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This article highlights the importance of preventing psychosis in low-resource settings, specifically in low- and middle-income countries (LAMIC). Schizophrenia and other psychotic disorders have a significant impact on individuals and society, particularly in LAMIC. Detecting individuals at clinical high risk for psychosis (CHR) is crucial in delaying or preventing the onset of a full-threshold disorder. However, implementing early intervention services in LAMIC faces challenges such as limited resources, stigma, and cultural barriers. The article emphasizes the need for more research and attention in this field to improve pathways to care for individuals with psychosis. The text also discusses three research studies related to mental health, including the prevalence of stressful life events in CHR individuals in Mexico, the impact of the institutional model on psychiatric patients in Chile, and mental health problems among COVID-19 survivors in India. [Extracted from the article]

Le harcèlement en milieu scolaire (bullying) durant l'enfance et l'adolescence est un problème de santé publique. L'état à haut risque de psychose (UHR) est associé à une prévalence plus importante de harcèlement scolaire en comparaison avec les sujets contrôles. Nous nous sommes proposés de résumer les résultats des études existantes en vue de comprendre les mécanismes reliant harcèlement scolaire et état UHR, leurs spécificités cliniques et évolutives, ainsi que leurs implications interventionnelles. Le type de harcèlement scolaire subi au cours de l'enfance et de l'adolescence est associé à la nature des symptômes psychotiques subcliniques qui apparaissent plus tard au cours de la vie. Le développement de symptômes psychotiques chez les victimes de harcèlement scolaire dans l'enfance semble être lié à la fréquence, à la gravité et à la durée de la victimisation. Des preuves limitées suggèrent que la cessation du harcèlement scolaire pourrait prévenir l'apparition des symptômes psychotiques ou d'un état à risque de psychose. Plusieurs modèles explicatifs du lien entre harcèlement scolaire et survenue ultérieure de psychose ou d'états prépsychotiques ont été avancés dans la littérature, notamment les anomalies développementales prémorbides, la qualité de l'attachement, les schémas cognitifs dysfonctionnels et théorie de l'esprit, et les anomalies de l'axe hypothalamo-hypophysaire. Malgré le nombre limité de preuves, un dépistage de l'existence d'une victimisation antérieure lors de l'évaluation initiale des sujets UHR et leur prise en charge adéquate semblent justifiés. Toutefois, aucune étude n'a évalué à ce jour des protocoles d'intervention spécifiques pour la prise en charge du harcèlement scolaire chez les sujets UHR. Bullying in schools during childhood and adolescence is a growing public health problem due to its high prevalence worldwide and its various negative impacts on mental health. Evidence suggests that the "ultra-high risk for psychosis" (UHR) state is associated with a higher prevalence of bullying compared to the control subjects. We proposed to summarize the results of existing studies to provide a more thorough understanding of the mechanisms linking bullying and an UHR state, their clinical and evolutionary specificities, as well as their interventional implications. PubMed and Medline search, Scopus, journal and textbook articles have been consulted for the review of literature on the relationship between bullying and psychosis in UHR subjects. We found that the type of bullying experienced during childhood and adolescence may be related to the nature of subclinical psychotic symptoms experienced later. The development of psychotic symptoms in victims of bullying appears to be related to the frequency, severity, and duration of victimization. Limited evidence suggests that stopping bullying may prevent the onset of psychotic symptoms or an UHR state. Several explanatory models of the link between bullying and the subsequent onset of psychosis or prepsychotic states have been advanced in the literature, including premorbid developmental abnormalities, quality of attachment, dysfunctional cognitive patterns and theory of mind, and hypothalamic-pituitary axis abnormalities. Despite the limited body of evidence, screening for the existence of prior victimization during the initial assessment of UHR subjects and their adequate management seem to be justified. However, to date, no study has evaluated specific intervention protocols for the management of bullying in UHR subjects. [ABSTRACT FROM AUTHOR]

Background: Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to conduct a meta‐analysis that estimates prevalence rates of PEs in students, and to assess whether these rates differ by gender, age, culture, and COVID‐19 exposure. Method: We searched nine electronic databases, from their inception until January 31, 2022 for relevant studies. We pooled the estimates using the DerSimonian–Laird technique and random‐effects meta‐analysis. Our main outcome was the prevalence of self‐reported PEs in high school and college/university students. We subsequently analyzed our data by age, gender, population, country, culture, evaluation tool, and COVID‐19 exposure. Results: Out of 486 studies retrieved, a total of 59 independent studies met inclusion criteria reporting 210′ 024 students from 21 different countries. Nearly one in four students (23.31%; 95% CI 18.41%–29.05%), reported having experienced PEs (heterogeneity [Q = 22,698.23 (62), p = 0.001] τ2 = 1.4418 [1.0415‐2.1391], τ = 1.2007 [1.0205‐1.4626], I2 = 99.7%, H = 19.13 [18.59‐19.69]). The 95% prediction intervals were 04.01%–68.85%. Subgroup analyses showed that the pooled prevalence differed significantly by population, culture, and COVID‐19 exposure. Conclusion: This meta‐analysis revealed high prevalence rates of self‐reported PEs among teen and young adult students, which may have significance for mental health screening in school settings. An important realization is that PEs may have very different mental health meaning in different cultures. [ABSTRACT FROM AUTHOR]

There is strong evidence that sleep disturbances are commonly experienced by people with psychosis. Evidence has also shown that sleep disturbances are present since the very early stages of the disease, even during the pre- diagnostic phase. More recently, research involving young individuals at ultra- high risk (UHR) for psychosis documented frequent occurrence of sleep disturbances in this group. The very early onset of sleep disturbances in the course of psychosis has drawn attention to the possible links between sleep parameters and the risk of psychosis. To date, the nature of sleep disturbances characterizing the UHR stage remains unclear, with available studies having yielded mixed findings. In this regard, we performed this review to update the body of literature on the nature of sleep disturbances, their underlying mechanisms, their clinical and functional consequences, the prevention and intervention strategies in the at-risk for psychosis population. Our findings provided further support to the presence of disturbed sleep in UHR individuals as evidenced by subjective and objective sleep measures such as polysomnography, sleep electroencephalograms, and actigraphy. Reviewing the possible mechanisms underlying the relationship between sleep and psychosis emphasized its complex and multifactorial nature which is yet to be determined and understood. Further research is warranted to determine which facets of sleep disturbances are most detrimental to this specific population, and to what extent they can be causal factors or markers of psychosis. [ABSTRACT FROM AUTHOR]

Aim: We aimed to further elucidate the under‐researched, underdiagnosed and misunderstood comorbid pica in the context of psychosis. Method: We report a case of teen‐onset plastophagia in an antipsychotic‐naïve girl at ultra‐high risk (UHR) for psychosis. Results: HA is a 17‐year‐old unmarried girl who had a history of good premorbid functioning, no personal psychiatric history and an uncle with schizophrenia. She was referred to our psychiatry department with the complaint of having the habit of eating plastic for about 2 years. A thorough clinical history revealed that she developed, since more than a year, difficulty in school and interpersonal functioning. After clinical evaluation, a diagnosis of UHR with major depressive disorder, iron deficiency anaemia and pica was made. Conclusion: We draw attention to the possibility of an overlap between the pathogenesis of pica and psychosis, and we highlight the importance of early diagnosis and management of both pica and UHR since they can lead to serious medical and mental consequences. [ABSTRACT FROM AUTHOR]

• Impulsivity—a prominent feature of psychotic disorders at the different stages of the disease—seems to be highly prevalent, can distinguish patients from healthy controls, and has a range of negative consequences on patients across the psychosis spectrum. • It remains unclear and understudied how impulsivity might differ across the course of psychosis and what impact it could have on clinical, psychological and functional outcomes in patients at the early stages of the disease. • Our findings showed that a substantial proportion of UHR individuals (38.7 %) were considered highly impulsive at baseline, with no significant changes over time having been noted in the scores of the three impulsivity dimensions over the 12-month follow-up period. • At 6 months of follow-up, higher 6-month attentional and motor impulsivity were significantly associated with lower quality of life and greater general psychological distress. In addition, higher baseline motor impulsivity significantly predicted more severe positive psychotic symptoms at 12 months of follow-up. • Given the identified impact of impulsivity on different aspects of patients' everyday lives, it appears to be worthwhile to consider it as one of the major assessment and treatment targets in young people in the prodromal phase of psychosis. Impulsivity is associated with serious detrimental consequences on physical, mental, behavioral and social aspects of health among patients with psychosis. The present prospective 12-month follow-up study aimed to determine the prevalence of highly impulsive individuals among Ultra High Risk (UHR) patients, how impulsivity evolves over the follow-up period, and whether impulsivity impacts clinical, psychological and functional outcomes in this population. UHR patients were invited to complete a battery of measurements at three-time points: at baseline, and at 6 and 12 months of follow-up. Impulsivity was assessed using both behavioral (the Wisconsin Card Sorting Test, WCST) and self-report (the Barratt Impulsiveness Scale, BIS-11) measures. Findings showed that at 6 months of follow-up, higher 6-month BIS-11 attentional and motor impulsivity were significantly associated with lower quality of life and greater general psychological distress. In addition, higher baseline BIS-11 motor impulsivity significantly predicted more severe positive psychotic symptoms at 12 months of follow-up. However, WCST scores did not show any significant associations with study variables at the different times of follow-up. Interventions targeting impulsivity in UHR individuals could help decrease psychological distress and positive psychotic symptoms' severity, as well as improve quality of life in UHR individuals. [ABSTRACT FROM AUTHOR]

Background: The use of social media networks has grown exponentially in the past decade. These forms of communication are concerning when considering mental health. There has been very little research to inform our understanding of how social media addiction (SMA) may relate to mental illness. Aims: We aimed to examine the link between SMA and Psychotic-Like Experiences (PLEs) in a sample of nonclinical Tunisian youth. Methods: The Positive Subscale of Community Assessment of Psychotic Experiences and the Arabic Social Media Addiction Scale (ASMAS) were administered to a total of 1007 college students (64.6% female; mean age = 21.9). Results: The majority of students (86.4%) spent their free time on the internet, and 98.5% reported regular use of social media networks. After controlling for demographic variables (gender, age) and substance use, the number of hours of social media use per day and the social consequences dimension of the ASMAS contributed significantly to the prediction of positive PLEs (bizarre experiences, perceptual abnormalities, persecutory ideation and magical thinking). Conclusions: Our results build on previous literature that mainly focused on general internet use, and consistently indicated an association between SMA and PLEs. SMA may be an important target for early intervention in psychosis. [ABSTRACT FROM AUTHOR]

Aim: Prior research has consistently demonstrated a relationship between childhood trauma (CT) exposure and an increased risk of developing psychotic‐like experiences (PLE) and disorders. Studying the link between CT and PLE in non‐clinical populations with or without genetic risk factors could help elucidate the etiopathogeny of psychotic disorders, by removing the effect of confounding variables related to psychotic‐spectrum illnesses. Method: A total of 60 non‐affected siblings of patients with schizophrenia and 75 controls (aged 18‐35 years) participated in a cross‐sectional survey. The Positive Subscale of Community Assessment of Psychotic Experiences (CAPE) and the CT Questionnaire were used. Results: We found no significant difference with regard to positive dimension of the CAPE between the two groups. Siblings have reported higher CAPE negative symptoms scores than controls (27.9 vs 24.2; P =.015), and more emotional abuse and physical neglect during childhood than controls. After controlling for demographic and psychosocial variables, sexual abuse, emotional neglect and physical neglect were positively related to positive psychotic symptoms in the control group, whereas no dimension of CT has been linked to these symptoms in the sibling group. Conclusion: The link between CT and psychosis seems to be complex, not only dependent on genetic vulnerability or early environmental factors shared by siblings of patients with psychotic disorders, but also several other confounding factors, including other psychopathological symptoms. Prevention strategies for individuals at genetic risk of psychosis should pay particular attention to CT as a potential predictor of sub‐clinical depression and psychosis. [ABSTRACT FROM AUTHOR]

• Higher rates of childhood trauma were reported across the spectrum of psychosis compared to the general population. • Few studies have examined the link between Childhood Trauma and psychotic-like experiences (PLEs) in community samples. • We found an association between a specific dimension of trauma, which is sexual abuse, and PLEs. • Our results add support to the usefulness of probing previous sexual abuse during initial mental health screening. Current research has shown that experiencing childhood trauma may predispose individuals for psychosis and expression of Psychotic like experiences (PLEs). We aimed to examine the prevalence and characteristics of PLEs and depressive and negative experiences in a sample of Tunisian college students, and to evaluate the impact of childhood traumas in the occurrence and severity of these experiences at the time of the survey. A total of 482 college students (63.7% female; aged 18–32) participated in a cross-sectional survey. The Positive Subscale of Community Assessment of Psychotic Experiences (CAPE) was used to measure PLEs. The Childhood Trauma Questionnaire was used to assess childhood trauma and neglect. 53.5% (n = 258) of the students reported at least one positive PLE 'nearly always', and 40.9% (n = 197) reported at least one negative PLE with this frequency. After controlling for demographic variables (gender, age) and psychosocial factors (drug use, depression, anxiety and stress), sexual abuse significantly contributed to PLEs. There is a need for further cross-cultural research regarding the phenotypal expression of PLEs and its associated variables. Child sexual abuse victims should receive systematic and complete psychological screening during their adolescence/ early adulthood including, among others, PLEs and psychotic symptoms. [ABSTRACT FROM AUTHOR]

• There is sufficient evidence that levels of suicidality are typically higher in individuals at ultra-high risk (UHR) for psychosis than in other clinical groups, such as help-seekers that reach UHR clinics but do not meet UHR criteria, and young people with first episode psychosis (FEP). • The limited studies that have focused on suicidal thoughts and behaviors in UHR populations were predominantly cross-sectional and most of them have emerged from western countries. In addition, there is a lack of research on the role of potential and well-established causal factors for suicidality in this population. • The present study contributes to the existing literature by providing novel prospective data on suicidality in UHR individuals from a previously unexplored country and region. • Our findings support previous evidence that the prevalence of suicidal ideation and behavior in UHR individuals is concerning, and suggest that a routine monitoring of suicide risk by early intervention services is highly required. • Some factors related to suicidal ideation and attempts have preliminarily been identified in the present study, and deserve further investigations, i.e. the duration of untreated illness, self-esteem levels, and the severity of psychotic symptoms. The limited studies that focused on suicidality in individuals at Ultra-High Risk (UHR) of psychosis were predominantly cross-sectional, emerging from Western countries. We aimed to examine suicide risk among Tunisian UHR and First Episode Psychosis (FEP) patients at baseline, and to evaluate the evolution and correlates of suicidal ideation over a 12-month period in the UHR group exclusively. 35 UHR (aged 22.8 ± 4.0 years, 45.7% male) and 33 FEP (aged 27.3 ± 4.8 years, 63.6% male) participants were included. The Comprehensive Assessment of at Risk Mental States, the Positive and Negative Syndrome Scale (PANSS), The Rosenberg Self-Esteem Scale, and The Multidimensional Scale of Perceived Social Support were used. No significant differences were found between the UHR and the FEP groups with regard to levels of suicidal ideation at baseline. Suicidal ideation scores showed a significant decrease over time in UHR participants (p =.014; η2=0.242). An increase in total PANSS scores at 1 year (Beta=0.03; p =.048; 95%CI 0.001, 0.060; η2=0.182) significantly increased suicidal ideation scores at 1 year in the UHR group. Our findings contribute to the limited body of evidence on this topic by providing new prospective data from a population, country and region that has never been researched previously. [ABSTRACT FROM AUTHOR]

Little consideration has been given to the impact of COVID-19 on people at risk of psychosis despite their particular preexisting vulnerability. We aimed to examine the role of coping strategies in determining the levels of fear in nonclinical students with high levels of self-reported schizotypal personality traits as compared to low-schizotypy controls. This was a cross-sectional survey. The Schizotypal Personality Questionnaire, the Fear of COVID-19 Scale and The Brief-Coping Orientation to Problems Experienced were used. High-schizotypy students had significantly higher maladaptive strategies scores and higher levels of fear of COVID-19 as compared to low-schizotypy students. Multivariate analyses have shown that high-schizotypy individuals were likely to rely on coping responses that are maladaptive (venting) and have potential exacerbating effects on fear of COVID-19, whereas low-schizotypy individuals were likely to use adaptive responses (acceptance) that seemed to be effective in reducing fear of COVID-19. This study provided preliminary cross-sectional evidence for a differential impact of COVID-19 on individuals according to their schizotypy features. However, larger longitudinal population-based studies are necessary to confirm our findings. • Little consideration has been given to the impact of COVID-19 on people at risk of psychosis. • The fear of COVID-19 may lead to the onset of psychotic symptoms in naïve psychiatric individuals. • High-schizotypy individuals exhibited high levels of fear of COVID-19. • High-schizotypy individuals were likely to rely on coping responses that are maladaptive. [ABSTRACT FROM AUTHOR]