The psychosis prodrome in adolescent patients viewed through the lens of DSM-IV.
OBJECTIVE
Recently developed research criteria have made it possible to identify adolescents at imminent risk for psychosis. However, the array of symptomatology in these patients is broad and has not yet been systematically characterized using established diagnostic and assessment tools.


METHODS
The authors characterized 24 adolescent research participants at the UCLA Center for the Assessment and Prevention of Prodromal States (CAPPS) using structured interviews for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, (DSM-IV), the Child Behavior Checklist (CBCL), and information regarding psychiatric treatment histories. Two composite cases are also presented.


RESULTS
The most common DSM-IV diagnosis at study entry was major depression, followed by anxiety disorder not otherwise specified (NOS), and social phobia. Most participants met criteria for at least one subthreshold condition, including obsessive-compulsive disorder (OCD), psychosis, mania or hypomania, and generalized anxiety. CBCL data revealed high rates of affective disturbance and broad-ranging symptomatology, as did participants' diagnostic and treatment histories.


CONCLUSIONS
Consistent with retrospective studies of patients with first-episode psychosis, findings revealed frequent mood and anxiety disturbance during the prodromal phase of illness. The DSM-IV does not offer a clear framework for describing the widespread subthreshold symptomatology that characterizes putatively prodromal patients. The authors consider whether the psychosis prodrome merits designation as a recognized clinical entity.
Meyer
Stephanie E
SE
Division of Child and Adolescent Psychiatry, Neuropsychiatric Institute and Hospital, University of California-Los Angeles, CA 90024, USA. semeyer@mednet.ucla.edu
Bearden
Carrie E
CE
Lux
Sabrina R
SR
Gordon
Jamie L
JL
Johnson
Jennifer K
JK
O'Brien
Mary P
MP
Niendam
Tara A
TA
Loewy
Rachel L
RL
Ventura
Joseph
J
Cannon
Tyrone D
TD
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology; D002648:Child; D002652:Child Behavior; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000523:psychology; D009771:Obsessive-Compulsive Disorder / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D012307:Risk Factors