Boldrini Tommaso, Lo Buglio Gabriele, Schiano Lomoriello Arianna, Barsanti Alice, Cordova Elena, De Salve Francesca, Gennaro Alessandro, Girardi Paolo, Göksal Renan, Katagiri Naoyuki, Kim Sung-Wan, Lavoie Suzie, Lingiardi Vittorio, Malvini Lara, McGorry Patrick D, Miola Alessandro, Nelson Barnaby, Oasi Osmano, Percudani Mauro, Placenti Claudio, Pontillo Maria, Rossi Chiara, Salcuni Silvia, Takahashi Tsutomu, Vicari Stefano, Polari Andrea
Department of Psychology and Educational Science, Pegaso Telematic University, Naples, Italy.
Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Asian J Psychiatr. 2024 Dec;102:104254. doi: 10.1016/j.ajp.2024.104254. Epub 2024 Sep 26.
The current range of labeling terms-at-risk mental state (ARMS), ultra-high risk for psychosis (UHR), and attenuated psychotic syndrome (APS)-used to refer to the psychosis-risk concept is varied, and their acceptability and potential stigma are not well understood. By involving Italian youth with lived experience of mental ill-health, we aimed to generate new labeling terms for psychosis-risk, and to evaluate literacy, attitudes, and preferences regarding these and the existing terms. Additionally, we investigated opinions of disclosure of the at-risk concept in clinical practice.
Through a dual-moderator focus group, novel diagnostic terms were coined for the at-risk concept: psychosis proneness (PP), change of personal reality (CPR), and hints of subjectivity dysregulation (HSD). A specifically designed questionnaire was then completed by 47 help-seeking youths, 60 relatives, and 61 clinicians to test newly generated and already established at-risk terms.
Literacy on already established terms was significantly lower among youth (mean= 42 %) and relatives (mean= 38 %). ARMS was the preferred and least stigmatizing term among young people and clinicians. UHR was considered the most stigmatizing label. Among newly generated terms, CPR was the least stigmatizing and most informative. Disclosure of at-risk terminology was generally preferred after establishing a trusting clinician-patient relationship.
Findings support ARMS as a useful and acceptable term in clinical practice with young people, while UHR is associated with the highest stigma. CPR is promising and should be tested in cross-cultural studies. In Italy, there is an urgent need for improving literacy on prevention in mental health.
目前用于指代精神病风险概念的一系列标签术语——处于风险中的精神状态（ARMS）、精神病超高风险（UHR）和精神病性症状衰减综合征（APS）各不相同，其可接受性和潜在污名化情况尚未得到充分理解。通过让有精神疾病生活经历的意大利年轻人参与进来，我们旨在为精神病风险生成新的标签术语，并评估对这些术语以及现有术语的认知度、态度和偏好。此外，我们调查了在临床实践中披露风险概念的观点。
通过一个双主持人焦点小组，为风险概念创造了新的诊断术语：精神病易感性（PP）、个人现实改变（CPR）和主观调节失调迹象（HSD）。然后，47名寻求帮助的年轻人、60名亲属和61名临床医生完成了一份专门设计的问卷，以测试新生成的和已有的风险术语。
年轻人（平均=42%）和亲属（平均=38%）对现有术语的认知度显著较低。ARMS是年轻人和临床医生中最受欢迎且污名化程度最低的术语。UHR被认为是污名化程度最高的标签。在新生成的术语中，CPR的污名化程度最低且信息最丰富。在建立信任的医患关系后，通常更倾向于披露风险术语。
研究结果支持ARMS作为在临床实践中与年轻人使用时有用且可接受的术语，而UHR的污名化程度最高。CPR很有前景，应在跨文化研究中进行测试。在意大利，迫切需要提高心理健康预防方面的认知度。
