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Previous studies have shown an association between hopelessness and suicidal behaviour in clinical populations. The aim of the study was to investigate sensitivity, specificity, and predictive validity of the Beck Hopelessness Scale (BHS) for suicidal ideation in adolescents who show early risk signs on the psychiatric disorder continuum. Three-hundred and two help-seeking adolescents (mean age = 15.5 years) who were entering an early intervention team at Helsinki University Central Hospital, Finland, completed questionnaires of BHS and suicidal ideation, derived from Beck Depression Inventory (BDI-II). Results suggest that a BHS cut-off score ≥8 (sensitivity = 0.70, specificity = 0.76) or cut-off score ≥9 (sensitivity = 0.63, specificity = 0.80) may be useful to detect suicidal ideation with BHS in help-seeking adolescents population. Results remain mainly the same in a separate analysis with adolescents at risk for psychosis. The results support previous cut-off points for BHS in identification of suicidal ideation. The results suggest also that lower cut-off scores may be useful in sense of sensitivity, especially in clinical settings.

Aim: In the recent literature, there has been growing interest in assessment methods for detecting increased risk of developing psychosis. Self-report methods are popular but may lead to different results compared to clinical interviews., Methods: The difference in psychosis risk scores was tested between self-reported psychosis risk symptoms (PROD-SR) and self-reported symptoms additionally confirmed by interview (PROD-SR + I). The symptom categories were derived from 12 common psychosis risk symptoms included in the PROD screening instrument. The data were collected by questionnaires and interviews conducted with 395 adolescents (mean age 15.3 years) in an early intervention and detection team, JERI, at Helsinki University Central Hospital, Finland., Results: The results show a significant difference between the PROD-SR risk symptom sum scores and the PROD-SR + I risk symptom sum scores (N = 395; Z = -15.123; P < 0.001). In an item-by-item analysis, the item 'Disorders in connection with hearing' had the strongest kappa value (0.827) agreement between an interviewed and self-report psychosis risk item. Agreement in most items remained between slight and substantial (kappa values from 0.082 to 0.649)., Conclusions: The results suggest that there is a significant difference between psychosis risk symptom responses collected by self-report and self-report responses which are additionally confirmed by interview. Auditory disorders are the most reliably reported item with self-report., (© 2014 Wiley Publishing Asia Pty Ltd.)

The aim of the present study was to compare change in functioning, affective symptoms and level of psychosis-risk symptoms in symptomatic adolescents who were treated either in an early intervention programme based on a need-adapted Family- and Community-orientated integrative Treatment Model (FCTM) or in standard adolescent psychiatric treatment (Treatment As Usual, TAU). 28 pairs were matched by length of follow-up, gender, age, and baseline functioning. At one year after the start of treatment, the matched groups were compared on change in functioning (GAF-M), five psychosis-risk dimensions of the Structured Interview for Psychosis-Risk Syndromes (SIPS), and self-reported anxiety, depression, and hopelessness symptoms (BAI, BDI-II, BHS). FCTM was more effective in improving functioning (20% vs. 6% improvement on GAF-M), as well as self-reported depression (53% vs. 14% improvement on BDI-II) and hopelessness (41% vs. 3% improvement on BHS). However, for psychosis-risk symptoms and anxiety symptoms, effectiveness differences between treatment models did not reach statistical significance. To conclude, in the present study, we found greater improvement in functioning and self-reported depression and hopelessness among adolescents who received a need-adapted Family- and Community-orientated integrative Treatment than among those who were treated in standard adolescent psychiatry., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: Health-related quality of life (HRQoL) is a widely studied phenomenon in health care. This study aimed to identify which factors can be extracted from a generic 16-dimension (16D) HRQoL instrument in a sample of adolescents seeking help for early psychiatric symptoms., Methods: Data were collected at the Helsinki University Central Hospital (HUCH), Finland, by an early intervention team. In total, 394 help-seeking adolescents (mean age 15.3 years, SD 2.14 years, 183 boys and 211 girls) completed a 16D HRQoL questionnaire., Results: Exploratory factor analysis (generalized least squares method, promax rotation) identified four factors in the 16D instrument. The first factor of "psychophysiological health" included the dimensions of vitality, breathing, distress, sleeping, physical appearance, mental functioning and depression. The second factor, "physical and social health", consisted of the items discomfort and symptoms, friends and elimination. The items hearing, eating and speech were loaded on factor three, "health in somatosensory functioning". Moreover, the single item of school and hobbies was loaded on factor four, "health in functioning ability". However, the items of vision and mobility were not loaded on any factor. Since the 16D instrument was originally designed for 11-15-year-old adolescents, analysis was repeated using a subsample of this age group (n = 245)., Conclusions: The results here suggest that the 16D instrument consists of four factors and forms its own latent variable structure in this specific sample of adolescents seeking help for early psychiatric symptoms. However, items such as vision, mobility and school and hobbies should be interpreted with caution as a part of the factor structure of a 16D instrument among this population.

Aim: There is some previous evidence suggesting that the risk state for psychosis is associated with decreased functioning ability, health-related quality of life (QoL), anxiety and depression. The aim of this study is to identify which factors predict psychosis risk screening status., Methods: The data were collected in Helsinki University Central Hospital, Finland, by an early intervention team. One hundred eighty-one help-seeking adolescents (mean age 15.3 years) completed questionnaires of QoL (16D), alcohol consumption (Alcohol Use Disorders Identification Test), anxiety (Beck Anxiety Inventory), hopelessness (BBeck Hopelessness Scale) and depression (Beck Depression Inventory II). Functioning ability was assessed by the Global Assessment of Functioning, whereas the PROD-screen was used to interview and assess risk symptoms for psychosis., Results: In a logistic regression analysis, a lower functioning ability explained independently (P = 0.006) psychosis risk screening status after age, gender, alcohol consumption, QoL, anxiety, hopelessness and depression symptoms were adjusted., Conclusions: The present results suggest that lower functioning ability is associated independently with psychosis risk screening status. Hence, therapeutic input for those at risk should focus upon improving functioning., (© 2014 Wiley Publishing Asia Pty Ltd.)

Previous studies have shown an association between suicidal behavior and schizophrenia. However, little is known about this association in those with psychotic experiences and symptoms that do not meet the criteria for full psychosis. The aim of the study was to investigate how psychosis risk symptoms are associated with suicidal ideation. Three-hundred and nine help-seeking adolescents (mean age 15.5 years) who were screened by an early intervention and detection team JERI in Helsinki University Central Hospital, Finland, were interviewed and asked to complete questionnaires of psychosis risk symptoms, suicidal ideation and depression. Psychosis risk symptoms were assessed by self-report and confirmed by interview with questions from PROD-screen, depression was measured with BDI-II questionnaire and suicidal ideation was derived from BDI-II questionnaire. In a logistic regression analysis psychosis risk symptom visual distortions explained independently (OR 4.33; 95% CI 1.28-14.64) suicidal ideation when age, gender, depression and psychosis risk symptoms thought disorders, persecuting feelings and auditory distortions were controlled for. Results suggest that visual distortions are independently associated with suicidal ideation in young people. This finding should be taken into account in assessing help-seeking adolescents., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Background: Several studies have reported on how anxiety disorders and anxiety symptoms are already present before the onset of psychosis. However, anxiety disorders are typically studied in these studies at diagnosis-level. The aim of present study was to investigate the profile of anxiety symptoms in subjects at risk of developing psychosis and to compare the anxiety profile with those who are not at risk., Method: Data were collected at Helsinki University Central Hospital (HUCH) by an early detection and intervention team. Of 185 help-seeking respondents, between 12 and 18 years of age, 59 adolescents were classified as being at risk of psychosis and 126 as not being at risk via an interview conducted by a validated at-risk assessment tool (PROD). Anxiety was measured using the Beck Anxiety Inventory (BAI)., Results: The anxiety total sum score was higher in the at-risk group for psychosis (mean 8.33 vs. 13.34, p = .000). Both subfactors of the anxiety scale, cognitive anxiety (p = .000) and somatic anxiety (p = .000), differed significantly by risk status. After using the Bonferroni correction for multiple analysis, items of relax (p = .000), nervous (p = .002), losing control (p = .000) and faint (p = .002) had statistically significant higher mean scores in the group at risk of psychosis. In logistic regression analysis, being female (p = .015) and the subfactor relating to cognitive anxiety (p = .044) significantly explained the at-risk status for psychosis., Conclusions: Adolescents at risk for psychosis have a higher level of anxiety compared with other help-seeking adolescents. These results should be considered in clinical practice., (© 2012 The Authors. Child and Adolescent Mental Health. © 2012 Association for Child and Adolescent Mental Health.)

Aim: Schizophrenia is a severe illness associated with poor health-related quality of life (HRQoL), and there is some evidence that a risk state for psychosis is associated with decreased HRQoL. The aim of the present study was to investigate group differences in HRQoL in help seekers at risk for psychosis and not at risk for psychosis., Methods: The data were collected by a Finnish early detection and intervention team at Helsinki University Central Hospital. A total of 202 help-seeking adolescents (110 girls, 92 boys; 11-22 years of age) were assessed with a PROD screen and HRQoL scale of 16D., Results: As the main result, subjects at risk for psychosis had a poorer HRQoL index than other help seekers (P < 0.001). An additional analysis of sub-items for the HRQoL at-risk group had poorer mean scores at a statistically significant level after Bonferroni correction for multiple tests in the following sub-items: vitality (P = 0.016), distress (P = 0.016), physical appearance (P < 0.001), school and hobbies (P = 0.016), friends (P = 0.048), mental function (P < 0.001) and depression (P < 0.001). In a logistic regression analysis of sub-items of the HRQoL scale, lower scores in the sub-item of mental function independently explained the at-risk status for psychosis (P = 0.009)., Conclusions: Adolescents at risk for psychosis have a poorer HRQoL index than other help seekers and they also differ in several sub-items, particularly in the lower scores in mental function. In the future, these findings should be considered in the care of adolescents at risk for psychosis., (© 2013 Wiley Publishing Asia Pty Ltd.)

Background: Little is known about how symptoms are changed in adolescents who receive treatment in an early detection and intervention service., Aims: The aims of the present research were to study change in depression, anxiety and hopelessness symptoms in a sample of help-seeking adolescents who participated in a community- and family-oriented early intervention programme., Methods: The data was collected in Helsinki University Central Hospital (HUCH), Finland, by the JERI (Jorvi Early psychosis Recognition and Intervention) early intervention team; 85 help-seeking adolescents filled questionnaires of anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory II) and hopelessness (Beck Hopelessness Scale). The PROD screen was used to assess risk of psychosis., Results: Paired samples t-test of anxiety, depression and hopelessness showed statistically significant improvement on all scales (P < 0.001) in all participants (n = 85) between baseline and the end of intervention. Improvement was significant on scales of anxiety (P = 0.004), depression (P < 0.001) and hopelessness (P < 0.001) for participants at risk of psychosis (n = 34). Effect sizes were from medium to large for changes. After the treatment, of all participants, 68.8% were at a remission level of symptoms in anxiety, 84.7% in symptoms of depression and 88.2% in symptoms of hopelessness. Of sub-group of participants at risk of psychosis, 58.8% were at a remission level of symptoms in anxiety, 76.4% in symptoms of depression and 79.4% in symptoms of hopelessness., Conclusions: Present results suggest that there is both statistically and clinically remarkable improvement in anxiety, depression and hopelessness symptoms after the intervention. These findings should be considered in the psychiatric care of help-seeking adolescents and adolescents at risk of psychosis.

Abstract Objective. Early intervention has been shown to benefit people at-risk for psychosis, but knowledge about how early intervention benefits all help-seeking adolescents is lacking. The aim of the present study was to study change in health-related quality of life (QoL) and functioning ability in help-seeking adolescents who participate in a community- and family-oriented early intervention program. Methods. The data was collected in Finland by an early-intervention team. Ninety help-seeking adolescents between 12 and 21 years of age filled out a questionnaire on QoL (16D) and functioning ability (GAF), which was assessed by workers at the beginning and at the end of the intervention. A PROD screen was used to assess heightened risk of developing psychosis. Results. QoL and functioning ability showed significant differences (p < 0.001) between the beginning and the end of the intervention, as well in a subgroup of participants at heightened risk of developing psychosis (QoL, p = 0.008; GAF, p < 0.001: n = 35). 35.6% improved over the clinical cut-off point in functioning ability and 48.6% of the subjects at-risk. 53.3% reached clinically significant improvement in QoL and 54.2% of the subjects at heightened risk of developing psychosis. Conclusions. The results suggest that there is both statistically and clinically remarkable improvement in QoL and functioning ability after a need-adapted, family- and community-oriented intervention.

Background: Hopelessness has been a widely studied phenomenon in psychotic disorders. However, previous evidence of hopelessness in at-risk state of psychosis is lacking. The primary aim of the present study was to investigate associations between at-risk state of psychosis and the level of hopelessness, the secondary aim being to investigate, at item-level, hopelessness differences in hopelessness profile of adolescents at risk of psychosis., Methods: Hopelessness was assessed with the Beck Hopelessness Scale (BHS) and risk of psychosis with the PROD screen by an early detection team at the Helsinki University Central Hospital in a sample of 200 help-seeking adolescents between 11 and 22 years of age. Of them, 66 were classified as belonging to the at-risk of psychosis group and 134 to the not-at-risk of psychosis group., Results: The at-risk group scored higher in total sum scores of hopelessness than the not-at-risk group (9.15 vs. 6.63, P = 0.002). In an additional analysis of the BHS, the sub-item "I have great faith in the future" (P < 0.001) differed by risk status of psychosis after correction for multiple analysis. In a logistic regression analysis, BHS subfactor III (sum scores of items "I can't imagine what my life would be like in 10 years" and "I don't expect to get what I really want") explained (P = 0.047) the at-risk status of psychosis after age, gender and other BHS subfactors had been adjusted for., Conclusions: Adolescents at risk of psychosis have higher hopelessness than other help-seekers. In light of a heightened possibility of suicidal behaviour, psychiatric care should pay attention to these findings.

Background: Depression and psychosis are severe diseases with onset in adolescence., Aims: The aim of this study was to investigate the association between an at-risk status of psychosis and depression symptoms in adolescents., Method: The data were collected by an early intervention team in Finland. The PROD screen was used to assess the risk of psychosis, and Beck Depression Inventory-II was used as a measurement to assess the level of depression symptoms. Of 203 help-seeking respondents, 66 were classified as at-risk for psychosis, and 137 respondents were other help-seekers. The mean age of the subjects was 15.3 years., Results: Subjects at-risk had significantly poorer scores in total scores for depression (p  <  0.001), and in an item-by-item analysis, the subjects at-risk had poorer scores for sadness (p  <  0.001), past failure (p  =  0.001), suicidal thoughts (p  <  0.001), crying (p  =  0.002), agitation (p  =  0.001), loss of energy (p  =  0.002) and concentration difficulty (p  <  0.001). In a logistic regression analysis of items that differed by risk status for psychosis, item of concentration difficulty (p  =  0.038) explained the at-risk status after adjustment for sex., Conclusions: The present results suggest that subjects that are at-risk for psychosis have more depression symptoms than other help-seekers. This should be considered in the psychiatric care of adolescents.

Aim: Assessing potential risk of developing psychosis has gained growing attention in recent literature. The selection of suitable assessment methods is the central question for this research endeavour. Whereas prodromal detection instruments are mostly interview-based instruments, there are short screening instruments for self-report use., Methods: Difference in psychosis risk scores was tested between self-report results and interview results, with risk symptoms of psychosis included in PROD screening instrument. Subjects were recruited by an early intervention team in Finland., Results: There was a significant difference between psychosis risk scores based on self-report versus interview in a sample of adolescents (n=87; P<0.001)., Conclusions: Results suggest that when using screening instruments, risk scores and risk status may vary by the method the information is collected. Checking self-report results by an additional interview is recommended for both clinical and scientific uses., (© 2011 Blackwell Publishing Asia Pty Ltd.)

Aim: As research in the care of people at risk of developing first-episode psychosis has mostly focused on cognitive behavioural therapy and antipsychotic medication, little is known about associations between changes in mental well-being and effect of people participating in the care., Methods: Multiprofessional early intervention team met with adolescents who are at risk of psychosis, including coworkers and their families. Correlations were calculated between change scores in prepsychotic, functioning ability, quality of life (QoL), depression and anxiety scales, and number of family, coworker and adolescent-participating social network meetings, and total number of social network meetings during the care., Results: Larger change scores in functioning ability were positively associated with the number of social network meetings with participating coworker (P = 0.041), but not with other types of participant meetings. Larger change scores in prepsychotic symptoms were positively associated with the number of meetings where the adolescent was participating (P = 0.001), the number of network meetings where the coworker was participating (P = 0.007) and the number of all meetings (P = 0.001). The number of any other type of meetings did not associate with change scores in QoL, depression and anxiety., Conclusion: According to the present results, adolescents at risk of psychosis seem to benefit from the inclusion of coworkers from the adolescents' natural surroundings in care; this could help to increase functioning ability. Different combinations of meetings, such as larger number of total meetings, larger number of meetings with the adolescent and larger number of meetings with coworkers from the adolescents' natural surroundings, seem to associate with stronger decrease in pre-psychotic symptoms., (© 2011 Blackwell Publishing Asia Pty Ltd.)

Background: While functioning ability, quality of life (QoL) and depression are widely studied phenomena in schizophrenia, little is known about functioning ability, QoL and depression, especially among adolescents at high risk of developing first-episode psychosis., Aim: To investigate associations between high risk of developing psychosis and functioning ability, depression and QoL among adolescents., Methods: The data was collected by an early intervention team in Espoo, Finland, between 1 January 2007 and 31 May 2008. Subjects at high risk of developing psychosis were compared with subjects not at high risk in terms of functioning ability (GAF), QoL (16D) and depressive symptoms (RBDI) in a cross-sectional setting. The study was conducted with 80 adolescents (mean age 14.7, range 12-18 years)., Results: Those at high risk of developing psychosis had significantly lower and poorer scores in functioning ability (53.4 vs. 58.4, P=0.006), had higher and poorer scores in QoL (10.81 vs. 7.05, P=0.002) and higher and poorer scores in depression (8.95 vs. 4.76, P=0.001) than those who did not meet the criteria of being at high risk of developing psychosis. Poorer functioning ability independently explained being at high risk of developing psychosis at a statistically significant level (P=0.021) in a logistic regression analysis after age, gender, depression and QoL were adjusted for., Conclusions: Poor functioning ability seems to be associated with high risk of developing psychosis among adolescents.

Watching television, video and computer games, and internet constitute a significant part of children's leisure time. High media exposure, however, increases the risk of psychosocial symptoms in children, such as aggressions, difficulties of behavioral regulation and concentration. In particular, media violence is thought to be harmful for children's well-being. Although the risks associated with media exposure may at least partly reflect the accumulation of social risk factors, they also seem to have an independent role as a factor increasing the symptoms. It is likely that the adverse effects of media can be lessened by providing guidance for parents.

Aim: Being at high risk of developing psychosis has been suggested to be a result of a combination of acute life stressors and trait-like vulnerability to psychosis. Reducing levels of stress could support overall functioning and mental condition in those at risk., Methods: The Jorvi Early Psychosis Recognition and Intervention (JERI) project at Helsinki University Central Hospital, Jorvi Hospital, Finland, is an early intervention team for adolescents at risk of developing first-episode psychosis. The project is based on the idea of multiprofessional, community, home, family and network-oriented, stress-reducing, overall functioning-supporting, low-threshold care. The JERI team meets multiprofessionally with adolescents in their natural surroundings, for example, at school or at home, together with their parents, network and community co-worker, who has originally contacted the JERI team because of unclear mental health problems. Subjects were assessed with the PROD-prodromal screen to identify those at risk of developing first-episode psychosis., Results: Statistically significant difference between baseline and follow-up measures was found in at risk subjects (n = 28) in scales of overall functioning (P = 0.000), depression (P = 0.001), anxiety (P = 0.001), quality of life (QOL) and pre-psychotic symptoms., Conclusions: JERI-type intervention may improve level of overall functioning and support mental condition in adolescents at risk of developing first-episode psychosis, even though further study with larger numbers of subjects, with a control group and with a longer follow-up time, is needed., (© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.)

The aim of this study was to investigate the effects of various forms of TV exposure on the quality of children's sleep. In this randomized population-based survey questionnaires concerning TV viewing, sleep disturbances, and psychiatric symptoms were administered to 321 parents of children aged 5-6 years. Sleep disturbance scores were the main outcome measures. Active TV viewing and passive TV exposure were related to sleeping difficulties, especially sleep-wake transition disorders and overall sleep disturbances. Particularly, passive TV exposure and viewing adult-targeted TV programs were strongly related to sleep disturbances. The association remained significant when socioeconomic status, family income, family conflicts, the father's work schedule, and the child's psychiatric symptoms were controlled statistically. The adjusted odds ratios were 2.91 (95% CI 1.03-8.17) and 3.01 (95% CI 1.13-8.05), respectively. TV viewing and particularly passive TV exposure and viewing adult-targeted programs significantly increase the risk of sleeping difficulties. The results suggest that health-care professionals should be aware of the association between TV exposure and sleep disturbances.