Cognitive-behavioral therapy in ultra high risk states of psychosis (UHR)

Ultra-high risk of psychosis (UHR) is a condition associated with a higher risk of developing schizophrenia or another psychotic disorder as compared to the general population. Three groups of symptoms are reported to be related to UHR states: attenuated psychotic symptoms (APS), brief limited intermittent psychotic symptoms (BLIPS) and genetic risk and deterioration syndrome (GDR). In addition, specific cognitive deficits within attention, verbal and visual memory, executive functions and processing speed are all described as linked to UHR. UHR individuals also manifest negative cognitive beliefs and attribution biases, which affect their everyday lives. Hence, a first-line treatment recommended in UHR states is cognitive-behavioral therapy (CBT), whose effectiveness has been assessed across different studies. In this paper we describe the characteristics of UHR states, including specific cognitive difficulties they are linked with, alongside therapeutic recommendations and specificity of dedicated cognitive-behavioral treatment options.