Psychotic onset in adolescence and young adulthood: Theoretical and treatment perspectives

Author/s Federica Paterlini
Publishing Year 2022 Issue 2022/3
Language Italian Pages 30 P. 31-60 File size 259 KB
DOI 10.3280/RSF2022-003003
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The scientific literature, in recent years, is increasingly studded with articles that deal with the theme of early recognition and intervention, highlighting its importance in order to intercept the distress of young people and reduce their subjective suffering, the risk of transition to psychosis and reduce the subsequent disability. A large-scale meta-analysis found that 12.3% of psychotic disorders occur before the age of 18 and 47.8% before the age of 25, with a peak of onset at 20.5 years [1]. Some of these disorders have their onset before the age of 18. It is now known that the prodromal period in which nuanced, subthreshold and non-specific symptoms emerge can be over 10 years. In view of this, it is useful to evaluate the risk of psychotic onset in the adolescent phase. Services that deal with minors should increasingly have a look also at what emerges before the psychotic disorder, at those phenotypes at risk of transition. The aim of this work is to analyze, without presuming to be exhaustive, which early assessment models can be used for adolescence and young age in order to recognize, evaluate and help young help seekers at risk of developing psychosis and to know which are, to date, the possible psychosocial treatments that can be activated in the services in order to take care of this segment of the population that experiences anguish and stigmatization caused by their psychological condition when they access mental health services [2-5]. The psychopharmacological aspect pertaining to psychiatric and neuropsychiatric colleagues will not be treated. Research should provide answers to clinicians who daily encounter the suffering of children and families and focus on the best identification and the most effective psychosocial treatments.

Keywords: Psychotic onset, ultra-high risk, Early intervention, Early identification, Early recognition, Psychosocial treatment.

  1. Solmi M, Radua J, Olivola M, Croce E, Soardo L, Salazar de Pablo G et al. Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies. Molecular Psychiatry 2022; 27, 281-295.
  2. Kline E, Thompson E, Bussell K, Pitts S, Reeves G, Schiffman J. Psychosis- like experiences and distress among adolescents using mental health services. Schizophrenia Research 2014; 152(2-3): 498-502.
  3. Rusch N, Muller M, Heekeren K, Theodoridou A, Metzler S, Dvorsky D et al. Longitudinal course of self-labeling, stigma stress and well-being among young people at risk of psychosis. Schizophrenia Research 2014; 158(1-3): 82-4.
  4. Rusch N, Corrigan PW, Heekeren K, Theodoridou A, Dvorsky D, Metzler S et al. Well-being among persons at risk of psychosis: the role of self-labeling, shame, and stigma stress. Psychiatric Services 2014; 65(4): 483-9.
  5. Stowkowy J, Perkins DO, Woods SW, Nyman K, Addington J. Personal beliefs about experiences in those at clinical high risk for psychosis. Behaviour Cognitive Psychotherapy 2015; 43(6): 669-75.
  6. Hjorthøj C, Stürup AE, McGrath JJ, Nordentoft M. Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis. Lancet Psychiatry 2017; 4: 295-301.
  7. Nordentoft M, Wahlbeck K, Hällgren J, Westman J, Ösby U, Alinaghizadeh H et al. Excess mortality, causes of death and life expectancy in 270,770 patients with recent onset of mental disorders in Denmark, Finland and Sweden. PLoS ONE 2013; 8(1): e55176.
  8. Fusar-Poli P, McGorry PD, Kane JM. Improving outcomes of first-episode psychosis: an overview. World Psychiatry 2017; 16: 251-65.
  9. Correll CU, Galling B, Pawar A, Krivko A, Bonetto C, Ruggeri M et al. Comparison of early intervention services vs treatment as usual for early-phase psychosis: a systematic review, meta-analysis, and meta-regression. JAMA Psychiatry 2018; 75: 555-65.
  10. Larson MK, Walker EF, Compton, MT. Early signs, diagnosis and therapeutics of the prodromal phase of schizophrenia and related psychotic disorders. Expert Review of Neurotherapeutics 2010; 10(8): 1347-1359.
  11. Heiden W, Häfner H, The epidemiology of onset and course of schizophrenia. European Archives of Psychiatry and Clinical Neurosciences 2000; 250 (6): 292-303.
  12. Norman RMG Lewis SW, Marshall M. Duration of untreated psychosis and its relationship to clinical outcome 2005. British Journal of Psychiatry 2005; 187 (48): s19-s23.
  13. Phillips L J, Leicester S B, O'Dwyer L E, Francey S M, Koutsogiannis J et al. The PACE Clinic: Identification and management of young people at “ultra” high risk of psychosis. Journal of Psychiatric Practice 2002; 8(5): 255-269.
  14. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace T. Association
  15. Between Duration of Untreated Psychosis and Outcome in Cohorts of First- Episode Patients A Systematic Review. Archives General in Psychiatry 2005; 62(9): 975-983.
  16. Cocchi A, Meneghelli A, Preti A. “Programma 2000”: celebrating 10 years of activity of an Italian pilot programme on early intervention in psychosis. Australian & New Zeland Journal of Psychiatry 2008; 42: 1003-12.
  17. Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri L et al. Characterization of young people with first episode psychosis or at ul-tra-high risk: the Reggio Emilia At-Risk Mental States (ReARMS) pro-gram. Rivista di Psichiatria 2019; 54(6): 254-263.
  18. Broome MR, Woolley JB, Johns LC, Valmaggia LR, Tabraham P, Gafoor R
  19. et al. Outreach and support in south London (OASIS): implementation of a clinical service for prodromal psychosis and the at risk mental state. European Psychiatry 2005; 20(5-6): 372-8.
  20. Fusar-Poli P, Spencer T, De Micheli A, Curzi V et al. Outreach and support
  21. in South-London (OASIS) 2001-2020: Twenty years of early detection, prognosis and preventive care for young people at risk of psychosis. European Neuropsychopharmacology 2020; 39: 111-122.
  22. Chapman J. The Early Symptoms of Schizophrenia. British Journal of Psychiatry 1966; 112(484): 225-251.
  23. Jackson H J, Mc Gorry PD, ed. The Recognition and Management of Early Psychosis: A Preventive Approach Second Edition Cambridge University Press: Cambridge Medicine 2009.
  24. Malla A K, Norman R M, Voruganti L P. Improving outcome in schizophrenia: the case for early intervention. Canadian medical association journal 1999; 160(6): 843-846.
  25. McGorry P, Krstev H, Harrigan S. Early detection and treatment delay:
  26. implications for outcome in early psychosis. Current Opinion in Psychiatry 2000; 13(1): 37-43.
  27. Marshall M, Lewis S, Lockwood A, Drake R, Jones P, Croudace, T. Association Between Duration of Untreated Psychosis and Outcome in Cohorts of First- Episode Patients. Archives of General Psychiatry 2005; 62(9): 975.
  28. McGorry P D, Hickie I B, Yung A R, Pantelis C, Jackson H J. Clinical staging
  29. of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Australian & New Zealand Journal of Psychiatry 2006; 40(8): 616-622.
  30. Yung A R, McGorry P D. The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophrenia Bulletin 1996; 22(2): 353-370.
  31. McGorry PD, Hickie IB, Yung AR, Pantelis C, Jackson HJ. Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Australian and New Zeland Journal of Psychiatry 2006; 40(8): 616-22.
  32. McGorry PD. Issues for DSM-V: clinical staging: a heuristic pathway to valid
  33. nosology and safer, more effective treatment in psychiatry. American Journal of Psychiatry 2007; 164(6): 859-60.
  34. Yung A R, Phillips L J, Yuen H P, Francey S M, McFarlane C A, Hallgren M et al. Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophrenia Research 2003; 60(1): 21-32.
  35. Raballo A, Larøi F. Clinical staging: A new scenario for the treatment of psychosis. Lancet 2009; 374: 365-367.
  36. Phillips LJ, Yung AR, McGorry PD. Identification of young people at risk of
  37. psychosis: validation of Personal Assessment and Crisis Evaluation Clinic intake criteria. Australian and New Zeland Journal in Psychiatry 2000; 34 Suppl: 164-9.
  38. Yung A R, Nelson B, Stanford C, Simmons M B, Cosgrave E M et al. Validation of “prodromal” criteria to detect individuals at ultra-high risk of psychosis: 2-year follow-up. Schizophrenia Research 2008; 105: 10–17.
  39. Pelizza L, Paterlini F, Azzali S, Garlassi S, Scazza I et al. The approved Italian version of the comprehensive assessment of at-risk mental states (CAARMS- ITA): Field test and psychometric features. Early Intervention Psychiatry 2019; 13(4): 810-817.
  40. Fusar-Poli P. Predicting Psychosis. Archives of General Psychiatry 2012; 69(3): 220-9.
  41. Morrison A P, French P, Stewart S L K, Birchwood M, Fowler D et al. Early detection and intervention evaluation for people at risk of psychosis: multisite randomised controlled trial. British Medical Journal 2012; 344: e2233–e2233.
  42. Salazar de Pablo G, Radua J, Pereira J, Bonoldi I, Arienti V, Besana F et al. Probability of Transition to Psychosis in Individuals at Clinical High Risk: An Updated Meta-analysis. JAMA Psychiatry 2021; 78(9): 970-978.
  43. Nelson B, Yuen H P, Wood S J, Lin A, Spiliotacopoulos D et al. Long-term Follow-up of a Group at Ultra High Risk (“Prodromal”) for Psychosis. JAMA Psychiatry, 2013; 70(8): 793.
  44. Fusar Poli P et al. The Psychosis High-Risk StateA Comprehensive State-of-the-Art Review. JAMA Psychiatry, 2013; 70(1): 107-120.
  45. Raballo A, Poletti M, Preti A, McGorry P. Clinical high risk for psychosis in children and adolescents: A meta-analysis of transition prevalences. Schizophrenia Research 2022 May; 243: 254-261.
  46. Fusar-Poli P, Borgwardt S. Integrating the negative psychotic symptoms in the high risk criteria for the prediction of psychosis. Medical Hypotheses 2007; 69(4): 959-960.
  47. Bechdolf A, Pukrop R, Köhn D, Tschinkel S, Veith V et al. Subjective quality of life in subjects at risk for a first episode of psychosis: A comparison with first episode schizophrenia patients and healthy controls. Schizophrenia Research 2005; 79(1): 137-143.
  48. Fusar-Poli P, Cappucciati M, Borgwardt S, Woods SW, Addington J et al. Heterogeneity of psychosis risk within individuals at clinical high risk: a meta-analytical stratification. JAMA Psychiatry 2016; 73(2): 113.
  49. Huber G, Gross G. The concept of basic symptoms in schizophrenic and schizoaffective psychoses. Recenti Progressi in Medicina 1989; 80(12): 646-52.
  50. Pelizza L, Poletti M, Azzali S, Paterlini F, Garlassi S, Scazza I et al. Suicide risk in young people at Ultra-High Risk (UHR) of psychosis: Findings from a 2-year longitudinal study. Schizophrenia Research 2020; 220: 98-105.
  51. Pelizza L, Poletti M, Azzali S, Paterlini F, Garlassi S, Scazza I et al. Suicidal Thinking and Behavior in Adolescents at Ultra-High Risk of Psychosis: A Two-year Longitudinal Study. Suicide and Life Threatening Behavior 2019; 49(6): 1637-1652.
  52. Taylor PJ, Hutton P, Wood L. Are people at risk of psychosis also at risk of suicide and self-harm? A systematic review and meta-analysis. Psychological Medicine 2015; 45(5): 911-26.
  53. Schultze-Lutter F, Ruhrmann S, Fusar-Poli P, Bechdolf A, Schimmelmann B, Klosterkotter J. Basic Symptoms and the Prediction of First-Episode Psychosis. Current Pharmaceutical Design 2012; 18(4): 351-357.
  54. Keshavan MS, DeLisi LE, Seidman LJ. Early and broadly defined psychosis risk mental states. Schizophrenia Research 2011; 126(1-3): 1-10.
  55. Bove E, Raballo A. Sintomi di base e vulnerabilita’ esperienziale alla psicosi. Rivista Sperimentale di Freniatria 2013; 3: 47-62.
  56. Klosterkötter J, Schultze-Lutter F, Bechdolf A, Ruhrmann S. Prediction and prevention of schizophrenia: what has been achieved and where to go next? World Psychiatry 2011; 10(3): 165-174.
  57. Klosterkötter J, Ebel H, Schultze-Lutter F, Steinmeyer EM. Diagnostic validity of basic symptoms European. Archives Psychiatry Clinical and Neuroscience 1996; 246(3): 147-154.
  58. Fusar-Poli P, Borgwardt S, Bechdolf A, Addington J, Riecher-Rössler A et al. The Psychosis High-Risk State. JAMA Psychiatry 2013; 70(1): 107.
  59. Klosterkötter J, Hellmich M, Steinmeyer EM, Schultze-Lutter F. Diagnosing schizophrenia in the initial prodromal phase. Archives General of Psychiatry. 2001; 58(2): 158-64.
  60. Ruhrmann S, Schultze-Lutter F, Salokangas RK, Heinimaa M, Linszen D et al. Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European Prediction of Psychosis Study. Archives General of Psychiatry, 2010; 67(3): 241-251.
  61. Fusar-Poli P, Borgwardt S, Valmaggia L. Heterogeneity in the assessment of the at-risk mental state for psychosis. Psychiatry Services 2008; 59(7): 813.
  62. Schultze-Lutter F, Michel C, Schmidt S, Schimmelmann B, Maric N et al. EPA guidance on the early detection of clinical high risk states of psychoses. European Psychiatry 2015; 30 (3): 405-416.
  63. Schimmelmann BG, Conus P, Cotton S, McGorry PD, Lambert M. Pre- treatment, baseline, and outcome differences between early-onset and adultonset psychosis in an epidemiological cohort of 636 first-episode patients. Schizophrenia Research 2007; 95(1-3): 1-8.
  64. Nelson B, Raballo A. I disturbi nucleari del sè e gli stati mentali a rischio: uno sguardo fenomenologico al paradigma della ricerca Ultra-High Risk. Rivista Sperimentale di Freniatria 2013; 3: 97-129.
  65. Raballo A, Pappagallo E, Dell’ Erba A, Lo Cascio N, Patane’ M et al. Self- Disorders and Clinical High Risk for Psychosis: An Empirical Study in Help- Seeking Youth Attending Community Mental Health Facilities. Schizophrenia Bulletin 2016; 42(4): 926-932.
  66. McGorry PD, Mei C. Ultra-high-risk paradigm: lessons learnt and new directions. Evidence Based Mental Health 2018; 21 (4): 131-133.
  67. Raballo A, Mechelli A, Menculini G, Tortorella A. Risk syndromes in psychiatry: a state-of-the-art overview. Archives of Psychiatry and Psychotherapy; 2019: (2) 7-14.
  68. Fusar-Poli P, Salazar de Pablo G, Correll C U, Meyer-Lindenberg A, Millan M J et al. Prevention of Psychosis. JAMA Psychiatry, 2020; 77(7), 755.
  69. McGorry, P D, Nelson B, Clinical High Risk for Psychosis—Not Seeing the Trees for the Wood. JAMA Psychiatry 2020; 77(7): 559-560.
  70. Craig Morgan, Monica Charalambides, Gerard Hutchinson, Robin M. Murray, Migration, Ethnicity, and Psychosis: Toward a Sociodevelopmental Model. Schizophrenia Bulletin 2010; 36 (4): 655-664.
  71. Oliver D, Radua J, Reichenberg A, Uher R, Fusar-Poli P. Psychosis Polyrisk Score (PPS) for the detection of individuals at risk and the prediction of their outcomes Frontiers in Psychiatry 2019; 10:174.
  72. Raballo A, Poletti M, Preti A, McGorry P. Clinical high risk for psychosis in children and adolescents: A meta-analysis of transition prevalences. Schizophrenia Research 2022; 243: 254-261.
  73. Fusar-Poli P, Borgwardt S, Valmaggia L. Heterogeneity in the assessment of the atrisk mental state for psychosis . Psychiatric Services 2008; 59(7): 813. McGorry P, Alison R, Yung M D et al. The “Close-in” or Ultra High-Risk Model: A Safe and Effective Strategy for Research and Clinical Intervention in Prepsychotic Mental Disorders. Schizophrenia Bulletin 2003; Volume 29 Issue 4: 771-790.
  74. Jung AR, Pan Yuen H et al. Mapping the Onset of Psychosis: The Comprehensive Assessment of At-Risk Mental States. Australian & New Zealand Journal of Psychiatry 2005; 39 (11-12): 964-971.
  75. Raballo A, Nelson B, Thompson A, Yung A. The comprehensive assessment of atrisk mental states: from mapping the onset to mapping the structure. Schizophrenia research 2011; 127(1-3): 107-114.
  76. Schultze-Lutter F, Schimmelmann B G, Schmidt S J. Resilience, risk, mental health and well-being: Associations and conceptual differences. European Child & Adolescent Psychiatry 2016; 25(5): 459-466.
  77. Braham A, Bannour A S, Ben Romdhan A et al. Validation of the A rabic version of the C omprehensive A ssessment of At Risk Mental States (CAARMS) in Tunisian adolescents and young adults. Early Intervention in Psychiatry 2014; 8(2): 147-154.
  78. Pelizza L, Paterlini F, Azzali S, Garlassi S, Scazza I, Pupo S et al. The approved Italian version of the comprehensive assessment of at-risk mental states (CAARMS-ITA): Field test and psychometric features. Early Intervention in Psychiatry 2019;13(4): 810-817.
  79. Hall R C. Global assessment of functioning: a modified scale. Psychosomatics 1995; 36(3): 267-275.
  80. Miller T J, McGlashan T H, Rosen J L, Cadenhead K et al. Prodromal Assessment With the Structured Interview for Prodromal Syndromes and the Scale of Prodromal Symptoms: Predictive Validity, Interrater Reliability, and Training to Reliability. Schizophrenia Bulletin 2003; 29(4): 703-715
  81. Paterlini F, Pelizza L, Galli G et al. Interrater reliability of the authorized Italian version of the Comprehensive Assessment of At-Risk Mental States (CAARMS-ITA). Journal of Psychopathology 2019; 25: 24-28.
  82. Fusar-Poli P, Hobson R, Raduelli M, Balottin U. Reliability and validity of the comprehensive assessment of the at risk mental state, Italian version (CAARMS-I). Current pharmaceutical design 2012; 18(4): 386-391.
  83. Andreasen NC, Endicott J, Spitzer RL, Winokur G. The Family History Method Using Diagnostic Criteria: Reliability and Validity. Archives of General Psychiatry 1977; 34(10): 1229-1235.
  84. Riecher-Rössler A, Gschwandtner U, Aston J, Borgwardt S, Drewe M et al. The Basel early-detection-of-psychosis (FEPSY)-study? design and preliminary results. Acta Psychiatrica Scandinavica 2007; 115(2): 114-125.
  85. Riecher-Rössler A, Aston J, Ventura J, Merlo M, Borgwardt S et al. Das Basel Screening Instrument für Psychosen (BSIP): Entwicklung, Aufbau, Reliabilität und Validität. Fortschritte Der Neurologie · Psychiatrie, 2008; 76(4), 207-216.
  86. Häfner H, Riecher-Rössler A, Hambrecht M, Maurer K, Meissner Set al. IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophrenia Research, 1992; 6(3), 209-223.
  87. Pelizza L, Raballo A, Semrov E, Chiri L R, Azzali S et al. Validation of the
  88. “early detection Primary Care Checklist” in an Italian community help-seeking sample: The “checklist per la Valutazione dell’Esordio Psicotico”. Early Intervention in Psychiatry, 2019; 13(1): 86-94.
  89. Pelizza L, Raballo A, Semrov E, Azzali S, Scazza I et al. Identification of young people at “Ultra-High Risk” (UHR) of developing psychosis: validation of the “Checklist per la valutazione dell’esordio psicotico” for use in primary care setting. Journal of Psichopathology 2016; 22: 172-179.
  90. Cole E, Leavey G, King M, et al. Pathways to care for patients with a first episode of psychosis: a comparison of ethnic groups. British Journal of Psychiatry 1995; 167: 770-6.
  91. Addington J, Van Mastrigt S, Hutchinson J et al. Pathways to care: help seeking behavior in first episode psychosis. Acta Psychiatrica Scandinavica 2002; 106: 358-64.
  92. French P, Owens J, Parker S et al. Identification of young people in the early stages of psychosis: validation of a checklist for use in primary care. Psychiatry Research 2012; 200:911-6.
  93. Maggini C, Dalle Luche R ed. Scala di Bonn per la valutazione dei sintomi di base (BSABS). Pisa: ETS; 1992.
  94. Schultze-Lutter F, Addington J, Ruhrmann S, Klosterkötter J. Schizophrenia Proneness Instrument, Adult Version (SPI-A). Rome, Italy: Giovanni Fioriti Editore; 2007.
  95. Schultze-Lutter F, Marshall M, Koch E. Schizophrenia Proneness Instrument, Child and Youth Version (SPI-CY), Extended English Translation. Rome Italy: Giovanni Fioriti Editore; 2012.
  96. Parnas J, Møller P, Kircher T, Thalbitzer J, Jansson L, Handest P et al. EASE: Examination of Anomalous Self-Experience. Psychopathology 2005; 38(5): 236-58.
  97. Sass L, Pienkos E, Skodlar B, Stanghellini G, Fuchs T, Parnas J et al. EAWE: Examination of Anomalous World Experience. Psychopathology 2017; 50 (1): 10-54.
  98. Rasmussen AR, Stephensen H, Parnas J. EAFI: Examination of Anomalous Fantasy and Imagination Psychopathology 2018; 51(3): 216-226.
  99. Ho B C, Andreasen N C. Long delays in seeking treatment for schizophrenia. The Lancet 2001; 357(9260): 898-900.
  100. Lieberman J A, Fenton W S. Delayed detection of psychosis: causes, consequences, and effect on public health. American Journal of Psychiatry 2000; 157(11): 1727-1730.
  101. McGorry PD. Preventive strategies in early psychosis: verging on reality. British Journal of Psychiatry 1998; 172 (suppl. 33): 1-2.
  102. Pelizza L, Azzali S, Paterlini F et al. The “Reggio Emilia At-Risk Mental States” program: a diffused, “liquid” model of early intervention in psychosis implemented in an Italian Department of Mental Health. Early Intervention in Psychiatry 2019; 13: 1513-24.
  103. Cocchi A, Balbi A, Corlito G et al. Early intervention in psychosis: a feasibility study financed by the Italian Center on Control of Maladies. Early Intervention in Psychiatry 2015; 9: 163-71.
  104. Pelizza L, Azzali S, Garlassi S et al. Adolescents at ultra-high risk of psychosis in Italian neuropsychiatry services: prevalence, psychopathology and transition rate. European Children and Adolescents Psychiatry 2018; 27: 725-37.
  105. Pelizza L, Azzali S, Paterlini F et al. The Italian version of the 16-item prodromal questionnaire (iPQ-16): field-test and psychometric features. Schizophrenia Research 2018; 199: 353-60.
  106. Corcoran C, Malaspina D, Hercher L. Prodromal interventions for schizophrenia vulnerability: the risks of being “at risk”. Schizophrenia Research 2005; 73(2- 3): 173-184.
  107. A. Cocchi, A. Meneghelli ed. Rischio ed esordio psicotico: una sfida che continua. Manuale d'intervento precoce. Milano: Edi-Ermes; 2012.
  108. Kline P, Moretti E. People, places, and public policy: Some simple welfare economics of local economic development programs. Annual Review of Economics 2014; 6(1): 629-662.
  109. Rüsch N, Corrigan P W, Heekeren K et al. Well-being among persons at risk of psychosis: the role of self-labeling, shame, and stigma stress. Psychiatric Services, 2014; 65(4), 483-489.
  110. Saleem M M, Stowkowy J, Cadenhead K S, Cannon T D et al. Perceived discrimination in those at clinical high risk for psychosis. Early intervention in psychiatry 2014; 8(1): 77-81.
  111. Raballo A, Poletti M, McGorry P. Architecture of change: rethinking child and adolescent mental health. The Lancet Psychiatry 2017; 4(9): 656-658.
  112. Pelizza L, Pompili M, Azzali S, Paterlini F, Garlassi S, Scazza I et al. Suicidal thinking and behaviours in First Episode Psychosis: Findings from a 3-year longitudinal study. Early intervention in psychiatry 2021; 15(3): 624-633.
  113. Addington J, Epstein I, Liu L, French P, Boydell KM, Zipursky RB. A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophrenia Research 2011; 125(1): 54-61.
  114. Häfner H, Maurer K, Löffler W, Fätkenheuer B, an der Heiden W, Riecher- Rössler A et al. The epidemiology of early schizophrenia. Influence of age and gender on onset and early course. British Journal of Psychiatry 1994; Suppl. (23): 29-38.
  115. Gaebel W, Möller HJ. European guidance–a project of the European Psychiatric Association. European Psychiatry 2012; 27: 65-7.
  116. Bosnjak Kuharic D, Kekin I, Hew J, Rojnic Kuzman M, Puljak L. Interventions for prodromal stage of psychosis. Cochrane Database Systematic Review; 2019 (11).
  117. Arango C, Díaz-Caneja CM, McGorry PD, et al. Preventive strategies for mental health. Lancet Psychiatry 2018; 5(7): 591-604.
  118. Sommer IE, Bearden CE, van Dellen E et al. Early interventions in risk groups for schizophrenia: what are we waiting for? NPJ Schizophrenia 2016; 2: 16003.
  119. González-Pinto A, Ruiz de Azúa S, Ibáñez B, Otero-Cuesta S, Castro-Fornieles J, Graell-Berna M et al. Can positive family factors be protective against the development of psychosis? Psychiatry Research 2011; 186(1): 28-33.
  120. Gore FM, Bloem PJ, Patton GC, Ferguson J, Joseph V, Coffey C et al. Global burden of disease in young people aged 10–24 years: a systematic analysis. Lancet 2011; 377(9783): 2093-102.
  121. Schimmelmann BG, Schultze-Lutter F. Early detection and intervention of psychosis in children and adolescents: urgent need for studies. European Child & Adolescent Psychiatry 2012; 21(5): 239-41.
  122. Schimmelmann BG, Conus P, Cotton S, McGorry PD, Lambert M. Pre- treatment, baseline, and outcome differences between early-onset and adultonset psychosis in an epidemiological cohort of 636 first-episode patients. Schizophrenia Research 2007; 95 (1-3): 1-8.
  123. Davies C, Cipriani A, Ioannidis JPA, Radua J, Stahl D, Provenzani U, McGuire P, Fusar-Poli P. Lack of evidence to favor specific preventive interventions in psychosis: a network meta-analysis. World Psychiatry 2018; 17(2): 196-209.
  124. Van Os J, Delespaul P. Toward a world consensus on prevention of schizophrenia. Dialogues in Clinical Neuroscience 2005; 7(1): 53-67.
  125. McGorry PD, Nelson B, Wood SJ, Shah JL, Malla A, Yung A. Transcending false dichotomies and diagnostic silos to reduce disease burden in mental disorders. Social Psychiatry and Psychiatric Epidemiology 2020; 55: 1098-1103.
  126. Bird V, Premkumar P, Kendall T, Whittington C, Mitchell J, Kuipers E. Early intervention services, cognitive-behavioural therapy and family intervention in early psychosis: systematic review. British Journal of Psychiatry 2010; 197(5): 350-6.
  127. Poletti M, Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I. et al. Overcoming the gap between child and adult mental health services: The Reggio Emilia experience in an early intervention in psychosis program. Early Intervention in Psychiatry, 2021; 15: 1749-1758.
  128. Onwumere J, Bebbington P, Kuipers E. Interventi familiari nella psicosi precoce: specificità ed efficacia. Epidemiologia e scienze psichiatriche 2011; 20(2): 113-119.
  129. Raballo A, Poletti M, Carpenter WT. Rethinking the Psychosis Threshold in Clinical High Risk. Schizophrenia Bullettin 2019; 1-45 (1): 1-2.
  130. Fusar-Poli P, Rocchetti M, Sardella A, Avila A, Brandizzi M, Caverzasi E et al. Disorder, not just state of risk: meta-analysis of functioning and quality of life in people at high risk of psychosis. British Journal of Psychiatry 2015; 207(3): 198-206.

Federica Paterlini, Esordi psicotici in adolescenza e giovane età adulta: prospettive teoriche e di trattamento in "RIVISTA SPERIMENTALE DI FRENIATRIA" 3/2022, pp 31-60, DOI: 10.3280/RSF2022-003003