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Background: In their early stages, serious mental illnesses (SMIs) are often indistinguishable from one another, suggesting that studying alterations in brain activity in a transdiagnostic fashion could help to understand the neurophysiological origins of different SMI. The purpose of this study was to examine brain activity in youth at varying stages of risk for SMI using functional magnetic resonance imaging tasks (fMRI) that engage brain systems believed to be affected. Methods: Two hundred and forty three participants at different stages of risk for SMI were recruited to the Canadian Psychiatric Risk and Outcome (PROCAN) study, however only 179 were scanned. Stages included asymptomatic participants at no elevated risk, asymptomatic participants at elevated risk due to family history, participants with undifferentiated general symptoms of mental illness, and those experiencing attenuated versions of diagnosable psychiatric illnesses. The fMRI tasks included: (1) a monetary incentive delay task; (2) an emotional Go‐NoGo and (3) an n‐back working memory task. Results: Strong main effects with each of the tasks were found in brain regions previously described in the literature. However, there were no significant differences in brain activity between any of the stages of risk for SMI for any of the task contrasts, after accounting for site, sex and age. Furthermore, results indicated no significant differences even when participants were dichotomized as asymptomatic or symptomatic. Conclusions: These results suggest that univariate BOLD responses during typical fMRI tasks are not sensitive markers of SMI risk and that further study, particularly longitudinal designs, will be necessary to understand brain changes underlying the early stages of SMI. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to identify a sample of youth in distinct stages of risk for the development of a serious mental illness (SMI) according to a published clinical staging model and to follow this sample longitudinally to determine clinical changes over time. This article reports the 6‐ and 12‐month follow‐up of the cohort. Methods: This study recruited 243 youth, ages 12 to 25. The sample included (a) 42 healthy controls, (b) 41 nonhelpseeking individuals with no mental illness but some risk of SMI, for example, having a first‐degree relative with an SMI (stage 0), (c) 53 youth experiencing distress and mild symptoms of anxiety or depression (stage 1a), and (d) 107 youth with attenuated symptoms of SMIs such as bipolar disorder or psychosis (stage 1b). Participants completed a range of measures assessing depression, anxiety, mania, suicide ideation, attenuated psychotic symptoms, negative symptoms, anhedonia and beliefs about oneself at baseline, 6‐ and 12‐months. Results: There were few changes for healthy controls and stage 0 participants, although approximately 7% did move to a symptomatic stage within 12‐months. Of stage 1a participants, 50% remained symptomatic, with 7.5% moving to stage 1b or developing a SMI. Approximately 9% of stage 1byouth developed a SMI within 12‐months and approximately one‐third had remission of symptoms during the follow‐up. Conclusions: Results suggest that the implementation of a transdiagnostic staging model may be useful in youth mental health and support consideration of clinical stage‐based treatment for youth with early features of risk. [ABSTRACT FROM AUTHOR]

Aim: The aim of this paper is to describe the substance use of participants who are at‐risk for serious mental illness (SMI). Method: The Canadian Psychiatric Risk and Outcome study (PROCAN) is a two‐site study of 243 youth and young adults aged 13 to 25 years, categorized into four groups: healthy controls (n = 42), stage 0 (asymptomatic individuals with risk of SMI typically family high risk; n = 41), stage 1a (distress disorder or mild symptoms of anxiety or depression; n = 53) and stage 1b (attenuated syndromes, including bipolar disorder or psychosis; n = 107). Substance use measures were administered at baseline, 6‐ and 12‐months. Results: At baseline, the most commonly reported substance used in the past month was alcohol (43.6%), followed by cannabis (14.4%) and tobacco (12.4%). There were no significant group differences in use. 42.4% of all participants reported ever using cannabis in their lifetime, whereas 21.4% reported currently using cannabis. There were no group differences in ever having used cannabis. Regarding lifetime substance abuse disorders, cannabis use disorder (5.7%) and alcohol use disorder (4.5%) were the most common and more often reported in stage 1b participants relative to other groups. Furthermore, alcohol, cannabis and tobacco use remained relatively consistent at 6‐ and 12‐month follow‐ups when compared to baseline use. Conclusion: Alcohol was the most commonly used substance followed by cannabis and tobacco. Although substance use did not differ between those at different stages of risk, overall prevention strategies are still warranted for youth at‐risk for SMI, especially those who are more symptomatic and potentially at greater risk of developing an SMI. [ABSTRACT FROM AUTHOR]

Background: This study was conducted as a pilot exercise intervention in youth at‐risk for serious mental illness (SMI). The objectives were to examine the feasibility of an exercise intervention and to determine what improvement was observed, following participation in a moderate‐ to high‐intensity aerobic exercise programme. Methods: Forty‐four male and female youth at‐risk for SMI were recruited. Participants completed clinical, lifestyle and fitness assessments prior to and following a 16‐week moderate‐ to high‐intensity aerobic exercise intervention. Sixty‐minute exercise sessions were held three times per week. Results: Forty‐one participants completed the entire intervention and assessments; thus, the retention rate was 93.2%. Exercise participants achieved a mean of 98.3 (standard deviation (SD) 26.1) minutes/week of high‐intensity and a mean of 32.8 (SD 8.7) minutes/week of moderate‐intensity aerobic exercise over the course of 16 weeks. Improvements in aerobic fitness and body composition as well as reductions in anxiety and depression were observed after the exercise intervention. Conclusion: Aerobic exercise is a feasible and sound intervention strategy in youth at‐risk for SMI. Further research is required to expand upon these initial findings and develop knowledge of the mechanisms, optimum dose and factors that influence the efficacy of exercise. [ABSTRACT FROM AUTHOR]

Aim: Certain personality traits may be related to an increased risk of developing a severe mental illness (SMI). This study examined differences in personality characteristics in a sample of youth at‐risk of SMI across different clinical stages compared to healthy controls (HCs). Method: Personality characteristics were assessed with the NEO‐Five‐Factor Inventory‐3 for 41 non‐help seeking asymptomatic youth with risk factors for SMI (Stage 0), 52 youth with early mood and anxiety symptoms and distress (Stage 1a), 108 youth with an attenuated psychiatric syndrome (Stage 1b), and 42 HCs. Results: Symptomatic participants scored significantly higher in neuroticism, and lower in extraversion, and conscientiousness compared to non‐symptomatic participants. Compared to published norms, symptomatic participants had ratings of extraversion and conscientiousness in the low range and those with attenuated psychiatric syndromes scored high on neuroticism. Conclusion: The observed personality profiles of the symptomatic stages were similar to reported profiles for discrete disorders. Early identification of this profile could aid identification of those at risk of SMI. [ABSTRACT FROM AUTHOR]

Aim: Functional impairment is common in serious mental illness (SMI). This study assessed social and role functioning in a sample of youth at risk of SMI who met different stages of risk based on a transdiagnostic clinical staging model described by McGorry and colleagues. Method: The sample consisted of 243 male and female youths aged 12‐26 and included: non‐help‐seeking youth with risk factors (stage 0; n = 41); youth with mild symptoms (stage 1a; n = 52); youth with attenuated psychiatric syndromes (stage 1b; n = 108); and healthy controls (HCs; n = 42). Social and role functioning were assessed with the Global Functioning: Social and Role scales. Results: Participants in stage 1b (attenuated syndromes) had significantly poorer social and role functioning than stage 0 participants and HCs (P <.001) and poorer social functioning than stage 1a (P <.05). Stage 1a participants had significantly poorer social functioning than HCs (P <.01) and significantly poorer role functioning than stage 0 participants (P <.01). Participants in stages 1a and 1b did not significantly differ from each other in role functioning only. Conclusions: This study demonstrates that mild to moderate functional impairments are present in young people experiencing subthreshold psychiatric symptoms and distress in the absence of a diagnosable mental illness. Results partially validate the model in that social although not role functioning declines across the stages. [ABSTRACT FROM AUTHOR]

Aim: To investigate sleep behaviours of youth at‐risk for serious mental illness (SMI). Methods: This study included 243 youth, ages 12 to 25:42 healthy controls, 41 asymptomatic youth at‐risk for mental illness (stage 0); 53 help‐seeking youth experiencing distress (stage 1a) and 107 youth with attenuated syndromes (stage 1b). The Pittsburgh Sleep Quality Index was used to assess sleep dysfunction. Results: Stage 1b individuals indicated the greatest deficit in global sleep dysfunction (F = 26.18, P <.0001). Stages 1a and 1b reported significantly worse subjective sleep quality, a longer sleep latency, increased use of sleep medications as well as greater daytime dysfunction compared to the asymptomatic groups. Conclusion: Research investigating sleep behaviours of youth considered to be at‐risk for SMI is limited. This study provides early evidence that sleep disturbances are worse for individuals considered to be at higher risk of illness development. [ABSTRACT FROM AUTHOR]

Aim: Major depressive disorder (MDD) onset generally occurs in adolescence/early adulthood. However, pharmacotherapy use in younger populations is restricted due to black box warnings. Aerobic exercise may be a viable treatment option for mild‐to‐moderate MDD, but little is known about its acceptability/effectiveness in young adults. Methods: Unmedicated and relatively inactive 18‐to‐24 olds with MDD completed fitness/clinical assessments at baseline and after 12 weeks of supervised aerobic exercise (3×/wk; 30‐minute sessions in target heart rate [HR] zone), with the aim of increasing cardiovascular fitness (VO2max‐indexed). Results: Post‐intervention, predicted VO2max increased, whereas depression scores decreased. A correlation existed between time spent in target HR zone and anxiety symptom decreases. Exercise adherence and satisfaction were high, and drop‐out was minimal. Conclusions: This pilot is among the first to assess the feasibility of aerobic exercise as an antidepressant treatment strategy in young adults, a group for which options have limited acceptability. [ABSTRACT FROM AUTHOR]