title: Are current labeling terms suitable for people who are at risk of psychosis?
abstract: Inclusion of 'attenuated psychosis syndrome (APS)' in the DSM-5 has been hotly debated because of the concern about stigmatising young patients with a 'psychosis risk' label. This study aimed to investigate whether current labeling terms such as 'at risk mental state', 'ultra-high risk' (UHR) and 'APS' are suitable for people who are at risk of psychosis. This study included 105 subjects (55 patients aged 15-25years who used an early interventional service to prevent psychosis and 50 professionals who worked with them). A questionnaire regarding their opinions about the stigma associated with the above labels and the Mental Health Consumers' Experience of Stigma scale were administered. The patients were less likely than the professionals to agree that there was stigma associated with the terms 'UHR' and 'APS'. Significantly more patients with a family history of psychosis and those who had transitioned to psychosis agreed that there was stigma associated with the term 'UHR' and/or that this term should be changed. Patients who agreed with the negative attitude items for the three labeling terms and the need to change the terms 'UHR' and 'schizophrenia' showed significantly higher scores on the Stigma scale. In conclusion, patients at risk of psychosis may experience less stigma related to labels than expected by professionals, suggesting that mental health professionals may not be able to help patients unless they listen to their views on nosological and treatment issues rather than make assumptions. Previous stigmatising experiences may have strengthened the stigma attached to this label.
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Orygen Youth Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Polari
authors.affiliation: Orygen Youth Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Fritha
authors.initials: F
authors.lastname: Melville
authors.affiliation: Orygen Youth Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Moller
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Orygen Youth Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Amminger
authors.affiliation: Orygen Youth Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Herrman
authors.affiliation: Orygen Youth Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McGorry
authors.affiliation: Orygen Youth Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: nelsonb@unimelb.edu.au.
authors.forename: Barnaby
authors.initials: B
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D008297:Male; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000145:classification* / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D012306:Risk; D057545:Social Stigma; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D055815:Young Adult
keywords: Attenuated psychosis syndrome; DSM-5; High risk; Labeling term; Schizophrenia; Stigma