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10.1 Screening for Clinical High-Risk for Psychosis (CHR-P) in an Adolescent and Young Adult Population Seeking Help Through the Massachusetts General Hospital Resilience Evaluation-Social Emotional Training (RE-SET) Program
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10.1 Screening for Clinical High-Risk for Psychosis (CHR-P) in an Adolescent and Young Adult Population Seeking Help Through the Massachusetts General Hospital Resilience Evaluation-Social Emotional Training (RE-SET) Program

Jacqueline A. Clauss
Journal of the American Academy of Child and Adolescent Psychiatry, Vol.63(10 Suppl), pp.S325-S326
10/01/2024
DOI: 10.1016/j.jaac.2024.07.688
url
https://doi.org/10.1016/j.jaac.2024.07.688View
Published (Version of record) Open Access

Abstract

Objectives Clinical high-risk for psychosis (CHR-P) is a syndrome associated with increased risk for developing a psychotic disorder. Following this presentation, participants will be able to describe the CHR-P syndrome and appreciate the diagnostic complexity within this syndrome. Methods Prior to a clinical evaluation with the Massachusetts General Hospital (MGH) Resilience Evaluation-Social Emotional Training (RE-SET) program, eligible patients and their caregivers completed a battery of measures of symptoms, clinical history, and social functioning. Following an initial diagnostic evaluation, patients completed the Structured Interview for Psychosis-Risk Syndromes. We used hierarchical logistic regression to determine predictive ability and incremental validity of clinical risk factors to detect CHR-P status. Results A total of 98 help-seeking individuals (mean age: 18.1; SD: 4.1) were assessed, 24 (24.5%) of whom met the CHR-P criteria. Patients (n = 43) reported moderate levels of perceived stress, loneliness, and depression, and severe anxiety symptoms. Referrer-reported decline in social functioning in the past year (OR = 6.54; p = .038), ASD diagnosis (OR = 16.21; p = .026), and endorsing at least 2 Adolescent Psychosis-like Symptom Screener items (OR = 9.52 [1.68, 54.06]; p = .011) predicted CHR-P status (model R2 = .43; p = .008). Self-reported hours awake per day improved prediction of CHR-P over the above variables (OR = 4.41 [1.31, 14.82], p = .016; model R2 = .31, p = .002). Conclusions Individuals referred for evaluation of CHR-P present with high diagnostic complexity and significant clinical need. Evaluation of CHR-P may be improved with greater attention to sleep, ASD diagnosis, and social functioning.

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