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Published on: November 21, 2013
A Multidisciplinary Child-Adult Psychiatry Model to Refine the Risk of Psychotic Transition in Clinical High Risk
Romain Sibut1,2, Louise Rhetore1, Justine Besse3
1Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
None:
The concepts of Clinical High Risk of psychotic transition (CHRp) and emerging psychosis are rapidly evolving. Their development and assessment have been mainly driven by adult psychiatry. However, adolescents present developmental and psychological characteristics that the CAARMS does not fully explore. In CHRp adolescents, the specificity of the psychotic transition -i.e. the ability to distinguish early psychotic symptoms from other developmental or psychiatric phenomena- is low.The aim of this study is to illustrate the particularities of our Clinical High Risk of psychotic transition (CHRp) diagnostic outpatient clinic: Specialized Clinic for CHRp. The clinic is designed to improve the accuracy of identifying adolescents truly at risk of psychotic transition.We present the case of a 14-year-old girl referred to our outpatient clinic with suspected CHRp. This clinical case describes the different phases of her evaluation: the CAARMS assessment, the neurodevelopmental and attachment history, the collaborative interview and the summary.Combining adult psychiatry's expertise in emerging psychosis with the child and adolescent psychiatrist's specific knowledge of differential diagnoses and neurodevelopment at this age may enhance the accuracy of psychotic transition in CHRp adolescents.
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