Évolution des états mentaux à risque de transition vers un trouble psychotique : une revue de la littérature
Year: 2018
Type: dissertation
Abstract: The concept of at risk mental state for psychosis has been developed in order to detect subjects who are supposed to be in the prodromal phase of psychosis disorder, in an attempt to modify the natural history of the disease. The aim of this thesis was to synthesize the work on this concept with a review of the literature. The concept of at-risk mental state for psychosis was developed from retrospective studies that identified prodromal symptoms. These symptoms were included in the "Ultra-High Risk state for Psychosis" criteria (UHR-P), which is said to describe a late period of the prodromal phase, defining attenuated psychotic symptoms syndrome (APSS), brief limited and intermittent psychotic symptoms (BLIPS), and genetic risk and deterioration syndrome (GRD). In parallel, the basic symptoms (BS), felt subjectively, describe a supposedly earlier period of the prodromal phase. About a third of these screened subjects will develop a psychotic disorder at more than 4 years. For the others, the symptoms may persist, but in about two-thirds of cases there is complete remission in the medium term. High-risk individuals have an increased prevalence of non-psychotic disorders. Several predictive factors of clinical, environmental, and paraclinical transition have been found in this population. This new paradigm has attempted to integrate DSM 5 with the diagnosis of attenuated psychotic syndrome (APS), which has been retained only in section III. Several criticisms come from the decline in transition rates, study methodology, transition threshold, and the concept of "high-risk". This concept tends to adjust, the development of individualized risk calculation tools seems particularly promising. Efforts should continue to lead to the identification and early treatment of subjects with psychotic vulnerability.
Source: HAL
Author: Romain Durandeau
Institution: Université de Bordeaux
Language: French
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2909772448