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Parenting is an inherently stressful experience for individuals across sociodemographic backgrounds; parenting in the context of a child anxiety or depressive disorder can exacerbate stress levels. Yet, such effects from child to parent are not unidirectional; there is a strong intergenerational link among anxiety and depression, suggesting a complex interplay of genetic and environmental experiences that contributes to child, parent, and overall family well-being. Few parenting behaviors are uniformly associated with more/fewer internalizing symptoms in children though parent warmth has been negatively associated with anxiety and depression in youth across ages, genders, and cultures (Rothenberg et al., 2020). In contrast, parent psychological control has been consistently associated with greater levels of internalizing symptoms across diverse samples of youth. Given the role of the family in youth anxiety and depression, prevention and intervention programs have integrated parents in a variety of ways with mixed results. Future work that examines the complex interplay of child, parent, family, and broader cultural variables using increasingly sophisticated methodological and statistical approaches is needed to move the field forward in substantive ways.
Early detection of psychosis is a promising area in preventive psychiatry. The use of early intervention can prevent the first episode psychosis and improve outcomes.
Objectives
Identification of premorbid features of depressive patients at clinical high risk for psychosis (CHR) comparing with depressive patients without CHR in order to improve early recognition of the psychotic process.
Methods
219 young depressive in-patients with CHR criteria for SOPS with attenuated positive and attenuated negative symptoms and 52 young depressive in-patients without CHR were examined. Presence of obstetric complications, neurodevelopmental deviance, neurological and psychiatric signs at the premorbid stage, and the level of premorbid functioning on the PAS were examined.
Results
It has been established that depressive patients at CHR and without CHR had some obstetric complications (57.5% and 40.4%, respectively). Neurodevelopmental deviance in the first year of live was in 57.5% patients with CHR. At the age of 3-5 sleep disorders, ADHD and phobias were more common in patients at CHR than without it (58.8% and 32.7%, p=0.014). In pubertal, patients at CHR were more likely to show depression symptoms, obsessions, and aggression - 90.4% versus 76.9% (p=0.029). On the PAS scale, a decrease of the level of premorbid functioning has been observed in two groups of patients with and without CHR from the age of 12: from 12 to 15 years, 0.4 and 0.3 (p=0.004), from 16 to 18 years, 0.47 and 0.37 (p 0.001).
Conclusions
Premorbid functioning were worst in patients with CHR, which indicates the possibility of early clinical detection of psychosis.
The identification of the psychosis high-risk state in help-seeking patients with depressive symptoms offers the possibility of detection and intervention at the early stages of schizophrenia.
Objectives
Estimating the 5-year follow-up rate of the manifestation of psychosis and levels of functioning in patients with the clinical high-risk state and depressive symptoms.
Methods
81 inpatients (average age 19.6 years) with depressive symptoms and attenuated psychosis (60 patients with APS and 21 patients with BLIPS). Average duration of inpatient treatment was 56.3 days, antidepressant therapy (mean dosage equivalent to fluoxetine 43.1 mg/day) and antipsychotic therapy (mean dosage equivalent to chlorpromazine 408.9 mg/day) were conducted. All patients were followed up after discharge at least during 5 years (average follow-up 7.1 years). Levels of functioning were assessed on the PSP scale.
Results
The manifestation of psychosis was identified in 21.0% (17 patients) (on average in the third year of follow-up), complete symptomatic and functional remission was established in 11.1% (9 patients) (PSP 100-81), complete symptomatic and incomplete functional remission was established in 27.2% (22 patients) (PSP 80-61). Incomplete symptomatic and incomplete functional remission – in 24.7% (20 patients) (PSP 60-41) and 13.5% (11 patients) (PSP<40).
Conclusions
The combination of antidepressants and antipsychotics therapy in patients with the clinical high-risk state for psychosis reduced the risk of psychosis manifestation but did not significantly affect the level of outcome compared to other studies.
Disclosure
No significant relationships.
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