La thérapie familiale en francophonie (serveur d'exploration)

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Perinatal Risks and Childhood Premorbid Indicators of Later Psychosis: Next Steps for Early Psychosocial Interventions

Identifieur interne : 000034 ( Pmc/Checkpoint ); précédent : 000033; suivant : 000035

Perinatal Risks and Childhood Premorbid Indicators of Later Psychosis: Next Steps for Early Psychosocial Interventions

Auteurs : Cindy H. Liu ; Matcheri S. Keshavan ; Ed Tronick ; Larry J. Seidman

Source :

RBID : PMC:4466191

Abstract

Schizophrenia and affective psychoses are debilitating disorders that together affect 2%–3% of the adult population. Approximately 50%–70% of the offspring of parents with schizophrenia manifest a range of observable difficulties including socioemotional, cognitive, neuromotor, speech-language problems, and psychopathology, and roughly 10% will develop psychosis. Despite the voluminous work on premorbid vulnerabilities to psychosis, especially on schizophrenia, the work on premorbid intervention approaches is scarce. While later interventions during the clinical high-risk (CHR) phase of psychosis, characterized primarily by attenuated positive symptoms, are promising, the CHR period is a relatively late phase of developmental derailment. This article reviews and proposes potential targets for psychosocial interventions during the premorbid period, complementing biological interventions described by others in this Special Theme issue. Beginning with pregnancy, parents with psychoses may benefit from enhanced prenatal care, social support, parenting skills, reduction of symptoms, and programs that are family-centered. For children at risk, we propose preemptive early intervention and cognitive remediation. Empirical research is needed to evaluate these interventions for parents and determine whether interventions for parents and children positively influence the developmental course of the offspring.


Url:
DOI: 10.1093/schbul/sbv047
PubMed: 25904724
PubMed Central: 4466191


Affiliations:


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PMC:4466191

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<p>Schizophrenia and affective psychoses are debilitating disorders that together affect 2%–3% of the adult population. Approximately 50%–70% of the offspring of parents with schizophrenia manifest a range of observable difficulties including socioemotional, cognitive, neuromotor, speech-language problems, and psychopathology, and roughly 10% will develop psychosis. Despite the voluminous work on premorbid vulnerabilities to psychosis, especially on schizophrenia, the work on premorbid intervention approaches is scarce. While later interventions during the clinical high-risk (CHR) phase of psychosis, characterized primarily by attenuated positive symptoms, are promising, the CHR period is a relatively late phase of developmental derailment. This article reviews and proposes potential targets for psychosocial interventions during the premorbid period, complementing biological interventions described by others in this Special Theme issue. Beginning with pregnancy, parents with psychoses may benefit from enhanced prenatal care, social support, parenting skills, reduction of symptoms, and programs that are family-centered. For children at risk, we propose preemptive early intervention and cognitive remediation. Empirical research is needed to evaluate these interventions for parents and determine whether interventions for parents and children positively influence the developmental course of the offspring.</p>
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<article-title>Perinatal Risks and Childhood Premorbid Indicators of Later Psychosis: Next Steps for Early Psychosocial Interventions</article-title>
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<contrib contrib-type="author">
<name>
<surname>Liu</surname>
<given-names>Cindy H.</given-names>
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<xref ref-type="corresp" rid="c1">*</xref>
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<sup>1</sup>
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<sup>2</sup>
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<given-names>Matcheri S.</given-names>
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<sup>1</sup>
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<surname>Tronick</surname>
<given-names>Ed</given-names>
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<sup>2</sup>
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<xref ref-type="aff" rid="AF0003">
<sup>3</sup>
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<surname>Seidman</surname>
<given-names>Larry J.</given-names>
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<sup>1</sup>
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<xref ref-type="aff" rid="AF0004">
<sup>4</sup>
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<addr-line>Boston</addr-line>
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<addr-line>Boston</addr-line>
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<addr-line>MA</addr-line>
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<institution>Department of Newborn Medicine</institution>
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<addr-line>Boston</addr-line>
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<addr-line>MA</addr-line>
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<sup>*</sup>
To whom correspondence should be addressed; 75 Fenwood Road, Boston, MA 02115, US; tel: 617-754-1227, fax: 617-754-1250, e-mail:
<email>cliu@bidmc.harvard.edu</email>
</corresp>
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<month>7</month>
<year>2015</year>
</pub-date>
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<day>22</day>
<month>4</month>
<year>2015</year>
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<volume>41</volume>
<issue>4</issue>
<fpage>801</fpage>
<lpage>816</lpage>
<permissions>
<copyright-statement>© The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<abstract>
<p>Schizophrenia and affective psychoses are debilitating disorders that together affect 2%–3% of the adult population. Approximately 50%–70% of the offspring of parents with schizophrenia manifest a range of observable difficulties including socioemotional, cognitive, neuromotor, speech-language problems, and psychopathology, and roughly 10% will develop psychosis. Despite the voluminous work on premorbid vulnerabilities to psychosis, especially on schizophrenia, the work on premorbid intervention approaches is scarce. While later interventions during the clinical high-risk (CHR) phase of psychosis, characterized primarily by attenuated positive symptoms, are promising, the CHR period is a relatively late phase of developmental derailment. This article reviews and proposes potential targets for psychosocial interventions during the premorbid period, complementing biological interventions described by others in this Special Theme issue. Beginning with pregnancy, parents with psychoses may benefit from enhanced prenatal care, social support, parenting skills, reduction of symptoms, and programs that are family-centered. For children at risk, we propose preemptive early intervention and cognitive remediation. Empirical research is needed to evaluate these interventions for parents and determine whether interventions for parents and children positively influence the developmental course of the offspring.</p>
</abstract>
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