OBJECTIVEIndividuals at high risk for schizophrenia may benefit from early intervention but few v... more OBJECTIVEIndividuals at high risk for schizophrenia may benefit from early intervention but few validated risk predictors are available. Genetic profiling is one approach to risk stratification that has been extensively validated in research cohorts, but its utility in clinical settings remains largely unexplored. Moreover, the broad health consequences of a high genetic risk of schizophrenia are poorly understood, despite being relevant to treatment decisions.METHODWe used electronic health records for 106,160 patients from four healthcare systems to evaluate the penetrance and pleiotropy of genetic risk for schizophrenia. Polygenic risk scores (PRSs) for schizophrenia were calculated from summary statistics and tested for association with 1359 disease categories, including schizophrenia and psychosis, in phenome-wide association studies. Effects were combined through meta-analysis across sites.RESULTSPRSs were robustly associated with schizophrenia (odds ratio per standard deviati...
... Schizophr Res 2007;94:231239. Bowie CR, Leung WW, Reichenberg A, et al. ... Clin Neuropsycho... more ... Schizophr Res 2007;94:231239. Bowie CR, Leung WW, Reichenberg A, et al. ... Clin Neuropsychol 2001;15:109113. Joy S, Kaplan E, Fein D. Speed and memory in the WAIS-III Digit SymbolCoding subtest across the adult lifespan. Arch Clin Neuropsychol 2004;19:759767. ...
Aim:Many emerging adults disengage from early intervention in psychosis (EIP) services prematurel... more Aim:Many emerging adults disengage from early intervention in psychosis (EIP) services prematurely. Service disengagement may be in part due to having unresolved treatment decision-making needs about use of mental health services. A basic understanding of the decision-making needs of this population is lacking. The purpose of this qualitative study was to identify the range of treatment decisions that emerging adults face during their initial engagement in an EIP program and elucidate barriers and facilitators to decision-making.Methods:Twenty emerging adults with early psychosis were administered semi-structured interviews to capture treatment decision-making experiences during the first six months after enrollment in an EIP program. Interviews were audio-recorded and transcribed verbatim. Responses were independently coded by two authors using an integrated thematic analysis approach; differences in coding were discussed to consensus. Data analysis was facilitated using NVivo 12 Plus.Results:Emerging adults identified numerous decisions faced after EIP enrollment. Decisions pertaining to life and treatment goals and to starting and continuing psychiatric medication were commonly selected as the most difficult/complicated. Decision-making barriers included not having the right amount or type of information/knowledge; social factors (e.g., lacking social support, opposition/pressure); lacking internal resources (e.g., cognitive and communication skills, self-efficacy, motivation); and unappealing options. Obtaining information/knowledge, social supports (e.g., connection/trust, learning from others’ experiences, encouragement), considering personal values, and time were decision-making facilitators.Conclusions:This study informs development and optimization of interventions to support decision-making among emerging adults with early psychosis, which may promote service engagement.
AimMany emerging adults disengage from early intervention in psychosis (EIP) services prematurely... more AimMany emerging adults disengage from early intervention in psychosis (EIP) services prematurely. Service disengagement may be in part due to having unresolved treatment decision‐making needs about use of mental health services. A basic understanding of the decision‐making needs of this population is lacking. The purpose of this qualitative study was to identify the range of treatment decisions that emerging adults face during their initial engagement in an EIP program and elucidate barriers and facilitators to decision‐making.MethodsTwenty emerging adults with early psychosis were administered semistructured interviews to capture treatment decision‐making experiences during the first six months after enrolment in an EIP program. Interviews were audio‐recorded and transcribed verbatim. Responses were independently coded by two authors using an integrated thematic analysis approach; differences in coding were discussed to consensus. Data analysis was facilitated using NVivo 12 Plus....
A review of some of the latest study findings on the pharmacological treatment of prodromal psych... more A review of some of the latest study findings on the pharmacological treatment of prodromal psychosis.
Background Emerging adults with early psychosis demonstrate high rates of service disengagement f... more Background Emerging adults with early psychosis demonstrate high rates of service disengagement from critical early intervention services. Decision support interventions and peer support have both been shown to enhance service engagement but are understudied in this population. The purposes of this article are to describe the development of a novel peer-delivered decision coaching intervention for this population and to report plans for a pilot study designed to gather preliminary data about its feasibility, acceptability, and potential impact. Methods The intervention was developed based on formative qualitative data and in collaboration with a diverse team of researchers, key stakeholders, and expert consultants. The pilot trial will utilize a single-group (N = 20), pre-post, convergent mixed-methods design to explore whether and how the intervention addresses decision-making needs (the primary intervention target). The impact of the intervention on secondary outcomes (e.g., engag...
Background Young adults ages 18 to 25 with first episode psychosis (FEP) have an increased risk o... more Background Young adults ages 18 to 25 with first episode psychosis (FEP) have an increased risk of discontinuation antipsychotic medications and psychiatric service disengagement that lead to symptom exacerbation and deterioration. We seek to (1) examine the feasibility, usability, and potential impact of a Shared Decision Making (SDM) Antipsychotic Medication Decision Aid (DA) on decision-making, adherence to the decision made, and service engagement among young adults with FEP and (2) understand the role of additional patient-level factors on SDM. Methods A randomized controlled trial is being conducted in a coordinated specialty care community program for FEP in an urban setting. Eligible patients are randomly assigned to receive an intervention, the Antipsychotic Medication Decision Aid, or treatment as usual. Patients receive their assigned intervention before their medication appointment with the psychiatrist and complete four interviews: before the appointment (T0), after the...
Schizophrenia Research, Volume 102, Issue 1, Pages 117, June 2008, Authors:Irene Bratti; Joseph V... more Schizophrenia Research, Volume 102, Issue 1, Pages 117, June 2008, Authors:Irene Bratti; Joseph Ventura; Stephen Marder; Steven Reise; Richard Keefe; Robert Bilder.
OBJECTIVEIndividuals at high risk for schizophrenia may benefit from early intervention but few v... more OBJECTIVEIndividuals at high risk for schizophrenia may benefit from early intervention but few validated risk predictors are available. Genetic profiling is one approach to risk stratification that has been extensively validated in research cohorts, but its utility in clinical settings remains largely unexplored. Moreover, the broad health consequences of a high genetic risk of schizophrenia are poorly understood, despite being relevant to treatment decisions.METHODWe used electronic health records for 106,160 patients from four healthcare systems to evaluate the penetrance and pleiotropy of genetic risk for schizophrenia. Polygenic risk scores (PRSs) for schizophrenia were calculated from summary statistics and tested for association with 1359 disease categories, including schizophrenia and psychosis, in phenome-wide association studies. Effects were combined through meta-analysis across sites.RESULTSPRSs were robustly associated with schizophrenia (odds ratio per standard deviati...
... Schizophr Res 2007;94:231239. Bowie CR, Leung WW, Reichenberg A, et al. ... Clin Neuropsycho... more ... Schizophr Res 2007;94:231239. Bowie CR, Leung WW, Reichenberg A, et al. ... Clin Neuropsychol 2001;15:109113. Joy S, Kaplan E, Fein D. Speed and memory in the WAIS-III Digit SymbolCoding subtest across the adult lifespan. Arch Clin Neuropsychol 2004;19:759767. ...
Aim:Many emerging adults disengage from early intervention in psychosis (EIP) services prematurel... more Aim:Many emerging adults disengage from early intervention in psychosis (EIP) services prematurely. Service disengagement may be in part due to having unresolved treatment decision-making needs about use of mental health services. A basic understanding of the decision-making needs of this population is lacking. The purpose of this qualitative study was to identify the range of treatment decisions that emerging adults face during their initial engagement in an EIP program and elucidate barriers and facilitators to decision-making.Methods:Twenty emerging adults with early psychosis were administered semi-structured interviews to capture treatment decision-making experiences during the first six months after enrollment in an EIP program. Interviews were audio-recorded and transcribed verbatim. Responses were independently coded by two authors using an integrated thematic analysis approach; differences in coding were discussed to consensus. Data analysis was facilitated using NVivo 12 Plus.Results:Emerging adults identified numerous decisions faced after EIP enrollment. Decisions pertaining to life and treatment goals and to starting and continuing psychiatric medication were commonly selected as the most difficult/complicated. Decision-making barriers included not having the right amount or type of information/knowledge; social factors (e.g., lacking social support, opposition/pressure); lacking internal resources (e.g., cognitive and communication skills, self-efficacy, motivation); and unappealing options. Obtaining information/knowledge, social supports (e.g., connection/trust, learning from others’ experiences, encouragement), considering personal values, and time were decision-making facilitators.Conclusions:This study informs development and optimization of interventions to support decision-making among emerging adults with early psychosis, which may promote service engagement.
AimMany emerging adults disengage from early intervention in psychosis (EIP) services prematurely... more AimMany emerging adults disengage from early intervention in psychosis (EIP) services prematurely. Service disengagement may be in part due to having unresolved treatment decision‐making needs about use of mental health services. A basic understanding of the decision‐making needs of this population is lacking. The purpose of this qualitative study was to identify the range of treatment decisions that emerging adults face during their initial engagement in an EIP program and elucidate barriers and facilitators to decision‐making.MethodsTwenty emerging adults with early psychosis were administered semistructured interviews to capture treatment decision‐making experiences during the first six months after enrolment in an EIP program. Interviews were audio‐recorded and transcribed verbatim. Responses were independently coded by two authors using an integrated thematic analysis approach; differences in coding were discussed to consensus. Data analysis was facilitated using NVivo 12 Plus....
A review of some of the latest study findings on the pharmacological treatment of prodromal psych... more A review of some of the latest study findings on the pharmacological treatment of prodromal psychosis.
Background Emerging adults with early psychosis demonstrate high rates of service disengagement f... more Background Emerging adults with early psychosis demonstrate high rates of service disengagement from critical early intervention services. Decision support interventions and peer support have both been shown to enhance service engagement but are understudied in this population. The purposes of this article are to describe the development of a novel peer-delivered decision coaching intervention for this population and to report plans for a pilot study designed to gather preliminary data about its feasibility, acceptability, and potential impact. Methods The intervention was developed based on formative qualitative data and in collaboration with a diverse team of researchers, key stakeholders, and expert consultants. The pilot trial will utilize a single-group (N = 20), pre-post, convergent mixed-methods design to explore whether and how the intervention addresses decision-making needs (the primary intervention target). The impact of the intervention on secondary outcomes (e.g., engag...
Background Young adults ages 18 to 25 with first episode psychosis (FEP) have an increased risk o... more Background Young adults ages 18 to 25 with first episode psychosis (FEP) have an increased risk of discontinuation antipsychotic medications and psychiatric service disengagement that lead to symptom exacerbation and deterioration. We seek to (1) examine the feasibility, usability, and potential impact of a Shared Decision Making (SDM) Antipsychotic Medication Decision Aid (DA) on decision-making, adherence to the decision made, and service engagement among young adults with FEP and (2) understand the role of additional patient-level factors on SDM. Methods A randomized controlled trial is being conducted in a coordinated specialty care community program for FEP in an urban setting. Eligible patients are randomly assigned to receive an intervention, the Antipsychotic Medication Decision Aid, or treatment as usual. Patients receive their assigned intervention before their medication appointment with the psychiatrist and complete four interviews: before the appointment (T0), after the...
Schizophrenia Research, Volume 102, Issue 1, Pages 117, June 2008, Authors:Irene Bratti; Joseph V... more Schizophrenia Research, Volume 102, Issue 1, Pages 117, June 2008, Authors:Irene Bratti; Joseph Ventura; Stephen Marder; Steven Reise; Richard Keefe; Robert Bilder.
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