Early Intervention Services for youth at Clinical High-Risk for Psychosis: The Reggio Emilia At-Risk Mental State (ReARMS) experience

Titolo Rivista RIVISTA SPERIMENTALE DI FRENIATRIA
Autori/Curatori Michele Poletti
Anno di pubblicazione 2022 Fascicolo 2022/3
Lingua Inglese Numero pagine 20 P. 61-80 Dimensione file 187 KB
DOI 10.3280/RSF2022-003004
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Between 2012-2017, 300 individuals completed the baseline assessment, 205 of them met criteria for CHR-P or First-Episode Psychosis, and 154 accepted the enrolment in the ReARMS for treatment and follow-up. Empirical contributions based on the ReARMS dataset involved the structure of assessment and intervention, the Italian validation of ad-hoc instruments of assessment, clinical features of enrolled individuals (anhedonia, aberrant salience, suicidality and metacognition) and longitudinal trajectories in terms of outcome and response to treatments. age between adolescence and young adulthood, being effective in intercepting an early and usually enduring psychopathological suffering, independently from the transition to psychosis. Rather than being rigidly focused on homotypic trajectories from CHR-P to psychosis, increasing evidence on heterotypic trajectories starting from CHR-P to multiple psychopathological outcomes suggest to update early intervention services toward increased organizational flexibility, for example in therapeutic options.

Tra il 2012 e il 2017, 300 persone hanno completato la valutazione di base, 205 di loro hanno soddisfatto i criteri per CHR-P o primo episodio psicotico e 154 hanno accettato di partecipare al progetto ReARMS rispetto al successivo percorso di trattamento e monitoraggio. I contributi empirici basati sul dataset ReARMS hanno riguardato la struttura della valutazione e dell’intervento, la validazione italiana di strumenti di valutazione ad hoc, le caratteristiche cliniche degli individui arruolati (quali anedonia, salienza aberrante, suicidalità e metacognizione) e le traiettorie longitudinali in termini di esito e risposta ai trattamenti. Discussione: I dati del progetto ReARMS confermano che i servizi di intervento precoce possono essere implementati nei servizi di salute mentale, specialmente nell'età di transizione tra l’adolescenza e la giovane età adulta, essendo efficaci nell’intercettare una sofferenza psicopatologica precoce e solitamente duratura, indipendentemente dal passaggio alla psicosi. Piuttosto che essere rigidamente focalizzati sulle traiettorie omotipiche dalla CHR-P alla psicosi, l’evidenza crescente sulle traiettorie eterotipiche, da uno stato di rischio psicotico a molteplici esiti psicopatologici, suggerisce di aggiornare i servizi di intervento precoce verso una maggiore flessibilità organizzativa, ad esempio nelle opzioni terapeutiche.

Keywords:Alto rischio clinico per la psicosi; Servizi di Intervento Precoce, Progetto ReARMS; Progetto Regionale Esordi Psicotici.

  1. McGorry PD, Mei C. Early intervention in youth mental health: progress and future directions. Evidence Based Mental Health 2018; 21(4): 182-184.
  2. Birchwood M, Todd P, Jackson C. Early intervention in psychosis. The critical period hypothesis. British Journal of Psychiatry Supplement 1998; 172(33): 53-59. DOI: 10.1192/S0007125000297663
  3. Vieta E, Salagre E, Grande I, Carvalho AF, Fernandes BS, Berk M, et al. Early Intervention in Bipolar Disorder. American Journal of Psychiatry 2018 1; 175(5): 411-426.
  4. Harrington R, Clark A. Prevention and early intervention for depression in adolescence and early adult life. European Archives of Psychiatry and Clinical Neuroscience 1998; 248(1): 32-45.
  5. Preti A, Meneghelli A, Poletti M, Raballo A. Through the prism of comorbidity: A strategic rethinking of early intervention in obsessive-compulsive disorder. Schizophrenia Research 2022; 239: 128-133.
  6. 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 Zealand Journal of Psychiatry 2006; 40(8): 616-622.
  7. Yung AR, McGorry PD. The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophrenia Bulletin 1996; 22(2): 353-370.
  8. Fusar-Poli P, Borgwardt S, Bechdolf A, Addington J, Riecher-Rössler A, Schultze-Lutter F, et al. The psychosis high-risk state: a comprehensive state- of-the-art review. JAMA Psychiatry 2013; 70(1): 107-120.
  9. Yung AR, Yuen HP, McGorry PD, Phillips LJ, Kelly D, Dell’Olio M, et al.
  10. Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States. Australian and New Zealand Journal of Psychiatry 2005; 39(11- 12): 964-971.
  11. McGlashan TH. Structured Interview for prodromal symptoms (SIPS). Yale University, New Haven, 2001.
  12. Huber G, Gross G. The concept of basic symptoms in schizophrenic and schizoaffective psychoses. Recenti Progressi in Medicina 1989; 80(12): 646-652.
  13. Schultze-Lutter F. Subjective symptoms of schizophrenia in research and the clinic: the basic symptom concept. Schizophrenia Bulletin 2009; 35(1): 5-8.
  14. Schultze-Lutter F, Klosterkotter J, Picker H, Steinmeyer EM, Ruhrmann. Predicting first-episode psychosis by basic symptom criteria. Clinical Neuropsychiatry 2007; 4(1): 11-22.
  15. Fusar-Poli P. The Clinical High-Risk State for Psychosis (CHR-P), Version II.
  16. Schizophrenia Bulletin 2017; 43(1): 44-47.
  17. Bove E, Raballo A, Sintomi di base e vulnerabilità esperienziale alla psicosi. Rivista Sperimentale di Freniatria 2013; 137(3): 47-62. DOI: 10.3280/RSF2013-003004
  18. Dalle Luche Riccardo Piero, Dai sintomi di base al Sè psicotico. Rivista Sperimentale di Freniatria 2013; 137(3): 63-95. DOI: 10.3280/RSF2013-00300
  19. 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; 137(3): 97-129. DOI: 10.3280/RSF2013-003006
  20. Cocchi A, Meneghelli A. Rischio psicotico: che fare? Rivista Sperimentale di Freniatria 2013; 137(3): 131-155. DOI: 10.3280/RSF2013-003007
  21. Phillips LJ, Leicester SB, O’Dwyer LE, Francey SM, Koutsogiannis J, Abdel- Baki A, 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. DOI: 10.1097/00131746-200209000-00002
  22. Rickwood D, Paraskakis M, Quin D, Hobbs N, Ryall V, Trethowan J, et al. Australia’s innovation in youth mental health care: The headspace centre model. Early Intervention in Psychiatry. 2019; 13(1): 159-166.
  23. Broome MR, Woolley JB, Johns LC, Valmaggia LR, Tabraham P, Gafoor R, 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): 372-378.
  24. Miller TJ, McGlashan TH, Rosen JL, Cadenhead K, Cannon T, Ventura J, et al.
  25. 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.
  26. Cocchi A, Meneghelli A, Preti A. Programma 2000: celebrating 10 years of activity of an Italian pilot programme on early intervention in psychosis. Australian and New Zealand Journal of Psychiatry 2008; 42(12): 1003-1012. DOI: 10.1080/00048670802512032
  27. Meneghelli A, Cocchi A, Preti A. ‘Programma2000’: a multi-modal pilot programme on early intervention in psychosis underway in Italy since 1999. Early Intervention in Psychiatry 2010; 4(1): 97-103.
  28. Cocchi A, Cavicchini A, Collavo M, Ghio L, Macchi S, Meneghelli A, Preti A. Implementation and development of early intervention in psychosis services in Italy: a national survey promoted by the Associazione Italiana Interventi Precoci nelle Psicosi. Early Intervention in Psychiatry 2018; 12(1): 37-44.
  29. Fusar-Poli P, Schultze-Lutter F, Cappucciati M, Rutigliano G, Bonoldi I, Stahl D, et al. The dark side of the moon: meta-analytical impact of recruitment strategies on risk enrichment in the Clinical High Risk State for Psychosis. Schizophrenia Bulletin 2016; 42(3): 732-743.
  30. Fusar-Poli P, Raballo A, Parnas J. What Is an Attenuated Psychotic Symptom? On the Importance of the Context. Schizophrenia Bulletin 2017; 43(4): 687- 692.
  31. Fusar-Poli P, Cappucciati M, Borgwardt S, Woods SW, Addington J, Nelson B,
  32. et al. Heterogeneity of psychosis risk within individuals at Clinical High Risk: a meta-analytical stratification. JAMA Psychiatry. 2016; 73(2): 113-120.
  33. 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.
  34. 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.
  35. Lång U, Yates K, Leacy FP, Clarke MC, McNicholas F, Cannon M, Kelleher I. Systematic review and meta-analysis: psychosis risk in children and adolescents with an at-risk mental state. Journal of the American Academy of Child and Adolescent Psychiatry 2022; 61(5): 615-625.
  36. Salazar de Pablo G, Soardo L, Cabras A, Pereira J, Kaur S, Besana F, et al. Clinical outcomes in individuals at clinical high risk of psychosis who do not transition to psychosis: a meta-analysis. Epidemiology and Psychiatric Sciences 2022; 31: e9. DOI: 10.1017/S2045796021000639
  37. McGorry PD, Hartmann JA, Spooner R, Nelson B. Beyond the “at risk mental state” concept: transitioning to transdiagnostic psychiatry. World Psychiatry. 2018;17(2):133-142.
  38. Mei C, van der Gaag M, Nelson B, Smit F, Yuen HP, Berger M, et al. Preventive interventions for individuals at ultra high risk for psychosis: An updated and extended meta-analysis. Clinal Psychology Review 2021; 86: 102005.
  39. Raballo A, Poletti M, Preti A. Meta-analyzing the prevalence and prognostic effect of antipsychotic exposure in clinical high-risk (CHR): when things are not what they seem. Psychological Medicine 2020; 50(16): 2673-2681. DOI: 10.1017/S0033291720004237
  40. Raballo A, Poletti M, Preti A. Do antidepressants prevent transition to psychosis in individuals at clinical high-risk (CHR-P)? Systematic review and meta-analysis. Psychological Medicine. 2022 Jun 3:1-11. DOI: 10.1017/S0033291722001428
  41. Yung AR, Phillips LJ, Yuen HP, Francey SM, McFarlane CA, Hallgren M, McGorry PD. Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophrenia Research 2003; 60(1): 21-32.
  42. Penttilä M, Jääskeläinen E, Hirvonen N, Isohanni M, Miettunen J. Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis. British Journal of Psychiatry. 2014;205(2): 88-94.
  43. Raballo A, Poletti M, Carpenter WT. Rethinking the psychosis threshold in Clinical High Risk. Schizophrenia Bulletin. 2019;45(1):1-2.
  44. Raballo A, Poletti M. Overlooking the transition elephant in the ultra- high-risk room: are we missing functional equivalents of transition to psychosis? Psychological Medicine. 2022; 52(1): 184-187. DOI: 10.1017/S0033291719003337
  45. Raballo A, Poletti M, Preti A. Attenuated psychosis syndrome or pharmacologically attenuated first-episode psychosis?: An undesirably widespread confounder. JAMA Psychiatry. 2020; 77(12): 1213-1214.
  46. Catalan A, Radua J, McCutcheon R, Aymerich C, Pedruzo B, González-Torres MÁ, Baldwin H, Stone WS, Giuliano AJ, McGuire P, Fusar-Poli P. Examining the variability of neurocognitive functioning in individuals at clinical high risk for psychosis: a meta-analysis. Translational Psychiatry. 2022; 12(1): 198.
  47. Millman ZB, Roemer C, Vargas T, Schiffman J, Mittal VA, Gold JM. Neuropsychological performance among individuals at Clinical High-Risk for Psychosis vs putatively low-risk peers with other psychopathology: a systematic review and meta-analysis. Schizophrenia Bulletin. 2022; 48(5): 999-1010.
  48. Devoe DJ, Farris MS, Townes P, Addington J. Interventions and transition in youth at risk of psychosis: a systematic review and meta-analyses. Journal of Clinical Psychiatry. 2020; 81(3): 17r12053.
  49. Zheng Y, Xu T, Zhu Y, Li C, Wang J, Livingstone S, Zhang T. Cognitive behavioral therapy for prodromal stage of psychosis-outcomes for transition, functioning, distress, and quality of life: a systematic review and meta-analysis. Schizophrenia Bulletin. 2022; 48(1): 8-19.
  50. Mei C, van der Gaag M, Nelson B, Smit F, Yuen HP, Berger M, Krcmar M, French P, Amminger GP, Bechdolf A, Cuijpers P, Yung AR, McGorry PD. Preventive interventions for individuals at ultra high risk for psychosis: An updated and extended meta-analysis. Clinical Psychology Review. 2021; 86: 102005.
  51. Ruggeri M, Bonetto C, Lasalvia A, et al. A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial. Trials 2012; 13: 73. DOI: 10.1186/1745-6215-13-73
  52. Regione Emilia-Romagna. Raccomandazioni regionali per la promozione della salute e del benessere in persone all’esordio psicotico. Bologna: Centro stampa della Regione Emilia-Romagna, 2016.
  53. Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, et al. Characterization of young people with first episode psychosis or at ultra-high risk: the Reggio Emilia At-Risk Mental States (ReARMS) program. Rivista di Psichiatria 2019; 54(6): 254-263. DOI: 10.1708/3281.32544
  54. Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, 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(6): 1513-1524.
  55. National Institute for Health and Care Excellence (NICE). Psychosis and schizophrenia in children and young people: recognition and management. Leicester: British Psychological Society, 2013.
  56. Schmidt SJ, Schultze-Lutter F, Schimmelmann BG, Maric NP, Salokangas RK, Riecher-Rössler A, et al. EPA guidance on the early intervention in clinical high risk states of psychoses. European Psychiatry 2015; 30(3): 388-404.
  57. 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(6): 1749-1758.
  58. Kessler RC, Angermeyer M, Anthony JC, DE Graaf R, Demyttenaere K, Gasquet I, et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry 2007; 6(3): 168-176.
  59. Pelizza L, Raballo A, Semrov E, Chiri LR, Azzali S, Scazza I, et al. Validation of the “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.
  60. Pelizza L, Chiri LR, Azzali S, Garlassi S, Scazza I, Paterlini F, et al. Identifying adolescents in the early stage of psychosis: A screening checklist for referrers. Journal of Clinical Psychology 2022; 78(6): 1184-1200.
  61. Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, et al. Screening for psychosis risk among help-seeking adolescents: Application of the Italian version of the 16-item prodromal questionnaire (iPQ-16) in child and adolescent neuropsychiatry services. Early Intervention in Psychiatry 2019; 13(4): 752-760.
  62. Azzali S, Pelizza L, Paterlini F, Garlassi S, Scazza I, Chiri LR, et al. Reliability of the italian version of the 16-item Prodromal Questionnaire (iPQ-16) for psychosis risk screening in a young help-seeking community sample. Journal of Psychopathology 2018; 24(1): 16-23.
  63. Pelizza L, Azzali S, Paterlini F, Scazza I, Garlassi S, Chiri LR, et al. The Italian version of the Brief 21-Item Prodromal Questionnaire: field test, psychometric properties and age-sensitive cut-offs. Psychopathology 2018; 51(4)234-244. DOI: 10.1159/000490708
  64. Scazza I, Pelizza L, Azzali S, Paterlini F, Garlassi S, Chiri LR, et al. Reliability of the Italian version of the Brief (21-item) Prodromal Questionnaire (IPQ-B) for psychosis risk screening in a young help-seeking population. Journal of Psychopathology 2018; 24(4): 204-214.
  65. 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.
  66. Paterlini F, Pelizza L, Galli G, Azzali S, Scazza I, Garlassi S, 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(1): 24-28.
  67. Pelizza L, Azzali S, Garlassi S, Scazza I, Paterlini F, Chiri LR, et al. Assessing aberrant salience in young community help-seekers with early psychosis: The approved Italian version of the Aberrant Salience Inventory. Journal of Clinical Psychology 2021; 77(3): 782-803.
  68. Pelizza L, Azzali S, Garlassi S, Scazza I, Paterlini F, Chiri LR et al. Examining subjective experience of social cognition in early psychosis: validation of the Italian version of the GEOPTE scale in an adolescent and young adult clinical sample. Journal of Psychopathology 2019; 25(4): 220-230.
  69. Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, et al. Negative symptom dimensions in first episode psychosis: Is there a difference between schizophrenia and non-schizophrenia spectrum disorders? Early Intervention in Psychiatry 2021; 15(6): 1513-1521.
  70. Pelizza L, Poletti M, Azzali S, Paterlini F, Garlassi S, Scazza I, et al. Anhedonia in adolescents at ultra-high risk (UHR) of psychosis: findings from a 1-year longitudinal study. European Archives of Psychiatry and Clinical Neuroscience 2020; 270(3): 337-350.
  71. Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, et al. Anhedonia in the Psychosis Risk Syndrome: State and Trait Characteristics. Psychiatria Danubina 2021; 33(1): 36-47.
  72. Pelizza L, Garlassi S, Azzali S, Paterlini F, Scazza I, Chiri LR, et al. Anhedonia in young people with first episode psychosis: a longitudinal study. Nordic Journal of Psychiatry 2020; 74(6): 381-389. DOI: 10.1080/08039488.2020.1733661
  73. Azzali S, Pelizza L, Scazza I, Paterlini F, Garlassi S, Chiri LR, et al. Examining subjective experience of aberrant salience in young individuals at ultra-high risk (UHR) of psychosis: A 1-year longitudinal study. Schizophrenia Research 2022; 241: 52-58.
  74. Scazza I, Pelizza L, Azzali S, Garlassi S, Paterlini F, Chiri LR, et al. Aberrant salience in first-episode psychosis: Longitudinal stability and treatment- response. Early Intervention in Psychiatry 2022; 16(8): 912-919.
  75. Poletti M, Pelizza L, Azzali S, Scazza I, Paterlini F, Garlassi S, Chiri LR, Pupo S, Raballo A. Association between psychosocial interventions and aberrant salience in adolescents with early psychosis: A follow-up study. Scandinavian Journal of Psychology 2022; 63(4): 290-296.
  76. Poletti M, Pelizza L, Azzali S, Garlassi S, Scazza I, Paterlini F, et al. Subjective experience of aberrant salience in young people at Ultra-High Risk (UHR) for psychosis: a cross-sectional study. Nordic Journal of Psychiatry 2022; 76(2): 129-137. DOI: 10.1080/08039488.2021.1942547
  77. Poletti M, Azzali S, Paterlini F, Garlassi S, Scazza I, Chiri LR, et al. Familiarity for serious mental illness in help-seeking adolescents at Clinical High Risk of Psychosis. Frontiers in Psychiatry 2021; 11: 552282.
  78. 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 & Life Threatening Behavior 2019; 49(6): 1637-1652.
  79. 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.
  80. 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.
  81. Pelizza L, Poletti M, Azzali S, Garlassi S, Scazza I, Paterlini F, et al. Subjective experience of social cognition in adolescents at ultra-high risk of psychosis: findings from a 24-month follow-up study. European Child and Adolescent Psychiatry 2020; 29(12): 1645-1657.
  82. Pelizza L, Poletti M, Azzali S, Garlassi S, Scazza I, Paterlini F, et al. Subjective experience of social cognition in young people at Ultra-High Risk of psychosis: a 2-year longitudinal study. Nordic Journal of Psychiatry 2021; 75(2): 97-108. DOI: 10.1080/08039488.2020.1799430
  83. Pelizza L, Azzali S, Garlassi S, Scazza I, Paterlini F, Rocco LC, et al. A 2-year longitudinal study on subjective experience of social cognition in young people with first episode psychosis. Actas Espanolas Psiquiatria 2020; 48(6): 287-301.
  84. Pelizza L, Azzali S, Garlassi S, Paterlini F, Scazza I, Chiri LR, et al. Adolescents at ultra-high risk of psychosis in Italian neuropsychiatry services: prevalence, psychopathology and transition rate. European Child and Adolescent Psychiatry 2018; 27(6): 725-737.
  85. Poletti M, Pelizza L, Azzali S, Paterlini F, Garlassi S, Scazza I, et al. Clinical high risk for psychosis in childhood and adolescence: findings from the 2-year follow-up of the ReARMS project. European Child and Adolescent Psychiatry 2019; 28(7): 957-971.
  86. Ajnakina O, Morgan C, Gayer-Anderson C, Oduola S, Bourque F, Bramley S, et al. Only a small proportion of patients with first episode psychosis come via prodromal services: a retrospective survey of a large UK mental health programme. BMC Psychiatry 2017; 17(1): 308.
  87. Guloksuz S, Pries LK, Ten Have M, de Graaf R, van Dorsselaer S, Klingenberg B, et al. Association of preceding psychosis risk states and non-psychotic mental disorders with incidence of clinical psychosis in the general population: a prospective study in the NEMESIS-2 cohort. World Psychiatry 2020; 19(2): 199-205.
  88. Davies C, Cipriani A, Ioannidis JPA, Radua J, Stahl D, Provenzani U, et al. Lack of evidence to favor specific preventive interventions in psychosis: a network meta-analysis. World Psychiatry 2018; 17(2): 196-209.
  89. Ajnakina O, David AS, Murray RM. ‘At risk mental state’ clinics for psychosis - an idea whose time has come - and gone! Psychological Medicine 2019; 49(4): 529-534. https://doi.org/10.1017/s0033291718003859.
  90. Moritz S, Gawęda Ł, Heinz A, Gallinat J. Four reasons why early detection centers for psychosis should be renamed and their treatment targets reconsidered: we should not catastrophize a future we can neither reliably predict nor change. Psychological Medicine 2019; 49(13): 2134-2140. DOI: 10.1017/s0033291719001740.
  91. Shah JL, Scott J, McGorry PD, Cross SPM, Keshavan MS, Nelson B, et al. Transdiagnostic clinical staging in youth mental health: a first international consensus statement. World Psychiatry. 2020 Jun;19(2):233-242.
  92. Shah JL, Jones N, van Os J, McGorry PD, Gülöksüz S. Early intervention service systems for youth mental health: integrating pluripotentiality, clinical staging, and transdiagnostic lessons from early psychosis. Lancet Psychiatry 2022; 9(5): 413-422. DOI: 10.1016/S2215-0366(21)00467-3
  93. Raballo A, Poletti M, McGorry P. Architecture of change: rethinking child and adolescent mental health. Lancet Psychiatry. 2017; 4(9): 656-658. DOI: 10.1016/S2215-0366(17)30315-2
  94. Signorini G, Singh SP, Marsanic VB, Dieleman G, Dodig-Ćurković K, Franic T, Gerritsen SE, Griffin J, Maras A, McNicholas F, O’Hara L, Purper-Ouakil D, Paul M, Russet F, Santosh P, Schulze U, Street C, Tremmery S, Tuomainen H, Verhulst F, Warwick J, et al. The interface between child/adolescent and adult mental health services: results from a European 28-country survey. European Child and Adolescent Psychiatry 2018; 27(4): 501-511.
  95. Poletti M, Preti A, Raballo A. Mind the (transition) gap: Youth mental health-oriented early intervention services to overcome the child-adolescent vs. adult hiatus. Frontiers in Psychiatry. 2022; 13: 965467.

Michele Poletti, Early Intervention Services for youth at Clinical High-Risk for Psychosis: The Reggio Emilia At-Risk Mental State (ReARMS) experience in "RIVISTA SPERIMENTALE DI FRENIATRIA" 3/2022, pp 61-80, DOI: 10.3280/RSF2022-003004