Abstract
AimEarly intervention programs for first‐episode psychosis have led to the awareness that the period before onset of a first episode is important in light of early intervention. This has induced a focus on the so‐called ‘at risk mental state’ (ARMS). Individuals with ARMS are at increased risk for later psychotic disorder, but also for other psychiatric disorders as well as poor psychosocial functioning. Thus, adequate detection and treatment of ARMS is essential.MethodsSince 2018, screening for and treatment of ARMS is recommended standard care in the Netherlands. Implementation is still ongoing. We initiated a naturalistic long‐term cohort study of ARMS individuals, the onset and transition of and recovery from adverse development (OnTheROAD) study, with the aim to monitor course and outcome of symptoms and psychosocial functioning over time, as well as patterns of comorbidity and associations with factors of risk and resilience. To this end, participants complete a broad battery of instruments at baseline and yearly follow‐up assessments up to 3 years. Outcome is defined in terms of symptom severity level, functioning and quality of life. In particular, we aim to investigate the impact of negative symptoms as part of the ARMS concept. Results from this study can aid in refining the existing ARMS criteria, understanding the developmental course of ARMS and investigating the hypothesized pluripotentiality in outcome of ARMS. New knowledge may inform the further development of specialized early interventions.Results and ConclusionsIn this article, we describe the rationale, outline and set‐up of OnTheROAD.
Highlights
Clinicians and researchers are still searching for valid diagnostic tools to select optimal interventions and accurately predict course and outcome of early psychopathological expressions (Kapur, Philips, & Insel, 2012)
It is labelled rather as ultra high risk phase, clinical high risk phase or at risk mental state (ARMS), indicating that, this population is at risk for developing more severe illness, adverse development is not necessarily unavoidable
We are interested in the role of negative symptoms in ARMS (Wunderink, 2017), as these symptoms are increasingly acknowledged as important predictors of both clinical (Pisculic et al, 2012; Demjaha, Valmaggia, Stahl, Byrne, & McGuire, 2010) and functional (Kim et al, 2013; Lin et al, 2011; Yung et al, 2019) outcome
Summary
Clinicians and researchers are still searching for valid diagnostic tools to select optimal interventions and accurately predict course and outcome of early psychopathological expressions (Kapur, Philips, & Insel, 2012). A broad line of research has shown that its clinical picture, characterized by psychological distress, attenuated psychotic symptoms (APS) and a broad spectrum of other psychiatric symptoms, can be identified as a prospective risk factor (Yung et al, 2003). From this perspective, it is labelled rather as ultra high risk phase, clinical high risk phase or at risk mental state (ARMS), indicating that, this population is at risk for developing more severe illness, adverse development is not necessarily unavoidable
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