Individual research recommendation details

Recommendation ID

CG155/1

Question

What are the long-term outcomes, both psychotic and nonpsychotic, for children and young people with attenuated or transient psychotic symptoms suggestive of a developing psychosis, and can the criteria for 'at risk states' be refined to better predict those who will and those who will not go on to develop psychosis?

Any explanatory notes
(if applicable)

The suggested programme of research would be in two phases. First, a systematic review and meta-analysis of prospective observational studies/cohorts of children and young people identified at high or ultra-high risk of developing psychosis would be undertaken. The review would identify risk and protective factors most strongly associated with the later development of psychotic and non-psychotic outcomes. Second, the factors identified in the first phase would be used to identify a large cohort of children and young people with these factors and to evaluate the effectiveness of these refined criteria for predicting the later development of psychotic and non-psychotic outcomes.
Why this is important:- A major problem with trials of treatments for populations of children and young people deemed to be 'at risk' or 'at ultra-high risk' of developing psychosis is identifying the precise symptoms and/or behaviours or (risk) factors that are most strongly associated with the development of psychosis; and conversely, which (protective) factors are likely to be associated with a lowered risk of later psychosis. At present, identified factors have a low predictive value, with only about 10–20% of children and young people who have been identified as at high risk going on to develop psychosis. If these risk and protective factors could be refined, it would be possible to better target children and young people who are most at risk, and reduce the numbers of those thought to be 'at risk' who do not go on to later develop psychosis.

Source guidance details

Comes from guidance

Psychosis and schizophrenia in children and young people: recognition and management

Number

CG155

Date issued

January 2013

Other details