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© 2021, The Author(s).Following the publication of the original article [1], the authors discovered a typographical error in the method section under the inclusion criteria subsection. The text “[the] inclusion criteria are as follows: (1) aged 16-65 years” should read “[the] inclusion criteria are as follows: (1) aged 15-65 years”. The authors were granted ethical approval for this age range by the MERC at Maastricht University Medical Centre (MUMC), The Netherlands reference: (NL46439.068.13) and the University Clinical Leuven, Belgium (reference: B322201629214). The typographical error therefore has had no implications for the RCT.

BackgroundEvidence suggests that cannabis use, childhood adversity, and urbanicity, in interaction with proxy measures of genetic risk, may facilitate onset of psychosis in the sense of early affective dysregulation becoming ‘complicated’ by, first, attenuated psychosis and, eventually, full-blown psychotic symptoms.MethodsData were derived from three waves of the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). The impact of environmental risk factors (cannabis use, childhood adversity, and urbanicity) was analyzed across severity levels of psychopathology defined by the degree to which affective dysregulation was ‘complicated’ by low-grade psychotic experiences (‘attenuated psychosis’ – moderately severe) and, overt psychotic symptoms leading to help-seeking (‘clinical psychosis’ – most severe). Familial and non-familial strata were defined based on family history of (mostly) affective disorder and used as a proxy for genetic risk in models of family history × environmental risk interaction.ResultsIn proxy gene–environment interaction analysis, childhood adversity and cannabis use, and to a lesser extent urbanicity, displayed greater-than-additive risk if there was also evidence of familial affective liability. In addition, the interaction contrast ratio grew progressively greater across severity levels of psychosis admixture (none, attenuated psychosis, clinical psychosis) complicating affective dysregulation.ConclusionKnown environmental risks interact with familial evidence of affective liability in driving the level of psychosis admixture in states of early affective dysregulation in the general population, constituting an affective pathway to psychosis. There is interest in decomposing family history of affective liability into the environmental and genetic components that underlie the interactions as shown here.

BackgroundThe jumping to conclusions (JTC) reasoning bias and decreased working memory performance (WMP) are associated with psychosis, but associations with affective disturbances (i.e. depression, anxiety, mania) remain inconclusive. Recent findings also suggest a transdiagnostic phenotype of co-occurring affective disturbances and psychotic experiences (PEs). This study investigated whether JTC bias and decreased WMP are associated with co-occurring affective disturbances and PEs.MethodsData were derived from the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). Trained interviewers administered the Composite International Diagnostic Interview (CIDI) at three time points in a general population sample (N = 4618). The beads and digit-span task were completed to assess JTC bias and WMP, respectively. CIDI was used to measure affective disturbances and an add-on instrument to measure PEs.ResultsCompared to individuals with neither affective disturbances nor PEs, the JTC bias was more likely to occur in individuals with co-occurring affective disturbances and PEs [moderate psychosis (1–2 PEs): adjusted relative risk ratio (RRR) 1.17, 95% CI 0.98–1.41; and high psychosis (3 or more PEs or psychosis-related help-seeking behaviour): adjusted RRR 1.57, 95% CI 1.19–2.08], but not with affective disturbances and PEs alone, whereas decreased WMP was more likely in all groups. There was some evidence of a dose–response relationship, as JTC bias and decreased WMP were more likely in individuals with affective disturbances as the level of PEs increased or help-seeking behaviour was reported.ConclusionThe findings suggest that JTC bias and decreased WMP may contribute to a transdiagnostic phenotype of co-occurring affective disturbances and PEs.

Background and status of (inter)national research: The current COVID-19 pandemic shows the relevance of resilience, which means good adaption despite adversity. In later life, resilience is closely connected with well-being and successful aging. High resilience in old age is a suitable explanation, [for full text, please go to the a.m. URL]

Aims Childhood trauma is associated with an elevated risk for psychosis, but the psychological mechanisms involved remain largely unclear. This study aimed to investigate emotional and psychotic stress reactivity in daily life as a putative mechanism linking childhood trauma and clinical outcomes in individuals at ultra-high-risk (UHR) for psychosis. Methods Experience sampling methodology was used to measure momentary stress, affect and psychotic experiences in the daily life of N = 79 UHR individuals in the EU-GEI High Risk Study. The Childhood Trauma Questionnaire was used to assess self-reported childhood trauma. Clinical outcomes were assessed at baseline, 1- and 2-year follow-up. Results The association of stress with positive (β = −0.14, p = 0.010) and negative affect (β = 0.11, p = 0.020) was modified by transition status such that stress reactivity was greater in individuals who transitioned to psychosis. Moreover, the association of stress with negative affect (β = 0.06, p = 0.019) and psychotic experiences (β = 0.05, p = 0.037) was greater in individuals exposed to high v. low levels of childhood trauma. We also found evidence that decreased positive affect in response to stress was associated with reduced functioning at 1-year follow-up (B = 6.29, p = 0.034). In addition, there was evidence that the association of childhood trauma with poor functional outcomes was mediated by stress reactivity (e.g. indirect effect: B = −2.13, p = 0.026), but no evidence that stress reactivity mediated the association between childhood trauma and transition (e.g. indirect effect: B = 0.14, p = 0.506). Conclusions Emotional and psychotic stress reactivity may be potential mechanisms linking childhood trauma with clinical outcomes in UHR individuals.

The work was supported by: Clinician Scientist Medical Research Council fellowship (project reference MR/M008436/1) to MDF; the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust to DQ; DFG Heisenberg professorship (no. 389624707) to UR. National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The EU-GEI Project is funded by the European Community’s Seventh Framework Programme under grant agreement No. HEALTH-F2-2010-241909 (Project EU-GEI). The Brazilian study was funded by the São Paulo Research Foundation under grant number 2012/0417-0., Quattrone, D., Ferraro, L., Tripoli, G., La Cascia, C., Quigley, H., Quattrone, A., Jongsma, H.E., Del Peschio, S., Gatto, G., Gayer-Anderson, C., Jones, P.B., Kirkbride, J.B., La Barbera, D., Tarricone, I., Berardi, D., Tosato, S., Lasalvia, A., Szöke, A., Arango, C., Bernardo, M., Bobes, J., Del Ben, C.M., Menezes, P.R., Llorca, P.-M., Santos, J.L., Sanjuán, J., Tortelli, A., Velthorst, E., De Haan, L., Rutten, B.P.F., Lynskey, M.T., Freeman, T.P., Sham, P.C., Cardno, A.G., Vassos, E., Van Os, J., Morgan, C., Reininghaus, U., Lewis, C.M., Murray, R.M., Di Forti, M.

Background: Most mental disorders first emerge in youth and, in their early stages, surface as subthreshold expressions of symptoms comprising a transdiagnostic phenotype of psychosis, mania, depression and anxiety. Elevated stress reactivity is one of the most widely studied mechanisms underlying psychotic and affective mental health problems. Thus, targeting stress reactivity in youth is a promising indicated and translational preventive strategy for adverse mental health outcomes later in life and for improving resilience. Compassion-focused interventions (CFIs) offer a wide range of innovative therapeutic techniques particularly amenable to being implemented as Ecological Momentary Interventions (EMIs), a specific type of mHealth intervention, to enable youth to access interventions in a given moment and context in daily life. This approach may bridge a gap in current youth mental health care. Objectives: The aim of this study will be to investigate the clinical feasibility, candidate underlying mechanisms and initial signals of efficacy of a novel, transdiagnostic, hybrid EMI for improving resilience to stress in youth (EMIcompass).Methods: In an exploratory randomized controlled trial (RCT), youth aged 14-25 with current distress, a broad Clinical High At-Risk Mental State (CHARMS) or a first episode of a severe mental disorder will be randomly allocated to the EMIcompass intervention (EMI plus face-to-face training sessions) in addition to treatment as usual (TAU) or a control condition of TAU only. Primary (stress reactivity) and secondary candidate mechanisms (resilience, interpersonal sensitivity, threat anticipation, negative affective appraisals, momentary physiological markers of stress reactivity) as well as primary (psychological distress) and secondary outcomes (primary psychiatric symptoms, general psychopathology) will be assessed at baseline, post-intervention and 4-week follow-up. Results: The first enrolment was in August 2019 and as of May 2021, enrolment and randomization has been completed (n = 92 participants). We expect the end of data collection in August 2021.Conclusions: The current study is the first to establish feasibility, evidence on underlying mechanisms, and preliminary signals of efficacy of a compassion-focused EMI in youth. If successful, a confirmatory RCT will be warranted. Overall, our approach has the potential to significantly advance preventive interventions in youth mental health provision. Trial registration: German Clinical Trials Register (DRKS), DRKS00017265; Date of registration: 31.07.2019.

Die stationsäquivalente psychiatrische Behandlung (StäB) wurde 2018 als neue Krankenhausleistung für Menschen eingeführt, die die Indikation für eine stationäre Behandlung erfüllen. Die rasanten Fortschritte im Bereich der Informations- und Kommunikationstechnologie bieten völlig neue Chancen für innovative digitale Versorgungsangebote wie telemedizinische, eHealth oder mHealth Verfahren. Ziel dieser Arbeit ist es einen umfassenden Überblick über neue digitale Versorgungsformen zu geben, die zur Personalisierung der StäB in der alltäglichen Lebenswelt bei schweren psychischen Erkrankungen beitragen und somit klinische und soziale Outcomes verbessern sowie direkte und indirekte Kosten reduzieren könnten. Es lassen sich vier primäre digitale Versorgungsformen identifizieren, die in diesem Sinne in der StäB gewinnbringend genutzt werden könnten: (1) Kommunikation, Behandlungskontinuität und -flexibilität durch Online-Chat und Videotelefonie; (2) Monitoring von Symptomen und Verhaltensweisen in Echtzeit durch Anwendung des ambulatorischen Assessments (Engl. Ecological Momentary Assessments (EMA)); (3) Nutzung von multimodalen EMA-Daten für die Generierung und Darbietung von personalisiertem Feedback über subjektives Erleben und Verhaltensmuster sowie (4) auf Person, Moment und Kontext zugeschnittene, adaptive ambulatorische Interventionen (Engl. Ecological Momentary Interventions (EMIs)). Neue digitale Versorgungsformen haben erhebliches Potential die Effektivität und Kosteneffektivität der aufsuchenden fachpsychiatrischen und psychotherapeutischen Behandlung zu steigern. Ein wichtiger nächster Schritt besteht nun darin, die Anwendung dieser Versorgungsformen im Bereich der StäB zu modellieren und deren Qualität aus Patientensicht, Sicherheit, und initiale Prozess- und Ergebnisqualität sowie Implementierungsbedingungen sorgfältig zu untersuchen. Abstract:Ward-equivalent treatment (StäB), a form of crisis resolution and home treatment in Germany, has been introduced in 2018 as a new model of mental health service delivery for people with an indication for inpatient care. The rapid progress in the field of information and communication technology offers entirely new opportunities for innovative digital mental health care such as telemedicine, eHealth, or mHealth interventions. This paper aims to provide a comprehensive overview of novel digital forms of service delivery in the daily lives of help-seeking individuals for personalized delivery of StäB that may contribute to improving clinical and social outcomes as well as reducing direct and indirect costs. Four primary digital forms of service delivery have been identified that can be used for personalized delivery of StäB: (1) communication, continuity of care, and flexibility through online chat and video call; (2) monitoring of symptoms and behaviour in real-time through ecological momentary assessment (EMA); (3) use of multimodal EMA data to generate and offer personalized feedback on subjective experience and behavioural patterns as well as (4) adaptive ecological momentary interventions (EMIs) tailored to the person, moment, and context in daily life. New digital forms of service delivery have considerable potential to increase the effectiveness and cost-effectiveness of crisis resolution, home treatment, and assertive outreach. An important next step is to model and initially evaluate these novel digital forms of service delivery in the context of StäB and carefully investigate their quality from the user perspective, safety, feasibility, initial process and outcome quality as well as barriers and facilitators of implementation.

Hintergrund und Stand (inter)nationaler Forschung: Studien aus früheren SARS und MERS-Epidemien zeigten eine erhebliche psychosoziale Belastung bei Personen in Quarantäne gezeigt, insbesondere Depressivität, Ängstlichkeit, Stress und posttraumatische Symptomatik. Besonders wurde [zum vollständigen Text gelangen Sie über die oben angegebene URL], 19. Deutscher Kongress für Versorgungsforschung (DKVF)

Digital interventions offer new avenues for prevention and treatment in youth. Ecological momentary interventions (EMIs) allow for adaptive and real-time delivery of intervention components in daily life. Compassion-focused interventions may be particularly amenable to translation into an EMI to strengthen emotional resilience in youth. We aimed to investigate initial therapeutic effects, feasibility, and safety of a novel, accessible, transdiagnostic, ecological momentary, compassion-focused intervention for improving emotional resilience (‘EMIcompass’) in an uncontrolled pilot study including help-seeking youth with psychotic, depressive, and/or anxiety symptoms. The EMIcompass intervention consisted of three sessions with a trained psychologist and a 3-week EMI administered through a mobile health app. In total, ten individuals (Mage=20.3 years) were included. Reduced stress sensitivity, momentary negative affect, and psychotic experiences as well as increased positive affect were found at post-intervention and 4-week follow-up. Further, reductions in psychotic, anxiety, and depressive symptoms of medium to large effect size were found (r=0.30-0.65). Most participants were satisfied (80%) and reported low burden of app usage. No adverse events were observed. Our findings provide initial evidence on beneficial effects, feasibility, and safety of the EMIcompass intervention in help-seeking youth. An exploratory randomised controlled trial is warranted to establish feasibility and preliminary evidence of efficacy.

Genetic discovery in psychiatry and clinical psychology is hindered by suboptimal phenotypic definitions. We argue that the hierarchical, dimensional, and data-driven classification system proposed by the Hierarchical Taxonomy of Psychopathology (HiTOP) consortium provides a more effective approach to identifying genes that underlie mental disorders, and to studying psychiatric etiology, than current diagnostic categories. Specifically, genes are expected to operate at different levels of the HiTOP hierarchy, with some highly pleiotropic genes influencing higher order psychopathology (e.g., the general factor), whereas other genes conferring more specific risk for individual spectra (e.g., internalizing), subfactors (e.g., fear disorders), or narrow symptoms (e.g., mood instability). We propose that the HiTOP model aligns well with the current understanding of the higher order genetic structure of psychopathology that has emerged from a large body of family and twin studies. We also discuss the convergence between the HiTOP model and findings from recent molecular studies of psychopathology indicating broad genetic pleiotropy, such as cross-disorder SNP-based shared genetic covariance and polygenic risk scores, and we highlight molecular genetic studies that have successfully redefined phenotypes to enhance precision and statistical power. Finally, we suggest how to integrate a HiTOP approach into future molecular genetic research, including quantitative and hierarchical assessment tools for future data-collection and recommendations concerning phenotypic analyses. (PsycINFO Database Record (c) 2020 APA, all rights reserved).