Papers by Andrew Thompson
Psychiatric Bulletin, 2008
Health services research is vital in any medical specialty. In psychiatry, it has become more hig... more Health services research is vital in any medical specialty. In psychiatry, it has become more high-profile with the reconfiguration of different approaches to delivering care to patients. Research in this area often appeals to clinicians, who feel that the findings may be applicable to ‘real life’ clinical experience. However, many become disillusioned when faced with unexpected problems, not only with regulatory bodies such as ethics committees and funding organisations, but also by the practicalities of recruiting patients and involving fellow clinicians in their studies.
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Psychological Medicine, 2015
Background.Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor f... more Background.Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor functional outcome regardless of development of psychotic disorder. Studies examining longitudinal predictors of poor functioning have tended to be small and report only medium-term follow-up data. We sought to examine clinical predictors of functional outcome in a long-term longitudinal study.Method.Participants were 268 (152 females, 116 males) individuals identified as UHR 2–14 years previously. A range of clinical and sociodemographic variables were assessed at baseline. Functioning at follow-up was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS).Results.Baseline negative symptoms, impaired emotional functioning, disorders of thought content, low functioning, past substance use disorder and history of childhood maltreatment predicted poor functioning at follow-up in univariate analyses. Only childhood maltreatment remained significant in the multivariat...
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Schizophrenia Research, 2013
Only a few studies have examined affect recognition in clinical high-risk populations (Pinkham et... more Only a few studies have examined affect recognition in clinical high-risk populations (Pinkham et al., 2007; Addington et al., 2008; van Rijn et al., 2011). We have recently shown that impairment in emotion recognition in both modalities (facial and prosody) may be apparent before the full expression of psychotic illness (Amminger et al., 2012). This raises the question: do affect recognition deficits contribute to the functional impairment commonly seen in at-risk participants (Addington et al., 2011; Nelson et al., in press)? Another question that has not been resolved is whether psychopathology is associated with affect recognition deficits in the early stages of psychosis.
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Schizophrenia Research, 2014
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Schizophrenia Research, 2010
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Psychological Medicine, 2009
BackgroundNon-clinical psychosis-like symptoms (PLIKS) occur in about 15% of the population. It i... more BackgroundNon-clinical psychosis-like symptoms (PLIKS) occur in about 15% of the population. It is not clear whether adverse events during early development alter the risk of developing PLIKS. We aimed to examine whether maternal infection, diabetes or pre-eclampsia during pregnancy, gestational age, perinatal cardiopulmonary resuscitation or 5-min Apgar score were associated with development of psychotic symptoms during early adolescence.MethodA longitudinal study of 6356 12-year-old adolescents who completed a semi-structured interview for psychotic symptoms in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Prenatal and perinatal data were obtained from obstetric records and maternal questionnaires completed during pregnancy.ResultsThe presence of definite psychotic symptoms was associated with maternal infection during pregnancy [adjusted odds ratio (OR) 1.44, 95% confidence interval (CI) 1.11–1.86, p=0.006], maternal diabetes (adjusted OR 3.43, 95% CI...
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Early Intervention in Psychiatry, 2011
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Early Intervention in Psychiatry, 2012
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Early Intervention in Psychiatry, 2011
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British Journal of Psychiatry, 2009
BackgroundAdverse effects of maternal substance use during pregnancy on fetal development may inc... more BackgroundAdverse effects of maternal substance use during pregnancy on fetal development may increase risk of psychopathology.AimsTo examine whether maternal use of tobacco, cannabis or alcohol during pregnancy increases risk of offspring psychotic symptoms.MethodA longitudinal study of 6356 adolescents, age 12, who completed a semi-structured interview for psychotic symptoms in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort.ResultsFrequency of maternal tobacco use during pregnancy was associated with increased risk of suspected or definite psychotic symptoms (adjusted odds ratio 1.20, 95% CI 1.05–1.37, P = 0.007). Maternal alcohol use showed a non-linear association with psychotic symptoms, with this effect almost exclusively in the offspring of women drinking >21 units weekly. Maternal cannabis use was not associated with psychotic symptoms. Results for paternal smoking during pregnancy and maternal smoking post-pregnancy lend some support for a caus...
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British Journal of Psychiatry, 2008
BackgroundNon-clinical psychotic symptoms appear common in children, but it is possible that a pr... more BackgroundNon-clinical psychotic symptoms appear common in children, but it is possible that a proportion of reported symptoms result from misinterpretation. There is a well-established association between pre-morbid low IQ score and schizophrenia. Psychosis-like symptoms in children may also be a risk factor for psychotic disorder but their relationship with IQ is unclear.AimsTo investigate the prevalence, nature and frequency of psychosis-like symptoms in 12-year-old children and study their relationship with IQ.MethodLongitudinal study using the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. A total of 6455 children completed screening questions for 12 psychotic symptoms followed by a semi-structured clinical assessment. IQ was assessed at 8 years of age using the Wechsler Intelligence Scale for Children (3rd UK edition).ResultsThe 6-month period prevalence for one or more symptoms was 13.7% (95% CI 12.8–14.5). After adjustment for confounding variables, t...
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BMC Health Services Research, 2012
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Australian & New Zealand Journal of Psychiatry, 2011
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Journal of Affective Disorders, 2010
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Schizophrenia Research, 2011
There has been recent optimism with regard to improving the predictive validity of those individu... more There has been recent optimism with regard to improving the predictive validity of those individuals who develop a psychotic disorder from the "Ultra High Risk" (UHR) or putatively prodromal population using combinations of clinical variables. We aimed to test the recent results from a large collaborative consortium in an independent cohort from the PACE (Personal Assistance and Clinical Evaluation) clinic in Australia. The North American Prodrome Longitudinal Study (NAPLS) consortium study reported 5 important clinical predictive variables within their US sample of UHR patients: genetic risk with functional decline; high unusual thought content score; high suspicion/paranoia score; low social functioning and history of substance abuse. We examined the predictive validity of these variables using data from a cohort of 104 UHR patients from the PACE clinic in Melbourne, Australia. Cox regression was used to explore the relationship between these variables at baseline and transition to psychosis by 28months. Three of the five variables were found to be associated with transition in our sample: high unusual thought content scores; low functioning; and having genetic risk with functional decline. A combination of two out of three of these features produced a reasonable predictive validity (positive predictive value (PPV) 65.4%, sensitivity 37.3%, and specificity 87.2%) but with overall lower PPVs than that reported by the NAPLS consortium. Three out of five of the identified clinical predictors for transition to psychosis from the NAPLS study were replicated in an independent sample. Using a combination of clinical variables the predictive validity of determining whether a UHR individual develops a psychotic disorder was improved above UHR criteria alone. Although psychosis prediction is improved using this model, the probability of a person not developing psychotic disorder is still quite high at 35%.
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Social Psychiatry and Psychiatric Epidemiology, 2013
Both adolescent psychotic experiences and poor social functioning precede psychotic disorder; how... more Both adolescent psychotic experiences and poor social functioning precede psychotic disorder; however, whether poor social functioning is also a risk factor for rather than a consequence of adolescent psychotic experiences is not clear. We investigate this question as well as whether deterioration in social functioning confers the strongest risk of psychotic experiences and whether theory of mind ability mediates any association, in a large community sample. Measures of social functioning (peer problems and prosocial behaviour) at ages 7 and 11 and theory of mind ability and psychotic experiences at age 12 were collected in a large community sample (n = 3,592). The association between social functioning and psychotic experiences was examined using logistic regression models at each age and any additional impact of deterioration in social functioning between ages 7 and 11. The potential role of theory of mind as a mediator was also investigated. Peer problems at both ages were independently associated with psychotic experiences at age 12 (7 years OR 1.11 95 % CI 1.03, 1.20), (11 years OR 1.13 95 % CI 1.05, 1.22). Theory of mind ability did not mediate this association. The association was not restricted to those with deteriorating social functioning (interaction term; p = 0.49). Poor childhood social functioning precedes adolescent psychotic experiences. There was no evidence that those with deteriorating social functioning were at greatest risk.
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Schizophrenia Research, 2011
Improving the identification of clinical vulnerability to psychosis in help-seeking subjects is c... more Improving the identification of clinical vulnerability to psychosis in help-seeking subjects is crucial for refining risk stratifications and implementing intervention strategies. To define underlying dimensions of subclinical psychopathology in Ultra-High-Risk (UHR) subjects; to test their temporal stability and association with baseline clinical and functional features; and to evaluate their predictive value for subsequent transition to psychosis. 223 subjects meeting the Personal Assessment and Crisis Evaluation (PACE) criteria for UHR were assessed with the Comprehensive Assessment of At-Risk Mental States (CAARMS) and monitored for a period of up to three years. Data were analysed via principal component analysis (PCA), Spearman correlation analysis and Cox regression. PCA of the CAARMS yielded three orthogonal symptom clusters (negative, disorganized and perceptual-affective instability) with substantial temporal stability over a one-month time span. These clusters were strongly related to global functioning, quality of life, baseline major psychopathology and duration of symptoms before referral. The severity of the CAARMS disorganized component was the strongest predictor of transition to frank psychosis at follow-up. A dimensional approach to CAARMS-measured symptoms may refine current early identification heuristics and provide an alternative way to characterize UHR profiles complementary to the current categorical one.
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Schizophrenia Research, 2010
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Schizophrenia Bulletin, 2012
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Psychiatry Research, 2010
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Papers by Andrew Thompson