Characterizing psychosis risk traits in Africa: A longitudinal study of Kenyan adolescents

SCHIZOPHRENIA RESEARCH

卷:176

Article

Mamah, Daniel¹  Musau, Abednego³  Mutiso, Victoria N.³  Owoso, Akinkunle¹  Ben Abdallah, Arbi²  Cottler, Linda B.⁴  Striley, Catherine W.⁴  Walker, Elaine F.⁵  Ndetei, David M.^3,6 

[1] Washington Univ, Sch Med, Dept Psychiat, 660 S Euclid, St Louis, MO 63110 USA

[2] Washington Univ, Sch Med, Dept Anesthesiol, St Louis, MO 63110 USA

[3] Africa Mental Hlth Fdn, Nairobi, Kenya

[4] Univ Florida, Dept Epidemiol, Gainesville, FL USA

[5] Emory Univ, Dept Psychol, Atlanta, GA 30322 USA

[6] Univ Nairobi, Dept Psychiat, Nairobi, Kenya

关键词: Prodrome;    Psychosis;    Schizophrenia;    Kenya;    Africa;    Risk;   

DOI  :  10.1016/j.schres.2016.08.004

来源: Elsevier

【 摘 要 】

The schizophrenia prodrome has not been extensively studied in Africa. Identification of prodromal behavioral symptoms holds promise for early intervention and prevention of disorder onset. Our goal was to investigate schizophrenia risk traits in Kenyan adolescents and identify predictors of psychosis progression. 135 high-risk (HR) and 142 low-risk (LR) adolescents were identified from among secondary school students in Machakos, Kenya, using the structured interview of psychosis-risk syndromes (SIPS) and the Washington early recognition center affectivity and psychosis (WERCAP) screen. Clinical characteristics were compared across groups, and participants followed longitudinally over 0-, 4-, 7-, 14- and 20-months. Potential predictors of psychosis conversion and severity change were studied using multiple regression analyses. More psychiatric comorbidities and increased psychosocial stress were observed in HR compared to LR participants. HR participants also had worse attention and better abstraction. The psychosis conversion rate was 3.8%, with only disorganized communication severity at baseline predicting conversion (p=0.007). Decreasing psychotic symptom severity over the study period was observed in both HR and LR participants. ADHD, bipolar disorder, and major depression diagnoses, as well as poor occupational functioning and avolition were factors relating to lesser improvement in psychosis severity. Our results indicate that psychopathology and disability occur at relatively high rates in Kenyan HR adolescents. Few psychosis conversions may reflect an inadequate time to conversion, warranting longer follow-up studies to clarify risk predictors. Identifying disorganized communication and other risk factors could be useful for developing preventive strategies for HR youth in Kenya. (C) 2016 The Authors. Published by Elsevier B.V.

【 授权许可】

Free