Youth at risk of psychosis : neurocognitive profiles and non-pharmacological interventions

Authors: Peredo Nunez De Arco, Rossana
Advisor: Mérette, Chantal
Abstract: Introduction: Interest in the early stages of psychosis has been increasing in the last years, mainly because it appears mostly in adolescence. Also, numerous studies have reported that early identification and treatment may not only delay the transition to a frank mental disorder, but also prevent detrimental effects on global functioning. In order to identify these individuals, some clinical criteria have already been developed; it is known for example that children at genetic risk of psychosis engage early in a deficient cognitive trajectory. Even though models of prediction are very promising, the number of false positives is still high, which impairs the development of preventive treatments. The objective of the first article was to identify two neurocognitive profiles among offspring at genetic risk of psychosis. The objective of the second article was to assess, the effect of non-pharmacological interventions on transition to psychosis, compared to any no non-pharmacological treatment, in individuals at risk of psychosis and the effect of these interventions on non-psychotic comorbidities. Methodology: First a hierarchical clustering analysis was performed in order to identify the two neurocognitive profiles. Then a systematic review and meta-analysis of randomized controlled trials was conducted to analyse all non-pharmacological interventions published until now. Results: The cluster analysis yielded two subgroups of high risk offspring, one of them showing a cognitive performance almost identical to control subjects, whereas the other having performed worse than the control scores. The meta-analysis reported that non-pharmacological therapies were associated with a reduced risk of transition to psychosis. Conclusion: Non-pharmacological interventions may have potential in the treatment of individuals at risk of psychosis however; further research is needed accompanied by efforts to diminish withdrawal rates. Our study suggests that interventions with a neurocognitive target should be addressed earlier. Still further research is needed in longitudinal studies.
Document Type: Mémoire de maîtrise
Issue Date: 2017
Open Access Date: 23 January 2019
Grantor: Université Laval
Collection:Thèses et mémoires

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