuen, Ashleigh Lin, Daniela Spiliotacopoulos, Annie Bruxner, Christina Broussard, Magenta Simmons, Debra L Foley, Warrick J BrewerAbstract:Importance The ultra high-risk (UHR) criteria were introduced to prospectively identify patients at high risk of psychotic disorder. Although the short-term outcome of UHR patients has been well researched, the long-term outcome is not known. Objective To assess the Rate and baseline predictors of Transition to psychotic disorder in UHR patients up to 15 years after study entry. Design Follow-up study of a cohort of UHR patients recruited to participate in research studies between 1993 and 2006. Setting The Personal Assessment and Crisis Evaluation (PACE) clinic, a specialized service for UHR patients in Melbourne, Australia. Participants Four hundred sixteen UHR patients previously seen at the PACE clinic. Main Outcomes and Measures Transition to psychotic disorder, as measured using the Comprehensive Assessment of At-Risk Mental States, Brief Psychiatric Rating Scale/Comprehensive Assessment of Symptoms and History, or state public mental health records. Results During the time to follow-up (2.4-14.9 years after presentation), 114 of the 416 participants were known to have developed a psychotic disorder. The highest risk for Transition was within the first 2 years of entry into the service, but individuals continued to be at risk up to 10 years after initial referral. The overall Rate of Transition was estimated to be 34.9% over a 10-year period (95% CI, 28.7%-40.6%). Factors associated with Transition included year of entry into the clinic, duration of symptoms before clinic entry, baseline functioning, negative symptoms, and disorders of thought content. Conclusions and Relevance The UHR patients are at long-term risk for psychotic disorder, with the highest risk in the first 2 years. Services should aim to follow up patients for at least this period, with the possibility to return for care after this time. Individuals with a long duration of symptoms and poor functioning at the time of referral may need closer monitoring. Interventions to improve functioning and detect help-seeking UHR patients earlier also may be indicated.
Zachary P Kilpatrick - One of the best experts on this subject based on the ideXlab platform.
-
persistent search in single and multiple confined domains a velocity jump process model
Journal of Statistical Mechanics: Theory and Experiment, 2016Co-Authors: Daniel B Poll, Zachary P KilpatrickAbstract:We analyze velocity-jump process models of persistent search for a single target on a bounded domain. The searcher proceeds along ballistic trajectories and is absorbed upon collision with the target boundary. When reaching the domain boundary, the searcher chooses a random direction for its new trajectory. For circular domains and targets, we can approximate the mean first passage time (MFPT) using a Markov chain approximation of the search process. Our analysis and numerical simulations reveal that the time to find the target decreases for targets closer to the domain boundary. When there is a small probability of direction-switching within the domain, we find the time to find the target decreases slightly with the turning probability. We also extend our exit time analysis to the case of partitioned domains, where there is a single target within one of multiple disjoint subdomains. Given an average time of Transition between domains , we find that the optimal Rate of Transition that minimizes the time to find the target obeys .
-
persistent search in confined domains a velocity jump process model
arXiv: Statistical Mechanics, 2016Co-Authors: Daniel B Poll, Zachary P KilpatrickAbstract:We analyze velocity-jump process models of persistent search for a single target on a bounded domain. The searcher proceeds along ballistic trajectories and is absorbed upon collision with the target boundary. When reaching the domain boundary, the searcher chooses a random direction for its new trajectory. For circular domains and targets, we can approximate the mean first passage time (MFPT) using a Markov chain approximation of the search process. Our analysis and numerical simulations reveal that the time to find the target decreases for targets closer to the domain boundary. When there is a small probability of direction-switching within the domain, we find the time to find the target decreases slightly with the turning probability. We also extend our exit time analysis to the case of partitioned domains, where there is a single target within one of multiple disjoint subdomains. Given an average time of Transition between domains $\langle T \rangle$, we find that the optimal Rate of Transition that minimizes the time to find the target obeys $\beta_{\rm min} \propto 1/ \sqrt{\langle T \rangle}$.
