SU9. Beyond Psychosis Risk: Introduction to a Broad at Risk Mental State

Abstract

Background: The development of the ultra-high risk (UHR) criteria for psychosis over 20 years ago created a new paradigm for research into sub-threshold states. While the UHR criteria connote a risk for subsequent psychotic disorders, they are also strongly cross-linked with other syndro-mal and functional outcomes. This refects the overlapping and nonspe-cifc nature of early psychopathology, calling for a subthreshold concept, which is more pluripotential: an extension of the UHR approach in order to encompass transdiagnostic targets. In this presentation, we will introduce the rationale and design of the "CHARMS" (Clinical High at Risk Mental State) study, aimed at validating a novel set of criteria to prospec-tively identify help-seeking young people at risk of developing a range of serious mental disorders. Method(s): The CHARMS study is a cohort study of help-seeking young people aged 12-25 years attending youth mental health services in Melbourne, Australia. New referrals meeting the CHARMS criteria are allocated to the CHARMS+ group; referrals under CHARMS threshold are allocated to CHARMS-group; referrals meeting criteria for a full-threshold disorder are excluded. Transition status and clinical/functional outcomes are reassessed at 6 and 12 months. Result(s): Twenty-seven participants from our youth mental health services have been recruited to date: 20 (74%) participants meeting CHARMS criteria (CHARMS+) and 7 (26%) participants under CHARMS threshold (CHARMS-). Of CHARMS+, 65% meet criteria for one CHARMS sub-threshold group, 25% for 2, and 10% for 3 or more. Six-month follow-up assessments will commence in October 2016. Preliminary data (baseline and follow-up) on approximately 60 participants will be presented at the conference. Conclusion(s): This study is the frst to introduce and validate a set of clinical criteria to identify a broader "at risk" patient population, facilitating young people's access to clinical services and early treatment by breaking down the reliance on current diagnostic silos. It will foster understanding of risk factors and pathogenic mechanisms that drive the onset of severe mental disorder and may introduce a new paradigm for the next generation of preventive intervention trials.