Attenuated psychosis syndrome shows clinical significance


Attenuated psychosis syndrome shows clinical significance
By Lucy Piper, Senior medwireNews Reporter
09 January 2014
Schizophr Bull 2013; Advance online publication

medwireNews: The community prevalence of attenuated psychosis syndrome is sufficient to make it a valid addition to the DSM-5, but only with revisions to the current criteria, findings from the BEAR Study show.

Attenuated psychosis syndrome was included in section III of the DSM-5 as “a condition for further study,” due to doubt regarding the community prevalence of attenuated psychotic symptoms (APS) and the level of APS-related distress leading to help-seeking.

The results from The Bern Epidemiological At-Risk (BEAR) Study, involving 1229 individuals aged 16 to 40 years, show a lifetime prevalence of APS of 12.9%, making these symptoms “not rare,” say researcher Frauke Schultze-Lutter (University of Bern, Switzerland) and colleagues.

The team acknowledges, however, that just 0.3% of individuals met the current criteria for attenuated psychosis syndrome. This low prevalence was mainly due to the fact that only 3.8% met the current criteria for frequency (at least weekly occurrence in the past month) and just 1.1% met the criteria for onset/worsening (onset or worsening of APS within the past year).

But given that attenuated psychosis syndrome was proposed as a self-contained syndrome and therefore requires no progression criteria, Schultze-Lutter and co-workers suggest revising the criteria to simply differentiate from schizotypal traits.

When attenuated psychosis syndrome was assessed using this revision and with the original symptom, frequency, and distress/disability criteria, the prevalence was 2.6%. Also, it was associated with other nonpsychotic mental disorders and impaired psychosocial functioning within the past year.

“This suggests that this revised syndrome possesses greater clinical utility than the original syndrome,” the authors write in Schizophrenia Bulletin.