Clinical and functional characteristics of at-risk mental state among non-help seeking adolescents: a cross-sectional study

Abstract

Abstract Background At-risk mental state (ARMS) individuals are at high risk to develop psychosis. In addition to attenuated symptoms, ARMS is associated with cognitive and functional impairment. Aim Our study goal was to explore prevalence rates of ARMS, comorbidities, functioning, and cognitive performance among non-help seeking adolescents. Methods In a cross-sectional design, a sample of high school students were examined with Comprehensive Assessment of At Risk Mental States interview. All participants were administered Kiddie-Schedule for Affective Disorders and Schizophrenia, Social and Occupational Functioning Assessment Scale (SOFAS), KIDSCREEN-52, and a battery of cognitive tests. Results The total of 82 adolescents was enrolled, 21 of them met the ARMS criteria. Subthreshold mental disorders were more frequent in the at-risk mental state positive (ARMS+) group than in the at-risk mental state negative (ARMS-) group. Lower score in (SOFAS) were observed in the ARMS+ group compared to the ARMS- group. In the total sample, high risk symptoms intensity was negatively associated with the SOFAS score. No significant differences in the KIDSCREEN-52 scores or cognitive functioning were found between the groups. Conclusion Our findings suggest that non-help seeking adolescents with at-risk mental state have worse level of functioning compared to controls and higher rates of non-psychotic psychiatric comorbidities. In the management of ARMS individuals, the guidelines recommend non-pharmacological interventions as the first-line option, pharmacotherapy with antipsychotics is reserved for non-responders, more severe, or progressive high-risk symptoms.