Psychiatria pre prax 1/2016

Attenuated psychosis syndrome in DSM-5 and cognitive behavioural therapy

For the past twenty years, there has been increasing academic interest in people presenting with potentially prodromal symptoms. A consistent feature of late prodromes is the presence of attenuated or subthreshold psychotic features. These differ from frank psychotic symptoms in their intensity, frequency and duration. Attenuated psychosis syndrome (APS) was introduced in DSM-5 as a condition for further study. Early detection and intervention in people at ultra-high risk of developing psychosis can be succesful to prevent or at least delay a first episode of psychosis. Cognitive behavioural therapy (CBT) has become an evidence-based treatment option for these people in recent years and metaanalysis showed that conversions to psychosis can be reduced in about 50%. CBT should be offered as first line therapy to ultra-high risk patients. The aim of this paper is to bring an overview of the latest knowledge of the issue.

Keywords: prodrome, psychosis, subclinical psychotic symptoms, at risk mental state, cognitive behavioural therapy