[ENGAGE] Enhancing prediction and building novel interventions for youth at high risk for psychosis
Speaker
Dr. Vijay A. MittalLocation
Sage Room, Psych. 1312Info
Up to 1/3rd of adolescents and young adults showing risk signs and subtle symptoms (i.e., those meeting criteria for a clinical high-risk syndrome) will go on to develop a psychotic disorder such as schizophrenia in a two-year period. The syndrome has received a good deal of attention because if clinicians can intervene early, they may be able to lessen or prevent the progression of illness progression all together. But it is currently difficult to determine who is mostly likely to transition to formal psychosis and further, while treatments that are typically effective for formal psychotic disorders show some promise here, limitations around cost, availability, and side-effects, complexity unique to the risk syndrome (e.g., heterogeneity), and factors related to a characteristically young and developing population (e.g., dynamic and changing treatment targets, equi/multifinality) get in the way of adherence, clinically meaningful efficacy, or wide-spread implementation. Novel risk-markers and treatments are required, but where will these come from? In this presentational I will discuss a series of studies from my laboratory that went from naturalistic and exploratory work (detecting and confirming a signal), to experiments (homing in on the problem), to pilot investigations (testing mechanism engagement and refining parameters), and finally to the eventual implementation of randomized controlled trials aimed at improving prediction and treatment of this critical population. First, I will discuss a program of research that interrogates overlap between mechanisms driving the onset of psychosis and circuits regulating the motor system, and present work that utilizes movement abnormalities to identify high-risk youth mostly likely to later develop psychosis. Next, I will turn toward discussing how findings of progressive hippocampal impairment in those at risk for psychosis eventually lead to the development of an efficacious exercise intervention targeting symptom progression. Finally, I will discuss barriers and resulting opportunities that have come up in the course these projects and provide suggestions for those looking to engage in similar work.
