We are conducting the Clinical Risk part of the study to learn about risk and protective factors related to changes that might lead to the future development of serious mental illnesses like schizophrenia and related psychotic disorders. Approximately 135 people (75 with recent changes in their experiences, thinking, and/or everyday functioning as described below, and 60 healthy volunteers) will participate in this part of the study.
This is not a treatment study but a study to understand experiences and functioning at this point in time and any changes that may take place in the next year. Accurate identification and understanding of early clinical risk states will provide an important foundation for future research in prevention and early treatment of serious mental illness. Early detection and intervention will likely lead to significantly better clinical outcomes and promote healthy functioning for individuals and their families.
Clinical risk, sometimes called "clinical high risk" or "ultra-high risk," refers to people who show particular kinds of psychiatric symptoms involving early changes in thinking, perception, mood and/or everyday functioning. "Prodromal" means early symptoms and signs of an illness that may precede the beginning of the acute, fully developed illness. In this case, we are studying the "prodrome" to psychotic disorders, such as schizophrenia. Some of the people who enter the clinical high risk part of the study may develop a psychotic illness, and they will be asked to enter the first episode component of this study.
The clinical high risk part of the study will follow the development of teenagers and young adults who are showing new or increasing social, role and cognitive difficulties and/or thinking problems. Relationships among these clinical signs and symptoms, markers of stress, genetics and brain functioning and their change will be examined over time. By monitoring individuals, we hope to understand how cognition, thought processes, social and role functioning, and brain structure and function change.
Individuals with new difficulties in attention/concentration, mood (depression or anxiety), school or work, friendships and other relationships (e.g., becoming less social), and/or personal beliefs or thoughts may be eligible to participate. Click here for common early warning signs that require monitoring.
Two sets of assessments will be conducted: one set at the beginning of the study and a second set 1 year later. Each assessment period will take approximately 5 visits over a two - three week period. A 6-month phone check-in will be performed to identify any new changes that may have developed. Changes, such as an increase in symptoms or a decrease in their level of functioning, would prompt an earlier follow-up visit. Participation entails clinical interviews, filling out questionnaires, providing hormonal and genetic samples, a specialized set of stimulus evoked EEGs ("Event Related Potentials"), and MRI scans. Parents, if available, also participate in clinical interviews.
Individuals who are experiencing new difficulties and a change in functioning are invited to consider participation in the study. Referrals to the study can be made by school personnel, community members, family physicians, pediatricians, psychiatrists, mental health professionals, family members or individuals themselves. Dr. Seidman is directing this component of the CIDAR grant.