Early intervention for ultra-high risk youth in Japan: clinical practice in three leading centres

Presentation First Author: 
Masahiro Katsura

Background: Clinical observations of at-risk mental state (ARMS), including transition rates to psychosis, have largely emerged from research on Western populations. In Japan, several research centres provide clinical services for ARMS; however, studies at each site have involved small samples, limiting their statistical power. Thus, we combined samples from three leading centres to produce large-scale multi-centre datasets of Japanese observations. Methods: Clinical information on ARMS samples were gathered from specialised services for ARMS from Toho, Tohoku, and Toyama Universities. Each centre identified individuals with ARMS using ultra-high risk criteria and adopted a case-by-case approach to treatment, which included psychosocial interventions and antipsychotic medication, if necessary. Results:A total of 313 individuals with ARMS (mean age, 21.2 ± 7.5 years; male, 38.0%) were identified by March 2014. Nearly half of referral sources were psychiatrists or psychosomatic physicians, while about a quarter of individuals were self-referred. A third had comorbid diagnoses of anxiety disorders, and about a quarter, mood disorders at baseline. Preliminary analysis showed that 36 (15.7%) of the 228 individuals who were followed-up at 12 months had developed full-blown psychosis. Discussion: The present study gathered a relatively large dataset of ARMS observations in Japan, and replicated previous major Western studies in terms of most clinical characteristics and psychosis transition rates. However, it remains unclear as to whether individuals with ARMS can be properly identified and treated in general clinical settings other than specialised research centres. Development of an educational programme on ARMS for mental health professionals in Japan seems helpful.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Naohisa Tsujino - Shimako Nishiyama - Yoko Baba - Noriyuki Ohmuro - Yuko Higuchi - Tsutomu Takahashi - Takahiro Nemoto - Hiroo Matsuoka - Michio Suzuki - Masafumi Mizuno - Kazunori Matsumoto
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