How do we detect youth at-risk for psychosis: Findings from London child health & development study
For the past 20 years, efforts to detect individuals with increased vulnerability for psychosis have focused on help-seeking youth who fulfil clinical high-risk (CHR) criteria, approximately 20% of whom go on to develop full psychosis. However, at the point of detection, this population is already characterised by significant functional disability and high levels of psychiatric comorbidity; moreover, only a third experience symptom remission. Such findings indicate the need for alternative early detection methods, which are not restricted to those accessing clinical services.
To this end, the London Child Health and Development Study (CHADS) was established in 2004 which piloted a novel school-screening procedure to identify children presenting well-established antecedents of schizophrenia. Following mass screening of 8,000 children aged 9-12 years and 1,500 of their caregivers, we recruited a subset of at-risk and typically-developing children for intensive laboratory assessments (N=123). The cohort has been assessed biennially throughout adolescence, with clinical outcomes measured at the most recent follow-up (age 17-21 years).
In her talk, Dr Cullen will provide an overview of the CHADS recruitment strategy, describe the results of analyses comparing at-risk children to their typically-developing peers on neuroimaging, biological, cognitive, and psychosocial measures, and present new findings relating to clinical outcomes measured at the most recent assessment phase.
Presenter: Alexis Cullen
Dr Alexis E. Cullen is a Research Fellow at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, UK and a Senior Researcher at the Karolinska Institutet, Sweden. Her interdisciplinary research spans the fields of stress neurobiology, epidemiology, and developmental psychopathology.
Dr Cullen completed her PhD at the IoPPN where she has spent the past 15 years contributing to a longitudinal study of children at elevated risk for developing psychosis. Her work has shown that these children present neuroanatomical, cognitive, and HPA-axis abnormalities that are similar (although less marked) to those observed in individuals with established psychosis.
Funded by the UK Wellcome Trust, she established the Stress, Inflammation and Psychosis (SIP) study to examine biological markers of stress and inflammation across the clinical stages of psychosis (ranging from at-risk children to adults with chronic illness). Collaborating with colleagues at Emory University, Atlanta, she has worked on the NAPLS-2 dataset, investigating the relationship between psychosocial stressors and HPA axis abnormalities, and co-authored a revision of the neural diathesis-stress model of schizophrenia. Her current NARSAD Young Investigator Grant builds on this work and examines stress-biomarker signatures across the psychosis spectrum. At the Karolinska Institutet, she is involved in an international study examining refugees with psychosis in Sweden and Denmark.