In recent years an increasing number of studies focus on the issue of early diagnosis and intervention.In recent years an increasing number of studies focus on the issue of early diagnosis and intervention.At the same time, a large number of special service units for early psychosis have been establishedaround the world especially in Australia, USA, UK, Germany etc. Recently, similar units operate in Greecealso. The Diagnostic Manual of Mental Disorders of the American Psychiatric Association in its latest editionin 2013 (DSM-5), introduced the category "Attenuated Psychosis Syndrome" (APS) for people withearly psychotic experiences in the section: "Conditions for further study '. This new category has specificcriteria and describes a situation, in which a person displays psychotic symptoms in an attenuatedform, with quite unaffected reality testing, but not qualifying a diagnosis of schizophrenic spectrum.The clinical expression of APS should be differentiated with several well known psychiatric disorderssuch as: brief psychotic disorder, schizotypal personality disorder, major depression with psychotic features,adolescence adjustment disorders, drug use, etc. The "Attenuated Psychosis Syndrome" occursmainly in adolescence and in young adulthood. The mean percentage of transition to psychosis forthese individuals is estimated at 36%, three years after the onset of initial symptoms, while the risk oftransition to psychosis, although smaller, seems to remain up to ten years later. For some other individuals,transition to other psychiatric disorders occurs, such as depression with psychotic elements, orbipolar disorder, while a significant number of them will not transmit to even more serious disorders.At the biological level, studies focused in brain’s neuroimaging, suggest significant volumetric differencesamong people at high risk for psychosis who later develop psychosis compared to those whodon’t, while studies of psychophysiological indicators or / and genetic markers show promising resultsfor the identification of relevant parameters indicating the transition to psychosis. Αlthough an heterogeneouspopulation, people with APS, show significant difficulties in social, professional and cognitivelevel, that should be therapeutically addressed. In an attempt to improve the clinical status of theseindividuals, to delay or even to prevent a psychotic episode, a series of interventions have been used bypsychiatrists. These interventions include: (a) administration of drugs, especially atypical antipsychoticsor antidepressants in low dosage, (b) administration of non-pharmaceutical supplements (e.g. omega-3), (c) psychotherapeutic interventions, mainly cognitive behavior therapy and (d) a combination of theabove. Many questions need to be answered such as, the period of therapeutic intervention, identificationof indicators (biological or/and clinical) that may determine the most suited for the APS individualstherapeutic interventions or, that may foresee, to prevent the transition to psychosis. Thus, the continuationof research in populations of APS individuals in multiple levels is necessary.
Key words: Attenuated psychosis syndrome, differential diagnosis, biological data, therapeutic interventions.
G. Samiotakis, C. Kollias, H. Lazaratou, D. Anagnostopoulos, V. Kontaxakis (page 120) - Full article (Greek)